Social cure model: testing the link between identity centrality and body appreciation in diverse sexual orientation and gender identity groups.

BACKGROUND: The level of experienced sociocultural pressure to have an idealized body can vary depending on a person's gender identity and sexual orientation. The current study explored whether differences in levels of body appreciation among people with different sexual orientations and gender identities vary because of differing levels of experienced pressure by in-group members and varying levels of experienced hostile behaviors because of their looks or body. Thereby, the study tests the social cure model, according to which high levels of identity centrality are associated with better mental health. METHODS: An online cross-sectional questionnaire study was conducted with 1,587 people (51.3% cisgender women, 39.3% cisgender men, 9.5% non-binary; 52.9% identified as heterosexual, 27.7% identified as bisexual/pansexual, 11.2% identified as gay/lesbian, 8.2% identified as asexual/demi/queer; Mage = 32.9, SD = 12.6) from German-speaking countries. Variables were assessed with German-language versions of the Multidimensional and Multicomponent Measure of Social Identification, Body Appreciation Scale-2, the Perceived Stigmatization Questionnaire, and the Sociocultural Attitudes Towards Appearance Questionnaire-4, revised. A manifest-path model was calculated. RESULTS: Non-binary persons reported lower levels of body appreciation than did cisgender men and sexual minority persons reported lower levels of body appreciation than did heterosexual persons. Furthermore, sexual minority persons experienced more hostile behaviors directed towards them because of their looks or body than did heterosexual persons. Similarly, non-binary persons experienced more hostile behaviors than did men. Non-binary persons were subjected to lower levels of in-group pressure than were men. Gay/lesbian persons and asexual persons were subjected to lower levels of in-group pressure than were heterosexual persons. More hostile behaviors and stronger in-group pressure were related to lower body appreciation. In cisgender women and men indirect links revealed associations between strong identity centrality and low levels of body appreciation through the mediator of high in-group pressure. CONCLUSIONS: Data in sexual minority individuals or non-binary persons supported the social cure model, according to which persons can find support and validation for their looks and body from in-group members. In cisgender women and men, strong identification as a woman or man can be related to stronger in-group pressure and in turn to lower body appreciation.

Enhancing resilience and well-being among low-SES populations: The mediating effect of community resources.

Residents of low-socioeconomic status (SES) neighborhoods suffer from social, economic, and health problems and high exposure to crime and neglect. Based on the social cure approach, the study aimed to examine whether community resources are associated with resilience and well-being, and whether they mediate the associations between personal resources and these outcomes. The moderating effect of participating in community activity was also investigated. A total of 400 residents of low-SES communities, 200 of whom were community activists, completed questionnaires measuring personal resources, community resources, and the outcomes (resilience, well-being). Structural equation modeling revealed the mediating role of community resources. Moderation analysis indicated that different paths led to the outcomes among activists and nonactivists. The results indicate that personal resources alone do not substantially enhance welfare in low-SES communities, but should be channeled through community belonging and commitment. Moreover, professionals working with these communities should take into account the distinctions between activists and nonactivists.

Therapists who foster social identification build stronger therapeutic working alliance and have better client outcomes.

BACKGROUND: For decades we have known that therapeutic working alliance is a key contributor to client engagement and positive outcomes in therapy. However, we have made little progress in narrowing down its determinants, which is critical in supporting trainees to optimize such alliance. We make a case for the value of incorporating social psychological frameworks into models of alliance and explore the role of social identity processes in the development of therapeutic alliance. METHOD: Across two studies, over 500 psychotherapy clients completed validated measures of alliance, social identification with their therapist, positive therapy outcomes, and a range of client and therapist characteristics. FINDINGS: Social identification strongly predicted alliance in both samples, whereas client and therapist characteristics showed few such associations. Alliance mediated the relationship between social identification and positive therapy outcomes. In addition, we found evidence that (a) personal control is a key psychological resource in therapy that arises from social identification, and (b) therapists who engage in identity leadership (i.e., who represent and build a social identity that they share with clients) are more likely to foster social identification and its downstream benefits. INTERPRETATION: These data show that social identity processes are key to the emergence of working alliance. We conclude with a discussion of how recent social identity and identity leadership interventions might be adapted to train therapists in relevant identity-building skills.

Social identification moderates the effect of crowd density on safety at the Hajj.

Crowd safety is a major concern for those attending and managing mass gatherings, such as the annual Hajj or pilgrimage to Mecca (also called Makkah). One threat to crowd safety at such events is crowd density. However, recent research also suggests that psychological membership of crowds can have positive benefits. We tested the hypothesis that the effect of density on safety might vary depending on whether there is shared social identification in the crowd. We surveyed 1,194 pilgrims at the Holy Mosque, Mecca, during the 2012 Hajj. Analysis of the data showed that the negative effect of crowd density on reported safety was moderated by social identification with the crowd. Whereas low identifiers reported reduced safety with greater crowd density, high identifiers reported increased safety with greater crowd density. Mediation analysis suggested that a reason for these moderation effects was the perception that other crowd members were supportive. Differences in reported safety across national groups (Arab countries and Iran compared with the rest) were also explicable in terms of crowd identification and perceived support. These findings support a social identity account of crowd behavior and offer a novel perspective on crowd safety management.

Link workers' and clients' perspectives on how social prescribing offers a social cure for loneliness.

Social prescribing is a healthcare model designed to reduce loneliness and improve individuals' health by addressing unmet social needs. The present study adopted the Social Cure framework to provide an understanding of the psychosocial processes involved in helping participants to engage with social activities, from both the link workers' and clients' perspectives. Semi-structured interviews were conducted with 15 link workers (Mage = 40.12; 87% female) and 15 clients (Mage = 55.33; 73% female, 7% non-binary) of social prescribing programmes across Australia and the transcripts were analysed using reflexive thematic analysis. Three overarching themes were identified: (1) Breaking Down Barriers, (2) Finding Fit with Others, and (3) Rebuilding a Sense of Self. These findings communicate how social prescribing addressed the psychosocial barriers of clients, and how joining groups that fostered positive shared social identities resulted in meaningful improvements to clients' well-being.

Sport-based interventions and health in prisons: The impact of Twinning Project on prisoner wellbeing and attitudes.

Social isolation and lack of support networks are key factors contributing to mental health problems among incarcerated people, which, in turn, are associated with an increased risk of reoffending. Enabling prisoners to form positive group relations and social identities is one approach to address the cycle of ill health and incarceration. We examine the impact of a football-based intervention, the Twinning Project, on prisoners' wellbeing and social relations. Longitudinal and correlational analyses of data from N = 164 UK prisoners show how social bonding is linked with significant boosts to psychological need satisfaction, life satisfaction, efficacy beliefs as well as higher levels of wellbeing.

Discrimination and social identity processes predict impairment and dysfunction among heavy drinkers.

BACKGROUND: Previous research has linked discrimination to poorer health. Yet health risk behaviours such as heavy alcohol consumption are often targeted with stigmatising public health campaigns. The current study sought to establish the link between experiencing discrimination and health outcomes among heavy drinkers, with a focus on exploring the multiple social identity processes that might underpin this relationship. METHODS: A survey was conducted with 282 people who self-reported consuming alcohol above recommended guidelines. We measured discrimination experienced as a drinker, components of social identification as a drinker (centrality, satisfaction, solidarity, homogeneity, and self-stereotyping), and two health outcomes: psychological distress and severity of alcohol use disorder symptomatology. RESULTS: Discrimination was a moderate-large predictor of psychological distress and alcohol use disorder symptoms. Three social identity constructs were implicated in the link between discrimination and ill-health: identity centrality and homogeneity positively mediated this relationship while identity satisfaction was a negative mediator. The model explained a large proportion of the variance (39-47%) in health outcomes. DISCUSSION: Results are interpreted with an emphasis on the need to avoid stigmatising messaging and to prioritise social identity processes to prevent and treat substance use disorders. We further highlight the need for social identity researchers to consider the multidimensional nature of social identities, especially in the context of stigmatised groups.

New social identities in Ukrainian 'refugees': A social cure or social curse?

Experiencing traumatic events often drives profound post-traumatic stress (PTS), but trauma also has the potential to engender positive consequences, such as post-traumatic growth (PTG). Traumatic experiences may also lead to gaining new identities which can have both protective (i.e., social cure) or damaging (i.e., social curse) effects on health and well-being. This study aims to examine the role of new social identities and related social identity resources acquired after war-related experiences (i.e., identification with a new host society and identification as a refugee) in contributing to different trauma trajectories. The sample included 468 participants who left Ukraine due to the war that commenced on February 24th, 2022, and became residents of Ireland or Poland. The findings indicate that identification with the host society was associated with lower PTS and greater PTG. Whereas identification with refugees was related to higher PTS, but it was not directly associated with PTG. Further, the psychological resources derived from these new identities mediated the relationship between identification strength and PTG. This study offers practical insights for interventions targeting refugees in their new countries of residence.

The reciprocal relationship between social identification and social support over time: A four-wave longitudinal study.

It has been argued that the positive effect of a shared social identity on health and well-being critically hinges on the interplay between social identity and social support. This interplay, however, is poorly understood. Building on Haslam et al., we argue that their relationship can be conceptualized as being reciprocal and dynamic with each variable influencing the other. The present study is the first to examine how the reciprocal relationship between social identification and perceived social support unfolds over time. In a sample of university freshmen (NT1  = 172), we examined this reciprocal relationship in a four-wave survey study spanning over a period of 13 months. In line with Haslam et al., the results revealed a self-reinforcing cycle with social identification at T1 being positively related to perceived social support at T2, which, in turn, was positively related to social identification at T3, which predicted perceived social support at T4. In conclusion, our study advances knowledge regarding the interplay between social identity and social support over time and, hence, contributes to our understanding of the mechanisms underlying the social cure effect.

Expanding the social cure: a mixed-methods approach exploring the role of online group dance as support for young people (aged 16-24) living with anxiety.

There is an increased interest in whether online arts interventions support mental health and social connections. This study explored eight weeks of online group dance as support for young people (aged 16-24) living with anxiety. The applicability of the 'social cure' theoretical framework to the novel context of an online dance class was sought. The study utilised an embedded QUAL+quan design, incorporating participatory focus group discussions (n = 3 groups; n = 11 participants) and one-on-one interviews (n = 2 participants), creative reflections (n = 16 participants) and ethnographic fieldnotes, and a repeated measures design with surveys at three timepoints (week 1, n = 27; week 4, n = 18; week 8, n = 14). Thematic analysis identified two overarching themes demonstrating how the dance classes (i) provided the opportunity to co-construct a meaningful shared identity and (ii) supported holistic wellbeing. The quantitative findings supported this, suggesting lower anxiety, depression, and loneliness and higher wellbeing, self-esteem, self-efficacy, and group closeness. This study expands the social cure to its application to an online dance context for the first time.

Social cure in the time of COVID-19: Social identity and belongingness predict greater well-being and academic motivation in university students.

Social isolation during the COVID-19 pandemic increased negative affect and feelings of loneliness among university students. OBJECTIVE: Given that identifying as a member of a social group, like a university student, serves as a protective factor against diminished well-being, we examined whether students' social identity might offer a "social cure" during COVID-related remote learning. PARTICIPANTS: Three hundred fifty-six students from a large, public university that was fully remote in 2021. RESULTS: Students with a stronger social identity as a member of their university reported lower loneliness and greater positive affect balance during remote learning. Social identification was also associated with greater academic motivation, whereas two well-established predictors of positive student outcomes - perceived social support and academic performance - were not. Nonetheless, academic performance, but not social identification, predicted lower general stress and COVID-related worry. CONCLUSIONS: Social identity may be a potential social cure for university students who are learning remotely.

Health literacy among self-help leprosy group members reduces stereotype endorsement and stigma-related harm in rural Nepal.

There is increasing appreciation that group memberships can have both beneficial and damaging impacts on health. In collaboration with Nepal Leprosy Trust (NLT), this longitudinal study explores a group-based approach to stigma reduction among people affected by leprosy in rural Nepal (N = 71)-a hard to reach and underrepresented non-WEIRD population. Informed by the 'social cure' literature, and the progressive model of self-stigma, we use a longitudinal design. We found that a sense of belonging to a self-help group can facilitate education in terms of health literacy, and over time these two factors also have impacts on participants stigma. Specifically, self-help group belonging predicted improvements in health literacy, leading to reduced endorsement of negative stereotypes and thus less stigma-related harm among people affected by leprosy. The study offers promising evidence that group-based interventions, which support health education, can reduce the harmful impact of stigma in very challenging contexts.

The amplifying effect of perceived group politicization: Effects of group perceptions and identification on anxiety and coping self-efficacy among members of UK COVID-19 mutual aid groups.

Mutual aid groups developed and mobilized in communities across the UK and globally at the outset of the pandemic in order to support vulnerable community members with practical assistance and emotional support, with some understanding their work in political terms. This study adopted a "social cure" lens to investigate the effects of group identification and group perceptions on anxiety and coping self-efficacy among members of UK Covid-19 mutual aid groups. Survey data were collected from self-identified members of these groups (N = 844) during the initial period of "lockdown" restrictions in April - May 2020. Correlational analyses showed that identification with the mutual aid group was linked to more positive group perceptions and better self-reported psychological outcomes. Perceived group politicization showed the reverse pattern. Mixed support for the "social cure" model was evident; the effect of group identification on coping self-efficacy (but not anxiety) was serially mediated by perceived support and collective efficacy. Perceived group politicization was a significant moderator, seeming to amplify the indirect effect of group identification on coping self-efficacy via perceived support. Results are discussed in light of previous empirical work on the social cure and Covid-19 mutual aid groups. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

'Oh no, not a group!' The factors that lonely or isolated people report as barriers to joining groups for health and well-being.

OBJECTIVES: Belonging to groups can significantly affect people's health and well-being for the better ('the social cure') or worse ('the social curse'). Encouraging people to join groups is a central component of the Social Prescribing movement; however, not everyone who might benefit from Social Prescribing aspires to participating in groups. This study aims to identify what barriers are preventing people from experiencing the associated health and well-being benefits of group belonging. METHOD: Semi-structured interviews analysed using reflexive thematic analysis. Participants were 11 white British people (aged 48-86), 1 male and 10 female, recruited by a charity partner of a Social Prescribing project. RESULTS: The themes derived from the interviews are as follows: (1) 'The dread, the fear of being in a group': When groups do not meet needs; (2) 'I can remember as quite a young child backing out of things': Accumulative barriers over the lifetime, and (3) 'I'm singing away and feeling terribly miserable': the challenges of fitting in with others in groups. The themes reflect how people can feel deterred from social interaction, which interferes with their ability to derive a sense of belonging or shared identity associated with the 'social cure'. CONCLUSIONS: A key challenge for Social Prescribing is to meet the social needs of people disinclined to join groups; groups can be detrimental to health and well-being if there are barriers to integration. Alternative ways of structuring groups or activities may be more effective and can still avail of the belonging and identity associated with 'the social cure'.

Social Prescribing as 'Social Cure': A longitudinal study of the health benefits of social connectedness within a Social Prescribing pathway.

We examined whether the Social Cure (SC) perspective explains the efficacy of a Social Prescribing (SP) pathway which addresses healthcare needs through enhancing social connections. Data were collected at pathway entry from patients with long-term health conditions, or who felt isolated/lonely/anxious (N = 630), then again 4 months later (N = 178), and 6-9 months later (N = 63). Being on the pathway was associated with increased group memberships between T0 and T1. The relationship between increased group memberships and quality-of-life was serially mediated by belonging, support and loneliness. This study is the first to show SP enhances health/well-being via SC mechanisms.

A community-led intervention to build neighbourhood identification predicts better wellbeing following prolonged COVID-19 lockdowns.

Introduction: A growing body of research supports the importance of social cohesion for population wellbeing. However, the majority of this research has been correlational, and rarely have interventions been evaluated. Method: We conducted a two-timepoint study investigating the role of Neighbour Day, a grass-roots, community-led intervention that seeks to build social cohesion across the population. Among a sample of 843, 125 were Neighbour Day participants while the remainder were not. Results: We found that, compared to non-participants, Neighbour Day participants had significantly higher neighbourhood identification, experienced greater social cohesion, and had larger neighbourhood social networks. Between timepoints, the majority of the sample experienced prolonged lockdowns to prevent COVID-19 transmission, and so unsurprisingly, wellbeing declined and psychological distress increased. However, Neighbour Day participants were protected against these negative mental health effects of lockdown. These benefits of Neighbour Day participation were mediated via neighbourhood identification. Discussion: Overall, the findings speak to the promise of large-scale interventions to build social identity, particularly due to their capacity to build resilience and protect people's wellbeing during times of collective change or crisis.

Sweet as Sugar-How Shared Social Identities Help Patients in Coping with Diabetes Mellitus.

Social identification is health-beneficial as social groups provide social support (i.e., the social cure effect). We study this social cure effect in diabetes patients by focusing on two relevant sources of social support, namely medical practitioners (MP) and fellow patients. As both groups have diabetes-specific knowledge, we predict that sharing an identity with them provides access to specific support, which, in turn, optimizes individuals' diabetes management and reduces diabetes-related stress. We further predict that identifying with their MP or fellow patients will be more strongly related to perceived social support among individuals with lower diabetes-specific resilience because they pay more attention to supportive cues. We tested this moderated mediation model in a two-wave study with n = 200 diabetes patients. Identification with the MP related to more support, which, in turn, was related to better diabetes management and less diabetes-specific stress. Identification with fellow patients related to more support; however, social support was unrelated to diabetes management and stress. Resilience only moderated the relationship between MP identification and support, as people with lower resilience levels reported more support from their MP. This study shows the importance of social identification with the MP and other diabetes patients, especially for people with lower resilience levels.

National identification, a social cure for COVID-19? Evidence from 67 countries.

BACKGROUND: Social distancing and mass quarantines were implemented worldwide in response to the current COVID-19 pandemic. Prior research has shown that such measures bear negative consequences for population mental health and well-being. Conversely, a growing body of evidence suggests that feeling positively identified with a group is associated with physical and mental health benefits. AIMS: This study tested whether national identification could promote wellbeing and physical health during the COVID-19 pandemic. METHOD: We used survey data conducted among 67 countries (N = 46,450). RESULTS: Mixed-model analyses revealed that national identity was associated with wellbeing - despite adjustment on social belonging, COVID-19 perceived risk, exposure and ideology. This effect did not extend to physical health. CONCLUSIONS: These results suggest that the mere feeling of belonging to a national group may have mental health benefits. We discuss the implications of our findings within the social cure framework and their relevance for population mental health under COVID-19.

Loneliness in older people and COVID-19: Applying the social identity approach to digital intervention design.

The COVID-19 pandemic is worsening loneliness for many older people through the challenges it poses in engaging with their social worlds. Digital technology has been offered as a potential aid, however, many popular digital tools have not been designed to address the needs of older adults during times of limited contact. We propose that the Social Identity Model of Identity Change (SIMIC) could be a foundation for digital loneliness interventions. While SIMIC is a well-established approach for maintaining wellbeing during life transitions, it has not been rigorously applied to digital interventions. There are known challenges to integrating psychological theory in the design of digital technology to enable efficacy, technology acceptance, and continued use. The interdisciplinary field of Human Computer Interaction has a history of drawing on models originating from psychology to improve the design of digital technology and to design technologies in an appropriate manner. Drawing on key lessons from this literature, we consolidate research and design guidelines for multidisciplinary research applying psychological theory such as SIMIC to digital social interventions for loneliness.

Personal condition but social cure: Agentic ingroups elevate well-being in chronically ill patients through perceptions of personal control.

OBJECTIVES: Social-cure research has shown that ingroup identification can be beneficial for personal health and well-being. Initial evidence for healthy participants suggests that this might be due to group membership providing a sense of personal control. In this research, we investigate this pathway for chronically ill patients, assuming that any ingroup (even patient identity) can serve as social cure by increasing control as long as the ingroup is perceived as agentic (i.e., effective). DESIGN: We conducted six correlational field studies with patients suffering from different chronic conditions, e.g., cancer (Ntotal = 795). METHODS: All participants were asked about one specific ingroup, e.g., their self-help group. Our main measures were ingroup identification, ingroup agency, personal control and well-being, as well as self-esteem and social support (both discussed as alternative mediators). We performed simple mediation and/or moderated mediation analyses for each study and across studies (merging Studies 2-6). RESULTS: Overall, the impact of ingroup identification on personal well-being was uniquely mediated via personal control (Studies 1, 2, 3, 6) but, as expected, only for those perceiving their ingroup as highly agentic (Studies 4, 5, 6). CONCLUSIONS: Ingroup agency is a boundary condition for the control-based pathway of the social cure effect supporting the model of group-based control. This has practical implications for clinical interventions with chronically ill patients.