Relations Between Social Support and

Physical Health
Corey M. Clark
Rochester Institute of Technology
Social support is one of most important factors in predicting the physical health and well-being
of everyone, ranging from childhood through older adults. The absence of social support shows
some disadvantage among the impacted individuals. In most cases, it can predict the
deterioration of physical and mental health among the victims. The initial social support given is
also a determining factor in successfully overcoming life stress. The presence of social support
significantly predicts the individual's ability to cope with stress. Knowing that they are valued by
others is an important psychological factor in helping them to forget the negative aspects of their
lives, and thinking more positively about their environment. Social support not only helps
improve a person's well-being, it affects the immune system as well. Thus, it also a major factor
in preventing negative symptoms such as depression and anxiety from developing.
The social support and physical health are two very important factors help the overall well-being
of the individual. A general theory that has been drawn from many researchers over the past few
decades postulation that social support essentially predicts the outcome of physical and mental
health for everyone. There are six criteria of social support that researchers use to measure the
level of overall social support available for the specific person or situation (Cutrona, Russell, &
Rose, 1986). First, they would look at the amount of attachment provided from a lover or spouse.
Second, measuring the level of social integration that the individuals involved with, it usually
comes from a group of people or friends. Third, the assurance of worth from others such as
positive reinforcement that could inspires and boosts the self-esteem. The fourth criterion is the
reliable alliance support that provided from others, which means that the individual knows they
can depend on receiving support from family members whenever it was needed. Fifth, the
guidance of assurances of support given to the individual from a higher figure of person such as
a teacher or parent. The last criterion is the opportunity for nurturance. It means the person
would get some social enhancement by having children of their own and providing a nurturing
experience.

This paper organizes studies of social support into three age-appropriate categories- adolescents,
middle-aged adults, and older adults. For example, an experiment related to social support and
physical health that empathizes cancer is assigned to the older adult category. If the specific area
of concern can be applied to everyone, then it is placed into middle-aged adult group for
generalization purpose. After reviewing those studies and experiments, it should be clearly
shown that social support is very important factor in determining the status of physical health,
mental health, and immune system functioning for everyone.

Adolescents
Adolescents could develop some kinds of sensitive feelings, which may impact on their health if
they do not get adequate social attention from others. They may become involved in an
unfortunate situation that makes them feel overwhelmed or awkward. The adolescent is still
developing, could easily experience some strain to their emotion if no help is immediately
available. Anxiety and depression are two main psychological disorders that often can be seen
among the adolescents.

Family and Peer Support

For adolescents, family support is the most important element in their lives. As part of their
growth experience, adolescents usually expect a lot of things from their parents. Inadequate
support from the parents will likely increase the chance of getting depression among adolescents
who get into unfortunate situation with their parents. This occurs because adolescent usually
become confused when they expect to get plenty of help and positive reinforcement from their
parents, but it does not happen (Stice, Ragan, & Randall, 2004).

Beside family support, peer support also is very important factor for adolescents. Children can
expect a lot from their friends. Peer support can be considered as an alternate method of getting
social support if the adolescents receive inadequate attention from their parents. This social
support method is not as reliable as family support because young children could easily withdraw
from their own friends if they become depressed. Another problem arises in this area, when the
depressed students isolate themselves from public gatherings. This would prevent those suffering
adolescents from getting any social support at all (Stice et al., 2004). Receiving social support is
very essential for adolescents to become successful with themselves and achieve a satisfactory
level at school.

Gifted Adolescents

Gifted adolescents also can encounter plenty of problems if they do not get adequate social
support. In some cases, intelligent students are sent to residential schools that offer special
programming for students who are gifted in math and science. Oftentimes, the family support
would be severely limited for those adolescents, because the residential school usually lies far
away from home. This kind of schooling is a totally new experience for gifted students, because
they are living in the dormitory. Normally, students would experience the dormitory living for
the first time when they go to college. At those ages, students are looking forward to seeking
independence from their parents. This usually leaves a hole for those adolescents with reduced
social support, whereas they have to rely on some people from the residential school (Dunn,
Putallaz, Sheppard, & Lindstrom, 1987).

Gifted adolescents usually have to rely on counselors and peers at the school. The counselors
usually help those students to ease the transition from home to a residential living situation. In
contrast to students who attend regular school, there is a better chance for those gifted students to
experience emotional well-being, be in a good physical health, and have a good immune system
as long as adequate social support can be provided at the school to prevent or lessen the chance
for those people from getting depressed (Dunn et al., 1987).

Middle-Aged Adults
The importance of social support continues well into adulthood for everyone. It would benefit a
person's general health and immune systems, regardless of whether or not they have a lot of
stress. For example, the cardiovascular system would function much better in those adults who
have better social support (Uchino, Cacioppo, & Kiecolt-Glaser, 1996). The social contact,
familial support, and involvement with leisure activities have significantly demonstrated a
relationship with lowering of blood pressure. Contact among family members is the best method
of reliving stress. The fellowship among friends is adequate, but not as powerful as family.
Strangers have a negative effect on reducing blood pressure. In one study cited in Uchino's
article, the individual with many siblings and experiencing low stress was found to be the best
possible combination for lowering the blood pressure.

Health

Many studies indicate that anyone who has high social support tends to have less chance of
getting depression and anxiety disorders. In contrast, only a handful of studies show that there is
no relationship between social support and lowering the blood pressure. The level of social
support also has been found to be related to a lower rate of disease and early death. The familial
support is a psychological enhancement to help the individual reduce their stress. These findings
are somewhat weak and further studies need to be done to gather more specific information
about the influence of social support on physical health (Uchino et al., 1996).

There is a significant relation between emotions and health. Anyone who has positive emotion
and beliefs is likely to enhance their physical health. As expected, being in a good mood will
cause refreshed mind to relieve some of the stresses. Laughing is said to have a good deal of
influence on reducing or forgetting about the hassles of daily life. Strong social support is
necessary to help succeed in achieving these traits of overall physical well-being (Salovey,
Detweiler, Steward, & Rothman, 2000).

Personality Type

There are some aggressive adults living in our society. This would probably mean those adults
are diagnosed with Type A personality. Anger, aggressiveness, and hostility are the common
characteristics of this type of personality. These are unhealthy personality traits, which could
adversely affect the general health of those adults. Eventually, the research finds that there is
some direct link between Type A personality and coronary heart diseases (Friedmann & Booth-
Kewley, 1987). There is no scientific evidence yet, but researchers have suggested a general
hypothesis that low social support may cause Type A personality. The researchers also revealed
a strong relationship between social support and the absence of coronary heart diseases. More
social support would soothe the individuals with Type A personality, leading to better physical
health, thus reducing the risk of developing coronary heart diseases. Environmental stress is
likely to increase the chance of getting physical illness (Maddi, Bartone, & Puccett, 1987).

Socioeconomic Status

One's socioeconomic status also is a major factor in whether or not an individual gets enough
social support. The socioeconomic status is the measurement of level of income each person has
to determine their level of economic status in our society. For example, if the specified person's
income is rather low, compared to nationally average, that person would be considered as a part
of the low socioeconomic status. As expected, anyone who comes from a lower socioeconomic
class would be more likely to receive less social support. They basically do not have enough
resources in their environment available to assist with social support. The individuals with low
socioeconomic status also tend to have less self-control. Consequently, they become more
sensitive to stressors in their environment and less able to control their reactions. It means those
adults would trigger some frustrations when they face any kind of stress. Unfortunately, the
social strain, which is common in their daily lives, increases the risk for lower social class
individuals to develop some kinds of physical and mental illness or a lower sense of well-being.
This should not come to surprise that adults who have higher socioeconomic status tend to
receive more social support (Gallo, Bogart, Vranceanu, & Matthews, 2005).

Mothers of Children With Disabilities

Mothers with children who have permanent and chronic diseases usually become overwhelmed
with all of the demands. They often feel burdened because it takes too much responsibility to
take care of disabled children and meet such social demands as work at same time. Hope and
good social support are very important elements to help reinforce those affected mothers. Hope
serves as a psychological factor and social support serves as a comfort factor. As mentioned
above, by thinking positively, hope should be able to take away the affected mothers' obsessions
and make them think about something else for better. One interesting note from a study shows
the stress level for those mothers varies widely. It greatly depends on the independent skills the
disabled children have. For example, if the children have a very serious disability such as
cerebral palsy, it would indicate their mothers will have to take all of the responsibilities as
caregivers. On other hand, those children who have milder symptoms of disease would be able to
function more independently. In this case, the affected mothers would be in a much better shape,
but they still have to deal with some caregivers' responsibilities along with social demands such
as daily hassles. The availability of social support from others, especially family members, helps
the affected mothers to adjust to environmental demands (Horton & Wallander, 2001).

Stressors at Work

Many adults normally deal with a lot of stress at work. The high demands and low social
contact/support within the workforce tend to cause the development of depressive symptoms
among workers over a period of time. A high level of social support from a supervisor may help
prevent depression from developing. This is not a guarantee, especially if the high demands
continue to overwhelm the workers. To accomplish a satisfactory stress level in a high demand
environment surely would require plenty of support and reinforcement from supervisors. The
surprise finding in this specific study shows that the best combination for workers would be low
stressors and low social contact. This study, which was taken place in Germany, shows that there
is not much correlation of social support and stressors among the co-workers. These findings are
still vague. This study included a limited number of workers. The researchers will need to study
more workers in a greater variety of work environments over the place before they can
generalize this result (Dormann & Zapf, 1999).
Some unfortunate adults experience the impact of job losses due to firings or layoffs. The
unexpected layoffs usually are huge stressors among those workers who were impacted. Those
displaced workers are likely to develop some problems that could influence their physical or
mental health. For example, those affected workers normally report the loss of self-esteem and
locus of control. This spikes the chance of those workers becoming depressed. The depression
itself could signal the beginning of deterioration in health and well-being among those displaced
workers (Mallinckrodt & Bennett, 1992).

The layoffs also make a big impact on the workers' life. Now, they have to worry about the
financial support of their family. Worrying about the financial ability only add, more problem,
for those who are unemployed. The social supports from family members benefit those
individuals. By providing adequate social support, the displaced workers' physical and mental
health is enhanced. This also prevents deterioration in physical/mental functioning down the
road. Social support also would reinforce the displaced workers to make some adjustments into a
new life (Mallinckrodt et al., 1992).

Older Adults
The physical functioning of older adults usually weakens as they become older. It is the key
factor in predicting the health outcome of older adults is their status at the time they retire. The
body and immune system of older adults usually become fragile as they become older. The
resource of social support also tends to decrease somewhat. These several factors combined are
the key to predict and control the health of older adults.

Employment Status

Older adults usually face significant changes when they reach their retirement ages. As they are
basically done with their career, this stage of the life establishes a new focus for older adults. The
retired workers have several choices to make; fully retire from the workforce, continue working
part-time and collect some money, or focus primarily on non-paying jobs or volunteer activities.
Volunteering is a big factor relating to social support for older adults. This element will help
build companionship and interact with more people in the community. This step may become
necessary as older adults lose some social support from their family members. This group of
people needs to keep themselves busy by connecting with other people as often as needed. This
method leads to better overall mental and physical health and better well-being. The amount of
social support is the key to determine life satisfaction among the older adults. As expected, older
adults who elect not to do any working during their retirement experience a lower level of life
satisfaction. Their body function would deteriorate more quickly compared to other older adults
who keep themselves busy (Aquino, Russell, Cutrona, & Altmaier, 1996).

Health

The initial level of social support essentially predicts the outcome of older adults' general health
in the following years. Inadequate initial social support at the beginning of retirement would
predict that older adults will develop depressive symptoms over time. Older adults would be able
to ignore the negative effects in their lives with help and reinforcement from others. This is
considered a psychological effect. Not enough social support would likely make the individuals
notice their daily hassles and life stressors much more clearly. This step could accelerate the
deteriorating effect of their physical and mental health. Unfortunately, there is no relationship
found between social support and major life events. Whatever happens to older adult as they
nearing to their death, it will happen, regardless the amount of social support available in the
environment (Russell & Cutrona, 1991).

Cancer

The spouses of older adults who are fighting cancer usually get overwhelmed with all of the
demands and stressors. They often worry about their loved ones prognosis with cancer. On a
positive side, social support is said to be a huge psychological factor for these affected spouses.
As more social support becomes available to those victims, the better the individuals' immune
system and well-being will become. This should improve the bodily function of those impacted
spouses and allow them to be able to handle the stress much more efficiently. It is very important
for those impacted individuals being able to switch back and forth between two different worlds:
the world of their ill spouses and the real world outside of the house or nursing home. Social
support is widely known to buffer the stress level among those impacted spouses. Knowing that
others are there to help makes the big difference. For those caring for spouses with cancer who
have low social support usually report a deterioration in their general health. As widely known,
low social support available usually means the impacted spouses have to rely on themselves
more than usual. It is essentially focusing attention between the stressful spouses and their loved
ones. The unfortunate situation often comes to impair the function of those affected spouses
when they become overwhelmed with their stress, along with the deteriorating conditions among
the cancer patients they are caring for. It is evident here that the spouses usually cannot handle
taking care of the cancer patients by themselves. This is the primary reason why plenty of social
support should be given to those impacted families. If the immediate family members or relatives
are not available to help the burdened spouses, outside help should be immediately given; this
can be someone who are nurses, counselors, or social workers. It should be marked clearly that
social support is only a psychological factor because the cancer patients usually progresses as
expected toward the end regardless of all of the hopes (Baron, Cutrona, Hicklin, Russell, &
Lubaroff, 1990).

Stress

Initial mental health is a very important predictor for all older adults at the time they enter their
retirement ages. Good mental health would predict a healthy social support and fairly good
physical health for the years to come (Cutrona et al., 1986). Once an individual's mental health
declines at any point during their retirement ages, it would increases the likehood for negative
elements to persist with the impacted individuals. It has been found that it will be very difficult
for those older adults to get out of the slump and have a positive perspective in their life once
again. Knowing that they are valued by others makes a big difference in predicting the outcome
of mental health for those older adults. If the impacted individuals demonstrate negative life
events such as divorces, or any other kinds of daily stress, it becomes obvious to outsiders that
inadequate social support is available for those people.
 Conclusion
There is evidence that social experience is very essential in predicting the well-being for
everyone, ranging from childhood through older adults (Cohen & Willis, 1985). After a few
decades of studying, the researchers have finally gained some understanding about the
relationship between social support and physical health. Nonetheless, some areas of research still
face some problems because they sometimes focus too specify on one population, ignoring the
generalization rules for using the random samples to generalize the result to a whole population.

The continuity of research on the relation between social support and physical health will enable
us to understand better about the effect of good social support toward physical and mental health,
along with a general well-being. Many studies have been shown that if a high level of social
support becomes available to everyone, it will benefit their overall health in a long run. The
importance of social support implies to everyone in our society, ranging from young childhood
through older adulthood. The providers of social support can be anyone in society who brings the
positive environment and reinforcement to the individuals, especially from their family
members. The amount of social support available in the environment for the individual can be
determined by looking at the six criterions of social support, and set up observational scores from
each category then find the average score from all six categories. The higher average score it gets
means the better social support the person has in their life, thus reducing their chance of
developing any negative outcome in their health.

Peer Commentary

The Six Criteria for Social Support

Gregory S. Beattie
Rochester Institute of Technology

Corey M. Clark's paper, "Relations Between Social Support and Physical Health," discussed the
implication of social support and people's physical health. He discussed the three age groups,
adolescences, middle-aged adults, and older adults.

One area that I found lacking in Clark's paper was the description of the six criteria for social
support and the application of those six criteria to the three age groups discussed in the paper. He
stated that the six criteria were:

1. Support from a lover/spouse

2. Support from a group of people/friends
3. Assurance of worth from others
4. Reliable support
5. Guidance and support from a higher figure
6. Opportunity of nurturance
In his section about adolescences, he only lists three criteria that were important to that specific
age group--family and peer support--which incorporate the second, forth, and fifth criteria. He
does list the problem of gifted adolescence and how they have to adapt to the lack of social
support from family and instead garner support from fellow students and teachers, who in a sense
play a parental role to the gifted student. This leads me to wonder about the other three criteria.
Does having a relationship during the adolescent years play a role in the relation between social
support and the physical health of adolescents? What will happen when a constant stream of
support is suddenly cut off? Is reliable support that important during the years of teenage
rebellion? Clark leaves those questions unanswered.

In the next age group, middle-aged adults, the six critera are better applied and explained. There
are, however, several new ideas that should not be a part of this paper. Where does the
personality type of a person factor into the relation of social support and health? Again, as said
above regarding adolescence, there is no information about the relationship of a person with his
or her lover and the impact that relationship can have on social support. Clark's paper does go in
depth about the support of people/friends such as family that in turn will give the person
assurance of self worth and the knowledge that the support is reliable. He also discusses the
opportunity for nurturance by using a socioeconomic support example about money not being
able to provide much opportunity for nurturance.

The last age group, older adults, was wonderfully written and fully used the criteria Clark listed.
He went into depth about how older people had to rely on other people for social support and he
provided examples of how they could to that. Then he moved on to the impact cancer had on the
person's spouse and family and how social support could disintegrate in that situation. The fifth
criteria was omitted from this age group, because there is no higher figure to look to for support
when you are the mellow age of 80.

All in all, Clark's paper was wonderful. He encompassed the three major age groups, but he
could have added more detail especially about the criteria. Other than that, it contained a clear set
of ideals that he wanted to articulate for the general public.

Peer Commentary

Which Came First, the Depression or the Social Isolation?

Ryan M. Cuff
Rochester Institute of Technology

Clark identified several areas in which social relationships can be found, and correlations
between stress levels and various physical and mental ailments. However, there seem to be a few
key areas in which Clark does not provide sufficient information to come to the conclusions that
he does. No clear causational is shown nor are the alternatives of the negative impact of social
structures discussed.

When dealing with adolescents, things may not be so clear-cut as Clark has represented them.
Although many teenagers expect a great number of things from their parents, independence is
one of them. If a parent fails to provide that, could the social interaction lead to smothering and
affect the child negatively? Also not address would be the effects of removing a teen from a
negative social environment, in which case could the removal of social contact decrease stress
levels and result in better physical health? Beyond those questions, Clark never showed whether
poor social support caused depression or depression caused kids to have poor social support
groups. Although it is certainly easy to assume poor social support could cause depression, Clark
never definitively showed a causal relation.

When looking at the middle-aged group, another series of issues were not clearly covered.
Looking at the claim of better cardio-vascular health in those with better social support, there is
nothing stated as a cause. Left as it is, we would have to conclude that having a social support
group causes better cardio-vascular health, but is it not more likely there is something about
having a social support group which causes improved cardio-vascular health, such as increased
participation in physical group activities? Again, a correlation has been shown, but that does not
establish a causal relation. Given that middle-aged individuals are more free to go outside a
simple school system to make social relationships, the chances of negative relationships would
severely decrease compared to teenagers; however, middle-age is the time of onset of many
abnormal psychological conditions, so Clark may wish to include the effects of social
relationships on people with abnormal psychological conditions, or the effects relationships with
these people.

Moving to look at older adults, a major area of social interaction is never mentioned. The notion
of retirement communities, which are obviously geared toward providing a social environment
for similar individuals, is never discussed. It is to be hoped that the effects of such a social
environment would be discussed in a paper dealing with the effects of social support on physical
health.

Clark's analysis of social impact on physical health proves to be a great starting point. However,
it ultimately draws conclusions that are not supported by the evidence given and fails to address
some issues would seem to be fundamental to the topic at hand.

Peer Commentary

Social Support: How Friends and Family Can Save Your

Life
Colin M. Gorman
Rochester Institute of Technology

The physical health of an individual can be greatly affected by his or her social support system
and level of social support. The most elemental factor by which this effect of socialization works
is a basic and sometimes overlooked reason for the success of psychotherapy. Sometimes just
knowing that there is someone to talk to and confide in can help people overcomes their
problems just as much as any treatment. Those with a greater social support system, whether
family or friends, have a greater chance of resolving problems with which they are faced. The
process of coping can be improved simply because someone is there to talk with about problems,
give people unconditional love and support or possible providing a resolution.

For peer acceptance, a greater effect of physical benefits will be shown with respect to the
number of peers. Simply speaking, having one friend is better than having none. If a child has no
friends, the effects on his or her mental and physical state can be devastating. This is especially
true for children with disorders such as attention-deficit disorder, whose spontaneity can affect
the way they perceive and react to social situations, causing them to become "outcasts" from the
group. This can result in low self-esteem and sometimes depression. A child with one close
friend can go through adolescence with little negative ramifications. Belonging to a group not
only provides psychological benefits, it can improve physical health and one's perception of
physical health greatly (Espelage, Hale, & Hannum, 2005).

Parental support for children also provides much needed social support. Parents must provide a
child with unconditional love and care, and must also set boundaries and regulations. By creating
rules for the child to follow, the parent helps to shape the child's social actions and to acquaint
the child with the way the world operates. Without these bounders a child may gain a peer social
support but with inappropriate actions may lose them rather quickly. For parents who provide
care for disabled children, economic status is a major factor that affects the physical health of the
caregiver in addition to the child. For childhood disabilities that may cost a great deal of money
to treat, the parent's social well-being can be affected by whether the parent can afford to help the
child. Parental caregivers in the U.S. tend to have a lesser social support system than that in
Canada, mainly because of Canada's universal health plan, because the mother is less focused on
money for treating her child, given that it is provided by the government (Brehaut et al., 2004).

For individuals with debilitating or life-threatening conditions such as cancer or HIV/AIDS, a

strong social network can aid in recovery and improve quality of life. Whether they are being
cared for on an inpatient or an outpatient basis, if patients are happy with their current social
relationships, such as with spouses, friends, and family, this can aid in their prognosis. Having
strong social systems can give patients a more positive state of mind when it comes to their
affliction. With support, a patient is more able to accept and can come to terms with the illness.
This in turn allows a patient to make positive strides in treatment (Gore-Felton et al., 2002).
Even when dealing in mental health, a strong social system can aid in the road to recovery. In
victims of trauma, whether sexually based assault such as rape or nonsexually based assault such
as combat experience, strong social support will aid in their recovery (Durand, Knudson, Martin,
Rosen, & Stretch, 2000).

Having a job provides one with basic needs of modern times such as money, status, and a sense
of accomplishment. Wen people are fired or laid off from their job, it can be devastating. But
having social support can make the transition from job to job much smoother. Social support can
help in three major categories: (a) dealing with the financial loss of a job, (b) dealing with the
symptoms that come with losing one's job, such as poor physical health brought on by low self-
esteem or depression, and (c) how motivated the person is to seek a new job. These three
conditions can shorten the time of unemployment and improve the person's overall positive
outlook on life (Fretz, & Mallinckrodt, 1988).
Later in life, when individuals reache the point at which they are unable to care for themselves or
others, a decision must be made whether they will take up residence in a retirement home or
hospital. For the initial decision of attending the residence, there seems to be a much higher rate
of happiness if individuals decide for themselves that they are to move. Being forced into a care
residence can cause negative feelings and sometimes depression because of feelings of
uselessness. However, if the person willingly and openly decides to take up residence in a care
facility, the advantages are great. In addition to providing physical care, the social system of the
facility can provide the residences with ample amounts of peer interactions, due mainly to
proximity. Because of their more active social life, residents in care facilities have a more
positive outlook on life and tend to be happier than those living by themselves (Field, Orrell, &
Walker, 2002).

Peer Commentary

The Unraveling Tie That Binds

Sara M. Kilpatrick
Rochester Institute of Technology

Social support is supposed to protect us, make us happier and healthier, and keep us sane; at
least, that is the argument presented in Corey M. Clark's report "Relations Between Social
Support and Physical Health." As emphasized throughout Clark's report, social support acts as
our mind's defense against stressful life events and provides the necessary coping skills to deal
with these events. But what happens when our network of family members, friends, and
colleagues are causing the stress? Clark neglected the negative effects of social support and the
damage it can cause on our psychological and physiological well-being.

Clark accurately pointed out that "social support essentially predicts the outcome of physical and
mental health for everyone." However, he assumed that this social support is positive. In fact,
social support can be detrimental to a person's overall well-being. For example, people with
schizophrenia are more likely to relapse when they return home to live with family than if they
live alone (Butcher, Mineka, & Hooley, 2004). Similarly, social networks can have a negative
affect on girls with eating disorders (Butcher et al., 2004).

Many researchers agree that social support is beneficial to a person's physical and mental health;
however, they leave something out. It is crucial for the public to understand that when
researchers and psychologists make such a statement, they are assuming that social support is
healthy; Clark assumes the same in his report. Healthy social support is not always available to
us when we need it. We are constantly bombarded with phone calls, appointments, projects, and
deadlines. As a society, we lack the necessary time and energy needed to develop and maintain
healthy social support systems. Furthermore, we are not in control of what happens in other
people's lives; in other words, people we routinely interact with may be sick or under
considerable stress themselves.

Some social networks may be unhealthy because they reinforce behaviors that are, in themselves,
harmful. Drug and alcohol abusers who are in recovery need to stay away from these networks if
they want to stay sober. These social networks are neither healthy nor positive; instead, these
social networks should be avoided at all costs. Adolescents should be especially cautious of such
social networks. Peer support is an essential factor in an adolescent's social network;
furthermore, if these peers support harmful behaviors, an adolescent may be more likely to
engage in such harmful behaviors.

Social networks that are healthy and available can still be detrimental to a person's well-being.
Clark points out two specific events in his report in which social support should be beneficial:
job loss and chronic illness. In these situations, social support is expected to decrease depression;
however, the opposite may occur. Some people who experience job loss or chronic illness may
feel that they are a burden to their family. They may also feel that they are incapable, which may
lead to low self-esteem. These beliefs may lead to feelings of hopelessness and helplessness
sufficient causes of depression (Butcher et al., 2004); therefore social support may actually act as
an indirect cause of depression.

Similarly, it is important to note that some attempts of support are not always viewed positively.
Family members and friends who, for instance, offer advice may cause more harm than good for
an individual. Some individuals may perceive attempted support as degrading or humiliating;
moreover, forced support through the social network may also induce feelings of helplessness.

Social support is not always beneficial to a person's physical and mental health. Negative,
unhealthy social support can be destructive to a person's overall well-being. Although Clark's
position on social support is accurate, it is not complete. Research needs to examine both the
positive and negative effects of social support if they intend on formulating valid theories about
mental disorders. By acknowledging the negative side of social support, networks can be
improved in terms of their health and availability; in other words, if we can identify the
weaknesses of a particular theory, then we can correct these errors and create an effective tool in
fighting mental and physical deterioration.

Social support can only be beneficial if it is adaptable to the environment; furthermore, social
support has to be geared towards an individual's specific needs. We have to be more aware of
what our friends, family members, and even ourselves need in terms of support. Once we are
aware of this, we can more effectively enhance the positive effect of networks, rather than be
burdened by the negative.

Author Response

Factors Involved in Social Support

Corey M. Clark
Rochester Institute of Technology

I would like to thank to those who have evaluated my paper and helped reinforce it by
elaborating some essential points that I failed to discuss. Beattie elaborated on the description of
six criteria of social support that affect the physical health in all three age groups. He discovered
several questions that I left unanswered in my paper. For instance, Beattie made the point that
every social support criteria do not fit into all three age groups. Originally, I was trying to make
this paper a focus on middle-aged adulthood. When I added the adolescent and older adulthood
sections, I tried to explain the background and significance of the relations between social
support and physical health in these age groups. The consequence was that I left out several
criteria that did not apply to adolescents and older adults. As Beattie pointed out, I could have
explained the absence of several criteria in adolescents and older adults. For example, older
adults do not have any role models to look up to build on their social support and physical health
status; therefore, they have to rely on five other criteria for their well-being.

Cuff discovered that my paper did not include some important examples of causation. Once
again, the relation between social support and physical health is a widely publicized topic. This
topic contains a lot of background on the relations between social support and physical health. I
tried to cover all of those areas as much as possible. Unfortunately, this left my paper missing
some of the important points and examples that I could have added. All of the points about
casual relation that Cuff presented are very important points that I could have added to my paper.

Gorman's peer commentary filled in some information that I failed to discuss in my paper. I
explained the transition of older adults from work into retirement. Gorman's peer commentary
added information about the decision-making steps necessary before moving on into retirement,
such as the types of residence to live in. Because this topic has been widely discussed, I could
not put all of the information and examples into this paper. Consequently, I never include the
life-threatening conditions of middle-aged adulthood as an example of the relation between
social support and physical health. Gorman's peer commentary provided a great example of
recovering from life-threatening conditions by being involved in the community and support
groups that share common interests and problems.

Kilpatrick was concerned about the missing discussion of negative relations between social
support and physical health in my paper. As she pointed out, I basically discussed only the
positive aspects of this topic. My paper discussed how social support affected physical health in
positive ways. It is widely known that there is a positive correlation between social support and
physical health. As Kilpatrick pointed out, the reality is that social support can also have
negative influences on physical health, especially among those who have psychological
disorders. I should have acknowledged the negative aspects of social support in my paper.

References
Aquino, J. A., Russell, D. W., Cutrona, C. E., & Altmaier, E. M. (1996). Employment status,
social support, and life satisfaction among the elderly. Journal of Counseling Psychology, 43,
480-489.

Baron, R. S., Cutrona, C. E., Hicklin, D., Russell, D. W., & Lubaroff, D. M. (1990). Social
support and immune function among spouses of cancer patients. Journal of Personality and
Social Psychology, 59, 344-352.
Brehaut, J. C., Kohen, D. E., O'Donnell, M., Raina, P., Rosenbaum, P., Russell, D. J., Swinton,
M., & Walter, S. D. (2004). The health of primary caregivers of children with cerebral palsy:
How does it compare with that of other Canadian caregivers? Pediatrics, 114, 182-191.

Butcher, J. N., Mineka, S., & Hooley, J. M. (2004). Abnormal psychology (12th ed.). Boston:
Allyn and Bacon.

Cohen, S., & Willis, T. A. (1985). Stress, social support, and the buffering hypothesis.
Psychological Bulletin, 98, 310-357.

Cutrona, C., Russell, D., & Rose, J. (1986). Social support and adaptation to stress by the elderly.
Psychology and Aging, 1, 47-54.

Dormann, C., & Zapf, D. (1999). Social support, social stressors at work, and depressive
symptoms: Testing for main and moderating effects with structural equations in a three-wave
longitudinal study. Journal of Applied Psychology, 84, 874-884.

Dunn, S. E., Putallaz, M., Sheppard, B. H., & Lindstrom, R. (1987). Social support and
adjustment in gifted adolescents. Journal of Educational Psychology, 79, 467- 473.

Durand, D. B., Knudson, K. H., Martin, L., Rosen, L. Nl, & Stretch, R. H. (2000). Psychological
and physical health effects of sexual assaults and nonsexual traumas among male and female
United States Army soldiers. Behavioral Medicine, 26, 11-23.

Field, E. M., Walter, H. M., & Orrell, M. W. (2002). The social networks and health of older
people living in sheltered housing. Aging & Mental Health, 6, 372-386.

Fretz, B. R., & Mallinckrodt, B. (1988). Social support and the impact of job loss on older
professionals. Journal of Counseling Psychology, 35, 281-286.

Friedman, H. S., & Booth-Kewley, S. (1987). Personality, Type A behavior, and coronary heart
disease: The role of emotional expression. Journal of Personality and Social Psychology, 53,
783-792.

Gallo, L. C., Bogart, L. M., Vranceanu, A., & Matthews, K. A. (2005). Socioeconomic status,
resources, psychological experiences, and emotional responses: A test of the reserve capacity
model. Journal of Personality and Social Psychology, 88, 386-399.

Gore-Felton, C., Kim, P., Koopman, C., Israelski, D., Marouf, F., Spiegel, S., & Turner-Cobb, J.
M. (2002). Coping, social support, and attachment style as psychosocial correlates of adjustment
in men and women with HIV/AIDS. Journal of Behavioral Medicine, 25, 337-353.

Hale, C. .J., Hannum, J. W., & Espelage, D. L. (2005). Social support and physical health: The
importance of belonging. Journal of American College Health, 53, 276-284.
Horton, T. V., & Wallander, J. L. (2001). Hope and social support as resilience factors
psychological distress of mothers who care for children with chronic physical conditions.
Rehabilitation Psychology, 46, 382-399.

Maddi, S. R., Bartone, P. T., & Puccetti, M. C. (1987). Stressful events are indeed a factor in
physical illness: Reply. Journal of Personality and Social Psychology, 52, 833-843.

Mallinckrodt, B., & Bennett, J. (1992). Social support and the impact of job loss in dislocated
blue-collar workers. Journal of Counseling Psychology, 39, 482-489.

Russell, D. W., & Cutrona, C. E. (1991). Social support, stress, and depressive symptoms among
the elderly: Test of a process model. Psychology and Aging, 6, 190-201.

Salovey, P., Detweiler, J. B., Steward, W. T., & Rothman, A. J. (2000). Emotional states and
physical health. American Psychologist, 55, 110-121.

Stice, E., Ragan, J., & Randall, P. (2004). Prospective relations between social support and
depression: Differential direction of effects for parent and peer support? Journal of Abnormal
Psychology, 113, 155-159.

Uchino, B. N., Cacioppo, J. T., & Kiecolt-Glaser, J. K. (1996). The relationship between social
support and physiological processes: A review with emphasis on underlying mechanisms and
implications for health. Psychological Bulletin, 119, 488-531.

Last modified November 2005