Social Support And Stress Research Paper

1. History Of The Study Of The Beneficial Effects Of Supportive Ties

Although the concept of social support was introduced in the social sciences in the 1970s, the idea that social relations may have a health-enhancing function is long-standing. Moreover, medicine has often spoken of the curative aspects of love, friendship, and positive social attachments. The influence of positive social interactions on mental health were first introduced in psychiatry by the French physician, Pinel, in the early nineteenth century and the English and American physicians, Connoly and Rush, in the late eighteenth to mid-nineteenth centuries. Having witnessed the madhouses of the time at Bedlam and the Bictre, they found that maniacs were treated with great cruelty. They offered a radical alternative to treatment. They suggested instead, that the mentally ill be treated gently, with patience, and with the use of ‘kindness’ and ‘community’ as the active ingredients of treatment.

Sociological influences into the importance of positive social attachments can be traced to the seminal work of Durkheim (1897), who found suicide to be related to social alienation from others. Later, the Chicago School of Sociology represented by Park et al. (1926) in their classic book The City, proposed that health and social accomplishment vs. sickness and deviancy were consequences of the extent that social groups were integrated into and supported by the broader community. Their theory was ahead of its time, and clearly challenged the then current explanations that genetic or moral inadequacy was responsible for deviancy. Such genetic and morality explanations were the predominant psychological view of the time held by such eminent scholars as Lewis Terman of Stanford and Robert Yerkes of Harvard, who argued that Jewish and other ‘brunette’ immigrant groups were genetically inferior and should be prevented from immigrating (Kamin 1974). Moving to more recent empirical investigations, researchers in the 1970s examined the relationship between social attachments and wellbeing. They found an association between socioenvironmental conditions and infant mortality, tuberculosis, and mental illness. They noted that social disorganization and negative social conditions contributed to increased illness on psychological and physical levels.

In a pioneering investigation, Berkman (1977) examined the social relationships and health of a random sample of adults in Alameda County, California. Those individuals who had ongoing social relationships, such as marriage, close friendships and relatives, church membership, and informal and formal group associations, had the lowest mortality rates. She interpreted her findings to mean that social isolation and lack of social and community ties disrupted people’s disease resistance and that the presence of positive social attachments, in contrast, acted as a resistance resource. But how are social relationships translated into physical or emotional health? Sarason (1974) suggested that people obtained a psychological sense of community, and theorized that this sense of community contributed to people’s wellbeing. The healthy community guards its residents by facilitating healthy behavior (caring), offering people a positive sense of who they are (self-esteem), provides for safety and mutual support, and opens access to resources. He defined psychological sense of community as ‘the sense that one was part of a readily available, mutually supportive network of relationship upon which one could depend … (who are) part of the structure of one’s everyday living … (and) available to one in a ‘‘give and get’’ way.’ The work of Caplan (1974), a pioneering psychiatrist, was perhaps the first to identify the concept of social support and its importance in the stress process as the active ingredient that these other theorists were noting. Caplan identified the nature of the process by which social relationships provided psychological sustenance, acting ‘to mobilize … psychological resources and master … emotional burdens; share tasks; and supply (needed resources)’ (Caplan 1974). Caplan further emphasized that support provision supplied and activated resources, but also contributed to a positive sense of another critical stress resistance resource— sense of mastery.

2. Social Support’s Influence On Mental And Physical Health

When people encounter stressful conditions they may benefit from the assistance of others. The people who they naturally might rely on are termed their social support network. The social support network consists of the constellation of individuals who have a relationship with one another that is characterized by helping. How strong the social support network is depends on how often social support occurs between network members, the kinds of support that is communicated through the network, and the strength of the ties. Different kinds of social support networks also perform different function. To find a job, a large, loosely connected network may be of most assistance, even though the relationships are not close. The greater number of contacts may maximize the chance of learning about job openings and obtaining interviews. In contrast, many studies have shown that when major life stressors occur, such as death, illness, or divorce, then a small intimate network might prove most helpful. In such a close network, people are more likely to share their sorrows and receive consistent, ongoing help and emotional succor. Moreover, the help received from intimate others has greater personal meaning (Sarason et al. 1986). Social support contributes both to mental and physical health. Social support is related to lower psychological distress in the form of anxiety and depression. Comprehensive reviews of the literature found that social support contributes to mental health both through the positive feelings that are engendered by having close attachments with others and because help is mobilized in times of need (Cohen and Wills 1985, Schwarzer and Leppin 1989). The attachment aspects of social support are seen as contributing to wellbeing whether or not stressful events are present. This has been called support’s direct effect. In contrast, the contribution of the actual receipt of support and knowing support will be forthcoming if needed may prove most beneficial during high stress periods. In this regard, those who have access to social support do better in particular when challenged by stressful circumstances. This has been called support’s stress buffering effect.

Research has also examined social support’s positive impact on physical health. Comprehensive reviews of this literature found that social support contributes to better clinical health outcomes (i.e., less disease) (House et al. 1988) and more positive stress responding on a physiological level that is subclinical (Uchino et al. 1996). Social support is related to lower morbidity and mortality across a wide array of diseases including heart disease, cancer, and the common cold. Those who are ill but who obtain social support also have been found to have less severe symptoms including less pain, less physical disability, and more rapid recovery. On a physiological level that underlies health, social support is related to beneficial influences on cardiovascular, endocrine, and immune systems. Social support may, in part, help by encouraging positive health behavior but this does not seem to be the major channel through which its positive influence occurs. Rather, social support has direct benefits on lowering cardiovascular reactivity, improved immune responding, and more physiologically adaptive responding of stress-related hormones. As in the mental health studies, support from intimates seems most important for sustaining physical health.

In the excitement and groundswell of interest in social support, researchers and theorists almost entirely forgot that interpersonal relationships could also be a critical source of stress. Rook (1984) shattered this honeymoon with the social support concept by reminding the field that interpersonal conflict was also one of the main contributors to stress. Moreover, it is notable that positive and negative social interactions often emanate from the same people. Rook also showed that when positive and negative interactions cooccur, that the negative ones are more disruptive of wellbeing than the positive ones are health enhancing. In work with women during the Israel–Lebanon War, researchers further found that even positive social interactions could have a negative impact when people shared a crisis. They called this the pressure cooker effect, whereby stress contagion occurs among people who find their resources commonly drained and their problems accentuated by having to deal with the same severe problem. This finding is especially critical because many of life’s problems impact families or groups of people in a shared way, such as the case when there is a death in the family or in the face of disaster.

3. Social Support And The Exchange Of Resources

The process and value of social support is placed in broader ecological context by Hobfoll’s (1998) Conservation of Resources (COR) theory. COR theory’s basic tenet is that people strive to obtain, retain, protect, and foster that which they value. These things that they value are termed resources. Resources are either valued in their own right or serve as a means of obtaining valued ends. There are four basic kinds of resources: objects, conditions, personal characteristics, and energies. Object resources are physical entities that are valued such as transportation, a house, or a diamond ring. Condition resources are social circumstances that avail people to other resources, such as love, money, status, or shelter. They include such conditions as marriage, tenure, and employment. Personal characteristics include skills or personality attributes that enable an individual to better withstand stressful conditions, achieve desired goals, or obtain other resources. They include personal attributes such as sense of mastery, self-esteem, and optimism and skills such as job skills or social skills. Finally, energy resources are resources that can be used to obtain other resources, but that may become valued in and of themselves. They include money, credit, and knowledge.

COR theory proposes that stress occurs when people (a) are threatened with resource loss, (b) actually lose resources, or (c) fail to gain resources following resource investment. Further, people use resources in order to limit such losses or to gain resources. For example, people use self-esteem in order to bolster their self-confidence after doing poorly on an examination. Similarly, people invest money to purchase insurance in order to offset potential financial loss. Because resources are often hard to obtain and maintain, resource loss according to COR theory is considered to be more salient and of greater impact than resource gain. Resource gain, in turn, becomes more important in the face of resource loss.

COR theory helps explain the importance of social support. People have limited resources and, especially when under stress, they may find their resources inadequate. Through social support people can rely on others to offer the resources they lack, bolster their flagging resources, or remove them from the stressful circumstances so that they can regain resources or the ability to use their resources. This may take the form of offering object resources, such as shelter or transportation, and energy resources, such as money or information. It may also take the form of bolstering personal resources that the stressful conditions have depleted. For example, divorce may compromise individuals’ self-confidence, hope, and optimism. Emotional support can act to replenish these diminished resources by reminding individuals that they are loved, important, and likely to succeed in the future. COR theory also explains the potential costs of social support. First, the resources offered may be of poor quality. Supportive messages may contain submessages that are actually undermining, such as when people offer support but imply that they have the upper hand. Second, using social support means incurring social obligations that may be costly in the future. This is the case because people often refrain from wanting to incur obligations, and because when they need to return the favors bestowed upon them they may have to risk valuable resources at an inopportune time. This may differ in communal vs. individualistic cultures, but even in communal cultures where the transport of support is more balanced, incurring obligations has social costs.

A third cost of obtaining social support is that other resources often have to be expended to call on and employ help. Reaching out to others requires time, a critical resources that may already be taxed during stressful conditions. Calling on help may also force people to admit to some inadequacy, which they may not wish to acknowledge. Particularly in Anglo-Saxon and Germanic cultures the concept of ‘standing on one’s own two feet’ is a central value. This, in turn, may diminish self-esteem, self-confidence, and sense of mastery.

COR theory further emphasizes that social support is not just a matter of receiving resources from others when needed. Building a supportive social network requires extensive, long-term outlays of resources in order to build and maintain supportive ties. This means that to have support available requires a history of resource investment. In some relationships this may be one-sided, as in parent–child relations. Similarly, different relationships are characterized by varying histories of give and take. These patterns will set the stage for the commerce of social support when a crisis occurs.

4. Fitting Of Social Support To The Type Of Stress

The help offered by social support may or may not fit the demands of any given stressful situation. This relationship between the nature of the demand and the adequacy of social support in meeting those demands has been termed social support fit. Emotional support has been found to fit many kinds of demands, and is the most robust, wide-reaching kind of support. However, even emotional support may not be appropriate for a given demand. When advice is needed it is important that the right kind of advice be available. Similarly, when support is needed for tasks some kinds of help may hinder more than they help.

An important aspect of social support fit is highlighted by COR theory. Specifically, many stressful circumstances are chronic. COR theory suggests that resource reservoirs are finite and that even if initial support has excellent fit with demand, this does not mean that the right kinds of support will be available for the ongoing demands that ensue (Norris and Kaniasty 1996). People, however loving and helpful, may need to return to their own immediate family or may need to shelter their resources for the needs of other members of the family. How this is the case with money is readily understood, but love too takes time to communicate. Even a parent may have to withdraw resources from a needy child so as not to sacrifice the needs of other children at some point. Chronic stressors will deplete individuals’ resource reservoirs and those of their support system.

5. Future Research Directions

Future research on social support is likely to take a number of directions. On the biological level, researchers are only beginning to uncover the relationships between social support and physiological reactivity and disease. Research will examine more specific diseases and the interaction of social support with the time element of disease. Hence, researchers will be examining social support’s impact on premorbid states, disease onset, and recovery. On the physiological level, research will be looking at how social support influences physiological reactivity that precedes disease or sustains health.

On the more social psychological level, research will be investigating developmental aspects of social support in terms of how it comes about and how it is sustained. This will include evaluation of how culture plays a role in social support interactions and the different meanings of social support in different cultures. Social support’s impact will continue to be examined in every imaginable stressful circumstance, from university examinations, to the workplace, to disasters. With an aging population, how social support impacts the process of adaptation among older adults will be an expanding area of interest. It is clear that social support is multifaceted and can be looked at on multiple levels and interest in the topic is likely to not only continue but to actually increase in scope.

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