Abstract
Directive and Nondirective Support were distinguished (interrater agreement = 88.2%) through open-ended interviews completed by 60 adults with Insulin Dependent Diabetes Mellitus. Supporting validity, the sum of both Directive and Nondirective Support was correlated with scores on the Interpersonal Support Evaluation List (ISEL;r=.36). Supporting their distinction, Directive and Nondirective Support were inversely correlated (r=26), and Directive but not Nondirective Support decreased with age. Partial correlations controlled for general support, as measured by the ISEL, to examine the unique associations of Directive and Nondirective Support. For those less than 30 years old, Nondirective Support was associated with better metabolic control (p = .004). For those 30 or older, Directive Support appeared counterproductive, being associated with greater negative mood (p = .02). Different types of support may play different roles in different areas of disease management (e.g., metabolic control versus mood) and as a function of individual characteristics such as age.
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References
Anderson, B. J., Miller, J. P., Auslander, W. F., & Santiago, J. (1981). Family characteristics of diabetic adolescents: Relationship to metabolic control. Diabetes Care, 4, 586–591
Auslander, W. F., Anderson, B. J., Bubb, J., Jung, K. G., & Santiago, J. V. (1990).Risk factors to health in diabetic children: A prospective study from diagnosis. Health and Social Work, 15, 133–142.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of Genera! Psychiatry, 4, 561–571.
BowIby, J. (1973). Self-reliance and some conditions that promote it. In R. Gosling (Ed.), Support, inovation, and autonomy (pp. 23–47). London: Tavistock.
Bowlby, J. (1988). A secure base. New York: Basic Books.
Chodorow, N. (1978). The reproduction of mothering: Psychoanalysis and the sociology of gender. Berkeley: University of California Press.
Cohen, S., & Hoberman, H. M. (1983). Positive events and social support as buffers of life change stress. Journal of Applied Social Psychology, 13, 99–125.
Cox, D. J., & Gonder-Frederick, L. (1992). Major developments in behavioral diabetes research. Journal of Consulting and Clinical Psychology, 63, 628–638.
Coyne, J. C. (1976). Depression and the response of others. Journal of Abnormal Psychology, 85. 186–193.
Coyne, J. C., Ellard, J. H., & Smith, D. A. F. (1990). Social support, interdependence, and the dilemmas of helping. In B. R. Sarason, I. G. Sarason, & G. R. Pierce (Eds.), Social support: An interactional view. New York: Wiley.
Cutrona, C. E., & Russell, D. W. (1987). The provisions of social relationships and adaptation to stress. In W. H. Jones & D. Pcrlman (Eds.), Advances in personal relationships: A research annual (pp. 37–67). Greenwich, CT: JAI.
Cutrona, C. E., & Russell, D. W. (1990). Type of social support and specific stress: Toward a theory of optimal matching. In B. R. Sarason, I. G. Sarason, & G. R. Pierce (Eds.), Social support: An interactional view (pp. 319–366). New York: Wiley.
Doeglas, D., Suurmeijer, T., Briancon, S., Mourn, T., Krol, B., Bjelle, A., Sanderman, R., & van den Heuvel, W. (1996). An international study on measuring social support: Interactions and satisfaction. Social Science and Medicine, 43, 1389–1397.
Fiske, V., Coyne, J. C. & Smith, D.A. (1991). Couples coping with myocardial infarction: An empirical reconsideration of the role of oveiprotection. Journal of Family Psychology, 5, 4–20.
Gavard, J. A., Lust man, P. J., & Clouse, R. E. (1993). Prevalence of depression in adults with diabetes: An epidemiological evaluation. Diabetes Care, 16, 1167–1178.
Glasgow, R. E., & Toobert, D. J. (1988). Social environment and regimen adherence among type II diabetic patients. Diabetes Care, 11, 377–386.
Griffith, L. S., Field, B. J., & Lustman, P. J. (1990). Life stress and social support in diabetes: Association with glycemic control. International Journal of Psychiatry in Medicine, 20, 365–374.
Henderson, S. (1981). Social relationships, adversity and neurosis: An analysis of prospective observations. British Joumut of Psychiatry, 138, 391–398.
Hooley, J. M., & Tcasdale, J. D. (1989). Predictors of relapse in unipolar depressives: Expressed emotion, marital distress, and perceived criticism. Journal of Abnormal Psychology. 98, 229–235.
House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241, 540–544.
Husaini, B., Castor, R., Linn, J., Moore, S., Warren, H., & Whitten-Stovall, R. (1990). Social support and depression among the black and white elderly. Journal of Community Psychology, 18, 12–18.
Leff, J. P., & Vaughn, C. (1981). The role of maintenance therapy and relatives’ expressed emotion in relapse of schizophrenia: A two-year follow-up. British Journal of Psychiatry, 139, 102–104.
Lteberman, M. A. (1986). Social supports—the consequences of psychologizing: A commentary. Journal of Consulting and Clinical Psychology, 54, 461–465.
Lieberman, M. A., & Videka-Sherman, L. (1986). The impact of self-help groups on the mental health of widows and widowers. American Journal of Orthopsychiatry, 56, 435–449.
Martin, R., Davis, G. M., Baron, R. S., Suls, J., & Blanchard, E. B. (1994). Specificity in social support: Perceptions of helpful and unhelpful provider behaviors among irritable bowel syndrome, headache, and cancer patients. Health Psychology, 13, 432–439.
Minuchin, S., Rosman, B. L., & Baker, L. (1978). Psychosomatic families. Cambridge, MA: Harvard University Press.
Schafer, L. C., McCaul, K. D., & Glasgow, R. E. (1986). Supportive and nonsupportive family behaviors: Relationships to adherence and metabolic control on persons with type I diabetes. Diabetes Care. 9, 179–185.
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Preparation of this article was supported by the Washington University Diabetes Research and Training Center (NIDDK 20579, D. Kipnis, Principal Investigator, the late J. Santiago, Center Director) and Cancer Center (NCI 94-029, D. Thde, Principal Investigator), and by grants from the National Heart. Lung, and Blood Institute (HL 45293 and 43555, E. Fisher, Principal Investigator; and HL 36588, N. Schneiderman, Principal Investigator).
We thank Sue Ireland and Ruth Quillian, who assisted in coding data, and Patrician Wick, who assisted with data collection.
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Fisher, E.B., La Greca, A.M., Greco, P. et al. Directive and nondirective social support in diabetes management. Int. J. Behav. Med. 4, 131–144 (1997). https://doi.org/10.1207/s15327558ijbm0402_3
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DOI: https://doi.org/10.1207/s15327558ijbm0402_3