Social support is a broad construct comprising both the social structure of an individual’s life and the specific functions served by various interpersonal relationships. Structural aspects of support are often measured by assessing social integration, indicating the extent to which an individual is a part of social networks. Researchers usually divide functional support into two domains: perceived support, or people’s subjective construal of the support they believe to be available to them, and received (or enacted) support, which is aid actually rendered by other persons. Perceived and received support take a number of forms. Informational support involves the provision of recommendations, advice, and other helpful information. Tangible (or instrumental) support is the furnishing of financial, material, or physical assistance, such as the provision of money or labor. Emotional (or appraisal) support involves the expression of affection, empathy, caring, and so on. Belonging (or companionship) support creates a sense of belonging and can involve the presence or availability of others for social engagement. The different facets of social support often have distinct implications for psychological well-being and physical health. For example, higher perceived support is usually associated with preferable mental and physical health outcomes, including lower risk of cardiovascular disease (an association for which the evidence is particularly robust) and all-cause mortality. The proposed mechanisms by which social support influences health typically fall into one of two theoretical frameworks: the buffering model, which contends that support protects against the negative impacts of stressors, and the direct effects model, which holds that social support can also be beneficial in the absence of stressors. Not all support is beneficial; links between received support and health are fraught with complex moderators, such that received support that is beneficial in one circumstance may be ineffective or even detrimental under other conditions. More recent research has examined the factors that determine the direction and magnitude of the effects of received social support. Some evidence suggests support may be most beneficial when it is unobtrusive and matches the receiver’s needs. In contrast, unhelpful or unsolicited received support may feel controlling, frustrate receivers, or lower self-esteem and self-efficacy. Research has also started to consider the costs and benefits of providing social support, especially in the context of serving as a caregiver for a family member with chronic disease. Intervention attempts, especially for caregivers and individuals with unmet needs, increasingly recognize the importance of social support. A more recently emerging literature explores the ways in which computer-mediated communication and online social networks relate to social support.
Overview and History
Thoits 1995 provides a classic overview of the study of social support and the direction of the field at that time. A thorough and more current presentation of the development of social support and its implications for individuals is given by Taylor 2011. Ditzen and Heinrichs 2014 provides a concise, more recent introduction. Cohen and Wills 1985 presents the two main competing hypotheses on how social support may influence health outcomes, and House, et al. 1988 uses relevant literature to establish a causal link between social support and health. Gottlieb 1985 expands the construct of social support to include the transactional process of giving and receiving support that occurs in interpersonal relationships. This bidirectional process is further discussed in Sarason and Sarason 2009, with particular emphasis on the fit of an individual to his or her social support environment. Explorations of the potential pathways through which social support affects physiology and health are found in Uchino 2006.
Cohen, S., and T. A. Wills. 1985. Stress, social support, and the buffering hypothesis. Psychological Bulletin 98.2: 310–357.
A seminal work examining the potential mechanisms through which social support influences physical health. Authors provide a thorough review of the literature on how social support is conceptualized and measured, as well as support for and against both the main effect and buffering hypotheses of social support.
Ditzen, B., and M. Heinrichs. 2014. Psychobiology of social support: The social dimension of stress buffering. Restorative Neurology and Neuroscience 32.1: 149–162.
A brief but broad introduction to various subtopics in social support research. The structured organization renders this paper accessible to nonexperts, though the emphasis on health may make it more suitable for advanced readers. Includes citations of many classic papers in the field.
Gottlieb, B. H. 1985. Social support and the study of personal relationships. Journal of Social and Personal Relationships 2.3: 351–375.
An exploration of the form and function of social support in both initiating and maintaining relationships. The author posits an expansion of the idea of social support from an intrapersonal, psychological construct to an interpersonal interaction, with an emphasis on the ways in which social support influences primary and secondary appraisals and coping processes. Additionally, the author provides a unique discussion of unintentional and indirect forms of social support.
House, J. S., K. R. Landis, and D. Umberson. 1988. Social relationships and health. Science 241.4865: 540–545.
A causal analysis of the association between low levels of social relationships and negative health outcomes. The authors argue that low-quality social support is a risk factor for, rather than a consequence of, poor health.
Sarason, I. G., and B. R. Sarason. 2009. Social support: Mapping the construct. Journal of Social and Personal Relationships 26.1: 113–120.
This article provides a discussion on how social support is and should be both conceptualized and operationalized. Particular attention is paid to the bidirectional perspective of social support wherein an individual’s level of social support is the result of an interaction between the individual and his or her environment. The relative importance of fit in supportive relationships is discussed, and suggestions for future directions are given.
Taylor, S. E. 2011. Social support: A review. In The Oxford handbook of health psychology. Edited by H. S. Friedman, 189–214. Oxford: Oxford Univ. Press.
Comprehensive overview of social support. The author details the forms of social support and its benefits, as well as potential negative responses to social support efforts. Particular attention is paid to pathways by which social support influences health. Key factors that influence who receives social support and how it is received are discussed, as are implications for social support interventions.
Thoits, P. A. 1995. Stress, coping, and social support processes: Where are we? What next? In Special issue: Forty years of medical sociology: The state of the art and directions for the future. Edited by Mary L. Fennell. Journal of Health and Social Behavior 35 (extra issue): 53–79.
Comprehensive overview of previous literature examining social support in the context of coping with stress, for which a general introduction is also given. Summarizes then-current innovations in the field and suggests future directions.
Uchino, B. N. 2006. Social support and health: A review of physiological processes potentially underlying links to disease outcomes. Journal of Behavioral Medicine 29.4: 377–387.
Thorough review of relevant literature examining which physiological mechanisms may bridge the relationship between social support and health outcomes. The author discusses differential functioning as a result of social support across the cardiovascular, neuroendocrine, and immune systems. Literature supports better functioning in all three systems in individuals with higher levels of social support.
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