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Social Isolation and Social Mediators of the Stress of Illness
Bd. 2, 1993, 250 S., 30.90 EUR, 30.90 CHF, br., ISBN 3-89473-417-5
Since the early 1970's, research using the theoretical construct social support has evolved as a general orientation in the health sciences. This theoretical, as well as intervention-related reorientation, has been directed towards the major task of incorporating the social environment into the emerging biopsychosocial paradigm of health and illness. More recently, social scientists have focused their attention on the specific task of relating social structure to individual well-being. This means the delineation of beneficial and morbidity-enhancing aspects of people's social role relations and statuses. This theoretical linkage is necessary, in order to integrate sociological perspectives with psychological and biological one within the biopsychosocial framework. Although the cognitive orientation in psychology has provided importand new insights into adaptive behaviors, it has neglected or only paid lip service to the basically social nature of adjustment processes. The social support orientation allows for the correction of this deficit.
Social support has been concerptualized as a component and as a context of adaptive behavior (such as for example the definition of the situation). As a component, significant others constitute external social resources which can be mobilized; that is, they are providers of perception-focused, emotion-focused or tangible coping assistance. Medical professionals, experienced members of self-help groups and the material partner may provide cognitive guidance aimed at the patient's accepting illness rather than denying it, at initiating promising strategies of coping, and at evolving a sense of optimism and personal control. As a contextual factor, cohesive social groups and dyads form a secure base and sense of existential anchoring of coherence, in which complex coping behaviors ca take place. Both as a component and as a contextm, social factors influence appraisals of the situation and of personal control early in the patient career. The same is true of long-run coping outcome and psychosocial transition. These topics have gained salience due to findings from group interventions in several studies with a behavioral medicine perspective (Ornish et al. Lancet, 1990; Spiegel et al. Lancet, 1989; Lorig et al. Arthritis and Rheumatism, 1989).