Social Support Hypothesis

The social support hypothesis, in contrast, is based on the idea introduced by Cobb (1976) that social support alleviates the detrimental effects of adverse life events.

From: Emotions, Technology, and Health , 2016

Social Support

Christine Schwarzer , Petra Buchwald , in Encyclopedia of Applied Psychology, 2004

3 Social Support and Health

Since Cassel hypothesized in 1974 that, under stressful conditions, the lack of social support will lead to a higher risk of becoming ill, research has shown that supportive interactions among people are protective against the health consequences of life stressors. It appears that social support can protect people in crises from a wide variety of pathological states, from low birthweight to death. However, recent research reviews of the empirical evidence of social relationship factors being protective against life stressors have yielded rather inconsistent results. One of the main reasons for such inconsistent findings might be the rich diversity of definitions and conceptualizations of social support and the complexity of the support process. A person's ability to cope effectively depends on the stressor itself, the type of preferred coping resource, and the resources available to the individual. There are several major types of coping resources, and social support is only one of them.

Investigating the question of stress buffering versus the direct effect provided a better understanding of the effects of social support. According to the stress buffering hypothesis, social support is needed only when people are under high stress. In that case, social support can buffer the negative stressful impact of critical life events such as divorce, loss of a loved one, chronic illness, pregnancy, job loss, and work overload on health. This means that the health and mental health benefits of social support are evident mainly during periods of high stress, whereas social support may have few physical or psychological benefits during periods of low stress. The stress buffering effect is depicted on the left-hand side of Fig. 1. Another model that explains how social support affects people suggests a direct effect and is illustrated on the right-hand side of Fig. 1. Here, social support has a direct positive effect on physical or mental health independent of stress levels. In other words, regardless of whether people are experiencing stressful situations, social support is generally beneficial.

FIGURE 1. Stress buffering effect (left) and direct effect (right) of social support.

Empirical evidence for both direct and buffering effects of social support has emerged. In 1986, Hobfoll reported that the direct and stress buffering effects occur simultaneously and that one type of effect is more prominent than the other in a given instance.

An overwhelming amount of evidence shows that social support has effects on both psychological and physical health. One remarkable result for physical health is that social support reduces the risk of dying from disease, suicide, or accidents by about the same percentage as does smoking. Moreover, increased social support from family, friends, and/or colleagues is related to decreased psychological distress. With help and support, people are psychologically better able to manage critical life events, such as unemployment and divorce, as well as everyday problems and hassles.

In Fig. 2, a theoretical framework for social support as a coping resource helps to illuminate the effects of social support on health, referring to stress theoretical underpinnings.

FIGURE 2. Theoretical framework for social support as a coping resource.

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Social Support☆

Petra Buchwald , in Reference Module in Neuroscience and Biobehavioral Psychology, 2017

Social Support and Health

Since Cassel hypothesized in 1974 that, under stressful condition, the lack of social support will lead to a higher risk of becoming ill, research has shown that supportive interactions among people are protective against the health consequences of life stressors. It appears that social support can protect people in crisis form a wide variety of pathological states, from low birthweight to death. However, recent research reviews of the empirical evidence of social relationship factors being protective against life stress yielded rather inconsistent results. One of the main reasons for such inconsistent findings might be the rich diversity of definitions and conceptualizations of social support and the complexity of the support process. A person's ability to cope effectively depends on the stressor itself as well as on the type of preferred coping resource, and the resources available to the individual. There are several major types of coping resources, and social support is only one of them.

A better understanding of the effects of social support was provided by investigating the stress-buffering versus the direct-effect question. According to the buffering hypothesis social support is needed only when people are under high stress. In that case social support can buffer the negative stressful impact of critical life events, such as divorce, loss of a loved one, chronic illness, pregnancy, job loss, and work overload on health. That means, the health and mental health benefits of social support are mainly evident during periods of high stress but when there is only little stress, social support may have few physical or psychological benefits. The stress-buffering effect is depicted in Fig. 1 on the left hand side. Another model which explains how social support affects people suggests a direct-effect and is illustrated in Fig. 1 on the right hand side. Here social support has a direct positive effect on physical or mental health independent of stress levels. In other words, whether or not people are experiencing stressful situations, social support is generally beneficial.

Figure 1. Stress-buffering effect (left) and direct effect (right) of social support.

Empirical evidence for both, direct and buffering effects of social support has emerged. Hobfoll as one expert on social support says that both direct and stress-buffering effects occur simultaneously and that one type of effect is more prominent in a given instance than the other.

An overwhelming amount of evidence showed that social support has effects on both, psychological and physical health. One remarkable result for physical health is, for example, that social support decreases the risk of dying from disease, suicide, or accidents by about the same percentage as smoking does. Moreover, increased social support from family, friends or colleagues is related to decrease psychological distress. With help and support people are psychologically better able to manage critical live events as unemployment, divorce as well as everyday problems and daily hassles.

In Fig. 2 a theoretical framework for social support as a coping resource should illuminate the effects of social support on health referring to stress theoretical underpinnings.

Figure 2. Theoretical framework for social support as a coping resource.

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What Is Emotional About Emotional Robotics?

Thorsten Kolling , ... Monika Knopf , in Emotions, Technology, and Health, 2016

Affect in Human-Animal Interactions

It is well known that for many people, animal companions provide emotional support through mutual affectionate attachments (i.e., the human-animal bond, Archer, 1997; Beck & Katcher, 2003). In a recent review, Beetz, Uvnäs-Moberg, Julius, and Kotrschal (2012) summarized their findings on the effects of human-animal interaction on psychosocial and psychophysiological parameters. The authors conclude that human-animal interactions (HAI) have clear positive effects on a variety of psychological states and factors, (1) improvement in social attention, behavior, interpersonal interaction, and mood, (2) reduction in stress-related parameters such as cortisol, heart rate, and blood pressure, (3) reduction in self-reported fear and anxiety, as well as (4) improvement in mental and physical health, especially cardiovascular health. Additionally, limited evidence from a small number of studies suggests that HAI has positive effects on (1) stress-related parameters such as epinephrine and norepinephrine in patients with heart failure (Cole, Gawlinksi, Steers, & Kotlerman, 2007), (2) immune system functioning (Charnetski, Riggers, & Brennan, 2004), (3) pain management in nursing homes (Darrah, 1996), (4) trustworthiness and trust in other persons (Guéguen & Ciccotti, 2008), and in children leads to (5) reduced aggression (Hergovic, Monshi, Semmler, & Ziegelmayer, 2002) and (6) enhanced empathetic skills (Hergovic et al., 2002) as well as (7) improved learning (Gee, Christ, & Carr, 2010).

In view of these positive findings on the effects of HAI on emotions, it is important for emotional robotics to find out the reasons why and how animals affect the mental and physical health of humans. Although a unified framework on the question is not available, three theories that specifically address the emotional effects of human-animal interactions would appear to be important (also see O'Haire, 2010).

The biophilia hypothesis (Wilson, 1984) claims that humans have an instinctive bond and an innate propensity to attend to and be attracted by animals. From an evolutionary standpoint, attending to animals in the wild and understanding an animal's behavior increases survival chances. In line with this reasoning, a number of studies have demonstrated that animals have calming and relaxing effects on humans (Gullone, 2000), while agitated and aggressive animals are purported to have the opposite effect. By testing different populations in different settings (DeMello, 1999; DeSchriver & Riddick, 1990; Friedman, 1995), it has also been shown that simply viewing calm and friendly animals, and even more so when interacting with them, can reduce anxiety (reduction in cardiovascular, behavioral, and psychological indicators and measures).

The social support hypothesis , in contrast, is based on the idea introduced by Cobb (1976) that social support alleviates the detrimental effects of adverse life events. A wealth of research indicates that social support is very important to well-being under stressful life circumstances and both helps prevent and alleviate depression and anxiety, and aid recovery from physical illnesses (see Thoits, 2011, for a review). In the context of HAI, the social support theory posits that humans and animals function as a source of social support in different ways (McNicholas & Collis, 2006). On the one hand, animals are a source of social support in and of themselves. They provide both emotional support in the form of concern, comfort, reassurance, sense of belongingness, and self-esteem, for example, by encouraging feelings of self-worth and confidence. According to a report by Bonas, McNicholas, and Collis (2000), animals score even more highly than humans on some aspects of social support, namely in terms of providing companionship, nurturance, and a reliable alliance. This finding is probably rooted in their constant availability, their nonjudgmental support, and their unconditional love (see Walsh, 2009). Unlike humans, animals are unable to criticize, retaliate, feel overwhelmed by or reject another's feelings, and thus they provide a more consistent, demonstrative, and positive mirror that promotes a positive sense of self (see Brown, 2004, for a perspective on human-animal bonding and self-psychology). In addition, a lack of cognitive as well as linguistic abilities means an animal is unable to lie, verbally criticize, or betray trust (Serpell, 2002), which may also explain the positive effects of HAI.

Besides providing direct social support, animals also act indirectly as social facilitators or "social lubricants" (Kruger & Serpell, 2006; McNicholas & Collis, 2006). They provide either a neutral topic of conversation (Fine, 2006), or they affect the beliefs of others about their owner. For example, it has been shown that persons with animal companions are perceived as happier, friendlier, less threatening, more relaxed, and more desirable as acquaintances or friends, even when they belong to groups that are commonly stigmatized (Eddy, Hart, & Boltz, 2001). Woods, Giles-Corti, Bulsara, and Bosch (2007) report that dogs can play a significant role in mediating social relationships ranging from greetings by strangers to deep friendships, and the membership in broad social networks. Thus, animals can indirectly help humans to fulfill their social and emotional needs.

Social cognitive theory is also used to explain the positive effects of nurturing and caring for animals. This theoretical perspective suggests that interaction with an animal enhances self-efficacy (Bandura, 1977) and personal agency. Studies show that animals are effective in both aspects (Allen, Kellegrew, & Jaffe, 2000; Berget, Ekeberg, & Braastad, 2008). This, in turn, may foster a sense of personal achievement and self-esteem (see Catanzaro, 2003), all of which encourage positive affect. Furthermore, the dependence of animals on humans provides a reason for people to adopt health-promoting behaviors toward themselves, and can also help them to schedule the day, e.g., retirees (Dembicki & Anderson, 1996). It has also been demonstrated in clinical samples that caring for and looking after another live being has positive behavioral effects (Allen et al., 2000; Berget et al., 2008).

Last, but not least, human-animal bonding is not unidirectional but dyadic in nature (Odendaal, 2000; Serpell, 2002). Not only do animals fulfill various roles for humans such as that of friend, companion, or servant, but humans also ascribe different roles to their animals (e.g., that of caretaker or teacher). Due to their dependence on humans, animals are provided with nurturance and protection (O'Haire, 2010), and they reward these efforts by reacting positively.

Overall, empirical research on the effects of human-animal interactions has demonstrated that interacting with animals has a number of positive emotional effects on humans, such as reduced stress, anxiety, and fear, and that these can be assessed on a behavioral as well as a physiological level. Human-animal interaction is not only of evolutionary importance but also directly and indirectly supports the human need for social and emotional fulfillment.

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Social reactions to disclosure of interpersonal violence and psychopathology: A systematic review and meta-analysis

Emily R. Dworkin , ... Sarah E. Ullman , in Clinical Psychology Review, 2019

1.2 Social reactions to interpersonal violence

According to the stress-buffering hypothesis, social support is especially beneficial to health under times of stress or adversity (S. Cohen & Wills, 1985; Taylor, 2011), and research has increasingly demonstrated the importance of reactions of others in recovery from trauma (S. B. Campbell & Renshaw, 2018; Wagner, Monson, & Hart, 2016). Expectancy violations may be more harmful after trauma, when the ability of social supporters to "step up" is put to the test. Of the forms of trauma, expectancy violations may be even more potent following SA and other forms of interpersonal victimization, given that they are highly-stigmatized forms of trauma (Kennedy & Prock, 2018). When survivors disclose, this creates an opportunity for their positive expectancies of their social supporters to be violated, given that social supporters may have problematic beliefs about victimization or limited knowledge of how to respond due to the stigmatized nature of these experiences (Banyard, Moynihan, Walsh, Cohn, & Ward, 2010). Although many survivors of violence report disclosing to others to obtain help, support, or understanding (Ahrens, Campbell, Ternier-Thames, Wasco, & Sefl, 2007) and may be distressed by a violation of these explicit expectations, any responses that violate basic expectations of caring or concern from social supporters in response to a crisis may be harmful. Indeed, research emphasized the harm of social reactions to victimization that involve betrayal (Freyd, 1994), which could be considered as a violation of an expectancy of protection. In addition, cognitive theories of the development of PTSD emphasize the importance of trauma-related beliefs (Ehlers & Clark, 2000; Resick, Monson, & Chard, 2016), which could include the development or confirmation of beliefs that others cannot or will not provide help or support when needed. In addition, social interactions after victimization may affect beliefs about oneself (e.g., self-blame) (Kennedy & Prock, 2018) as well as beliefs about appropriate coping strategies (e.g., approach versus avoidance) (S. B. Campbell, Renshaw, Kashdan, Curby, & Carter, 2017) that could affect recovery processes.

Following the broader literature on social support, social support offered in response to interpersonal victimization can be considered in terms of both received support and perceptions of that support. Received support in response to interpersonal violence, termed "social reactions," includes objectively-observable interactions with others regarding victimization, both positive and negative. These social reactions are typically assessed using the Social Reactions Questionnaire (SRQ) (Ullman, 2000). The SRQ was developed by using qualitative data and existing literature to generate a set of reactions commonly received by SA survivors. Survivors are asked to indicate how often they received each reaction from others following victimization. Factor analyses of the SRQ have characterized social reactions both in terms of valence (i.e., positive or negative) and specific types of positive (e.g., emotional support) and negative (e.g., victim blame, distraction) reactions. Overall, the vast majority of survivors who disclose report receiving both positive social reactions (97%) and negative social reactions (98%) (Filipas & Ullman, 2001). Perceived support in response to interpersonal violence, in contrast, reflects survivors' appraisals of these social reactions (e.g., perceptions of the degree to which the social reactions they receive are helpful or satisfying). Unlike the general form of perceived social support described previously, which reflects perceptions of both anticipated and actual support provided, perceived support in response to interpersonal violence reflects perceptions of the actual social reactions received. Importantly, qualitative research has shown that survivors sometimes report positive appraisals of negative social reactions and negative appraisals of positive social reactions (Ahrens & Aldana, 2012; Dworkin, Newton, & Allen, 2018; Lorenz et al., 2018), indicating that perceptions do not necessarily correspond to the actual social reactions received.

Evidence suggests that the relationship of these various types of victimization-specific social support to psychopathology largely parallels the broader social support literature. Specifically, the frequency with which survivors report receiving negative social reactions is associated with worse psychopathology, the frequency with which survivors report receiving positive social reactions has nonsignificant associations with psychopathology, and more positive perceptions of social reactions are associated with lower psychopathology. Next, we review the literature on each of these types of support in relation to psychopathology.

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Parenting in context: Revisiting Belsky's classic process of parenting model in early childhood

Lindsay Taraban , Daniel S. Shaw , in Developmental Review, 2018

Socioeconomic status

Although not considered in Belsky's original model, SES and, to a lesser extent, minority status emerged across a variety of domains as important contextual factors influencing the magnitude of associations between predictors and parenting outcomes. Overall, low-SES and minority status (although likely confounded) appear to enhance relations between stressors and impaired parenting. Among mothers in a large meta-analysis with adequate financial resources, for example, the effect size of the negative association between depression and positive parenting was zero; among mothers who were financially disadvantaged, however, this effect size was moderate (Lovejoy et al., 2000). Similarly, a meta-analysis of paternal depression found that the association between depression and more negative parenting was stronger for non-Caucasian fathers. Even more striking, high SES was found to reverse the directionality of negative associations between child negative emotionality and parenting in multiple studies (Crockenberg, 1986; Paulussen-Hoogeboom et al., 2007, 2008). Specifically, child negative emotionality was associated with more sensitive parenting among high-SES samples, but with reduced sensitive parenting among less affluent samples. In addition to increasing the likelihood that stressors will be more strongly related to impaired parenting, low SES also appears to increase the salience of protective factors. Consistent with the buffering hypothesis, social support has been found to be more strongly associated with positive parenting in the context of stress, such as among low-income, homeless, and African American mothers (Lutz et al., 2012; Green et al., 2007; Woody & Woody, 2007).

SES is typically measured using a single factor, most often income or educational attainment (Hauser & Warren, 1997). However, when thinking about associations with parenting, SES, particularly at the lower spectrum, goes far beyond "amount of dollars" or "amount of education" that parents have attained. Low-SES is likely associated with a host of other factors that impact parenting, such as neighborhood quality, access to quality childcare, availability of developmentally-appropriate toys and learning materials in the home, stability of caregivers over time, household chaos, access to high quality and affordable food, and exposure to toxins (e.g., Duncan & Magnuson, 2012; Shaw & Shelleby, 2014). Additionally, low SES is likely related to higher levels of daily and chronic stress, undermining parents' well-being (Baum, Garofalo, & Yali, 1999). Finally, it also is possible that there are certain traits that predispose individuals to moving into and remaining in low-income brackets and that could undermine parenting (e.g., personality, psychopathology). For example, lifetime history of low-SES status has been associated with high levels of neuroticism and low levels of conscientiousness (Jonassaint, Siegler, Barefoot, Edwards, & Williams, 2011). Thus, when considering direct associations between SES and parenting, or the moderating role of SES on associations between contextual predictors and parenting, it is important to keep in mind that SES itself it very unlikely to be a mechanism, and that it represents a broad and varied influence. Future research would benefit from further exploration of why and how SES influences parenting in early childhood.

It should be acknowledged that the pattern we observed regarding SES and parenting was based on a limited number of studies, and—as is a common problem in the field—there are likely studies reporting null effects of SES that have not been published in the literature or that we failed to find during our review of the literature. Still, we did not purposely search for studies related to SES, nor did we have any initial hypotheses about how SES would interact with context to predict parenting. Thus, we believed the pattern of results that emerged during the course of our review warranted comment. A more systematic review of the literature may be necessary to validate our initial hypothesis that SES increases the strength of associations between contextual factors and early childhood parenting.

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Understanding the multidimensional trajectory of psychosocial maternal risk factors causing preterm birth: A systematic review

Kavita Batra , ... Patricia Cruz , in Asian Journal of Psychiatry, 2020

4.3 Life-course variations and antenatal stress

4.3.1 Marital status

Unmarried women of all age groups were significantly more likely to have preterm labor/birth as compared to their married counterparts, and the risk was higher if the mother was under 20 years of age (El-Sayed et al., 2012). The association between marital status and preterm birth was hypothesized to be mediated through other important psychosocial constructs such as access to prenatal care, financial stability and social support, and pregnancy-related anxiety and depression (Cohen and Wills, 1985; El-Sayed et al., 2012). It is well established that lack of social support affects mental well-being (through anxiety and depression), which then further impairs the physiological processes of the body resulting in adverse health outcomes (Cohen and Wills, 1985). According to the "buffering hypothesis," social support prevents an individual from negative consequences of stressful events, hence acting as a buffer (Cohen and Wills, 1985). The type of social support was also investigated in one of the studies included in this review which reported the partner's support to be more significantly correlated with the birth outcome than the support from family and friends (Surkan et al., 2017). Women without support from their partner had higher levels of stress during pregnancy when compared to those who had partner involvement and support (OR 1.20, 95 % CI: 1.03–1.30) (Surkan et al., 2017). This finding was consistent with other studies which reported higher preterm birth (PTB) rates among mothers lacking social support (Hetherington et al., 2015; Merklinger-Gruchala & Kapiszewska 2019; Shah et al., 2010).

4.3.2 Pregnancy intendedness

Another life course variation which was reported to be associated with birth outcomes was pregnancy intendedness (Messer et al., 2005). Preterm birth is also believed to act through the stress pathway; women with an unintended pregnancy may have more stressful events as compared to those with a planned pregnancy (Orr and Arden Miller, 1997). Berkowitz and Kasl (1983) reported that pregnancy intendedness is a very important social indicator. African-American women were reported to have less pregnancy intendedness scores as opposed to white females (Berkowitz and Kasl, 1983). It was hypothesized that African-American women perceive less support from their partners as opposed to white females (Berkowitz and Kasl, 1983). Another reason that may have led to a lower pregnancy intendedness score was previous obstetric complications, which heightened maternal anxiety or depression, leading to preterm birth (Berkowitz and Kasl, 1983).

4.3.3 Homelessness

Cutts and colleagues (2015) identified homelessness as another important life course factor, capable of generating a cascade of events that can affect birth outcomes. It was reported that homelessness during the prenatal period was strongly associated with premature birth (Cutts et al., 2015). The results of the Cutts et al. study were consistent with a previous study which reported that adverse birth outcomes were more common among homeless women as compared to the general population (Stein et al., 2000). However, it is not clear if homelessness affects birth outcomes directly or indirectly. The mechanism through which homelessness operates remains elusive. According to past reviews, homelessness was considered as one of the long-term stressors in the pregnancy period and was believed to be associated with preterm birth (Dunkel-Schetter & Tanner, 2012). It could presumably be due to poor nutritional intake, low body mass index (BMI), and increased stress/anxiety, which would make homeless women even more likely to have adverse health outcomes, especially preterm labor (Dunkel-Schetter & Tanner, 2012; Johnson and McCool, 2003). Premature birth rates were even worse if the homeless women were African-American (Stein et al., 2000). The premature birth rates among African-American homeless women were 3 % higher compared to the national average (Stein et al., 2000).

4.3.4 Childhood experiences and stress

Among all other lifetime events, childhood experiences were also shown to have an effect on adult health outcomes (Selk et al., 2016). It was reported that women who experienced sexual abuse in childhood were 22 % more likely to have preterm deliveries in adulthood (Selk et al., 2016). In addition to the known neuroendocrine response causing psychosocial stress, other mechanisms such as the tendency to adopt unhealthy behaviors, impaired health (e.g., sexually transmitted diseases), injuries due to forced sexual activity, and the increased likelihood to have chronic diseases, can help to explain this association (Petrak, 2000; Roy et al., 2010). This report is congruent with a previous review which described a positive association between childhood maltreatment and adult psychological health and suggested that abuse in childhood was an important source of stress in pregnant women (Wegman and Stetler, 2009). Irrespective of the source of stress, the association of stress and preterm birth mediates through heightened anxiety which might activate the neuroendocrine system to cause premature labor (Berkowitz and Kasl, 1983). The association of maternal stress and adverse neonatal outcomes has also been studied in Asian settings and underscores the importance of implementing psychosocial support services for expectant mothers in the perinatal period (Lim et al., 2020).

Given a pre-existing risk of significant physical and emotional changes in the perinatal period, there is an urgent need for a call to action to prevent psychological morbidities among pregnant women (Tareen and Tandon, 2018). A multifaceted approach emphasizing the prevention of risk factors of maternal disorders, early diagnosis and screening by providers, addressing psychosocial problems, and adopting psychotherapy and medication regimens have been proposed to promote maternal and neonatal outcomes (Tareen and Tandon, 2018). The integrated approach of delivering mental health services (in conjunction with primary health services), such as supportive psychotherapy, routine maternal health monitoring, stress management, and life skills trainings have generated promising results in reducing anxiety and depression among expectant mothers living in low- or middle-income countries (George et al., 2020; Noorbala et al., 2019; Tandon et al., 2014). These psychological interventions have the potential to improve maternal and neonatal outcomes, highlighting the need for their widespread implementation across other countries, including the U.S.

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