Social support

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Old man at a nursing home in Norway.

Social support is the perception and actuality that one is cared for, has assistance available from other people, and that one is part of a supportive social network. These supportive resources can be emotional (e.g., nurturance), tangible (e.g., financial assistance), informational (e.g., advice), or companionship (e.g., sense of belonging) and 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, neighbours, coworkers, organizations, etc. Government provided social support is often referred to as public aid.

Social support is studied across a wide range of disciplines including psychology, medicine, sociology, nursing, public health, and social work. Social support has been linked to many benefits for both physical and mental health, but social support is not always beneficial.

Two main models have been proposed to describe the link between social support and health: the buffering hypothesis and the direct effects hypothesis.[1] Gender and cultural differences in social support have also been found.

Categories and definitions[edit]

Distinctions in measurement[edit]

Social support can be categorized and measured in several different ways.

There are four common functions of social support:[2][3][4]

  • Emotional support is the offering of empathy, concern, affection, love, trust, acceptance, intimacy, encouragement, or caring.[5][6] It is the warmth and nurturance provided by sources of social support.[7] Providing emotional support can let the individual know that he or she is valued.[6] It is also sometimes called esteem support or appraisal support.[2]
  • Tangible support is the provision of financial assistance, material goods, or services.[8][9] Also called instrumental support, this form of social support encompasses the concrete, direct ways people assist others.[5]
  • Informational support is the provision of advice, guidance, suggestions, or useful information to someone.[2][10] This type of information has the potential to help others problem-solve.[5][11]
  • Companionship support is the type of support that gives someone a sense of social belonging (and is also called belonging).[2] This can be seen as the presence of companions to engage in shared social activities.[12]

Researchers also commonly make a distinction between perceived and received support.[7][13] 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.[14]

Furthermore, social support can be measured in terms of structural support or functional support.[15] 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[2] Family relationships, friends, and membership in clubs and organizations contribute to social integration.[16] 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.[17] 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[18]

These different types of social support have different patterns of correlations with health, personality, and personal relationships.[13][19] For example, perceived support is consistently linked to better mental health whereas received support and social integration are not.[13][19] Some have suggested that "invisible support," a form of support where the person has support without his or her awareness, may be the most beneficial.[20][21]


Social support can come from a variety of sources, including (but not limited to): family, friends, romantic partners, pets, community ties, and coworkers.[7] Sources of support can be natural (e.g., family and friends) or more formal (e.g., mental health specialists or community organizations).[22] 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.[23] 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. Additionally, social support from friends did provide a buffer in response to marital stress, because they were less implicated in the marital dynamic[24]

Early familial social support has been shown to be important in children’s abilities to develop social competencies,[25] and supportive parental relationships have also had benefits for college-aged students.[26]

Links to mental and physical health[edit]


Mental health[edit]

Social support is associated with increased psychological well-being in the workplace[27] and in response to important life events.[28] In stressful times, social support helps people reduce psychological distress (e.g., anxiety or depression).[7] 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)[29] Social support has been found to promote psychological adjustment in conditions with chronic high stress like HIV,[30] rheumatoid arthritis,[31] cancer,[32] stroke,[33] and coronary artery disease.[34] Additionally, social support has been associated with various acute and chronic pain variables (for more information, see Chronic pain).

People with low social support report more sub-clinical symptoms of depression and anxiety than do people with high social support.[13][35] 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,[36] panic disorder,[37] social phobia,[38] major depressive disorder,[39] dysthymic disorder,[40] and eating disorders.[41][42] Among people with schizophrenia, those with low social support have more symptoms of the disorder.[43] In addition, people with low support have more suicidal ideation,[44] and more alcohol and drug problems.[45] Similar results have been found among children.[46]

Published in 2013 in the Journal of Affective Disorders, Jessica E. Akey, Lance S. Rintamaki, and Tera L. Kane did a qualitative study of 34 men and women diagnosed with an eating disorder and used the Health Belief Model (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 too, 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.[47]

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 mobility, and social disintegration.[48] [49] 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.[50]

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 affects 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.[51]

Many studies have been dedicated specifically to understanding the effects of social support in individuals with posttraumatic 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.[52] 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[53] However, perceived social support may be directly affected by the severity of the trauma. In some cases, support decreases with increases in trauma severity.[54]

College students have also been the target of various studies on the effects of social support on coping. Recent reports show college stresses have increased in severity [55] 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[56] 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.[57] 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.[58] Lack of social support in college students is also strongly related to life dissatisfaction and suicidal behavior.[59]

Physical health[edit]

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).[17][19] Numerous studies have shown that people with higher social support have an increased likelihood for survival.[60]

Individuals with lower levels of social support have: more cardiovascular disease,[19] more inflammation and less effective immune system functioning,[61][62] more complications during pregnancy,[63] and more functional disability and pain associated with rheumatoid arthritis,[64] among many other findings. Conversely, higher rates of social support have been associated with numerous positive outcomes, including faster recovery from coronary artery surgery,[65] less susceptibility to herpes attacks,[66] a lowered likelihood to show age-related cognitive decline,[67] and better diabetes control.[68] 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.[69]


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.[35][70][71] 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).[72][73] Additionally, elevated levels of perceived stress can impact the effect of social support on health-related outcomes.[74]

Other costs have been associated with social support. For example, received support has not been linked consistently to either physical or mental health;[13][19] if anything, received support has surprisingly been linked to worse mental health.[21] Additionally, if social support is overly intrusive, it can increase stress.[75]

Two dominant models[edit]

There are two dominant hypotheses addressing the link between social support and health: the buffering hypothesis and the direct effects hypothesis.[35] 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.[7]

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).[35] 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[35] or received support.[13]

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.[35] In addition to showing buffering effects, perceived support also shows consistent direct effects for mental health outcomes.[39] Both perceived support and social integration show main effects for physical health outcomes.[19] However, received (enacted) support rarely shows main effects.[13][19]

Theories to explain the links[edit]

Several theories have been proposed to explain social support’s link to health. Stress and coping social support theory;[13][35][70][73] dominates social support research[76] 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,[77] 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.[35][73] Evidence for stress and coping social support theory is found in studies that observe stress buffering effects for perceived social support.[35] One problem with this theory is that, as described previously, stress buffering is not seen for social integration,[78] and that received support is typically not linked to better health outcomes.[13][19]

Relational regulation theory (RRT)[76] 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.[79] 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.[76] 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.[80]

Life-span theory[19] 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,[80] and that perceived support is linked to adaptive personality characteristics and attachment experiences.[19]

Biological pathways[edit]

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.[81] Although these systems are listed separately here, evidence has shown that these systems can interact and affect each other.[19]

  • Immune system: Social support is generally associated with better immune function.[61][82] For example, being more socially integrated is correlated with lower levels of inflammation (as measured by C-reactive protein, a marker of inflammation),[83] and people with more social support have a lower susceptibility to the common cold.[69]
  • Neuroendocrine system: Social support has been linked to lower cortisol ("stress hormone") levels in response to stress.[84] 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.[85]
  • Cardiovascular system: Social support has been found to lower cardiovascular reactivity to stressors.[61] It has been found to lower blood pressure and heart rates,[86] 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.[7] For example, sometimes the presence of a support figure can lead to increased neuroendocrine and physiological activity.[23]

Support groups[edit]

Main article: Support group

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.[87][88] Studies have generally found beneficial effects for social support group interventions for various conditions,[89] including Internet support groups.[90]

Providing support[edit]

There are both costs and benefits to providing support to others. Providing long-term care or support for someone else is a chronic stressor that has been associated with anxiety, depression, alterations in the immune system, and increased mortality.[91][92] 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.[93] 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.[94]

Gender and culture[edit]

Gender differences[edit]

Gender differences have been found in social support research.[14] Women provide more social support to others and are more engaged in their social networks.[78][95][96] Evidence has also supported the notion that women may be better providers of social support.[78] 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.[97] Additionally, social support may be more beneficial to women.[98] Shelley Taylor 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 befriend).[96] 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.[99] It has been found that men’s behaviors are overall more antisocial, with less regard to the impact their coping may have upon others, and women more prosocial-active with importance stressed on how their coping affects people around them.[100][101] This may explain why women are more likely to experiences negative psychological problems such as depression and anxiety based on how women receive and process stressors.[99]

Cultural differences[edit]

Although social support is thought to be a universal resource, cultural differences exist in social support.[14] For example, European Americans have been found to call upon their social relationships for social support more often than Asian Americans or Asians during stressful occasions,[102] and Asian Americans expect social support to be less helpful than European Americans.[103] These differences in social support may be rooted in different cultural ideas about social groups.[102][103] Additionally, ethnic differences in social support from family and friends have been found.[104]

See also[edit]


  1. ^ [1]
  2. ^ a b c d e Wills, T.A. (1991). Margaret, Clark, ed. "Social support and interpersonal relationships". Prosocial Behavior, Review of Personality and Social Psychology 12: 265–289. 
  3. ^ Wills, T.A. (1985). "Supportive functions of interpersonal relationships". In S. Cohen & L. Syme. Social support and health. Orlando, FL: Academic Press. pp. 61–82. 
  4. ^ Uchino, B. (2004). Social Support and Physical Health: Understanding the Health Consequences of Relationships. New Haven, CT: Yale University Press. pp. 16–17. 
  5. ^ a b c Langford, C.P.H.; Bowsher, J.; Maloney, J.P.; Lillis, P.P. (1997). "Social support: a conceptual analysis". Journal of Advanced Nursing 25: 95–100. doi:10.1046/j.1365-2648.1997.1997025095.x. 
  6. ^ a b Slevin, M.L.; Nichols, S.E., Downer, S.M., Wilson, P., Lister, T.A., Arnott, S., Maher, J., Souhami, R.L., Tobias, J.S., Goldstone, A.H., Cody, M. (1996). "Emotional support for cancer patients: what do patients really want?". British Journal of Cancer 74: 1275–1279. 
  7. ^ a b c d e f Taylor, S.E. (2011). "Social support: A Review". In M.S. Friedman. The Handbook of Health Psychology. New York,NY: Oxford University Press. pp. 189–214. 
  8. ^ Heaney, C.A., & Israel, B.A. (2008). "Social networks and social support". In Glanz, K., Rimer, B.K., & Viswanath, K. Health Behavior and Health Education: Theory, Research, and Practice (4th ed.). San Francisco, CA: Jossey-Bass. 
  9. ^ House, J.S. (1981). Work stress and social support. Reading, MA: Addison-Wesley. 
  10. ^ Krause, N. (1986). "Social support, stress, and well-being". Journal of Gerontology 41 (4): 512–519. doi:10.1093/geronj/41.4.512. 
  11. ^ Tilden, V.P.; Weinert, S.C. (1987). "Social support and the chronically ill individual". Nursing Clinics of North America 22 (3): 613–620. 
  12. ^ Uchino, B. (2004). Social Support and Physical Health: Understanding the Health Consequences of Relationships. New Haven, CT: Yale University Press. p. 17. 
  13. ^ a b c d e f g h i Barrera, M (1986). "Distinctions between social support concepts, measures, and models". American Journal of Community Psychology 14 (4): 413–445. doi:10.1007/bf00922627. 
  14. ^ a b c Gurung, R.A.R. (2006). "Coping and Social Support". Health Psychology: A Cultural Approach. Belmont, CA: Thomson Wadsworth. pp. 131–171. 
  15. ^ Wills, T.A. (1998). "Social support". In Blechman, E.A., & Brownell, K.D. Behavioral medicine and women: A comprehensive handbook. New York, NY: Guilford Press. pp. 118–128. 
  16. ^ Lakey, B. "Social support and social integration". Retrieved 2011-11-13. 
  17. ^ a b Uchino, B. (2004). Social Support and Physical Health: Understanding the Health Consequences of Relationships. New Haven, CT: Yale University Press. 
  18. ^ Kessler, R. C.; McLeod, J. D. (1984). "Sex differences in vulnerability to undesirable life events". American Sociological Review 49: 620–631. doi:10.2307/2095420. 
  19. ^ a b c d e f g h i j k Uchino, B. (2009). "Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support.". Perspectives on Psychological Science 4: 236–255. doi:10.1111/j.1745-6924.2009.01122.x. 
  20. ^ Bolger, N.; Amarel, D. (2007). "Effects of social support visibility on adjustment to stress: Experimental evidence". Journal of Personality and Social Psychology 92: 458–475. doi:10.1037/0022-3514.92.3.458. 
  21. ^ a b Bolger, N.; Zuckerman, A.; Kessler, R.C. (2000). "Invisible support and adjustment to stress". Journal of Personality and Social Psychology 79: 953–961. doi:10.1037/0022-3514.79.6.953. 
  22. ^ Hogan, B.; Linden, W.; Najarian, B. (2002). "Social support interventions: Do they work?". Clinical Psychology Review 22 (3): 381–440. doi:10.1016/s0272-7358(01)00102-7. 
  23. ^ a b Kiecolt-Glaser, J.K.; Newton, T.L. (2001). "Marriage and health: His and hers". Psychological Bulletin 127 (4): 472–503. doi:10.1037/0033-2909.127.4.472. PMID 11439708. 
  24. ^ Jackson, P. B. "Specifying the buffering hypothesis: Support, strain, and depression". Social Psychology Quarterly 55: 363–378. doi:10.2307/2786953. 
  25. ^ Repetti, R.L.; Taylor, S.E.; Seeman, T.E. (2002). "Risky families: Family social environments and the mental and physical health of offspring". Psychological Bulletin 128 (2): 330–336. doi:10.1037/0033-2909.128.2.230. PMID 11931522. 
  26. ^ Valentiner, D.P.; Holahan, C.J,, Moos, R.H. (1994). "Social support, appraisals of event controllability, and coping: An integrative model". Journal of Personality and Social Psychology 66: 1094–1102. doi:10.1037/0022-3514.66.6.1094. 
  27. ^ House, J. S. (1981). Work Stress and social support. Addison-Wesley. 
  28. ^ Cobb, S. "Social support as a moderator of life stress". Psychosomatic Medicine 98: 300–314. 
  29. ^ Folkman, S.; Lazarus, R. S. (1991). "coping and emotion". Stress and coping: An anthology. Columbia University Press. 
  30. ^ Turner-Cobb, J.M.; Gore-Felton, C.; Marouf, F.; Koopman, C.; Kim, P.; Israelski, D.; Spiegel, D. (2002). "Coping, social support, and attachment style as psychosocial correlates of adjustment in men and women with HIV/AIDS". Journal of Behavioral Medicine 25: 337–353. 
  31. ^ Goodenow, C.; Reisine, S.T.; Grady, K.E. (1990). "Quality of social support and associated social and psychological functioning in women with rheumatoid arthritis". Health Psychology 9: 266–284. doi:10.1037/0278-6133.9.3.266. 
  32. ^ Penninx, B.W.J.H.; van Tilburg, T., Boeke, A.J.P., Deeg, D.J.H., Kriegsman, D.M.W., van Ejik, J.Th.M. (1998). "Effects of social support and personal coping resources on depressive symptoms: Different for various chronic diseases?". Health Psychology 17: 551–558. doi:10.1037/0278-6133.17.6.551. 
  33. ^ Robertson, E.K.; Suinn, R.M. (1968). "The determination of rate of progress of stroke patients through empathy measures of patient and family". Journal of Psychosomatic Research 12: 189–191. doi:10.1016/0022-3999(68)90045-7. 
  34. ^ Holahan, C.J.; Moos, R.H.; Holahan, C.K.; Brennan, P.I. (1997). "Social context, coping strategies, and depressive symptoms: An expanded model with cardiac patients". Journal of Personality and Social Psychology 72: 918–28. doi:10.1037/0022-3514.72.4.918. 
  35. ^ a b c d e f g h i Cohen, S; Wills, T.A. (1985). "Stress, social support, and the buffering hypothesis.". Psychological Bulletin 98 (2): 310–357. doi:10.1037/0033-2909.98.2.310. PMID 3901065. 
  36. ^ Brewin, C.R.; Andrews, B.; Valentine, J.D. (2000). "Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults". Journal of Social and Clinical Psychology 68: 748–766. doi:10.1037/0022-006x.68.5.748. 
  37. ^ Huang, M; Yen, C.; Lung, F. (2010). "Moderators and mediators among panic, agoraphobia symptoms, and suicidal ideation in patients with panic disorder". Comprehensive Psychiatry 51: 243–249. doi:10.1016/j.comppsych.2009.07.005. 
  38. ^ Torgrud, L.; Walker, J.; Murray, L.; Cox, B.; Chartier, M.; Kjernisted, K. (2004). "Deficits in perceived social support associated with generalized social phobia". Cognitive and Behavioral Therapy 33: 87–96. doi:10.1080/16506070410029577. 
  39. ^ a b Lakey, B., & Cronin, A. (2008). "Low social support and major depression: Research, theory, and methodological issues". In Dobson, K.S., & D. Dozois. Risk factors for depression. Academic Press. pp. 385–408. 
  40. ^ Klein, D.N.; Taylor, E.B.; Dickstein, S.; Harding, K. (1988). "Primary early-onset dysthymia: comparison with primary nonbipolar nonchronic major depression on demographic, clinical, familial, personality, and socioenvironmental characteristics and short-term outcome". Journal of Abnormal Psychology 97: 387–398. doi:10.1037/0021-843x.97.4.387. 
  41. ^ Stice, E; Presnell, K.; Spangler, D. (2002). "Risk factors for binge eating onset in adolescent girls: A 2-year prospective investigation". Health Psychology 21: 131–138. doi:10.1037/0278-6133.21.2.131. 
  42. ^ Grisset, N.I.; Norvell, N.K. (1992). "Perceived social support, social skills, and quality of relationships in bulimic women". Journal of Consulting and Clinical Psychology 60: 293–299. doi:10.1037/0022-006x.60.2.293. 
  43. ^ Norman, R.M.G.; Malla, A.K.; Manchanda, R.; Harricharan, R.; Takhar, J.; Northcott, S. (2005). "Social support and three-year symptom and admission outcomes for first year psychosis". Schizophrenia Research 80: 227–234. doi:10.1016/j.schres.2005.05.006. 
  44. ^ Casey, P.R.; Dunn, G.; Kelly, B.D.; Birkbeck, G.; Dalgard, O.S.; Lehtinen, V.; Britta, S.; Ayuso-Mateos, J.L.; Dowrick, C. (2006). "Factors associated with suicidal ideation in the general population". The British Journal of Psychiatry 189: 410–415. doi:10.1192/bjp.bp.105.017368. 
  45. ^ Stice, E.; Barrera, M., Jr., Chassin, L. (107). "Prospective differential prediction of adolescent alcohol use and problem use: Examining mechanisms of effect". Journal of Abnormal Psychology: 616–628. 
  46. ^ Chu, P.S.; Saucier, D.A.; Hafner, E. (2010). "Meta-analysis of the relationships between social support and well-being in children and adolescents". Journal of Social and Clinical Psychology 29: 624–645. doi:10.1521/jscp.2010.29.6.624. 
  47. ^ Akey, J. E., Rintamaki, L. S., & Kane, T. L. (2013). "Health Belief Model to deterrents of social support seeking among people coping with eating disorders". Journal of Affective Disorders, 145, 246-252. 
  48. ^ Cobb, S. (1976). "Social support as a moderator of life stress". Psychosomatic Medicine 98: 300–314. 
  49. ^ Cassel, J. (1974). "Psychosocial processes and "stress":theoretical formulation". International Journal of Health Services 4 (3): 471–482. doi:10.2190/wf7x-y1l0-bfkh-9qu2. 
  50. ^ Patterson, George T. (2003). "Examining the effects of coping and social support on work and life stress among police officers". Journal of Criminal Justice 31: 215–226. doi:10.1016/s0047-2352(03)00003-5. 
  51. ^ D'Ercole, Ann (1988). "Single Mothers: Stress, Coping, and Social Support". Journal of Community Psychology 16: 41–54. doi:10.1002/1520-6629(198801)16:1<41::aid-jcop2290160107>;2-9. 
  52. ^ Haden, Sara C.; Scarpa, Angela, Jones, Russell T., Ollendick, Thomas H. (2007). "Posttraumatic stress disorder symptoms and injury: the moderating role of perceived social support and coping for young adults". Personality and Individual Differences 42: 1187–1198. doi:10.1016/j.paid.2006.09.030. 
  53. ^ Brewin, C. R.; Andrews B., Valentine, J. D. (2000). "Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults". Journal of Consulting and Clinical Psychology 68 (5): 748–766. doi:10.1037/0022-006x.68.5.748. 
  54. ^ Norris, F. H.; Kaniasty, K. (1996). "Received and perceived social support in times of stress: A test of the support deterioration deterrence model". Journal of Personality and Social Psychology 71 (3): 498–511. doi:10.1037/0022-3514.71.3.498. 
  55. ^ benton, S. A.; Robertson, J. M., Tseng, W. C., Newton F. B., Benton, S. L. (2003). "Changes in counseling client problems over 13 years". Professional Psychology: Research and Practice 34: 66–72. doi:10.1037/0735-7028.34.1.66. 
  56. ^ Daniel, B. V.; Evans, S. G.; Scott, B. R. (2001). New Directions for Student Services 94: 3–13.  Missing or empty |title= (help)
  57. ^ Chao, Ruth Chu-Lien (2012). "Managing Perceived Stress Among College Students: The Roles of Social Support and Dysfunctional Coping". Journal of College Counseling 15 (1): 5–21. doi:10.1002/j.2161-1882.2012.00002.x. 
  58. ^ Thorsteinsson, E. B.; Brown, R. F. (2008). "Mediators and moderators of the stressor-fatigue relationship in nonclinical samples". Journal of Psychosomatic Research 66: 21–29. doi:10.1016/j.jpsychores.2008.06.010. 
  59. ^ Allgower, A.; Wardle, J.; Steptoe, A. (2001). "Depressive symptoms, social support, and personal health behaviors in young men and women". Health Psychology 20: 223–227. doi:10.1037/0278-6133.20.3.223. 
  60. ^ Holt-Lunstad, J.; Smith, T.B.; Layton, J.B. (2010). "Social relationships and mortality ris: A meta-analytic review". PLoS Med 7 (7): e1000316. doi:10.1371/journal.pmed.1000316. PMC 2910600. PMID 20668659. 
  61. ^ a b c Uchino, B. (2006). "Social support and health: A review of physiological processes potentially underlying links to disease outcomes". Journal of Behavioral Medicine 29: 377–387. doi:10.1007/s10865-006-9056-5. 
  62. ^ Kiecolt-Glaser, J.K.; McGuire, L.; Robles, T.F.; Glaser, R. (2002). "Emotions, morbidity, and mortality: New perspectives from psychoneuroimmunology". Annual Review of Psychology 53: 83–107. doi:10.1146/annurev.psych.53.100901.135217. PMID 11752480. 
  63. ^ Elsenbruch, S.; Benson, S.; Rucke, M.; Rose, M.; Dudenhausen, J.; Pincus-Knackstedt, M.K.; Klapp, B.F.; Arck, P.C. (2007). "Social support during pregnancy: effects on maternal depressive symptoms, smoking, and pregnancy outcome". Human Reproduction 22 (3): 869–877. doi:10.1093/humrep/del432. 
  64. ^ Evers, A.W.M.; Kraaimaat, F.W.; Geenen, R.; Jacobs, J.W.G.; Bijlsma, J.W.J. (2003). "Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis". Behaviour Research and Therapy 3: 1295–1310. 
  65. ^ Kulik, J.A.; Mahler, H.I.M. (1993). "Emotional support as a moderator of adjustment and compliance after coronary artery bypass surgery: A longitudinal study". Journal of Behavioral Medicine 16: 45–64. doi:10.1007/bf00844754. 
  66. ^ VanderPlate, C.; Aral, S.O.; Magder, L. (1988). "The relationship among genital herpes simplex virus, stress, and social support". Health Psychology 7: 159–168. doi:10.1037/0278-6133.7.2.159. 
  67. ^ Seeman, T.E.; Lusignolo, T.M.; Albert, M.; Berkman, L. (2001). "Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging". Health Psychology 20: 243–255. doi:10.1037/0278-6133.20.4.243. 
  68. ^ Marteau, T.M.; Bloc, S.; Baum, J.D. (1987). "Family life and diabetic control". Journal of Child Psychology and Psychiatry 28: 823–833. doi:10.1111/j.1469-7610.1987.tb00671.x. 
  69. ^ a b Cohen, S.; Doyle, W.J., Skoner, D.P., Rabin, B.S., Gwaltney, J.M., Jr. (1997). "Social ties and susceptibility to the common cold". Journal of the American Medical Association 277 (24): 1940–1944. doi:10.1001/jama.277.24.1940. PMID 9200634. 
  70. ^ a b Cutrona, C.E (1990). "Types of social support and specific stress: Toward a theory of optimal matching". In Sarason, B.R., Sarason, I.G., Pierce, G.R. Russell, D.W. New York: Wiley & Sons. pp. 319–366. 
  71. ^ Cohen, S., & McKay, G. (1984). "Social support, stress, and the buffering hypothesis: A theoretical analysis". In Baum, A., Taylor, S.E., & Singer, J. Handbook of psychology and health. Hillsdale, NJ: Erlbaum. pp. 253–268. 
  72. ^ Horowitz, L.M.; Krasnoperova, E.N.; Tatar, D.G.; Hansen, M.B.; Person, E.A.; Galvin, K.L.; Nelson, K.L. (2001). "The way to console may depend on the goal: Experimental studies of social support". Journal of Experimental Social Psychology 37: 49–61. doi:10.1006/jesp.2000.1435. 
  73. ^ a b c Thoits, P.A. (1986). "Social support as coping assistance". Journal of Consulting and Clinical Psychology 54: 416–423. doi:10.1037/0022-006x.54.4.416. 
  74. ^ Zhou, Eric S.; Penedo, Frank J.; Lewis, John E. (December 2010). "Perceived stress mediates the effects of social support on health-related quality of life among men treated for localized prostate cancer". Journal of Psychosomatic Research 69 (6): 587–590. doi:10.1016/j.jpsychores.2010.04.019. PMID 21109047. 
  75. ^ Shumaker, S.A.; Hill, D.R. (1991). "Gender differences in social support and physical health". Health Psychology 10: 102–111. doi:10.1037/0278-6133.10.2.102. 
  76. ^ a b c Lakey, B.; Orehek, E. (2011). "Relational Regulation Theory: A new approach to explain the link between perceived support and mental health". Psychological Review 118: 482–495. doi:10.1037/a0023477. 
  77. ^ Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer. 
  78. ^ a b c Thoits, P.A. (1995). "Stress, coping, and social support processes: Where are we? What next?". Journal of Health and Social Behavior 35: 53–79. doi:10.2307/2626957. 
  79. ^ Wethington, E.; Kessler, R.C. (1986). "Perceived support, received support, and adjustment to stressful life events". Journal of Health and Social Behavior 27: 78–89. doi:10.2307/2136504. 
  80. ^ a b Lakey, B. (2010). "Social support: Basic research and new strategies for intervention". In Maddux, J.E., & Tangney, J.P. Social Psychological Foundations of Clinical Psychology. New York: Guildford. pp. 177–194. 
  81. ^ Taylor, S.E. (2007). "Social support". In Friedman, H.S., & Silver, R.C. Foundations of health psychology. New York: Oxford University Press. pp. 145–171. 
  82. ^ Herbert, T.B.; Cohen, S. (1993). "Stress and immunity in humans: A meta-analytic review". Psychosomatic Medicine: 364–379. 
  83. ^ Loucks, E.B.; Berkman, L.F.; Gruenewald, T.L.; Seeman, T.E. (2006). "Relation of social integration to inflammatory marker concentrations in men and women 70-79 years". American Journal of Cardiology 97: 1010–1016. doi:10.1016/j.amjcard.2005.10.043. 
  84. ^ Turner-Cobb, J.M.; Sephton, S.E.; Koopman, C.; Blake-Mortimer, J.; Spiegel, D. (2000). "Social support and salivary cortisol in women with metastatic breast cancer". Psychosomatic Medicine 62: 337–345. 
  85. ^ Eisenberger, N.I.; Taylor, S.E.; Gable, S.L.; Hilmert, C.J.; Lieberman, M.D. (2007). "Neural pathways link social support to attenuated neuroendocrine stress response". NeuroImage 35: 1601–1612. doi:10.1016/j.neuroimage.2007.01.038. PMC 2710966. PMID 17395493. 
  86. ^ Unden, A.L.; Orth-Gomer, K.; Elofsson, S. (1991). "Cardiovascular effects of social support in the work place: twenty-four hour ECG monitoring of men and women". Psychosomatic Medicine 53 (1): 50–60. 
  87. ^ Helgeson, V.S.; Cohen, S. (1996). "Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research". Health Psychology 15: 135–148. doi:10.1037/0278-6133.15.2.135. 
  88. ^ Gottlieb, B.H. (1988). Marshalling social support: Formats, processes, and effects. Newbury Park, CA: Sage. 
  89. ^ Hogan, B.E.; Najarian, B. (2002). "Social support interventions: Do they work?". Clinical Psychology Review 22: 381–440. doi:10.1016/s0272-7358(01)00102-7. 
  90. ^ Hazzard, A.; Celano, M.; Collins, M.; Markov, Y. (2002). "Effects of STARBRIGHT World on knowledge, social support, and coping in hospitalized children with sickle cell disease and asthma". Children's Health Care 31: 69–86. doi:10.1207/s15326888chc3101_5. 
  91. ^ Schulz, R.; O'Brien, A.T.; Bookwala, J.; Fleissner, K. (1995). "Psychiatric and physical morbidity effects of dementia caregiving: Prevalence, correlates, and causes". The Gerontologist 35 (6): 771–791. doi:10.1093/geront/35.6.771. PMID 8557205. 
  92. ^ Kiecolt-Glaser, J.K.; Marucha, P.T.; Malarkey, W.B.; Mercado, A.M.; Glaser, R. (1995). "Slowing of wound healing by psychological stress". Lancet 346: 1194–1196. doi:10.1016/s0140-6736(95)92899-5. 
  93. ^ Brown, S.L.; Nesse, R.M.; Vinokur, A.D.; Smith, D.M. (2003). "Providing social support may be more beneficial than receiving it: Results from a prospective study of mortality". Psychological Science 14: 320–327. doi:10.1111/1467-9280.14461. 
  94. ^ Inagaki, T.K.; Eisenberger, N.I. (2011). "Neural correlates of giving support to a loved one". Psychosomatic Medicine. epub ahead of print. 
  95. ^ Belle, D. (1987). "Gender differences in the social moderators of stress". In Barnett, R.C., Biener, L., Baruch, G.K. Gender and stress. New York: The Free Press. pp. 257–277. 
  96. ^ a b Taylor, S.E.; Klein, L.C.; Lewis, B.P; Gruenewald, T.L.; Gurung, R.A.R.; Updegraff, J.A. (2000). "Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight". Psychological Review 107 (3): 411–429. doi:10.1037/0033-295X.107.3.411. PMID 10941275. 
  97. ^ Tamres, L.; Janicki, D.; Helgeson, V.S. (2002). "Sex differences in coping behavior: A meta-analytic review". Personality and Social Psychology Review 6: 2–30. doi:10.1207/s15327957pspr0601_1. 
  98. ^ Schwarzer, R.; Leppin, A. (1989). "Social support and health: A meta-analysis". Psychology and Health 3: 1–15. doi:10.1080/08870448908400361. 
  99. ^ a b Hobfoll, S.E., Cameron, R.P., Chapman, H.A., Gallagher, R.W. (1996). Social support and social coping in couples. Handbook of Social Support and The Family, 1, 413-433.
  100. ^ Malek, M.J. (2000). Coping profiles within the strategic approach to coping ccale and their relationship to physical and psychological well-being. Kent State University, 1-151.
  101. ^ Roussi, P., Vassilaki, E. (2000). The applicability of the multiaxial model of coping to a greek population. Anxiety, Stress and Coping, 14, 125-147
  102. ^ a b Taylor, S.E.; Sherman, D.K.; Kim, H.S.; Jarcho, J.; Takagi, K.; Dunagan, M.S. (2004). "Culture and social support: Who seeks it and why?". Journal of Personality and Social Psychology 87: 354–62. doi:10.1037/0022-3514.87.3.354. 
  103. ^ a b Kim, H.S.; Sherman, D.K.; Ko, D.; Taylor, S.E (2006). Personality and Social Psychology Bulletin 32: 1596–1607.  Missing or empty |title= (help)
  104. ^ Sagrestano, L.M.; Feldman, P.; Killingsworth-Rini, C.; Woo, G.; Dunkel-Schetter, C (1999). "Ethnicity and social support during pregnancy". American Journal of Community Psychology 27 (6): 873–902.