Social support and its interactions with personality and childhood background as predictors of psychiatric symptoms in Scottish and American medical students.

Two samples of first year medical students were studied, one in Houston, Texas, the other in Edinburgh, Scotland. Personality, measured on entry, and social support, measured prior to first year examinations, were used to predict scores at the latter time on anxiety self-ratings, depression self-ratings and the General Health Questionnaire. At both centres social support was implicated in symptomatology, but many significant effects were centre specific. Presence of a local friend in whom to confide, was important in Houston, while support from a relative and superficial support from classmates were salient in Edinburgh. In general, presence of support was associated with lower symptoms, but there were important exceptions similar in both centres. Students who did not have a boy/girl friend during the study period were less anxious than the rest. Regarding personality, students high on suspiciousness were more anxious and depressed when they had high levels of support. Among reserved (aloof and introspective) students both gain and loss of a boy/girl friend during the year were strongly associated with depressed mood. It is concluded that, particularly for students high in suspiciousness, reserve and shyness, the costs of social relationships sometimes outweigh the benefits.