Abstract
The current study investigates the relationship between social support and mental and physical health. Results indicate that poor functional support (or quality of support) is related to physical health problems while structural support (or social network size) is not. Moreover, although both poor functional and structural support are related to depression and anxiety, functional support is more strongly related to these outcome variables, the strongest relationship being associated with depression. Depression and hostility are also related to social isolation, although the relationship is again stronger for depression. The results suggest that the quality of social relationships is more important than quantity for optimal mental and physical health. The clinical relevance of these findings is that the quality of social support in the lives of individuals is central to recovery and should be addressed in medical and mental health treatment planning whenever it is an etiological or maintaining factor.
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References
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington D. C: Author.
Anderson, S.M. and Bern, S.L. (1981). Sex typing and androgyny in dyadic interaction: Individual differences in responsiveness to physical attractiveness. Journal of Personality and Social Psychology, 41, 74–86.
Andrews, G., Schonell, M., and Tennant, C. (1977). The relationship between physical, psychological, and social morbidity in a suburban community. American Journal of Epidemiology, 105, 27–35.
Aro, H.M. (1994). Risk and protective factors in depression: A developmental perspective. Acta Psychiatrica Scandinavica, 89 (Suppl.), 59–64.
Beach, S.R., Martin, J.K., Blum, T.C., and Roman, P.M. (1993). Effects of marital and co-worker relationships on negative affect: Testing the central role of marriage. The American Journal of Family Therapy, 21, 313–324.
Beck, A.T. and Steer, R.A. (1993). Beck Depression Inventory Manual. San Antonio, TX: The Psychological Corporation.
Belloc, N.B. and Breslow, L. (1972). Relationship of physical health status and health practice. Preventive Medicine, 1, 409–421.
Bellow, N.B., Breslow, L., and Hochstim, J.R. (1971). Measurement of physical health in a general population survey. American Journal of Epidemiology, 93, 328–336.
Berkman, L.F., Leo-Summers, L., and Horwitz, R.I. (1992). Emotional support and survival after myocardial infarction: A prospective, population-based study of the elderly. Annals of Internal Medicine, 117, 1003–1009.
Berkman, L.F. and Syme, S.L. (1979). Social networks, host resistance, and mortality: A nine year follow-up study of the Alameda County residents. American Journal of Epidemiology, 115, 684–694.
Blazer, D. (1982). Social support and mortality in an elderly community population. American Journal of Epidemiology, 115, 684–694.
Bolby, J. (1969). Attachment and loss: Vol. 1. Attachment. London: Hogarth Press.
Bolby, J. (1973). Attachment and loss: Vol. 2. Separation: Anxiety and anger. London: Hogarth Press.
Bolby, J. (1980). Attachment and loss: Vol. 3. Loss. New York: Basic Books.
Boyce, W.T. (1985). Social support, family relations, and children. In S. Cohen and S. L. Syme (Eds.), Social support and health. New York: Academic Press.
Broadhead, W.E., Kaplan, B.H., James, S.H., Wagner, E.H., Schoenbach, V.J., Grimson, R., Heyden, S., Tibblin, G., and Gehlbach, S.H. (1983). The epidemiological evidence for a relationship between social support and health. American Journal of Epidemiology, 117, 521–537.
Brown, J.D. (1991). Staying fit and staying well: Physical fitness as a moderator of life stress. Journal of Personality and Social Psychology, 60, 555–561.
Byrne, D.G. and Rosenman, R.J. (Eds.). (1990). Anxiety and the heart. New York: Hemisphere.
Case, R.B., Moss, A.J., Case, N., McDermott, M., and Eberly, S. (1992). Living alone after myocardial infarction: Impact on prognosis. Journal of the American Medical Association, 267, 515–519.
Carter, H. and Glick, P.C. (1970). Marriage and divorce: A social and economic study. Cambridge, MA: Harvard University Press.
Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38, 300–314.
Cohen, S. and Syme, S.L. (Eds.). (1985a). Social support and health. San Francisco, CA: Academic Press.
Cohen, S. and Syme, S.L. (1985b). Issues in the study and application of social support. In S. Cohen and S.L. Syme (Eds.), Social support and health (pp. 3–22). San Francisco, CA: Academic Press.
Cohen, S. and Wills, T.A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.
Coleman, D. and Iso-Ahola, S.E. (1993). Leisure and health: The role of social support and self-determination. Journal of Leisure Research, 25, 111–129.
Cook, W.W. and Medley, D.M. (1954). Proposed hostility and pharisaic-virtue scales for the MMPI. Journal of Applied Psychology, 38, 414–418.
Crowne, D.P. and Marlowe, D. (1964). The approval motive: Studies in evaluative dependence. New York: Wiley.
Davidson, D.M. and Schumaker, S.A. (1987). Social support and cardiovascular disease. Atherosclerosis, 7, 101–104.
Deaux, K. (1976). The behavior of women and men. Monterey, CA: Brooks/Cole.
Durkheim, E. (1951). Suicide: A study in sociology. New York: Free Press.
Engler, B.E. (1995). Personality theories: An Introduction (4th ed.). Boston, MA: Houghton Mifflin.
Erikson, E.H. (1963). Childhood and society (2nd ed.). New York: Norton.
Evans, R.L. and Norwook, L.K. (1983). Social support needs in adjustment to stroke. Archives of Physical Medicine and Rehabilitation, 61, 61–64.
Eurelings, B., Elisabeth, H.M., Diekstra, R.F., and Verschuur, M. (1995). Psychological distress, social support, and social support seeking: A prospective study among primary mental health care patients. Social Science and Medicine, 40, 1083–1089.
Evans, R.L. and Norwook, L.K. (1983). Social support needs in adjustment to stroke. Archives of Physical Medicine and Rehabilitation, 61, 61–64.
Fokias, D., Tyler, P. (1995). Social support and agoraphobia: A review. Clinical Psychology Review, 15, 347–366.
Franks, P., Campbell, T.L., and Shields, CG. (1992). Social relationships and health: The relative roles of family functioning and social support. Social Science and Medicine, 34, 779–788.
Frasure-Smith, N. and Prince, R. (1989). Long-term follow-up of the Ischemic Heart Disease Life Stress Monitoring Program. Psychosomatic Medicine, 51, 485–513.
Friedman, H.S. (Ed.). (1992). Hostility, coping, and health. Washington, D. C: American Psychological Association.
Friedman, H.S. and Booth-Kewley, S. (1987). The “Disease-Prone Personality”. A meta analytic view of the construct. American Psychologist, 42, 539–555.
Fromm, E. (1956). The art of loving. New York: Harper and Roe.
George, L.K. (1989). Stress, social support, and depression over the life-course. In S.K. Uriakios and C.L. Cooper (Eds.), Aging, stress and health (pp. 241–267). Chichester, England: John Wiley and Sons.
Glaser, K. and Eisenberg, L. (1956). Maternal deprivation. Pediatrics, 18, 626–642.
Glass, T.A. and Maddox, G.L. (1992). The quality and quantity of social support: Stroke recovery as a psychosocial transition. Social Science and Medicine, 34, 1249–1261.
Glenn, N. (1975). The contribution of marriage to the psychological well-being of males and females. Journal of Marriage and Family, 37, 594–601.
Glenn, N.D. and Weaver, C.N. (1981). The contribution of marital happiness to global happiness. Journal of Marriage and Family, 43, 161–168.
Goodenow, C, Reisine, S.T., and Grady, K.E. (1990). Quality of social support and associated social and psychological functioning in women with rheumatoid arthritis. Health Psychology, 9, 266–284.
Gore, S. (1978). The effect of social support in moderating the health consequences of unemployment. Journal of Health and Social Behavior, 19, 157–165.
Gove, W.R. (1972). The relationship between sex roles, marital status, and mental illness. Social Forces, 51, 34–44.
Gove, W.R., Hughes, M., and Style, C.B. (1983). Does marriage have positive effects on the psychological well-being of the individual? Journal of Health and Social Behavior, 24, 122–131.
Green, A.L. and Austin, C.P. (1993). Psychopathology of pancreatic cancer: A psychobiologic probe. Psychosomatics, 34, 208–221.
Gutfeld, G., Sangiorgio, M., and Rao, L. (1993). Support, stress, and sugar: Friendship may fight diabetes. Prevention, 5, 1–13.
Haynes, S.G. and Feinleib, M. (1980). Women, work and coronary heart disease: Prospective findings from the Framington Heart Study. American Journal of Public Health, 70, 133–141.
Helsing, K.J. and Szklo, M. (1981). Mortality after bereavement. American Journal of Epidemiology, 114, 41–52.
Henderson, S. (1981). Social relationships, adversity, and neurosis: An analysis of prospective observation. British Journal of Psychiatry, 138, 391–398.
Henderson, S., Byrne, D.G., and Duncan-Jones, P. (1981). Neurosis and the social environment. New York: Academic Press.
Herbert, T.B. and Cohen, S. (1993). Depression and immunity: A meta-analytic review. Psychological Bulletin, 113, 472–487.
Hobfoll, S.E. and Vaux, A. (1993). Social support: Social resources and social context. In L. Goldberger and S. Breznitz (Eds.), Handbook of stress: Theoretical and clinical aspects (2nd ed., pp. 685–705). New York: Free Press.
House, J.S., Landis, K.R., and Umberson, D. (1988). Social relationships and health. Science, 24, 540–545.
House, J.S., Robbins, C, and Metzner, H.L. (1982). The association of social relationships and activities with mortality: Prospective evidence from the Tecumseh Community Health Study. American Journal of Epidemiology, 116, 123–140.
Johnson, E. (1990). The deadly emotions: The role of anger, hostility, and aggression in health and emotional well-being. New York: Praeger.
Jones, K. and Vischi, T. (1980). Impact of alcohol, drug abuse and mental health treatment on medical care utilization: A review of the literature. Medical Care, 17 (Supplement 2). 13–34.
Jung, J. and Khalsa, H.K. (1989). The relationship of daily hassles, social support, and coping to depression in black and white students. Journal of General Psychology, 116, 407–417.
Kaplan, G.A., Wilson, T.W., Cohen, R.D., Kauhanen, J., Wu, M., and Salomen, J.T. (1994). Social functioning and overall mortality: Prospective evidence from the Kuopio Ischémie Heart Disease Risk Factor Study. Epidemiology, 5, 495–500.
Kitigawa, E.M. and Hauser, P.M. (1973). Differential mortality in the United States: A study in socioeconomic epidemiology. Cambridge, MA: Harvard University Press.
Kohut, H. (1971). The analysis of the self. New York: International Universities Press.
Lambert, M.J., Shapiro, D.A., and Bergin, A.E. (1986). The effectiveness of psychotherapy. In S.L. Garfield and A. E. Bergin (Eds.), Handbook of psychotherapy and behavioral change (3rd ed., pp. 157–212). New York: John Wiley and Sons.
Leigh, H. (1982). Evaluation and management of stress in general medicine: The psychosomatic approach. In L. Goldberger and S. Breznitz (Eds.), Handbook of stress: Theoretical and clinical aspects (pp. 733–744). New York: Free Press.
Lorig, K.R., Mazonson, P.D., and Holman, H.R. (1993). Evidence suggesting that health education for selfmanagement in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis and Rheumatism, 36, 439–446.
Maccoby, E.E. and Jacklin, C.N. (1974). The psychology of sex differences. Stanford, CA: Stanford University Press.
Mahler, M. (1975). The psychological birth of the human infant. New York: Basic Books.
Maslow, A. (1970). Motivation and personality (2nd Ed.). New York: Harper and Roe.
Matarazzo, J.D. and Leckliter, I.N. (1988). Behavioral health: The role of good and bad habits in health and illness. In S. Maes, C.D. Spielberger, P.B. Defares and I.G. Sarason (Eds.), Topics in health psychology (pp. 3–18). New York: John Wiley.
McGee, R., Williams, S., and Elwood, M. (1994). Depression and the development of cancer: A metaanalysis. Social Science and Medicine, 38, 187–192.
Mead, G.H. (1934). Mind, self, and society. Chicago: University of Chicago.
Mechanic, D. and Hansell, S. (1987). Adolescent competence, psychological well-being and self-assessed health. Journal of Health and Social Behavior, 28, 364–374.
Meltzer, J. and Hochstim, J. (1970). Reliability and validity of survey data on physical health. Public Health Reports, 85, 1075–1086.
Millstein, S.G. and Litt, I.F. (1990). Adolescent health. In S.S. Feldman and G.R. Elliot (Eds.), At the threshold: The developing adolescent (pp. 431–456). Cambridge, MA: Harvard University Press.
Moos, R.H. (1979). Social-ecological perspectives on health. In G.C. Stone, F. Cohen and N.E. Adler (Eds.) Health psychology: A handbook (pp. 523–547). San Francisco: Jossey-Bass.
Morano, C.D., Cisler, R.A., and Lemerond, J. (1993). Risk factors for adolescent suicidal behavior: Loss, insufficient family support, and hopelessness. Adolescence, 28, 851–865.
Mumford, E., Schlesinger, H.J., and Glass, G.V. (1981). Reducing medical costs through mental health treatment: Research problems and recommendations. In A. Broskowski, E. Marks and S.H. Budman (Eds.), Linking health and mental health (pp. 257–273). Beverly Hills, CA: Sage.
Murray, H.A. (1938). Explorations in personality. New York: Oxford University Press.
Nestman, F. and Hurrelmann, K. (Eds.). (1994). Social networks, and social support in childhood and adolescence: Prevention and intervention in childhood and adolescence. Berlin, Germany: Walter de Gruyter.
Orlinsky, D.E. and Howard, K.I. (1986). Process and outcome in psychotherapy. In S.L. Garfield and A.E. Bergin (Eds.), Handbook of psychotherapy and behavioral change (3rd ed., pp. 311–381). New York: John Wiley and Sons.
Ornish, D., Brown, S.E., Scherwitz, L.W., Billings, J.H., Armstrong, W.T., Ports, T.A., McLanahan, S.M., Kirkeeide, R.L., Brand, R.J., and Gould, K.L. (1990). Can lifestyle changes reverse coronary heart disease? Lancet, 336, 129–133.
Orth-Gomer, K. and Johnson, J.V. (1987). Social network interaction and mortality: A six year follow-up study of a random sample of the Swedish population. Journal of Chronic Diseases, 40, 949–957.
Orth-Gomer, K., Rosengren, A., and Wilhelmsen, L. (1993). Lack of social support and incidence of coronary heart disease in middle-aged Swedish men. Psychosomatic Medicine, 55, 37–43.
Pennebaker, J.W., Kiecolt-Glaser, J.K., and Glaser, R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239–245.
Powell, L.H., Shaker, L.A., Jones, B.A., Vaccarino, L.V., Thoresen, C.A., and Pattillo, J.R. (1993). Psychosocial predictors of mortality in 83 women with premature myocardial infarction. Psychosomatic Medicine, 55, 426–433.
Radioff, L.S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
Raha, S.N., McGee, R., and Stanton, W.R. (1992). Perceived attachments to parents and peers and psychological well-being in adolescence. Journal of Youth and Adolescence, 21, 471–485.
Robertson, E.K. and Suinn, R.M. (1968). The determination of rate of progress of stroke patients through empathy measures of patient and family. Journal of Psychosomatic Research, 12, 189–191.
Robinson, N.S. and Garber, J. (1995). Social support and psychopathology across the life span. In B. Cicchetti and D.J. Cohen (Eds.), Developmental psychopathology, Vol. 2: Risk disorder and adaptation (pp. 162–209). New York: John Wiley and Sons.
Rook, K.S. (1987). Social support versus companionship: Effects on life stress, loneliness, and evaluations by others. Journal of Personality and Social Psychology, 52, 1132–1147.
Ross, B. (1993). Emotional communication, emotional competence, and physical illness: A developmental interactionist view. In H.C. Traue and J.W. Pennebaker (Eds.), Emotion inhibition and health (pp. 32–56). Gottingen, Germany: Hogrere and Huber.
Ruberman, W., Weinblatt, E., Goldberg, J.D., and Chaudhary, B.S. (1984). Psychosocial influences on mortality after myocardial infarction. New England Journal of Medicine, 311, 552–559.
Sarason, I.G. (1980). Life stress, self-preoccupation, and social supports. In I.G. Sarason and C.D. Spielberger (Eds.), Stress and anxiety (Vol. 7, pp. 73–92). Washington D.C.: Hemisphere.
Sarason, B.R., Sarason, I.G., and Pierce, G.R. (Eds.). (1990). Social support: An interactional view. New York: John Wiley and Sons.
Schoenbach, V., Kaplan, B.H., Fredman, L., and Kleinbaum, D. (1986). Social ties and mortality in Evans County, Georgia. American Journal of Epidemiology, 123, 577–591.
Schuster, T.L., Kessler, R.C., and Aseltine, R.J., Jr. (1990). Supportive interactions, negative interactions, and depressed mood. American Journal of Community Psychology, 18, 423–438.
Seeman, T.E. and Syme, S.L. (1987). Social networks and coronary artery disease: A comparison of the structure and function of social relations as predictors of disease. Psychosomatic Medicine, 49, 341–354.
Shekelle, R.B., Raynor, W.J., Jr., Ostfield, A.M., Garon, P.C., Bieliauskas, L.A., Shuguey, C.L., Maliza, C, and Oglesby, P. (1981). Psychological depression and 17-year risk of death from cancer. Psychosomatic Medicine, 43, 117–125.
Shumaker, S.A. and Czakowski, S.M. (Eds.). (1994). Social support and cardiovascular disease. New York: Plenum.
Siegman, A.W. and Smith, T.W. (1994). Anger, hostility, and the heart. Hillsdale, NJ: Lawrence Erlbaum.
Spiegel, D., Bloom, J.R., Kraemer, H.C, and Gottheil, E. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888–891.
Spielberger, C.D., Gorsuch, R.L., and Lushene, R.E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
Spitz, R.A. (1965). The first year of life. New York: International Universities Press.
Stroebe, M. and Stroebe, W. (1983). Who suffers more? Sex differences in health risks of the widowed. Psychological Bulletin, 93, 279–301.
Suis, J. and Wan, C.K. (1993). The relationship between trait hostility and cardiovascular reactivity: A quantitative review and analysis. Psychophysiology, 30, 615–626.
Taylor, S.E. (1995). Health psychology. New York: McGraw-Hill.
Theorell, T., Blomkvist, V., Jonsson, H., Schulman, S., Berntorp, E., and Stigendal, L. (1995). Social support and the development of immune function in human immunodeficiency virus infection. Psychosomatic Medicine, 142, 732–736.
Thomas, P.D., Goodwin, J.M., and Goodwin, J.S. (1995). Effect of social support on stress-related changes in cholesterol level, uric acid level, and immune function in an elderly sample. Journal of Clinical Psychopharmacology, 142, 735–737.
Vaillant, G.E. (1977). Actaptation To Life. Boston: Little Brown.
VanderVoort, D.J. (1992). Belief systems and coping styles as mediating variables in the relationship between hostility and illness. Current Psychology: Research and Reviews, 11, 226–235.
VanderVoort, D.J. (1995). Depression, anxiety, hostility, and physical health. Current Psychology: Developmental, Learning, Personality, Social, 13, 69–82.
VanderVoort, D.J. (1988, April) Effects of social support on earthquake victims. Paper presented at the Annual Convention of the Rocky Mountain Psychological Association Convention, Salt Lake City, UT.
Veiel, H.O. and Baumann, U. (Eds.). (1992). The meaning and measurement of social support. New York: Hemisphere.
Vilhjalmsson, R. (1993). Life stress, social support and clinical depression: A reanalysis of the literature. Social Science and Medicine, 37, 331–342.
Vilhjalmsson, R. (1994). Effects of social support on self-assessed health in adolescence. Journal of Youth and Adolescence, 23, 437–453.
Weiner, H. and Fawzy, F.I. (1989). An integrative model of health, disease, and illness. In S. Cheren (Ed.), Psychosomatic medicine: Theory, physiology, and practice (Vol. 1, pp. 9-44).
Weisse, C.S. (1992). Depression and immunocompetence: A review of the literature. Psychological Bulletin, 11, 475–4189.
Weissman, M.M. (1987). Advances in psychiatric epidemiology: Rates and risks for major depression. American Journal of Public Health, 77, 445–451.
Welin, L., Svardsudd. L., Ander-Peciva, S., Tibblin, G., Tibblin, B., and Larson, G. (1985). Prospective study of social influences on mortality. Lancet, 11, 915–918.
Wheeler, L., Reis, H. and Nzlek, J. (1983). Loneliness, social interaction, and sex roles. Journal of Personality and Social Psychology, 45, 983–988.
Williams, R.B., Barefoot, J.C., Califf, R.M., Haney, T.L., Saunders, W.B., Pryor, D.B., Hlatky, M.A., Siegler, I.C., and Mark, D.B. (1992). Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. Journal of the American Medical Association, 267, 520–524.
Wills, T.A. (1985). Supportive functions of interpersonal relationships. In S. Cohen and S.L. Syme (Eds.), Social support and health (pp. 61–82). San Francisco, CA: Academic Press.
Windle, (1992). Temperment and social support in adolescence: Interrelations with depressive symptoms and delinquent behaviors. Journal of Youth and Adolescence, 21, 1–21.
Winefield, H.R., Winefield, A.H., and Tiggermann, M. (1992). Social support and psychological well-being in young adults: The Multi-Dimensional Support Scale. Journal of Personality Assessment, 58, 198–210.
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The author dedicates this paper to her beloved father, Charles VanderVoort and her colleagues Dr. Uwe Stuecher and Dr. Gay Barfield whom she describes as “natural altruists, the rarest and most loving type of people in the world.”
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Vandervoort, D. Quality of social support in mental and physical health. Curr Psychol 18, 205–221 (1999). https://doi.org/10.1007/s12144-999-1029-8
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DOI: https://doi.org/10.1007/s12144-999-1029-8