| Chapter 1: | Introduction |
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Others feel the level of stress experienced is affected by the activity of coping, that is, “the ways in which people actually respond to stressful situations, [is the result of] the extent and ways in which they draw upon various individuals and social resources that are potentially available” (Gore, 1985, p. 267; for discussion see Sarason, Sarason, Shearin, & Pierce, 1987).
Methodologically the buffer hypothesis is problematic in that stressful life events and social support can be difficult to untangle (Dohrenwend, Dohrenwend, Dodson, & Shrout, 1984; Thoits, 1982; Berkman & Kawachi, 2000). A change in social support, such as divorce, death of a friend, trouble with coworkers, or loss of ties because of geographic mobility can also constitute a stressful life event. Confounding these variables results in a bias in favor of the buffer hypothesis. For example, the finding that greater psychosocial distress is associated with lower social support may actually be because of the death of a spouse, an event that simultaneously increases distress and decreases social support. Measures of social support and stressful life events commonly do not take this potential overlap into consideration.
The direct effect of social support on health is the second vein of research on social support and health. Rather than acting as a buffer to stress, this camp views social support as directly protective of health. Berkman and Breslow (1983) theorize that a “social network provides a web that assures every person in it of receiving a certain amount of emotional and practical support. With strong social support, even someone who is experiencing difficulties does not suffer to the same extent as a more isolated individual” (p. 114). This direct effect has also been characterized as social embeddedness that provides a sense of belonging, reassurance of worth, an opportunity for nurturant behavior, and access to new contacts and diverse information (Berkman, 1984).
Although Berkman and Breslow’s (1983) Alameda County Study was one of the most influential early studies of the direct effects of social support on health, in the words of one of its authors, “ it was not meant to be an ideal model of how studies in this area ought to proceed. … [But rather] was meant to be thought provoking and to stimulate research into the area of how human relationships might influence physical health” (Berkman, 1986, p. 560).