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{{Short description|Support systems for individuals}} [[File:Nursing home.JPG|thumb|300px|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, most popularly, that one is part of a supportive [[social network]]. These supportive resources can be emotional (e.g., nurturance), informational (e.g., advice), or companionship (e.g., sense of belonging); tangible (e.g., financial assistance) 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, neighbors, coworkers, organizations, etc. Social support is studied across a wide range of disciplines including [[psychology]], [[communications]], [[medicine]], [[sociology]], [[nursing]], [[public health]], [[education]], [[Psychiatric rehabilitation|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,<ref>Vaux, A. (1988). ''Social Support: Theory, Research and Interventions''. My, NY: Praeger.</ref><ref>Drennon-Gala, D. (1987). The effect of social support that is perceived by children in early adolescence and its relationship with antisocial behavior. (Paper presented during a colloquy at the University of Rochester, Rochester, NY).</ref><ref>Drennon-Gala, D. (1994). The effects of social support and inner containment on the propensity toward delinquent behavior and disengagement in education (Doctoral dissertation). Retrieved from ProQuest Dissertations Publishing. 942562.</ref><ref>Drennon-Gala, D. (1995). Drennon-Gala, D. (1995). Delinquency and high school dropouts: reconsidering social correlates. Maryland: University Press of America; a member of the Rowman & Littlefield Publishing Group.</ref><ref>Racino, J. (2006). Social support. In: G. Albrecht, ''Encyclopedia on Disability'', 1470-1471. Thousand Oaks, CA: SAGE.</ref> and are linked to the development of caregiver and payment models, and community delivery systems in the US and around the world.<ref>O'Connor, S. (1995). More than they bargained for: The meaning of support to families. In: S. J. Taylor, R. Bogdan, & Lutfiyya, Z.M. ''The Variety of Community Experience'' (pp.193-210). Baltimore, MD: Paul H. Brookes.</ref> Two main models have been proposed to describe the link between social support and health: the [[Social buffering|buffering hypothesis]] and the direct effects hypothesis.<ref>{{Cite book | url=https://books.google.com/books?id=Q6xkh3QdyGEC&q=%22direct%20effects%20hypothesis%22%20%22main%20effects%20hypothesis%22&pg=PA426 | title=DSM-IV Sourcebook| isbn=9780890420744| last1=Association| first1=American Psychiatric| year=1997| publisher=American Psychiatric Association}}</ref> [[Gender]] and [[culture|cultural]] differences in social support have been found <ref>Harry, B., Kaylanpur, M. and Day, M. (1999). ''Building Cultural Reciprocity with Families: Case Studies in Special Education.'' London, Toronto: Brookes.</ref> in fields such as education "which may not control for age, disability, income and social status, ethnic and racial, or other significant factors". ==Categories and definitions== ===Distinctions in measurement=== Social support can be categorized and measured in several different ways. There are four common functions of social support:<ref name=Wills91>{{cite journal|last=Wills|first=T.A.|title=Social support and interpersonal relationships|journal=Prosocial Behavior, Review of Personality and Social Psychology|year=1991|volume=12|pages=265β289|editor1-first=Clark|editor1-last=Margaret}}</ref><ref>{{cite book|last=Wills|first=T.A.|title=Social support and health|year=1985|publisher=Academic Press|location=Orlando, FL|pages=61β82|editor=S. Cohen |editor2=L. Syme|chapter=Supportive functions of interpersonal relationships}}</ref><ref>{{cite book|last=Uchino|first=B.|title=Social Support and Physical Health: Understanding the Health Consequences of Relationships|url=https://archive.org/details/socialsupportphy0000uchi|year=2004|publisher=Yale University Press|location=New Haven, CT|pages=[https://archive.org/details/socialsupportphy0000uchi/page/16 16]β17|isbn=9780300127980 }}</ref> *''Emotional support'' is the offering of empathy, concern, affection, love, trust, acceptance, intimacy, encouragement, or caring.<ref name=Nursing>{{cite journal|last=Langford|first=C.P.H.|author2=Bowsher, J. |author3=Maloney, J.P. |author4=Lillis, P.P. |title=Social support: a conceptual analysis|url=https://archive.org/details/sim_journal-of-advanced-nursing_1997-01_25_1/page/95|journal=Journal of Advanced Nursing|year=1997|volume=25|issue=1|pages=95β100|doi=10.1046/j.1365-2648.1997.1997025095.x|pmid=9004016}}</ref><ref name="Slevin 1996 1275β1279">{{cite journal|last=Slevin|first=M.L. |author2=Nichols, S.E. |author3=Downer, S.M. |author4=Wilson, P. |author5=Lister, T.A. |author6=Arnott, S. |author7=Maher, J. |author8=Souhami, R.L. |author9=Tobias, J.S. |author10=Goldstone, A.H. |author11=Cody, M.|title=Emotional support for cancer patients: what do patients really want?|journal=British Journal of Cancer|year=1996|volume=74|issue=8 |pages=1275β1279|doi=10.1038/bjc.1996.529 |pmid=8883417 |pmc=2075927}}</ref> It is the warmth and nurturance provided by sources of social support.<ref name=SETReview>{{cite book|last=Taylor|first=S.E.|title=The Handbook of Health Psychology|year=2011|publisher=Oxford University Press|location=New York, NY|pages=189β214|editor=M.S. Friedman|chapter=Social support: A Review}}</ref> Providing emotional support can let the individual know that he or she is valued.<ref name="Slevin 1996 1275β1279"/> *''Tangible support'' is the provision of financial assistance, material goods, or services.<ref name="HealthBehav">{{cite book |last1=Heaney |first1=C.A. |title=Health Behavior and Health Education: Theory, Research, and Practice |last2=Israel |first2=B.A. |publisher=Jossey-Bass |year=2008 |editor=Glanz, K. |edition=4th |location=San Francisco, CA |chapter=Social networks and social support |editor2=Rimer, B.K. |editor3=Viswanath, K.}}</ref><ref name=House>{{cite book|last=House|first=J.S.|title=Work stress and social support|year=1981|publisher=Addison-Wesley|location=Reading, MA}}</ref> Also called instrumental support, this form of social support encompasses the concrete, direct ways people assist others.<ref name=Nursing /> *''Informational support'' is the provision of advice, guidance, suggestions, or useful information to someone.<ref name=Wills91 /><ref>{{cite journal|last=Krause|first=N.|title=Social support, stress, and well-being|journal=Journal of Gerontology|year=1986|volume=41|issue=4|pages=512β519|doi=10.1093/geronj/41.4.512|pmid=3722737}}</ref> This type of information has the potential to help others problem-solve.<ref name=Nursing /><ref>{{cite journal|last=Tilden|first=V.P.|author2=Weinert, S.C. |title=Social support and the chronically ill individual|url=https://archive.org/details/sim_nursing-clinics-of-north-america_1987-09_22_3/page/613|journal=Nursing Clinics of North America|year=1987|volume=22|issue=3|pages=613β620|doi=10.1016/S0029-6465(22)01312-3 |pmid=3649795|s2cid=252054894 }}</ref> *''Companionship support'' is the type of support that gives someone a sense of social belonging (and is also called belonging).<ref name=Wills91 /> This can be seen as the presence of companions to engage in shared social activities.<ref>{{cite book|last=Uchino|first=B.|title=Social Support and Physical Health: Understanding the Health Consequences of Relationships|url=https://archive.org/details/socialsupportphy0000uchi|year=2004|publisher=Yale University Press|location=New Haven, CT|page=[https://archive.org/details/socialsupportphy0000uchi/page/17 17]|isbn=9780300127980 }}</ref> Formerly, it was also referred to as "esteem support" or "appraisal support",<ref name="Wills91" /> 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.<ref name=SETReview /><ref name=Barrera>{{cite journal|last=Barrera|first=M|title=Distinctions between social support concepts, measures, and models|journal=American Journal of Community Psychology|year=1986|volume=14|issue=4|pages=413β445|doi=10.1007/bf00922627|s2cid=144597839}}</ref> ''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.<ref name=Cultural>{{cite book|last=Gurung|first=R.A.R.|title=Health Psychology: A Cultural Approach|year=2006|publisher=Thomson Wadsworth|location=Belmont, CA|pages=131β171|chapter=Coping and Social Support}}</ref> Furthermore, social support can be measured in terms of structural support or functional support.<ref>{{cite book|last=Wills|first=T.A.|title=Behavioral medicine and women: A comprehensive handbook|year=1998|publisher=Guilford Press|location=New York, NY|pages=118β128|editor=Blechman, E.A. |editor2=Brownell, K.D.|chapter=Social support}}</ref> ''Structural support'' (also called ''social integration'') refers to the extent to which a recipient is [[Social connection|connected]] within a social network, like the number of social ties or how integrated a person is within his or her social network.<ref name=Barrera /><ref name=Wills91 /> Family relationships, [[Friendship|friends]], and membership in clubs and organizations contribute to social integration.<ref>{{cite journal|last=Lakey|first=B|title=Social support and social integration|url=http://cancercontrol.cancer.gov/brp/constructs/social_support/social_support.pdf|access-date=2011-11-13|archive-date=2009-02-01|archive-url=https://web.archive.org/web/20090201164835/http://cancercontrol.cancer.gov/brp/constructs/social_support/social_support.pdf|url-status=dead}}</ref> ''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.<ref name=UBook>{{cite book|last=Uchino|first=B.|title=Social Support and Physical Health: Understanding the Health Consequences of Relationships|url=https://archive.org/details/socialsupportphy0000uchi|year=2004|publisher=Yale University Press|location=New Haven, CT|isbn=9780300127980 }}</ref> 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.<ref>{{cite journal|last=Kessler|first=R. C.|author2=McLeod, J. D. |title=Sex differences in vulnerability to undesirable life events|url=https://archive.org/details/sim_american-sociological-review_1984-10_49_5/page/620|year=1984|journal=American Sociological Review|volume=49|issue=5|pages=620β631|doi=10.2307/2095420|jstor=2095420|citeseerx=10.1.1.455.9669}}</ref> These different types of social support have different patterns of correlations with [[health]], [[personality]], and [[interpersonal relationship|personal relationships]].<ref name=Barrera /><ref name=U2009>{{cite journal|last=Uchino|first=B.|title=Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support.|journal=Perspectives on Psychological Science|year=2009|volume=4|issue=3|pages=236β255|doi=10.1111/j.1745-6924.2009.01122.x|pmid=26158961|citeseerx=10.1.1.713.8624|s2cid=17551921}}</ref> For example, perceived support is consistently linked to better mental health whereas received support and social integration are not.<ref name=Barrera /><ref name=U2009/> In fact, research indicates that perceived social support that is untapped can be more effective and beneficial than utilized social support.<ref name="Culture and Social Support: Who Seeks It and Why?">{{cite journal|last1=Taylor|first1=S.E.|last2=Sherman|first2=D.K.|last3=Kim|first3=H.S.|last4=Jarcho|first4=J.|last5=Takagi|first5=K.|last6=Dunagan|first6=M.S.|title=Culture and Social Support: Who Seeks It and Why?|journal=Journal of Personality and Social Psychology|date=2004|volume=87|issue=3|pages=354β362|doi=10.1037/0022-3514.87.3.354|pmid=15382985|s2cid=4516555 |ref=106|url=https://escholarship.org/content/qt1tr8z9gs/qt1tr8z9gs.pdf?t=pj5m7g}}</ref> 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.<ref>{{cite journal|last=Bolger|first=N.|author2=Amarel, D. |title=Effects of social support visibility on adjustment to stress: Experimental evidence|url=https://archive.org/details/sim_journal-of-personality-and-social-psychology_2007-03_92_3/page/458|journal=Journal of Personality and Social Psychology|year=2007|volume=92|issue=3|pages=458β475|doi=10.1037/0022-3514.92.3.458|pmid=17352603|citeseerx=10.1.1.323.9906}}</ref><ref name="Bolger 2000 953β961">{{cite journal|last=Bolger|first=N.|author2=Zuckerman, A. |author3=Kessler, R.C. |title=Invisible support and adjustment to stress|journal=Journal of Personality and Social Psychology|year=2000|volume=79|issue=6|pages=953β961|doi=10.1037/0022-3514.79.6.953|pmid=11138764|citeseerx=10.1.1.488.333}}</ref><ref name="Uchino, B. 2006">{{cite journal | last1 = Uchino | first1 = B | year = 2006 | title = Social support and health: A review of physiological processes potentially underlying links to disease outcomes | journal = Journal of Behavioral Medicine | volume = 29 | issue = 4| pages = 377β387 | doi=10.1007/s10865-006-9056-5| pmid = 16758315 | s2cid = 11954450 }}</ref> This view has been complicated, however, by more recent research suggesting the effects of invisible social support β as with visible support β are moderated by provider, recipient, and contextual factors such as recipients' perceptions of providers' responsiveness to their needs,<ref name="Maisel 2009 PS invisible support partner responsiveness">{{cite journal |last1=Maisel |first1=N.C. |last2=Gable |first2=S.L. |title=The paradox of received social support: the importance of responsiveness |journal=Psychological Science |date=2009 |volume=20 |issue=8 |pages=928β932 |doi=10.1111/j.1467-9280.2009.02388.x|pmid=19549083 |s2cid=5095380 }}</ref> or the quality of the relationship between the support provider and recipient.<ref name="Kent de Grey 2021 JSPR support visibility T1D">{{cite journal |last1=Kent de Grey |first1=R.G. |last2=Berg |first2=C.A. |last3=Tracy |first3=E.L. |last4=Kelly |first4=C.S. |last5=Lee |first5=J. |last6=Lichtman |first6=M.L. |last7=Butner |first7=J. |last8=Munion |first8=A.K. |last9=Helgeson |first9=V.S. |title=Can't you see I'm trying to help? Relationship satisfaction and the visibility and benefit of social support in type 1 diabetes |journal=Journal of Social and Personal Relationships |date=2021 |volume=38 |issue=3 |pages=805β824 |doi=10.1177/0265407520973762|s2cid=229503832 }}</ref> ===Sources=== Social support can come from a variety of sources, including (but not limited to): family, [[Friendship|friends]], romantic partners, pets, community ties, and coworkers.<ref name=SETReview /> Sources of support can be natural (e.g., family and friends) or more formal (e.g., mental health specialists or community organizations).<ref>{{cite journal|last=Hogan, B.|author2=Linden, W. |author3=Najarian, B. |title=Social support interventions: Do they work?|url=https://archive.org/details/sim_clinical-psychology-review_2002-04_22_3/page/381|journal=Clinical Psychology Review|year=2002|volume=22|issue=3|pages=381β440|doi=10.1016/s0272-7358(01)00102-7|pmid=17201192 }}</ref> 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.<ref name=KG>{{cite journal|last=Kiecolt-Glaser|first=J.K.|author2=Newton, T.L. |title=Marriage and health: His and hers|url=https://archive.org/details/sim_psychological-bulletin_2001-07_127_4/page/472|journal=Psychological Bulletin|year=2001|volume=127|issue=4|pages=472β503|doi=10.1037/0033-2909.127.4.472|pmid=11439708}}</ref> 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.<ref name="onlinelibrary.wiley.com">{{cite journal|doi=10.1111/j.1744-6570.2011.01211.x | pmid=21691415 | volume=64 | issue=2 | title=Workplace and Social Support and Work-Family Conflict: A Meta-analysis Clarifying the Influence of General and Work-Family-Specific Supervisor and Organizational Support | journal=Personnel Psychology | pages=289β313 | last1 = Ernst Kossek | first1 = Ellen |author2=Pichler, S. | pmc=3116443 | year=2011 }}</ref> Employee humor is negatively associated with burnout, and positively with, stress, health and stress coping effectiveness.<ref name="onlinelibrary.wiley.com"/> Additionally, social support from friends did provide a buffer in response to marital stress, because they were less implicated in the marital dynamic.<ref>{{cite journal|last=Jackson|first=P. B.|title=Specifying the buffering hypothesis: Support, strain, and depression|url=https://archive.org/details/sim_social-psychology-quarterly_1992-12_55_4/page/363|journal=Social Psychology Quarterly|volume=55|issue=4|pages=363β378|doi=10.2307/2786953|jstor=2786953|year=1992}}</ref> Early familial social support has been shown to be important in children's abilities to develop [[social competence|social competencies]],<ref>{{cite journal|last=Repetti|first=R.L.|author2=Taylor, S.E. |author3=Seeman, T.E. |title=Risky families: Family social environments and the mental and physical health of offspring|url=https://archive.org/details/sim_psychological-bulletin_2002-03_128_2/page/330|journal=Psychological Bulletin|year=2002|volume=128|pages=330β336|doi=10.1037/0033-2909.128.2.230|pmid=11931522|issue=2|citeseerx=10.1.1.327.165}}</ref> and supportive parental relationships have also had benefits for college-aged students.<ref>{{cite journal|last=Valentiner|first=D.P. |author2=Holahan, C.J. |author3=Moos, R.H. |title=Social support, appraisals of event controllability, and coping: An integrative model|url=https://archive.org/details/sim_journal-of-personality-and-social-psychology_1994-06_66_6/page/1094|journal=Journal of Personality and Social Psychology|year=1994|volume=66|issue=6 |pages=1094β1102|doi=10.1037/0022-3514.66.6.1094}}</ref> 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.<ref>{{cite journal | last1 = Chu | first1 = P. S. | last2 = Saucier | first2 = D. A. | last3 = Hafner | first3 = E. | year = 2010 | title = Meta-analysis of the relationships between social support and well-being in children and adolescents | url = https://archive.org/details/sim_journal-of-social-and-clinical-psychology_2010-06_29_6/page/624 | journal = Journal of Social and Clinical Psychology | volume = 29 | issue = 6| pages = 624β645 | doi=10.1521/jscp.2010.29.6.624}}</ref> === Online social support=== {{also|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 [[blog]]s, [[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.<ref name="Kraut 1998 AmPsy net social involvement">{{cite journal |last1=Kraut |first1=R. |last2=Patterson |first2=M. |last3=Lundmark |first3=V. |last4=Kiesler |first4=S. |last5=Mukophadhyay |first5=T. |last6=Scherlis |first6=W. |title=Internet para- dox: A social technology that reduces social involvement and psychological well-being? |journal=American Psychologist |date=1998 |volume=53 |issue=9 |pages=1017β1031 |doi=10.1037/0003-066X.53.9.1017|pmid=9841579 |s2cid=513632 }}</ref><ref name="Clark 2018 CDPS ICBF">{{cite journal |last1=Clark |first1=J.L. |last2=Algoe |first2=S.B. |last3=Green |first3=M.C. |title=Social network sites and well-being: The role of social connection. |journal=Current Directions in Psychological Science |date=2018 |volume=27 |issue=1 |pages=32β37 |doi=10.1177/0963721417730833|doi-access=free }}</ref> However, additional work showed null or even positive effects,<ref name="Kraut 2002 J Soc Iss Internet paradox revisited">{{cite journal |last1=Kraut |first1=R. |last2=Kiesler |first2=S. |last3=Boneva |first3=B. |last4=Cummings |first4=J. |last5=Helgeson |first5=V. |last6=Crawford |first6=A. |title=Internet paradox revisited |journal=Journal of Social Issues |date=2002 |volume=58 |pages=49β74 |doi=10.1111/1540-4560.00248|s2cid=144328559 |url=https://figshare.com/articles/journal_contribution/6470177 }}</ref> contributing to a more nuanced understanding of online social processes. Emerging data increasingly suggest that, as with offline support,<ref name="UBook" /> the effects of online social support are shaped by support provider, recipient, and contextual factors. For example, the interpersonal-connection-behaviors framework<ref name="Clark 2018 CDPS ICBF" /> 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.<ref>{{Cite journal|title = Social support in an Internet weight loss community|journal = International Journal of Medical Informatics|date = 2010-01-01|issn = 1386-5056|pmc = 3060773|pmid = 19945338|pages = 5β13|volume = 79|issue = 1|doi = 10.1016/j.ijmedinf.2009.10.003|first1 = Kevin O.|last1 = Hwang|first2 = Allison J.|last2 = Ottenbacher|first3 = Angela P.|last3 = Green|first4 = M. Roseann|last4 = Cannon-Diehl|first5 = Oneka|last5 = Richardson|first6 = Elmer V.|last6 = Bernstam|first7 = Eric J.|last7 = Thomas}}</ref> 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.<ref name="Cole 2017 CHB Online SS">{{cite journal |last1=Cole |first1=D.A. |last2=Nick |first2=E.A. |last3=Zelkowitz |first3=R.L. |last4=Roeder |first4=K.M. |last5=Spinelli |first5=T. |title=Online social support for young people: Does it recapitulate in-person social support; can it help? |journal=Computers in Human Behavior |date=2017 |volume=68 |pages=456β464 |doi=10.1016/j.chb.2016.11.058|pmid=28993715 |pmc=5630180 }}</ref> 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.<ref name="Kent de Grey 2019 DH OSEM" /> 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.<ref name="Clark 2018 CDPS ICBF" /> 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 (mood)|depression]], perceived [[Stress (biology)|stress]], cancer-related trauma measures, and even IVF treatments.<ref>{{Cite journal|title = Evaluation of an internet support group for women with primary breast cancer|journal = Cancer|date = 2003-03-01|issn = 1097-0142|pages = 1164β1173|volume = 97|issue = 5|doi = 10.1002/cncr.11174|pmid = 12599221|first1 = Andrew J.|last1 = Winzelberg|first2 = Catherine|last2 = Classen|first3 = Georg W.|last3 = Alpers|first4 = Heidi|last4 = Roberts|first5 = Cheryl|last5 = Koopman|first6 = Robert E.|last6 = Adams|first7 = Heidemarie|last7 = Ernst|first8 = Parvati|last8 = Dev|first9 = C. Barr|last9 = Taylor|s2cid = 21187729|doi-access = free}}</ref><ref>Miller, N., Pundak, C., Cohen, G. et al. Can Social Support on Facebook Influence Fertility Outcomes?. Reprod. Sci. 29, 212β219 (2022). https://doi.org/10.1007/s43032-021-00611-5</ref> 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.<ref>{{Cite journal|title = Social support in cyberspace: a content analysis of communication within a Huntington's disease online support group|journal = Patient Education and Counseling|date = 2007-10-01|issn = 0738-3991|pmid = 17629440|pages = 173β178|volume = 68|issue = 2|doi = 10.1016/j.pec.2007.06.002|first1 = Neil S.|last1 = Coulson|first2 = Heather|last2 = Buchanan|first3 = Aimee|last3 = Aubeeluck|url = http://eprints.nottingham.ac.uk/721/1/Coulson_Buchanan_Aubeeluck_2007_PEC.pdf|access-date = 2018-11-24|archive-date = 2018-12-16|archive-url = https://web.archive.org/web/20181216030851/http://eprints.nottingham.ac.uk/721/1/Coulson_Buchanan_Aubeeluck_2007_PEC.pdf|url-status = dead}}</ref> 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.<ref>Wong, E. T. K., & Ma, W. W. K. Exploring Relationship between Online Social Support and Individual.https://www.researchgate.net/profile/Will_Ma/publication/303147877_Exploring_relationship_between_online_social_support_and_individual_online_subjective_well-being_among_young_adults/links/57380a5408aea45ee83dbc55.pdf</ref><ref name="Ahn Shin 2013 CHB Soc Med & soc iso">{{cite journal |last1=Ahn |first1=D. |last2=Shin |first2=D.-H. |title=Is the social use of media for seeking connectedness or for avoiding social isolation? Mechanisms underlying media use and subjective well- being. |journal=Computers in Human Behavior |date=2013 |volume=29 |issue=6 |pages=2453β2462 |doi=10.1016/j.chb.2012.12.022}}</ref><ref name="Deters Mehl 2013 SPPS Fb posting loneliness">{{cite journal |last1=Deters |first1=F.G. |last2=Mehl |first2=M.R. |title=Does posting Facebook status updates increase or decrease loneliness? An online social networking experiment. |journal=Social Psychological and Personality Science |date=2013 |volume=4 |issue=5 |pages=579β586 |doi=10.1177/1948550612469233|pmid=24224070 |pmc=3820167 }}</ref><ref name="Liu Yu 2013 CBSN Fb induce SWB">{{cite journal |last1=Liu |first1=C.-Y. |last2=Yu |first2=C.-P. |title=Can Facebook use induce well- being? |journal=Cyberpsychology, Behavior, and Social Networking |date=2013 |volume=16 |issue=9 |pages=674β678 |doi=10.1089/cyber.2012.0301|pmid=24028138 }}</ref> An increasing number of interventions aim to create or enhance social support in online communities. While preliminary data often suggest such programs may be well received by users and may yield benefits, additional research is needed to more clearly establish the effectiveness of many such interventions.<ref name="Uchino 2016 SS & Mental Health">{{cite book |last1=Uchino |first1=Bert N. |last2=Bowen |first2=Kimberly |last3=Kent |first3=Robert |title=Encyclopedia of Mental Health |chapter=Social Support and Mental Health |editor1-last=Friedman |editor1-first=Howard S. |date=2016 |publisher=Academic Press |location=Oxford, England, UK |isbn=978-0-12-397753-3 |pages=185β189 |doi=10.1016/B978-0-12-397045-9.00117-8 |s2cid=146143848 |url=https://doi.org/http://dx.doi.org/10.1016/B978-0-12-397045-9.00117-8|edition=Second }}</ref> 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.<ref name="Kent de Grey 2019 DH OSEM">{{cite journal |last1=Kent de Grey |first1=R.G. |last2=Uchino |first2=B.N. |last3=Baucom |first3=B.R.W. |last4=Smith |first4=T.W. |last5=Holton |first5=A.E. |last6=Diener |first6=E.F. |title=Enemies and friends in high-tech places: The development and validation of the Online Social Experiences Measure |journal=Digital Health |date=2019 |volume=5 |doi=10.1177/2055207619878351|pmid=31579526 |pmc=6759713 }}</ref> Instruments specifically developed to measure social support in online contexts include the Online Social Support Scale<ref name="Nick 2018 PA OSSS">{{cite journal |last1=Nick |first1=E.A. |last2=Cole |first2=D.A. |last3=Cho |first3=S.J. |last4=Smith |first4=D.K. |last5=Carter |first5=T.G. |last6=Zelkowitz |first6=R.L. |title=The Online Social Support Scale: Measure development and validation |journal=Psychological Assessment |date=2018 |volume=30 |issue=9 |pages=1127β1143 |doi=10.1037/pas0000558|pmid=29781664 |pmc=6107390 }}</ref> (which has sub scales for esteem/emotional support, social companionship, informational support, and instrumental support) and the Online Social Experiences Measure <ref name="Kent de Grey 2019 DH OSEM" /> (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<ref>{{cite book|last=House|first=J. S.|title=Work Stress and social support|year=1981|publisher=Addison-Wesley}}</ref> and in response to important life events.<ref>{{cite journal|last=Cobb|first=S.|title=Social support as a moderator of life stress|journal=Psychosomatic Medicine|volume=98|issue=5|pages=300β314|doi=10.1097/00006842-197609000-00003|pmid=981490|year=1976|s2cid=6537305}}</ref> 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.<ref>{{Cite journal|title=Social support and adaptation to stress by the elderly|url=https://archive.org/details/sim_psychology-and-aging_1986-03_1_1/page/47|author1=Cutrona, Carolyn |author2=Russell, Dan |author3=Rose, Jayne |journal=Psychology and Aging |date=1986|volume=1 |issue=1 |pages=47β54 |doi=10.1037/0882-7974.1.1.47 |pmid=3267379 |id = {{ProQuest|614375933}}}}</ref> In stressful times, social support helps people reduce psychological distress (e.g., [[anxiety]] or [[Depression (mood)|depression]]).<ref name=SETReview /> 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)<ref>{{cite book|last = Folkman|first=S.|author2=Lazarus, R. S. |title=Stress and coping: An anthology|url = https://archive.org/details/stresscoping00sych|year=1991|publisher=Columbia University Press|chapter=coping and emotion|isbn=9780231074568 }}</ref> Social support has been found to promote psychological adjustment in conditions with [[chronic stress|chronic high stress]] like [[HIV]],<ref>{{cite journal|last=Turner-Cobb|first=J.M.|author2=Gore-Felton, C. |author3=Marouf, F. |author4=Koopman, C. |author5=Kim, P. |author6=Israelski, D. |author7=Spiegel, D. |title=Coping, social support, and attachment style as psychosocial correlates of adjustment in men and women with HIV/AIDS|journal=Journal of Behavioral Medicine|year=2002|volume=25|issue=4|pages=337β353|doi=10.1023/A:1015814431481|pmid=12136496|s2cid=868967}}</ref> [[rheumatoid arthritis]],<ref>{{cite journal|last=Goodenow|first=C.|author2=Reisine, S.T. |author3=Grady, K.E. |title=Quality of social support and associated social and psychological functioning in women with rheumatoid arthritis|url=https://archive.org/details/sim_health-psychology_1990_9_3/page/266|journal=Health Psychology|year=1990|volume=9|issue=3|pages=266β284|doi=10.1037/0278-6133.9.3.266|pmid=2340818}}</ref> [[cancer]],<ref>{{cite journal|last=Penninx|first=B.W.J.H. |author2=van Tilburg, T. |author3=Boeke, A.J.P. |author4=Deeg, D.J.H. |author5=Kriegsman, D.M.W. |author6=van Ejik, J.Th.M. |title=Effects of social support and personal coping resources on depressive symptoms: Different for various chronic diseases?|journal=Health Psychology|year=1998|volume=17|issue=6 |pages=551β558|doi=10.1037/0278-6133.17.6.551|pmid=9848806 |hdl=1871/39710 |url=https://research.vu.nl/ws/files/592730/1998%20HP%20Penninx%20vT%20et%20al%20Effects%20of%20social%20support.pdf |hdl-access=free }}</ref> [[stroke]],<ref>{{cite journal|last=Robertson|first=E.K.|author2=Suinn, R.M. |title=The determination of rate of progress of stroke patients through empathy measures of patient and family|journal=Journal of Psychosomatic Research|year=1968|volume=12|issue=3|pages=189β191|doi=10.1016/0022-3999(68)90045-7|pmid=5686041}}</ref> and [[coronary artery disease]].<ref>{{cite journal|last=Holahan|first=C.J.|author2=Moos, R.H. |author3=Holahan, C.K. |author4=Brennan, P.I. |title=Social context, coping strategies, and depressive symptoms: An expanded model with cardiac patients|url=https://archive.org/details/sim_journal-of-personality-and-social-psychology_1997-04_72_4/page/918|journal=Journal of Personality and Social Psychology|year=1997|volume=72|issue=4|pages=918β28|doi=10.1037/0022-3514.72.4.918|pmid=9108704}}</ref> Whereas a lack of social support has been associated with a risk for an individual's 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.<ref name=":5">{{Cite journal|title=Social support, social conflict, and immigrant women'smental health in a Canadian context: a scoping review|journal=Journal of Psychiatric and Mental Health Nursing|volume=22|issue=9|pages=655β667|last=Guruge, S; Thomson, M, S; George, U; and Chaze, F|date=2015|doi=10.1111/jpm.12216|pmid=26031541}}</ref> 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 [[Clinical depression|depression]] and [[anxiety]] than do people with high social support.<ref name=Barrera /><ref name=Cohen>{{cite journal|last=Cohen|first=S|author2=Wills, T.A. |title=Stress, social support, and the buffering hypothesis.|journal=Psychological Bulletin|year=1985|volume=98|pages=310β357|doi=10.1037/0033-2909.98.2.310|pmid=3901065|issue=2|s2cid=18137066}}</ref> In addition, people with low social support have higher rates of [[mental disorder|major mental disorder]] than those with high support. These include [[post-traumatic stress disorder]] (PTSD),<ref>{{cite journal|last=Brewin|first=C.R.|author2=Andrews, B. |author3=Valentine, J.D. |title=Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults|journal= Journal of Consulting and Clinical Psychology|year=2000|volume=68|issue=5|pages=748β766|doi=10.1037/0022-006x.68.5.748|pmid=11068961|s2cid=13749007}}</ref> [[panic disorder]],<ref>{{cite journal|last=Huang|first=M|author2=Yen, C. |author3=Lung, F. |title=Moderators and mediators among panic, agoraphobia symptoms, and suicidal ideation in patients with panic disorder|journal=Comprehensive Psychiatry|year=2010|volume=51|issue=3|pages=243β249|doi=10.1016/j.comppsych.2009.07.005|pmid=20399333|s2cid=45744026}}</ref> [[social phobia]],<ref>{{cite journal|last=Torgrud|first=L.|author2=Walker, J. |author3=Murray, L. |author4=Cox, B. |author5=Chartier, M. |author6=Kjernisted, K. |title=Deficits in perceived social support associated with generalized social phobia|journal=Cognitive Behaviour Therapy|year=2004|volume=33|issue=2|pages=87β96|doi=10.1080/16506070410029577|pmid=15279315|s2cid=10290187}}</ref> major depressive disorder,<ref name="Lakey, B., & Cronin, A. 2008 385β408">{{cite book|last=Lakey, B., & Cronin, A.|title=Risk factors for depression|url=https://archive.org/details/riskfactorsdepre00dobs|year=2008|publisher=Academic Press|pages=[https://archive.org/details/riskfactorsdepre00dobs/page/385 385]β408|editor=Dobson, K.S. |editor2=D. Dozois|chapter=Low social support and major depression: Research, theory, and methodological issues}}</ref> [[dysthymia|dysthymic disorder]],<ref>{{cite journal|last=Klein|first=D.N.|author2=Taylor, E.B. |author3=Dickstein, S. |author4=Harding, K. |title=Primary early-onset dysthymia: comparison with primary nonbipolar nonchronic major depression on demographic, clinical, familial, personality, and socioenvironmental characteristics and short-term outcome|url=https://archive.org/details/sim_journal-of-abnormal-psychology_1988-11_97_4/page/387|journal=Journal of Abnormal Psychology|year=1988|volume=97|issue=4|pages=387β398|doi=10.1037/0021-843x.97.4.387|pmid=3204224}}</ref> and [[eating disorders]].<ref>{{cite journal|last=Stice|first=E|author2=Presnell, K. |author3=Spangler, D. |title=Risk factors for binge eating onset in adolescent girls: A 2-year prospective investigation|url=https://archive.org/details/sim_health-psychology_2002-03_21_2/page/131|journal=Health Psychology|year=2002|volume=21|issue=2|pages=131β138|doi=10.1037/0278-6133.21.2.131|pmid=11950103}}</ref><ref>{{cite journal|last=Grisset|first=N.I.|author2=Norvell, N.K. |title=Perceived social support, social skills, and quality of relationships in bulimic women|url=https://archive.org/details/sim_journal-of-consulting-and-clinical-psychology_1992-04_60_2/page/293|journal=Journal of Consulting and Clinical Psychology|year=1992|volume=60|issue=2|pages=293β299|doi=10.1037/0022-006x.60.2.293|pmid=1592960}}</ref> Among people with [[schizophrenia]], those with low social support have more symptoms of the disorder.<ref>{{cite journal|last=Norman|first=R.M.G.|author2=Malla, A.K. |author3=Manchanda, R. |author4=Harricharan, R. |author5=Takhar, J. |author6=Northcott, S. |title=Social support and three-year symptom and admission outcomes for first year psychosis|journal=Schizophrenia Research|year=2005|volume=80|issue=2β3|pages=227β234|doi=10.1016/j.schres.2005.05.006 |pmid=15964175|s2cid=6329935}}</ref> In addition, people with low support have more [[suicidal ideation]],<ref>{{cite journal|last=Casey|first=P.R.|author2=Dunn, G. |author3=Kelly, B.D. |author4=Birkbeck, G. |author5=Dalgard, O.S. |author6=Lehtinen, V. |author7=Britta, S. |author8=Ayuso-Mateos, J.L. |author9=Dowrick, C. |title=Factors associated with suicidal ideation in the general population|journal=The British Journal of Psychiatry|year=2006|volume=189|issue=5|pages=410β415|doi=10.1192/bjp.bp.105.017368|pmid=17077430|hdl=10197/5727|doi-access=free|hdl-access=free}}</ref> and more [[substance abuse|alcohol and (illicit and prescription) drug problems]].<ref>{{cite journal|last=Stice|first=E. |author2=Barrera, M. Jr |author3=Chassin, L. |title=Prospective differential prediction of adolescent alcohol use and problem use: Examining mechanisms of effect|url=https://archive.org/details/sim_journal-of-abnormal-psychology_1998-11_107_4/page/616|journal=Journal of Abnormal Psychology|volume=107|issue=4 |pages=616β628|doi=10.1037/0021-843x.107.4.616 |year=1998 |pmid=9830249 }}</ref><ref>{{cite journal | last1 = Wiegel | first1 = C. | last2 = Sattler | first2 = S. | last3 = GΓΆritz | first3 = A. S. | year = 2015 | title = Work-related stress and cognitive enhancement among university teachers | journal = Anxiety, Stress, & Coping | volume = 29| issue = 1| pages = 1β18| doi = 10.1080/10615806.2015.1025764 | pmid = 25747817 | s2cid = 22273733 }}</ref> Similar results have been found among children.<ref>{{cite journal|last=Chu|first=P.S.|author2=Saucier, D.A. |author3=Hafner, E. |title=Meta-analysis of the relationships between social support and well-being in children and adolescents|url=https://archive.org/details/sim_journal-of-social-and-clinical-psychology_2010-06_29_6/page/624|journal=Journal of Social and Clinical Psychology|year=2010|volume=29|issue=6|pages=624β645|doi=10.1521/jscp.2010.29.6.624}}</ref> 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.<ref>{{cite journal |author1=Ano, G.G. |author2=Vasconcelles, EB|doi = 10.1002/jclp.20049 | volume=61 |issue=4| title=Religious coping and psychological adjustment to stress: A meta-analysis |url=https://archive.org/details/sim_journal-of-clinical-psychology_2005-04_61_4/page/461 | journal=Journal of Clinical Psychology | pages=461β480 | pmid=15503316 | date=Apr 2005}}</ref><ref>{{cite journal |author1=Salsman, J. M.|author2=Brown, T. L. |author3= Bretching, E. H.|author4=Carlson, C. R.|year=2005|title= The link between religion and spirituality and psychological adjustment: The mediating role of optimism and social support.|url=https://archive.org/details/sim_personality-and-social-psychology-bulletin_2005-04_31_4/page/522|journal=Personality and Social Psychology Bulletin|volume=31 | issue = 4 |pages=522β535 |doi=10.1177/0146167204271563|pmid=15743986 |s2cid=34780785 }}</ref> 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.<ref>{{cite journal |author1=Schuurmans-Stekhoven, J. B. |year=2014|title= Spirit or fleeting apparition? Why spirituality's link with social support might be incrementally invalid.|journal=Journal of Religion and Health|volume=31 | issue = 4 |pages=522β535|doi=10.1007/s10943-013-9801-3|pmid=24297674|s2cid=4913532}}</ref> 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 [[Help-seeking|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.<ref>{{cite journal | last = Akey, J. E. | first = Rintamaki, L. S., & Kane, T. L. | title = Health Belief Model to deterrents of social support seeking among people coping with eating disorders | journal = Journal of Affective Disorders | year = 2013 | doi=10.1016/j.jad.2012.04.045 | pmid = 22840616 | volume=145 | issue = 2 | pages=246β252}}</ref> 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.<ref>{{cite journal|last=Cobb|first=S.|title=Social support as a moderator of life stress|year=1976|journal=Psychosomatic Medicine|volume=98|issue=5|pages=300β314|doi=10.1097/00006842-197609000-00003|pmid=981490|s2cid=6537305}}</ref><ref>{{cite journal|last=Cassel|first=J.|title=Psychosocial processes and "stress":theoretical formulation|year=1974|journal=International Journal of Health Services|volume=4|issue=3|pages=471β482|doi=10.2190/wf7x-y1l0-bfkh-9qu2|pmid=4475665|s2cid=29387352}}</ref> 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.<ref>{{cite journal | last = Patterson|first= George T.|title=Examining the effects of coping and social support on work and life stress among police officers|journal=Journal of Criminal Justice|year=2003|volume=31|issue= 3|pages=215β226|doi=10.1016/s0047-2352(03)00003-5}}</ref> 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 [[Friendship|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.<ref>{{cite journal|last=D'Ercole|first=Ann|title=Single Mothers: Stress, Coping, and Social Support|url=https://archive.org/details/sim_journal-of-community-psychology_1988-01_16_1/page/41|year=1988|journal=Journal of Community Psychology|volume=16|pages=41β54|doi=10.1002/1520-6629(198801)16:1<41::aid-jcop2290160107>3.0.co;2-9}}</ref> Many studies have been dedicated specifically to understanding the effects of social support in individuals with (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.<ref>{{cite journal|last=Haden|first=Sara C. |author2=Scarpa, Angela |author3=Jones, Russell T. |author4=Ollendick, Thomas H.|title=Posttraumatic stress disorder symptoms and injury: the moderating role of perceived social support and coping for young adults|url=https://archive.org/details/sim_personality-and-individual-differences_2007-05_42_7/page/1187|journal=Personality and Individual Differences|year=2007|volume=42|issue=7 |pages=1187β1198|doi=10.1016/j.paid.2006.09.030}}</ref> In general, data shows that the support of family and [[Friendship|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.<ref>{{cite journal|last=Brewin|first=C. R. |author2=Andrews B. |author3=Valentine, J. D.|title=Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults|year=2000|journal=Journal of Consulting and Clinical Psychology|volume=68|issue=5|pages=748β766|doi=10.1037/0022-006x.68.5.748|pmid=11068961|s2cid=13749007 }}</ref> However, perceived social support may be directly affected by the severity of the trauma. In some cases, support decreases with increases in trauma severity.<ref>{{cite journal|last=Norris|first=F. H.|author2=Kaniasty, K. |title=Received and perceived social support in times of stress: A test of the support deterioration deterrence model|url=https://archive.org/details/sim_journal-of-personality-and-social-psychology_1996-09_71_3/page/498|year=1996|journal=Journal of Personality and Social Psychology|volume=71|issue=3|pages=498β511|doi=10.1037/0022-3514.71.3.498|pmid=8831159}}</ref> 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.<ref>{{cite journal|last=Benton|first=S. A. |author2=Robertson, J. M. |author3=Tseng, W. C. |author4=Newton F. B. |author5=Benton, S. L. |title=Changes in counseling client problems over 13 years|url=https://archive.org/details/sim_professional-psychology-research-and-practice_2003-02_34_1/page/66|year=2003|journal=Professional Psychology: Research and Practice|volume=34|pages=66β72|doi=10.1037/0735-7028.34.1.66|citeseerx=10.1.1.467.9639 }}</ref> 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.<ref>{{cite journal|last=Daniel|first=B. V.|year=2001|title=Understanding family involvement in the college experience today|journal=New Directions for Student Services|volume=2001|issue=94|pages=3β13|author2=Evans, S. G.|author3=Scott, B. R.|doi=10.1002/ss.7}}</ref> In the face of such mounting stress, students naturally [[Help-seeking|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.<ref>{{cite journal|last=Chao|first=Ruth Chu-Lien|title=Managing Perceived Stress Among College Students: The Roles of Social Support and Dysfunctional Coping|year=2012|journal=Journal of College Counseling|volume=15|issue=1|pages=5β21|doi=10.1002/j.2161-1882.2012.00002.x|s2cid=14498972}}</ref> 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.<ref>{{cite journal|last=Thorsteinsson|first= E. B.|author2=Brown, R. F. |title=Mediators and moderators of the stressor-fatigue relationship in nonclinical samples|year=2008|journal=Journal of Psychosomatic Research|volume=66|issue= 1|pages=21β29|doi=10.1016/j.jpsychores.2008.06.010|pmid= 19073289}}</ref> Lack of social support in college students is also strongly related to life dissatisfaction and suicidal behavior.<ref>{{cite journal|last=Allgower|first=A.|author2=Wardle, J. |author3=Steptoe, A. |title=Depressive symptoms, social support, and personal health behaviors in young men and women|url=https://archive.org/details/sim_health-psychology_2001-05_20_3/page/223|year=2001|journal=Health Psychology|volume=20|issue=3|pages=223β227|doi=10.1037/0278-6133.20.3.223|pmid=11403220}}</ref> ====Physical health==== Social support has a clearly demonstrated link to physical health outcomes in individuals, with numerous ties to physical health including [[Death|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).<ref name=UBook /><ref name=U2009 /> Numerous studies have shown that people with higher social support have an increased likelihood for survival.<ref>{{cite journal|last=Holt-Lunstad|first=J. |author-link1=Julianne Holt-Lunstad|author2=Smith, T.B. |author3=Layton, J.B. |title=Social relationships and mortality ris: A meta-analytic review|journal=PLOS Med|year=2010|volume=7|issue=7|doi=10.1371/journal.pmed.1000316|pmid=20668659|pmc=2910600|pages=e1000316 |doi-access=free }}</ref> Individuals with lower levels of social support have: more [[cardiovascular disease]],<ref name=U2009 /> more [[inflammation]] and less effective [[immune system]] functioning,<ref name=U2006>{{cite journal|last=Uchino|first=B.|title=Social support and health: A review of physiological processes potentially underlying links to disease outcomes|journal=Journal of Behavioral Medicine|year=2006|volume=29|issue=4|pages=377β387|doi=10.1007/s10865-006-9056-5|pmid=16758315|s2cid=11954450}}</ref><ref>{{cite journal|last=Kiecolt-Glaser|first=J.K.|author2=McGuire, L. |author3=Robles, T.F. |author4=Glaser, R. |title=Emotions, morbidity, and mortality: New perspectives from psychoneuroimmunology|journal=Annual Review of Psychology|year=2002|volume=53|pages=83β107|doi=10.1146/annurev.psych.53.100901.135217 |pmid=11752480|s2cid=211140}}</ref> more complications during [[pregnancy]],<ref>{{cite journal|last=Elsenbruch|first=S.|author2=Benson, S. |author3=Rucke, M. |author4=Rose, M. |author5=Dudenhausen, J. |author6=Pincus-Knackstedt, M.K. |author7=Klapp, B.F. |author8=Arck, P.C. |title=Social support during pregnancy: effects on maternal depressive symptoms, smoking, and pregnancy outcome|journal=Human Reproduction|year=2007|volume=22|issue=3|pages=869β877|doi=10.1093/humrep/del432|pmid=17110400|doi-access=}}</ref> and more functional disability and pain associated with rheumatoid arthritis,<ref>{{cite journal|last=Evers|first=A.W.M.|author2=Kraaimaat, F.W. |author3=Geenen, R. |author4=Jacobs, J.W.G. |author5=Bijlsma, J.W.J. |title=Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis|url=https://archive.org/details/sim_behaviour-research-and-therapy_2003-11_41_11/page/1295|journal=Behaviour Research and Therapy|year=2003|volume=41|issue=11|pages=1295β1310|doi=10.1016/s0005-7967(03)00036-6 |pmid=14527529}}</ref> among many other findings. Conversely, higher rates of social support have been associated with numerous positive outcomes, including faster recovery from coronary artery surgery,<ref>{{cite journal|last=Kulik|first=J.A.|author2=Mahler, H.I.M. |title=Emotional support as a moderator of adjustment and compliance after coronary artery bypass surgery: A longitudinal study|url=https://archive.org/details/sim_journal-of-behavioral-medicine_1993-02_16_1/page/45|journal=Journal of Behavioral Medicine|year=1993|volume=16|issue=1|pages=45β64|doi=10.1007/bf00844754|pmid=8433357|s2cid=7281273}}</ref> less susceptibility to [[herpes]] attacks,<ref>{{cite journal|last=VanderPlate|first=C.|author2=Aral, S.O. |author3=Magder, L. |title=The relationship among genital herpes simplex virus, stress, and social support|journal=Health Psychology|year=1988|volume=7|issue=2|pages=159β168|doi=10.1037/0278-6133.7.2.159|pmid=3371308}}</ref><ref>{{Cite journal|last1=Davis|first1=Alissa|last2=Roth|first2=Alexis|last3=Brand|first3=Juanita Ebert|last4=Zimet|first4=Gregory D.|last5=Van Der Pol|first5=Barbara|date=2016-03-01|title=Coping strategies and behavioural changes following a genital herpes diagnosis among an urban sample of underserved Midwestern women|journal=International Journal of STD & AIDS|volume=27|issue=3|pages=207β212|doi=10.1177/0956462415578955|issn=1758-1052|pmc=5008844|pmid=25792549}}</ref> a lowered likelihood to show age-related cognitive decline,<ref>{{cite journal|last=Seeman|first=T.E.|author2=Lusignolo, T.M. |author3=Albert, M. |author4=Berkman, L. |title=Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging|url=https://archive.org/details/sim_health-psychology_2001-07_20_4/page/243|journal=Health Psychology|year=2001|volume=20|issue=4|pages=243β255|doi=10.1037/0278-6133.20.4.243|pmid=11515736}}</ref> and better [[diabetes]] control.<ref>{{cite journal|last=Marteau|first=T.M.|author2=Bloc, S. |author3=Baum, J.D. |title=Family life and diabetic control|journal=Journal of Child Psychology and Psychiatry|year=1987|volume=28|issue=6|pages=823β833|doi=10.1111/j.1469-7610.1987.tb00671.x|pmid=3436991}}</ref><ref>{{Cite journal|last1=Johari|first1=Nuruljannah|last2=Manaf|first2=Zahara Abdul|last3=Ibrahim|first3=Norhayati|last4=Shahar|first4=Suzana|last5=Mustafa|first5=Norlaila|date=2016-01-01|title=Predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge|journal=Clinical Interventions in Aging|volume=11|pages=1455β1461|doi=10.2147/CIA.S105652|issn=1178-1998|pmc=5074738|pmid=27799751 |doi-access=free }}</ref><ref>{{Cite book |doi=10.1109/EMBC.2015.7318811|issn=1557-170X|pmid=26736711|isbn=978-1-4244-9271-8|volume=2015|pages=2135β2138|year=2015|last1=Gomez-Galvez|first1=Pedro|last2=Suarez Mejias|first2=Cristina|last3=Fernandez-Luque|first3=Luis|title=2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) |chapter=Social media for empowering people with diabetes: Current status and future trends|s2cid=8261941}}</ref><ref>{{Cite journal|last1=Fernandez-Luque|first1=Luis|last2=Mejova|first2=Yelena|last3=Mayer|first3=Miguel-Angel|last4=Hasvold|first4=Per Erlend|last5=Joshi|first5=Surabhi|date=2016-01-01|title=Panel: Big Data & Social Media for Empowering Patients with Diabetes|journal=Studies in Health Technology and Informatics|volume=225|pages=607β609|issn=0926-9630|pmid=27332274}}</ref> People with higher social support are also less likely to develop [[common cold|colds]] and are able to recover faster if they are ill from a cold.<ref name=C97>{{cite journal|last=Cohen|first=S. |author2=Doyle, W.J. |author3=Skoner, D.P. |author4=Rabin, B.S. |author5=Gwaltney, J.M. Jr |title=Social ties and susceptibility to the common cold|journal=Journal of the American Medical Association|year=1997|volume=277|pages=1940β1944|doi=10.1001/jama.277.24.1940|pmid=9200634|issue=24}}</ref> There is sufficient evidence linking cardiovascular, neuroendocrine, and immune system function with higher levels of social support.<ref name="Uchino, B. 2006"/> Social support predicts less atherosclerosis and is associated with the slower progression of an already diagnosed cardiovascular disease.<ref name="Uchino, B. 2006"/> There is also a clearly demonstrated link between social support and better immune function, especially in older adults.<ref name="Uchino, B. 2006"/> While links have been shown between neuroendocrine functionality and social support, further understanding is required before specific significant claims can be made.<ref name="Uchino, B. 2006"/> Social support is also hypothesized to be beneficial in the recovery from less severe cancers.<ref name="Nausheen, B. 2009">{{cite journal | last1 = Nausheen | first1 = B. | last2 = Gidron | first2 = Y. | last3 = Peveler | first3 = R. | last4 = Moss-Morris | first4 = R. | year = 2009 | title = Social support and cancer progression: A systematic review | journal = Journal of Psychosomatic Research | volume = 67 | issue = 5| pages = 403β415 | doi=10.1016/j.jpsychores.2008.12.012| pmid = 19837203 }}</ref> 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.<ref name="Nausheen, B. 2009"/> 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.<ref name="Callaghan, P. 1993">{{cite journal | last1 = Callaghan | first1 = P. | last2 = Morrissey | first2 = J. | year = 1993 | title = Social support and health: A review | url = https://archive.org/details/sim_journal-of-advanced-nursing_1993-02_18_2/page/203 | journal = Journal of Advanced Nursing | volume = 18 | issue = 2| pages = 203β210 | doi=10.1046/j.1365-2648.1993.18020203.x| pmid = 8436711 }}</ref> There are serious ethical concerns involved with controlling too many factors of social support in individuals, leading to an interesting crossroads in the research.<ref name="Callaghan, P. 1993"/> ===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".<ref>Racino, J. (2000). ''Personnel Preparation in Disability and Community Life''. Springfield, IL: Charles C. Thomas Publishers.</ref><ref>Wehman, P. and Kregel, J. (1998). ''More than a Job: Securing Satisfying Careers for People with Disabilities''. London, Toronto: Paul H. Brookes.</ref> 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".<ref>{{cite journal | last1 = Nisbet | first1 = J. | last2 = Hagner | first2 = D. | year = 1988 | title = Natural supports in the workplace: A reexamination of supported employment | journal = JASH | volume = 13 | issue = 4| pages = 260β267 | doi = 10.1177/154079698801300404 | s2cid = 141750815 }}</ref> Inclusion studies, based upon affiliation and [[friendship]], or the conversely, have a similar theoretical basis <ref>Sapon-Shevin, M. (1992). Including all children and their gifts within regular classrooms. In: S. Stainback & W. Stainback, ''Controversial Issues Confronting Special Education'' (pp. 69-81). London: Allyn and Bacon.</ref><ref>{{cite journal | last1 = Strully | first1 = J. | last2 = Strully | first2 = C. | year = 1985 | title = Friendship and our children | journal = JASH | volume = 10 | issue = 4| pages = 224β227 | doi = 10.1177/154079698501000406 | s2cid = 143241415 }}</ref> as do "person-centered 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).<ref>{{cite journal | last1 = Maduro | first1 = R | year = 1991 | title = The old man as a creative artist in India | journal = Generations | volume = XV | issue = 2| pages = 17β20 }}</ref><ref>{{cite journal | last1 = Kunkel | first1 = S | year = 1989 | title = An extra eight hours a day | journal = Generations | volume = XIII | issue = 2| pages = 57β60 }}</ref> 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.<ref name = Cohen /><ref name=Cut>{{cite book|last=Cutrona|first=C.E|title=Russell, D.W.|year=1990|publisher=Wiley & Sons|location=New York|pages=319β366|editor=Sarason, B.R. |editor2=Sarason, I.G. |editor3=Pierce, G.R.|chapter=Types of social support and specific stress: Toward a theory of optimal matching}}</ref><ref name=McKay>{{cite book|last=Cohen, S., & McKay, G.|title=Handbook of psychology and health|year=1984|publisher=Erlbaum|location=Hillsdale, NJ|pages=253β268|editor=Baum, A. |editor2=Taylor, S.E. |editor3=Singer, J.|chapter=Social support, stress, and the buffering hypothesis: A theoretical analysis}}</ref> 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).<ref>{{cite journal|last=Horowitz|first=L.M.|author2=Krasnoperova, E.N. |author3=Tatar, D.G. |author4=Hansen, M.B. |author5=Person, E.A. |author6=Galvin, K.L. |author7=Nelson, K.L. |title=The way to console may depend on the goal: Experimental studies of social support|journal=Journal of Experimental Social Psychology|year=2001|volume=37|pages=49β61|doi=10.1006/jesp.2000.1435}}</ref><ref name="Thoit"/> Additionally, elevated levels of perceived stress can impact the effect of social support on health-related outcomes.<ref>{{cite journal|last=Zhou|first=Eric S.|author2=Penedo, Frank J. |author3=Lewis, John E. |title=Perceived stress mediates the effects of social support on health-related quality of life among men treated for localized prostate cancer|journal=Journal of Psychosomatic Research|date=December 2010|volume=69|issue=6|pages=587β590|pmid=21109047|doi=10.1016/j.jpsychores.2010.04.019|pmc=2994072}}</ref> Other costs have been associated with social support. For example, received support has not been linked consistently to either physical or mental health;<ref name=Barrera /><ref name=U2009 /> perhaps surprisingly, received support has sometimes been linked to worse mental health.<ref name="Bolger 2000 953β961"/> Additionally, if social support is overly intrusive, it can increase stress.<ref>{{cite journal|last=Shumaker|first=S.A.|author2=Hill, D.R. |title=Gender differences in social support and physical health|url=https://archive.org/details/sim_health-psychology_1991_10_2/page/102|journal=Health Psychology|year=1991|volume=10|issue=2|pages=102β111|doi=10.1037/0278-6133.10.2.102|pmid=2055208}}</ref> 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.<ref name="Uchino, B. 2006"/> ===Two dominant models=== There are two dominant hypotheses addressing the link between social support and health: the [[Social buffering|buffering hypothesis]] and the direct effects hypothesis.<ref name=Cohen /> 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 [[stress (psychological)|stressful times]]. Evidence has been found for both hypotheses.<ref name=SETReview /> 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).<ref name=Cohen /> 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<ref name=Cohen /> or received support.<ref name=Barrera /> 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.<ref name=Cohen /> In addition to showing buffering effects, perceived support also shows consistent direct effects for mental health outcomes.<ref name="Lakey, B., & Cronin, A. 2008 385β408"/> Both perceived support and social integration show main effects for physical health outcomes.<ref name=U2009 /> However, received (enacted) support rarely shows main effects.<ref name=Barrera /><ref name=U2009 /> ===Theories to explain the links=== Several theories have been proposed to explain social support's link to health. Stress and coping social support theory<ref name=Barrera /><ref name=Cohen /><ref name = Cut/><ref name =Thoit>{{cite journal|last=Thoits|first=P.A.|title=Social support as coping assistance|url=https://archive.org/details/sim_journal-of-consulting-and-clinical-psychology_1986-08_54_4/page/416|journal=Journal of Consulting and Clinical Psychology|year=1986|volume=54|issue=4|pages=416β423|doi=10.1037/0022-006x.54.4.416|pmid=3745593}}</ref> dominates social support research<ref name=RRT>{{cite journal|last=Lakey|first=B.|author2=Orehek, E. |title=Relational Regulation Theory: A new approach to explain the link between perceived support and mental health|journal=Psychological Review|year=2011|volume=118|issue=3|pages=482β495|doi=10.1037/a0023477|pmid=21534704|s2cid=20717156|url=https://pure.rug.nl/ws/files/149972773/Relational_Regulation_Theory_A_New_Approach_to_Explain_the_Link_Between.pdf }}</ref> 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 [[coping (psychology)|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,<ref>{{cite book|last=Lazarus, R.S., & Folkman, S.|title=Stress, appraisal, and coping|year=1984|publisher=Springer|location=New York}}</ref> events are stressful insofar as people have negative thoughts about the event ([[appraisal theory|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 [[adaptation|adaptive]] appraisal and coping.<ref name=Cohen /><ref name = Thoit /> Evidence for stress and coping social support theory is found in studies that observe stress buffering effects for perceived social support.<ref name=Cohen /> One problem with this theory is that, as described previously, stress buffering is not seen for social integration,<ref name=T95>{{cite journal|last=Thoits|first=P.A.|title=Stress, coping, and social support processes: Where are we? What next?|journal=Journal of Health and Social Behavior|year=1995|volume=35|pages=53β79|doi=10.2307/2626957|jstor=2626957|s2cid=22619638}}</ref> and that received support is typically not linked to better health outcomes.<ref name=Barrera /><ref name=U2009 /> Relational regulation theory (RRT)<ref name=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.<ref>{{cite journal|last=Wethington|first=E.|author2=Kessler, R.C. |title=Perceived support, received support, and adjustment to stressful life events|journal=Journal of Health and Social Behavior|year=1986|volume=27|issue=1|pages=78β89|doi=10.2307/2136504|pmid=3711634|jstor=2136504}}</ref> 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.<ref name=RRT /> RRT hypothesizes that the link between perceived support and mental health comes from people [[Emotional self-regulation|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.<ref name=L2010>{{cite book|last=Lakey|first=B.|title=Social Psychological Foundations of Clinical Psychology|url=https://archive.org/details/socialpsychologi00phdj|year=2010|publisher=Guildford|location=New York|pages=[https://archive.org/details/socialpsychologi00phdj/page/n195 177]β194|editor=Maddux, J.E. |editor2=Tangney, J.P.|chapter=Social support: Basic research and new strategies for intervention}}</ref> Life-span theory<ref name=U2009 /> 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 theory|attachment]] with parents. Social support develops along with adaptive [[Trait theory|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,<ref name = L2010 /> and that perceived support is linked to adaptive personality characteristics and attachment experiences.<ref name=U2009 /> Lifespan theories are popular from their origins in Schools of Human Ecology at the universities, aligned with family theories, and researched through federal centers over decades (e.g., University of Kansas, Beach Center 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.<ref name="The effects of allocentrism, idiocentrism, social support, and big five personality dimensions on work-family conflict.">{{cite journal|last1=Shafiro|first1=M.|title=The effects of allocentrism, idiocentrism, social support, and big five personality dimensions on work-family conflict.|journal=Dissertation Abstracts International: Section B: The Sciences and Engineering|date=2011|volume=66|issue=3|pages=191β203|doi=10.1016/j.jvb.2010.12.010|ref=108}}</ref> ===Biological pathways=== Many studies have tried to identify [[biopsychosocial model|biopsychosocial]] pathways for the link between social support and health. Social support has been found to positively impact the [[immune system|immune]], [[neuroendocrine system|neuroendocrine]], and [[cardiovascular system]]s.<ref name=T07>{{cite book|last=Taylor|first=S.E.|title=Foundations of health psychology|url=https://archive.org/details/foundationshealt00frie|year=2007|publisher=Oxford University Press|location=New York|pages=[https://archive.org/details/foundationshealt00frie/page/145 145]β171|editor=Friedman, H.S. |editor2=Silver, R.C.|chapter=Social support|isbn=978-0-19-513959-4 }}</ref> Although these systems are listed separately here, evidence has shown that these systems can interact and affect each other.<ref name=U2009 /> *Immune system: Social support is generally associated with better immune function.<ref name=U2006 /><ref>{{cite journal|last=Herbert|first=T.B.|author2=Cohen, S. |title=Stress and immunity in humans: A meta-analytic review|journal=Psychosomatic Medicine|year=1993|pages=364β379|doi=10.1097/00006842-199307000-00004|pmid=8416086|volume=55|issue=4|citeseerx=10.1.1.125.6544|s2cid=2025176}}</ref> For example, being more socially integrated is correlated with lower levels of inflammation (as measured by [[C-reactive protein]], a marker of inflammation),<ref>{{cite journal|last=Loucks|first=E.B.|author2=Berkman, L.F. |author3=Gruenewald, T.L. |author4=Seeman, T.E. |title=Relation of social integration to inflammatory marker concentrations in men and women 70-79 years|journal=American Journal of Cardiology|year=2006|volume=97|issue=7|pages=1010β1016|doi=10.1016/j.amjcard.2005.10.043|pmid=16563907}}</ref> and people with more social support have a lower susceptibility to the common cold.<ref name=C97 /> *Neuroendocrine system: Social support has been linked to lower [[cortisol]] ("stress hormone") levels in response to stress.<ref>{{cite journal|last=Turner-Cobb|first=J.M.|author2=Sephton, S.E. |author3=Koopman, C. |author4=Blake-Mortimer, J. |author5=Spiegel, D. |title=Social support and salivary cortisol in women with metastatic breast cancer|journal=Psychosomatic Medicine|year=2000|volume=62|issue=3|pages=337β345|doi=10.1097/00006842-200005000-00007|pmid=10845347|s2cid=5823189}}</ref> [[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.<ref>{{cite journal|last=Eisenberger|first=N.I.|author2=Taylor, S.E. |author3=Gable, S.L. |author4=Hilmert, C.J. |author5=Lieberman, M.D. |title=Neural pathways link social support to attenuated neuroendocrine stress response|journal=NeuroImage|year=2007|volume=35|issue=4|pages=1601β1612|doi=10.1016/j.neuroimage.2007.01.038 |pmid=17395493 |pmc=2710966}}</ref> *Cardiovascular system: Social support has been found to lower cardiovascular reactivity to stressors.<ref name=U2006 /> It has been found to lower [[blood pressure]] and [[heart rate]]s,<ref>{{cite journal|last=Unden|first=A.L.|author2=Orth-Gomer, K. |author3=Elofsson, S. |title=Cardiovascular effects of social support in the work place: twenty-four hour ECG monitoring of men and women|journal=Psychosomatic Medicine|year=1991|volume=53|issue=1|pages=50β60|pmid=2011650|doi=10.1097/00006842-199101000-00005|s2cid=21410981}}</ref> 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.<ref name=SETReview /> For example, sometimes the presence of a support figure can lead to increased neuroendocrine and [[physiological]] activity.<ref name=KG /> ===Support groups=== {{Main|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.<ref>{{cite journal|last=Helgeson|first=V.S.|author2=Cohen, S. |title=Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research|url=https://archive.org/details/sim_health-psychology_1996-03_15_2/page/135|journal=Health Psychology|year=1996|volume=15|issue=2|pages=135β148|doi=10.1037/0278-6133.15.2.135|pmid=8681922|citeseerx=10.1.1.559.9698}}</ref><ref>{{cite book|last=Gottlieb, B.H.|title=Marshalling social support: Formats, processes, and effects|year=1988|publisher=Sage|location=Newbury Park, CA}}</ref> Studies have generally found beneficial effects for social support group interventions for various conditions,<ref>{{cite journal|last=Hogan|first=B.E.|author2=Najarian, B. |title=Social support interventions: Do they work?|url=https://archive.org/details/sim_clinical-psychology-review_2002-04_22_3/page/381|journal=Clinical Psychology Review|year=2002|volume=22|issue=3|pages=381β440|doi=10.1016/s0272-7358(01)00102-7|pmid=17201192}}</ref> including Internet support groups.<ref>{{cite journal|last=Hazzard|first=A.|author2=Celano, M. |author3=Collins, M. |author4=Markov, Y. |title=Effects of STARBRIGHT World on knowledge, social support, and coping in hospitalized children with sickle cell disease and asthma|url=https://archive.org/details/sim_childrens-health-care_winter-2002_31_1/page/69|journal=Children's Health Care|year=2002|volume=31|pages=69β86|doi=10.1207/s15326888chc3101_5|s2cid=57962730}}</ref> These groups may be termed "self help" groups in nation-states, may be offered by non-profit organizations, 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.<ref name=":3">{{Cite journal|title=Using peer support groups to enhance community integration of veterans in transition.|journal=Psychological Services|volume=15|issue=2|pages=135β145|last=Drebing, Charles, E; Reilly, Erin; Henze, Kevin, T; Kelly, Megan; Russo, Anthony; Smolinsky, John; Gorman, Jay; Penk, Walter, E|date=2018|doi=10.1037/ser0000178|pmid=29723015|s2cid=21654236}}</ref> 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.''<ref name=":4">{{Cite journal|title=Sharing, supporting and sobriety: a qualitative analysis of messages posted to alcohol-related online discussion forums in the United Kingdom|journal=Journal of Substance Use|volume=19|issue=1β2|pages=176β180|last=Coulson|first=Neil|date=2013|doi=10.3109/14659891.2013.765516|s2cid=145539173}}</ref>'' ===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.<ref>{{cite journal|last=Schulz|first=R.|author2=O'Brien, A.T. |author3=Bookwala, J. |author4=Fleissner, K. |title=Psychiatric and physical morbidity effects of dementia caregiving: Prevalence, correlates, and causes|journal=The Gerontologist|year=1995|volume=35|pages=771β791|doi=10.1093/geront/35.6.771 |pmid=8557205 |issue=6}}</ref><ref>{{cite journal|last=Kiecolt-Glaser|first=J.K.|author2=Marucha, P.T. |author3=Malarkey, W.B. |author4=Mercado, A.M. |author5=Glaser, R. |title=Slowing of wound healing by psychological stress|journal=Lancet|year=1995|volume=346|issue=8984|pages=1194β1196|doi=10.1016/s0140-6736(95)92899-5 |pmid=7475659|s2cid=13005846|doi-access=free}}</ref> 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 [[Friendship|friends]], relatives, and neighbors, or emotional support to spouses has been linked to a significant decrease in the risk for mortality.<ref>{{cite journal|last=Brown|first=S.L.|author2=Nesse, R.M. |author3=Vinokur, A.D. |author4=Smith, D.M. |title=Providing social support may be more beneficial than receiving it: Results from a prospective study of mortality|journal=Psychological Science|year=2003|volume=14|issue=4|pages=320β327|doi=10.1111/1467-9280.14461|pmid=12807404|s2cid=12398465}}</ref> 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<ref>{{Cite web|url=https://www.researchgate.net/publication/51554220|title=Daily Support in Couples Coping With Early Stage Breast Cancer: Maintaining Intimacy During Adversity|last=Belcher, A. J., Laurenceau, J.-P., Graber, E. C., Cohen, L. H., Dasch, K. B., & Siegel, S. D.}}</ref> Also, a recent neuroimaging study found that giving support to a significant other during a distressful experience increased activation in [[reward system|reward]] areas of the brain.<ref>{{cite journal|last=Inagaki|first=T.K.|author2=Eisenberger, N.I. |title=Neural correlates of giving support to a loved one|journal=Psychosomatic Medicine|year=2011|volume=74|issue=1|doi=10.1097/psy.0b013e3182359335|pmid=22071630|pages=3β7|s2cid=8514912}}</ref> ===Social defense system=== In 1959 [[Isabel Menzies Lyth]] identified that threat to a person's identity in a group where they share similar characteristics develops a defense 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.<ref>{{Cite web| title=Social Systems as a Defense Against Anxiety | first=Isabel Menzies | last=Lyth | url=http://www.moderntimesworkplace.com/archives/ericsess/sessvol1/Lythp439.opd.pdf | archive-url=https://web.archive.org/web/20061113130803/http://moderntimesworkplace.com/archives/ericsess/sessvol1/Lythp439.opd.pdf | archive-date=2006-11-13}}</ref><ref>{{cite web|url=http://www.businesscoachinstitute.com/library/key_concepts.shtml|title=Key Concepts in Interpersonal Psychology|website=www.businesscoachinstitute.com|access-date=20 April 2018|archive-date=3 May 2018|archive-url=https://web.archive.org/web/20180503114822/http://www.businesscoachinstitute.com/library/key_concepts.shtml|url-status=dead}}</ref> ==Gender and culture== ===Gender differences=== Gender differences have been found in social support research.<ref name=Cultural /> Women provide more social support to others and are more engaged in their social networks.<ref name=T95 /><ref>{{cite book|last=Belle|first=D.|title=Gender and stress|year=1987|publisher=The Free Press|location=New York|editor=Barnett, R.C. |editor2=Biener, L. |editor3=Baruch, G.K.|pages=257β277|chapter=Gender differences in the social moderators of stress}}</ref><ref name=Tend>{{cite journal|last=Taylor|first=S.E.|author2=Klein, L.C. |author3=Lewis, B.P |author4=Gruenewald, T.L. |author5=Gurung, R.A.R. |author6=Updegraff, J.A. |title=Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight|journal=Psychological Review|year=2000|volume=107|pages=411β429|doi=10.1037/0033-295X.107.3.411|pmid=10941275 |issue=3|citeseerx=10.1.1.386.912}}</ref> Evidence has also supported the notion that women may be better providers of social support.<ref name=T95 /> 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.<ref name="Gender Differences In Perceptions Of Stressors And Utilization Of Social Support Among University Students">{{cite journal|last1=Day|first1=A.|last2=Livingtone1|first2=H.|title=Gender Differences In Perceptions Of Stressors And Utilization Of Social Support Among University Students|journal=Canadian Journal of Behavioural Science|date=2003|volume=35|issue=2|pages=73β83|ref=109|doi=10.1037/h0087190}}</ref><ref>{{cite journal|last=Tamres|first=L.|author2=Janicki, D. |author3=Helgeson, V.S. |title=Sex differences in coping behavior: A meta-analytic review|journal=Personality and Social Psychology Review|year=2002|volume=6|pages=2β30|doi=10.1207/s15327957pspr0601_1|s2cid=144326879}}</ref> Additionally, social support may be more beneficial to women.<ref>{{cite journal|last=Schwarzer|first=R.|author2=Leppin, A. |title=Social support and health: A meta-analysis|journal=Psychology and Health|year=1989|volume=3|pages=1β15|doi=10.1080/08870448908400361}}</ref> [[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 response|flight or fight]] versus [[tend and befriend]]).<ref name=Tend /> 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.<ref name="Hobfoll">{{cite book | last1 = Hobfoll | first1 = S.E. | last2 = Cameron | first2 = R.P. | last3 = Chapman | first3 = H.A. | last4 = Gallagher | first4 = R.W. | title = Handbook of Social Support and the Family | chapter = Social Support and Social Coping in Couples | year = 1996 | volume = 1 | pages = 413β433 | doi=10.1007/978-1-4899-1388-3_17| isbn = 978-1-4899-1390-6 }}</ref> It has been found that men's behaviors 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.<ref>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.</ref><ref>{{cite journal | last1 = Roussi | first1 = P. | last2 = Vassilaki | first2 = E. | year = 2000 | title = The applicability of the multiaxial model of coping to a greek population | journal = Anxiety, Stress, & Coping | volume = 14 | issue = 2| pages = 125β147 | doi=10.1080/10615800108248351| s2cid = 145739354 }}</ref> 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.<ref name="Hobfoll" /> 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.<ref name="Gender Differences In Perceptions Of Stressors And Utilization Of Social Support Among University Students"/> ===Cultural differences=== Although social support is thought to be a universal resource, cultural differences exist in social support.<ref name=Cultural /> In many Asian cultures, the person is seen as more of a collective unit of society, whereas Western cultures are more individualistic and conceptualize social support as a transaction in which one person [[Help-seeking|seeks help]] from another. In more interdependent Eastern cultures, people are less inclined to enlist the help of others.<ref name="Culture and Social Support: Who Seeks It and Why?"/> 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,<ref name=S04>{{cite journal|last=Taylor|first=S.E.|author2=Sherman, D.K. |author3=Kim, H.S. |author4=Jarcho, J. |author5=Takagi, K. |author6=Dunagan, M.S. |title=Culture and social support: Who seeks it and why?|journal=Journal of Personality and Social Psychology|year=2004|volume=87|issue=3|pages=354β62|doi=10.1037/0022-3514.87.3.354 |pmid=15382985|s2cid=4516555 |url=https://escholarship.org/uc/item/1tr8z9gs}}</ref> and Asian Americans expect social support to be less helpful than European Americans.<ref name=S06>{{cite journal|last=Kim|first=H.S.|author2=Sherman, D.K. |author3=Ko, D. |author4=Taylor, S.E |journal=Personality and Social Psychology Bulletin|year=2006|volume=32|issue=12|pages=1596β1607|doi=10.1177/0146167206291991 |pmid=17122173|title=Pursuit of Comfort and Pursuit of Harmony: Culture, Relationships, and Social Support Seeking|url=https://archive.org/details/sim_personality-and-social-psychology-bulletin_2006-12_32_12/page/1596|citeseerx=10.1.1.584.9979|s2cid=10209604}}</ref> These differences in social support may be rooted in different cultural ideas about [[social groups]].<ref name=S04 /><ref name=S06/> It is important to note that these differences are stronger in emotional support than instrumental support.<ref name="Culture and Social Support: Who Seeks It and Why?"/> Additionally, ethnic differences in social support from family and friends have been found.<ref>{{cite journal|last=Sagrestano|first=L.M.|author2=Feldman, P. |author3=Killingsworth-Rini, C. |author4=Woo, G. |author5=Dunkel-Schetter, C |title=Ethnicity and social support during pregnancy|url=https://archive.org/details/sim_american-journal-of-community-psychology_1999-12_27_6/page/873|journal=American Journal of Community Psychology|year=1999|volume=27|issue=6|pages=873β902 |doi=10.1023/a:1022266726892|pmid=10723538|s2cid=11342841}}</ref> 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.<ref name="Culture and Social Support: Who Seeks It and Why?"/> Different cultures have different ways of social support.<ref>{{Cite journal|last=Glazer|first=Sharon|date=September 2006|title=Social support across cultures|journal=International Journal of Intercultural Relations|volume=30|issue=5|pages=605β622|doi=10.1016/j.ijintrel.2005.01.013|issn=0147-1767|hdl=11603/7290|hdl-access=free}}</ref> In African American households support is limited. Many black mothers raise their children without a male figure.<ref>{{Cite journal|last=Stevens|first=Joseph H.|date=June 1988|title=Social Support, Locus of Control, and Parenting in Three Low-Income Groups of Mothers: Black Teenagers, Black Adults, and White Adults|url=https://archive.org/details/sim_child-development_1988-06_59_3/page/635|journal=Child Development|volume=59|issue=3|pages=635β642|doi=10.2307/1130563|issn=0009-3920|jstor=1130563|pmid=3383672}}</ref> Women struggle with job opportunities due to job biases and racial discrimination.<ref>{{Cite journal|date=July 1984|title=Land Reform and Tourism Development: Policy-Making In the Philippines. Linda K. Richter. Schenkman Publishing Company, Inc., 3 Mount Auburn Place, Cambridge, Massachusetts 02138. 1982. 240p|journal=Journal of Travel Research|volume=23|issue=1|pages=45β46|doi=10.1177/004728758402300191|s2cid=220683428|issn=0047-2875}}</ref> 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. <ref>{{Cite journal|last1=Lindblad-Goldberg|first1=Marion|last2=Dukes|first2=Joyce Lynn|date=January 1985|title=Social support in Black, low-income, single-parent families: Normative and dysfunctional patterns.|url=https://archive.org/details/sim_american-journal-of-orthopsychiatry_1985-01_55_1/page/42|journal=American Journal of Orthopsychiatry|volume=55|issue=1|pages=42β58|doi=10.1111/j.1939-0025.1985.tb03420.x|pmid=3970150|issn=1939-0025}}</ref> Women trying to balance the mom and dad role, takes away from the moral support certain kids need.<ref>{{Cite journal|last=Clark|first=D. O.|date=1992-04-01|title=Residence Differences in Formal and Informal Long-Term Care|url=https://archive.org/details/sim_gerontologist_1992-04_32_2/page/227|journal=The Gerontologist|volume=32|issue=2|pages=227β233|doi=10.1093/geront/32.2.227|pmid=1533603|issn=0016-9013|doi-access=free}}</ref> ==See also== * [[Family support]] *[[Interpersonal emotion regulation]] * [[Invisible support]] * [[Narcissistic supply]] * [[Respect]] * [[Peer support]] * [[Prosocial behavior]] * [[Social capital]] *[[Social connection]] * [[Social undermining]] * [[Stress (psychological)]] * [[Supported employment]] * [[Supported housing]] * [[Welfare spending|Welfare]] *[[Social Support Questionnaire]] *[[Help-seeking]] ==References== {{Reflist|2}} {{Organized labor}} {{DEFAULTSORT:Social Support}} [[Category:Social networks]] [[Category:Clinical psychology]] [[Category:Communication theory]] [[Category:Social influence]] [[Category:Economic sociology]]
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