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served as action editor for this article. Preparation of this article was supported by the John D. and Catherine T. MacArthur Foundation Network on Determinants and Consequences of Health-Promoting and Disease-Preventing Behavior, chaired by Judith Rodin. We would like to thank Burton Singer and George Kaplan for consulting with us on this article, Kenneth Wallston for his helpful review and comments on an earlier draft, members of the MacArthur Network for their input, and Lynae Darbes for her assistance in the research.

A perceived availability of social support measure (the ISEL) was designed with independent subscales measuring four separate support functions. In a sample of college students, both perceived availability of social support and number of positive events moderated the relationship between negative life stress and depressive and physical symptomatology. In the case of depressive symptoms, the data fit a “buffering” hypothesis pattern, i.e., they suggest that both social support and positive events protect one from the pathogenic effects of high levels of life stress but are relatively unimportant for those with low levels of stress. In the case of physical symptoms, the data only partially support the buffering hypothesis. Particularly, the data suggest that both social support and positive events protect one from the pathogenic effects of high levels of stress but harm those (i.e., are associated with increased symptomatology) with low levels of stress. Further analyses suggest that self‐esteem and appraisal support were primarily responsible for the reported interactions between negative life stress and social support. In contrast, frequency of past social support was not an effective life stress buffer in either the case of depressive or physical symptomatology. Moreover, past support frequency was positively related to physical symptoms and unrelated to depressive symptoms, while perceived availability of support was negatively related to depressive symptoms and unrelated to physical symptoms.

Although there has been a substantial effort to establish the beneficial effects of social support on health and well-being, relatively little work has focused on how social support influences physical health. This article outlines possible mechanisms through which support systems may influence the etiology of physical disease. I begin by reviewing research on the relations between social support and morbidity and between social support and mortality. I distinguish between various conceptualizations of social support used in the existing literature and provide alternative explanations of how each of these conceptualizations of the social environment could influence the etiology of physical disease. In each case, I address the psychological mediators (e.g., health relevant cognitions, affect, and health behaviors) as well as biologic links (e.g., neuroendocrine links to immune and cardiovascular function). I conclude by proposing conceptual and methodological guidelines for future research in this area, highlighting the unique contributions psychologists can make to this inherently interdisciplinary endeavor.

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