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Relations Between Social Support and Physical Health

Corey M. Clark
Rochester Institute of Technology


Social support is one of most important factors in predicting the physical health and well-being of everyone, ranging from childhood through older adults. The absence of social support shows some disadvantage among the impacted individuals. In most cases, it can predict the deterioration of physical and mental health among the victims. The initial social support given is also a determining factor in successfully overcoming life stress. The presence of social support significantly predicts the individual's ability to cope with stress. Knowing that they are valued by others is an important psychological factor in helping them to forget the negative aspects of their lives, and thinking more positively about their environment. Social support not only helps improve a person's well-being, it affects the immune system as well. Thus, it also a major factor in preventing negative symptoms such as depression and anxiety from developing.


The social support and physical health are two very important factors help the overall well-being of the individual. A general theory that has been drawn from many researchers over the past few decades postulation that social support essentially predicts the outcome of physical and mental health for everyone. There are six criteria of social support that researchers use to measure the level of overall social support available for the specific person or situation (Cutrona, Russell, & Rose, 1986). First, they would look at the amount of attachment provided from a lover or spouse. Second, measuring the level of social integration that the individuals involved with, it usually comes from a group of people or friends. Third, the assurance of worth from others such as positive reinforcement that could inspires and boosts the self-esteem. The fourth criterion is the reliable alliance support that provided from others, which means that the individual knows they can depend on receiving support from family members whenever it was needed. Fifth, the guidance of assurances of support given to the individual from a higher figure of person such as a teacher or parent. The last criterion is the opportunity for nurturance. It means the person would get some social enhancement by having children of their own and providing a nurturing experience.

This paper organizes studies of social support into three age-appropriate categories- adolescents, middle-aged adults, and older adults. For example, an experiment related to social support and physical health that empathizes cancer is assigned to the older adult category. If the specific area of concern can be applied to everyone, then it is placed into middle-aged adult group for generalization purpose. After reviewing those studies and experiments, it should be clearly shown that social support is very important factor in determining the status of physical health, mental health, and immune system functioning for everyone.

Adolescents

Adolescents could develop some kinds of sensitive feelings, which may impact on their health if they do not get adequate social attention from others. They may become involved in an unfortunate situation that makes them feel overwhelmed or awkward. The adolescent is still developing, could easily experience some strain to their emotion if no help is immediately available. Anxiety and depression are two main psychological disorders that often can be seen among the adolescents.

Family and Peer Support

For adolescents, family support is the most important element in their lives. As part of their growth experience, adolescents usually expect a lot of things from their parents. Inadequate support from the parents will likely increase the chance of getting depression among adolescents who get into unfortunate situation with their parents. This occurs because adolescent usually become confused when they expect to get plenty of help and positive reinforcement from their parents, but it does not happen (Stice, Ragan, & Randall, 2004).

Beside family support, peer support also is very important factor for adolescents. Children can expect a lot from their friends. Peer support can be considered as an alternate method of getting social support if the adolescents receive inadequate attention from their parents. This social support method is not as reliable as family support because young children could easily withdraw from their own friends if they become depressed. Another problem arises in this area, when the depressed students isolate themselves from public gatherings. This would prevent those suffering adolescents from getting any social support at all (Stice et al., 2004). Receiving social support is very essential for adolescents to become successful with themselves and achieve a satisfactory level at school.

Gifted Adolescents

Gifted adolescents also can encounter plenty of problems if they do not get adequate social support. In some cases, intelligent students are sent to residential schools that offer special programming for students who are gifted in math and science. Oftentimes, the family support would be severely limited for those adolescents, because the residential school usually lies far away from home. This kind of schooling is a totally new experience for gifted students, because they are living in the dormitory. Normally, students would experience the dormitory living for the first time when they go to college. At those ages, students are looking forward to seeking independence from their parents. This usually leaves a hole for those adolescents with reduced social support, whereas they have to rely on some people from the residential school (Dunn, Putallaz, Sheppard, & Lindstrom, 1987).

Gifted adolescents usually have to rely on counselors and peers at the school. The counselors usually help those students to ease the transition from home to a residential living situation. In contrast to students who attend regular school, there is a better chance for those gifted students to experience emotional well-being, be in a good physical health, and have a good immune system as long as adequate social support can be provided at the school to prevent or lessen the chance for those people from getting depressed (Dunn et al., 1987).

Middle-Aged Adults

The importance of social support continues well into adulthood for everyone. It would benefit a person's general health and immune systems, regardless of whether or not they have a lot of stress. For example, the cardiovascular system would function much better in those adults who have better social support (Uchino, Cacioppo, & Kiecolt-Glaser, 1996). The social contact, familial support, and involvement with leisure activities have significantly demonstrated a relationship with lowering of blood pressure. Contact among family members is the best method of reliving stress. The fellowship among friends is adequate, but not as powerful as family. Strangers have a negative effect on reducing blood pressure. In one study cited in Uchino's article, the individual with many siblings and experiencing low stress was found to be the best possible combination for lowering the blood pressure.

Health

Many studies indicate that anyone who has high social support tends to have less chance of getting depression and anxiety disorders. In contrast, only a handful of studies show that there is no relationship between social support and lowering the blood pressure. The level of social support also has been found to be related to a lower rate of disease and early death. The familial support is a psychological enhancement to help the individual reduce their stress. These findings are somewhat weak and further studies need to be done to gather more specific information about the influence of social support on physical health (Uchino et al., 1996).

There is a significant relation between emotions and health. Anyone who has positive emotion and beliefs is likely to enhance their physical health. As expected, being in a good mood will cause refreshed mind to relieve some of the stresses. Laughing is said to have a good deal of influence on reducing or forgetting about the hassles of daily life. Strong social support is necessary to help succeed in achieving these traits of overall physical well-being (Salovey, Detweiler, Steward, & Rothman, 2000).

Personality Type

There are some aggressive adults living in our society. This would probably mean those adults are diagnosed with Type A personality. Anger, aggressiveness, and hostility are the common characteristics of this type of personality. These are unhealthy personality traits, which could adversely affect the general health of those adults. Eventually, the research finds that there is some direct link between Type A personality and coronary heart diseases (Friedmann & Booth-Kewley, 1987). There is no scientific evidence yet, but researchers have suggested a general hypothesis that low social support may cause Type A personality. The researchers also revealed a strong relationship between social support and the absence of coronary heart diseases. More social support would soothe the individuals with Type A personality, leading to better physical health, thus reducing the risk of developing coronary heart diseases. Environmental stress is likely to increase the chance of getting physical illness (Maddi, Bartone, & Puccett, 1987).

Socioeconomic Status

One's socioeconomic status also is a major factor in whether or not an individual gets enough social support. The socioeconomic status is the measurement of level of income each person has to determine their level of economic status in our society. For example, if the specified person's income is rather low, compared to nationally average, that person would be considered as a part of the low socioeconomic status. As expected, anyone who comes from a lower socioeconomic class would be more likely to receive less social support. They basically do not have enough resources in their environment available to assist with social support. The individuals with low socioeconomic status also tend to have less self-control. Consequently, they become more sensitive to stressors in their environment and less able to control their reactions. It means those adults would trigger some frustrations when they face any kind of stress. Unfortunately, the social strain, which is common in their daily lives, increases the risk for lower social class individuals to develop some kinds of physical and mental illness or a lower sense of well-being. This should not come to surprise that adults who have higher socioeconomic status tend to receive more social support (Gallo, Bogart, Vranceanu, & Matthews, 2005).

Mothers of Children With Disabilities

Mothers with children who have permanent and chronic diseases usually become overwhelmed with all of the demands. They often feel burdened because it takes too much responsibility to take care of disabled children and meet such social demands as work at same time. Hope and good social support are very important elements to help reinforce those affected mothers. Hope serves as a psychological factor and social support serves as a comfort factor. As mentioned above, by thinking positively, hope should be able to take away the affected mothers' obsessions and make them think about something else for better. One interesting note from a study shows the stress level for those mothers varies widely. It greatly depends on the independent skills the disabled children have. For example, if the children have a very serious disability such as cerebral palsy, it would indicate their mothers will have to take all of the responsibilities as caregivers. On other hand, those children who have milder symptoms of disease would be able to function more independently. In this case, the affected mothers would be in a much better shape, but they still have to deal with some caregivers' responsibilities along with social demands such as daily hassles. The availability of social support from others, especially family members, helps the affected mothers to adjust to environmental demands (Horton & Wallander, 2001).

Stressors at Work

Many adults normally deal with a lot of stress at work. The high demands and low social contact/support within the workforce tend to cause the development of depressive symptoms among workers over a period of time. A high level of social support from a supervisor may help prevent depression from developing. This is not a guarantee, especially if the high demands continue to overwhelm the workers. To accomplish a satisfactory stress level in a high demand environment surely would require plenty of support and reinforcement from supervisors. The surprise finding in this specific study shows that the best combination for workers would be low stressors and low social contact. This study, which was taken place in Germany, shows that there is not much correlation of social support and stressors among the co-workers. These findings are still vague. This study included a limited number of workers. The researchers will need to study more workers in a greater variety of work environments over the place before they can generalize this result (Dormann & Zapf, 1999).

Some unfortunate adults experience the impact of job losses due to firings or layoffs. The unexpected layoffs usually are huge stressors among those workers who were impacted. Those displaced workers are likely to develop some problems that could influence their physical or mental health. For example, those affected workers normally report the loss of self-esteem and locus of control. This spikes the chance of those workers becoming depressed. The depression itself could signal the beginning of deterioration in health and well-being among those displaced workers (Mallinckrodt & Bennett, 1992).

The layoffs also make a big impact on the workers' life. Now, they have to worry about the financial support of their family. Worrying about the financial ability only add, more problem, for those who are unemployed. The social supports from family members benefit those individuals. By providing adequate social support, the displaced workers' physical and mental health is enhanced. This also prevents deterioration in physical/mental functioning down the road. Social support also would reinforce the displaced workers to make some adjustments into a new life (Mallinckrodt et al., 1992).

Older Adults

The physical functioning of older adults usually weakens as they become older. It is the key factor in predicting the health outcome of older adults is their status at the time they retire. The body and immune system of older adults usually become fragile as they become older. The resource of social support also tends to decrease somewhat. These several factors combined are the key to predict and control the health of older adults.

Employment Status

Older adults usually face significant changes when they reach their retirement ages. As they are basically done with their career, this stage of the life establishes a new focus for older adults. The retired workers have several choices to make; fully retire from the workforce, continue working part-time and collect some money, or focus primarily on non-paying jobs or volunteer activities. Volunteering is a big factor relating to social support for older adults. This element will help build companionship and interact with more people in the community. This step may become necessary as older adults lose some social support from their family members. This group of people needs to keep themselves busy by connecting with other people as often as needed. This method leads to better overall mental and physical health and better well-being. The amount of social support is the key to determine life satisfaction among the older adults. As expected, older adults who elect not to do any working during their retirement experience a lower level of life satisfaction. Their body function would deteriorate more quickly compared to other older adults who keep themselves busy (Aquino, Russell, Cutrona, & Altmaier, 1996).

Health

The initial level of social support essentially predicts the outcome of older adults' general health in the following years. Inadequate initial social support at the beginning of retirement would predict that older adults will develop depressive symptoms over time. Older adults would be able to ignore the negative effects in their lives with help and reinforcement from others. This is considered a psychological effect. Not enough social support would likely make the individuals notice their daily hassles and life stressors much more clearly. This step could accelerate the deteriorating effect of their physical and mental health. Unfortunately, there is no relationship found between social support and major life events. Whatever happens to older adult as they nearing to their death, it will happen, regardless the amount of social support available in the environment (Russell & Cutrona, 1991).

Cancer

The spouses of older adults who are fighting cancer usually get overwhelmed with all of the demands and stressors. They often worry about their loved ones prognosis with cancer. On a positive side, social support is said to be a huge psychological factor for these affected spouses. As more social support becomes available to those victims, the better the individuals' immune system and well-being will become. This should improve the bodily function of those impacted spouses and allow them to be able to handle the stress much more efficiently. It is very important for those impacted individuals being able to switch back and forth between two different worlds: the world of their ill spouses and the real world outside of the house or nursing home. Social support is widely known to buffer the stress level among those impacted spouses. Knowing that others are there to help makes the big difference. For those caring for spouses with cancer who have low social support usually report a deterioration in their general health. As widely known, low social support available usually means the impacted spouses have to rely on themselves more than usual. It is essentially focusing attention between the stressful spouses and their loved ones. The unfortunate situation often comes to impair the function of those affected spouses when they become overwhelmed with their stress, along with the deteriorating conditions among the cancer patients they are caring for. It is evident here that the spouses usually cannot handle taking care of the cancer patients by themselves. This is the primary reason why plenty of social support should be given to those impacted families. If the immediate family members or relatives are not available to help the burdened spouses, outside help should be immediately given; this can be someone who are nurses, counselors, or social workers. It should be marked clearly that social support is only a psychological factor because the cancer patients usually progresses as expected toward the end regardless of all of the hopes (Baron, Cutrona, Hicklin, Russell, & Lubaroff, 1990).

Stress

Initial mental health is a very important predictor for all older adults at the time they enter their retirement ages. Good mental health would predict a healthy social support and fairly good physical health for the years to come (Cutrona et al., 1986). Once an individual's mental health declines at any point during their retirement ages, it would increases the likehood for negative elements to persist with the impacted individuals. It has been found that it will be very difficult for those older adults to get out of the slump and have a positive perspective in their life once again. Knowing that they are valued by others makes a big difference in predicting the outcome of mental health for those older adults. If the impacted individuals demonstrate negative life events such as divorces, or any other kinds of daily stress, it becomes obvious to outsiders that inadequate social support is available for those people.

Conclusion

There is evidence that social experience is very essential in predicting the well-being for everyone, ranging from childhood through older adults (Cohen & Willis, 1985). After a few decades of studying, the researchers have finally gained some understanding about the relationship between social support and physical health. Nonetheless, some areas of research still face some problems because they sometimes focus too specify on one population, ignoring the generalization rules for using the random samples to generalize the result to a whole population.

The continuity of research on the relation between social support and physical health will enable us to understand better about the effect of good social support toward physical and mental health, along with a general well-being. Many studies have been shown that if a high level of social support becomes available to everyone, it will benefit their overall health in a long run. The importance of social support implies to everyone in our society, ranging from young childhood through older adulthood. The providers of social support can be anyone in society who brings the positive environment and reinforcement to the individuals, especially from their family members. The amount of social support available in the environment for the individual can be determined by looking at the six criterions of social support, and set up observational scores from each category then find the average score from all six categories. The higher average score it gets means the better social support the person has in their life, thus reducing their chance of developing any negative outcome in their health.


Peer Commentary

The Six Criteria for Social Support

Gregory S. Beattie
Rochester Institute of Technology

Corey M. Clark's paper, "Relations Between Social Support and Physical Health," discussed the implication of social support and people's physical health. He discussed the three age groups, adolescences, middle-aged adults, and older adults.

One area that I found lacking in Clark's paper was the description of the six criteria for social support and the application of those six criteria to the three age groups discussed in the paper. He stated that the six criteria were:

  1. Support from a lover/spouse
  2. Support from a group of people/friends
  3. Assurance of worth from others
  4. Reliable support
  5. Guidance and support from a higher figure
  6. Opportunity of nurturance
In his section about adolescences, he only lists three criteria that were important to that specific age group--family and peer support--which incorporate the second, forth, and fifth criteria. He does list the problem of gifted adolescence and how they have to adapt to the lack of social support from family and instead garner support from fellow students and teachers, who in a sense play a parental role to the gifted student. This leads me to wonder about the other three criteria. Does having a relationship during the adolescent years play a role in the relation between social support and the physical health of adolescents? What will happen when a constant stream of support is suddenly cut off? Is reliable support that important during the years of teenage rebellion? Clark leaves those questions unanswered.

In the next age group, middle-aged adults, the six critera are better applied and explained. There are, however, several new ideas that should not be a part of this paper. Where does the personality type of a person factor into the relation of social support and health? Again, as said above regarding adolescence, there is no information about the relationship of a person with his or her lover and the impact that relationship can have on social support. Clark's paper does go in depth about the support of people/friends such as family that in turn will give the person assurance of self worth and the knowledge that the support is reliable. He also discusses the opportunity for nurturance by using a socioeconomic support example about money not being able to provide much opportunity for nurturance.

The last age group, older adults, was wonderfully written and fully used the criteria Clark listed. He went into depth about how older people had to rely on other people for social support and he provided examples of how they could to that. Then he moved on to the impact cancer had on the person's spouse and family and how social support could disintegrate in that situation. The fifth criteria was omitted from this age group, because there is no higher figure to look to for support when you are the mellow age of 80.

All in all, Clark's paper was wonderful. He encompassed the three major age groups, but he could have added more detail especially about the criteria. Other than that, it contained a clear set of ideals that he wanted to articulate for the general public.


Peer Commentary

Which Came First, the Depression or the Social Isolation?

Ryan M. Cuff
Rochester Institute of Technology

Clark identified several areas in which social relationships can be found, and correlations between stress levels and various physical and mental ailments. However, there seem to be a few key areas in which Clark does not provide sufficient information to come to the conclusions that he does. No clear causational is shown nor are the alternatives of the negative impact of social structures discussed.

When dealing with adolescents, things may not be so clear-cut as Clark has represented them. Although many teenagers expect a great number of things from their parents, independence is one of them. If a parent fails to provide that, could the social interaction lead to smothering and affect the child negatively? Also not address would be the effects of removing a teen from a negative social environment, in which case could the removal of social contact decrease stress levels and result in better physical health? Beyond those questions, Clark never showed whether poor social support caused depression or depression caused kids to have poor social support groups. Although it is certainly easy to assume poor social support could cause depression, Clark never definitively showed a causal relation.

When looking at the middle-aged group, another series of issues were not clearly covered. Looking at the claim of better cardio-vascular health in those with better social support, there is nothing stated as a cause. Left as it is, we would have to conclude that having a social support group causes better cardio-vascular health, but is it not more likely there is something about having a social support group which causes improved cardio-vascular health, such as increased participation in physical group activities? Again, a correlation has been shown, but that does not establish a causal relation. Given that middle-aged individuals are more free to go outside a simple school system to make social relationships, the chances of negative relationships would severely decrease compared to teenagers; however, middle-age is the time of onset of many abnormal psychological conditions, so Clark may wish to include the effects of social relationships on people with abnormal psychological conditions, or the effects relationships with these people.

Moving to look at older adults, a major area of social interaction is never mentioned. The notion of retirement communities, which are obviously geared toward providing a social environment for similar individuals, is never discussed. It is to be hoped that the effects of such a social environment would be discussed in a paper dealing with the effects of social support on physical health.

Clark's analysis of social impact on physical health proves to be a great starting point. However, it ultimately draws conclusions that are not supported by the evidence given and fails to address some issues would seem to be fundamental to the topic at hand.


Peer Commentary

Social Support: How Friends and Family Can Save Your Life

Colin M. Gorman
Rochester Institute of Technology

The physical health of an individual can be greatly affected by his or her social support system and level of social support. The most elemental factor by which this effect of socialization works is a basic and sometimes overlooked reason for the success of psychotherapy. Sometimes just knowing that there is someone to talk to and confide in can help people overcomes their problems just as much as any treatment. Those with a greater social support system, whether family or friends, have a greater chance of resolving problems with which they are faced. The process of coping can be improved simply because someone is there to talk with about problems, give people unconditional love and support or possible providing a resolution.

For peer acceptance, a greater effect of physical benefits will be shown with respect to the number of peers. Simply speaking, having one friend is better than having none. If a child has no friends, the effects on his or her mental and physical state can be devastating. This is especially true for children with disorders such as attention-deficit disorder, whose spontaneity can affect the way they perceive and react to social situations, causing them to become "outcasts" from the group. This can result in low self-esteem and sometimes depression. A child with one close friend can go through adolescence with little negative ramifications. Belonging to a group not only provides psychological benefits, it can improve physical health and one's perception of physical health greatly (Espelage, Hale, & Hannum, 2005).

Parental support for children also provides much needed social support. Parents must provide a child with unconditional love and care, and must also set boundaries and regulations. By creating rules for the child to follow, the parent helps to shape the child's social actions and to acquaint the child with the way the world operates. Without these bounders a child may gain a peer social support but with inappropriate actions may lose them rather quickly. For parents who provide care for disabled children, economic status is a major factor that affects the physical health of the caregiver in addition to the child. For childhood disabilities that may cost a great deal of money to treat, the parent's social well-being can be affected by whether the parent can afford to help the child. Parental caregivers in the U.S. tend to have a lesser social support system than that in Canada, mainly because of Canada's universal health plan, because the mother is less focused on money for treating her child, given that it is provided by the government (Brehaut et al., 2004).

For individuals with debilitating or life-threatening conditions such as cancer or HIV/AIDS, a strong social network can aid in recovery and improve quality of life. Whether they are being cared for on an inpatient or an outpatient basis, if patients are happy with their current social relationships, such as with spouses, friends, and family, this can aid in their prognosis. Having strong social systems can give patients a more positive state of mind when it comes to their affliction. With support, a patient is more able to accept and can come to terms with the illness. This in turn allows a patient to make positive strides in treatment (Gore-Felton et al., 2002). Even when dealing in mental health, a strong social system can aid in the road to recovery. In victims of trauma, whether sexually based assault such as rape or nonsexually based assault such as combat experience, strong social support will aid in their recovery (Durand, Knudson, Martin, Rosen, & Stretch, 2000).

Having a job provides one with basic needs of modern times such as money, status, and a sense of accomplishment. Wen people are fired or laid off from their job, it can be devastating. But having social support can make the transition from job to job much smoother. Social support can help in three major categories: (a) dealing with the financial loss of a job, (b) dealing with the symptoms that come with losing one's job, such as poor physical health brought on by low self-esteem or depression, and (c) how motivated the person is to seek a new job. These three conditions can shorten the time of unemployment and improve the person's overall positive outlook on life (Fretz, & Mallinckrodt, 1988).

Later in life, when individuals reache the point at which they are unable to care for themselves or others, a decision must be made whether they will take up residence in a retirement home or hospital. For the initial decision of attending the residence, there seems to be a much higher rate of happiness if individuals decide for themselves that they are to move. Being forced into a care residence can cause negative feelings and sometimes depression because of feelings of uselessness. However, if the person willingly and openly decides to take up residence in a care facility, the advantages are great. In addition to providing physical care, the social system of the facility can provide the residences with ample amounts of peer interactions, due mainly to proximity. Because of their more active social life, residents in care facilities have a more positive outlook on life and tend to be happier than those living by themselves (Field, Orrell, & Walker, 2002).


Peer Commentary

The Unraveling Tie That Binds

Sara M. Kilpatrick
Rochester Institute of Technology

Social support is supposed to protect us, make us happier and healthier, and keep us sane; at least, that is the argument presented in Corey M. Clark's report "Relations Between Social Support and Physical Health." As emphasized throughout Clark's report, social support acts as our mind's defense against stressful life events and provides the necessary coping skills to deal with these events. But what happens when our network of family members, friends, and colleagues are causing the stress? Clark neglected the negative effects of social support and the damage it can cause on our psychological and physiological well-being.

Clark accurately pointed out that "social support essentially predicts the outcome of physical and mental health for everyone." However, he assumed that this social support is positive. In fact, social support can be detrimental to a person's overall well-being. For example, people with schizophrenia are more likely to relapse when they return home to live with family than if they live alone (Butcher, Mineka, & Hooley, 2004). Similarly, social networks can have a negative affect on girls with eating disorders (Butcher et al., 2004).

Many researchers agree that social support is beneficial to a person's physical and mental health; however, they leave something out. It is crucial for the public to understand that when researchers and psychologists make such a statement, they are assuming that social support is healthy; Clark assumes the same in his report. Healthy social support is not always available to us when we need it. We are constantly bombarded with phone calls, appointments, projects, and deadlines. As a society, we lack the necessary time and energy needed to develop and maintain healthy social support systems. Furthermore, we are not in control of what happens in other people's lives; in other words, people we routinely interact with may be sick or under considerable stress themselves.

Some social networks may be unhealthy because they reinforce behaviors that are, in themselves, harmful. Drug and alcohol abusers who are in recovery need to stay away from these networks if they want to stay sober. These social networks are neither healthy nor positive; instead, these social networks should be avoided at all costs. Adolescents should be especially cautious of such social networks. Peer support is an essential factor in an adolescent's social network; furthermore, if these peers support harmful behaviors, an adolescent may be more likely to engage in such harmful behaviors.

Social networks that are healthy and available can still be detrimental to a person's well-being. Clark points out two specific events in his report in which social support should be beneficial: job loss and chronic illness. In these situations, social support is expected to decrease depression; however, the opposite may occur. Some people who experience job loss or chronic illness may feel that they are a burden to their family. They may also feel that they are incapable, which may lead to low self-esteem. These beliefs may lead to feelings of hopelessness and helplessness sufficient causes of depression (Butcher et al., 2004); therefore social support may actually act as an indirect cause of depression.

Similarly, it is important to note that some attempts of support are not always viewed positively. Family members and friends who, for instance, offer advice may cause more harm than good for an individual. Some individuals may perceive attempted support as degrading or humiliating; moreover, forced support through the social network may also induce feelings of helplessness.

Social support is not always beneficial to a person's physical and mental health. Negative, unhealthy social support can be destructive to a person's overall well-being. Although Clark's position on social support is accurate, it is not complete. Research needs to examine both the positive and negative effects of social support if they intend on formulating valid theories about mental disorders. By acknowledging the negative side of social support, networks can be improved in terms of their health and availability; in other words, if we can identify the weaknesses of a particular theory, then we can correct these errors and create an effective tool in fighting mental and physical deterioration.

Social support can only be beneficial if it is adaptable to the environment; furthermore, social support has to be geared towards an individual's specific needs. We have to be more aware of what our friends, family members, and even ourselves need in terms of support. Once we are aware of this, we can more effectively enhance the positive effect of networks, rather than be burdened by the negative.


Author Response

Factors Involved in Social Support

Corey M. Clark
Rochester Institute of Technology

I would like to thank to those who have evaluated my paper and helped reinforce it by elaborating some essential points that I failed to discuss. Beattie elaborated on the description of six criteria of social support that affect the physical health in all three age groups. He discovered several questions that I left unanswered in my paper. For instance, Beattie made the point that every social support criteria do not fit into all three age groups. Originally, I was trying to make this paper a focus on middle-aged adulthood. When I added the adolescent and older adulthood sections, I tried to explain the background and significance of the relations between social support and physical health in these age groups. The consequence was that I left out several criteria that did not apply to adolescents and older adults. As Beattie pointed out, I could have explained the absence of several criteria in adolescents and older adults. For example, older adults do not have any role models to look up to build on their social support and physical health status; therefore, they have to rely on five other criteria for their well-being.

Cuff discovered that my paper did not include some important examples of causation. Once again, the relation between social support and physical health is a widely publicized topic. This topic contains a lot of background on the relations between social support and physical health. I tried to cover all of those areas as much as possible. Unfortunately, this left my paper missing some of the important points and examples that I could have added. All of the points about casual relation that Cuff presented are very important points that I could have added to my paper.

Gorman's peer commentary filled in some information that I failed to discuss in my paper. I explained the transition of older adults from work into retirement. Gorman's peer commentary added information about the decision-making steps necessary before moving on into retirement, such as the types of residence to live in. Because this topic has been widely discussed, I could not put all of the information and examples into this paper. Consequently, I never include the life-threatening conditions of middle-aged adulthood as an example of the relation between social support and physical health. Gorman's peer commentary provided a great example of recovering from life-threatening conditions by being involved in the community and support groups that share common interests and problems.

Kilpatrick was concerned about the missing discussion of negative relations between social support and physical health in my paper. As she pointed out, I basically discussed only the positive aspects of this topic. My paper discussed how social support affected physical health in positive ways. It is widely known that there is a positive correlation between social support and physical health. As Kilpatrick pointed out, the reality is that social support can also have negative influences on physical health, especially among those who have psychological disorders. I should have acknowledged the negative aspects of social support in my paper.


References

Aquino, J. A., Russell, D. W., Cutrona, C. E., & Altmaier, E. M. (1996). Employment status, social support, and life satisfaction among the elderly. Journal of Counseling Psychology, 43, 480-489.

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