First Advisor

Cynthia D. Mohr

Term of Graduation

Winter 2024

Date of Publication

2-28-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (Ph.D.) in Applied Psychology

Department

Psychology

Language

English

Subjects

close relationships, depression, mental health, social support, structural equation modeling

DOI

10.15760/etd.3716

Physical Description

1 online resource (xi, 237 pages)

Abstract

Social relationships are impactful to mental health and well-being, both positively and negatively. Different sources of support vary in their ability to meet our needs and ultimately influence our well-being. While research has examined aspects of supportive and harmful social relationships and mental health, much of this work is cross-sectional or limited to a single source of support. This dissertation aimed to better elucidate the relationship between social relationships and mental health by integrating multiple theoretical perspectives and multiple sources of support, in a series of three empirical studies to order to inform theory and interventions targeting mental health of high-risk groups.

Veterans are at increased risk of suicide relative to their civilian counterparts (Office of Mental Health and Suicide Prevention, 2018). Study 1 examined an acute indicator of suicide risk, agitation, and its temporal associations with social support from spouse, family, and friends over a 9-month period using three-wave cross-lagged panel models in a sample of employed veterans (SERVe; Hammer et al., 2017). Results revealed preliminary support for a reciprocal association between agitation and some sources of support, with directionality of cross-lagged effects varying across sources. Agitation was impacted by one’s relationships with family, whereas family support predicted subsequent agitation. For coupled veterans, spousal support predicted subsequent agitation. Social support from friends was not related to agitation longitudinally, illuminating nuances in the temporal associations between agitation and social support from spouse, family, and friends.

Marital transitions, widowhood or divorce, are incredibly stressful for older adults and have long-term impacts on mental health and well-being (Lin et al., 2019; Sasson & Umberson, 2014). Study 2 also took a longitudinal approach to examining social relationships and mental health by examining support and strain from multiple sources (spouse, family, friends, and children) as predictors of depressive symptom trajectories prior to and following a marital transition using latent piecewise growth curve modeling. Social strain did not emerge as a significant predictor of depressive symptom trajectories post-marital transition. Social support from spouse was related to more difficult mental health recoveries after transition, whereas social support from friends was related to a quicker adjustment. These results provide additional evidence for the importance of a strong friend network to mitigate the detrimental effects of marital transitions on mental health among older adults adjusting to widowhood or divorce.

Military-connected individuals are at increased risk for mental health disorders and adverse behavioral health outcomes (Mohr et al., 2018; Office of Mental Health and Suicide Prevention, 2018; Steenkamp et al., 2015) but are less likely to seek help for mental health problems than physical health problems (Britt, 2000). Previous research indicates that social support, mental health stigma, and organizational barriers to care impact service member behavioral health and treatment seeking for many military-connected individuals (Coleman et al., 2017). Study 3 aimed to elucidate the interactive effects of social relationships and suicide risk factors on behavioral health care utilization, utilizing a sample of active-duty soldiers who participated in the Resilience-Supportive Leadership Training (RESULT) study. Main effects models revealed that perceived partner responsiveness, stigma, and barriers to care were all associated with less frequent behavioral health treatment use. For coupled participants, perceived partner responsiveness attenuated the effects of stigma and barriers to care on treatment use, evidenced by results of moderation models. Study 3 findings highlight the important role spouses play in the process of treatment seeking and utilization among this high-risk sample. Taken together, this series of studies provides evidence for the importance of including distinct sources of social support when examining the interactive effects of mental health and social relationships over time, ultimately informing future interventions targeting social relationships to improve mental health and as inform barriers and facilitators to seeking behavioral health care.

Rights

In Copyright. URI: http://rightsstatements.org/vocab/InC/1.0/ This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).

Persistent Identifier

https://archives.pdx.edu/ds/psu/41488

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