Chris Segrin

Social skills deficits associated with depression.

This article reviews the empirical evidence of impaired social skills associated with depression. Conceptualizations of social skills are examined followed by evidence from self-report, observer-rating, and behavioral assessments of depressed peoples social skills. Evidence of social skills deficits in children with depression and in people with bipolar disorder is also examined. The effectiveness of social skills training as a treatment of depression is evaluated. Three different theoretical relationships between disrupted social skills and depression are described and evaluated, including poor social skills as a cause of depression, depression as a cause of poor social skills, and poor social skills as a vulnerability factor in the development of depression. Currently, there is some evidence to support each of these conceptualizations, as the relationship between poor social skills and depression can take a variety of forms.

Negative reactions to depressive behaviors: a communication theories analysis.

Interpersonal aspects of depression have received considerable research attention in the past 2 decades. This work often has been guided by J. C. Coynes (1976b) interactional model of depression or P. M. Lewinsohns (1974) social skill deficit theory of depression. A review of this research indicates that depressed people reliably experience rejection from those in their social environment and that depression generally is associated with impairments in social behavior. However, this research does not explain exactly what depressed people do to elicit rejection, or exactly why others react negatively to them. Research derived from communication theories on responsiveness, politeness, and expectations for nonverbal involvement illuminates the interpersonal cycle in depression. The role of these impairments in the cause, symptoms, course, subtypes, and therapy of depression is discussed.

Telephone interpersonal counseling with women with breast cancer: symptom management and quality of life.

PURPOSE/OBJECTIVES To examine the effectiveness of a telephone interpersonal counseling (TIP-C) intervention compared to a usual care attentional control for symptom management (depression and fatigue) and quality of life (positive and negative affect, stress) for women with breast cancer. DESIGN Experimental with repeated measures. SETTING Academic cancer center and urban, private oncology offices. SAMPLE 48 women with breast cancer who were in their mid-50s, married, and employed at the time of the study. METHODS Women were assigned to either the six-week TIP-C or attentional usual care groups. Women were matched on stage and treatment. Data were collected at baseline, after the six interventions, and one month postintervention. Measures included the Center for Epidemiologic Studies Depression Scale, Positive and Negative Affect Schedule, Multidimensional Fatigue Inventory, and Index of Clinical Stress. MAIN RESEARCH VARIABLES Depression, positive and negative affect, fatigue, and stress. FINDINGS Women in the intervention group experienced decreases in depression, fatigue, and stress over time and increases in positive affect. CONCLUSIONS The preliminary results partially supported the effectiveness of TIP-C for symptom management and quality of life. The authors hypothesized that decreased depression, reduced negative affect, decreased stress, decreased fatigue, and increased positive affect over time would be the resulting psychosocial effects, given the theoretical underpinnings of the intervention. IMPLICATIONS FOR NURSING Nurses need to assess the quantity and quality of the social support network early in treatment; women with less social support need to be referred to counseling and support services. Because these women have limited participation in face-to-face interventions, they should be encouraged to participate in telephone or online support programs or in other programs or organizations (e.g., churches, social clubs) that would provide support.

Dyadic interdependence on affect and quality-of-life trajectories among women with breast cancer and their partners

This study explored interdependence on quality-of-life factors for women with breast cancer and their partners. Multiple theoretical perspectives predict that the emotional distress experienced by women with breast cancer would be shared by their partners. To test these predictions, 48 women with breast cancer and their partners (husbands, daughters, friends, or other relations) participated in a three-wave, 10- week, longitudinal study. Quality-of-life (QOL) indicators (depressive symptoms, positive and negative affect, and stress) were measured in both women and their partners. Baseline data revealed significant partner effects from stress and negative affect in women with breast cancer to their partners’ depression. Analysis of QOL rates and directions of change over time revealed that the QOL was on a similar trajectory. As the emotional well-being of women with breast cancer improved or deteriorated, their partners’ well-being changed also.

The Effect of Resident Physician Stress, Burnout, and Empathy on Patient-Centered Communication During the Long-Call Shift

During the long-call shift medical residents experience a number of stressors that could compromise the quality of care they provide to their patients. The aim of this study was to investigate how perceived stress and burnout affect changes in empathy over the long-call shift and how those changes in empathy are associated with patient-centered communication practices. Residents (n = 93) completed self-report measures of stress, burnout, and empathy at the start of their long-call shift and then completed measures of empathy and patient-centered communication at the end of the same shift. There was a significant decline in physician empathy from the beginning to the end of the long-call shift. Perceived stress was significantly associated with higher burnout, which was, in turn, significantly associated with declines in empathy from pre- to posttest. Declines in empathy predicted lower self-reported patient-centered communication during the latter half of the shift. This study suggests that residents who perceive high levels of stress are at risk for burnout and deterioration in empathy toward their patients, both of which may compromise the quality of their interactions with patients.

Psychosocial interventions to improve quality of life in prostate cancer survivors and their intimate or family partners

PurposeThe primary purpose was to test the effectiveness of two telephone-delivered psychosocial interventions for maintaining and improving quality of life (QOL) (psychological, physical, social, and spiritual well-being) among 71 prostate cancer survivors and the 70 intimate or family partners who were supporting them in their recovery.MethodsThis study used a three-wave repeated measures experimental design. Both the interpersonal counseling intervention (TIP-C) and health education attention condition (HEAC) were delivered using the telephone.ResultsImprovements in depression, negative affect, stress, fatigue, and spiritual well-being were significantly higher for survivors in the HEAC than for those in the TIP-C condition. Partners in the HEAC condition showed significantly greater improvements in depression, fatigue, social support from family members, social well-being, and spiritual well-being compared to partners in the TIP-C condition. The results revealed superior outcomes for those assigned to the HEAC intervention.ConclusionsThe psychosocial interventions in this study were effective in maintaining or improving the QOL for prostate cancer survivors and their partners. Both the survivor and their intimate partner or family member benefitted from the interventions. Future research is needed to determine the optimal timing and client characteristics for each intervention.

Functions of Loneliness, Social Support, Health Behaviors, and Stress in Association With Poor Health

Prior research has established clear links between social support, loneliness, and various health outcomes. This study was designed to test several theoretically derived explanations for such associations. A survey of 265 adults ages 19–85 years was conducted with measures of social support, loneliness, stress, health behaviors, and general health. Results showed that loneliness was more strongly associated with number of close relationships than with sheer contact with social network members. Further, loneliness mediated the association between social support and better health. In addition, health behaviors, especially poor sleep and medical adherence, mediated the association between loneliness and poor health. These results provide confirmation of theoretical mechanisms postulated to explain why loneliness is associated with poor health.

Social Support, Loneliness, Recuperative Processes, and Their Direct and Indirect Effects on Health

This study tested predictions that potentially explain why social support is associated with better health and loneliness is associated with poorer health. Social support was predicted to be associated with better health because it minimizes loneliness, which itself is associated with poor health. In particular, this study evaluated the role of recuperative processes, namely, sleep and leisure, in the association between loneliness and poor health. Participants were 224 adults aged 18–81 years who completed measures of social support, loneliness, health, sleep quality, and leisure. Results indicated that social support had an indirect association with better health, through lower loneliness. There was also evidence supporting or at least partially supporting the assumption that one mechanism by which loneliness is associated with poorer health is through less functional recuperative processes, specifically sleep and leisure. Finally, social support moderated the association between age and health such that among those with relatively high levels of social support, age and health were positively associated.

Social cognitive mediators and relational outcomes associated with parental divorce

People exposed to parental divorce experience a number of relational and attitudinal effects. One such effect, the inter-generational transmission of divorce, involves a greater risk for divorce among those adult children whose parents were divorced. Social cognitive theory would explain many of the outcomes of parental divorce as inhibitory or disinhibitory effects learned through vicarious experience. Predictions from social cognitive theory were tested on a community-based sample of 821 adults. Results replicated the intergenerational transmission of divorce as well as higher family conflict, more negative attitudes toward marriage, greater likelihood of marriage to a previously divorced person, and a decreased likelihood of currently being in a close relationship as a function of parental divorce. Either family-of-origin conflict or negative marital attitudes mediated many of these effects. In other words, it is not parental divorce that is entirely responsible for certain relational and attitudinal effects.

Close Relationships in Task Environments Perceptions of Relational Types, Illicitness, and Power

This article reports on the impact of the perceived motivations of participants of organizational romances, the illicitness of the relationship, and the power of the relational participants upon individual and group performance. Interviews conducted with 128 observers indicated that (a) only certain types of relationships showed associations with either category of organizational effectiveness indexes, (b) illicitness was generally associated with negative outcomes in the work group, but not in the involved individuals, and (c) neither the power of the participants nor the differences in power between them was reliably associated with declines in either individual performance or work group functioning.