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Perceived social support helps, but does not buffer the negative impact of anxiety disorders on quality of life and perceived stress

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Anxiety disorders are prevalent and substantially hinder quality of life, in all domains, including social connections, mental and physical health. Past research on stress indicates that perceived social support improves wellbeing both directly by providing positive experiences and indirectly through buffering the effects of stress. This study examined whether social support moderates the negative impact of anxiety disorders on quality of life.

Method

The study was conducted on a community sample in Cyprus, screened for anxiety disorders. The hypothesized model takes into account potential differences between individuals with and without anxiety in health, tendency to seek support, stressful life events, and depression. Furthermore, differences between different anxiety disorders on these variables were examined.

Results

Results indicate that perceived social support has a positive, direct effect on quality of life and perceived stress for all participants but that it does not appear to moderate the adverse effects of having a disorder on quality of life or stress. The negative effects of anxiety appeared to mostly be carried by comorbid depression.

Conclusions

Social support is important for quality of life. Potential interventions for anxiety disorders should take this into account, as well as the substantially detrimental role of co-morbid depression symptoms on wellbeing outcomes.

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References

  1. Regier DA, Boyd JH, Burke JD, Rae DS, Myers JK, Kramer M, Robins LN, George LK, Karno M, Locke BZ (1988) One-month prevalence of mental disorders in the United States: based on five Epidemiologic Catchment Area sites. Arch Gen Psychiatry 45:977–986

    Article  PubMed  CAS  Google Scholar 

  2. Wittchen HU, Jacobi F (2005) Size and burden of mental disorders in Europe -a critical review and appraisal of 27 studies. Neuropsychopharmacol 15:357–376

    Article  CAS  Google Scholar 

  3. Rapaport MH, Clary C, Fayyad R, Endicott J (2005) Quality of life impairment in depressive and Anxiety disorders. Am J Psychiatry 162:1171–1178

    Article  PubMed  Google Scholar 

  4. Kashdan TB (2007) Social Anxiety spectrum and diminished positive experience: theoretical synthesis and meta-analysis. Clin Psychol Rev 27:348–365

    Article  PubMed  Google Scholar 

  5. Olatunji B, Cisler J, Tolin D (2007) Quality of life in the anxiety disorders: a meta analytic review. Clin Psychol Rev 27:572–581

    Article  PubMed  Google Scholar 

  6. Simon M, Otto W, Korbly B, Peters M, Nicolaou C, Pollack H (2002) Quality of life in social anxiety disorder compared with panic disorder and the general population. Psychiat Serv 53:714–718

    Article  Google Scholar 

  7. Wittchen HU, Zhao S, Kessler RC, Eaton WW (1994) DSM-III-R generalized Anxiety disorder in the National Comorbidity Survey. Arch Gen Psychiatry 51:355–364

    Article  PubMed  CAS  Google Scholar 

  8. Henning E, Turk C, Mennin D, Fresco D, Heimberg R (2007) Impairment and quality of life in individuals with generalized Anxiety disorder. Dep Anxiety 24:342–349

    Article  Google Scholar 

  9. Magee WJ, Eaton WW, Wittchen H, McGonalgle KA, Kessler RC (1996) Agoraphobia, simple phobia, and social phobia in National Comorbid Survey. Arch Gen Psychiat 53:159–168

    Article  PubMed  CAS  Google Scholar 

  10. Manfro GG, Otto MW, McArdle ET, Worthington JJ III, Rosenbaum JF, Pollack MH (1996) Relationship of antecedent stressful life events to childhood and family history of Anxiety and the course of panic disorder. J Affect Disord 41:135–139

    Article  PubMed  CAS  Google Scholar 

  11. Brown E, Juster HR, Heimberg R, Winning CD (1998) Stressful life events and personality styles: relation to impairment and treatment outcome in patients with social phobia. J Anxiety Disord 12:233–251

    Article  PubMed  CAS  Google Scholar 

  12. Wade S, Monroe S, Micelson L (1993) Chronic life stress and treatment outcome in agoraphobia with panic attacks. Am J Psychiat 150:1491–1495

    PubMed  CAS  Google Scholar 

  13. Goldberg RW, Rollins AL, Lehman AF (2003) Social network correlates among people with Psychiatric disabilities. Psychiat Rehabilit J 26:393–404

    Article  Google Scholar 

  14. Unger J, McAvay G, Bruce ML, Berkman L, Seeman T (1999) Variation in the impact of social network characteristics on physical functioning in elderly persons: MacArthur Studies of Successful Aging. J Gerontol Soc Sci 54B:S245–S251

    Article  Google Scholar 

  15. Leavy RL (1983) Social support and psychological disorder: a review. J Community Psychol 11:3–21

    Article  PubMed  CAS  Google Scholar 

  16. Handley TE, Inder KJ, Kelly BJ, Attia JR, Lewin TJ, Fitzgerald MN, Kay-Lambkin FJ (2011) You′ve got to have friends: the predictive value of social integration and support in suicidal ideation among rural communities. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-011-0436-y

  17. Cohen S, Willis TA (1985) Stress, social support, and the buffering hypothesis. Psychol Bull 98:310–357

    Article  PubMed  CAS  Google Scholar 

  18. Stroebe W (2000) Moderators of the stress-health relationship In: Stroebe W (ed) Social psychology and health, Open University Press, Philadelphia, pp 236–273

  19. Blixen CE, Kippes C (1999) Depression, social support, and quality of life in older adult with osteoarthritis. J Nurs Scholarship 31:221–227

    Article  CAS  Google Scholar 

  20. Cohen S (1992) Stress, social support and disorder. In: Veiel H, Baumann U (eds) The meaning and measurement of social support. Hemisphere Press, New York

    Google Scholar 

  21. Helgeson VS (1993) Two important distinctions in social support: kind of support and perceived vs received. J Appl Soc Psychol 23:825–845

    Article  Google Scholar 

  22. Davidson JRT, Hughes DL, George LK, Blazer DG (1993) The epidemiology of social phobia: findings from the Duke epidemiological catchment area study. Psychol Med 23:709–718

    Article  PubMed  CAS  Google Scholar 

  23. Stopa L, Clark DM (2000) Social phobia and interpretation of social events. Behav Res Ther 38:273–283

    Article  PubMed  CAS  Google Scholar 

  24. Hansson L (2002) Quality of life in depression and Anxiety. Int Rev Psychiat 14:185–189

    Article  Google Scholar 

  25. La Greca AM, Lopez N (1998) Social Anxiety among adolescents: linkages with peer relations and friendships. J Abnorm Child Psych 26:83–94

    Article  Google Scholar 

  26. Yen CF, Kuo CY, Tsai PT, Ko CH, Yen JY, Tzu-Ting Chen TT (2007) Correlations of quality of life with adverse effects of medication, social support, course of illness, psychopathology, and demographic characteristics in patients with panic disorders. Dep Anxiety 24:563–570

    Article  Google Scholar 

  27. Eng W, Heimberg RG (2006) Interpersonal correlates of generalized Anxiety disorder: self vs other perception. J Anxiety Disord 20:380–387

    Article  PubMed  Google Scholar 

  28. Katschnig H (1997) How useful is the concept of quality of life in Psychiatry? In: Katschnig H, Freeman H, Sartorius N (eds) Quality of life in mental disorders, Wiley, Chichester

  29. Kapsou M, Panayiotou G, Kokkinos CM, Demetriou AG (2010) Dimensionality of coping: an empirical contribution to the construct validation of the Brief-COPE with a Greek-speaking sample. J Health Psychol 15:215–229

    Article  PubMed  Google Scholar 

  30. Lim L, Jin AZ, Ng TP (2011) Anxiety and depression, chronic physical conditions, and quality of life in an urban population sample study. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-011-0420-6

    PubMed  Google Scholar 

  31. Mineka S, Watson D, Clark LA (1998) Comorbidity of Anxiety and unipolar mood disorders. Annu Rev Psychol 49:377–412

    Article  PubMed  CAS  Google Scholar 

  32. Cohen S, Williamson G (1988) Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S (eds) The social psychology of health. Sage, Newbury Park, pp 31–67

    Google Scholar 

  33. van Eck M, Berkhof H, Nicolson N, Sulon J (1996) The effects of perceived stress, traits, mood states, and stressful daily events on salivary cortisol. Psychosom Med 58:447–458

    PubMed  Google Scholar 

  34. Zimmerman M, Mattia JI (2001) The Psychiatric Diagnostic Screening Questionnaire: development, reliability and validity. Comp Psychiatry 42:175–189

    Article  CAS  Google Scholar 

  35. Sheeran T, Zimmerman M (2004) Factor structure of the Psychiatric Diagnostic Screening Questionnaire (PDSQ), a screening questionnaire for DSM-IV axis I disorders. J Behav Ther Exp Psychiatry 35:49–55. doi:101016/jjbtep200402002

    Article  PubMed  CAS  Google Scholar 

  36. Zimmerman M, Chelminski I (2006) A scale to screen for DSM-IV Axis I disorders in Psychiatric out-patients: performance of the Psychiatric Diagnostic Screening Questionnaire. Psychol Med 36:1601–1611

    Article  PubMed  CAS  Google Scholar 

  37. Karekla M, Panayiotou G (manuscript in preparation). Psychometric properties of the Greek version of the PDSQ

  38. Wolpe L, Lang PJ (1964) A fear survey schedule for use in behaviour therapy. Behav Res Ther 2:27–30

    Article  PubMed  CAS  Google Scholar 

  39. Arrindell WA, Emmelkamp PMG, van der Ende J (1984) Phobic dimensions: I reliability and generalizability across samples, gender, and nations. Adv Behav Res Ther 6:207–254

    Article  Google Scholar 

  40. Skevington SM, Lotfy M, O’Connell K, A WHOQOL Group (2004) The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 13:299–310

    Article  PubMed  CAS  Google Scholar 

  41. Ginieri-Coccossis M, Triantafillou E, Antonopoulou V, Christodoulou GN (2001) Translation and cross-cultural adaptation of WHOQOL-100 in Greece. Psychiat Tod 32:1

    Google Scholar 

  42. Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385–396

    Article  PubMed  CAS  Google Scholar 

  43. Cole S (1999) Assessment of differential item functioning in the Perceived Stress Scale-10. J Epidemiol Commun H 53:319–320

    Article  CAS  Google Scholar 

  44. Sarason IG, Sarason BR, Sheerin EN, Pierce RG (1987) A brief measure of social support: practical and theoretical implications. J Soc Pers Relat 4:497–510

    Article  Google Scholar 

  45. Panayiotou G, Karekla M (manuscript in preparation) Adaptations of measures to assess social support and aspects of daily well-being

  46. Dohrenwend BS, Krasnoff L, Askenasy AR, Dohrenwend BP (1978) Exemplification of a method for scaling life events: the Peri Life Events Scale. J Health Soc Behav 19:205–229

    Article  PubMed  CAS  Google Scholar 

  47. Carver CS (1997) You want to measure coping but your protocol’s too long: consider the Brief COPE. Int J Behav Med 4(1):92–100

    Article  PubMed  CAS  Google Scholar 

  48. Ramsawh HJ, Weisberg RB, Dyck I, Stout R, Keller MB (2011) Age of onset, clinical characteristics, and 15-year course of Anxiety disorders in a prospective, longitudinal, observational study. J Affect Disord 132:260–264

    Article  PubMed  Google Scholar 

  49. Wittchen HU, Zhao S, Kessler RC, Eaton WW (1994) DSM-III-R generalized Anxiety disorder in the National Comorbidity Survey. Arch Gen Psychiat 51:35564

    Article  Google Scholar 

  50. Lang P, McTeague LM (2009) The Anxiety disorder spectrum: fear imagery, physiological reactivity, and differential diagnosis Anxiety Stress. Copin 22:5–25

    Google Scholar 

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Acknowledgments

This research was partially funded by the Cyprus Research Promotion Foundation and European Union Structural Funds. The authors wish to thank Margarita Kapsou, Dora Georgiou, Elena Constantinou and the many undergraduate students who made data collection possible for this research.

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Correspondence to Georgia Panayiotou.

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Panayiotou, G., Karekla, M. Perceived social support helps, but does not buffer the negative impact of anxiety disorders on quality of life and perceived stress. Soc Psychiatry Psychiatr Epidemiol 48, 283–294 (2013). https://doi.org/10.1007/s00127-012-0533-6

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  • DOI: https://doi.org/10.1007/s00127-012-0533-6

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