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Social support is the perception and actuality that one is cared for, has assistance available from other people, and most popularly, that one is part of a supportive
social network A social network is a social structure made up of a set of social actors (such as individuals or organizations), sets of Dyad (sociology), dyadic ties, and other Social relation, social interactions between actors. The social network perspectiv ...

social network
. These supportive resources can be emotional (e.g., nurturance), informational (e.g., advice), or companionship (e.g., sense of belonging); tangible (e.g., financial assistance) or intangible (e.g., personal advice). Social support can be measured as the perception that one has assistance available, the actual received assistance, or the degree to which a person is integrated in a social network. Support can come from many sources, such as family, friends, pets, neighbors, coworkers, organizations, etc. Government-provided social support may be referred to as public aid in some nations. Social support is studied across a wide range of disciplines including
psychology Psychology is the scientific Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is an occurrence in the real world. ...

psychology
,
communications Communication (from Latin Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally spoken in the area around Rome, known as Latium. Through the power of the Roman Rep ...
,
medicine Medicine is the science Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts ( descriptive knowledge), skills (proced ...

medicine
,
sociology Sociology is a social science Social science is the branch The branches and leaves of a tree. A branch ( or , ) or tree branch (sometimes referred to in botany Botany, also called , plant biology or phytology, is the scie ...
,
nursing Nursing is a profession within the health care Healthcare is the maintenance or improvement of health Health is a state of physical, mental and social well-being Well-being, also known as ''wellness'', ''prudential value'' or ''qua ...

nursing
,
public health Public health has been defined as "the science and art of preventing disease", prolonging life and improving quality of life Quality of life (QOL) is defined by the World Health Organization The World Health Organization (WHO) is a s ...

public health
,
education Education is the process of facilitating learning, or the acquisition of knowledge, skills, value (ethics), values, morals, beliefs, habits, and personal development. Educational methods include teaching, training, storytelling, discussion ...

education
,
rehabilitation Rehabilitation or Rehab may refer to: Health * Rehabilitation (neuropsychology), therapy to regain or improve neurocognitive function that has been lost or diminished * Rehabilitation (wildlife), treatment of injured wildlife so they can be returne ...
, and
social work Social work is an academic discipline and practice-based profession A Profession is a disciplined group of individuals who adhere to ethical standards and who hold themselves out as, and are accepted by the public as possessing special kno ...

social work
. Social support has been linked to many benefits for both physical and mental health, but "social support" (e.g., gossiping about friends) is not always beneficial. Social support theories and models were prevalent as intensive academic studies in the 1980s and 1990s, and are linked to the development of caregiver and payment models, and community delivery systems in the US and around the world. Two main models have been proposed to describe the link between social support and health: the buffering hypothesis and the direct effects hypothesis.
Gender Gender is the range of characteristics pertaining to, and differentiating between femininity Femininity (also called womanliness or girlishness) is a set of attributes, behaviors, and roles generally associated with women A woman is ...

Gender
and
cultural Culture () is an umbrella term which encompasses the social behavior Social behavior is behavior among two or more organisms within the same species, and encompasses any behavior in which one member affects the other. This is due to an int ...

cultural
differences in social support have been found in fields such as education "which may not control for age, disability, income and social status, ethnic and racial, or other significant factors".


Categories and definitions


Distinctions in measurement

Social support can be categorized and measured in several different ways. There are four common functions of social support: *''Emotional support'' is the offering of empathy, concern, affection, love, trust, acceptance, intimacy, encouragement, or caring. It is the warmth and nurturance provided by sources of social support. Providing emotional support can let the individual know that he or she is valued. *''Tangible support'' is the provision of financial assistance, material goods, or services. Also called instrumental support, this form of social support encompasses the concrete, direct ways people assist others. *''Informational support'' is the provision of advice, guidance, suggestions, or useful information to someone. This type of information has the potential to help others problem-solve. *''Companionship support'' is the type of support that gives someone a sense of social belonging (and is also called belonging). This can be seen as the presence of companions to engage in shared social activities. Formerly, it was also referred to as "esteem support" or "appraisal support,"but these have since developed into alternative forms of support under the name "appraisal support" along with normative and instrumental support. Researchers also commonly make a distinction between perceived and received support. ''Perceived support'' refers to a recipient's subjective judgment that providers will offer (or have offered) effective help during times of need. ''Received support'' (also called enacted support) refers to specific supportive actions (e.g., advice or reassurance) offered by providers during times of need. Furthermore, social support can be measured in terms of structural support or functional support. ''Structural support'' (also called ''social integration'') refers to the extent to which a recipient is connected within a social network, like the number of social ties or how integrated a person is within his or her social network. Family relationships, friends, and membership in clubs and organizations contribute to social integration. ''Functional support'' looks at the specific functions that members in this social network can provide, such as the emotional, instrumental, informational, and companionship support listed above. Data suggests that emotional support may play a more significant role in protecting individuals from the deleterious effects of stress than structural means of support, such as social involvement or activity. These different types of social support have different patterns of correlations with
health Health, according to the World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations United Nations Specialized Agencies are autonomous organizations working with the United Nations and each ...

health
,
personality Personality is the characteristic sets of behaviors, cognitions, and emotional patterns that evolve from biological and environmental factors. While there is no generally agreed upon definition of personality, most theories focus on motivation a ...
, and
personal relationships ''Personal Relationships'' is a quarterly peer-reviewed academic journal An academic or scholarly journal is a periodical publication in which Scholarly method, scholarship relating to a particular list of academic disciplines, academic discipline ...
. For example, perceived support is consistently linked to better mental health whereas received support and social integration are not. In fact, research indicates that perceived social support that is untapped can be more effective and beneficial than utilized social support. Some have suggested that
invisible supportIn psychology Psychology is the science of mind and behavior. Psychology includes the study of consciousness, conscious and Unconscious mind, unconscious phenomena, as well as feeling and thought. It is an academic discipline of immense scope ...
, a form of support where the person has support without his or her awareness, may be the most beneficial. This view has been complicated, however, by more recent research suggesting the effects of invisible social support–as with visible support–are moderated by provider, recipient, and contextual factors such as recipients' perceptions of providers' responsiveness to their needs, or the quality of the relationship between the support provider and recipient.


Sources

Social support can come from a variety of sources, including (but not limited to): family, friends, romantic partners, pets, community ties, and coworkers. Sources of support can be natural (e.g., family and friends) or more formal (e.g., mental health specialists or community organizations). The source of the social support is an important determinant of its effectiveness as a coping strategy. Support from a romantic partner is associated with health benefits, particularly for men. However, one study has found that although support from spouses buffered the negative effects of work stress, it did not buffer the relationship between marital and parental stresses, because the spouses were implicated in these situations.However, work-family specific support worked more to alleviate work-family stress that feeds into marital and parental stress. Employee humor is negatively associated with burnout, and positively with, stress, health and stress coping effectiveness. Additionally, social support from friends did provide a buffer in response to marital stress, because they were less implicated in the marital dynamic. Early familial social support has been shown to be important in children's abilities to develop social competencies, and supportive parental relationships have also had benefits for college-aged students. Teacher and school personnel support have been shown to be stronger than other relationships of support. This is hypothesized to be a result of family and friend social relationships to be subject to conflicts whereas school relationships are more stable.


Online social support

Social support is also available among
social media Social media are interactive technologies that facilitate the creation Creation may refer to: Religion * Creation ''ex nihilo'', the concept that matter was created by God out of nothing * Creation myth A creation myth (or cosmogonic myth) ...

social media
sites. As technology advances, the availability for online support increases. Social support can be offered through social media websites such as
blog A blog (a truncation In mathematics and computer science, truncation is limiting the number of numerical digit, digits right of the decimal point. Truncation and floor function Truncation of positive real numbers can be done using the f ...
s,
Facebook Facebook is an American online social media and social networking service owned by Meta Platforms. Founded in 2004 by Mark Zuckerberg with fellow Harvard College students and roommates Eduardo Saverin, Andrew McCollum, Dustin Moskovitz, an ...

Facebook
groups, health forums, and online support groups. Early theories and research into Internet use tended to suggest negative implications for offline social networks (e.g., fears that Internet use would undermine desire for face-to-face interaction) and users' well-being. However, additional work showed null or even positive effects, contributing to a more nuanced understanding of online social processes. Emerging data increasingly suggest that, as with offline support, the effects of online social support are shaped by support provider, recipient, and contextual factors. For example, the interpersonal-connection-behaviors framework reconciles conflicts in the research literature by suggesting that social network site use is likely to contribute to well-being when users engage in ways that foster meaningful interpersonal connection. Conversely, use may harm well-being when users engage in passive consumption of social media. Online support can be similar to face-to-face social support, but may also offer convenience, anonymity, and non-judgmental interactions. Online sources such as social media may be less redundant sources of social support for users with relatively little in-person support compared to persons with high in-person support. Online sources may be especially important as potential social support resources for individuals with limited offline support, and may be related to physical and psychological well-being. However, socially isolated individuals may also be more drawn to computer-mediated vs. in-person forms of interaction, which may contribute to bidirectional associations between online social activity and isolation or depression. Support sought through social media can also provide users with emotional comfort that relates them to others while creating awareness about particular health issues. Research conducted by Winzelberg et al. evaluated an online support group for women with breast cancer finding participants were able to form fulfilling supportive relationships in an asynchronous format and this form of support proved to be effective in reducing participants' scores on
depression Depression may refer to: Mental health * Depression (mood), a state of low mood and aversion to activity * Mood disorders characterized by depression are commonly referred to as simply ''depression'', including: ** Dysthymia ** Major depressive ...
, perceived stress, and cancer-related trauma measures. This type of online communication can increase the ability to cope with stress. Social support through social media is potentially available to anyone with Internet access and allows users to create relationships and receive encouragement for a variety of issues, including rare conditions or circumstances. Coulson claims online support groups provide a unique opportunity for health professionals to learn about the experiences and views of individuals. This type of social support can also benefit users by providing them with a variety of information. Seeking informational social support allows users to access suggestions, advice, and information regarding health concerns or recovery. Many need social support, and its availability on social media may broaden access to a wider range of people in need. Both experimental and correlational research have indicated that increased social network site use can lead to greater perceived social support and increased social capital, both of which predict enhanced well-being. An increasing number of interventions aim to create or enhance social support in online communities. While preliminary data often suggest such programs may be well-received by users and may yield benefits, additional research is needed to more clearly establish the effectiveness of many such interventions. Until the late 2010s, research examining online social support tended to use ad hoc instruments or measures that were adapted from offline research, resulting in the possibility that measures were not well-suited for measuring online support, or had weak or unknown psychometric properties. Instruments specifically developed to measure social support in online contexts include the Online Social Support Scale (which has sub scales for esteem/emotional support, social companionship, informational support, and instrumental support) and the Online Social Experiences Measure (which simultaneously assesses positive and negative aspects of online social activity and has predictive validity regarding cardiovascular implications of online social support).


Links to mental and physical health


Benefits


Mental health

Social support profile is associated with increased psychological well-being in the workplace and in response to important life events. There has been an ample amount of evidence showing that social support aids in lowering problems related to one's mental health. As reported by Cutrona, Russell, and Rose, in the elderly population that was in their studies, their results showed that elderly individuals who had relationships where their self-esteem was elevated were less likely to have a decline in their health. In stressful times, social support helps people reduce psychological distress (e.g.,
anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...

anxiety
or
depression Depression may refer to: Mental health * Depression (mood), a state of low mood and aversion to activity * Mood disorders characterized by depression are commonly referred to as simply ''depression'', including: ** Dysthymia ** Major depressive ...
). Social support can simultaneously function as a problem-focused (e.g. receiving tangible information that helps resolve an issue) and emotion-focused coping strategy (e.g. used to regulate emotional responses that arise from the stressful event) Social support ≤has been found to promote psychological adjustment in conditions with chronic high stress like
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus ''Lentivirus'' is a genus Genus (plural genera) is a taxonomic rank Taxonomy (general) is the practice and science of classification of things or concepts, inc ...

HIV
,
rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects synovial joint, joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and ...
,
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumor A benign tumor is a mass of cells Cell most often refers to: * Cell (biolo ...

cancer
,
stroke A stroke is a medical condition A disease is a particular abnormal condition that negatively affects the structure or function (biology), function of all or part of an organism, and that is not due to any immediate external injury. Di ...

stroke
, and
coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), or simply heart disease, involves the reduction of blood flow to the heart muscle Cardiac muscle (also called heart muscle or myocardium) i ...
. Whereas a lack of social support has been associated with a risk for an individuals mental health. This study also shows that the social support acts as a buffer to protect individuals from different aspects in regards to their mental and physical health, such as helping against certain life stressors. Additionally, social support has been associated with various acute and chronic pain variables (for more information, see
Chronic pain Chronic pain is classified as pain that lasts longer than three to six months. In medicine, the distinction between Acute (medicine), acute and Chronic condition, chronic pain is sometimes determined by the amount of time since onset. Two commonly ...
). People with low social support report more sub-clinical symptoms of
depression Depression may refer to: Mental health * Depression (mood), a state of low mood and aversion to activity * Mood disorders characterized by depression are commonly referred to as simply ''depression'', including: ** Dysthymia ** Major depressive ...
and
anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...

anxiety
than do people with high social support. In addition, people with low social support have higher rates of major mental disorder than those with high support. These include
post traumatic stress disorder Post-traumatic stress disorder (PTSD)Acceptable variants of this term exist; see the '' Terminology'' section in this article. is a mental disorder that one can develop after exposure to a traumatic event, such as sexual assault, warfare, ...
,
panic disorder Panic disorder is a mental Mental may refer to: * of or relating to the mind Films * Mental (2012 film), ''Mental'' (2012 film), an Australian comedy-drama * Mental (2016 film), ''Mental'' (2016 film), a Bangladeshi romantic-action movie * ''Me ...
,
social phobia Social anxiety disorder (SAD), also known as social phobia, is an anxiety disorder characterized by sentiments of fear and anxiety in social situations, causing considerable Mental distress, distress and impaired ability to function in at least ...
, major depressive disorder, dysthymic disorder, and
eating disorders An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's health, physical or mental health, mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders i ...
. Among people with
schizophrenia Schizophrenia is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may b ...

schizophrenia
, those with low social support have more symptoms of the disorder. In addition, people with low support have more
suicidal ideation Suicidal ideation (or suicidal thoughts) is thinking about, considering, or planning suicide. It is not a diagnosis, but is a symptom of some mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a beha ...
, and more alcohol and (illicit and prescription) drug problems. Similar results have been found among children. Religious coping has especially been shown to correlate positively with positive psychological adjustment to stressors with enhancement of faith-based social support hypothesized as the likely mechanism of effect. However, more recent research reveals the role of religiosity/spirituality in enhancing social support may be overstated and in fact disappears when the personality traits of "agreeableness" and "conscientiousness" are also included as predictors. In a 2013 study, Akey et al. did a qualitative study of 34 men and women diagnosed with an eating disorder and used the
Health Belief ModelThe health belief model (HBM) is a social psychological Social psychology is the Science, scientific study of how the thoughts, feelings, and behaviors of individuals are influenced by the actual, imagined, and implied presence of others, 'imagi ...
(HBM) to explain the reasons for which they forgo seeking social support. Many people with eating disorders have a low perceived susceptibility, which can be explained as a sense of denial about their illness. Their perceived severity of the illness is affected by those to whom they compare themselves to, often resulting in people believing their illness is not severe enough to seek support. Due to poor past experiences or educated speculation, the perception of benefits for seeking social support is relatively low. The number of perceived barriers towards seeking social support often prevents people with eating disorders from getting the support they need to better cope with their illness. Such barriers include fear of social stigma, financial resources, and availability and quality of support. Self-efficacy may also explain why people with eating disorders do not seek social support, because they may not know how to properly express their need for help. This research has helped to create a better understanding of why individuals with eating disorders do not seek social support, and may lead to increased efforts to make such support more available. Eating disorders are classified as mental illnesses but can also have physical health repercussions. Creating a strong social support system for those affected by eating disorders may help such individuals to have a higher quality of both mental and physical health. Various studies have been performed examining the effects of social support on psychological distress. Interest in the implications of social support were triggered by a series of articles published in the mid-1970s, each reviewing literature examining the association between psychiatric disorders and factors such as change in marital status,
geographic mobilityGeographic mobility is the measure of how populations and goods move over time. Geographic mobility, population mobility, or more simply mobility is also a statistic that measures migration within a population. Commonly used in demography Demo ...
, and social disintegration. Researchers realized that the theme present in each of these situations is the absence of adequate social support and the disruption of social networks. This observed relationship sparked numerous studies concerning the effects of social support on mental health. One particular study documented the effects of social support as a coping strategy on psychological distress in response to stressful work and life events among police officers. Talking things over among coworkers was the most frequent form of coping utilized while on duty, whereas most police officers kept issues to themselves while off duty. The study found that the social support between co-workers significantly buffered the relationship between work-related events and distress. Other studies have examined the social support systems of single mothers. One study by D'Ercole demonstrated that the effects of social support vary in both form and function and will have drastically different effects depending upon the individual. The study found that supportive relationships with friends and co-workers, rather than task-related support from family, was positively related to the mother's psychological well-being. D'Ercole hypothesizes that friends of a single parent offer a chance to socialize, match experiences, and be part of a network of peers. These types of exchanges may be more spontaneous and less obligatory than those between relatives. Additionally, co-workers can provide a community away from domestic life, relief from family demands, a source of recognition, and feelings of competence. D'Ercole also found an interesting statistical interaction whereby social support from co-workers decreased the experience of stress only in lower income individuals. The author hypothesizes that single women who earn more money are more likely to hold more demanding jobs which require more formal and less dependent relationships. Additionally, those women who earn higher incomes are more likely to be in positions of power, where relationships are more competitive than supportive. Many studies have been dedicated specifically to understanding the effects of social support in individuals with post traumatic stress disorder (PTSD). In a study by Haden et al., when victims of severe trauma perceived high levels of social support and engaged in interpersonal coping styles, they were less likely to develop severe PTSD when compared to those who perceived lower levels of social support. These results suggest that high levels of social support alleviate the strong positive association between level of injury and severity of PTSD, and thus serves as a powerful protective factor. In general, data shows that the support of family and friends has a positive influence on an individual's ability to cope with trauma. In fact, a meta-analysis by Brewin et al. found that social support was the strongest predictor, accounting for 40%, of variance in PTSD severity. However, perceived social support may be directly affected by the severity of the trauma. In some cases, support decreases with increases in trauma severity. College students have also been the target of various studies on the effects of social support on coping. Reports between 1990 and 2003 showed college stresses were increasing in severity. Studies have also shown that college students' perceptions of social support have shifted from viewing support as stable to viewing them as variable and fluctuating. In the face of such mounting stress, students naturally seek support from family and friends in order to alleviate psychological distress. A study by Chao found a significant two-way correlation between perceived stress and social support, as well as a significant three-way correlation between perceived stress, social support, and dysfunctional coping. The results indicated that high levels of dysfunctional coping deteriorated the association between stress and well-being at both high and low levels of social support, suggesting that dysfunctional coping can deteriorate the positive buffering action of social support on well-being. Students who reported social support were found more likely to engage in less healthy activities, including sedentary behavior, drug and alcohol use, and too much or too little sleep. Lack of social support in college students is also strongly related to life dissatisfaction and suicidal behavior.


Physical health

Social support has a clearly demonstrated link to physical health outcomes in individuals, with numerous ties to physical health including
mortality Mortality is the state of being mortal, or susceptible to death (1906) Death is the permanent, Irreversible process, irreversible cessation of all biological process, biological functions that sustain a living organism. Brain death is some ...

mortality
. People with low social support are at a much higher risk of death from a variety of diseases (e.g., cancer or cardiovascular disease). Numerous studies have shown that people with higher social support have an increased likelihood for survival. Individuals with lower levels of social support have: more
cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart The heart is a cardiac muscle, muscular Organ (biology), organ in most animals, which pumps blood through the blood vessels of the circulatory system. The pumped ...
, more
inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogen In biology Biology is the natural science that studies life and living organisms, including their anato ...
and less effective
immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as Tumor immunology, cancer cells and objects such ...
functioning, more complications during
pregnancy Pregnancy, also known as gestation, is the time during which one or more offspring In biology, offspring are the young creation of living organisms, produced either by a Asexual reproduction, single organism or, in the case of sexual repr ...

pregnancy
, and more functional disability and pain associated with rheumatoid arthritis, among many other findings. Conversely, higher rates of social support have been associated with numerous positive outcomes, including faster recovery from coronary artery surgery, less susceptibility to
herpes Herpes simplex is a viral infection A viral disease (or viral infection) occurs when an organism's body is invaded by pathogen In biology Biology is the natural science that studies life and living organisms, including their anatomy, ...
attacks, a lowered likelihood to show age-related cognitive decline, and better
diabetes Diabetes mellitus, commonly known as just diabetes, is a group of metabolic disorders characterized by a hyperglycemia, high blood sugar level over a prolonged period of time. Symptoms often include frequent urination, Polydipsia, increased th ...

diabetes
control. People with higher social support are also less likely to develop
colds The common cold, also known simply as a cold, is a virus, viral infectious disease of the upper respiratory tract that primarily affects the Respiratory epithelium, respiratory mucosa of the human nose, nose, throat, Paranasal sinuses, sinuses, ...
and are able to recover faster if they are ill from a cold. There is sufficient evidence linking cardiovascular, neuroendocrine, and immune system function with higher levels of social support. Social support predicts less atherosclerosis and can slow the progression of an already diagnosed cardiovascular disease. There is also a clearly demonstrated link between social support and better immune function, especially in older adults. While links have been shown between neuroendocrine functionality and social support, further understanding is required before specific significant claims can be made. Social support is also hypothesized to be beneficial in the recovery from less severe cancers. Research focuses on breast cancers, but in more serious cancers factors such as severity and spread are difficult to measure in the context of impacts of social support. The field of physical health often struggles with the combination of variables set by external factors that are difficult to control, such as the entangled impact of life events on social support and the buffering impact these events have. There are serious ethical concerns involved with controlling too many factors of social support in individuals, leading to an interesting crossroads in the research.


Costs

Social support is integrated into service delivery schemes and sometimes are a primary service provided by governmental contracted entities (e.g., companionship, peer services, family caregivers). Community services known by the nomenclature community support, and workers by a similar title, Direct Support Professional, have a base in social and community support "ideology". All supportive services from
supported employment Supported employment refers to service provisions wherein people with disabilities A disability is a societal imposition on people who have impairments, making it more difficult for people to do certain activities or interact with the world ...
to
supported housing Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives, and is an active "community services and funding" stream across the United States. Supportive housing is ...
,
family support Family support is the support of families with a member with a disability A disability is a societal imposition on people who have impairments, making it more difficult for people to do certain activities or interact with the world around the ...
, educational support, and supported living are based upon the relationship between "informal and formal" supports, and "paid and unpaid caregivers". Inclusion studies, based upon affiliation and friendship, or the conversely, have a similar theoretical basis as do "person-centered support" strategies. Social support theories are often found in "real life" in cultural, music and arts communities, and as might be expected within religious communities. Social support is integral in theories of aging, and the "social care systems" have often been challenged (e.g., creativity throughout the lifespan, extra retirement hours). Ed Skarnulis' (state director) adage, "Support, don't supplant the family" applies to other forms of social support networks. Although there are many benefits to social support, it is not always beneficial. It has been proposed that in order for social support to be beneficial, the social support desired by the individual has to match the support given to him or her; this is known as the matching hypothesis. Psychological stress may increase if a different type of support is provided than what the recipient wishes to receive (e.g., informational is given when emotional support is sought). Additionally, elevated levels of perceived stress can impact the effect of social support on health-related outcomes. Other costs have been associated with social support. For example, received support has not been linked consistently to either physical or mental health; perhaps surprisingly, received support has sometimes been linked to worse mental health. Additionally, if social support is overly intrusive, it can increase stress. It is important when discussing social support to always consider the possibility that the social support system is actually an antagonistic influence on an individual.


Two dominant models

There are two dominant hypotheses addressing the link between social support and health: the buffering hypothesis and the direct effects hypothesis. The main difference between these two hypotheses is that the direct effects hypothesis predicts that social support is beneficial all the time, while the buffering hypothesis predicts that social support is mostly beneficial during stressful times. Evidence has been found for both hypotheses. In the buffering hypothesis, social support protects (or "buffers") people from the bad effects of stressful life events (e.g., death of a spouse, job loss). Evidence for stress buffering is found when the
correlation In statistics Statistics is the discipline that concerns the collection, organization, analysis, interpretation, and presentation of data Data (; ) are individual facts, statistics, or items of information, often numeric. In a m ...

correlation
between stressful events and poor health is weaker for people with high social support than for people with low social support. The weak correlation between stress and health for people with high social support is often interpreted to mean that social support has protected people from stress. Stress buffering is more likely to be observed for perceived support than for social integration or received support. The theoretical concept or construct of resiliency is associated with coping theories. In the direct effects (also called main effects) hypothesis, people with high social support are in better health than people with low social support, regardless of stress. In addition to showing buffering effects, perceived support also shows consistent direct effects for mental health outcomes. Both perceived support and social integration show main effects for physical health outcomes. However, received (enacted) support rarely shows main effects.


Theories to explain the links

Several theories have been proposed to explain social support's link to health. Stress and coping social support theory dominates social support research and is designed to explain the buffering hypothesis described above. According to this theory, social support protects people from the bad health effects of stressful events (i.e., stress buffering) by influencing how people think about and
cope The cope (known in Latin as ''pluviale'' 'rain coat' or ''cappa'' 'cape') is a liturgical vestment, more precisely a long mantle or cloak, open in front and fastened at the breast with a band or clasp. It may be of any liturgical colours, litu ...
with the events. An example in 2018 are the effects of school shootings on the well being and future of children and children's health. According to stress and coping theory, events are stressful insofar as people have negative thoughts about the event ( appraisal) and cope ineffectively. Coping consists of deliberate, conscious actions such as problem solving or relaxation. As applied to social support, stress and coping theory suggests that social support promotes appraisal and coping. Evidence for stress and coping social support theory is found in studies that observe stress buffering effects for perceived social support. One problem with this theory is that, as described previously, stress buffering is not seen for social integration, and that received support is typically not linked to better health outcomes. Relational regulation theory (RRT) is another theory, which is designed to explain main effects (the direct effects hypothesis) between perceived support and mental health. As mentioned previously, perceived support has been found to have both buffering and direct effects on mental health. RRT was proposed in order to explain perceived support's main effects on mental health which cannot be explained by the stress and coping theory. RRT hypothesizes that the link between perceived support and mental health comes from people regulating their emotions through ordinary conversations and shared activities rather than through conversations on how to cope with stress. This regulation is relational in that the support providers, conversation topics and activities that help regulate emotion are primarily a matter of personal taste. This is supported by previous work showing that the largest part of perceived support is relational in nature. Life-span theory is another theory to explain the links of social support and health, which emphasizes the differences between perceived and received support. According to this theory, social support develops throughout the life span, but especially in childhood attachment with parents. Social support develops along with adaptive
personality traits In , trait theory (also called dispositional theory) is an approach to the study of human . Trait theorists are primarily interested in the measurement of ''traits'', which can be defined as habitual patterns of behaviour, , and . According to thi ...
such as low hostility, low neuroticism, high optimism, as well as social and coping skills. Together, support and other aspects of personality ("psychological theories") influence health largely by promoting health practices (e.g., exercise and weight management) and by preventing health-related stressors (e.g., job loss, divorce). Evidence for life-span theory includes that a portion of perceived support is trait-like, and that perceived support is linked to adaptive personality characteristics and attachment experiences. Lifespan theories are popular from their origins in Schools of Human Ecology at the universities, aligned with family theories, and researched through federal centers over decades (e.g., University of Kansas, Beach Center for Families; Cornell University, School of Human Ecology). Of the Big Five Personality Traits, agreeableness is associated with people receiving the most social support and having the least-strained relationships at work and home. Receiving support from a supervisor in the workplace is associated with alleviating tensions both at work and at home, as are inter-dependency and idiocentrism of an employee.


Biological pathways

Many studies have tried to identify
biopsychosocial The biopsychosocial model is an interdisciplinary model that looks at the interconnection between biology Biology is the natural science that studies life and living organisms, including their anatomy, physical structure, Biochemistry, chemic ...
pathways for the link between social support and health. Social support has been found to positively impact the
immune In biology, immunity is the capability of multicellular organisms Multicellular organisms are organism In biology, an organism (from Ancient Greek, Greek: ὀργανισμός, ''organismos'') is any individual contiguous system that emb ...
,
neuroendocrine Neuroendocrine cells are cells that receive neuronal input (neurotransmitter Neurotransmitters are chemical messengers that transmit a signal from a neuron across the synapse to a target cell, which can be a different neuron, muscle cell, or ...
, and
cardiovascular system The circulatory system, also called the cardiovascular system or the vascular system, is an organ system that permits blood to circulate and transport nutrients (such as amino acids and electrolytes), oxygen, carbon dioxide, hormones, and bloo ...
s. Although these systems are listed separately here, evidence has shown that these systems can interact and affect each other. *Immune system: Social support is generally associated with better immune function. For example, being more socially integrated is correlated with lower levels of inflammation (as measured by
C-reactive protein C-reactive protein (CRP) is an annular (ring-shaped) pentameric protein found in blood plasma, whose circulating concentrations rise in response to inflammation. It is an acute-phase protein of hepatic origin that increases following interleukin-6 s ...

C-reactive protein
, a marker of inflammation), and people with more social support have a lower susceptibility to the common cold. *Neuroendocrine system: Social support has been linked to lower
cortisol Cortisol is a steroid hormone, in the glucocorticoid class of hormones. When used as a medication, it is known as hydrocortisone. It is produced in many animals, mainly by the ''zona fasciculata'' of the adrenal cortex in the adrenal gland. ...

cortisol
("stress hormone") levels in response to stress.
Neuroimaging Neuroimaging or brain imaging is the use of various techniques to either directly or indirectly Medical imaging, image the neuroanatomy, structure, function, or pharmacology of the nervous system. It is a relatively new discipline within medicine ...
work has found that social support decreases activation of regions in the brain associated with social distress, and that this diminished activity was also related to lowered cortisol levels. *Cardiovascular system: Social support has been found to lower cardiovascular reactivity to stressors. It has been found to lower
blood pressure Blood pressure (BP) is the pressure Pressure (symbol: ''p'' or ''P'') is the force In physics, a force is an influence that can change the motion (physics), motion of an Physical object, object. A force can cause an object with mas ...

blood pressure
and
heart rate Heart rate is the speed of the heartbeat Heartbeat or heartbeats may refer to: Physiology *Cardiac cycle, of the heart *Contraction of the cardiac muscle, muscles of the heart, or a perceived effect of it, such as: **Heart sounds, the noises gene ...

heart rate
s, which are known to benefit the cardiovascular system. Though many benefits have been found, not all research indicates positive effects of social support on these systems. For example, sometimes the presence of a support figure can lead to increased neuroendocrine and
physiological Physiology (; ) is the scientific Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is an occurrence in the real world. ...
activity.


Support groups

Social support groups can be a source of informational support, by providing valuable educational information, and emotional support, including encouragement from people experiencing similar circumstances. Studies have generally found beneficial effects for social support group interventions for various conditions, including Internet support groups. These groups may be termed "self help" groups in nation-states, may be offered by non-profit organizations, and in 2018, may be paid for as part of governmental reimbursement schemes. According to Drebing, previous studies have shown that those going to support groups later show enhanced social support... in regard to groups such as
Alcoholics Anonymous Alcoholics Anonymous (AA) is an international mutual aid fellowship with the stated purpose of enabling its members to "stay sober and help other alcoholics achieve sobriety." AA is nonprofessional, non-denominational, self-supporting, and apo ...
(AA) and
Narcotics Anonymous Narcotics Anonymous (NA), founded in 1953, describes itself as a "nonprofit fellowship or society of men and women for whom drugs had become a major problem." Narcotics Anonymous uses a 12-step model developed for people with varied substan ...
(NA), were shown to have a positive correlation with participation in their subsequent groups and abstaining from their addiction. Because correlation does not equal causation, going to those meeting does not cause one to abstain from divulging back into old habits rather that this been shown to be helpful in establishing sobriety. While many support groups are held where the discussions can be face to face there has been evidence that shows online support offers the same amount of benefits. Coulson found that through discussion forums several benefits can be added such as being able to cope with things and having an overall sense of well being.''''


Providing support

There are both costs and benefits to providing support to others. Providing
long-term care Long-term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Long term care is focused on individualized and ...
or support for someone else is a chronic stressor that has been associated with anxiety, depression, alterations in the immune system, and increased mortality. Thus, family caregivers and "university personnel" alike have advocated for both respite or relief, and higher payments related to ongoing, long-term care giving. However, providing support has also been associated with health benefits. In fact, providing instrumental support to friends, relatives, and neighbors, or emotional support to spouses has been linked to a significant decrease in the risk for mortality. Researchers found that within couples where one has been diagnosed with breast cancer, not only does the spouse with the illness benefit from the provision and receipt of support but so does the spouse with no illness. It was found that the relationship well being was the area that benefited for the spouses of those with breast cancer Also, a recent neuroimaging study found that giving support to a significant other during a distressful experience increased activation in reward areas of the brain.


Social defense system

In 1959 Isabel Menzies Lyth identified that threat to a person's identity in a group where they share similar characteristics develops a defense system inside the group which stems from emotions experienced by members of the group, which are difficult to articulate, cope with and finds solutions to. Together with an external pressure on efficiency, a collusive and injunctive system develops that is resistant to change, supports their activities and prohibit others from performing their major tasks.


Gender and culture


Gender differences

Gender differences have been found in social support research. Women provide more social support to others and are more engaged in their social networks. Evidence has also supported the notion that women may be better providers of social support. In addition to being more involved in the giving of support, women are also more likely to seek out social support to deal with stress, especially from their spouses. However, one study indicates that there are no differences in the extent to which men and women seek appraisal, informational, and instrumental types of support. Rather, the big difference lies in seeking emotional support. Additionally, social support may be more beneficial to women.
Shelley Taylor Shelley Elizabeth Taylor (born 1946) is a distinguished professor of psychology at the University of California, Los Angeles. She received her Ph.D. from Yale University, and was formerly on the faculty at Harvard University. A prolific author of b ...
and her colleagues have suggested that these gender differences in social support may stem from the biological difference between men and women in how they respond to stress (i.e., flight or fight versus
tend and befriendTend-and-befriend is a behavior exhibited by some animals, including humans, in response to threat. It refers to protection of offspring In biology, offspring are the young born of living organism, organisms, produced either by a single organism o ...
). Married men are less likely to be depressed compared to non-married men after the presence of a particular stressor because men are able to delegate their emotional burdens to their partner, and women have been shown to be influenced and act more in reaction to social context compared to men. It has been found that men's behaviors are overall more asocial, with less regard to the impact their coping may have upon others, and women more prosocial with importance stressed on how their coping affects people around them. This may explain why women are more likely to experience negative psychological problems such as depression and anxiety based on how women receive and process stressors. In general, women are likely to find situations more stressful than males are. It is important to note that when the perceived stress level is the same, men and women have much fewer differences in how they seek and use social support.


Cultural differences

Although social support is thought to be a universal resource, cultural differences exist in social support. In many Asian cultures, the person is seen as more of a collective unit of society, whereas Western cultures are more individualistic and conceptualize social support as a transaction in which one person seeks help from another. In more interdependent Eastern cultures, people are less inclined to enlist the help of others. For example,
European Americans European Americans (also referred to as Euro-Americans) are Americans Americans are the citizens Citizenship is a relationship between an individual and a state to which the individual owes allegiance and in turn is entitled to its p ...

European Americans
have been found to call upon their social relationships for social support more often than
Asian Americans Asian Americans are Americans Americans are the Citizenship of the United States, citizens and United States nationality law, nationals of the United States of America.; ; ''Ricketts v. Attorney General''897 F.3d 491, 494 n.3 (3d Cir. 20 ...
or Asians during stressful occasions, and Asian Americans expect social support to be less helpful than European Americans. These differences in social support may be rooted in different cultural ideas about
social groups In the social sciences, a social group can be defined as two or more people who interact with one another, share similar characteristics, and collectively have a sense of unity. Regardless, social groups come in a myriad of sizes and varieties ...
. It is important to note that these differences are stronger in emotional support than instrumental support. Additionally, ethnic differences in social support from family and friends have been found. Cultural differences in coping strategies other than social support also exist. One study shows that Koreans are more likely to report substance abuse than European Americans are. Further, European Americans are more likely to exercise in order to cope than Koreans. Some cultural explanations are that Asians are less likely to seek it from fear of disrupting the harmony of their relationships and that they are more inclined to settle their problems independently and avoid criticism. However, these differences are not found among Asian Americans relative to their Europeans American counterparts. Different cultures have different ways of socials support. In African American households support is limited. Many black mothers raise their children without a male figure. Women struggle with job opportunities due to job biases and racial discrimination. Many Black women face this harsh reality causing them to go through poverty. When there is poverty within home, the main focus is to make sure the bills are paid. Sometimes causing children to play adult roles and very young age.  Women trying to balance the mom and dad role, takes away from the moral support certain kids need. *
Family support Family support is the support of families with a member with a disability A disability is a societal imposition on people who have impairments, making it more difficult for people to do certain activities or interact with the world around the ...
* Cultural support * Interpersonal emotion regulation *
Invisible supportIn psychology Psychology is the science of mind and behavior. Psychology includes the study of consciousness, conscious and Unconscious mind, unconscious phenomena, as well as feeling and thought. It is an academic discipline of immense scope ...
*
Narcissistic supply In psychoanalytic theory Psychoanalytic theory is the theory of personality organization and the dynamics of personality development that guides psychoanalysis, a clinical method for treating psychopathology. First laid out by Sigmund Freud in the ...
*
Peer support Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other. It commonly refers to an initiative consisting of trained supporters (although it can be provided by peers without training), and can ...
*
Social connection Social connection is the experience of feeling close and connected to others. It involves feeling love Love encompasses a range of strong and positive emotion Emotions are mental state, psychological states brought on by neurophysiolo ...
*
Social undermining Social undermining is the expression of negative emotions directed towards a particular person or negative evaluations of the person as a way to prevent the person from achieving their goal A goal is an idea of the future or desired result th ...
*
Stress (psychological) In psychology Psychology is the scientific Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is an occurrence i ...
*
Supported employment Supported employment refers to service provisions wherein people with disabilities A disability is a societal imposition on people who have impairments, making it more difficult for people to do certain activities or interact with the world ...
*
Supported housing Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives, and is an active "community services and funding" stream across the United States. Supportive housing is ...
*
Welfare Welfare (or commonly, social welfare) is a type of government support intended to ensure that members of a society can meet basic human needs Maslow's hierarchy of needs is an idea in psychology Psychology is the science of mind and ...
* Social Support Questionnaire


References

{{DEFAULTSORT:Social Support Social networks Clinical psychology Communication theory Economic sociology Mental health