Learning Objectives
- Explain how social support is vital in health and longevity
- Identify common stress reduction techniques
Social Support
The need to form and maintain strong, stable relationships with others is a powerful, pervasive, and fundamental human motive (Baumeister & Leary, 1995). Building strong interpersonal relationships with others helps us establish a network of close, caring individuals who can provide social support in times of distress, sorrow, and fear. Social support can be thought of as the soothing impact of friends, family, and acquaintances (Baron & Kerr, 2003). Social support can take many forms, including advice, guidance, encouragement, acceptance, emotional comfort, and tangible assistance (such as financial help). Thus, other people can be very comforting to us when we are faced with a wide range of life stressors, and they can be extremely helpful in our efforts to manage these challenges. Even in nonhuman animals, species mates can offer social support during times of stress. For example, elephants seem to be able to sense when other elephants are stressed and will often comfort them with physical contact—such as a trunk touch—or an empathetic vocal response (Krumboltz, 2014).
Scientific interest in the importance of social support first emerged in the 1970s when health researchers developed an interest in the health consequences of being socially integrated (Stroebe & Stroebe, 1996). Interest was further fueled by longitudinal studies showing that social connectedness reduced mortality. In one classic study, nearly 7,000 Alameda County, California, residents were followed over 9 years. Those who had previously indicated that they lacked social and community ties were more likely to die during the follow-up period than those with more extensive social networks. Compared to those with the most social contacts, isolated men and women were, respectively, 2.3 and 2.8 times more likely to die. These trends persisted even after controlling for a variety of health-related variables, such as smoking, alcohol consumption, self-reported health at the beginning of the study, and physical activity (Berkman & Syme, 1979).
Since the time of that study, social support has emerged as one of the well-documented psychosocial factors affecting health outcomes (Uchino, 2009). A statistical review of 148 studies conducted between 1982 and 2007 involving over 300,000 participants concluded that individuals with stronger social relationships have a 50% greater likelihood of survival compared to those with weak or insufficient social relationships (Holt-Lunstad, Smith, & Layton, 2010). According to the researchers, the magnitude of the effect of social support observed in this study is comparable with quitting smoking and exceeded many well-known risk factors for mortality, such as obesity and physical inactivity.
Figure 1. Close relationships with others, whether (a) a group of friends or (b) a family circle, provide more than happiness and fulfillment—they can help foster good health. (credit a: modification of work by “Damian Gadal_Flickr”/Flickr; credit b: modification of work by Christian Haugen)
A number of large-scale studies have found that individuals with low levels of social support are at greater risk of mortality, especially from cardiovascular disorders (Brummett et al., 2001). Further, higher levels of social supported have been linked to better survival rates following breast cancer (Falagas et al., 2007) and infectious diseases, especially HIV infection (Lee & Rotheram-Borus, 2001). In fact, a person with high levels of social support is less likely to contract a common cold. In one study, 334 participants completed questionnaires assessing their sociability; these individuals were subsequently exposed to a virus that causes a common cold and monitored for several weeks to see who became ill. Results showed that increased sociability was linearly associated with a decreased probability of developing a cold (Cohen, Doyle, Turner, Alper, & Skoner, 2003).
For many of us, friends are a vital source of social support. But what if you find yourself in a situation in which you have few friends and companions? Many students who leave home to attend and live at college experience drastic reductions in their social support, which makes them vulnerable to anxiety, depression, and loneliness. Social media can sometimes be useful in navigating these transitions (Raney & Troop Gordon, 2012) but might also cause increases in loneliness (Hunt, Marx, Lipson, & Young, 2018). For this reason, many colleges have designed first-year programs, such as peer mentoring (Raymond & Shepard, 2018), that can help students build new social networks. For some people, our families—especially our parents—are a major source of social support.
Social support appears to work by boosting the immune system, especially among people who are experiencing stress (Uchino, Vaughn, Carlisle, & Birmingham, 2012). In a pioneering study, spouses of cancer patients who reported high levels of social support showed indications of better immune functioning on two out of three immune functioning measures, compared to spouses who were below the median on reported social support (Baron, Cutrona, Hicklin, Russell, & Lubaroff, 1990). Studies of other populations have produced similar results, including those of spousal caregivers of dementia sufferers, medical students, elderly adults, and cancer patients (Cohen & Herbert, 1996; Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002).
In addition, social support has been shown to reduce blood pressure for people performing stressful tasks, such as giving a speech or performing mental arithmetic (Lepore, 1998). In these kinds of studies, participants are usually asked to perform a stressful task either alone, with a stranger present (who may be either supportive or unsupportive), or with a friend present. Those tested with a friend present generally exhibit lower blood pressure than those tested alone or with a stranger (Fontana, Diegnan, Villeneuve, & Lepore, 1999). In one study, 112 female participants who performed stressful mental arithmetic exhibited lower blood pressure when they received support from a friend rather than a stranger, but only if the friend was a male (Phillips, Gallagher, & Carroll, 2009). Although these findings are somewhat difficult to interpret, the authors mention that it is possible that females feel less supported and more evaluated by other females, particularly females whose opinions they value.
Taken together, the findings above suggest one of the reasons social support is connected to favorable health outcomes is because it has several beneficial physiological effects in stressful situations. However, it is also important to consider the possibility that social support may lead to better health behaviors, such as a healthy diet, exercising, smoking cessation, and cooperation with medical regimens (Uchino, 2009).
Dig Deeper: Coping with Prejudice and Discrimination
Being the recipient of prejudice and discrimination is associated with a number of negative outcomes. Many studies have shown how perceived discrimination is a significant stressor for marginalized groups (Pascoe & Smart Richman, 2009). Discrimination negatively impacts both physical and mental health for individuals in stigmatized groups. As you’ll learn when you study social psychology, various social identities (such as gender, age, religion, sexuality, ethnicity) often lead people to simultaneously be exposed to multiple forms of discrimination, which can have even stronger negative effects on mental and physical health (Vines, Ward, Cordoba, & Black, 2017). For example, the amplified levels of discrimination faced by Latinx transgender women may have related effects, leading to high stress levels and poor mental and physical health outcomes.
Perceived control and the general adaptation syndrome help explain the process by which discrimination affects mental and physical health. Discrimination can be conceptualized as an uncontrollable, persistent, and unpredictable stressor. When a discriminatory event occurs, the target of the event initially experiences an acute stress response (alarm stage). This acute reaction alone does not typically have a great impact on health. However, discrimination tends to be a chronic stressor. As people in marginalized groups experience repeated discrimination, they develop a heightened reactivity as their bodies prepare to act quickly (resistance stage). This long-term accumulation of stress responses can eventually lead to increases in negative emotion and wear on physical health (exhaustion stage). This explains why a history of perceived discrimination is associated with a host of mental and physical health problems including depression, cardiovascular disease, and cancer (Pascoe & Smart Richman, 2009).
Protecting stigmatized groups from the negative impact of discrimination-induced stress may involve reducing the incidence of discriminatory behaviors in conjunction with protective strategies that reduce the impact of discriminatory events when they occur. Civil rights legislation has protected some stigmatized groups by making discrimination a prosecutable offense in many social contexts. However, some groups (e.g., transgender people) often lack important legal recourse when discrimination occurs. Moreover, most modern discrimination comes in subtle forms that fall below the radar of the law. For example, discrimination may be experienced as selective inhospitality that the target perceives as race-based discrimination, but little is done in response since it would be easy to attribute the behavior to other causes. Although some cultural changes are increasingly helping people to recognize and control subtle discrimination, such shifts may take a long time.
Similar to other stressors, buffers like social support and healthy coping strategies appear to be effective in lowering the impact of perceived discrimination. For example, one study (Ajrouch, Reisine, Lim, Sohn, & Ismail, 2010) showed that discrimination predicted high psychological distress among African American mothers living in Detroit. However, the women who had readily available emotional support from friends and family experienced less distress than those with fewer social resources. While coping strategies and social support may buffer the effects of discrimination, they fail to erase all of the negative impacts. Vigilant antidiscrimination efforts, including the development of legal protections for vulnerable groups, are needed to reduce discrimination, stress, and the resulting physical and mental health effects.
Try It
Stress Reduction Techniques
Figure 2. Stress reduction techniques may include (a) exercise, (b) meditation and relaxation, or (c) biofeedback. (credit a: modification of work by “UNE Photos”/Flickr; credit b: modification of work by Caleb Roenigk; credit c: modification of work by Dr. Carmen Russoniello)
One reason exercise may be beneficial is because it might buffer some of the deleterious physiological mechanisms of stress. One study found rats that exercised for six weeks showed a decrease in hypothalamic-pituitary-adrenal responsiveness to mild stressors (Campeau et al., 2010). In high-stress humans, exercise has been shown to prevent telomere shortening, which may explain the common observation of a youthful appearance among those who exercise regularly (Puterman et al., 2010). Further, exercise in later adulthood appears to minimize the detrimental effects of stress on the hippocampus and memory (Head, Singh, & Bugg, 2012). Among cancer survivors, exercise has been shown to reduce anxiety (Speck, Courneya, Masse, Duval, & Schmitz, 2010) and depressive symptoms (Craft, VanIterson, Helenowski, Rademaker, & Courneya, 2012). Clearly, exercise is a highly effective tool for regulating stress.
In the 1970s, Herbert Benson, a cardiologist, developed a stress reduction method called the relaxation response technique (Greenberg, 2006). The relaxation response technique combines relaxation with transcendental meditation, and consists of four components (Stein, 2001): sitting upright on a comfortable chair with feet on the ground and body in a relaxed position, a quiet environment with eyes closed, repeating a word or a phrase—a mantra—to oneself, such as “alert mind, calm body,” passively allowing the mind to focus on pleasant thoughts, such as nature or the warmth of your blood nourishing your body.
The relaxation response approach is conceptualized as a general approach to stress reduction that reduces sympathetic arousal, and it has been used effectively to treat people with high blood pressure (Benson & Proctor, 1994).
Another technique to combat stress, biofeedback, was developed by Gary Schwartz at Harvard University in the early 1970s. Biofeedback is a technique that uses electronic equipment to accurately measure a person’s neuromuscular and autonomic activity—feedback is provided in the form of visual or auditory signals. The main assumption of this approach is that providing somebody biofeedback will enable the individual to develop strategies that help gain some level of voluntary control over what are normally involuntary bodily processes (Schwartz & Schwartz, 1995). A number of different bodily measures have been used in biofeedback research, including facial muscle movement, brain activity, and skin temperature, and it has been applied successfully with individuals experiencing tension headaches, high blood pressure, asthma, and phobias (Stein, 2001).
