Social Support is a multidimensional construct which is not unilaterally beneficial i.e. maladaptive vicarious learning; Dependence; Provision of bad advice. It is generally thought that the more social support a person receives the more beneficial upon their health and well-being. Access to appropriate resources may protect the individual from the deleterious effects of stress Martin (1989). Lazarus and Folkman (1984) state all else being equal, morale, health and functional capabilities will be better if support is perceived to be adequate.
Levels of social support a person receives have been associated with mental and physical health and well-being. In stressful times, social support helps people reduce psychological distress (e.g., anxiety or depression). Social support has been found to promote psychological adjustment in conditions with chronic high stress like HIV, rheumatoid arthritis, cancer, stroke, and coronary artery disease. People with low social support report more sub-clinical symptoms of depression and 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, panic disorder, social phobia, major depressive disorder, dysthymic disorder, and eating disorders.
Social support has numerous ties to physical health, including mortality. People with low social support are at a much higher risk of death from a variety of diseases (e.g., cancer, 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, more inflammation and less effective immune system functioning, more complications during 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 attacks, a lowered likelihood to show age-related cognitive decline, and better diabetes control. People with higher social support are also less likely to develop colds and are able to recover faster if they are ill from a cold.
There are two main hypotheses that address the link between social support and health: the buffering hypothesis and the main 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 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.
In the 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.
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 with the events. 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 adaptive 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 main 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 such as low hostility, low neuroticism, high optimism, as well as social and coping skills. Together, support and other aspects of personality 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.
Many studies have tried to identify biopsychosocial pathways for the link between social support and health. Social support has been found to positively impact the immune, neuroendocrine, and cardiovascular systems. In terms of the 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, a marker of inflammation), and people with more social support have a lower susceptibility to the common cold.
In terms of the neuroendocrine system, Social support has been linked to lower cortisol (“stress hormone”) levels in response to stress. Neuroimaging 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. Finally, The Cardiovascular system and Social support have been linked as social support has been found to lower cardiovascular reactivity to stressors. It has been found to lower blood pressure and heart rates, which are known to benefit the cardiovascular system.
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