Social support and social structure

Structures and Processes of Social Support

Annual Review of Sociology, 1988

This chapter reviews the recent literature on social support and health and its relation to preexisting research and theory in the areas of social networks and social integration. We identify crucial directions for future theoretical and empirical work, focusing on the need to better understand the structures and processes through which social relationships affect human health and wellbeing. Two elements of social relationship structure are distinguished: (a) social integration, which refers to the existence or quantity of social relationships, and (b) social network structure, referring to the structural properties that characterize a set of relationships. We further identify three social processes through which these structures may have their effects: (i) social support, which pertains to the emotionally or instrumentally sustaining quality of social relationships; (ii) relational demands and conflict, referring to the negative or conflictive aspects of social relationships; and (iii) social regulation or control, referring to the controlling or regulating quality of social relationships. We also consider the social (as well as psychological and biological) determinants of levels and consequences of relationship structures and processes. In conclusion, we discuss the relevance of research and theory on social relationships and health to current demographic trends and public policy concerns. Recent scientific interest in social support derives largely from lectures by two distinguished physician epidemiologists with strong psychosocial interests and expertise-John Cassel's (1976) Wade Hampton Frost Memorial Lecture to the American Public Health Association and Sidney Cobb's (1976) Presidential Address to the Psychosomatic Society. Cassel and Cobb each reviewed extant studies to demonstrate the centrality of social relationships and supports to the maintenance of health, emphasizing their potential to moderate or buffer potentially deleterious health effects of psychosocial stress and perhaps of other health hazards (also see Caplan 1974 and Caplan & Killilea 1976). Their papers stimulated new research on the impact of social relationships on all aspects of health as well as subsequent reviews of relevant studies conducted both before and after 1976.

Journal of Behavioral Medicine, 1981

Social support research has been hampered by a lack of clarity both in the definitions of social support and in the conceptualization of its effects on health outcomes. The present study compared social network size and three types of perceived social support—tangible, emotional, and informational —in relation to stressful life events, psychological symptoms and morale, and physical health status in a sample of 100 persons 45–64 years old. Social network size was empirically separable from, though correlated with, perceived social support and had a weaker overall relationship to outcomes than did support. Low tangible support and emotional support, in addition to certain life events, were independently related to depression and negative morale; informational support was associated with positive morale. Neither social support nor stressful life events were associated with physical health. It was concluded that social support research would benefit from attention to the multidimensionality of support and greater specificity in hypotheses about the relationship between types of support and adaptational outcomes.

The measurement of social support: The social support network inventory

Comprehensive Psychiatry, 1983

HE PLURALISTIC OR BIOPYSCHOSOCIAL model of illness acknowledges that social factors play a role in the development of physical and emotional illness. Or, in Cassel's language, that there is a "contribution of the social environment to host resistance."' Research continues to explore those social variables which directly or indirectly contribute to pathophysiologic processes, vulnerability to illness, symptom formation, and treatment response. One major area of research concerns the influence of stress and life events beginning with early writings of Cannon2 and Adolf Meyer.-' Since the development of quantitative instruments for measuring life events, pioneered by Holmes and Rahe,4 there has been a flurry of studies examining the relationship between this variable and a variety of dependent symptom variables. Unfortunately, life events have rarely accounted for more than 15% and frequently less than 10% of the variance in any psychiatric outcome measures. Cognizant of the limits of a parsimonious theory linking stressful life events to illness, Caplan5 and others have suggested that social supports or social networks may be an intermediary variable serving to buffer the potentially negative effects of stress. Subsequently, a variety of investigators have shown an inverse association between specific aspects of social support and the development of depression in the general population6 and in recent widows;' an inverse relationship between social support and symptom severity has also been shown in unipolar populations. R.9 Components of social support have also been examined in relationship to schizophrenia,'O anxiety," and psychosomatic disorders.r2 In most of these studies, social support has emerged as a better predictor of outcome than life events, causing speculation that there is a direct effect in addition to that of buffering stress. Although the use of specific questions on aspects of social support (eg, number of friends, relatives in the immediate geographic area, presence of a close contidante) are useful, it became clear by the mid-70's that quantitative instruments were needed to reliably assess social support in research investigations and clinicians. This report presents the rationale, design, and psychometric testing of one instrument-the Social Support Network Inventory (SSNI)-which the authors began developing in 1979. It should be noted that other investigators such as Pattison" began developing similar instruments at that time; an excellent review of the methodology of these instruments has been provided by Lin.13

Problems and prospects for the social support-reactivity hypothesis

Annals of Behavioral Medicine, 1998

Social support and integration have been linked to health and longevity in many correlational studies. To explain how social relationships might enhance health, investigators are examining the effects of social support on physiological processes implicated in disease. Much of this research focuses on testing the social support-reactivity hypothesis, which maintains that social support enhances health by reducing psychobiologic reactivity to stressors. This article identifies the basic assumptions, problems, and prospects of this research endeavor. The major problems discussed include: (a) inconsistent findings across studies; (b) unidentified cognitive and emotional mediators; (c) individual differences in response to social support; and (d) a lack of experimental studies on the role of social support in adjustment to chronic stress. Besides raising consciousness about these problems, I offer ideas for advancing research in this area.

Social and Emotional Support and its Implication for Health

PURPOSE OF REVIEW—To summarize recent research findings from selected publications focusing on links between social support and physical health. RECENT FINDINGS—Current research is extending our understanding of social support's influences on health. Many epidemiological studies have concentrated on further linking measures of social support to physical health outcomes. A few studies are now moving into newer areas, such as emphasizing health links to support receipt and provision. Researchers are also interested in outlining relevant pathways, including potential biological (i.e., inflammation) and behavioral (i.e., health behaviors) mechanisms. Interventions attempting to apply basic research on the positive effects of social support are also widespread. Although the longer-term effects of such interventions on physical health remain to be determined, such interventions show promise in influencing the quality of life in many chronic disease populations. SUMMARY—Recent findings often show a robust relationship in which social and emotional support from others can be protective for health. However, the next generation of studies must explain why this relationship exists and the specificity of such links. This research is in its infancy but will be crucial in order to better tailor support interventions that can impact on physical health outcomes.

Social Support: Methodological Issues in Design and Measurement

1984

Despite plentiful evidence of a link between social support and adaptation to stress, we still know virtually nothing about why this connection exists. This paper is designed to help the researcher plan a study that offers the optimal test of any given explanation. We assume that the research is founded on a conceptual model of the association between stress, support, and strain. The specijicity of such a model will depend upon what has been established from existing knowledge. The paper focuses on key issues in measurement% design, and analysis. A fundamental problem in measurement of social support is how to select from a host of possible strategies. The measurement section introduces important considerations that should govern that choice. The design section alerts the reader to sources of bias that commonly constrain the inferences that can be drawn from social support research. It also addresses the thorny problem of timing measurement to capture a process that transpires over time. The analysis section illustrates how structural equations can be used to model specific social support effects and discusses the circumstances that would make inclusion of additional variables advisable. Finally, we consider the limitations of relying exclusively on quantitative data and illustrate ways in which qualitative research can be used to develop unique information about the role of social support in circumventing the effects of stress.

Social Interaction and Social Support

Journal of Social Issues, 1984

Typical research models of social support are overly simple on two grounds. First, they treat social support as exogenous to the model. That is, models incorporate the effects of social support on stressors and on psychological distress, but typically ignore the influences of stressors, psychological distress, personal characteristics of recipients, and environmental constraints on support. Second, the models typically consider only positive consequences of social interactions, although these interactions may also have negative consequences. Further, actions that are perceived as helpful by the donor, the recipient, or both can have harmful effects if they do not fit individual circumstances. Five dimensions offit between the characteristics of the recipient and those of the supportive act are proposed: amount, timing, source, structure, and function. Implications for research and intervention are discussed. Models and studies of social support should be improved in two ways. First, many studies treat social support as though it were exogenous to the model. Such studies, in caricature, assess some form of stressor, show the effects of the stressor on some mental or physical health outcome, and demonstrate that social The writing of this article was supported, in part, by the Russell Sage Foundation. The authors are grateful for criticisms and suggestions from Urie Bronfenbrenner, Arlene Brownell, Barbara J.

" Social Support: A Psychological and Cultural Perspective."

It is always refreshing to revisit an old concept and redefine it in light of modern psychological and cultural changes. Perhaps, we can describe social support as enjoying warm and secure bonding, living in a tight community, having a close circle of friends, being part of a family-oriented home, belonging to an intimate sphere of people, flourishing in an interactive environment, having daily input from significant others, relying on colleagues in time of need, and growing up in a warm culture... all of these, and more, are features portraying the rich aspects of social support. Although the styles, means, techniques, and manifestations change across time and location, the core nature, function, and value of meaningful support remain the same. The psychosocial literature is full of definitions, discussions, and illustrations of what it means to have nurturing relationships with tangible resources. Fundamentally, the concept of social support can be defined as an available help, a ready assistance, and a personal care from many sources and places, together sharing sustainable aid in different ways and forms, at different times and stages, and for different reasons and a variety of needs. Social support is rather a phenomenon that facilitates survival in time of crisis, connects a particular need with a corresponding resource, empowers function during difficulty, and increases resiliency in time of adversity. Therefore, the benefits of such a support are both in intervention and prevention to enable further mobility and enhance personal growth. This phenomenon draws from the gains of living in close community (bonding, intimacy, and sustenance) and the new emphasis of positive psychology (health, strength, and virtue).

The structure of social support: A Conceptual and empirical analysis

Journal of Community Psychology, 1983

The growth of research on social support has led to a comparable proliferation in the ways it is conceptualized and operationalized. The overall purpose of the present paper was to bring some clarity to this concept by critically examining how it has been presented in the literature and by proposing both rationally and empirically derived typologies for organizing social support functions. From a review of prominent discussions of support functions, a rational typology was proposed that included six categories: Material Aid, Behavioral Assistance, Intimate Interaction, Feedback, and Positive Social Interaction. To empirically examine the structure of social support, a factor analysis was conducted on items from a scale of socially supportive behaviors. The four factors that subsequently emerged were labeled Directive Guidance, Nondirective Support, Positive Social Interaction, and Tangible Assistance. Application of these findings to the assessment of support and future research on support/wellbeing relationships were discussed. w P 5 z C m r

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