eprintid: 36698
rev_number: 13
eprint_status: archive
userid: 9068
dir: disk0/00/03/66/98
datestamp: 2025-06-30 05:53:22
lastmod: 2025-07-01 08:13:35
status_changed: 2025-06-30 05:53:22
type: doctoralThesis
metadata_visibility: show
creators_name: van Stein, Katharina R.
title: Pain, stress, and stigma: an investigation of if and how social support makes a difference
subjects: ddc-150
divisions: i-100200
adv_faculty: af-10
abstract: Social support is uniformly assumed to be beneficial for our general health. For the largest part, studies from the last decades report that social support is positively related to mental as well as physical health outcomes. However, due to differing definitions of social support and methods to assess it, there are mixed findings and caution is warranted when interpreting or generalizing them. This work aims to investigate the role of social support on different levels in order to understand how it is related to health outcomes.
In the first chapter, the concept of social support and how it is assumed to unfold its beneficial impact is outlined. The second chapter sets out the minority stress model: A model that aims to explain the relation between minority stressors, resilience factors, and health outcomes. It assumes that additionally to general stressors which everybody experiences, marginalized groups experience additional stressors specific to their minority status. These additional stressors are assumed to put an extra strain on marginalized individuals and thus, it is highly relevant to wellbeing. The third chapter comprises Paper #1, an original study which investigated the relation between internalized stigma, social resilience factors and mental health. It found social resilience factors (social support and community connectedness) to be negatively associated with mental health problems, but they did not significantly moderate the relationship of internalized stigma with mental health symptoms. Chapter four begins with explaining the disease endometriosis and its specific characteristics. Then, nociception, pain, and pain chronification processes are elaborated. Paper #2 provides an overview of the literature with a focus on the psychological burden of endometriosis. It emphasizes, among other aspects, the central role of social interaction, integration, and isolation in burden due to endometriosis. Derived from this, Paper #3 examines how social support is related to the experience of pain in endometriosis and chronic pelvic pain in every-day life. In this pre-registered psychophysiological ecological momentary assessment, social support on a between-person level was negatively related to pain levels. Further findings are reported and discussed. Chapter five summarizes the main findings and discusses, why broad-scale social support is often found to be positively associated with health outcomes, while on the momentary level findings are mixed. In conclusion, this dissertation combines novel findings from gender minorities and pain patients and relates them to established models of social support and health. These connections offer valuable insights for developing mental health prevention measures and interventions.
date: 2025
id_scheme: DOI
id_number: 10.11588/heidok.00036698
ppn_swb: 1929411219
own_urn: urn:nbn:de:bsz:16-heidok-366983
date_accepted: 2025-05-07
advisor: HASH(0x5608d3bb0398)
language: eng
bibsort: VANSTEINKAPAINSTRESS2025
full_text_status: public
place_of_pub: Heidelberg
citation:   van Stein, Katharina R.  (2025) Pain, stress, and stigma: an investigation of if and how social support makes a difference.  [Dissertation]     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/36698/1/Dissertation_vanStein_2025-06-02.pdf