Social Networks – Mental Health Matters

What is Communal Coping?

Published on 02/03/2023 by Andrew MarshallLeave a comment

Introduction

Communal coping is the collective effort of members of a connected network (familial or social) to manage a distressing event (Lyons, Michelson, Sullivan and Coyne, 1998). This definition and the scope of the concept positions communal coping as an offshoot of social support.

According to Lyons et al. (1998), the communal coping conceptual framework emerged for two reasons. First, to expand the research that supports the claim that the coping process sometimes requires individual and collective effort (e.g. Fukuyama, 1995). Second, the need for a specific framework for investigating the cooperative characteristic of coping. To support the need for a framework which explores the social aspect of coping as a combined effort, the authors argued that the communal coping conceptual framework emphasizes the connectedness and reliance on personal network for coping. Developments to the communal coping framework include the explanation of the complex nature of the communal coping process (Afifi, Helgeson & Krouse, 2006) and specific personal outcomes (Helgeson, Jakubiak, Vleet, & Zajdel, 2018) following a communal coping process.

Background

Lyons et al. (1998) introduced the communal coping framework. The first model Lyons et al. (1998) proposed mainly distinguished between communal coping and existing perception of coping as an individualistic or prosocial process. Also, the model provided a lens for examining other aspects of coping such as the benefits, cost and influential factors. Afifi, Hutchinson, and Krouse (2006) noted some of the achievements of the model is that it accounts for the relational process within coping and shifts the focus of researchers from treating the phenomenon as mainly a psychological process but also a relational or communication.

However, despite the contributions of the model to the coping research, some questions still need an answer and a couple of research challenges remained unaddressed. For instance, Afifi et al. (2006) noted some researchers confused the process of communal coping for collective coping, types, provision and seeking of social support. The scholars attributed the lack of conceptualisation of communal coping as one of the factors responsible for the confusion. To address this gap in research and advance the existing model by Lyon’s and colleagues, Afifi et al. proposed a theoretical framework. The scholars anticipated the model will serve as a template for measuring communal coping.

The goals for designing the new model were specifically to understand the communal coping process within naturally occurring groups (e.g. post-divorce families). Through the new model, Afifi et al. (2006) attempted to:

Provide a description of the complexities that characterise relying on other people to cope with a stressful event;
Expand the discourse on the dynamic and interactive nature of the coping process;
Explore the various factors that contribute to stressors within groups;
Identify how characteristics of the group such as its structure, the beliefs, norms, and perspectives of its members are likely to influence the coping process; and
Examine how context, source, and nature of the stressor impact the coping process.

The refinement of the model addressed the problems Lyon and colleagues’ model could not account for. Nonetheless, one question remained unanswered ‘how does communal coping influence coping outcome?’. Thereby still leaving a gap in research. Helgeson, Jakubiak, Vleet, and Zajdel (2018) attempted to fill this gap by proposing a model that acknowledges the adjustment process and outcome of communal coping.

Similar to prior models, Helgeson et al’s (2018) framework identified supportive communication as a significant aspect of communal coping that is linked to individual adjustment to a stressor (e.g. illness). A core tenet within the model is that communication enhances coping outcomes. In this vein, Helgeson et al’s model purports the outcomes of communal coping for stressed individuals include:

A high sense of control over the stressor;
Perception of the stressor as less stressful;
Enhanced feeling of self- regulatory capacity; and
Experiencing quality relationships.

Components of Communal Coping

The existing research on coping (Lazarus & Folkman, 1984) served as a backdrop for the development of the communal coping framework. Zimmer-Gembeck and Skinner (2009, p.333) defined coping as:

“how people of all ages mobilize, guide, manage, coordinate, energize, modulate, and direct their behavior, emotion, and orientation (or how they fail to do so) during stressful encounters”.

From this definition, one can infer coping researchers consider the management of a stressor as an individual effort. In addition, despite the significant contribution of coping studies to empirical knowledge in research areas such as coping resources (Lazarus & Folkman, 1980) and maintaining these resources (Hobbfall, 1989) it is still important to understand how collective coping efforts could make a difference in coping outcome of collective stressors such as the death of a breadwinner, natural disasters, environmental hazards, and epidemics. During these kinds of events, the desire to cope may not necessarily be for self-interest but the preservation of existing relationships and promoting the wellbeing of others that are affected. In these cases, collectively coping as part of a community or family supersedes individual effort to manage the distress. In this vein, Lyons et al. (1998) suggested the components of communal coping are salient and activated in such situations where at least one person treats the distressing event as ‘our problem’. Therefore, the components of the communal coping process require a communal coping orientation, communication about the stressor and cooperative action to address the stressor.

The components of communal coping may be defined as active steps towards achieving a positive coping outcome as part of a social unit. Lyons et al. (1998) proposed these active steps begin with one person adopting a communal orientation about how to manage the distressing event. The outcome of this action is the individuals involve share a mutual understanding of how to manage and overcome the stressor as a social unit versus ‘your problem’ where a specific individual is responsible for managing and overcoming the stressor. The actualisation of this first step largely depends on and is completed through communication. In other words, the individuals involved need to communicate about the stressor.

Communication allows for a conversation about the situation, circumstances, and likely solutions. The conversations at this point may be controlled by the individual experiencing the stressor to inform members of their network who are willing to share responsibility for the stressor on how the issue should be addressed. Or, the conversation may be controlled by members of the personal network of the individual experiencing the stressor to negotiate their involvement in how to manage the stress. Irrespective of the direction the communication takes, the primary goal is to share a common sense of responsibility for the stressor as “our problem” among the people involved.

The outcome of the first two steps le toad the emergence of a sense of cooperative action. At this point, everyone works cooperatively to create strategies for alleviating the problem or stressor. Given that there is a likelihood for the processes of the three components of communal coping to unfold differently across situations and for affected individuals, it is not unusual to find differences in communal coping styles. Some of the factors responsible for these differences include the sense of obligation experienced by the connected individuals (Stack 1974) or compassion for others (Nussbam, 1990); the type and purpose of the relationship as well as the characteristics of the individual in the leadership role and personalities of members within the communal coping network (Lyon et al. 1998). However, despite these differences in coping styles, communal coping is beneficial for the management of and recovery from a distressing event.

Influences on Communal Coping

Lyon et al. (1998) suggested four factors that influence how people use communal coping – situation, cultural context, characteristics of the personal relationship and sex. For instance, in a study on the role of marriage on health behaviours, Lewis, McBride, Pollak et al. (2006) discovered the transformation of motivation influenced how one chooses to help the other cope through a stressor. The scholars argued that in the case of romantic relationships, one partner’s mere realization that a stressor (e.g. health treat) poses a danger to relationship quality could motivate the need for communal coping.

In addition, the perceived salience of communal coping within certain situations is defined by the severity of the stressor. Therefore, the ways individuals define the severity of a problem are likely dependent on:

The priority or relevance attached to the problem;
If they are directly or indirectly affected; and
The decision whether to employ an individual or collective coping strategy.

In this vein, following their studies on communal coping within post-divorce families, Afifi, Hutchinson, and Krouse (2006, p.399) argued the “specific demands or requirement of a stressor” influence the communal coping process.

The cultural context in which the distressing event occur also influence the salience of communal coping in alleviating the stressor. The concepts of collectivism and individualism are often used in cultural comparative studies about a phenomenon. Cultures that promote group interest (collectivist cultures) over personal goals (individualist culture) are more likely to invest in communal coping (refer to Bryer, 1986). Given that culture is a way of life, it reflects in the performance of our relationships such as how we define close relationships and depend on these relationships (Lyons et al., 1998). Therefore, one can conclude that relationships in which strong relational ties exist will perhaps guarantee better performance of communal coping than relationships without strong relational ties.

Moreover, the language of the affected individual also influences the coping process. Researchers (e.g. Rohrbaugh, Shoham, Skoyen, Jensen, and Mehl, 2012) labelled communal coping language as ‘we – talk’. In their studies of addiction and cessation (cigarette and alcohol) due to health threats, Rohrbaugh and colleagues discovered the pronoun used by couples in their study influenced the communal coping outcomes. In the cases where couples defined the addiction as “our problem” versus “your problem” or “my problem”, there were implicit adaptive problem-solving outcomes.

Lastly, gender roles influence the performance of communal coping. Wells, Hobfoll and Lavin (1997) suggested the multiple roles some women take on tend to result in stressors. However, Women tend to be the fervent giver of social support making members of this gender community an active performer in the communal coping process (Vaux 1985, Bem 1993). Lyon et al. (1998) noted women’s tendency to give social support to others supersedes receiving support as maintaining relationship quality is important for this group. The downside to this sense of responsibility is women manage and overcome their stressor alone which take an emotional and psychological toll.

Benefits of Communal Coping

Adapting the communal coping strategy after a distressing event is beneficial for the coping process itself, the self and relationships (Afifi, Helgeson & Krouse, 2006). As a beneficial strategy for the coping process communal coping holds the potential to allow connected individuals to increase their resources and ability to deal with the situation. For example, a single stressful event may require reliance on other people or the exploration of others’ financial resources to cope with the situation.

Another significant benefit of communal coping as a coping strategy is the facilitation of emotional social support which in turn facilitates psychological wellbeing. Individuals who can share their emotional distress with others are less likely to experience depression and burnout (Williamson & Shultz, 1990)or commit suicide (LaSalle, 1995).

Under certain circumstances, the constant encouragement of communal coping among connected individuals promotes a likelihood of consistent availability of social support. In these cases, communal coping may serve as a form of long-term investment. The last two statements are not intended to categorise communal coping and social support as the same phenomenon but rather to argue that the former creates a conducive social and relational climate for the later. According to Lyons et al. (1998), some of the long-term investments of communal coping may result in rewards such as food and money.

Moreover, in the event of a common disaster such as earthquakes and wars, communal coping allows the people involved to experience a sense of ‘solidarity’ or a feeling of ‘I am not the only victim’. This realisation promotes mutual disclosure among all the affected individuals, a behaviour found to buffer stress as well as ameliorate negative feelings and concerns (Pennebaker & Haber, 1993). In their study on how the process of communal coping unfolds after social support resources have diminished, Richardson and Maninger (2016) discovered that a sense of mutuality and shared problem increased.

Taken together, there is enough evidence that communal coping has a significant impact on relationships. These impacts are evident in the development and maintenance of relationships; the desire or obligation to cater to the wellbeing of others and the collective good (Lyon et al., 1998). Perhaps, in well-established relationships, communal coping is likely to strengthen relationship characteristics such as trust. For instance, the confidence that people within a connected network will exchange support during or after a distressing situation promotes a sense of dependence which may improve the quality of a relationship.

Lyons and colleagues argued the actualisation of relationship development and maintenance regarding relational trust or improving relationship quality emerge from a sense of compassion (empathy-driven) or obligation (responsibility – driven) towards the wellbeing of others in the relationship. Although empathy-driven and obligation – driven motives are distinct based on the type of relational tie, in most cases the end goal is for the collective good.

The benefits of communal coping described to this point focus on the intention to meet the emotional need of others during a stressful life event. However, the self can also benefit from participating in the process. There is a likelihood for the person offering empathy-driven or obligation – driven support to experience a sense of fulfilment. Lyons et al. (1998) used social integration and excitement to explain self-benefits of communal coping. In their explanation of social integration as a benefit of communal coping, Lyons et al. noted people who consider themselves resourceful in the coping process of others consider themselves competent, valued, loved and indispensable. In the same vein, communal coping fosters a sense of togetherness and cooperation. Excitement usually results from a sense of togetherness and cooperation that yield positive results.

Given that people and resources such as money, time and goods are exchanged in the process of communal coping during certain stressful events, there is a likelihood for some of the individuals involved to experience discomfort. Lyons et al. (1998) alluded to this discomfort as costs of communal coping.

Costs of Communal Coping

A significant characteristic of communal coping is ‘dependency’. Cultural (collectivism versus individualism) and social factors play into how we expect others to depend on us and how much we are willing to depend on others. Communal coping will perhaps be perceived as a cost in situations where there is a lack of mutual understanding and expectation within a social unit consisting of members experiencing a common or personal stressful event. In such instances, Lyon et al. (1998) noted individuals in the social unit will need to deal with issues such as equity and individual-adaptation.

The equity problem arises from a lack of agreement or existing social norms on the expectation of individual efforts channelled towards communal coping. In a comparison of gender roles after a distressing event, women specifically wives and mothers were expected to hold higher responsibility for helping others manage and recover from a stressor. More so, given that communal coping requires significant reliance on other people, individuals who are used to this style of coping during or after a stressful event may experience trouble adapting to a situation or circumstance in the absence of someone to rely on. There is evidence for this in studies about how people embedded in a strong community experience difficulty after a change of location for the pursuit of life goals.

One drastic consequence of communal coping is the possibility of stress contagion to occur. In this case, rather than working towards alleviating the stressor, connected individuals wallow in negative emotions and feelings. This behaviour escalates old and fosters new stressors for all the people involved. These factor provide evidence that the communal coping process follows a complicated pattern likely to yield contradictory results. Even more, some complex factors influence how people use communal coping. The complex nature of these factors is evident in how they are not universal or consistent.

Concept Application

The communal coping framework is relatively new and there has not been much variation in the context to which the concept has been applied. Mickelson, Lyons, Sullivan and Coyne (2001) argue for the need to apply the communal coping conceptual framework to less collective stressors such as recovery from natural disaster (e.g. Richardson & Maninger, 2018) to more individualistic stressors such as job loss and illness (e.g. Vleet, Helgeson, Seltman, Korytwoski, Hausmann, 2018). Scholars who have attempted to apply the communal coping framework to context outside of illness and natural disaster have looked at the concept in relation to relational transgression (Pederson & Faw, 2019); the experience of athletes and members of their family (Nelly, McHugh, Dun & Holt, 2017) and ; the experience of refugees (Afifi, Afifi, Merill & Nimah, 2016).

Concept Critique

The communal coping framework is very dynamic in the sense that it can be applied to distinct research contexts yet facilitate empirical and general knowledge that aligns with the tenets of its models. This strength also lies in the weakness of the framework. Some scholars within the distinct field to which the concept has been applied propose models for communal coping with little to significant variations. For instance, Lyons and colleagues (1998) from the field of psychology proposed the first model. Their model served as a backdrop for the emergence of other models from experts in communication (Afifi, Helgeson & Krouse, 2006); sociology and anthropology (Helgeson, Jakubiak, Vleet, & Zajdel, 2018). Keefe, LeFevbre, Egert, et al. (2000) also advocated for a communal coping model of pain catastrophising. With the growth in the application of the conceptual framework, it might be beneficial to consider developing a model for studying the phenomenon that can be used across all fields or areas of research. A probable benefit of this suggestion is the promotion of jointly agreed conceptualisation of the communal coping phenomenon.

References and Further Reading

Afifi, T. D., Afifi, W. A., Merrill, A. F., & Nimah, N. (2016). ‘Fractured communities’: uncertainty, stress, and (a lack of) communal coping in Palestinian refugee camps. Journal of Applied Communication Research, 44(4), 343-361doi:10.1080/00909882.2016.1225166
Afifi, T. D., Hutchinson, S., & Krouse, S. (2006). Toward a theoretical model of communal coping in postdivorce families and other naturally occurring groups. Communication Theory, 16(3), 378–409.
Berg, C. A., Meegan, S. P., & Deviney, F. P. (1998). A social-contextual model of coping with everyday problems across the lifespan. International Journal of Behavioral Development, 22(2), 239–261.
Coyne, J. C., & Fiske, V. (1992). Couples coping with chronic and catastrophic illness.
Fiske, Veronica; Coyne, James C.; Smith, David A. (1991). “Couples coping with myocardial infarction: An empirical reconsideration of the role of overprotectiveness”. Journal of Family Psychology. 5(1): pp.4-20.
Fukuyama, F. (1995). Trust: The social virtues and the creation of prosperity (Vol. 99). New York, NY: Free press.
Lyons, R. F., Mickelson, K. D., Sullivan, M. J., & Coyne, J. C. (1998). Coping as a communal process. Journal of Social and Personal Relationships, 15(5), 579–605.
Keefe, F. J., Lefebvre, J. C., Egert, J. R., Affleck, G., Sullivan, M. J., & Caldwell, D. S. (2000). The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing. Pain, 87(3), 325–334.
Helgeson, V. S., Jakubiak, B., Van Vleet, M., & Zajdel, M. (2018). Communal coping and adjustment to chronic illness: Theory update and evidence. Personality and Social Psychology Review, 22(2), 170–195.
Hobfoll, S. E., & London, P. (1986). The relationship of self-concept and social support to emotional distress among women during war. Journal of Social and Clinical Psychology, 4(2), 189–203.
Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American psychologist, 44(3), 513.
Lazarus, R. S., & Folkman, S. (1984). Coping and adaptation. The handbook of behavioral medicine, 282325.
Lewis, M. A., McBride, C. M., Pollak, K. I., Puleo, E., Butterfield, R. M., & Emmons, K. M. (2006). Understanding health behavior change among couples: An interdependence and communal coping approach. Social science & medicine, 62(6), 1369–1380.
Lyons, Renee F.; Mickelson, Kristin D.; Sullivan, Michael J.L.; Coyne, James C. (October 1998). “Coping as a Communal Process”. Journal of Social and Personal Relationships. 15 (5): 579–605.
Rohrbaugh, M. J., Shoham, V., Skoyen, J. A., Jensen, M., & Mehl, M. R. (2012). We‐talk, communal coping, and cessation success in a couple‐focused intervention for health‐compromised smokers. Family process, 51(1), 107–121.
Nussbaum, M. C. (1990). Love’s knowledge: Essays on philosophy and literature. OUP USA.
Skinner, E. A., & Zimmer‐Gembeck, M. J. (2009). Challenges to the developmental study of coping. New directions for child and adolescent development, 2009(124), 5–17.
Pennebaker, J. W., & Harber, K. D. (1993). A social stage model of collective coping: The Loma Prieta earthquake and the Persian Gulf War. Journal of Social Issues, 49(4), 125-145
Richardson, B. K., & Maninger, L. (2016). “We were all in the same boat”: An exploratory study of communal coping in disaster recovery. Southern Communication Journal, 81(2), 107–122.
Stack, C. B. (1975). All our kin: Strategies for survival in a black community. Basic Books.
Wells, J. D., Hobfoll, S. E., & Lavin, J. (1997). Resource loss, resource gain, and communal coping during pregnancy among women with multiple roles. Psychology of Women Quarterly, 21(4), 645–662.
Vaux, A. (1990). An ecological approach to understanding and facilitating social support. Journal of social and personal relationships, 7(4), 507-518
Van Vleet, M., Helgeson, V. S., Seltman, H. J., Korytkowski, M. T., & Hausmann, L. R. (2019). An examination of the communal coping process in recently diagnosed diabetes. Journal of social and personal relationships, 36(4), 1297–1316.
Wellman, B., Carrington, P., & Hall, A. (1983). Networks as personal communities. Centre for Urban and Community Studies, University of Toronto.
Williamson, G. M., & Schulz, R. (1990). Relationship orientation, quality of prior relationship, and distress among caregivers of Alzheimer’s patients. Psychology and Aging, 5(4), 502.

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What is Social Support?

Published on 12/29/202201/31/2023 by Andrew Marshall4 Comments

Introduction

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. These supportive resources can be:

Emotional (e.g. nurturance);
Informational (e.g. advice);
Companionship (e.g. sense of belonging);
Tangible (e.g. financial assistance); and/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, neighbours, co-workers, organisations, 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, communications, medicine, sociology, nursing, public health, education, rehabilitation, and 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 and 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”.

Refer to Social Support Questionnaire, Communal Coping, and Invisible Support.

Categories and Definitions

Distinctions in Measurement

Social support can be categorised 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 judgement 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 organisations 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, personality, and personal relationships. 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 utilised social support. 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. 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 co-workers. Sources of support can be natural (e.g. family and friends) or more formal (e.g. mental health specialists or community organisations). 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 humour 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 sites. As technology advances, the availability for online support increases. Social support can be offered through social media websites such as blogs, 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-behaviours 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, 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 programmes 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 or depression). 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, rheumatoid arthritis, cancer, stroke, and coronary artery disease. 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).

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. Among people with schizophrenia, those with low social support have more symptoms of the disorder. In addition, people with low support have more suicidal ideation, 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 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 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 mobility, and social disintegration. Researchers realised 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 co-workers 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 socialise, 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 behaviour, 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 behaviour.

Physical Health

Social support has a clearly demonstrated link to physical health outcomes in individuals, with 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 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, 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 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 to supported housing, family support, 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-centred 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 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 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 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 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 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 centres over decades (e.g. University of Kansas, Beach Centre 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 pathways for the link between social support and health. Social support has been found to positively impact the immune, neuroendocrine, and cardiovascular systems. 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, 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 (“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.
Cardiovascular system: 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.

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 activity.

Support Groups

Refer to 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. 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 organisations, 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 (AA) and Narcotics Anonymous (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 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 neighbours, 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 Defence System

In 1959 Isabel Menzies Lyth identified that threat to a person’s identity in a group where they share similar characteristics develops a defence 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 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). 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 behaviours 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 conceptualise 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 have been found to call upon their social relationships for social support more often than Asian Americans 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. 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 at a very young age. Women trying to balance the mom and dad role, takes away from the moral support certain kids need.

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