Saturday, July 31, 2010

How does a social support system affect mental health?


Introduction

Social support is a pervasive phenomenon spanning people’s relationships throughout their lives. In everyday life, particularly in times of distress, people convey a need for support from relatives, friends, partners, coworkers, or other members of their social community. This powerful inclination to seek and provide support is thought to have adaptive evolutionary significance because interdependency may enhance the likelihood of survival, especially when under threat of predation. The human response to seek the presence of others in the aftermath of natural disasters or other trauma testifies to the need for and benefits of social affiliation. Research suggests that social support is sought to such an extent because it is an effective method of coping with stress and may protect against potential adverse mental health consequences.













A primary psychological need to belong may underlie the tendency to turn to others under demanding circumstances. In support of this possibility, aside from fostering adjustment to stressful and demanding events, a sufficient quantity and quality of support are essential for optimal functioning in daily life. It is important that social contact is regular, positive, and meaningful, and that interaction is perceived as having the potential for disclosure of private and sensitive feelings. The need to belong may compel people to provide this kind of emotional support or more tangible assistance to those with whom they have formed interpersonal attachments. Indeed, the theoretical literature has proposed several types of social support in a bid to form a taxonomy of support and to detail the situations in which various types of social support are most effective.




Instrumental and Emotional Social Support

The numerous ways that supportive people can help others have been categorized broadly as either instrumental or emotional in focus. Instrumental support involves the provision of direct, pragmatic assistance aimed at solving problems. This can be by passing on information to facilitate better understanding of a stressful event, by helping to remove obstacles or counteract losses and harm, or by providing goods or financial assistance. Instrumental assistance can reduce the impact of a stressor by promoting effective coping strategies through the distribution of information and by facilitating protective action through the supply of tangible resources. Emotional support, in contrast, is aimed at the person instead of the objective problem or stressor. It may include helping the person escape from negative emotions and feel better, conveying warmth and affection, reaffirming a commitment to a nurturing relationship, talking about emotions, listening to what the suffering person wants to say, and in general encouraging the other person to feel loved, cared for, and valued.


Evidence within the social support literature is mixed as to whether instrumental or emotional support is more important for mental health. In 1999, Chockalingam Viswesvaran and colleagues conducted a meta-analysis of social support studies focusing on work situations and found emotional support to be more predictive of good outcomes following stressful experiences. Instrumental support may have a closer relationship with physical health, as demonstrated by Viveca Östberg and Carin Lennartsson, who found economic support to be more predictive than emotional support of good physical health. Emotional support may potentially capture the essence of social support more completely than instrumental support, insofar as it contributes to feeling worthwhile, competent, and esteemed as a member of a group. However, substantial overlap is typically observed in the measurement of both types of support. This may reflect the emotional meaning of instrumental support and how certain emotions facilitate action. For example, information may relieve emotional concerns such as worry and anxiety, and positive emotion may promote problem-solving behavior.


Therefore, although a taxonomy of social support strategies is useful, the distinction between types is by no means absolute, and instrumental and emotional support may interact. As is apparent in the definition of social support, it is important to recognize that it is not enough that support is in place, but rather that the perception or experience of that assistance is required for effects to occur.




Experience of Social Support

Considerable reassurance can be found in simply knowing that one is cared for and that support is available from others in times of distress. Implicit social support refers to the emotional comfort derived from social networks without explicit discussion of problems or stressful events. The perception of social support is the comfort of implicit social support combined with the belief that others can be relied on to provide care and solace when needed. This perception has been shown not to coincide exactly with the actual amount of instrumental or emotional support that one receives. In fact, perceived available social support can be beneficial in reducing stress even if support is not actually used. Sheldon Cohen and S. Leonard Syme in 1985, and several researchers since, have provided evidence that beliefs about the availability of social support are more closely related to mental health than received support. The critical importance of subjective perceptions of social support opens up the question as to what psychological factors may condition how support is viewed.


The extent to which a person feels affective concern from others may be substantially related to factors such as personality, attachment style, and various needs and goals. For instance, Nancy Collins and Brooke Feeney in 2004 showed the construal of supportive interaction to vary as a function of the participant’s attachment style. Insecure attachment is characterized by a diminished expectation that others will be emotionally available and responsive when needed. Such anxious or avoidant people rated messages sent by an assigned partner in a stressful task as less supportive than did securely attached people. The divergence between the support that insecurely attached people feel they need and the support they perceive to be available has been linked to early experiences with parents or other attachment figures. Such experiences are thought to negatively influence both the construal of social support and the cultivation of supportive relationships by enhancing the salience of potential rejection and stimulating avoidance behaviors.


The urge to approach rather than avoid others has been linked to positive emotion, which functions to broaden momentary thought-action repertoires and build personal resources. In the context of social support, considering the well-being of others and having compassionate goals has been shown to build support over time. Jennifer Crocker and Amy Canevello in 2008 demonstrated compassionate goals to increase perceived social support, connectedness, and trust over a ten-week period in first-semester college students. Goals are thought to condition the development of one’s support system. This occurs positively when the focus of the relational goal is on supporting others and responding to their needs rather than obtaining something for the self (for example, promoting a desired self-image through one’s relationships). In this way, responsiveness is reciprocated even though this is not the primary goal of support offered out of compassion.




Protective Role of Social Support

In 1995, Roy Baumeister and Mark Leary proposed that humans have a fundamental need to belong, and that a sufficient quantity of stable interpersonal relationships characterized by affective concern is essential for optimal levels of well-being in daily life. Integration in a social network characterized by mutual obligation and the perception that one is loved and cared for can have ameliorative effects on mental health through promoting a stream of positive feelings, a sense of stability, and a perception that one has a worthwhile role in the community. Evidence supporting the beneficial effects of social integration has been detailed by Sheldon Cohen and Thomas A. Wills, who describe a main effect model of social support. In this model, social integration can enhance well-being without improving the capacity for coping with stressful events. However, the authors show that another form of social support, perceived available support, protects against the effects of stressful events, thus mitigating the relationship between stressors and the development of mental illness. This stress-buffering model has led to the proposition that deficits in social support enhance the risk for depression, alcoholism, anxiety, and psychosomatic symptoms. Michael Windle in 1992 showed that parental social support, but not peer support, had beneficial stress protective effects. Similarly, Eric Stice and colleagues, in a 2004 prospective study, demonstrated that deficits in parental but not peer support were related to a worsening of depressive symptoms over time and an increased likelihood of the onset of major depression.


As well as the source of social support, there is evidence to suggest that the type and degree of explicitness of support are important factors in determining the effect of the support provided. Stephanie Brown and colleagues in 2003 found that providing social support to others can be more beneficial to health and well-being than receiving support, and can even reduce the risk of mortality. Actively supporting others may reinforce existing relationships, provide a sense of meaning, and fortify the belief that one is esteemed and matters to others. Explicit acts of support may have potential costs to the recipient, such as leading to perceptions of being a burden, and feelings of stress, guilt, and indebtedness. Support may be most effective when responsiveness is subtle and the receiver is unaware of the explicit action of the support network. For example, when stressful decisions are being made regarding college course selection, job changes, or resolving interpersonal problems, explicit advice from multiple and potentially conflicting sources can interfere with decision making and cause additional stress. Less visible emotional support may reduce the distress associated with major life changes or threatening situations. It is also imperative that there is a suitable match between the support provider and the type of support provided. During times of stress, emotional support may be best received from an intimate partner or one’s immediate family, whereas information and advice may be more welcomed from an expert.




Bibliography


Baumeister, Roy F., and Mark R. Leary. “The Need to Belong: Desire for Interpersonal Attachments as a Fundamental Human Motivation.” Psychological Bulletin 117.3 (1995): 497–529. Print.



Brown, Stephanie, Randolph M. Nesse, Amiram D. Vinokur, and Dylan M. Smith. “Providing Social Support May Be More Beneficial than Receiving It: Results from a Prospective Study of Mortality.” Psychological Science 14.4 (2003): 320–27. Print.



Bruhn, John G. The Sociology of Community Connections. New York: Springer, 2011. Print.



Cohen, Sheldon, and Thomas A. Wills. “Stress, Social Support, and the Buffering Hypothesis.” Psychological Bulletin 98.2 (1985): 310–57. Print.



McDonnell, Roberta. Creativity and Social Support in Mental Health. New York: Palgrave, 2014. Print.



Roy, Ranjan. Social Support, Health, and Illness. Toronto: U of Toronto P, 2011. Print.



Stice, Eric, Jennifer Ragan, and Patrick Randall. “Prospective Relations Between Social Support and Depression: Differential Direction of Effects for Parent and Peer Support.” Journal of Abnormal Psychology 113.1 (2004): 155–59. Print.



Taylor, Shelley. “Social Support.” Foundations of Health Psychology. Ed. Howard S. Friedman and Roxane C. Silver. New York: Oxford UP, 2006. Print.

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