Catherine Haslam

The social cure: Identity, health, and well-being

The consequences of brain injury are well documented and include a range of dif®culties across emotional, cognitive, physical, and social domains. In the social domain, loss of opportunity, support, or capacity to manage the demands of situations in the workplace, community, with family and friends is common. Research is beginning to focus on changes in both social and personal identity following brain injury, and theoretical frameworks are being drawn upon that allow consideration of the relationship between biological, psychological, and social factors. Social identity is de®ned by social roles, and group memberships and also provides an important means through which we form and maintain our sense of self (see Jetten, Haslam, & Haslam, this volume).A growing body of research shows that social networks and identities have a profound impact on mental and physical health. With such mounting evidence of the importance of social relationships in protecting health, the challenge we face is explaining why this should be the case. What is it that social groups offer that appears to be just as beneficial as a daily dose of vitamin C or regular exercise?.This edited book brings together the latest research on how group memberships, and the social identities associated with them, determine peoples health and well-being. The volume provides a variety of perspectives from clinical, social, organisational and applied fields that offer theoretical and empirical insights into these processes and their consequences. The contributions present a rich and novel analysis of core theoretical issues relating to the ways in which social identities, and factors associated with them (such as social support and a sense of community), can bolster individuals sense of self and contribute to physical and mental health. In this way it is shown how social identities constitute a social cureâ, capable of promoting adjustment, coping and well-being for individuals dealing with a range of illnesses, injuries, trauma and stressors. In addition, these theories provide a platform for practical strategies that can maintain and enhance well-being, particularly among vulnerable populations.Contributors to the book are at the forefront of these developments and the books strength derives from its analysis of factors that shape the health and well-being of a broad range of groups. It presents powerful insights which have important implications for health, clinical, social and organisational psychology and a range of cognate fields.

Maintaining group memberships: Social identity continuity predicts well-being after stroke

A survey study of patients recovering from stroke (N = 53) examined the extent to which belonging to multiple groups prior to stroke and the maintenance of those group memberships (as measured by the Exeter Identity Transitions Scales, EXITS) predicted well-being after stroke. Results of correlation analysis showed that life satisfaction was associated both with multiple group memberships prior to stroke and with the maintenance of group memberships. Path analysis indicated that belonging to multiple groups was associated with maintained well-being because there was a greater likelihood that some of those memberships would be preserved after stroke-related life transition. Furthermore, it was found that cognitive failures compromised well-being in part because they made it hard for individuals to maintain group memberships post-stroke. These findings highlight the importance of social identity continuity in facilitating well-being following stroke and, more broadly, show the theoretical contribution that a social identity approach to mental health can make in the context of neuropsychological rehabilitation.

Social group memberships protect against future depression, alleviate depression symptoms and prevent depression relapse.

A growing body of research suggests that a lack of social connectedness is strongly related to current depression and increases vulnerability to future depression. However, few studies speak to the potential benefits of fostering social connectedness among persons already depressed or to the protective properties of this for future depression trajectories. We suggest that this may be in part because connectedness tends to be understood in terms of (difficult to establish) ties to specific individuals rather than ties to social groups. The current study addresses these issues by using population data to demonstrate that the number of groups that a person belongs to is a strong predictor of subsequent depression (such that fewer groups predicts more depression), and that the unfolding benefits of social group memberships are stronger among individuals who are depressed than among those who are non-depressed. These analyses control for initial group memberships, initial depression, age, gender, socioeconomic status, subjective health status, relationship status and ethnicity, and were examined both proximally (across 2 years, N = 5055) and distally (across 4 years, N = 4087). Depressed respondents with no group memberships who joined one group reduced their risk of depression relapse by 24%; if they joined three groups their risk of relapse reduced by 63%. Together this evidence suggests that membership of social groups is both protective against developing depression and curative of existing depression. The implications of these results for public health and primary health interventions are discussed.

Depression and Social Identity An Integrative Review

Social relationships play a key role in depression. This is apparent in its etiology, symptomatology, and effective treatment. However, there has been little consensus about the best way to conceptualize the link between depression and social relationships. Furthermore, the extensive social-psychological literature on the nature of social relationships, and in particular, research on social identity, has not been integrated with depression research. This review presents evidence that social connectedness is key to understanding the development and resolution of clinical depression. The social identity approach is then used as a basis for conceptualizing the role of social relationships in depression, operationalized in terms of six central hypotheses. Research relevant to these hypotheses is then reviewed. Finally, we present an agenda for future research to advance theoretical and empirical understanding of the link between social identity and depression, and to translate the insights of this approach into clinical practice.

An investigation of errorless learning in memory-impaired patients: improving the technique and clarifying theory

In rehabilitating individuals who demonstrate severe memory impairment, errorless learning techniques have proven particularly effective. Prevention of errors during acquisition of information leads to better memory than does learning under errorful conditions. This paper presents results of a study investigating errorless learning in three patient groups: those demonstrating mild, moderate, and severe memory impairments. The first goal of the study was to trial a new version of errorless learning, one encouraging more active participation in learning by patients via the use of elaboration and self-generation. This technique led to significantly better memory performance than seen under standard errorless conditions. This finding highlights the value of encouraging active and meaningful involvement by patients in errorless learning, to build upon the benefits flowing from error prevention. A second goal of the study was to clarify the mechanisms underlying errorless learning. Memory performance under errorless and errorful conditions was compared within and across each group of patients, to facilitate theoretical insight into the memory processes underlying performance. The pattern of results observed was equivocal. The data most strongly supported the hypothesis that the benefits seen under errorless learning reflect the operation of residual explicit memory processes, however a concurrent role for implicit memory processes was not ruled out.

The Social Treatment: The Benefits of Group Interventions in Residential Care Settings

We report findings from an intervention study that investigates the impact of group reminiscence (GR) and individual reminiscence (IR) activities on older adults living in care settings. This research aimed to provide a theory-driven evaluation of reminiscence based on a social identity framework. This framework predicts better health outcomes for group-based interventions as a result of their capacity to create a sense of shared social identification among participants. A total of 73 residents, living in either standard or specialized (i.e., dementia) care units, were randomly assigned to one of three interventions: GR (n = 29), IR (n = 24), and a group control activity (n = 20). The intervention took place over 6 weeks, and cognitive screening and well-being measures were administered both pre- and post-intervention. Results indicated that only the group interventions produced effective outcomes and that these differed as a modality-specific function of condition: Collective recollection of past memories enhanced memory performance, and engaging in a shared social activity enhanced well-being. Theoretically, these findings point to the important role that group membership plays in maintaining and promoting health and well-being.

Overcoming alcohol and other drug addiction as a process of social identity transition: the social identity model of recovery (SIMOR)

Abstract In recent years, there has been an increasing focus on a recovery model within alcohol and drug policy and practice. This has occurred concurrently with the emergence of community- and strengths-based approaches in positive psychology, mental health recovery and desistance and rehabilitation from offending. Recovery is predicated on the idea of substance user empowerment and self-determination, using the metaphor of a “journey”. Previous research describing recovery journeys has pointed to the importance of identity change processes, through which the internalised stigma and status of an “addict identity” is supplanted with a new identity. This theoretical paper argues that recovery is best understood as a personal journey of socially negotiated identity transition that occurs through changes in social networks and related meaningful activities. Alcoholics Anonymous (AA) is used as a case study to illustrate this process of social identity transition. In line with recent social identity theorising, it is proposed that (a) identity change in recovery is socially negotiated, (b) recovery emerges through socially mediated processes of social learning and social control and (c) recovery can be transmitted in social networks through a process of social influence.

No country for old men?: the role of a ‘Gentlemen's Club’ in promoting social engagement and psychological well-being in residential care

Objective: Social isolation is a common problem in older people who move into care that has negative consequences for well-being. This is of particular concern for men, who are marginalised in long-term care settings as a result of their reduced numbers and greater difficulty in accessing effective social support, relative to women. However, researchers in the social identity tradition argue that developing social group memberships can counteract the effects of isolation. We test this account in this study by examining whether increased socialisation with others of the same gender enhances social identification, well-being (e.g. life satisfaction, mood), and cognitive ability. Method: Care home residents were invited to join gender-based groups (i.e. Ladies and Gentlemens Clubs). Nine groups were examined (five male groups, four female groups) comprising 26 participants (12 male, 14 female), who took part in fortnightly social activities. Social identification, personal identity strength, cognitive ability and well-being were measured at the commencement of the intervention and 12 weeks later. Results: A clear gender effect was found. For women, there was evidence of maintained well-being and identification over time. For men, there was a significant reduction in depression and anxiety, and an increased sense of social identification with others. Conclusion: While decreasing well-being tends to be the norm in long-term residential care, building new social group memberships in the form of gender clubs can counteract this decline, particularly among men.

Google Calendar: A new memory aid to compensate for prospective memory deficits following acquired brain injury

Prospective memory impairment is common following acquired brain injury (ABI) and intervention has proved challenging. The current treatment of choice involves using external memory aids as a method of compensation, with those incorporating active reminders proving most successful. In this paper we report findings of an investigation into the effectiveness of a novel external memory aid, Google Calendar. This aid incorporates active reminders and overcomes some of the limitations associated with existing aids. Twelve participants with ABI took part in the study incorporating a randomised control crossover within-subjects design, consisting of a 5-week baseline phase, followed by two 5-week intervention phases where either Google Calendar or a standard diary were used. Participants identified activities to target during the study and a family member monitored their success. Google Calendar was more effective than the diary in enhancing prospective memory performance. It also proved more popular, on account of its active reminders which helped trigger the retrieval of intentions, whilst reducing the need for monitoring. While further research is required to substantiate these initial findings, it is recommended that clinicians familiarise themselves with using Google Calendar, as it appears to offer additional potential in the management of prospective memory deficits following ABI.

How successful is errorless learning in supporting memory for high and low-level knowledge in dementia?

Errorless learning has been shown to be very successful in the rehabilitation of memory problems particularly in patients with severe forms of memory impairment. Much of this research has focused on testing knowledge of specific details studied, ignoring any additional, higher-level knowledge that patients may have acquired during the learning process. Hence, it is pertinent to ask whether errorless learning is equally successful in the acquisition of high and low-level knowledge. In this paper, we present results of several studies comparing the effectiveness of errorless and standard trial-and-error methods in acquisition of high and low-level knowledge in people diagnosed with dementia and non-impaired controls. In Study 1, participants were asked to learn novel face–name–occupation associations; and knowledge across a range of levels, from very general (i.e., high-level) to very specific (i.e., low-level), was examined. For patients with probable Alzheimers disease and controls there was evidence of increased benefit from errorless training in general, but the technique was most beneficial for patients attempting to retrieve specific detail. Study 2 was conducted to address the problem raised by the failure in Study 1 to manipulate learning condition at our highest knowledge level. This novel manipulation was successful, but neither of the patients received the standard benefit from errorless training. Study 3, involving a small group of dementia patients with mixed diagnoses, was conducted to replicate findings from Study 1. Results from the group analysis confirmed that the benefit obtained from errorless learning increased as a function of knowledge specificity, but again several patients failed to show a consistent effect of learning condition. Implications for use of the errorless technique are discussed. This research was funded by the Northcott Devon Medical Association, Exeter, UK.