Social Support and Networks — Lecture Notes

Moderator vs Mediator

Mediator: This is a variable that explains why a relationship exists between two other variables. The first variable influences the mediator, and then the mediator influences the outcome. Think of it as a stepping stone.
- Example: Stress
\rightarrow Rumination (thinking a lot about problems)
\rightarrow Depression. Here, rumination explains why stress can lead to depression.
- Simple idea: Stress causes rumination, and rumination causes depression.
- Formal way to write it: $Predictor \rightarrow Mediator \rightarrow Outcome$
Moderator: This is a variable that changes the strength or direction of a relationship between two other variables. It answers the question "for whom" or "under what conditions" does a relationship hold.
- Example: Stress \times Social Support
\rightarrow Depression. Here, social support changes how strongly stress affects depression. High social support might weaken the link between stress and depression.
- Simple idea: Stress has a stronger or weaker effect on depression depending on the level of social support.
- Formal way to write it: $Predictor \times Moderator \rightarrow Outcome$
Practical Implication: Mediators tell you why something happens; moderators tell you when or for whom it happens.

A. What is Social Support

Definition (Cobb, 1976): Social support means getting information from others that makes you feel loved, cared for, valued, and like you belong to a group that helps each other.
Where does it come from?: Your relationships and social groups that offer help, advice, and emotional comfort.
Types of Social Support:
- Tangible or Instrumental Support: This is practical, hands-on help or resources.
- Examples: Lending money, giving a ride, cooking a meal.
- Important for: Problems you can fix or control.
- Emotional Support: This is about showing care, empathy, and concern.
- Examples: Listening to someone, comforting them, offering reassurance.
- Important for: Problems you can't control.
- Esteem Support: This is about making someone feel good about themselves.
- Examples: Praising their efforts, encouraging them, agreeing with their ideas, reminding them of their strengths.
- Helps: Build self-worth and confidence.
- Informational Support: This is about giving useful advice or facts.
- Examples: Explaining a medical procedure, giving directions, sharing knowledge.
- How often do we get these?: Tangible support is less common; emotional, esteem, and informational support happen more frequently.
Qualities of Social Networks (your social circle) that affect how much support you get:
- Size: How many people you regularly talk to.
- Frequency of Contact: How often you interact with them.
- Composition: Who are the people in your network (e.g., family, friends, colleagues).
- Intimacy: How close your relationships are and how comfortable you are sharing personal things.

B. Why is Social Support Important?

1) Self-Determination Theory (Deci & Ryan, 1985)

This theory says people have three basic psychological needs:
- Need for competence: Feeling capable and effective.
- Need for autonomy: Feeling in control of your own life and choices.
- Need for relatedness: Feeling connected and close to others.
How social support helps: It helps fulfill these needs, which leads to better well-being and motivation.
2) Primate Evidence (Harlow, 1959)
What he found: Monkeys who grew up without enough early social interaction had trouble forming relationships later on.
Key takeaway: Showed how important early parent-child bonding is for development.
Famous experiment: Monkeys preferred a soft, cloth mother (even if she didn't give food) over a wire mother that provided food, especially when scared. This showed that comfort and security are vital, not just food.
Illustration: Pictures from Harlow's studies showed the monkeys clinging to the cloth surrogate, indicating that touch and comfort are essential for well-being.
3) Touch Therapy
Early skin-to-skin contact (De la Roiste & Bushnell, 1996): Premature babies who received gentle touch (2 times a day for 10 minutes) started eating by mouth earlier, went home sooner, and had higher IQs at one year old.
Meaning: Physical touch and closeness can speed up development and improve health.
Other findings: Touch can also reduce anxiety and improve physical responses like heart rate.
4) Loneliness
Feeling lonely or not being socially connected can significantly affect your health.
Horsten et al. (2000): Middle-aged women who felt less socially connected had a higher chance of heart problems coming back over 5 years.
Eng et al. (2002): People with smaller social networks had a higher risk of dying from any cause, including heart disease, accidents, and suicide, over 10 years.
Hawkley et al. (2003): People who weren't lonely had better heart function (higher cardiac output); lonely people showed higher total peripheral resistance (which can lead to high blood pressure).

C. Social Support and Health

Correlational studies

These studies look at natural relationships without changing anything. They show a link, but don't prove cause and effect.
Findings: Being more socially connected is generally linked to better health.
- Schwarzer & Leppin (1992): Lower chances of death or illness.
- Vogt, Mullooly, Ernest, Pope, & Hollis (1992): Less illness related to heart attack and stroke; better recovery.
- Rosengren, Wilhelmsen, & Orth-Gomer (2004): Lower risk for coronary heart disease (CHD) in middle-aged Swedish men, even after considering other risk factors.
- Barefoot, Gronbaek, Jensen, Schnohr, & Prescott (2005): Lower risk of dying from ischemic heart disease.
- Sarason, Pierce, Shearin, Sarason, Waltz, & Poppe (1991): Lower rates of illness and death from cardiovascular disease (CVD).
Important note: These studies show a connection, but it's hard to say if social support causes better health, or if healthier people just tend to have more social support, or if something else entirely is influencing both.

Experimental studies

These studies actively change something (like providing social support) to see its effect.
Cardiovascular reactivity (CVR): This measures how your heart and blood vessels respond to stress. It's used as a sign of stress response and future health risk.
- Kamarck, et al. (1997): People whose blood pressure reacted more strongly to stress in a lab setting had a greater increase in artery wall thickness over 4 years (a sign of heart disease risk).
Face-to-face social support vs. mere presence vs. alone:
- Glynn, Christenfeld, & Gerin (1999); Gramer (2002): Having someone offer face-to-face support helps reduce stress responses both in daily life and in experiments.
- The Mere Presence paradigm: Just having a supportive person there can help reduce stress, but direct, face-to-face support usually has a stronger effect.
Perceived availability: It's not just about having support, but believing that support is there if you need it.
- Gallo, Smith, & Kircher (2000); Uchino & Garvey (1997): Both concluded that believing support is available is important for managing stress.
Mental activation studies: These studies look at how thinking about social support affects stress responses.
- Smith et al.; Ratnasingam & Bishop: Showed that preparing to receive support or thinking about supportive relationships can influence how the body reacts to stress.

Online social support

Support received through the internet (social media, forums, etc.) also has benefits.
Benefits: Can reduce stress, depression, and anxiety; can boost self-esteem.
- LaRocco, House, & French (1980); Lin & Bhattacherjee (2009): Showed general positive effects.
- Shaw & Gant (2002): Found a link between online social support and higher self-esteem.
- Teoh, Chong, Yip, Lee, & Wong (2015): Online support from a friend helped reduce stress responses in women, but online support from a stranger didn't have the same clear effect.

When social support does not help

Social support isn't always helpful; it depends on the situation and how it's given.
Perceived vs. actual support: The person receiving support must feel that it's genuinely helpful. If they don't, it might have no effect or even a negative one.
Mismatch: Support isn't effective if the type of support offered doesn't match the problem (e.g., giving advice when someone just needs a hug), or if the person is too distressed to receive it well.
Barriers to seeking help: People might avoid asking for help due to worries about:
- Confidentiality: Not wanting others to know their problems.
- Burden: Not wanting to be a bother to others.
- Stigma: Feeling ashamed or embarrassed.
- Inappropriate sharing: Revealing too much, which can be uncomfortable.
- Overprotectiveness: Support that slows down recovery by doing too much for someone.
Negative effects: Support can accidentally encourage unhealthy habits (like smoking) or make someone feel worse if asking for help is seen as a weakness.

D. How Does Social Support Affect Health?

There are different theories on how social support improves health:

1) Buffering Stress (stress-buffering hypothesis)

Main idea: Social support acts like a shield, protecting people from the harmful effects of very high stress.
How it works: It helps you change how you think about a stressful situation (cognitive appraisal) or how you respond to it.
In terms of equations: It means that the effect of stress on a health outcome changes depending on the level of social support – there's an "interaction effect" between stress and social support.
Conceptual equation: $Outcome = \beta0 + \beta1 Stress + \beta2 SocialSupport + \beta3 (Stress \times SocialSupport) + \varepsilon$
- If $\beta_3$ is a negative number, it means social support reduces the negative impact of stress.

2) Direct Effects Hypothesis

Main idea: Social support is generally good for your health, regardless of how stressed you are. It's always beneficial.
How it works: It provides consistent positive experiences, promotes healthy behaviors, and builds a sense of belonging.
In terms of equations: The effect of social support on health is simply added to the equation; there's no special interaction with stress.
Conceptual equation: $Outcome = \beta0 + \beta1 Stress + \beta_2 SocialSupport + \varepsilon$

3) Dual-Effect Model (Teoh & Hilmert, 2018)

Main idea: Social support's effect on your body's stress response (CVR) depends on how involved or disengaged you are with a task.
When it helps: If you're highly involved in a task, social support can reduce your stress response.
When it might increase stress: If you're bored or disengaged from a task, social support might actually increase your stress response.
When it has minimal effect: At moderate levels of engagement, the effect of social support is small.
Meaning: The impact of social support on your body's stress reactions depends on the specific situation.

4) Appraisal Model (Lepore, 1998)

Main idea: Social support helps you feel more capable of handling a problem.
How it works: When you have support, you might see a stressful situation differently – perhaps as less threatening or more manageable. This change in perspective can lessen the negative impact.

5) Empirical illustration (Gerin, Milner, Chawla, & Pickering, 1995)

Experiment setup: People were put in high-stress or low-stress situations, either alone or with a supportive person ("together").
What they found:
- Under high stress: Having social support (being "together") led to lower diastolic blood pressure (DBP) compared to being alone.
- Interaction: The benefit of social support was most noticeable under high stress. When stress was low, being with someone didn't change blood pressure much compared to being alone.
Overall: This study shows that social support can indeed help buffer (reduce) the effects of stress on your cardiovascular system, especially when you're under more pressure.

E. How to Measure Social Support?

Challenges in measurement:
- Often, the ways we measure social support haven't been thoroughly checked against real-world outcomes or objective measures (they might lack "criterion validity").
- Examples of external criteria (often imperfect): Symptom checklists (e.g., for depression), personality tests, observations by doctors or therapists.
Online Social Support Scale (Nick et al., 2018):
- This is a survey where people rate their online interactions over the past two months.
- Rating scale: 0 = Never, 1 = Rarely, 2 = Sometimes, 3 = Pretty Often, 4 = A Lot.
- Sample questions (1–15):
- 1. People show that they care about me online.
- 2. Online, people say or do things that make me feel good about myself.
- 3. People encourage me when I'm online.
- 4. People pay attention to me online.
- 5. I get likes, favorites, upvotes, views, etc. online.
- 6. I get positive comments online.
- 7. When I'm online, people tell me they like the things I say or do.
- 8. Online, people are interested in me as a person.
- 9. People support me online.
- When I'm online, people make me feel good about myself.
- When I'm online, I talk or do things with other people.
- People spend time with me online.
- People hang out and do fun things with me online.
- Online, I belong to groups of people with similar interests.
- People talk with me online about things we have in common.
- Scoring: You either add up the scores for all items or take an average to get an overall online social support score.

F. Social Support in Various Settings

Social support plays a role in many different parts of life:

1) Social Support in the Workplace

Problems with limited involvement: If workers don't get to participate in decisions, it can lead to more absences, people quitting, lateness, job unhappiness, and even active resistance; also poorer work performance.
Recommendations for a better workplace environment:
- Reduce uncomfortable physical things (like loud noise or too many people).
- Make things more predictable and less surprising.
- Let workers help make decisions whenever possible.
- Make jobs more interesting if you can.
- Encourage friendly relationships among co-workers.
- Focus on rewarding good work instead of only punishing mistakes.
- Look for early signs that someone is feeling stressed.
- Support can come from the organization itself, supervisors/managers, and colleagues.

2) Social Support among the Elderly

Sydney Older Persons Study (Edelbrook et al., 2001):
- Women: Tended to receive more practical help (instrumental support); gave more emotional support; often found daughters to be their main confidants (people they could trust); joined more social groups; and needed more help with getting around and more emotional comfort.
- Men: Received less emotional support; participated in fewer social activities; generally didn't feel they lacked support, but never-married men specifically showed even lower emotional support.

3) Social Support from Religion

How religion helps: It can act as a way to cope with stress by providing:
- A set of beliefs that reduce distress.
- A way to find meaning in difficult events.
- A direct source of social support through religious communities.

4) Religious Responses to Grief and Loss (e.g., 2004 tsunami in Sri Lanka)

Coping mechanisms: Creating personal memorials (shrines) to remember loved ones; performing rituals like lighting lamps and saying prayers helps people cope with loss.
Community support: Practices like Dhaane (alms-giving) and sharing communal meals are supportive activities that bring people together during times of grief.

5) Traditional Healing

Dang-ki healing (Chinese spirit mediumship): This is practiced in places like Singapore and other parts of Asia. It involves the belief that a god or spirit can temporarily enter a person (the medium) to offer help and guidance. This shows how cultural traditions can be a source of social support and contribute to well-being.

Quick Reference: Key Concepts and Formulas

Mediator vs Moderator (recap):
- Mediator: $Predictor \rightarrow Mediator \rightarrow Outcome$
- Moderator: $Predictor \times Moderator \rightarrow Outcome$
Social support types summarized: Practical/instrumental, emotional, esteem, informational.
Buffering vs Direct Effects models:
- Buffering interaction: $Outcome = \beta0 + \beta1 Stress + \beta2 SocialSupport + \beta3 (Stress \times SocialSupport) + \varepsilon$
- Direct effects: $Outcome = \beta0 + \beta1 Stress + \beta_2 SocialSupport + \varepsilon$
Dual-Effect Model: Says that social support can have different effects on your body's stress response (CVR) depending on how engaged you are with a task.
Appraisal Model (Lepore, 1998): Social support helps you change how you see and handle a stressful situation, making it seem less overwhelming.
Representative empirical findings: Real-world studies include observations (correlational studies), controlled experiments (like face-to-face support vs. just being present), benefits of online support, and how support works in different groups (at work, for older people, in religious communities).

References (as cited in the notes)

Cobb (1976)
Deci & Ryan (1985)
Harlow (1959)
De la Roiste & Bushnell (1996)
Horsten et al. (2000)
Eng et al. (2002)
Hawkley et al. (2003)
Schwarzer & Leppin (1992)
Vogt et al. (1992)
Rosengren et al. (2004)
Barefoot et al. (2005)
Sarason et al. (1991)
Kamarck et al. (1997)
Glynn, Christenfeld, & Gerin (1999)
Gramer (2002)
Gallo, Smith, & Kircher (2000)
Uchino & Garvey (1997)
Smith et al.; Ratnasingam & Bishop
Lin & Bhattacherjee (2009)
Shaw & Gant (2002)
Teoh, Chong, Yip, Lee, & Wong (2015)
Nick et al. (2018)
Lepore (1998)
Gerin, Milner, Chawla, & Pickering (1995)
Teoh & Hilmert (2018) (Dual-Effect Model)
Edelbrook et al. (2001)
Dang-ki and related sources
2020 CNA Lifestyle article on cabin fever during COVID-19 (contextual