Social Isolation and Social Mediators of the Stress of Illness

ab 25,90 

Millard Waltz

ISBN 978-3-89473-417-5
Band-Nr. 2
Jahr 1993
Seiten 250
Bindung broschiert
Reihe Medizinsoziologie

Artikelnummer: 978-3-89473-417-5 Kategorien: ,


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).