Methodological issues in social support and social network research.

With the plethora of articles describing a relationship between social support and/or social network and health status, it was considered useful to take stock of the current status of research in this area, focusing on two critical methodological issues: clarity of definition, and validity and reliability of the measurement instruments. Of the 33 instruments reviewed only modest agreement was found in conceptual definition, and frequently the concepts were not defined or ill-defined. Of particular concern is the definitional confusion between social support and social network. Variables used to operationalize these concepts confirm this lack of specificity and ambiguity in definition. As for validity and reliability, many of the investigators reported no data on these issues; others provided information that only modestly supported the validity or reliability of their instrument. The conclusion of this assessment suggests the need to clarify the essential elements of social support and social networks in order to better distinguish between the behavioral (support) and structural (network) variables that may be affecting health status. A question is also raised as to the likelihood of a single questionnaire being designed that would accurately measure the perceptions of support or supportive behaviors in the variety of supportive research that will continue to be studied. Finally, more rigorous standards need to be used by investigators in establishing the validity and reliability of the instruments in order to improve their predictive utility.

[1]  R. Turner Social support as a contingency in psychological well-being. , 1981 .

[2]  J. Cassel,et al.  Social Support and Health , 1977, Medical care.

[3]  P. Duncan-Jones,et al.  Measuring social relationships The Interview Schedule for Social Interaction , 1980, Psychological Medicine.

[4]  J. Medalie,et al.  Angina pectoris among 10,000 men. II. Psychosocial and other risk factors as evidenced by a multivariate analysis of a five year incidence study. , 1976, The American journal of medicine.

[5]  D. Streiner,et al.  Methodological issues in developing a scale to measure social support. , 1981, Schizophrenia bulletin.

[6]  S Gore,et al.  The effect of social support in moderating the health consequences of unemployment. , 1978, Journal of health and social behavior.

[7]  A. Jette,et al.  Elders' use of informal long-term care assistance. , 1983, The Gerontologist.

[8]  R. Mitchell Social networks and psychiatric clients: The personal and environmental context , 1982, American journal of community psychology.

[9]  R P Russell,et al.  Five-year blood pressure control and mortality following health education for hypertensive patients. , 1983, American journal of public health.

[10]  F. Gallo The effects of social support networks on the health of the elderly. , 1983, Social work in health care.

[11]  P Bebbington,et al.  The buffer theory of social support – a review of the literature , 1987, Psychological Medicine.

[12]  B. Gottlieb,et al.  The measurement of social support and its relation to stress. , 1979 .

[13]  J. Mitchell,et al.  The Concept and Use of Social Networks , 1969 .

[14]  J. Cassel The contribution of the social environment to host resistance: the Fourth Wade Hampton Frost Lecture. , 1976, American journal of epidemiology.

[15]  B. J. Hirsch Natural support systems and coping with major life changes , 1980 .

[16]  J. House Work stress and social support , 1981 .

[17]  S. Henderson,et al.  The Social Network, Support and Neurosis , 1977, British Journal of Psychiatry.

[18]  E. Wagner,et al.  The epidemiologic evidence for a relationship between social support and health. , 1983, American journal of epidemiology.

[19]  B. Bloom,et al.  Social support: Its structure and impact on marital disruption , 1982, American journal of community psychology.

[20]  I. Sarason,et al.  Assessing Social Support: The Social Support Questionnaire. , 1983 .

[21]  S. Reeder,et al.  Structural and Social Psychological Factors in the Decision to Seek Medical Care for Symptoms , 1981, Medical care.

[22]  J. Mckinlay Social Networks, Lay Consultation and Help-Seeking Behavior , 1973 .

[23]  D. Blazer Social support and mortality in an elderly community population. , 1982, American journal of epidemiology.

[24]  G. Andrews,et al.  The relation of social factors to physical and psychiatric illness. , 1978, American journal of epidemiology.

[25]  E. Sadalla,et al.  Relationships among community size, mediators, and social support variables: A path analytic approach , 1981 .

[26]  C. Fischer,et al.  Networks and places: social relations in the urban setting , 1977 .

[27]  M. E. Perkins Support Systems and Community Mental Health , 1975 .

[28]  M. Lieberman,et al.  The stress process. , 1981, Journal of health and social behavior.

[29]  G J Wentowski,et al.  Reciprocity and the coping strategies of older people: cultural dimensions of network building. , 1981, The Gerontologist.

[30]  S. Cobb Presidential Address-1976. Social support as a moderator of life stress. , 1976, Psychosomatic medicine.

[31]  A. Antonovsky Health, stress, and coping , 1979 .

[32]  G. Andrews,et al.  LIFE EVENT STRESS, SOCIAL SUPPORT, COPING STYLE, AND RISK OF PSYCHOLOGICAL IMPAIRMENT , 1978, The Journal of nervous and mental disease.

[33]  T. Harris,et al.  Social Origins of Depression: A Study of Psychiatric Disorder in Women , 1979 .

[34]  J. Sokolovsky,et al.  Schizophrenia and social networks: ex-patients in the inner city. , 1978, Schizophrenia bulletin.

[35]  M. Hammer,et al.  Social networks and schizophrenia. , 1978, Schizophrenia bulletin.

[36]  C. M. Parkes,et al.  Broken Heart: A Statistical Study of Increased Mortality among Widowers , 1969, British medical journal.

[37]  R. Weiss The provisions of social relationships , 1974 .

[38]  J. A. Barnes Class and Committees in a Norwegian Island Parish , 1954 .

[39]  C. Holahan,et al.  Social support and psychological distress: a longitudinal analysis. , 1981, Journal of abnormal psychology.

[40]  W. Lancee,et al.  Correlates of enduring distress patterns following bereavement: social network, life situation and personality , 1982, Psychological Medicine.

[41]  N. Lin,et al.  Social support scales: a methodological note. , 1981, Schizophrenia bulletin.

[42]  W. Lancee,et al.  Predictors and correlates of adaptation to conjugal bereavement. , 1982, The American journal of psychiatry.

[43]  E. Paykel,et al.  Life Events and Social Support in Puerperal Depression , 1980, British Journal of Psychiatry.

[44]  J. House,et al.  The association of social relationships and activities with mortality: prospective evidence from the Tecumseh Community Health Study. , 1982, American journal of epidemiology.

[45]  M. Marmot Socio-economic and cultural factors in ischaemic heart disease. , 1982, Advances in cardiology.

[46]  D. Streiner,et al.  A longitudinal study of the influence of the psychosocial environment on health status: a preliminary report. , 1980, Journal of health and social behavior.

[47]  G. Brodsky,et al.  Social support and social adjustment: Implications for mental health professionals , 1979 .

[48]  Claude S. Fischer,et al.  A Procedure for Surveying Personal Networks , 1978 .

[49]  T. H. Holmes,et al.  Life change, coping ability and chronic intrinsic asthma. , 1973, Journal of psychosomatic research.

[50]  L. Berkman,et al.  Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. , 1979, American journal of epidemiology.

[51]  J. Cassel,et al.  Psychosocial assets, life crisis and the prognosis of pregnancy. , 1972, American journal of epidemiology.

[52]  J. French,et al.  Relationships of cessation of smoking with job stress, personality, and social support. , 1975, The Journal of applied psychology.

[53]  J. Earp,et al.  The effects of family involvement and practitioner home visits on the control of hypertension. , 1982, American journal of public health.

[54]  Manuel Barrera,et al.  Preliminary development of a scale of social support: Studies on college students , 1981 .

[55]  John E. Ware,et al.  A model of mental health, life events, and social supports applicable to general populations , 1981 .

[56]  R. Perrucci,et al.  Network structure and reactions to primary deviance of mental patients. , 1982, Journal of health and social behavior.

[57]  P. Killworth,et al.  Informant Accuracy in Social Network Data , 1976 .

[58]  K. Orth-Gomér,et al.  The measurement of social support in population surveys. , 1987, Social science & medicine.

[59]  N. Lin,et al.  The epidemiological significance of social support systems in depression. , 1981 .

[60]  C. Tolsdorf,et al.  Social networks, support, and coping: an exploratory study. , 1976, Family process.

[61]  J. Sokolovsky,et al.  Toward a resolution of methodological dilemmas in network mapping. , 1981, Schizophrenia bulletin.

[62]  E. Bott Family and Social Network; Roles, Norms, and External Relationships in Ordinary Urban Families. , 1971 .

[63]  J S Norbeck,et al.  The Development of an Instrument to Measure Social Support , 1981, Nursing research.

[64]  Benjamin H. Gottlieb,et al.  The development and application of a classification scheme of informal helping behaviours. , 1978 .

[65]  N. Lin,et al.  Social support, stressful life events, and illness: a model and an empirical test. , 1979, Journal of health and social behavior.

[66]  C. Tennant,et al.  The relation between physical, psychological, and social morbidity in a suburban community. , 1977, American journal of epidemiology.

[67]  Y. S. Matsumoto Social stress and coronary heart disease in Japan. A hypothesis. , 1970, The Milbank Memorial Fund quarterly.

[68]  M. Dimond Social support and adaptation to chronic illness: the case of maintenance hemodialysis. , 1979, Research in nursing & health.

[69]  J. Mckinlay Social Network Influences on Morbid Episodes and the Career of Help Seeking , 1981 .

[70]  G. Brown,et al.  Social support, self-esteem and depression , 1986, Psychological Medicine.

[71]  B. Wellman,et al.  The Network City , 1973 .