Social Support
Brian Lakey

Perceived Support
The most commonly used measures of social support are measures of perceived support. In general these measures show consistent and strong relations to mental health, and are often related to many indices of physical health (Sarason, Sarason & Gurung, 2001 xClose
Sarason, B. R., Sarason, I. G., & Gurung, R. A. R. (2001). Close personal relationships and health outcomes: A key to the role of social support. In B. R. Sarason & S. Duck (Eds.) Personal relationships: Implications for clinical and community psychology (pp. 15-41). New York: Wiley.; Uchino, 2004 xClose
Uchino, B. N. (2004). Social support and physical health outcomes: Understanding the health consequences of our relationships. New Haven, CT: Yale University Press.; Wills & Filer, 2001 xClose
Wills, T. A., & Filer, M. (2001). Social networks and social support. In A. Baum, T. A. Revenson, & J. E. Singer (Eds.), Handbook of health psychology (pp. 209-234). Mahwah, NJ: Erlbaum.). Among the most common measures are the Interpersonal Support Evaluation List and the Social Provisions Scale. Descriptions of a wide range of other measures of perceived support can be found in Wills and Shinar (2000).

The Interpersonal Support Evaluation List. The Interpersonal Support Evaluation List (ISEL; Cohen & Hoberman, 1983 xClose
Cohen, S., & Hoberman, H. M. (1983). Positive events and social supports as buffers of life change stress. Journal of Applied Social Psychology, 13, 99-125.; Cohen, Mermelstein, Kamarck, & Hoberman, 1985 xClose
Cohen, S., Mermelstein, R., Kamarck, T., & Hoberman, H. (1985). Measuring the functional components of social support. In I. G. Sarason & B. R. Sarason (Eds.) Social support: theory research and application (pp. 73-94). The Hague: Martinus Nijhoff.) has both college student (48 items) and general population (40 items) versions, and provides four subscales: Appraisal (e.g., "There are several people that I trust to help solve my problems"); Belonging (e.g., "I often meet or talk with family or friends"); Tangible (e.g., "If I needed a ride to the airport very early in the morning, I would have a hard time finding someone to take me"[reverse scored]); and Self-esteem support (e.g., "There is someone who takes pride in my accomplishments"). Items are rated on a four-point scale with anchors ranging from "definitely true" to "definitely false." The ISEL has excellent internal consistency and good test-retest reliability (Cohen, et al., 1985 xClose
Cohen, S., Mermelstein, R., Kamarck, T., & Hoberman, H. (1985). Measuring the functional components of social support. In I. G. Sarason & B. R. Sarason (Eds.) Social support: theory research and application (pp. 73-94). The Hague: Martinus Nijhoff.).

The Social Provisions Scale. The Social Provisions Scale (SPS; Cutrona & Russell, 1987 xClose
Cutrona, C. E., & Russell, D. W. (1987). The provisions of social relationships and adaptation to stress. Advances in Personal Relationships, 1, 37-67.) is a 24-item measure that provides six subscales, Reliable Alliance (e.g., "There are people I can depend on to help me if I really need it"); Attachment (e.g., "I feel a strong emotional bond with at least one other person"); Guidance (e.g., "There is a trustworthy person I could turn to for advice if I were having problems"); Nurturance (e.g., "There are people who depend on me for help"); Social Integration (e.g., "There are people who enjoy the same social activities I do"); and Reassurance of Worth (e.g., "There are people who admire my talents and abilities"). The original version of the scale uses a Likert response format, although other formats are sometimes used (e.g., Cutrona, 1986 xClose
Cutrona, C. E. (1986). Objective determinants of perceived social support. Journal of Personality and Social Psychology, 50, 346-355.). There is also a 12-item short form, and a form that refers to specific relationships (Cutrona, 1989 xClose
Cutrona, C. E. (1989). Ratings of social support by adolescents and adult informants: Degree of correspondence and prediction of depressive symptoms. Journal of Personality and Social Psychology, 57, 723-730.). The SPS has excellent internal consistency and good test-retest reliability (Cutrona & Russell, 1987 xClose
Cutrona, C. E., & Russell, D. W. (1987). The provisions of social relationships and adaptation to stress. Advances in Personal Relationships, 1, 37-67.).

Construct validity. The construct validity of measures of perceived support is extensive, as such measures correlate with a wide range of other measures of relationship perceptions (Lakey & J. Cohen, in press xClose
Lakey, B., & Cohen, J. L. (in press). Social support assessment. To appear in S. Ayers, A. Baum, C. McManus, S. Newman, K. Wallston, J. Weinman, & R. West (Eds.), Cambridge Handbook of Psychology, Health, & Medicine (2nd Edition). Cambridge, England: Cambridge University Press.). Indeed, measures of perceived support are related to generic relationship satisfaction, intimacy, low levels of conflict, and secure attachment styles (Lakey & J. Cohen, in press xClose
Lakey, B., & Cohen, J. L. (in press). Social support assessment. To appear in S. Ayers, A. Baum, C. McManus, S. Newman, K. Wallston, J. Weinman, & R. West (Eds.), Cambridge Handbook of Psychology, Health, & Medicine (2nd Edition). Cambridge, England: Cambridge University Press.). In addition, relationship partners show some agreement about the supportiveness of their relationships -- there is moderate agreement among dyads when rating the supportiveness of their relationships. However, measures of perceived support are also related to a number of constructs typically thought of as reflecting individual differences. As already mentioned, perceived support is positively related to mental health, but in addition is related to self esteem, perception of personal control, extraversion, positive affect and social skills, and negatively related to dysfunctional attitudes (Lakey & J. Cohen, in press xClose
Lakey, B., & Cohen, J. L. (in press). Social support assessment. To appear in S. Ayers, A. Baum, C. McManus, S. Newman, K. Wallston, J. Weinman, & R. West (Eds.), Cambridge Handbook of Psychology, Health, & Medicine (2nd Edition). Cambridge, England: Cambridge University Press.). Thus, measures of perceived support appear to reflect both the characteristics of relationships and also the personal characteristics of respondents. When respondents provide separate ratings for each support provider, approximately 15% of the variance reflects respondent personality, whereas about 55% represents actual relationships (Branje, van Aken & van Lieshout, 2002 xClose
Branje, S. J. T., van Aken, M. A. G., & van Lieshout, C. F. M. (2002). Relational support in families with adolescents, Journal of Family Psychology, 16, 351-362.; Lakey, McCabe, Fisicaro & Drew, 1996 xClose
Lakey, B., McCabe, K. M., Fisicaro, S. A., & Drew, J. B. (1996). Environmental and personal determinants of support perceptions: Three generalizability studies. Journal of Personality and Social Psychology, 70, 1270-1280.). However, this same research indicates that social support is largely a matter of personal taste, and that there is little agreement among observers about the supportiveness of the same providers. Yet, according to the principles of reliability theory (Cronbach, Gleser, Nanda & Rajaratnam, 1972 xClose
Cronbach, L. J., Gleser, G. C., Nanda, H., & Rajaratnam, N. (1972). The dependability of behavioral measurements: Theory of generalizability of scores and profiles. New York: John Wiley.), when respondents make global ratings of their social networks, the measures come to be more highly saturated with personality variance. That is, if respondents' global ratings represent a weighted average of the supportiveness of specific relationships (e.g., Global Perceived Support = (.5) * Support from Relationship 1 + (.3) * Support from Relationship 2 + (.2) * Support From Relationship 3), and if perceptions of each relationship are partly influenced by perceivers' personality, then computing the weighted average magnifies the personality variance present in each relationship when arriving at a global perception. Thus, to maximize the extent to which perceived support measures reflect personal relationships and not respondent personality, social support should be assessed separately for each of the most important relationships, and these scales should be treated separately rather than summed across different relationship partners.

Enacted Support
Measures of enacted support typically ask respondents to estimate the frequency with which respondents have received specific supportive behaviors (or simply whether or not they have received the behaviors). Descriptions of a wide range of measures of enacted support can be found in Wills and Shinar (2000) xClose
Wills, T. A. & Shinar, O. (2000). Measuring perceived and received social support. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and intervention (pp. 86-135) New York: Oxford University Press. .

The most commonly used measure of this kind is the Inventory of Socially Supportive Behaviors (ISSB; Barrera, Sandler & Ramsey, 1981 xClose
Barrera, M., Sandler, I. N., & Ramsey, T. B. (1981). Preliminary development of a scale of social support: Studies on college students. American Journal of Community Psychology, 9, 435-447.). The ISSB is a 40-item measure, using the following response options: "not at all," "once or twice," "about once a week," "several times a week," or "about every day." The ISSB provides four subscales (Finch, Barrera, Okun, Bryant, Pool, & Snow-Turek, 1997 xClose
Finch, J. F., Barrera, M. Jr., Okun, M. A., Bryant, W. H. M., Pool, G. J., & Snow-Turek, A. L. (1997). The factor structure of received social support: Dimensionality and the prediction of depression and life satisfaction. Journal of Social & Clinical Psychology, 16), including Directive Guidance (e.g., "suggested some action you should take"), Nondirective Support (e.g., "Expressed interest and concern in your well-being"), Positive Social Exchange (e.g., "Talked with you about some interests of yours") and Tangible Assistance (e.g., "Gave you over $25"). The ISSB has excellent internal consistency and good test-retest reliability (Barrera et al., 1981 xClose
Barrera, M., Sandler, I. N., & Ramsey, T. B. (1981). Preliminary development of a scale of social support: Studies on college students. American Journal of Community Psychology, 9, 435-447.).

Construct validity. The construct validity of measures of enacted support is not as well established as that for measures of perceived support. For example, measures of enacted support appear to have less consistent and weaker relations to both mental and physical health than do measures of perceived support (Barrera, 1986 xClose
Barerra, M., Jr. (1986). Distinctions between social support concepts, measures, and models. American Journal of Community Psychology, 14, 413-445.; Uchino, 2004 xClose
Uchino, B. N. (2004). Social support and physical health outcomes: Understanding the health consequences of our relationships. New Haven, CT: Yale University Press.). Similarly, enacted support has weaker links to self-esteem and other aspects of cognition than does perceived support (Lakey & J. Cohen, in press xClose
Lakey, B., & Cohen, J. L. (in press). Social support assessment. To appear in S. Ayers, A. Baum, C. McManus, S. Newman, K. Wallston, J. Weinman, & R. West (Eds.), Cambridge Handbook of Psychology, Health, & Medicine (2nd Edition). Cambridge, England: Cambridge University Press.). Nonetheless, people who report receiving high levels of enacted support express more positive affect and extroversion than people who report low levels (Lakey & J. Cohen, in press xClose
Lakey, B., & Cohen, J. L. (in press). Social support assessment. To appear in S. Ayers, A. Baum, C. McManus, S. Newman, K. Wallston, J. Weinman, & R. West (Eds.), Cambridge Handbook of Psychology, Health, & Medicine (2nd Edition). Cambridge, England: Cambridge University Press.). There is, however, some evidence that researchers may not have discovered the circumstances under which enacted support is related to health. For example, Reynolds and Perrin's (2004) xClose
Reynolds, J. S., & Perrin, N. A. (2004). Mismatches in social support and psychosocial adjustment to breast cancer. Health Psychology, 23, 425-430. study of cancer patients found that enacted support was linked to mental health more strongly when the enacted support matched the desires of the recipients. Similarly, Bolger, Zuckerman and Kessler (2000) xClose
Bolger, N., Zuckerman, A., Kessler, R. C. (2000). Invisible support and adjustment to stress. Journal of Personality & Social Psychology, 79, 953-961. reported that enacted support was only related to good mental health when the support went unnoticed by recipients. Other recent evidence on inter-observer agreement also supports the validity of the ISSB. Close relationship partners displayed higher agreement regarding enacted support than they did for either perceived support or personality (J. Cohen, Lakey, Tiell & Neely, 2005 xClose
Cohen, J. L., Lakey, B., Tiell, K., & Neely, L. C. (2005). Recipient--provider agreement on enacted support, perceived support and provider personality. Psychological Assessment, 17, 375-378.). Thus, respondents appear to report enacted support comparatively accurately, but enacted support does not seem to be related as strongly or as consistently to the same kinds of positive relationship and personal characteristics, as is perceived support.

Social Integration
Measures of social integration typically count the total number of relationships, the number of different types of relationships, frequency of contact with relationship partners, or the number of roles that respondents have, although some also assess additional information such as the percentage of network members who know each other or are related to the respondents (i.e., density). Descriptions of a number of social integration measures can be found in Brissette, Cohen and Seeman (2000) xClose
Brissette, I., Cohen, S., & Seeman, T. E. (2000). Measuring social integration and social networks. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement and intervention (pp. 53-85). New York: Oxford University Press..

Social Network Index. S. Cohen and colleagues' Social Network Index (SNI; S. Cohen, 1991 xClose
Cohen, S. (1991). Social supports and physical health: Symptoms, health behaviors, and infectious diseases. In A. L. Greene, E. M., Cummings, & K. H. Karraker (Eds.), Life-span developmental psychology: Perspectives on stress and coping (pp. 213-234). Hillsdale, NJ: Erlbaum.; Cohen, Doyle, Skoner, Rabin, & Gwaltnery, 1997 xClose
Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltnery, J. M. (1997). Social ties and suspectibility to the common cold. Journal of the American Medical Association, 277, 1940-1944.) is a prototypical measure of social integration. The SNI assesses the number of different types of relationships in which respondents participate, with participation defined as talking to the other person in the relationship (in person or by phone), at least once every two weeks. The SNI lists twelve different types of relationships (e.g., spouse, parents, children, friends, and workmates) and each type of relationship counts for one point. Thus, high scores reflect having a range of different types of relationships, rather than a large number of relationships.

Construct validity. Measures of social integration have an impressive track record of forecasting poor health, particularly mortality (Berkman & Syme, 1979 xClose
Berkman, L. F., & Syme, S. L. (1979). Social networks, host resistance, and mortality. American Journal of Epidemiology, 109, 186-204.; House, Landis, & Umberson, 1988 xClose
House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241, 540-545.; Uchino, 2004 xClose
Uchino, B. N. (2004). Social support and physical health outcomes: Understanding the health consequences of our relationships. New Haven, CT: Yale University Press.). Beyond these well-documented links, the construct validity of measures of social integration is less well documented than for measures of perceived support. For example, measures of social integration are not closely linked to psychological distress in most samples (Barrera, 1986 xClose
Barerra, M., Jr. (1986). Distinctions between social support concepts, measures, and models. American Journal of Community Psychology, 14, 413-445.). However, social integration does appear to be related to extroversion, positive affect and positive health practices (Lakey & J. Cohen, in press xClose
Lakey, B., & Cohen, J. L. (in press). Social support assessment. To appear in S. Ayers, A. Baum, C. McManus, S. Newman, K. Wallston, J. Weinman, & R. West (Eds.), Cambridge Handbook of Psychology, Health, & Medicine (2nd Edition). Cambridge, England: Cambridge University Press.; Uchino, 2004 xClose
Uchino, B. N. (2004). Social support and physical health outcomes: Understanding the health consequences of our relationships. New Haven, CT: Yale University Press.).

Other Types of Social Support Measures
Although researchers have occasionally noted the desirability of assessing social support using behavioral observation, only a small number of such measures have been developed (e.g., Cutrona, Hessling & Suhr, 1997 xClose
Cutrona, C. E., Hessling, R. M., & Suhr, J. A. (1997). The influence of husband and wife personality on marital social support interactions. Personal Relationships, 4, 379-393.; Pasch, Bradbury & Davila, 1997 xClose
Pasch, L. A., Bradbury, T. N., & Davila, J. (1997). Gender, negative affectivity, and observed social support behavior in marital interaction. Personal Relationships, 4, 361-378.). One promising observational assessment is the Social Support Behavior Code (SSBC; Cutrona et al., 1997 xClose
Cutrona, C. E., Hessling, R. M., & Suhr, J. A. (1997). The influence of husband and wife personality on marital social support interactions. Personal Relationships, 4, 379-393.). Trained observers count the frequency of different kinds of supportive behaviors in specific conversations. The specific types of supportive behavior assessed are informational support (e.g., "suggests a course of action"), emotional support (e.g., "expresses sorrow or regret for the distress of [the support recipient]"), esteem support (e.g., "gives positive feedback") and tangible support (e.g., "offers to perform a task directly related to the stress"). The SSBC has good inter-rater agreement (Cutrona et al., 1997 xClose
Cutrona, C. E., Hessling, R. M., & Suhr, J. A. (1997). The influence of husband and wife personality on marital social support interactions. Personal Relationships, 4, 379-393.), but it has not yet been used extensively in research, and so there is comparatively little information about its construct validity.

Finally, a variety of scholars have begun using diary measures of social support, in which respondents report support received on a daily basis (Bolger et al., 2000 xClose
Bolger, N., Zuckerman, A., Kessler, R. C. (2000). Invisible support and adjustment to stress. Journal of Personality & Social Psychology, 79, 953-961.). Diary measures offer the promise of substantially increasing the precision by which day-by-day processes in social support can be measured.