Financial distress and suicidal behaviour during COVID-19: family identification attenuates the negative relationship between COVID-related financial distress and mental ill-health

COVID-19 provides a 'perfect storm' of social and economic suicide risk-factors. Recent research has evidenced an initial impact of the pandemic upon suicide rates, but has yet to understand how elevated financial threat and social isolation may predict suicide ideation/behaviour, or which social factors promote resilience. This study addressed these shortcomings. An online longitudinal survey study (N = 370) which took place from May-September 2020 showed COVID-related financial distress predicts suicidal thoughts and behaviour via increased depression and loneliness. Family identification attenuates these relationships. Our findings reaffirm the importance of social factors in reducing mental ill-health outcomes of economic crises

On the association between greater family identification and lower paranoid ideation among non-clinical individuals: evidence from Cypriot and Spanish students

A large literature has provided evidence of the 'social cure': a positive relationship between group identification (a sense of group belonging) and mental wellbeing, commonly measured in terms of levels of depression, anxiety, or stress. However, non-clinical populations may experience other symptoms of mental distress, including paranoia. We hypothesised that since group identification promotes satisfying and supportive relationships (something paranoid individuals appear to lack), there should be a negative relationship between family identification and paranoid ideation. We confirmed this in a cross-sectional study with Cypriot students (N = 108) and in a two-wave longitudinal study with Spanish students (N = 206). The second study also revealed that family identification predicts paranoia over time, but not vice versa. These studies are the first to confirm that family identification is a negative predictor of paranoid ideation, and highlight the need to further explore the effects of group identification on psychotic-like symptoms

Social isolation predicts frequent attendance in primary care

Background. Frequent attenders in primary care have complex physical and mental healthcare needs as well as low satisfaction with their healthcare. Interventions targeting mental health or psychoeducation have not been effective in reducing attendance. Here, we test the proposition that both frequent attendance and poor health are partly explained by unmet social needs (i.e., limited social group support networks). Methods. Study 1 (N=1752) was a large cross-sectional community sample of primary care attenders in Scotland. Study 2 (N = 79) was a longitudinal study of a group of young people undergoing a life transition (moving countries and commencing university) that increased their risk of frequent attendance. Study 3 (N=46) was a pre-post intervention study examining whether disadvantaged adults who joined a social group subsequently had reduced frequency of primary care attendance. Results. All three studies found that low social group connectedness was associated with a higher frequency of primary care attendance. This was not attributable to poorer health among those who were socially isolated. In Study 3, joining a social group led to reduced primary care attendance to the extent that participants experienced a (subjective) increase in their social group connectedness. Conclusions. Unmet social needs among frequent attenders warrant closer consideration. Interventions that target social group connectedness show promise for reducing overutilization of primary care services

When groups help and when groups harm: origins, developments, and future directions of the 'social cure' perspective of group dynamics

A substantial literature supports the important role that social group memberships play in enhancing health. While the processes through which group memberships constitute a ‘Social Cure’ are becoming increasingly well-defined, the mechanisms through which these groups contribute to vulnerability and act as a ‘Social Curse’ are less understood. We present an overview of the Social Cure literature, and then go beyond this to show how the processes underpinning the health benefits of group membership can also negatively affect individuals through their absence. First, we provide an overview of early Social Cure research. We then describe later research concerning the potential health benefits of identifying with multiple groups, before moving on to consider the ‘darker side’ of the Social Cure by exploring how intra-group dynamics can foster Curse processes. Finally, we synthesise evidence from both the Cure and Curse literatures to highlight the complex interplay between these phenomena, and how they are influenced by both intra- and inter-group processes. We conclude by considering areas we deem vital for future investigation within the discipline

Diversity of group memberships predicts wellbeing: cross sectional and longitudinal evidence

Groups have their health and wellbeing impacts by satisfying their members’ needs and providing resources to help cope with threats. Multiple group memberships serve to accumulate these benefits and also provide resilience to the effects of group loss. However, the additional wellbeing benefits of belonging to multiple different types of group remain to be determined. In a pre-registered cross-sectional survey in Nottingham, England (Study 1, N = 328), we found that group-type diversity predicted wellbeing and that this effect was fully serially mediated by increased creative self-efficacy, then reduced loneliness. To confirm our hypothesis in a more robust sample we conducted longitudinal analyses on the English Longitudinal Study of Aging (ELSA) dataset (Study 2, N = 5,838) finding that group-type diversity at time one (T1) predicted wellbeing at T2 (4 years later), even when accounting for wellbeing and loneliness at T1. We discuss the implications for enhancing group-based health interventions

Families as support and burden: a mixed methods exploration of the extent to which family identification and support predicts reductions in stress among disadvantaged neighbourhood residents

Stronger family relationships predict positive health outcomes: a relationship that is partially due to the range of emotional, practical and informational support that families can provide. Yet not all families possess these resources. A survey study in a disadvantaged community in Nottingham, UK (N=142) demonstrated that family identification positively predicts ability to cope with financial stress, but that this relationship is moderated by whether family support is present or absent. Semi-structured interviews with 10 members of different families from the same community shed further light upon the nature of this relationship: individuals report that they tend to turn to their family rather than friends or community services in times of financial hardship, even though their family are unlikely to be able to support them effectively, and that this is often due to feelings of embarrassment or finance-related stigma. Our findings highlight the complex role that families can play in finance-related issues, as well as the need to encourage individuals to seek financial support from sources which provide effective (rather than emotionally comfortable) assistance

'Sometimes, it’s not just about the food': the social identity dynamics of foodbank helping transactions

Food insecurity in developed countries has increased rapidly. Research has suggested that stigma may inhibit food-aid help-seeking, but has failed to determine how such barriers might be overcome. Adopting a social identity perspective, this study explored the processes involved in food-aid helping transactions and sought to identify conditions that facilitate positive helping outcomes. Interviews were conducted with 18 clients and 12 volunteers at two English foodbanks, and a theoretically-guided Thematic Analysis was conducted. Two primary themes were identified: ‘Here to Help’ and ‘The Legitimate Recipient’. This paper offers a distinct and novel contribution by applying a social identity perspective to foodbank helping transactions, thereby demonstrating how group dynamics and behaviours are integral to these interactions, and by moving beyond the typical ‘Social Curse’ focus on barriers to help-seeking to explore how such obstacles may be overcome. Suggestions for addressing stigma-laden helping transactions and promoting successful delivery of aid are provided

The social cure of social prescribing: a mixed-methods study on the benefits of social connectedness on quality and effectiveness of care provision

Objectives: To assess the degree to which the ‘Social Cure’ model of psycho-social health captures the understandings and experiences of healthcare staff and patients in a Social Prescribing (SP) pathway and the degree to which these psycho-social processes predict the effect of the pathway on healthcare usage. Design: Mixed-method: Study 1: semi-structured interviews, Study 2: longitudinal survey. Setting: An English SP pathway delivered between 2017 and 2019. Participants: Study 1: GPs (n=7), healthcare providers (n=9) and service users (n=19). Study 2: 630 patients engaging with SP pathway at a four-month follow-up after initial referral assessment. Intervention: Chronically ill patients experiencing loneliness referred onto SP pathway and meeting with a Health Coach and/or Link Worker, with possible further referral to existing or newly-created relevant third-sector groups. Main Outcome Measure: Study 1: Health providers and users’ qualitative perspectives on the experience of the pathway and social determinants of health. Study 2: Patients’ primary care usage. Results: Healthcare providers recognised the importance of social factors in determining patient well-being, and reason for presentation at primary care. They viewed SP as a potentially effective solution to such problems. Patients valued the different social relationships they created through the SP pathway, including those with link workers, groups, and community. Group memberships quantitatively predicted primary care usage, and this was mediated by increases in community belonging, and reduced loneliness. Conclusions: Methodological triangulation offers robust conclusions that ‘Social Cure’ processes explain the efficacy of SP, which can reduce primary care usage through increasing social connectedness (group membership and community belonging) and reducing loneliness. Recommendations for integrating Social Cure processes into SP initiatives are discussed. Strengths and limitations of this study The strengths of this study: a. It identifies mechanisms that underlie effective Social Prescribing interventions. b. It identifies mechanisms that enable more appropriate use of primary care services. c. It reports the most comprehensive multi-perspective evaluation of an NHS model of Social Prescribing to date, with accounts from General Practitioners, Link Workers, Health Coaches and Patients. The limitations of this study: a. The results observed in our longitudinal analysis are short-term and are likely to develop further over longer time-periods, though observing benefits after such a short time is promising. b. The specific characteristics of this sample (adults with complex health needs from across the socio-economic spectrum, living in a relatively affluent area) need to be borne in mind when considering the applicability of SP to other populations

Greater number of group identifications is associated with lower odds of being depressed: evidence from a Scottish community sample

Purpose: Group identification has been shown to be associated with reduced risk of depression, but this research has important limitations. Our aim was to establish a robust link between group identification and depression whilst overcoming previous studies’ shortcomings. Methods: 1824 participants, recruited from General Practice throughout Scotland, completed a questionnaire measuring their identification with three groups (family, community, and a group of their choice), as well as their intensity of contact with each group. They also completed a self-rated depression measure and provided demographic information. Their medical records were also accessed in order to determine if they had been prescribed antidepressants in the previous six months. Results: Number of group identifications was associated with both lower self-rated depression and lower odds of having received a prescription for antidepressants, even after controlling for number of contact-intensive groups, level of education, gender, age, and relationship status. Conclusions: Identifying with multiple groups may help to protect individuals against depression. This highlights the potential importance of social prescriptions, where health professionals encourage a depressed patient to become a member of one or more groups with which the patient believes he/she would be likely to identify