Journal of Sociat Issues, Vol. 40, No. 4, 1984, pp.. 11-36
Toward a Theory of Social Support:
Closing Conceptual Gaps
Sally A. Shumaker
The National Institutes of Health
Arlene Brownell
Indiana State University
We define social support as "an exchange of resources between two individuals
perceived by the provider or the recipient to be intended to enhance the well-
being of the recipient.'' We then discuss the assumptions and implications of this
definition and address several gaps in the support literature. Specifically, we
consider the costs and benefits of supportive exchanges for both participants, the
dual and possibly incongruent perceptions of support held by the provider and
the recipient, and the importance of non-network sources of support. In addition,
we distinguish between the health-sustaining versus health-compensating func-
tions of support and how these functions link with the resources provided in
supportive exchanges. We next address the factors that can influence support
effects and suggest a broad range of outcomes for both the provider and the
recipient. Finally, we distinguish the dimensions of support from the contextual
variables that can influence its quality and effectiveness.
The era of unrestrained enthusiasm that has dominated social support re-
search and interventions for over ten years is coming to a close. Without dismiss-
The authors are grateful for suggestions from Charlene Depner, Ruth Faden, Kenneth Heller,
Karen Rook. M. Beth Shinn, Daniel Stokols, Ralph Swindle. Ralph Taylor, and Barry Wellman.
This manuscript was completed while Sally Shumaker was at The John Hopkins University. A
portion of Arlene Brownell s work on this article was prepared while she was a postdoctoral fellow
on an NIMH psychiatric epidemiology training grant, Michael S. Goldstein, Director, School of
Public Health, at the University of California, Los Angeles.
Address correspondence regarding this article to Sally A. Shumaker, Behavioral Medicine
Branch, DECA, NHLBI, Federal Building, Room 604, The National Institutes of Health, Bethesda,
MD 20204.
11
0022-4537/84/1200-0011$3.50/1 © 1984 The Society for lhe Psychological Study of Social Issues
12
Shumaker and Brownell
ing the important contributions already made to our understanding of this phe-
nomenon, investigators are now arguing the need for more systematic and
rigorous research (cf. House & Kahn, in press; Kessler & McLeod, in press;
Thoits, 1982). Relevant to the need for improved methodology is the problem of
conceptual ambiguity in this field (Antonucci, 1983; Oritt, Behrman, & Paul,
1982; Thoits, 1982; Wallston, Alagna, DeVellis, & DeVellis, 1983). Until now,
predictive validity has been emphasized in much of the research, while construct
validity has been neglected (Heller & Swindle, 1983). The costs of this emphasis
are threefold. First, disparate methods are used to assess the effects of social
support (Depner, Wethington, & Ingersoll-Dayton, 1984), severely limiting
efforts to integrate research findings meaningfully. Second, taxonomies gener-
ated to capture the complex and multidimensional nature of support are continu-
ing to expand: they now run the risk of including all aspects of interpersonal
transactions (Rook, 1983), thereby obscuring what is uniquely support. Finally,
critical conceptual gaps persist that need to be identified
and addressed before
empirical methods are improved and a theory of support develops.
First, a clear distinction must be made between the
content of supportive
exchanges and the purposes
or functions of social support. Because this distinc-
tion is not made, little attention is given to how support is supposed to work, how
it does work, and what its effects are. Second, studies on support include net-
work characteristics (e.g., size, density); in operationalizing the concept, howev-
er, researchers do not always specify the connections between
networks and
support.
Third, implicit in a network approach is the recognition that support in-
volves at least two individuals. Yet most investigators do not recognize that
issues relevant to interdependent relations and characteristics of
all participants
may significantly influence the phenomenon.
Fourth, a distinction needs to be made between
harmful interpersonal rela-
tions and the potentially
harmful effects of supportive exchanges. Several re-
searchers discuss the potential stress of relationships (Rook & Dooley, in press;
Shinn, Lehmann, & Wong, 1984; Wellman, 1981). However, we believe that
further distinctions need to be made among interactions that are intentionally
harmful, those that are unintentionally harmful, and those that seem harmful but
are actually beneficial. This point underscores the importance of considering
both provider and recipient perspectives.
Fifth, it is necessary to consider the difference between the
short- and the
long-term effects of social support. For the most part, outcome measures are
restricted to global indices of mental and physical health. Thus, investigators
ignore
when they intercept these ongoing health phenomena (Cohen & Syme, in
press), and they overlook the
immediate effects of supportive exchanges.
Sixth, most of the recent theoretical and empirical work on support is
embedded within a stress and coping paradigm. This implies that support is only
relevant to health when individuals are stressed. We contend that a clear, the-
Toward a Theory of Social Support
13
oretical distinction needs to be made between the
health-sustaining and the
compensatirtg (i.e., stress buffering) aspects of this phenomenon (Depner, Weth-
ington, & Korshaven, 1982; House, 1981). That is, we believe that support is
important to mental and physical health in the absence as well as in the presence
of stress, but that support operates differently in these two situations.
The last problem we consider involves the
contextual nature of support.
Social scientists argue that many phenomena cannot be adequately understood or
investigated without a full consideration of the ecological factors that influence
them (cf. Aitman, 1982; Bronfenbrenner, 1979; Schwartz, 1982; Stokols, 1983;
Trickett, 1983). By considering context, researchers are forced to distinguish
clearly between
dimensions of support (e.g., its specific functions and resources)
and
situational variables (e.g., organizational structure, physical design).
In spite of important conceptual strides, confusion remains regarding what
social support
is, what it is
not, how it
operates, and what are its real and
potential
short- and /ong-term effects. In our remaining discussion we introduce
a definition of support and use it as a point of departure to explore the phe-
nomenon and address the seven conceptual gaps identified above.
Defining Social Support
Social support is
an exchange of resources between at least two individuals
perceived by the provider or the recipient to be intended to enhance the well-
being of the recipient.
There are several ways in which this definition differs from others. First, we
include the concept of
exchange, the
perceptions of at least
two participants, and
a broad outcome measure. Further, because the outcome is tied to the perceived
intentions of either participant, the actual effects of support may be positive,
negative, or neutral. Finally, we do not limit support to network members nor to
a stress paradigm.
Social Support as an Exchange Process
The inclusion of the term
exchange in our definition of social support makes
explicit our assumption that support necessarily involves at least two individuals
and that there are potential costs and benefits associated with the exchange for
both participants (Altman & Taylor, 1972; Homans, 1961; Thibaut & Kelley,
1959). Research from the areas of reciprocity and prosocial behavior offer clues
as to how the participants might evaluate these costs and benefits.
Reciprocity
Theorists suggest that exchange-derived models are relevant to support
(Antonucci, 1983; Berkman, 1983; Heller & Mansbach, 1984; House & Kahn,
^'^
Shumaker and Brownell
in press; Rook & Dooley, in press). Cobb (1976), for example, argues that
belonging to a network characterized by
mutual obligations is a component of
social support, Gottlieb (1983) discusses the threat posed by inequity to the
stability of supportive relationships, and Shinn et al. (1984) consider how an
obligation to reciprocate might stress relations. The concepts of reciprocity
(Gouldner, 1960) and indebtedness (Greenberg, 1980) are particularly relevant
to the motives and actions of the recipient in supportive exchanges.
The concept. Gouldner (1960) posits that a norm of reciprocity operates
within this culture in that people usually return the benefits they receive from
others. Reciprocity can be influenced by recipients' perceptions of providers'
real costs and intentions in providing the benefit, as well as by the degree to
which the benefit actually helps the recipient (Shumaker & Jackson, 1979).
Greenberg (1980) takes the concept of reciprocity a step further by arguing
that accepting a benefit may place the recipient in an uncomfortable state of
tension (indebtedness): as a result, the recipient will want to reduce this discom-
fort by, for example, not accepting a benefit or by directly reciprocating it. Such
options, however, are not always available. Sometimes we are forced to accept
assistance when an opportunity to reciprocate in kind is limited or unavailable.
When this occurs, people find alternative ways to reduce their discomfort. They
may, for example, refuse to accept more help even though they continue to need
it (Castro, 1974). They may also deride the person who helped them (Castro,
1974; Gross & Latoni, 1974; Shumaker & Jackson, 1979), help someone else if
they cannot reciprocate directly (Kahn & Tice, 1973), or reevaluate the original
exchange to decrease their perception of debt (Shumaker & Jackson, 1979).
Implications. Two implications can be drawn from the reciprocity model.
First, if people feel they will not be able to return a benefit, they may be less
likely to seek assistance or accept it when offered. In situations where help is
needed over an extended period of time (for example, in cases of chronic dis-
ease), the recipient's inability to reciprocate fully may become increasingly
apparent and asking for help may become especially difficult.
Second, if reciprocity is prevented, then the relationship between providers
and recipients may diminish. Recipients, for example, may derogate providers or
the resources received to reduce feelings of discomfort. Over time this can cause
social ties to disintegrate, and make recipients more vulnerable to stressors.
There are ways of minimizing the negative effects of reciprocity. First,
providers can be sensitized to the recipients' needs to feel they are contributing
equitably to the relationship. Second, recipients might be encouraged to assist
someone other than the provider. Although research suggests that such oppor-
tunities do not eliminate a sense of debt, they do appear to reduce the tension
associated with indebtedness (cf. Shumaker & Jackson, 1979). The mutual care-
giving that occurs in self-help groups represents one way in which this occurs.
Toward a Theory of Social Support
15
Third, some of a recipient's burden can be moved from the informal net-
work to a formal support system. For example, clergy, health professionals, and
therapists may be valuable sources of support when circumstances cause distur-
bances in a relationship's normal balance between helping and receiving (cf.
Dunkel-Schetter, 1984). Formal support providers do not usually require reci-
procity in the same way that informal support providers do. Furthermore, formal
providers are less likely to be threatened by the needs of the recipient, require
little effort to sustain the linkage, and are often able to provide the recipient with
more expert information than informal providers (Shumaker, 1983). Finally, the
recipient's needs can be shared among several such sources (Chesler & Barbarin,
1984).
Limitations. There are limitations in the degree to which exchange con-
cepts, derived from economic theories, are relevant to support (cf. Chesler &
Barbarin, 1984). In its broadest sense, social support is the essence of being
"social": it is mutual nurturing and caring. Exchange models provide methods
for addressing the interdependency of relationships involved in supportive ex-
changes and suggest ways in which this interdependence may affect support
seeking and acceptance, as well as the overall quality of relationships over time.
The process of giving and receiving is more fluid than is implied by economic
modeling, however, and the imposition of exchange concepts can trivialize the
phenomenon by reducing mutual caring to a cost/benefit analysis. The reciproci-
ty model implies that the nurturance we offer one another is quantifiable and that,
on some level, a value is affixed to the resource. In reality it is difficult to affix a
value to what is gained by providing assistance to someone cared for.
A final point that should temper investigators' applications of this concept is
that reciprocity is less formalized with intimates than with more distant friends
(Gouldner, 1960). The "accounting" is less exact among close friends (Walster,
Walster, & Berscheid, 1978; Rubin, 1973). There is little doubt, however, that
an extended imbalance in exchanges will eventually threaten even the closest
relationships; research on reciprocity can tell us how support will be affected
when this occurs.
Thus, the value of the reciprocity model for social support derives from its
attention to factors that inhibit people's willingness to seek and accept help. By
being sensitive to situations in which the norm of reciprocity is salient (e.g.,
among distant friends or over extended periods of recipient need) investigators
can assess whether people lack access to support or are unwilling to become
indebted to others.
Prosocial Behavior
The concept. Although reciprocity concerns interdependent relationships,
empirical investigations focus on the recipients' motives. Most research on pro-
'^
Shumaker and Brownell
social behavior emphasizes the providers and what factors influence their deci-
sions to assist. For example, an individual's decision to help appears to follow a
sequence of "mini" decisions, which include recognizing the need for as-
sistance, interpreting the dilemma as an emergency, and deciding that the pro-
vider possesses the necessary skills and resources to act (Latane & Darley, 1970;
Latane & Nida, 1981). Each point in this sequence can be influenced by the
characteristics of the recipient (e.g., attractiveness), characteristics of the pro-
vider (e.g., mood, values about helping), and the number of other people
present.
Implications. There are several ways in which findings from the prosocial
literature may be useful for social support. First, attention is focused on the
elements that influence providers' decisions to offer assistance. Data suggest that
recipients must signal their need for assistance (at least in distress-related circum-
stances). Also, the providers'
ability and
willingness to read this signal accu-
rately may be influenced by a number of complex factors, including social skills,
mood, and values about giving help, as well as characteristics of the setting (cf.
Raven & Rubin, 1983).
Another interesting implication has to do with diffusion of responsibility.
Although the presence of more providers appears to
decrease the probability of
intervention, Latane and Nida (1981) argue that the person in need of assistance
(i.e., the recipient) may
believe that having more people present
increases the
likelihood that he or she will be helped. This suggests that people with a large
and
dense social network may assume that support is available when they need it.
Providers, however, may be less likely to offer support when their responsibility
for assistance is shared with others. Thus, in some instances network size may
work against the best interests of the recipient.
Limitations. There are several limitations in the applicability of prosocial
behavior research for social support. First, the research emphasis is on factors
that
precede a decision to intervene. In considering support, we are trying to
understand the
act of support itself;
who provides
what and for
what intended
outcomes.
Second, research on prosocial behavior is usually limited to single acts of
assistance. Social support measures, however, often assess ongoing rela-
tionships. Furthermore, research on prosocial behavior involves the actions of
one or more
strangers toward another stranger. Thus, for example, diffusion of
responsibility probably diminishes when people know one another. People are
more likely to help friends than strangers, are better able to interpret and respond
to their friends' needs, and can anticipate future assistance from their friends.
In spite of the limitations of prosocial research, we can gain some important
insights. As we discuss below, certain examples of prosocial behavior may
Toward a Theory of Social Support
17
represent a subset of support. Also, helpful acts are moderated by person and
place characteristics that have already been identified in the prosocial research
area, and these same moderators may influence whether people provide support.
Participants in Social Support Exchanges
There are two implications to the inclusion of at least two people in our
definition of social support. First, it suggests the need to consider the
rela-
tionship of the actors to one another and how this relationship might influence
support. Second, it implies that there are
two perspectives toward social support
and that these may differ.
Relationship Between Actors: Support Among Strangers
Our definition of support deliberately excludes network membership as a
necessary dimension of the phenomenon. Most conceptualizations of support,
however, limit the phenomenon to transactions among members of the same
network (cf. Cobb, 1976; Forland & Pancoast, 1978; Hirsch, in press; Pilisuk &
Minkler, 1980; Wellman, in press). Thoits (1982), for example, defines the
support system as "that subset of persons in the individual's total social network
upon whom he or she relies for socioemotional aid, instrumental aid, or both"
(p. 148).
Social support usually occurs between people who are members of the same
network. There are, however, important exceptions that should be considered in
a complete model of the phenomenon. Helpful acts may occur when people are
in distress and strangers come to their aid (e.g., prosocial behaviors, discussed
above). People expressing friendship toward one another, for example, the smile
or friendly greeting from a passing stranger or acquaintance, also could be
interpreted as a form of mutual nurturanee. Research from the area of self-
disclosure provides further insights as to how strangers can be involved in sup-
portive exchanges.
Self-disclosure is defined as "... the explicit communication ... of
some personal information" (Sermat & Smyth, 1973, p. 332). Many of the
resources associated with supportive exchanges (e.g., intimate interactions, reas-
surances, and empathy) occur within disclosure situations (Barrera & Ainlay,
1983; Lefcourt, Martin, & Saleh, 1984; Miller & Lefcourt, 1983). Self-dis-
closure usually occurs between people who know one another. It does not occur
in intimate relationships alone, however. Studies show that people often disclose
personal aspects of themselves to total strangers—a fellow passenger on an
airplane, another patient in a doctor's waiting room, the patron at a bar—and
these disclosures are hypothesized to occur and be rewarding
because of the
anonymity ofthe participants (Rubin, 1973; Spinner, 1978). That is, people who
IS
Shumaker and Brownell
are unable or unwilling to unburden themselves to friends may welcome the
opportunity afforded by an anonymous encounter.
In addition to face-to-face encounters, examples of anonymous self-dis-
closure abound in today's increasingly technological society. Crisis center
hotlines provide the highly stressed caller with immediate feedback, which may
simply involve listening, or may entail providing caring responses and referral
services. Similarly, a growing number of radio talk shows provide participants
with direct responses to their problems and listeners with vicarious information.
The accelerated growth of home computers has provided an additional avenue for
anonymous support. With the purchase of a modem, people can communicate
with other "users"; programs have been developed to assist people in linking up
with the resources of strangers (Van Gelder, 1983).
Support exchanges may also occur between a recipient and a stranger who is
an expert in a particular field (e.g., a therapist, lawyer, physician, or minister).
In fact, an important task in supportive interventions is the determination of
whether an individual's existing network is adequate or whether "outside help"
is more appropriate.
Thus, when researchers limit their measures of social support to resources
provided by network members, they may be ignoring other important resources.
People may prefer, in some situations, to seek assistance from a professional
support provider or to discuss a personal problem with a stranger, rather than
seek support from family or friends (cf. Cauce, Felner, & Primavera, 1982). An
interesting advantage of anonymous or stranger support is that the sense of
indebtedness felt when receiving assistance may be eliminated or reduced. How
support from network members compares to support from strangers is an em-
pirical question that merits investigation.
Perceptions of the Participants
Because at least two people' are always involved in a supportive exchange,
there will be distinct perceptions of the exchange that may not converge. Most
research assesses support perceptions from the egocentric view of the recipient
(see Antonucci, 1983, and Chesler & Barbarin, 1984, for recent exceptions). As
noted by House and Kahn (in press); "Thus far, almost all measures of support,
and also of social relationships and networks, have relied on the self-report ofthe
focal person (recipient) about how others behave or how the focal person per-
ceives their behavior" (p. 16). As a result, we know almost nothing about the
perceptions of the provider or the degree of congruence between the two actors'
'We confine our discussion of social support to dyadic relationships. However, we recognize
that support can occur among several members of a network simultaneously (e.g.. friends organizing
to help one network member who is in crisis; cf. Chesler & Barbarin. 1984).
Toward a Theory of Social Support
19
Recipient's
Perceptions of
the Exchange
Provider's Perceptions of the Exchanges
Helpful
Neutral
Harmful
Helpful
Congruent
Incongruent
Incongruent
Neutral
Incongruent
-Jlncongruentj
%,-
Harmful
Incongruent
Fig. 1. Degree of congruence in perceptions of interpersonal exchanges: pro-
vider versus recipient. Shaded cells are nonsocial support exchanges; unshaded
cells represent different forms of social support exchanges.
perceptions, yet degree of congruity has important implications for the quality
and the effects of support, as well as for the probability that it will continue.
In Fig. 1 we present a taxonomy of the possible perceptions held by the
provider and the recipient of interpersonal
exchanges. For simplicity, we reduce
all possible perceptions to three categories: helpful, neutral, and harmful. Five
examples of perceived interpersonal exchanges presented in Fig. 1 are social
support^ although only one cell represents congruent perceived support. The
remaining four exchanges are not social support since
both actors perceive the
exchanges as either neutral or harmful.
On the surface these may appear to be simple distinctions. Yet there is
confusion over supportive versus nonsupportive exchanges. Although theorists
recognize that interpersonal relations are not always supportive (e.g., Antonucci,
1983; Rook & Dooley, in press; Shinn et al., 1984) there remains some question
as to whether or not harmful relationships fall within the domain of social support
(cf. Thoits, 1982). The literature now includes concepts such as negative support
and negative buffers. These concepts, however, fail to broaden our understand-
ing of the phenomenon and appear instead to confuse the issue.
Three important points should be noted. First,
perceptions of exchanges are
not synonymous with the
effects of exchanges. Even when a resource exchange is
perceived by both actors as helpful, its actual impact on the recipient may not be
so.
Second, most supportive exchanges occur between individuals in on-going
relationships. Each cell in Fig. 1 represents a "snapshot" of a relationship at a
^At this point we feel it inappropriate to suggest a hierarchy among these five forms of support
with respect to degree of helpfulness to the recipient. Their possible variance in effectiveness is an
empirical question. We are merely providing a simple taxonomy of congruency outcomes where dual
perspectives are involved.
20
Shumaker and Brownell
particular time. This same relationship, however, can include exchanges that
could over time fall within all nine cells. What is important for that relationship
is where
most of the exchanges fall.
Third, we do not mean to imply that people are always thinking about what
they are doing and why. In most cases, exchanges are automatic and, probably,
not evaluated by either participant. Awareness of the quality of an exchange
might be triggered by crisis events when need for support is high, by a long
absence of supportive exchanges, by an unusually positive or negative exchange,
or by the request of a researcher for a report on the quality of a relationship.
Sources of incongruity. Situations in which both provider and recipient
perceive an exchange as supportive represent the optimal form of
perceived
support. There is a clear match between the recipient's perceived needs and the
provider's response to those needs. Over time, such a match has the highest
probability of engendering an ongoing, satisfying relationship. The more com-
plex forms of support are those in which the perceptions of providers and recip-
ients are incongruent. There are several possible sources of incongruity. For
example, incongruity may occur when providers and recipients have different
goals (Hirsch, in press). Heller and Swindle (1983), describe a situation in which
parents provide advice to their adolescent who responds by running away. These
researchers ask, "Is this social support?" According to our model, the answer is
yes from the parents' perspective; from the child's perspective, however, the
answer is no. This difference derives from the different ways in which these
actors interpret the adolescent's needs and goals.
Incongruity can also occur when actors in an exchange have different mod-
els of helping (Brickman, Rabinowitz, Karuza, Coates, Cohn, & Kidder, 1982).
In developing models of people's assumptions about the responsibility for prob-
lems and solutions, Brickman et al. (1982) suggest that people usually have
specific ideas regarding when it is appropriate to help another individual and how
this assistance should be provided. If providers and recipients differ in their ideas
about how assistance should be offered, then recipients are unlikely to receive
what they feel is needed.
Recipients may also be
unwilling to define clearly the type of resource they
require in a particular situation. For example, some individuals are reluctant to
make a direct request for assistance. In addition, recipients may wish to avoid
being placed in a dependent role.
Recipients may also be
unable to provide information about their needs.
People in crisis situations, for example, rarely exhibit consistency in their needs
and demands. They are often in the process of trying to make sense of the
situation (Taylor, 1983) and of determining a coping strategy. Finally, recipients
may
lack the interpersonal skills required to solicit assistance in an unambiguous
manner.
Toward a Theory of Social Support
21
Providers are encumbered by the same potential impediments as recipients.
For example, they may not be able to empathize with the plight of others, and
may be unable to "read" the requests for assistance. They may also be unwilling
to give the type of assistance requested by the recipient. That is, providers may
feel that they "know what is best" and ignore requests from the recipient that do
not conform to their ideas about what sort of assistance is necessary. Finally,
providers may be hesitant to help because they don't know what is needed and
are afraid their efforts will do more harm than good (cf. Chesler & Barbarin,
1984).
Types of incongruity. Incongruent support occurs when the recipient per-
ceives the exchange to be helpful, but the provider perceives it to be
harmful. In
work situations, for example, employees who are threatened by the advancement
of co-workers may pass on erroneous information in the guise of assistance,
when their true intent is to cause their co-workers to perform poorly.
There are many examples of incongruent social support in which providers
feel they are being
helpful, while recipients feel they are not. The bereaved are
often recipients of well-meaning but inappropriate remarks from friends and
relatives (cf. Kushner, 1983; Schiff, 1977). Comments such as, "It's probably
for the best," "Don't take it so hard," "She's better off now," or "You can
always have another child," do little to alleviate and may actually exacerbate the
pain of someone who has suffered the death of a loved one. Yet these responses
are not uncommon and merely exemplify the difficulty people have in dealing
with the grief of others and knowing how to be supportive. Brickman et al.
(1982) refer to these types of exchanges as "secondary victimization," or "the
process by which victims are victimized once again by awkward or ineffective
efforts to help them" (p. 378).
Implications of incongruity. Incongruent forms of support do not provide a
realistic picture of an individual's support
resources, and measures of resources
that tap into such exchanges may be unreliable. Harmful exchanges that are
perceived by recipients to be helpful, for example, may eventually cause harm,
and the recipients' misperceptions of the exchanges could prevent the recipients
from preparing for such an unexpected outcome. In a crisis situation this type of
incongruent support could prove to be particularly deleterious, as the recipients
could learn about their misperceptions when they are most vulnerable. Alter-
natively, providers may be surprised by and reject their assumed roles as suppor-
tive individuals in the recipients' lives.
Incongruent social support exchanges in which the recipient does not per-
ceive the exchange as helpful also have important implications. In these situa-
tions, the recipients may resent what they perceive to be insensitivity on the part
of their friends. Similarly, providers may feel frustrated by their unappreciated
22
Shumaker and Brownell
attempts at assistance. Both situations, moreover, could seriously endanger the
stability of the relationship (Brickman et al., 1982).
Thus, to understand social support fully, attention must be addressed to the
different perspectives that can occur in supportive exchanges. The possible dif-
ferences between perspectives of recipients and providers have important im-
plications for the reliability and validity of support measures, as well as for the
quality of interpersonal relations. By investigating
both perspectives we begin to
see how discrepancies arise and how they can be reduced or even eliminated.
Hence, intervention strategies might be more appropriately directed toward re-
ducing sources of incongruity rather than at increasing network size. As long as
social support remains, at least empirically, in the head ofthe recipient we will
have a distorted picture of recipients' available support resources and the effec-
tiveness of our interventions will be severely limited.
The How and Why of Social Support: Functions and Resources
Although definitions of support vary considerably, the assumption underly-
ing all models and empirical investigations of this phenomenon is that supported
people are physically and emotionally healthier than nonsupported people. There
is, however, a surprising absence of models that indicate
how social support
promotes well-being (cf. Cohen & Syme, in press; Conway, 1983; Thoits,
1982). One step toward understanding the process of support is to clearly dis-
tinguish between what support is supposed to do for the recipient,
its functions,
and how these functions can be achieved, the
resources provided in supportive
exchanges.
Resources in Supportive Exchanges
More attention has been focused on identifying and categorizing the re-
sources provided in supportive exchanges than any other dimension of social
support (cf. House, 1981; Pilisuk & Minkler, 1980; Wellman, in press). Some of
the resources mentioned in the literature are behavioral assistance, feedback,
guidance, information, comfort, intimacy, money, services, and lay referrals.
Several taxonomies have been proposed to organize these resources into mean-
ingful groups (cf. Cohen & McKay, 1984; House, 1981; Rook, 1983). Emo-
tional sustenance, material or tangible assistance, and information, for example,
have been suggested as classifications that encompass all of the resources associ-
ated with support.
To understand how support works, we believe it is critical to link resources
to the hypothesized functions of support. Specification of these linkages allows a
consideration of both the desired outcomes (i.e., outcomes consistent with the
Toward a Theory of Social Support
23
function), and the achieved outcomes of support (i.e., the full range of possible
effects).
Health-Stistaining Functions of Social Support
According to most models of support, its overall function is to enhance the
recipient's well-being—that is, to enhance the overall physical and mental health
ofthe individual. This general task can be reduced to several specific functions.
Gratification of afftliative needs. One frequently suggested purpose of so-
cial support is to gratify basic affiliative needs (Kaplan, Cassel, & Gore, 1977;
Thoits, 1982). Support can meet people's needs for the contact and compan-
ionship of others, and thereby mitigate the deleterious effects of isolation and
loneliness. Through support people can obtain the feelings of belonging that
satisfy their affiliative needs. The resources associated with this function could
include expressions of caring, love, understanding, concern, intimacy, and an
enhanced sense of belonging (e.g., the inclusion of the recipient in group
activities).
Self-identity maintenance and enhancement. Support has also been linked to
recipients' self-identity (cf. Mitchell, Billings, & Moos, 1982). Thoits (1983),
for example, argues that the self is composed of a set of discrete identities. She
suggests that it is through our interactions with others that our personalities
develop—that we acquire an awareness of, at a minimum, our social selves.
Similarly, according to social comparison theory (Festinger, 1954), people eval-
uate and clarify their belief systems by comparing their own opinions, attitudes,
and beliefs to those of others. The resources associated with the self-identity
function of support might include feedback regarding aspects of the self and
models of appropriate behavior in ambiguous or stressful situations (e.g., self-
help groups).
Social interactions can produce both positive and negative self-identities.
Scapegoating, labeling, stereotyping, and stigmatizing are all examples of how
we can obtain a negative sense of self through our interactions with others. For
example, some recipients may accept assistance, recognize their need and the
appropriateness of the resource to that need, hut still/ee/ badly about themselves
(e.g., identify themselves as dependent, needy).
Self-esteem enhancement. The self-identity function of support refers to the
general issue of learning who we are. In contrast, supportive exchanges can also
serve to
validate a person's sense of own value and adequacy (Gottlieb, 1983).
Resources relevant to the self-esteem function include reassurance and affirma-
tion of worth, approval, praise, and expressions of respect for the recipient.
24
Shumaker and Brownell
All of the above functions of support are relevant to the health-sustaining
nature of the phenomenon. They reflect some ways supportive relationships can
promote well-being in the absence of severe stress. These functions may also
come into play during stressful circumstances, and their effectiveness prior to
stress can determine how much strain a person experiences under stress. That is,
if people receive ongoing support that provides them with a sense of security,
bolsters their self-esteem, and strengthens their self-identity, then they are less
likely to be vulnerable to stressors than people who have not received such
support (Mitchell et al. 1982; Wallston et al. 1983).
Stress-Reducing Functions of Social Support
Cognitive appraisal. Several researchers associate support with cognitive
appraisal (cf. Cohen & McKay, 1984; Heller & Swindle, 1983). Cognitive
appraisal has been divided into two components in stress literature: primary and
secondary (Lazarus & Launier, 1978). Primary appraisal refers to a threatened
individual's
interpretation of a potential stressor. At this pre-stress stage, support
exchanges can broaden the individual's interpretation of the event and promote
its clearer understanding. During primary appraisal, supportive resources include
verbal information about the event and modeled responses to it.
If an event is interpreted as a threat, secondary appraisal comes into play.
This is also the point at which coping or "the strategies for dealing with threat"
(Lazarus, 1966) become relevant. Secondary appraisal refers to people's assess-
ment of their available coping resources. Support can interface with this stage of
the appraisal process by broadening the number of coping options. The resources
provided include modeled emotional and behavioral coping strategies, referrals
to appropriate professional service agencies, encouragement to seek assistance,
and the provision of information and problem-solving techniques.
The specificity model of support. In addition to influencing cognitive ap-
praisal, social support can function directly as a coping strategy by providing the
recipient with the resources needed to meet the specific needs evoked by the
stressor. Cohen and McKay (1984) argue that stressors can be categorized ac-
cording to the different needs they create for the stressed individual. The success
of support as a coping resource depends on how well the resource exchanged
meets the recipient's stress-related needs (see also Brownell, 1982; House, 1981;
Shinn et al., 1984). If the stressor involves loss of a job, for example, then an
important resource might be the provision of money or other forms of tangible
assistance (Brownell, 1982).
Cognitive adaptation. In her recent model of cognitive adaptation, Taylor
(1983) hypothesizes that people undergo three processes to cope
cognitively with
Toward a Theory of Social Support
25
threatening events: a search for the meaning of the event, an attempt to regain
mastery over their lives, and the enhancement of self-esteem. As she notes,
support can play an important role in each of these processes. We have already
discussed some of the resources associated with enhanced self-esteem. In terms
of meaning and mastery, relevant resources could include information about the
threat, methods for regaining control, and modeled behaviors for coping (e.g.,
self-help groups).
Social support versus coping. Social support can interface with almost
every coping strategy mentioned in the stress literature, and since coping and
support are related phenomena it is not surprising that support is often defined as
a coping resource (cf. Heller & Swindle, 1983; Hirsch, in press; Pearlin &
Schooler, 1978). However, the concepts are not synonymous; there are clear
distinctions between support and coping. Social support can exist independently
of coping (i.e., health-sustaining functions), and coping resources (e.g., money,
stamina, intelligence) and strategies (e.g., relaxation techniques) can occur in the
absence of support. A clearer understanding of the associations among these
phenomena should strengthen models of stress and coping as well as measures of
stress moderators.
Potential Effects of Social Support
Outcome variables used in support research have been severely limited
(Heller & Mansbach, 1984). In selecting measures of the effect of support,
researchers focus on what it
should be doing (i.e., its functions) rather than what
it
could be doing in particular circumstances. Several aspects of an exchange can
influence the range of possible outcomes.
Factors Influencing the Effects of Social Support
Person-environment fit. Several investigators have applied variations of the
concept of person-environment fit to the area of social support (cf. Caplan,
1974; House, 1981; Shinn et al., 1984). The basic premise underlying these
models is that the effectiveness of an exchange depends on the fit between
recipients' needs and resources. It is important to keep in mind that
lack of fit
does not necessarily mean lack of support. It does mean, however, that the
effects of support can vary.
Perceptions of the exchange. The degree of congruence between recipients'
and providers' perceptions of the exchange (see Figure 1) can also influence the
effects of support. Sensitivity to the potential sources of discrepancy in these
perceptions should affect the choice of outcome measures selected by investiga-
26
Shumaker and Brownell
tors. In studying adolescent populations, for example, measures addressing feel-
ings of autonomy versus dependency could tap into the differing ways in which
parents and adolescents perceive the same exchanges.
Resources exchanged. The specific resources provided in an exchange will
influence the obtained effects. Although a resource may fit a specific function of
support and its provision may be appropriate to the recipient's needs, it may still
have effects that go beyond the function being served. For example, parents
might respond to their adult child's job loss by sending him or her money; this
would meet the child's immediate need, but may also reinstate an earlier sense of
dependency.
Short- versus long-term effects. The effects of support can also change over
time (Rook & Dooley, in press). First, an immediate positive effect can dissi-
pate, become stronger, or become negative over time. Hobfoll and Wolfish
(1982), for example, found that some friends of women who were to undergo
breast biopsies recommended that the women ignore this diagnostic procedure
and try herbal remedies. The immediate effect could have been to calm the
recipient. (Note that Hobfoll & Wolfish, 1982, did not test this effect.) Over
time, however, the effect could be extremely negative.
The effects of support may also be negative initially, but become positive
later. A typical example would be encouraging a friend to stop smoking; the
smoker may resent this at first, but in time come to appreciate one's concern and
assistance.
Finally, exchanges can produce consistent short- and long-term effects.
That is, an exchange might be immediately positive and remain so, or be imme-
diately negative and remain negative over time. Furthermore, an exchange can
have an immediate (and even powerful) effect which disappears over time. For
example, people often join a support group to change undesirable behaviors
(e.g., smoking or over-eating) and, as long as they participate, behavior changes
occur. Yet it is not unusual for people to relapse once they leave the support
group.
Effects of Support on the Recipient
In designing support studies, investigators need to consider the ways in
which support outcomes might be affected by fit, the perceptions of the actors,
resources provided, and short- versus long-term effects, and choose their range
of outcome measures accordingly. By considering only the effects of the re-
source exchanged on the recipient, for example, we are able to generate a broad
range of outcomes that are not traditional in the support area (see Table 1).
Group membership, for example, can make one feel secure and enhance
Table 1. Social
Resources"
Support Resources and Their
Immediate
Potential Effects
Effects"
on the Recipient
Long-term
Expressions of caring,
love, understanding, and
concern; intimacy
Protection from harm
Inclusion in group activities
Health-Sustaining Functions
Reassurance of worth;
approval; praise,
expressions of respect
Feedback about behaviors,
beliefs, etc.
Model in ambiguous and
threatening situations
Listening; promoting self-
disclosure
Verbal information
regarding: severity of
threat and its objective
reality, potential coping
strategies, lay referrals,
referral to other network
members
Modeled responses to threat
Tangible assistance: money,
skills, services, task
sharing
+ feeling cared for and
valued
-I- enhanced positive mood
state
— feeling smothered,
controlled
-I- sense of social
integration
-I- increased perception of
number of friends and
support
— enhanced feeling of
obligation to conform to
group norms
— indebtedness
+ self-confidence
+ w/r to stress, prevention
of coping being
hampered by self-
recrimination
— over-confidence;
uncritical view of
judgments
— w/r to stress, narrow
consideration of options
+ reduced ambiguity
-I- reduced fear
-I- feeling of purpose
— leam inappropriate
responses
-I- emotional release
-I- feeling cared for
— embarrassment
Stress-Reducing
-I- clear interpretation of
threat
+ confidence
+ reduced helplessness
— sense of inadequacy if
models are "super
copers"
— increased perception of
threat (e.g., "sour
grapes" in work setting)
+ more able to meet
demands
-I- confidence
— indebtedness
— embarrassment
+ enhanced sense of
personal security
+ increased bonding
(attachment)
-I- emotional well-being
- dependency
-I- security
- thwart development of
individual identity
- model poor health habits
-I- positive self-esteem
+ emotional well-being
— dogmatism
- egotism
+ strong self-identity
+ emotional well-being
- poor physical health
-I- strong self-identity
-I- reduced anxiety
- low self-esteem
Functions
-I- physical and emotional
well-being
+ sense of personal
strength
+ sense of efficacy
- depression
- low self-esteem
- fear; anxiety
+ physical and emotional
well-being
+ positive self-esteem
- resentment
- dependency
"These are examples and not exhaustive lists.
28
Shumaker and Brownell
one's sense of belonging. At the same time, however, there are real costs associ-
ated with groups—including pressures to conform (cf. Cartwright & Zander,
1968). The peer pressure of adolescent groups provides an interesting example of
the possible dual outcomes of this resource. While group membership meets
people's affiliative needs, pressures to conform might cause people to behave in
unhealthy ways (e.g., to smoke or use drugs).
Attentive listening may also be provided. In stressful circumstances, listen-
ing to a troubled individual can be an important expression of support that helps
the individual discharge feelings and work through issues. Disclosure, however,
can also have negative effects. Recipients may feel embarrassed about the infor-
mation they have shared, and even resent the "prying" friend's concern. (More
effects related to support resources are presented in Table 1.)
Effects of Support on the Provider
Costs of providing support. The literature on "burn-out" focuses on costs
experienced by formal support providers (e.g., teachers, medical practitioners,
or social workers). Similarly, informal providers may "pay" for their roles in a
number of ways. Being available to someone in need can be emotionally draining
(Chesler & Barbarin, 1984; Kessler, McLeod, & Wethington, in press; Wortman
& Dunkel-Schetter, 1979). In their reanalysis of several data sets, Kessler et al.
found that women are more likely than men to recognize and respond to the
needs of others, to be involved as supporters in crises, and to be influenced by
the life crises of network members. They concluded from this that "the emo-
tional costs of caring for those in one's network accounts for a substantial part of
the pervasive mental health disadvantage of women" (p. 10).
In addition to emotional strain, there are several other costs that providers
may experience. The provision of some resources includes the expenditure of
time and money (e.g., transportation, loans, or babysitting). Over time, recip-
ients' need for such tangible resources may become a difficult burden.
The act of assisting another person can alter providers' attitudes toward
recipients. That is, providers may come to view recipients as too needy or weak.
Such an attitude change may be dramatic, and even harmful, to a relationship
when the recipient has previously been self-reliant and independent.
Stress in the lives of others can increase providers' sense of personal vul-
nerability. That is, they may become more aware of the risks that exist in their
own lives.
Finally, certain sources of stress for a recipient can also impact on the
provider. The diagnosis of a chronic disease in a loved one, for example, affects
the sick person's family and friends indirectly (Wortman & Dunkel-Schetter,
1979). Natural disasters or company lay-offs can affect members of the same
Toward a Theory of Social Support
29
social network directly. In such situations, providers must give support when
they too need it, and this may make the supportive role itself stressful.
Benefits of providing support. As costly as being supportive may be, it is the
benefits of providing support that keep people in mutually nurturing rela-
tionships. The major benefit for providers comes from knowing that, because of
them, others' lives may be better (cf. Baston, Fultz, & Schoenrade, 1984). "The
ability to be nurturant is a fulfilling and self-validating experience" (Kessler et
al., in press, p. 16). There are several other ways in which providers may gain
from their role.
Providing support may increase their sense of efficacy. Furthermore, pro-
viders can vicariously experience a broad range of life events and develop a
repertoire of coping strategies that may be useful in the future.
A recipient's disclosure of personal infonnation is an implicit act of trust
and, therefore, a compliment to the person who listens (Archer & Cook, 1984).
Self-disclosure also may represent the recipient's willingness to develop a rela-
tionship with the provider, or to strengthen an existing relationship (Archer &
Cook, 1984).
Providing support to someone in the same network increases the probability
that one's own needs will be met in the future. For example. House and Kahn (in
press) speculate that the reason women benefit especially from same-sex rela-
tionships is because there is more reciprocity between two women than between
two men, or between a man and a woman.
To summarize, a number of factors influence the effects of support on
recipients and providers. Even in the simplest examples, multiple effects can
occur which may be positive or negative, and may change over time. Future
investigators need to consider outcome measures that are responsive to these
issues. Including multiple outcome measures will allow researchers to better
understand the underlying processes and to be sensitized to the possible neu-
tralizing or negative effects of some resources.
The Context of Social Support
Social scientists discuss the possible influence of context on social support
(cf. Fckenrode & Gore, 1981), identify what factors may comprise context
(Cohen & Syme, in press) and how the embedded nature of support can influence
its effectiveness within a stress and coping paradigm (Shinn et al., 1984). How-
ever, as support is described in more complex and multidimensional terms
(Heitzman & Kaplan, 1983; Thoits, 1982; Wilcox, 1981), confusion arises re-
garding its dimensions versus its contexts. We have already elaborated on the
key
dimensions of support (e.g., functions, resources, exchange properties). We
30
Shumaker and Brownell
now consider its
effective context, the range of contextual factors that may affect
its form and occurrence (Stokols, 1983).
Characteristics of the Participants
Personal characteristics. Theorists have suggested several aspects of recip-
ients that may influence their ability to develop social relationships and their
skills in soliciting appropriate assistance (cf. Jones, 1984; Lefcourt et al., 1984;
Unger & Wandersman, in press). These recipient characteristics include affil-
iative needs, privacy needs, stability of self-concept, autonomy, locus of control,
and relational skills (e.g., empathy). Added to these are demographic factors
such as age, sex, and race (cf. Antonucci, in press; Vaux, in press). Research
addressing the degree to which these or other individual difference variables alter
a support exchange is still limited. Moreover, the small amount of research that
does exist focuses on characteristics of the recipient. Yet, as we have argued
throughout this article, the provider is an important part of the supportive ex-
change and characteristics of this individual are equally critical to understanding
the support phenomenon.
Network characteristics. The structure of recipients'
and providers' net-
works is also an important contextual aspect. Network density, size, and the
relationship between the provider and recipient, for example, can influence a
recipient's satisfaction with support (cf. Gottlieb, 1981; Gourash, 1978; Hirsch,
1979). Although it is not clear that a detailed network analysis enhances our
understanding of support sufficiently to justify its expense (House & Kahn, in
press), findings from laboratory studies focusing on
particular structural vari-
ables (e.g., relationship between participants, network dispersion) and how they
are associated with dimensions of support (e.g., degree of congruity in dual
perspectives) should improve understanding of the phenomenon and the effec-
tiveness of interventions.
Characteristics of Place
Organizational environment. Shinn et al. (1984) consider aspects of an
organization that may influence the development and maintenance of support
networks. Cooperative settings, for example, are more likely to enhance support
than competitive ones (see also House, 1981; Rook & Dooley, in press). The
social organization
oi all life domains (that is, neighborhood/community, work
place, family, school, recreational) will influence the types of networks that
emerge, as well as our ability to effectively utilize available support resources.
Thus, when investigating support within a particular domain, an assessment of
Toward a Theory of Social Support
31
how the organizational climate interfaces with support is important, especially if
the long-term aims of the researchers are to develop sound interventions.
Physical environment. A critical determinant of the
development of friend-
ship networks is the design of the physical environment (cf. Festinger, Schach-
ter, & Back, 1950; Fleming, Baum, & Singer, in press; Shumaker & Reizeiv
stein, 1982; Zimring, 1982). Also, the physical layout of a setting influences the
interactions among prospective network members (Altman, 1975). Yet we are
not aware of any studies of social support, or of any support interventions, that
consider the designed environment. This oversight is especially important if one
notes that the designed environment plays a critical role in facilitating or thwart-
ing the functions of support (cf. Shumaker & Reizenstein, 1982). For example,
physical designs that provide for privacy are more likely to promote private
communication and self-disclosure (Shumaker, 1979). Nondistracting settings
can facilitate an exchange of information and promote problem-solving (Kaplan,
1983). Finally, settings that provide opportunities for contact with others without
forcing interaction can promote social comparison and role modeling.
Summary and Research Questions
Summary
This paper has presented our definition of social support as the basis for a
model that involves an exchange between at least two persons, and which is
perceived by at least one of the participants to be intended to enhance the well-
being of the recipient. It then explored the implications of such a model, simul-
taneously addressing gaps in the literature.
We began by drawing upon the reciprocity and prosocial behavior literature,
which suggest how recipients and providers may consider the relative costs and
benefits of participating in a supportive relationship. We emphasized the import-
ance of the perspectives of both providers and recipients. In this context, we
considered non-network sources of support and the importance of congruence
between the participants' perceptions.
In order to understand how support enhances well-being, we distinguished
between its functions and the resources provided in a supportive exchange, and
specified linkages between these two dimensions. We distinguished between the
health-sustaining functions and the stress-related functions of support. We also
considered factors that can influence the effects of support, and described a wider
range of effects than have been represented in the traditional support literature.
Finally, we distinguished between dimensions of support itself and the con-
textual variables that can influence its quality.
32
Shumaker and Brownell
Research Questions
Research findings over the past 15 years provide strong evidence for a
positive association between support and personal well-being (cf. Cohen &
Syme, in press, for a current review). It is not surprising, therefore, that inter-
ventions designed to enhance support have been implemented. Until we have a
clear understanding of
how support operates, however,
any intervention may be
premature and represent wasteful expenditures of limited funds. Therefore, it is
incumbent on research scientists to provide a clear picture of this phenomenon
and to explain, conceptually and empirically, when and how support influences
well-being. The model of support presented in this article addresses
the process
of support; several research questions are imbedded within it.
We agree with researchers who argue that, to insure ecological validity,
social support should be studied in field settings (cf. Dunkel-Schetter, 1984). An
experimental approach is also useful, however, in that it allows investigators to
tease apart some of the subtler aspects of the phenomenon. Many of the research
questions posed below can be addressed in laboratory settings.
1. During what types of supportive exchanges are reciprocity and indebted-
ness most salient to the participants? For example, how do factors such as the
duration or intimacy of a relationship relate to feeling obliged to reciprocate
support? Does the duration of a need for support affect the salience of the norm?
Similarly, are there ways to attenuate negative effects ofthe reciprocity norm on
support?
2. What situational factors are more likely to elicit assistance from friends?
Is there a diffusion of responsibility among network members? If so, how strong
is the effect and what network structure variables (e.g., density, size) are most
likely to engender diffusion?
3. How does support from strangers compare to support from network
members? Are there situations in which the former is more helpful than the
latter?
4. What factors influence the congruence between participants' perceptions
ofthe supportive exchange? For example, how do their relationship (e.g., kin,
friend, spouse), their social competency skills, and situational factors influence
perceptions of support? Are incongruent exchanges better for recipients than no
support at all?
5. How are providers affected by their role? How does the impact of sup-
port on providers influence the support given recipients? What types of resource
exchanges have the most enduring effects on the recipient? And when does the
same resource exchange produce both positive and negative effects?
6. Finally, to disentangle context from the support phenomenon, studies
are needed which investigate the convergence and divergence of related phe-
Toward a Theory of Social Support
33
nomena (e.g., personality characteristics of the participants). More specifically,
what contextual variables significantly influence support processes? Which con-
textual variables inhibit and which ones enhance the occurrence of supportive
exchanges?
In this paper we identified and addressed conceptual gaps in the social
support area. Although we discuss these issues as part of our model of support,
we recognize that the concepts described here will benefit from further consid-
eration. By providing further attention to these gaps, social scientists will clarify
the understanding of support. More importantly, they will be able to design and
implement interventions that reinforce those aspects of supportive exchanges that
truly enhance the personal well-being of all participants.
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