Social support and the reactivity hypothesis: Conceptual issues in examining the efficacy of received support during acute psychological stress

Abstract

Social support has been reliably related to better physical health outcomes. One influential model suggests that social support is related to lower cardiovascular disease mortality because it reduces the potentially deleterious consequences of cardiovascular reactivity during acute stress. However, received support and perceived support are separable constructs and epidemiological research suggests variability in links between received support and health. This is important because most social support and acute laboratory stress studies are essentially based on the receipt of support. In this paper, we focus on the conceptualization of received support and its implications for understanding links to support laboratory reactivity paradigms. This analysis highlights the role of theoretically important task, recipient, and provider categories of factors that moderate the effectiveness of received support, as well as the need to examine links between naturalistic perceptions of support and cardiovascular reactivity during stress.

The Conjoined Effect of Naturalistic Perceived Available Support and Enacted Support on Cardiovascular Reactivity During a Laboratory Stressor

“…Importantly, to the authors' knowledge, only a few studies have examined the conjoined impact of both types of social support on cardiovascular responses during an acute laboratory challenge. The study of conjoined effects seems particularly important because a history of previous positive experiences of social support could have an impact on the effect of enacted social support in a particular situation [20,24]. For example, it has been suggested that past experiences with naturalistic support could signify implicit support and reduce threat appraisals in light of aversive encounters when a third party is present during a laboratory challenge [37].…”

“…For example, stressful situations in daily life often imply that individuals are faced with an aversive encounter while they are alone (because social support is not available in a particular situation), but receive social support before or after the occurrence of a stressor. Moreover, it should be noted that this paradigm is dissonant with operationalizations of social support as applied in epidemiological research linking support to disease [19,20]. Thus, it would be necessary to relate such naturalistic measures of social support to cardiovascular reactivity in the laboratory.…”

“…Hence, it seems that naturalistic measures of social support cover a different aspect of social support. Indeed, it has recently been proposed that perceived (i.e., naturalistic) support should be separated from received (i.e., enacted) support, because both constructs seem to be linked with different psychological concomitants and health outcomes [20,24]. In particular, Uchino [24] suggested that perceived support constitutes a stable interindividual difference factor that develops early in life and is related to feelings of control, self-efficacy, and the ability to "cope more effectively, flexibly, and proactively with life stressors" (Uchino [24], p. 241).…”

Continuing Down the Road to Reintegration: Status and Ongoing Support of the U.S. Air Force's Wounded Warriors

“…Supportive interpersonal relationships include service provider and recipient, as can be the case for the AF programs, such as AFW2. In some cases, as described briefly above, support from providers can be more effective than support from close relationships (e.g., Sarason and Sarason, 2006;Taylor, 2011;Uchino et al, 2011), although natural support networks can also be incorporated into treatment.…”

“…Often, published interventions focus on support that strangers, such as in peer support groups, provide (Cohen, 2004). In some cases, such as when relationship quality is poor or the supporters' own distress impedes support provision, these can actually be more effective than support that close relationships (i.e., marital) provide (see, e.g., Sarason and Sarason, 2006;Taylor, 2011;and Uchino et al, 2011).…”