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Updated: Mar 17, 2026

The Social Dimension of Stress: Experimental Manipulations of Social Support and Social Identity in the Trier Social Stress Test
Published on: November 19, 2015
The Relationship Between Social Support, Social Constraint, and Psychological Adjustment for Patients with Rare
Delesha M Carpenter1, Carolyn T Thorpe, Dayna S Alexander
1Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, One University Heights CPO 2125, Asheville, NC, USA.
Abstract:
Our goals were to describe the balance of social support to negative social interactions (i.e. social constraint) for autoimmune disease patients and determine whether support and constraint from spouses and non-spousal family and friends interact to influence patients' psychological adjustment. Using crosssectional survey data from 109 married vasculitis and lupus patients, we found that patients reported that spouses and family/friends provided more social support than social constraint. In regression models, constraint from spouses (β= -0.45, p<0.01) and family/friends (β= -0.89, p<0.001) were associated with worse patient psychological adjustment. A significant 3-way interaction revealed that patients with low spousal support had worse psychological adjustment as the levels of family and friend support increased. In contrast, patients with high levels of spousal support reported better psychological adjustment as family and friend support increased. Future longitudinal studies may help to elucidate the complex interplay between constraint and support from spouses, family, and friends.
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