The influence of social support and problematic support on optimism and depression in chronic illness: A prospective study evaluating self-esteem as a mediator.

Mediational analyses indicated that social support operated through self-esteem to influence optimism cross-sectionally and prospectively and depression cross- sectionally and social support was associated with high self- esteem, which in turn increased optimism and was related to decreased depression.

Abstract

The present study focused on the mechanism through which social and problematic support affects psychological adjustment in chronic illness. The authors hypothesized that self-esteem would mediate the relations between social and problematic support and adjustment. Eighty-six end-stage renal disease patients were assessed twice for social support problematic support, and self-esteem. Adjustment was assessed twice by depression and optimism. Mediational analyses indicated that social support operated through self-esteem to influence optimism cross-sectionally and prospectively and depression cross-sectionally. Social support was associated with high self-esteem, which in turn increased optimism and was related to decreased depression. Problematic support was unrelated to self-esteem obviating mediational analysis. Disaggregating social support into subscales showed that belonging support predicted decreases in depression, and both tangible and belonging support predicted increases in optimism.