The buffering hypothesis asserts that social support provides protection against the stress that produces psychological or physiological disorder or disease or reduces job performance. The stress-buffering function of social support has been of considerable interest to behavioral and medical scientists, especially since a 1979 Alameda County study showed that social conditions, such as marriage and group membership, were related to mortality.
Several issues emerge in research on the buffering hypotheses. Of particular importance is the definition and measurement of three variables: stress, social support, and outcome. Psychological stress is often measured on a checklist or inventory by self-report of major life events of the last few months, such as death in the family, divorce, and changes in work. Using weights from experts' ratings of stress, the experimenter obtains a total score. A less used kind of measure is called daily hassles, such as burdensome household chores and waiting in traffic. Social support is measured in three ways: (1) social network membership (sometimes called social integration), such as living with a family, belonging to a club, or attending a church; (2) perceived social support, such as self-report of availability of people to discuss problems or provide material aid; and (3) support behaviors, such as reported or observed actions of helping the specified person. The first two methods have received the most research attention. The outcome or dependent variables are usually physical or psychological disorders (or health), such as depression, recovery from surgery, smoking cessation, and development of cancer or AIDS symptoms in infected people. Productivity may be used as an outcome in industrial settings.
In general the findings across many studies with the first two social support measures have been positive. In a 1991 review, Sheldon Cohen (pp. 1-2) concluded, "The epi-demiological data on the role of social integration in morbidity and mortality have clearly established that the social environment plays an important role in health and well being . . . [and] when a perceived availability of a social support measure is used, these effects reliably occur in the prediction of psychological and physical symptoms." It appears that the body's immune system is affected by social support, and people who get colds readily are likely to have poor social supports. An overview of abstracts of articles since Cohen's conclusions show a majority of studies with posi tive results, but not all. A few studies of animals also support the buffering hypothesis.
Beyond these generally positive findings, many theoretical and research questions remain. One is the issue of whether the results are due to main effects or buffering effects. Is social support a true buffering effect having no influence of its own but being entirely conditional upon the presence of stress? Another related issue is the place of social support in the chain of multiple cause and effect as represented in the diathesis-stress theories of psychopathol-ogy. Diathesis refers to predispositions to disorder from biological or early experiential causes. Throughout the life cycle, social support and nonsupport interact with other variables to protect or not protect against stress.
An important theoretical task in clarifying the buffering hypothesis is the integration of the many possible variables into a model explaining why social support works. Cohen has presented a transactional model that includes core concepts about social networks, stressful events, and personality factors, including perceived social support, stress appraisal, and support behaviors ultimately affecting the development of a disorder. Basing his conclusion on several studies, Cohen indicates that one personality feature that seems particularly important to include in addition to social support is the sense of internalized control or self-efficacy (a person's sense of capability and effectiveness). Coping styles and genetic predispositions are other psychological variables that need to be included in an integrated theory of the relation between stress and disorder surrounding the buffering hypothesis.
On a larger than individual scale, community settings and institutions, such as churches, schools, and senior centers, can provide buffers for stress. Group interventions, such as workshops on stress inoculation for people in dangerous occupations or students facing examinations, may provide social support as well as increasing self-efficacy.
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