hypothesis of social support

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• HHS Author Manuscripts

New Look at Social Support: A Theoretical Perspective on Thriving through Relationships

Brooke c. feeney.

Carnegie Mellon University

Nancy L. Collins

University of California, Santa Barbara

Close and caring relationships are undeniably linked to health and well-being at all stages in the lifespan. Yet the specific pathways through which close relationships promote optimal well-being are not well understood. In this article, we present a model of thriving through relationships to provide a theoretical foundation for identifying the specific interpersonal processes that underlie the effects of close relationships on thriving. This model highlights two life contexts through which people may potentially thrive (coping successfully with life’s adversities and actively pursuing life opportunities for growth and development), it proposes two relational support functions that are fundamental to the experience of thriving in each life context, and it identifies mediators through which relational support is likely to have long-term effects on thriving. This perspective highlights the need for researchers to take a new look at social support by conceptualizing it as an interpersonal process with a focus on thriving.

“My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style. Surviving is important. Thriving is elegant.” - Maya Angelou

In recent years, there has been a dramatic increase in the scientific study of well-being and positive aspects of mental health (e.g., Deci & Ryan, 2000 ; Diener, Lucas, & Scollon, 2006 ; Keyes, 2005 , 2007 ; Lyubomirsky, Sheldon, & Schkade, 2005 ; Ryff & Singer, 1998 , 2008 ; Seligman, 2002 , 2008 ); and although theoretical models differ in how they define optimal well-being, they all agree that deep and meaningful close relationships play a vital role in human flourishing. A large body of empirical work supports this view, showing that people who are more socially integrated and who experience more supportive and rewarding relationships with others have better mental health, higher levels of subjective well-being, and lower rates of morbidity and mortality (e.g., Cohen, 2004 ; Cohen & Syme, 1985 ; Collins, Dunkel Schetter, Lobel, & Scrimshaw, 1993 ; Kawachi & Berkman, 2001 ; Lakey & Cronin, 2008 ; Miller, Lachman, Chen, Gruenewald, Karlamangla, & Seeman, 2011 ; Sarason, Sarason, & Gurung, 1997 ; Seeman, 2000 ; Uchino, 2009 ; Uchino, Cacioppo, & Kiecolt-Glaser, 1996 ; Vaux, 1988 ). Especially notable, a meta-analysis ( Holt-Lunstad & Smith, 2012 ) shows that being socially integrated in a network of meaningful relationships predicts mortality more strongly than many lifestyle behaviors (e.g., smoking, physical activity) that have been the focus of national health care campaigns. On the basis of these results, Holt-Lunstad and Smith (2012) suggest that public health campaigns should focus on helping people to cultivate high quality relationships. But what would such a campaign look like? What specific features of relationships should be targeted? Unfortunately, the mechanisms linking relationships to health, and the specific features of relationships that should be cultivated, are not well-understood.

There are several reasons for this gap in the literature. First, research on relationships and health has not been well-integrated with research and theory on close relationships. Most of the empirical work linking relationships to health and well-being conceptualizes social relations in terms of individuals’ general reports of their marital status, social networks, social integration, and perceived social support (e.g., Antonucci, Okorodudu, & Akiyama, 2002 ; Diener, Suh, Lucas, & Smith, 1999 ; Helgeson, 1993 ; Hughes, Waite, Hawkley, & Cacioppo, 2004 ; Lang & Carstensen, 1994 ; Ryff, 1989 ; Uchino et al., 1996 ). With few exceptions (e.g., Burman & Margolin, 1992 ; Kiecolt-Glaser & Newton, 2001 ; Pietromonaco, Uchino, & Dunkel Schetter, 2013 ), researchers have not considered specific dyadic behaviors or interaction patterns that underlie the effects of social relations on health and well-being, or the mechanisms through which these effects occur (see Uchino, Bowen, Carlisle, & Birmingham, 2012 , for further elaboration of this point). As a result, we know relatively little about how relationships promote or hinder thriving.

Second, research on relationships and health has focused almost exclusively on the importance of supportive relationships in the context of stress or adversity. Although stress-buffering is important ( Cobb, 1976 ; Cohen & Wills, 1985 ), there is also strong evidence for a main effects model of social support, indicating that close relationships are tied to well-being even in the absence of specific stressors ( Lakey & Orehek, 2011 ). Close relationships promote well-being in many ways, not just as a resource in times of adversity. Yet decades of research on social support has all but ignored another life context in which relationships can protect and enhance well-being – by enabling individuals to fully participate in life’s opportunities for growth and development in the absence of adversity.

Finally, research on social support has conceptualized health primarily in terms of the presence or absence of negative outcomes associated with acute and chronic stress (e.g., mortality, morbidity); this narrow focus has limited our understanding of the many ways in which social relationships can promote (or hinder) positive human health and well-being. One reason for this narrow focus is that research on social support has not been well-integrated with the literature on positive well-being, which shows that positive health endpoints are not simply the opposite of negative ones, and that optimal health is not simply the absence of mental and physical illness (e.g., Deci & Ryan, 2000 ; Diener et al., 2006 ; Keyes, 2007 ; Lyubomirsky et al., 2005 ; Ryff & Singer, 1998 ; Seligman, 2002 , 2008 ). How do close relationships support individuals not only in their ability to cope with stress/adversity, but also in their efforts to learn/grow, explore, achieve goals, cultivate new talents, and find purpose and meaning in life?

To understand how relationships affect health and well-being – and how people thrive – the literature is in need of theoretical models that describe specific interpersonal processes that have implications for human thriving. Our goal is to contribute to this effort by offering a model of social support and thriving that takes insights from three literatures that have remained largely independent – the positive well-being literature, the social support literature, and the close relationships literature. This model builds on traditional social support theory by (a) focusing on close relationships and dyadic support processes, (b) emphasizing the important end-state of receiving support as “thriving” (not just stress-buffering or maintenance of status quo), (c) highlighting the importance of support provision in life contexts other than adversity, and (d) identifying specific mediators that are likely to explain the link between support and long-term thriving outcomes. Our overarching goal is to offer an integrative perspective for understanding how close relationships promote (or hinder) thriving, and for guiding a new generation of research on this important and timely topic.

In this article we present an integrative model of thriving through relationships in which we conceptualize social support as an interpersonal process that functions to promote thriving in two life contexts – experiences of adversity and opportunities for growth in the absence of adversity. This model is presented in Figures 1 and ​ and2 2 and will be elaborated throughout the following sections. We begin by identifying core components of thriving and highlighting two life contexts in which individuals can thrive. Next, we specify two corresponding relational support functions that contribute to thriving in each life context, followed by a discussion of potential mechanisms linking these support functions to long-term thriving outcomes. We then present an elaborated model of the interpersonal processes involved in each type of support and the ways in which these processes can be effectively cultivated in close relationships. We conclude by providing a roadmap for future research.

Conceptual framework for thriving through relationships.

Model of interpersonal processes involved in the provision of source of strength (SOS) and relational catalyst (RC) support for thriving.

What does it mean to thrive?

To understand how close relationships promote (or hinder) thriving, it is important to begin with a clear definition of thriving. The Merriam-Webster Dictionary defines thriving as flourishing (growing or developing vigorously), prospering (being successful; gaining in wealth or possessions), and progressing toward or realizing a goal despite or because of circumstances ( www.merriam-webster.com ). Theoretical perspectives on thriving agree that thriving connotes growth, development, and prosperity, although differences emerge in the specification of what this growth and prosperity looks like, and the contexts in which it occurs (e.g., Bundick, Yeager, King, & Damon, 2010 ; Diener et al., 2010 ; Lerner, von Eye, Lerner, Lewin-Bizan, & Bowers, 2010 ; Ryff & Singer, 2000 ).

Components of Thriving

Although thriving has been conceptualized in a variety of ways, all perspectives agree that it includes flourishing both personally and relationally (e.g., Benson & Scales, 2009 ; Bundick et al., 2010 ; Diener et al., 2010 ; Keyes, 2003 ; 2007 ; Lerner et al., 2010 ; Ryff & Singer, 1998 ; 2000 ; 2008 ; Seligman, Steen, Park, & Peterson, 2005 ; Theokas et al., 2005 ). Integrating these perspectives, we conceptualize thriving in terms of five broad components of well-being and their respective indicators (see Table 1 ): (1) hedonic well-being (happiness and life satisfaction – the perceived quality of one’s life), (2) eudaimonic well-being (having purpose and meaning in life, having and pursuing passions and meaningful goals, personal growth, self-discovery, autonomy/self-determination, mastery/efficacy, development of skills/talents, accumulation of life wisdom, movement toward one’s full potential), (3) psychological well-being (positive self-regard, self-acceptance, resilience/hardiness, a positive belief system, the absence of mental health symptoms or disorders), (4) social well-being (deep and meaningful human connections, positive interpersonal expectations, a prosocial orientation toward others, faith in others/humanity), and (5) physical well-being (physical fitness, the absence of illness or disease, health status above expected baselines, longevity).

Descriptive Summary of Thriving Components

This definition incorporates Ryff and Singer’s (1998 ; 2008) specification of “criterial goods” that embody lives well lived, and other specifications of psychological flourishing (e.g., Henderson & Knight, 2012 ; Keyes, 2003 , 2007 ; Seligman et al., 2005 ) and positive health (e.g., Seligman, 2008 ). It is also consistent with a large literature on subjective well-being, which defines well-being in terms of pleasant affect, life satisfaction, and satisfaction within specific life domains (e.g., work, family), having social and personal resources for making progress toward valued goals ( Diener et al., 1999 ), and the fulfillment of basic needs for competence, autonomy, and relatedness that promote intrinsic motivation and growth ( Ryan & Deci, 2000 ). It also draws from humanistic theories regarding self-actualization and the motive to realize one’s full potential (e.g., Maslow, 1998 ; Rogers, 1961 ), from models of mental and physical resilience in response to stress (e.g., Epel, McEwen, & Ickovics, 1998 ), and from developmental perspectives on the defining markers of thriving ( Benson & Scales, 2009 ; Dowling, Gestadottir, Anderson, von Eye, & Lerner, 2003 ; King et al., 2005 ; Lerner, Dowling, & Anderson, 2003 ; Moore & Lippman, 2005 ; Scales, Benson, Leffert, & Blyth, 2000 ; Theokas et al., 2005 ). Our goal in consolidating these perspectives into the five components (and related indicators) listed above is to provide a conceptual framework – and a point of departure – for considering how relationship support promotes people’s progress or prosperity in these many domains of well-being, not just in stress-related diseases and outcomes.

This conceptualization of thriving does not require that thriving be viewed as an “all or none” outcome, or defined by a strict cut off point on some scale or measure. Thriving is a multi-dimensional construct that exists as a continuum – people can be more or less thriving across a variety of domains of well-being. Moreover, thriving must be considered with respect to the individual’s current circumstances. For example, an individual with cancer is likely to experience lower levels of health and well-being compared to an individual without cancer, but a cancer patient with a caring support network is likely to experience better outcomes (e.g., more purpose and meaning in life, deeper social connections) than a cancer patient who lacks a supportive network. Thus, thriving must be defined in relative rather than absolute terms. The goal of our theoretical perspective is to understand how relationship support (in stressful and non-stressful times) contributes to optimal well-being in the ways that are possible for individuals given the circumstances and environments in which they are situated.

Life Contexts through which Individuals Thrive

Building on prior models of resilience and thriving in the face of stress ( Carver, 1998 ; Epel et al., 1998 ), and models of flourishing and positive well-being ( Deci & Ryan, 2000 ; Diener et al., 2006 ; Ryff & Singer, 1998 ; Seligman, 2002 , 2008 ), the current perspective highlights two life contexts through which individuals may potentially thrive. A first context involves the experience of adversity. Individuals thrive in this context when they are able to cope successfully with adversities, not only by being buffered from potentially severe consequences of adversity when it arises, but also by emerging from the experience as a stronger or more knowledgeable person. Because thriving connotes growth and development, thriving in the face of adversity involves more than simply returning to baseline or maintenance of the status quo ( Carver, 1998 ; Epel et al., 1998 ). Thriving occurs when people weather the storms of life in ways that enable them to grow from the experience (e.g., perhaps through heightened sense of mastery, increased self-regard, a greater sense of purpose in life, and more meaningful social bonds; Ryff & Singer, 1998 ). Although everyone experiences adversity, individuals who thrive through adversity are eventually able to both cope with it in such a way that they do not stay down and defeated, and take something useful or constructive from the experience that enhances their well-being.

A second context through which individuals may thrive involves the experience of life opportunities for growth and prosperity in the absence of adversity. Individuals thrive in this context when they are able to fully participate in opportunities for fulfillment and personal growth through work, play, socializing, learning, discovery, creating, pursuing hobbies, and making meaningful contribution to community and society ( Deci & Ryan, 2000 ; Ryff & Singer, 1998 ). These opportunities may be viewed as positive challenges because they often involve goal strivings and goal pursuits that require time, effort, and concentration. Thriving individuals are likely to formulate and actively pursue personal goals, and to pursue them in a self-determined manner ( Deci & Ryan, 2000 ; Emmons, 1991 ). Theoretically, one must function well in both life contexts (adversity and life opportunities) in order to be a maximally thriving individual, as functioning in each context makes independent contributions to thriving outcomes.

Relational Support Functions as Predictors of Thriving

What enables people to thrive through adversity and through life opportunities for growth? That is, how do people “flower into the kinds of persons who don’t simply avoid problems and pathologies, but who embrace life and make full use of their special gifts in ways that benefit themselves and others?” ( Benson & Scales, 2009 , p. 90). Our ultimate goal is to make a case for how responsive social support within the context of one’s close relationships promotes thriving. In making this case, we present a model of thriving through relationships that puts relationships at the forefront in facilitating or hindering thriving. This perspective requires us to take a new look at social support and to re-conceptualize it in terms of the promotion of positive well-being instead of only buffering stress – and to view it as an interpersonal process that unfolds over time instead of an attitude or expectation (e.g., perceived available support).

A key proposition of this perspective is that well-functioning close relationships (with family, friends, and intimate partners) are fundamental to thriving because they serve two important support functions that correspond to the two life contexts through which people may potentially thrive – coping successfully with adversity, and participating in opportunities for growth and fulfillment in the absence of adversity. These support functions are rooted in attachment theory ( Bowlby, 1982 , 1973 , 1988 ; Mikulincer & Shaver, 2007 ), which proposes that all individuals enter the world with propensities to seek proximity to close others in times of stress (an attachment behavioral system), to explore the environment (an exploration system), and to support the attachment and exploration behavior of close others (a caregiving behavioral system). The perspective advanced here extends attachment theory in its focus on thriving and in its detailed articulation of ways in which supportive relationships contribute to thriving outcomes. We begin by elaborating on the two support functions that relationships serve that facilitate thriving through adversity and opportunities for growth.

Support for thriving through adversity

One important function that relationships serve is to support thriving through adversity, not only by buffering individuals from the negative effects of stress, but also by helping them to emerge from the stressor in a way that enables them to flourish either because of or despite their circumstances (see Figure 1 , paths a – c ). Relationships serve an important function of not simply helping people return to baseline, but helping them to thrive by exceeding prior baseline levels of functioning. A useful metaphor is that houses destroyed by storms are frequently rebuilt, not into the same houses that existed before, but into homes that are better able to withstand similar storms in the future. So too are people able to emerge from adverse life circumstances stronger and better off than they were before with the support of significant others who fortify and assist them in the rebuilding. In this sense, relationships can provide a source of strength, in addition to a refuge, in adverse circumstances.

In other work, we refer to the support of a relationship partner’s attachment behaviors (i.e., proximity-seeking and support-seeking in times of adversity) as the provision of a safe haven . This conceptualization is based on attachment theory’s notion of a safe haven ( Bowlby, 1988 ), which functions to support behaviors that involve “coming in” to a relationship for comfort, reassurance, and assistance in times of stress ( Collins & Feeney, 2000 ; Feeney, 2004 ; Feeney & Collins, 2004 ). Although the term safe haven has not generally been used in the social support literature, this is the type of support that has most often been studied in prior work. Indeed, when researchers use the term “social support,” they are almost always referring to the provision (or seeking) of instrumental or emotional aid in response to stressful or negative life events. From an attachment perspective, good support-providers are those who are able to effectively restore an attached person’s felt security when needed – by providing emotional comfort and facilitating problem resolution. However, when viewing thriving as the ultimate outcome of receiving support (and not only restoration of felt security), then the term safe haven does not fully capture all of what is needed to promote thriving through adversity. Thus, we expand attachment theory’s notion of a safe haven and refer to this relational support function that strengthens/fortifies as well as comforts/protects in times of adversity as Source of Strength (SOS) support (depicted in the top portion of Figure 1 ). We emphasize the promotion of thriving through adversity as the core purpose of this broader support function.

This idea of flourishing through adversity is consistent with work on post-traumatic growth or benefit finding (for reviews see Calhoun & Tedeschi, 2006 ; Helgeson & Lopez, 2010 ; Helgeson, Reynolds, & Tomich, 2006 ; Joseph, Murphy, & Regel, 2012 ; Linley & Joseph, 2004 ) and on the development of resilience in the face of adversity ( Aldwin, Sutton, & Lachman, 1996 ; Carver, 1998 ; Seery, Holman, & Silver, 2010 ). However, these processes are not typically considered in a relational context, nor has the support of growth through adversity been a focus of theoretical or empirical work in the social support literature (although there is emerging work within the post-traumatic growth literature that implicates social relations as predictors of growth or benefit finding; e.g., Dunn, Occhipinti, Campbell, Ferguson, & Chambers, 2011 ; Lelorain, Tessler, Florin, & Bonaud-Antignac, 2012 ; Lepore & Kernan, 2009 ; Leung et al., 2010 ; Luszczynska, Mohamed, & Schwarzer, 2005 ; Morris, Campbell, Dwyer, Dunn, & Chambers, 2011 ; Powell, Gilson, & Collin, 2012 ; Prati & Pietrantoni, 2009 ; Scrignaro, Barni, & Magrin, 2011 ).

How does one promote thriving through adversity? Table 2 provides a summary of the components of SOS support. First, consistent with attachment theory, the SOS support function must be enacted on a foundation of safe haven support. This involves providing safety and protection (a refuge), as well as relief of the burdens that one experiences during times of adversity ( Bowlby, 1982 ; Collins & Feeney, 2000 ). Relationship partners can provide this function by accepting a close other’s dependency needs ( Feeney, 2007 ), providing a comfortable environment for the expression of negative emotion ( Spiegel & Kimerling, 2001 ), providing emotional comfort and reassurance, conveying understanding and acceptance, providing instrumental aid with regard to alleviating the adverse circumstances, and shielding or defending the close other from negative forces related to the stressor. For example, one may provide a safe haven to a romantic partner who has been blindsided by friendship betrayal by accepting the partner’s expressions of distress, offering comfort, and defending/protecting the partner’s reputation from negative repercussions of the betrayal.

Descriptive Summary of Support Functions

On this foundation, the SOS support function promotes thriving through adversity (not just coping with adversity) through a process of fortification , which includes assisting in the development of a close other’s strengths and abilities relevant to coping with the adversity – either by pointing out strengths and abilities that the person already has but may not recognize (helping them learn about the self through adversity), or by recognizing a strength or ability that is needed for successful coping and assisting them in attaining it. For example, one may fortify a shy friend who is being taken advantage of at work by instilling confidence, coaching in ways of dealing with colleagues, helping to develop communication skills, and providing opportunities for practicing the skills. This promotes thriving because the recipient may not only stop the adverse events, but also use the new skills to reach new heights in his/her career.

A related and necessary function of SOS support involves assisting in the reconstruction process once an individual has been fortified with the strength to rebuild. This involves motivating a close other who has experienced adversity to stay in the game and use their strengths to implement new approaches that take into account the negative forces identified through the adverse experience. This includes motivating positive coping with adversity by encouraging positive action instead of dwelling on negative circumstances that cannot be changed. For example, an individual who copes with the loss of a job by ruminating and staying in bed all day would benefit from having someone who not only helps to nurture his/her strengths, but who also encourages him/her to use those strengths to rebuild in a positive way (e.g., to make a career change, go back to school) that can contribute to thriving.

Doing this successfully requires assisting in reframing/redefining the adversity as a mechanism for positive change. This function of SOS support involves a cognitive redefining of the adversity so that it does not seem as threatening or insurmountable as it may have initially. It includes helping a close other to view the adversity as one that can be overcome or to find benefits in the adverse experience. This redefinition should enable one to approach the adversity in a way that will promote thriving. For example, viewing an unwanted divorce as an indicator of one’s lack of desirability or the end of one’s life would be detrimental to positive coping and the possibility of thriving through adversity. Assistance in putting the adversity in perspective (e.g., as a common occurrence) and redefining it (e.g., as an impetus for positive change) may motivate the individual to use the experience as a stepping stone for forging new relationships.

It is important to note that a majority of the social support literature has focused on stress-buffering effects of social support. In fact, social support has been defined as the “provision of psychological and material resources intended to benefit an individual’s ability to cope with stress” ( Cohen, 2004 , p. 676). In positing the source of strength support function, we propose that support providers can do much more than buffer stress or return one to baseline levels of functioning. We propose that when support-providers provide a source of strength, they assist in helping the recipient to grow, flourish, or prosper (to thrive) through the adversity. Thus, we argue for a broader perspective on social support than has historically been taken in the literature, and we do this by proposing that support in times of adversity should be viewed more broadly than simply buffering negative effects of stress, and by proposing that social support must be considered in non-adverse life contexts as well, as we turn to next. We do not suggest that stress-buffering models of social support are incorrect, as there is an abundance of research showing stress-buffering effects. Instead, we propose that (1) support provision that promotes thriving goes beyond just buffering stress, and (2) support for thriving should be examined in more than just stressful life contexts.

Support for thriving through participation in life opportunities in the absence of adversity

Another important function that relationships serve is to provide support for thriving through participation in life opportunities in the absence of adversity ( Figure 1 , paths d – f ). Supportive relationships can help people thrive by promoting engagement in opportunities that enable them to enhance their positive well-being by broadening and building resources ( Bowlby, 1988 ; Fredrickson, 2001 ) and finding purpose and meaning in life ( Ryff & Singer, 1998 ). Although most research in the social support literature concerns support in times of stress, we emphasize that support in the absence of adversity is equally important for thriving. A key aspect of this perspective is that people must fully embrace life and its opportunities in order to thrive, and that close relationships are integral in this process.

In other work, we have referred to the support of a significant other’s exploration behavior (e.g., desires to learn, grow, play, discover, and accomplish goals) as the provision of a secure base (e.g., Feeney, 2004 , 2007 ). This is based on attachment theory’s notion of a secure base, which functions to support behaviors that involve “going out” from a relationship for autonomous exploration in the environment ( Bowlby, 1988 ; see also Crowell, Treboux, Gao, Fyffe, Pan, & Waters, 2002 ; Waters & Cummings, 2000 ). Although overlooked in the social support literature, good support-providers must not only know how to respond appropriately to attachment behavior and signals of distress, but also how to support exploration behavior (e.g., autonomous goal strivings, personal growth; Bowlby, 1988 ). Thus, an important aspect of support-giving involves the provision of a secure base from which an attached person can make excursions into the world (to play, work, learn, discover, create) knowing that he/she can return for comfort, reassurance, or assistance should he/she encounter difficulties along the way. Bowlby (1988) describes the concept of a secure base as one in which support-providers create the conditions that enable significant others to explore the world in a confident way:

In essence this role is one of being available, ready to respond when called upon to encourage and perhaps assist, but to intervene actively only when clearly necessary. In these respects it is a role similar to that of the officer commanding a military base from which an expeditionary force sets out and to which it can retreat, should it meet with a setback. Much of the time the role of the base is a waiting one but it is none the less vital for that. For it is only when the officer commanding the expeditionary force is confident his base is secure that he dare press forward and take risks (p. 11).

However, when viewing thriving as the ultimate outcome of receiving social support (instead of just providing a base for exploration, which emphasizes a passive, waiting role), the term secure base does not fully capture a support function that promotes thriving in the absence of adversity. Thus, for the model presented here, we expand attachment theory’s notion of a secure base to include additional components necessary for supporting thriving. We refer to this relational support function that promotes engagement in life opportunities in non-adverse times as Relational Catalyst (RC) support (depicted in the bottom portion of Figure 1 ) because support-providers can serve as active catalysts for thriving in this context. We emphasize the promotion of thriving through life opportunities as the core purpose of this broader support function.

How does one promote thriving through engagement in life opportunities? Table 2 provides a summary of the components of RC support. First, nurturing a desire to create and/or seize life opportunities for growth is a key function. This includes expressing enthusiasm for life opportunities; validating a close other’s goals, dreams, and aspirations (both big and small); encouraging a close other to challenge or extend himself/herself to grow as an individual (e.g., leave one’s comfort zone to try challenging as well as familiar activities); communicating the potential benefits of creating/pursuing life opportunities; and providing encouragement to embrace even small opportunities that may be stepping stones to bigger ones. Because opportunities are not always readily available, the encouragement to take initiative in creating one’s own opportunities is an important part of motivating the pursuit of life opportunities.

Doing this successfully involves providing perceptual assistance in the viewing of life opportunities , which is another function of RC support. This includes helping a close other to focus on the positive aspects of opportunities instead of being paralyzed by potential difficulties and communicating that even unsuccessful opportunity-pursuits can lead to growth and subsequent opportunities. Perceptual assistance also includes assisting the person in recognizing opportunities that might otherwise be missed. Because a major impediment to engaging in life opportunities begins with the recipient’s perception of them (e.g., as too difficult, as a threat to security, as likely to result in failure), relational catalysts help their significant others to notice and positively evaluate opportunities before they pass. This includes helping them create a vision of future possibilities, as visualizing potential outcomes may be a first step to attaining them.

A third function of RC support is to facilitate preparation for engagement in life opportunities by promoting the development of plans, strategies, skills, and resources for approaching opportunities. This includes encouraging the development of requisite skills (and giving necessary space to do so), providing instrumental or informational assistance in attaining necessary resources, accommodating plans/strategies for pursuing goals, providing direct instruction or feedback if one has relevant expertise, encouraging one to perform to his/her capabilities (and to stretch his/her capabilities), and encouraging the setting of attainable goals ( Wrosch, Scheier, Miller, Schulz, & Carver, 2003 ). A relational catalyst may also see a special quality in a person that others cannot yet see and nurture its development ( Rusbult, Finkel, & Kumashiro, 2009 ).

The final function of RC support is to provide the launching function during actual engagement in life opportunities. Part of this involves attachment theory’s notion of a secure base ( Bowlby, 1982 ; 1988 ; Feeney & Thrush, 2010 ) and includes (1) providing encouragement during the engagement, (2) not unnecessarily interfering (e.g., refraining from providing support that is not needed/wanted, from becoming emotionally over-involved [ Coyne & DeLongis, 1986 ; Coyne, Wortman, & Lehman, 1988 ], or from impeding the accomplishment of the goal/activity), as the primary function of a base is a waiting one ( Bowlby, 1988 ), and (3) being available in the event that the base is needed (e.g., to assist in removing obstacles, and to stay connected to the partner’s interests, choices, and feelings). Being available and staying connected are important because individuals who are confident in the availability of their base do not have to cling to that base to the extent that individuals who lack such confidence do ( Feeney, 2007 ).

Supporting capitalization ( Gable & Reis, 2010 ) – by celebrating successes and accomplishments along the way – is another important part of the launching function that should encourage persistence and continued engagement in opportunities for growth. Capitalization promotes thriving because the social sharing of good news and positive events with responsive others confers benefits that amplify the good event (e.g., making it more memorable, creating a longer lasting impact on positive well-being; Gable & Reis, 2010 ; Reis et al., 2010 ). Research shows that when people share personal positive events with close others, and when close others are perceived to respond actively and constructively (e.g., expressing genuine pride and excitement), then disclosers experience increased positive affect and well-being, above and beyond the impact of the positive event itself. However, when close others respond passively or destructively and thereby deflate the discloser’s excitement, the discloser is unable to fully benefit from the positive event ( Gable, Gonzaga, & Strachman, 2006 ; Gable, Reis, Impett, & Asher; 2004 ). Enjoying life in the absence of adversity by sharing positive events and experiences with others (which are often related to goal pursuits and personal growth such as performing well at work or school, or milestones such as marriage or the birth of a child) is part of full engagement in life. Thus, an important part of supporting thriving includes the support of capitalization by responding actively and constructively to a close other’s positive experiences.

Another important part of this launching function involves assisting in tune-ups and adjustments (e.g., in perceptions, skills, and strategies) as needed, and sensitively responding to setbacks. This supports thriving by increasing the likelihood that close others learn from their experiences and that each successive expedition is strengthened by building on the one before. In addition, relational catalysts support thriving by encouraging the pursuit of passions in a healthy and well-balanced manner such that other important opportunities or facets of life are not neglected (e.g., time spent with children, sleep and nutrition needs), by encouraging self-expansion ( Aron, Aron, Tudor, & Nelson, 1991 ; Aron, Aron, & Smollan, 1992 ), and by perceiving and behaving toward a close other in ways consistent with his or her ideal self ( Drigotas, Rusbult, Wieselquist, & Whitton, 1999 ; Kumashiro, Rusbult, Finkenauer, & Stocker, 2007 ; Rusbult, Kumashiro, Stocker, Kirchner, Finkel, & Coolsen, 2005 ). This functions to bring the individual closer to his or her ideal self (in terms of dispositions, values, and behavioral tendencies) through a process of behavioral affirmation (termed the Michelangelo Phenomenon ). A series of longitudinal studies on this process in couples ( Drigotas, 2002 ; Drigotas et al., 1999 ; Rusbult et al., 2005 ) has shown that when individuals perceive and behave toward a partner in ways that are consistent with the partner’s ideal self, this treatment leads to actual movement toward the ideal self, which in turn predicts enhanced relationship functioning and personal well-being. In contrast, when individuals perceive and behave in ways that are inconsistent with the partner’s ideal self (a process of disaffirmation), this leads to movement away from the ideal self and deterioration in personal and relationship well-being.

Elaboration on Support Functions

Several aspects of SOS and RC support require elaboration. First, SOS and RC support represent two distinct support functions that have different purposes and that occur in different life contexts. This is an important distinction because individuals are likely to differ in the extent to which they provide or seek each support function. For example, individuals who are uncomfortable with expressions of distress or vulnerability (e.g., avoidant attachment) may have difficulty providing or seeking SOS support ( Collins & Feeney, 2000 ; Feeney & Collins, 2001 ), whereas those who prefer to merge with others and fear losing them (e.g., anxious attachment) may have difficulty providing or seeking RC support ( Cassidy & Shaver, 2008 ; Feeney, Collins, Van Vleet, & Tomlinson, 2013 ).

Second, SOS and RC support are conceptualized as support functions that are provided through the use of a constellation of particular support behaviors . Support functions describe the role or purpose for which support exists, and specific support behaviors – emotional, esteem, informational, and tangible support ( Brock & Lawrence, 2009 ; Cutrona, 1996a ) – are employed in the service of accomplishing designated functions. Thus, a variety of support behaviors can be used for either support function, and these behaviors can be explicit (direct) or implicit (indirect), depending on the needs of the recipient. It is also important to note that although the provision of support requires time and effort, the support of a close other’s thriving (through SOS and RC support) does not always require a large investment of time and energy. Many of the behaviors we outline for promoting thriving are simple to enact, such as communicating availability, sharing companionship, providing encouragement, not unnecessarily interfering, communicating about life opportunities, and celebrating successes. In fact, research indicates that small acts of care (e.g., a few words of encouragement, an enthusiastic response to good news, being physically present and attuned) can have a profound impact on personal and relationship well-being (e.g., Coan, Schaefer, & Davidson, 2006 ; Collins, Jaremka, & Kane, 2014 ; Eisenberger et al., 2007 , 2011 ; Feeney 2004 , Feeney & Lemay, 2012 ; Feeney & Thrush, 2010 ; Gable & Reis, 2010 ; Kane, McCall, Collins, & Blascovich, 2012 ; Schnall, Harber, Stefanucci, & Proffitt, 2008 ), and that individuals can even benefit from symbolic proximity to close others (such that physical presence is not always required to reap the benefits of supportive others, Jakubiak & Feeney, 2014 ; Master et al., 2009 ; Mikulincer, Gillath, & Shaver, 2002 ; Smith et al., 2004 ) because they have developed mental representations of close others through repeated experience with them ( Bowlby, 1982 ; Baldwin, 1992 ).

Fourth, although responsive close relationships that provide SOS and RC support provide the optimal environment for thriving, the perspective advanced here does not suggest that one particular type of relationship (e.g., a romantic relationship) is necessary for thriving, or that one particular person should be the only source of relational support for thriving. Instead, people will be most likely to thrive when they are embedded in a network of responsive relationships (e.g., with friends, siblings, intimate partners, parents, mentors) that together serve these important support functions. This assertion is supported by research showing that complex measures of social integration (i.e., having close, meaningful relationships with diverse social network members) are stronger predictors of mortality than are measures of marital status or network size ( Holt-Lunstad & Smith, 2012 ), and with research showing the health costs associated with loneliness ( Hawkley & Cacioppo, 2003 ). This perspective is also consistent with Social Baseline Theory’s ( Beckes & Coan, 2011 ) emphasis on risk-distribution and load-sharing with social network members to decrease costs of dealing with environmental demands and to free resources for engaging effectively with the environment.

Fifth, by specifying specific support functions that relationships serve, the current perspective highlights the importance of support quality. It is not just whether someone provides support, but it is how they do it that determines the outcome of that support. Any behaviors in the service of providing SOS and RC support must be enacted both responsively and sensitively in order to promote thriving (see Reis, 2012 and Reis, Clark, & Holmes, 2004 , for theorizing on responsiveness). Being responsive involves providing the type and amount of support that is dictated by the situation and by the partner’s needs ( Cohen & Wills, 1985 ; Cutrona, 1990 ; Simpson, Winterheld, Rholes, & Orina, 2007 ). Responsive support-providers flexibly respond to needs and adjust their behavior in response to the contingencies of the situation ( Collins, Guichard, Ford, & Feeney, 2006 ; Feeney & Collins, 2001 ). Being sensitive involves responding to needs in such a way that the support recipient feels understood, validated, and cared for ( Burleson, 1994 , 2009 ; Maisel & Gable, 2009 ; Reis & Patrick, 1996 ; Reis & Shaver, 1988 ). This is accomplished by offering support in a way that expresses generous intentions, protects the recipient’s self-esteem, acknowledges the recipient’s feelings and needs, conveys acceptance, and respects the recipient’s point of view ( Collins et al., 2006 ). Sensitive support also is provided in a way that respects the support-recipients’ autonomy and self-determination (e.g., to chart their own course, to choose their own passions/goal pursuits, to choose their own ways of coping with or rebuilding after a stressor), which fosters confidence and intrinsic motivation ( Deci & Ryan, 2000 , 2002 ; Emmons, 1991 ; Rogers, 1961 ).

Thus, the degree to which support behavior is responsive depends on the type and amount of support given, and the degree to which it is sensitive depends on the manner in which the support is provided. Of course, being responsive and sensitive is not always easy, and even well intended support efforts may have unintended negative consequences ( Bolger & Amarel, 2007 ; Collins, Ford, Guichard, Kane, & Feeney, 2010 ; Coyne et al., 1988 ; Dunkel Schetter, Blasband, Feinstein, & Herbert, 1992 ; Gleason, Iida, Shrout, & Bolger, 2008 ; Rafaeli & Gleason, 2009 ; Rini, Dunkel Schetter, Hobel, Glynn, & Sandman, 2006 ; Rini & Dunkel Schetter, 2010 ). For example, support-providers may offer support in a way that makes the recipient feel weak, needy, or inadequate; induces guilt or indebtedness; makes the recipient feel like a burden; minimizes or discounts the recipient’s problem, goal, or accomplishment; blames the recipient for his or her misfortunes or setbacks; restricts autonomy or self-determination; or conveys a sense of contingent acceptance (e.g., that one must succeed in order to be accepted). Support-providers might also be neglectful or disengaged, over-involved, controlling, or otherwise out of sync with the recipient’s needs ( Collins et al., 2006 ; Feeney & Collins, 2001 ; Kunce & Shaver, 1994 ).

We suggest that unresponsive and insensitive support behaviors will undermine thriving because they promote either overdependence or underdependence: Overdependence (an over-reliance on others to do what can be done oneself) represents a means of clinging to significant others whose availability and acceptance is perceived to be uncertain, or to others who provide support when it is not needed. Underdependence (defensive self-reliance) represents a means of coping with a support environment in which significant others have been insensitive to or rejecting of one’s needs. Optimal dependence (a healthy dependence on others in response to genuine need), optimal independence (a healthy degree of autonomy), and optimal interdependence (relationships characterized by mutual dependence) is made possible when significant others support thriving by providing sensitive and responsive SOS and RC support.

Thus, it is important to recognize that close relationships can be a source of strain as well as support ( Brooks & Dunkel Schetter, 2011 ; Newsom, Mahan, Rook, & Krause, 2008 ; Rook, 1984 ; Rook, Mavandadi, Sorkin, & Zettel, 2007 ). The presence of poor quality support can have a negative impact on thriving, and the mere existence of a relationship (e.g., a marriage) is not enough to confer thriving benefits. Poor quality SOS support (or lack thereof) can exacerbate stress, prolong recovery, reduce resilience, and hinder growth from adversity. Likewise, poor quality RC support can thwart goal striving, reduce intrinsic motivation, and hinder the development of new talents and capacities. Thus, individuals may fail to thrive either because they are socially isolated and lack access to a reliable relational support system or because they are embedded in central relationships (e.g., a marriage or parent-child relationship) that offer poor quality support. The extent to which core relationship partners provide effective SOS and RC support and the resulting effects on thriving is an area ripe for future research.

Finally, it is important to acknowledge that people can cope with adversity and engage in life opportunities without support from significant others, and that people differ in their preferred levels of interdependence. However, our perspective is that people are most likely to thrive through adversity and life opportunities with these relational support functions intact. In emphasizing the importance of relational support, we do not minimize the role of individual initiative and personal fortitudes – such as grit, optimism, and hardiness – that also contribute to resilience and thriving. However, we believe that prior research and theory has underestimated the interpersonal basis for these personal characteristics and fortitudes. Our model suggests that social relationships (that provide responsive SOS and RC support) significantly contribute to the development and maintenance of these personal fortitudes.

Pathways to Thriving through Relationships

How do SOS and RC support shape thriving outcomes? We propose that SOS and RC support make independent contributions to thriving through specific mechanisms (see Figure 1 , paths b and e ). Each support process occurs in a different life context, involves different support functions, and results in different immediate outcomes that, over time, make independent contributions to the long-term thriving outcomes ( Figure 1 , paths c and f ).

The potential mechanisms linking SOS and RC support to thriving are important to delineate because they are necessary for understanding how thriving through relationships occurs and because they have received so little attention in the social support literature. The immediate outcomes of receiving support are rarely studied, and when they are studied, researchers tend to focus only on stress-related outcomes (e.g., coping, stress reactivity). By focusing on a broader definition of social support, and a broader conceptualization of health and well-being, the current model suggests a broader array of potential mechanisms and mediators. We suggest that the mechanisms for both support functions can be organized into eight broad categories that reflect immediate changes in the recipient’s (a) emotional state, (b) self-evaluations/self-perceptions, (c) appraisals of the situation or event, (d) motivational state, (e) situation-relevant behaviors/outcomes, (f) relational outcomes, (g) neural activation/physiological functioning, and (h) lifestyle behaviors. Because SOS and RC support processes occur in different life contexts and have different functions, there should be differences in the specific manifestation of each outcome category for each support function.

Moreover, these immediate outcomes are expected to temporally precede the core thriving outcomes, which develop over time and represent long-term outcomes. They are considered to be relatively circumscribed to the particular situation, and a collection of these circumscribed benefits contributes to thriving in a more global sense. For example, interpreting a single stressor as a challenge instead of a threat is not thriving, but an accumulation of such transformations would contribute to global thriving. Next, we describe each category of mediators for each support function. See Table 3 for a summary.

Immediate outcomes of receiving SOS and RC support: Pathways linking support to long-term thriving

Emotional State

Because a variety of negative emotions are associated with the experience of adversity, an important immediate outcome of receiving SOS support includes decreased negative emotion (e.g., fear, anxiety, doubt, distress, sadness, guilt, shame, anger, discouragement, loss/grief, embarrassment, humiliation, hurt/broken-heartedness, loneliness, despair, resentment, jealousy, and envy) – as well as faster recovery from negative emotional states generated by stressors ( Collins et al., 2014 ). Increases in some positive emotions, which are often overlooked in research on social support, also should result from receiving SOS support and may include love, hope, gratitude, forgiveness, serenity/peace, calm, relief, and felt security (a feeling of safety from threats, Bowlby, 1982 ; Sroufe & Waters, 1977 ). Thus, through the provision of SOS support, significant others assist in restoring and sustaining a positive affective balance ( Fredrickson, 2009 ; Ryff & Singer, 2000 ). These predictions are supported by research showing that receiving caring support from friends and romantic partners during stressful events decreases depression and anger ( Cutrona, 1986 ; Winstead & Derlega, 1985 ), increases positive mood ( Collins & Feeney, 2000 ; Collins et al., 2014 ), and increases feelings of calmness and security ( Kane et al., 2012 ; Simpson, Rholes, & Nelligan, 1992 ). They are also supported by laboratory research on emotion sharing, which shows that sharing negative emotions with close others can reduce emotional distress and facilitate emotional recovery when the listener expresses empathy and encourages cognitive reframing ( Nils & Rimé, 2012 ).

RC support is expected to activate (or amplify) a broader range of positive emotions than SOS support including enthusiasm/excitement, interest, happiness, joy, amusement, pride, and curiosity. RC support also may lead one to feel inspired, lively, energetic, and invigorated. These emotions (in addition to love and gratitude that should emerge from both support processes) reflect the anticipation and pursuit of valued life opportunities, as well as the social sharing of resulting accomplishments. These predictions are consistent with research showing that responsive support for goals/exploration is linked with greater expressed enthusiasm during exploration activities and increases in positive mood afterwards ( Feeney, 2004 ; Feeney & Thrush, 2010 ), and with research showing that when individuals share good news and receive enthusiastic responses, they experience enhanced positive mood that enables them to savor the experience and continue to accrue benefits from it ( Gable et al., 2004 ; Reis et al., 2010 ). Although RC support should act most strongly on positive emotions, it should also reduce negative emotions that are sometimes evoked when individuals pursue life opportunities, including concerns about failure or feelings of guilt for taking time for oneself or for using shared resources. Instilling excitement/enthusiasm for the pursuit of opportunities and releasing one from anticipatory concerns are primary functions of RC support.

Self-Evaluations and Self-Perceptions

Recipients of SOS support should experience feelings of self-acceptance, self-compassion (forgiving oneself for a failure or transgression, being kind to oneself), and a restored sense of self-integrity. Receipt of SOS support also should predict increased self-efficacy and perceived control to the extent that it has equipped the recipient with courage, knowledge, resources, or skills to overcome the adverse circumstance.

Because RC support promotes successful engagement in life opportunities, this should be a strong predictor of state self-esteem, self-confidence, and empowerment involving feelings of competency and self-efficacy (power to produce desired effects). Specific self-perceptions may include views of the self as capable of accomplishing goals, and as accomplished, skilled, and engaged in life. These predictions are consistent with evidence indicating that the responsive support of goal strivings/exploration is associated with increases in state self-esteem, perceived self-efficacy, perceived ability to achieve one’s goals, self-confidence, and perceived capability ( Feeney, 2004 ; 2007 ; Feeney & Thrush, 2010 ).

Appraisals of the Situation or Event

Receipt of SOS support should predict appraisals that one’s resources outweigh the demands of the situation ( Lazarus & Folkman, 1984 ). Other appraisals include views of the problem as controllable and temporary (not the way circumstances always will be), or the belief that one can adapt successfully to a problem or situation that cannot be changed. Particularly important for thriving, SOS support should predict appraisals of the experience as leading to positive change – that one may emerge from adversity as better or stronger than before.

Receipt of RC support should predict appraisals of the opportunity as a positive challenge versus a threat, and as likely to result in positive outcomes. This includes expectations of success, and appraisals of the experience as meaningful, valuable, and worth one’s time and effort. Corroborating these predictions, research has shown that being in the presence of a close other, or merely thinking about a supportive other, makes the physical world (a steep hill) appear less daunting ( Schnall et al, 2008 ), and that responsive support of exploration/goals is linked with greater perceptions that exploration is worthwhile ( Feeney & Thrush, 2010 ).

Motivational State

SOS support should more strongly (than RC support) result in a regulatory orientation that is prevention-focused, which emphasizes safety, responsibility, and security needs, and seeks to avoid losses (see Higgins, 1997 ; Shah & Higgins, 1997 ). However, because SOS support is not just about minimizing negative effects of adversity but is about thriving through the experience, this support function should assist individuals in switching from a prevention orientation to a promotion orientation (which emphasizes hopes, accomplishments, advancement needs, and seeks to approach gains; Shah & Higgins, 1997 ) once safety and security needs are met. In this way, SOS support can encourage growth through adversity by motivating individuals to make changes in their lives, work toward rebuilding, and persevere through difficult times.

Because RC support encourages pursuit of life opportunities and releases one from constraints that may hinder these pursuits, a natural immediate consequence should be an increase in approach versus avoidance motivation toward the opportunity ( Elliot, 2008 ). Approach motivation enables one to focus on the potential rewards to be gained by the opportunity instead of focusing on avoiding potentially negative outcomes (e.g., failure or embarrassment). One is motivated to stretch to new levels and not settle for good enough. This motivational state involves boldness and willingness to pull up stakes (not get stuck at one level) and leave one’s comfort zone in order to grow and reach one’s potential. Evidence for this comes from research showing that responsive support provision is associated with a greater willingness to engage in autonomous exploration ( Feeney, 2007 ), and from experimental work showing that thinking about a responsive romantic partner (vs. an acquaintance) reduces defensive responses (self-handicapping) to potential failure during a challenging task ( Caprariello & Reis, 2011 ). Responsive RC support should also lead to increased intrinsic motivation for pursuing life opportunities. This is consistent with research showing that intrinsic motivation, which is a principal source of enjoyment and vitality throughout life, is most likely to flourish in contexts characterized by a sense of security and relatedness, as well as contexts that nurture one’s sense of competence and autonomy ( Deci & Ryan, 2000 ; Ryan & Deci, 2000 ).

Situation-Relevant Behaviors, Resources, and Outcomes

Receiving SOS support should result in improved coping strategies and self-regulation (the ability to control one’s behavior, emotions, and thoughts; the ability to develop, implement, and maintain planned behavior; Miller & Brown, 1991 ; Muraven, Tice, & Baumeister, 1998 ). Additional outcomes include problem resolution (or reduction of problem severity), positive changes in one’s circumstances or successful adaptation to circumstances that cannot be changed (e.g., reduced rumination, positive reappraisal, acceptance), successful rebuilding (replacing features associated with the adversity with new and improved ones), and learning from the experience. This is consistent with research showing that support provision facilitates problem resolution (e.g., Lakey & Heller, 1988 ; Winstead, Derlega, Sanchez-Hucles, & Clarke, 1992 ), promotes effective coping and adjustment to economic disadvantage ( Chen & Miller, 2012 ) and to trauma and disease (see Revenson, 2003 ; Uchino, 2004 ), and facilitates benefit finding and growth following negative life events (see Helgeson & Lopez, 2010 ).

Receiving RC support should result in immediate outcomes relevant to pursuit of life opportunities: successful engagement in and persistence at the life opportunity, goal progress, opened doors for additional opportunities, and the production of a high quality result (if an opportunity involved a product such as the completion of a project). This involves approaching the activity with greater focus, more energy, and a propensity to navigate challenges more effectively than one might otherwise. Consistent with these predictions, components of RC support predict greater persistence at and better performance on a laboratory exploration activity ( Feeney & Thrush, 2010 ) and greater pursuit of personal goals ( Feeney, 2007 ).

Relational Outcomes, Attitudes, and Expectations

Immediate relational outcomes of receiving SOS support include feelings of trust in the support-provider (a state of confidence in the support-provider’s availability, goodwill, caring, and commitment; Murray, 2005 ; Murray, Holmes, & Griffin, 2000 ), emotional closeness as a result of feeling understood, validated, cared for, and accepted despite one’s vulnerabilities ( Reis & Shaver, 1988 ), and beliefs that seeking support and showing vulnerability is beneficial and met with compassionate responses. This is consistent with evidence indicating that acts of caring from a romantic partner during stressful situations can result in immediate increases in perceptions of feeling loved, valued, and accepted ( Collins et al., 2014 ; Kane et al., 2012 ), and that responsive support from friends and romantic partners in daily life increases feelings of relationship closeness ( Gleason et al., 2008 ; Reis et al., 2010 ).

Receipt of RC support should result in other immediate relational outcomes including feelings of being valued and respected; satisfaction that one’s relationship enables one to pursue goals in a self-determined manner; the formation of new social connections; self-expansion with a close other ( Aron, Ketay, Riela, & Aron, 2008 ); and beliefs that sharing life opportunities with others, capitalizing on the experiences, and seeking/receiving support for them is beneficial. This is consistent with experimental studies showing that sharing good news and receiving an active and constructive response increases trust, closeness, and prosocial motivation in new acquaintances ( Reis et al., 2010 ), with observational and daily diary studies showing that individuals feel happier and more satisfied in their relationships when they receive enthusiastic support for their positive event disclosures ( Gable et al., 2004 ; 2006 ; Reis et al., 2010 ), and with research showing that responsive support of exploration/goal-strivings predicts relationship mood/satisfaction ( Brunstein, Dangelmayer, & Schultheiss, 1996 ; Van Vleet & Feeney, 2011 ).

Neural Activation and Physiological Functioning

Immediate changes in neural and physiological functioning should result from the receipt of SOS support. Research indicates that neural regions associated with threat (amygdala, dorsal anterior cingulate cortex [dACC], anterior insula and periaqueductal gray [PAG]) can trigger physiological responses that have health implications, and that the experience of social connections can turn off this neural alarm system ( Eisenberger & Cole, 2012 ). Thus, deactivation of neural areas associated with threat and increased activation of reward-related neural areas (ventromedial prefrontal cortex [VMPFC] and the posterior cingulate cortex [PCC]) associated with safety ( Eisenberger & Cole, 2012 ) should be immediate outcomes of receiving SOS support. At the biological and physiological level, adaptive immune, endocrine, and cardiovascular functioning should result from receiving SOS support ( Miller, Chen, & Cole, 2009 ). This includes reduced cortisol and stress reactivity, reduced inflammation, reduced cardiovascular threat response ( Blascovich, 2008a ), and increased oxytocin, which has been linked with positive social interactions ( Marazziti et al., 2006 ).

This is supported by research showing that activation of neural regions associated with threat is linked to increased cortisol levels and greater inflammatory responses to stressors ( Eisenberger, Taylor, Gable, Hilmert, & Lieberman, 2007 ; Slavich, Way, Eisenberger, & Taylor, 2010 ; Wang et al., 2005 ), which should be attenuated when receiving SOS support. There is also evidence suggesting that activity in neural regions involved in detecting safety and reducing fear are involved in reducing cortisol responses to social stress (and in inhibiting sympathetic and promoting parasympathetic responses), and that simply seeing a picture of a highly supportive relationship partner during the experience of physical pain leads to increased VMPFC activity and corresponding decreases in self-reported pain and dACC activity ( Eisenberger et al., 2011 ). These neural processes are thought to be mediated by neuropeptides involved in social bonding (endogenous opioids and oxytocin), which are released in response to positive close social contact and have stress-reducing properties ( Eisenberger & Cole, 2012 ).

Further supporting this mechanism is research showing that holding the hand of a romantic partner attenuates neural activation in brain regions associated with threat and emotion regulation ( Beckes & Coan, 2011 ; Coan et al., 2006 ), suggesting that the presence of a caring partner reduces the need to mobilize personal resources in dealing with environmental demands. Additional evidence comes from research showing that cardiovascular reactivity is buffered in individuals who experience a stressor in the presence of a close, non-evaluative support provider (e.g., Allen, Blascovich, Tomaka, & Kelsey, 1991 ), that physical contact during a stressful task decreases heart rate and blood pressure (e.g., Ditzen et al., 2007 ), that emotional support from a romantic partner prior to a stressful task reduces cortisol reactivity ( Collins et al., 2014 ), and that spouses’ expressions of intimacy (physical affection) are associated with lower daily cortisol levels, especially among those who experience high work-related stress ( Ditzen, Hoppmann, & Klumb, 2008 ).

In contrast to SOS support, an immediate outcome of receiving RC support should be increased activation of neural areas associated with reward, positive affect, positive challenge, representation of goals, decision-making, and dopamine release (i.e., the striatum, orbitofrontal cortex, medial prefrontal cortex, ventral tegmental area, and amygdala; Aron, Fisher, Mashek, Strong, & Brown, 2005 ; Forbes & Dahl, 2005 ; Schultz, 2000 , Spanagel & Weiss, 1999 ). These activations should be linked to adaptive immune, endocrine, and cardiovascular functioning associated with positive affect and positive challenge. In contrast to SOS support, RC support is likely to generate more activated forms of positive emotions (e.g., excitement), which may lead to increased cardiovascular responding ( Pressman & Cohen, 2005 ) reflecting a challenge (vs. threat) cardiovascular pattern that occurs when individuals evaluate their resources as outweighing their task demands ( Blascovich, 2008a ). RC support also should result in lower levels of stress hormones and adaptive immune functioning given its proposed effect on positive emotion, which has been linked with these physiological processes ( Pressman & Cohen, 2005 ), and in increases in anabolic processes (growth and mineralization of bone and increases in muscle mass) likely to occur as a result of actively pursuing life opportunities (physical activity, e.g., Baldwin & Haddad, 2002 ; Cooper, 1994 ; Kjaer et al., 2005 ). This is consistent with work indicating that social support/loneliness/positive social interactions may influence health via changes in the cardiovascular, endocrine, and immune systems (e.g., Friedman & Ryff, 2012 ; Hawkley & Cacioppo, 2003 ; Heaphy & Dutton, 2008 ; Uchino, Uno, & Holt-Lunstad, 1999 ).

Lifestyle Behaviors

Immediate changes in lifestyle behaviors should result from the receipt of SOS support. This includes a healthier diet (e.g., less stress-induced eating); better sleep quality (as sleep is not inhibited by feelings of distress or rumination on life adversity); decreased use of alcohol, smoking or other addictive substances as a means of coping with stress; and better adherence to medical regimens. SOS support also can enable the recipient to engage in behaviors (e.g., resting, taking breaks) that promote the rebuilding of depleted mental and physical resources.

Increased physical and mental activity is especially likely to be influenced by support that encourages one to embrace life opportunities. RC support should not only stimulate one physically, but should also enhance cognition and brain activity associated with such enhanced cognition ( Cracchiolo et al., 2007 ). Additional lifestyle behaviors likely to be affected by RC support include engagement in restorative or recreational activities, as these activities represent a category of opportunities that people who receive RC support are more likely to embrace. Indirect support for these lifestyle predictions is provided by research showing that greater positive affect is associated with improved sleep quality ( Bardwell, Berry, Ancoli-Israel, & Dimsdale, 1999 ), more exercise ( Ryff, Singer, & Dienberg Love, 2004 ), greater engagement in restorative activities ( Smith & Baum, 2003 ), and more intake of dietary zinc ( Pressman & Cohen, 2005 ).

Mediators Predicting Long-Term Thriving

As shown in Figure 1 (paths c and f ), the immediate outcomes of receiving SOS and RC support should, over many interactions, make independent contributions to long-term thriving outcomes. This perspective considers immediate outcomes of support interactions to be important because they have a cumulative impact on long-term outcomes. With regard to SOS support, if an individual experiences reduced anxiety, increased feelings of security and hope, reduced autonomic reactivity to stress, positive coping, increased motivation to face the adversity and then rebuild, problem resolution, and increased trust/closeness after interacting with significant others when distressed, then these experiences should, over time, contribute to thriving in terms of enhanced prospects for good mental and physical health, relationship growth/prosperity (social well-being), and both hedonic (happiness, life satisfaction) and eudemonic (personal growth, movement toward full potential) well-being. Receiving SOS support can have positive effects on thriving that more than compensate for the negative effects of the stressor. Thus, buffering the effects of stressors is not the sole purpose of SOS support.

Likewise, the immediate outcomes of receiving RC support should (over many interactions) make independent contributions to the long-term thriving outcomes. If an individual experiences felt enthusiasm/excitement, a release from guilt and failure concerns, increased confidence/empowerment/self-esteem, successful engagement in life opportunities, adaptive physiological responses to challenge, and healthy interdependence after interacting with significant others regarding life opportunities, then these support experiences should, over time, contribute to thriving above and beyond contributions made by SOS processes.

Because the social support literature has not traditionally studied dyadic interaction or focused on thriving, there are few studies that directly test these predictions. The strongest evidence for paths c and d , Figure 1 , comes from studies linking social support to long-term relationship outcomes in couples. These studies show that responsive support engenders relationship benefits over time including increased satisfaction, intimacy, and trust (e.g., Acitelli, 1996 ; Carnelley, Pietromonaco, & Jaffe, 1996 ; Cutrona, 1996b ; Feeney, 1996 ; Julien & Markman, 1991 ; Pasch & Bradbury, 1998 ; Sarason, Sarason, & Pierce, 1990 ; Sullivan, Pasch, Johnson, & Bradbury, 2010 ).

Indirect support for path c is provided by studies linking the experience of optimism ( Carver & Scheier, 2009 ; Rasmussen, Scheier, & Greenhouse, 2009 ), hope ( Snyder, Irving, & Anderson, 1991 ), forgiveness ( Tsang, McCullough, & Fincham, 2006 ; Witvliet, Ludwig, & Vander Laan, 2001 ; Worthington, & Scherer, 2004 ), amusement ( Fredrickson, Mancuso, Branigan, & Tugade, 2000 ; Giuliani, McRae, & Gross, 2008 ; Martin, 2002 ), gratitude ( Emmons & McCullough, 2003 ; Lambert, Clark, Durtschi, Fincham, & Graham, 2010 ) and positive affect ( Folkman & Moskowitz, 2000 ; Tice, Baumeister, Shmueli, & Muraven 2007 ) to improved coping, self-regulation, and various indicators of psychological well-being. Additional indirect support comes from empirical research linking coping (e.g., Carver, 2011 ; Denson, Spanovic, Miller, & Denson, 2009 ; Park, 1998 ), anger, anxiety, and depression (e.g., Kubzansky, Cole, Kawachi, Vokonas, & Sparrow, 2006 ; Sirois, & Burg, 2003 ; Smith et al., 2008 ), shame (e.g., Dickerson, Gruenewald, & Kemeny, 2004 ), perceived stress (e.g., Cohen, Tyrrell, & Smith, 1991 ; Cohen & Williamson, 1991 ; DeLongis, Folkman, & Lazarus, 1988 ; Herbert & Cohen, 1993 ), physiological threat responses (e.g., Blascovich, 2008b ), and relationship trust (e.g., Schneider, Konijn, Righetti, & Rusbult, 2011 ) to indicators of physical health and resilience.

The predictions regarding RC support enabling an individual to thrive (path e and f , Figure 1 ) are consistent with research showing that a spouses’ support of exploration behavior and goal strivings predicts recipients’ greater engagement in exploration activities, greater likelihood of attaining goals over time, and increases in personal growth over the first year of marriage ( Brunstein et al., 1996 ; Feeney, 2007 ; Feeney & Van Vleet, 2010 ; Van Vleet & Feeney, 2011 ) – and with research indicating that responsive parental support underlies healthy exploration behavior and the development of autonomy in children ( Ainsworth, Blehar, Waters, & Wall, 1978 ; Belsky, Rovine, & Taylor, 1984 ; Bowlby, 1988 ) and adolescents ( Allen & Land, 1999 ; Moore, 1987 ; Noom, Dekovic, & Meeus, 1999 ). Other supporting evidence indicates that personal goal strivings motivated by one’s close relationships predicts goal attainment and well-being ( Gore & Cross, 2006 , 2010 ), and that a romantic partner’s behavioral affirmation of one’s ideal self helps individuals move closer to their ideal selves over time ( Rusbult et al., 2009 ).

The processes linking support for life opportunities to thriving in terms of psychological and physical health is supported by a longitudinal study with newlyweds showing that responsive support during the first year of marriage predicts better psychological and physical health one year later ( Van Vleet & Feeney, 2011 ) and by studies indicating that the successful pursuit of personally meaningful goals is related to elated vs. depressed mood, happiness, and satisfaction with life ( Brunstein, 1993 ; Brunstein, Schultheiss, & Grassman, 1998 ; Emmons, 1986 ; Emmons & King, 1988 ; Omodei & Wearing, 1990 ; Palys & Little, 1983 ; Ruehlman & Wolchik, 1988 ; Sheldon et al., 2010 ; Yetim, 1993 ; Zaleski, 1987 ). Additional evidence is provided by research linking positive emotions such as excitement, enthusiasm, and curiosity (emotions elicited or amplified by RC support) to psychological and physical health ( Cohen & Pressman, 2006 ; Fredrickson, 2000 ; Kashdan, McKnight, Fincham, & Rose, 2011 ; Kashdan & Silvia, 2009 ; Pressman & Cohen, 2005 ; Pressman et al., 2009 ). As a whole, these studies show that individuals high (vs. low) in well-being pursue goals that are important, fulfilling, challenging, fueled by optimistic expectations, and assisted by others ( Little, Salmela-Aro, & Phillips, 2007 ). The current perspective emphasizes that the interpersonal dynamics surrounding assistance by others plays a vital role in driving the effects of goal strivings on well-being.

Longitudinal studies that support this idea show that perceptions of goal attainability and social support for personal goals predict changes in subjective well-being over time ( Brunstein et al., 1996 ), and that favorable conditions to attain personal goals lead to high progress in goal achievement that translate into enhanced well-being ( Brunstein, 1993 ). Of all the variables assessed, support of personal goals by significant others was the most powerful predictor of subjective well-being ( Brunstein, 1993 ). Likewise, Ruehlman and Wolchik (1988) showed that project-relevant social support and hindrance, particularly from the person most important to an individual, accounted for variations in psychological well-being and distress. These effects are consistent with the perspective advanced here and with other researchers’ speculations that social resources and networks contribute to mental health by encouraging the setting of personal goals and helping people achieve them ( Diener & Fujita, 1995 ; Robbins, Lee, & Wan, 1994 ). In addition, indirect evidence for the effects of RC support on subjective well-being and mental health comes from work showing that support for competency, autonomy, and relatedness are associated with greater well-being among nursing home residents, with better performance and well-being in the workplace, and with well-being indicators including self-esteem, self-actualization, and a lack of depression and anxiety ( Deci, La Guardia, Moller, Scheiner, & Ryan, 2006 ; Ryan & Deci, 2000 ).

Evidence for the effects of RC support on thriving in terms of social well-being comes from studies showing that spousal support for personal goals predicts relationship satisfaction ( Brunstein et al., 1996 ; Kaplan & Maddux, 2002 ), that people draw closer to significant others who are instrumental in the accomplishment of their goals ( Fitzsimons & Finkel, 2011 ; Fitzsimons & Fishback, 2010 ; Fitzsimons & Shah, 2008 ), that responsive secure base support (a component of RC support) during the first year of marriage predicts increases in relationship quality one year later ( Van Vleet & Feeney, 2011 ), and that capitalization support (a component of RC support) received from friends, family, and romantic partners during a two-week diary period predicts increases in general perceptions of support from one’s social network two months later ( Gable, Gosnell, Maisel, & Strachman, 2012 , Study 3).

Elaborated Model of Interpersonal, Dyadic Processes

Thus far, our discussion has focused on macro-level processes linking relational support to long-term thriving outcomes; but it is also important to understand the micro-dynamics of SOS and RC support as they unfold in dyadic interaction. Thus, a goal of the present framework is to understand the links between close relationships and thriving by specifying the interpersonal support processes that occur in dyadic interaction. Toward this end, Figure 2 provides an elaborated model of the interpersonal processes involved in the provision of SOS and RC support for thriving. This model depicts an expansion of the boxes labeled “interpersonal SOS support processes” and “interpersonal RC support processes” in Figure 1 .

Interpersonal SOS Support Processes

As shown in the top of Figure 2 , the interpersonal SOS support process is set into motion with an individual’s experience of life adversity, which can motivate SOS support through two possible pathways: (1) Adversity may lead an individual to feel/express distress and desire proximity to and support from a close relationship partner (path a ; Bowlby, 1982 ; Collins & Feeney, 2000 , 2005 ), and these support-seeking behaviors should motivate the partner to provide SOS support (path b ; Collins & Feeney, 2000 , Feeney, Cassidy, & Ramos-Marcuse, 2008 ; Feeney & Collins, 2001 ; Simpson et al., 1992 ). (2) Alternatively, just the knowledge that an individual is experiencing an adverse event is often enough to motivate SOS support from close others without the individual having to explicitly seek support (path c ). Close others are likely to know when one is distressed (or when a situation is likely to cause distress) and provide support spontaneously and proactively.

In the next stage of the model, having someone who provides effective SOS support should result in the recipient perceiving that this behavior was supportive and responsive (path d ). This is consistent with research showing that subjective perceptions of support quality are predictable from actual features of the support-provider’s behavior ( Barbee & Cunningham, 1995 ; Collins & Feeney, 2000 ; 2004 ; Cutrona & Suhr, 1992 ; Dakof & Taylor, 1990 ; Dunkel-Schetter, Folkman, & Lazarus, 1987 ; Fincham & Bradbury, 1990 ; Lakey et al., 2010 ; Lehman & Hemphill, 1990 ; Pierce, Baldwin, & Lydon, 1997 ). Then, perceptions of partner responsiveness should predict the immediate outcomes described previously (path e ) and mediate the link between SOS support-provision and the immediate outcomes experienced by the recipient. Support behavior will be most effective when the recipient perceives that the provider both attended to and reacted supportively to core defining features of the self ( Reis et al., 2004 ), and that one has been understood, validated, and cared for ( Maisel & Gable, 2009 ; Reis & Patrick, 1996 ; Reis & Shaver, 1988 ).

There are times, however, when the immediate outcomes may be predicted directly from the receipt of SOS support (path f ), and not mediated by the recipient’s judgments or awareness of the support received (see Uchino et al, 2012 ). This occurs when SOS behavior is supportive without being perceived as such, including (a) when support is provided outside of the recipient’s awareness because it is subtle, indirect (e.g., the mere presence of a significant other can reduce threat; Coan et al., 2006 ), or otherwise invisible (e.g., giving a partner time/space; Bolger & Amarel, 2007 ; Howland & Simpson, 2010 ), or (b) when support is necessary but not initially appreciated by the recipient (e.g., encouraging a depressed partner to get needed therapy may be supportive even if it initially irritates the partner). Finally, the immediate outcomes are predicted to shape thriving as described previously (path g ).

Interpersonal RC Support Processes

As depicted in the bottom of Figure 2 , the interpersonal process surrounding RC support is set into motion with a potential life opportunity, which can motivate RC support through two pathways: (1) A potential life opportunity may motivate an individual to express thoughts and feelings about the opportunity with a relationship partner and to seek opportunity-relevant support as needed (path h ), and this behavior should motivate the partner to provide RC support (path i ). (2) Alternatively, the knowledge of an individual’s potential life opportunity may motivate RC support from a partner without the individual having to explicitly seek or express a need for it (path j ). Sensitive and responsive relationship partners are likely to be emotionally connected to one another, and thus aware of one another’s potential opportunities (and reactions to them) and provide RC support proactively.

Next, the recipient’s perception of the partner’s behavior should depend on the degree to which the partner effectively provides RC support (path k ). Sensitive and responsive provision of RC support should result in the recipient perceiving that it was supportive and caring ( Feeney, 2004 ; Feeney & Thrush, 2010 ). Then, perceptions of partner responsiveness should predict the immediate outcomes described previously (path l ) that are mediators of the link to long-term thriving through RC support (path n ). Alternatively, the immediate outcomes may be predicted directly from the receipt of RC support (path m ) in cases when (a) support is provided invisibly (e.g., the non-intrusive waiting role that is part of being a secure base may be invisible; directing attention to opportunities may be so subtle that recipients do not know they are being supported; sensitive support in this context may leave the recipient feeling independent rather than supported), and (b) being supportive involves telling the partner something they may not want to hear (e.g., that they are barking up the wrong tree, as adaptive self-regulation involves disengaging from goal pursuits that are unlikely to be fruitful, Wrosch et al., 2003 ). Then, the immediate outcomes of receiving RC support, which are relatively circumscribed to the particular situation, predict the long-term thriving outcomes described previously (path n ).

Thriving Influences on Future Life Experiences

Thriving individuals possess both personal and relationship fortitudes that should influence their experiences of, and reactions to, future life adversities ( Figure 2 , path o ) and opportunities ( Figure 2 , path p ). Individuals who are thriving in all the ways described previously (see Table 1 ) should experience, perceive, and approach adversities and opportunities in a more proactive and healthy manner than individuals who are not thriving. When encountering these life experiences, thriving individuals should be less distressed by and physiologically reactive to stressors, they should have a greater desire to pursue opportunities for growth, and they should experience increased approach (vs. avoidance) motivation in both life contexts ( Carver, 2006 ; Elliot, 2008 ; Gable, 2006 ).

Research supporting these predictions shows that individuals who perceive support to be available to them also view themselves as competent and as having a variety of positive attributes that are likely to help them deal with stress ( Sarason, Pierce, Shearin, Sarason, Waltz, & Poppe, 1991 ). Thus, thriving individuals are likely to appraise the demands of a situation as within their ability to cope ( Lazarus & Folkman, 1984 ; Folkman, Lazarus, Dunkel-Schetter, DeLongis, & Gruen, 1986 ) and to have a higher threshold for attachment system activation ( Bowlby, 1982 ; Bretherton, 1987 ). These predictions are also consistent with research showing that hardiness buffers the physical effects of stress on the body ( Contrada, 1989 ; Solcova & Sykora, 1995 ; Woodard, 2004 ) and that individuals who have self-affirmational resources are less reactive to and defensive about stressors because their overall feelings of self-integrity rely less on the outcome of that particular stressor (e.g., Creswell et al., 2005 ; Crocker, Niiya, & Mischkowski, 2008 ; Kumashiro & Sedikides, 2005 ; Murray, Bellavia, Feeney, Holmes, & Rose, 2001 ; Sherman & Cohen, 2006 ).

Cultivating Effective Support

Given the proposed centrality of SOS and RC support for thriving, it is important to consider how individuals can cultivate effective support in their relationships. Unfortunately, very little theoretical or empirical work has focused on the factors that promote or hinder effective social support processes in close relationships. Because social support is part of an interpersonal process, both the provider and recipient bear responsibility for cultivating effective support. We highlight the roles of both the provider and recipient next.

Support-Provider

The provision of responsive support within each life context requires the support-provider to possess at least three prerequisites – skills, resources, and motivation – each of which may be influenced by personality or individual difference factors ( Collins et al., 2010 ; Feeney & Collins, 2003 ). First, effective support provision requires a variety of skills including knowledge about how to support others ( Feeney & Collins, 2001 , Johnson, Hobfoll, & Zalcberg-Linetzy, 1993 ), perspective-taking abilities, the ability to regulate one’s own emotions, and the ability to comprehend and accurately interpret others’ thoughts and feelings (empathic accuracy; Verhofstadt et al., 2008 ; Verhofstadt, Ickes, & Buysse, 2010 ). These skills may be general (applying across different relationships) or relationship-specific (e.g., understanding how to support one sibling but not another).

Second, support-providers must possess adequate cognitive, emotional, and tangible resources . Without such resources, even a highly skilled support-provider may not have the capacity to provide responsive support. One can lack resources either chronically (e.g., chronic worry) or situationally (e.g., a highly demanding day at work). For example, in order to be responsive, one must possess adequate self-regulatory resources ( Vohs & Heatherton, 2000 ), which can be depleted when experiencing conditions of anxiety or depression, or when exerting self-control during one task (e.g., providing support to one’s child) leads to decrements on a subsequent task (e.g., providing support to one’s spouse). If self-regulatory resources are depleted, support-providers may become self-focused, unable to inhibit unhelpful behaviors (e.g., criticism), and lack the patience needed to be cooperative and non-intrusive in their support efforts ( Gailliot, 2010 ; Neff & Karney, 2009 ). Tangible resources also may be necessary, which may include material resources (e.g., money) and social resources (e.g., having one’s own support network). Yet again, these resources may be in short supply either chronically (e.g., long-term financial difficulties) or situationally (e.g., competing demands for one’s resources).

Third, support-providers must possess the motivation to provide responsive SOS and RC support. Two aspects of motivation are important: (a) one’s overall degree of motivation to provide support, and (b) the specific form of that motivation. First, because support provision often requires effort, as well as skills and resources, support-providers must be motivated to accept that responsibility and use their skills and resources in the service of another. Research shows that individuals differ in the degree to which they feel responsible for the welfare of another ( Clark & Mills, 1993 ; Williamson, Clark, Pegalis, & Behan, 1996 ) and in resulting motivation to provide support ( Feeney & Collins, 2003 ; Feeney et al., 2013 ). Felt responsibility may differ between people (e.g., a general communal orientation; Clark & Mills, 1993 ), relationships (e.g., felt responsibility for a particular person; Monin, Schulz, Feeney, & Cook, 2010 ; communal relationship strength, Mills, Clark, Ford, & Johnson, 2004 ), or situations (e.g., heightened sense of responsibility in response to a strong need; Feeney & Collins, 2001 ).

Second, support-providers may differ in the degree to which they are motivated by altruistic concerns (the desire to promote another’s welfare) or egoistic concerns (the desire to gain explicit benefits for the self or to avoid sanctions, Batson & Shaw, 1991 ). We suggest that support-providers will be most effective when they are more altruistically motivated by empathic concern ( Batson & Shaw, 1991 ), more approach (vs. avoidance) oriented toward giving to close others ( Impett, Gable, & Peplau, 2005 ), and more intrinsically motivated to care for others ( Feeney & Collins, 2003 ; Feeney et al., 2013 ). This is consistent with research showing that support-providers who are motivated by altruistic concerns are more effective than those who are motivated by egoistic concerns; that support motivations vary depending on factors such as adult attachment style, feelings of responsibility, and feelings of love/concern for the person in need ( Feeney & Collins, 2001 ; 2003 ; Feeney et al., 2013 ); that compassionate love is associated with increased support provision in close relationships ( Collins et al., in press ; Sprecher & Fehr, 2005 ); and that compassionate goals foster mutually supportive friendships whereas self-image goals undermine them ( Canevello & Crocker, 2010 ).

Support-Recipient

Currently, the bulk of the literature considers the support-recipient as relatively passive, as if the recipient has no responsibility in shaping his or her support outcomes. However, support-recipients can cultivate effective support by reaching out to others (vs. withdrawing), expressing needs in a clear and direct manner, being receptive to others’ support efforts, regulating demands on others (not taxing their social network), expressing gratitude, engaging in healthy dependence and independence, building a dense relationship network, and providing reciprocal support. As we discuss shortly, mutual responsiveness to need (accepting support when needed, and being willing and able to provide support in return) should cultivate the types of mutually caring relationships that enable people to thrive.

There is some limited evidence showing the important role of the support-recipient in eliciting positive or negative support outcomes. For example, direct support - seeking behavior elicits more helpful forms of support from relationship partners, insecurity is linked with ineffective support-seeking behaviors ( Collins & Feeney, 2000 ; Ognibene & Collins, 1998 ; Mikulincer & Florian, 1995 ; Mikulincer & Shaver, 2009 ; Simpson et al., 1992 ; Simpson, Rholes, Orina, & Grich, 2002 ), and attachment security predicts reactions to support received from relationship partners ( Simpson et al., 2007 ). Interpersonal trust also has been associated with help seeking behaviors that involve revealing distress and vulnerability ( Mortenson, 2009 ). However, there is a clear gap in the literature on the role of the support-recipient in cultivating or hindering support processes and positive support outcomes, and this will be a high priority for future research.

Mutual Responsiveness: Thriving Through Giving and Receiving Support

Research on social support and health has focused almost exclusively on the benefits accrued to the individual receiving support. However, models of optimal well-being recognize the importance of giving to others. As part of our integrative perspective on thriving, we bring these viewpoints together and postulate that giving SOS and RC support is important for the provider’s thriving and well-being as well, and important for the development and maintenance of thriving relationships – through both intrapersonal and interpersonal pathways.

With respect to intrapersonal pathways, individuals who provide effective SOS and RC support and see that their efforts were successful and appreciated should experience benefits including increases in positive emotions and self-evaluations, and a sense of meaning in life. Responsive support provision also should have direct effects on the provider’s own neural and physiological processes associated with social connection that contribute to health and well-being. It has been suggested that people have an inherent need to provide care to others and will be healthier to the extent that they are able to fill this need ( Bowlby, 1982 ; Deci et al., 2006 ). These predictions are supported by research showing that providing care to loved ones predicts reduced morbidity and mortality (e.g., Brown et al., 2003 , 2009 ; O’Reilly, Connolly, Rosato, & Patterson, 2008 ) and reduced cardiovascular arousal ( Piferi & Lawler, 2006 ) for the support-provider; providing autonomy support to a friend predicts the support-provider’s psychological health ( Deci et al., 2006 ); helping another with whom one would like to have a communal relationship improves the helper’s mood and self-evaluations ( Williamson & Clark, 1989 ); and spending money on others has a more positive impact on the giver’s happiness than spending money on oneself ( Aknin et al., 2013 ; Dunn, Aknin, & Norton, 2008 ). Supporting a loved one increases feelings of social connection, as well as ventral striatum and septal area activity in the brain, which is associated with reduced amygdala activation ( Inagaki & Eisenberger, 2012 ) and high densities of oxytocin and opoid receptors ( Zubieta et al., 2001 ) that have implications for reduced SNS and HPA responses ( Uvnas-Moberg, 1998 ) and for inhibiting the production of pro-inflammatory cytokines (see Eisenberger & Cole, 2012 , for a review).

With respect to interpersonal pathways, individuals who provide effective SOS and RC support will have significant others who are happier, healthier, and more willing and able to provide responsive support in return; they will also cultivate relationships that are satisfying, trusting, intimate, and communal – characteristics that benefit both relationship partners. These predictions are supported by research showing that giving (as well as receiving) support is linked to spouses’ marital satisfaction ( Brunstein et al., 1996 ; Kaplan & Maddux, 2002 ), that support reciprocity in couples is an important predictor of daily emotional well-being ( Gleason et al., 2003 ) and relationship closeness ( Gleason et al., 2008 ), and that the provision of responsive support increases the recipient’s expression of gratitude and affection ( Collins et al., 2014 ), as well as the recipient’s prosocial motivation and behavior ( Reis et al., 2010 ) toward the provider. Thus, this perspective on thriving through relationships predicts that caring for the needs of others creates an upward spiral of positivity, a virtuous cycle that benefits both provider and recipient ( Canevello & Crocker, 2010 ). In contrast, deficiencies in caring for others (e.g., being inconsistently responsive, over-involved, neglectful/disengaged, or negative/demeaning) creates significant others who are insecure, over-reactive to stressors, unhappy in their relationships, and experiencing deteriorations in psychological and physical health – characteristics that impede the recipient’s responsiveness to the provider and that inhibit the provider’s thriving as well.

Perceived versus Received Support for Thriving

A predominant portion of the social support literature has focused on social support as a predictor of mental and physical health (e.g., Cohen, 1988 ; 2004 ; 2005 ; Cohen & Syme, 1985 ; Cohen & Wills, 1985 ; Kawachi & Berkman, 2001 ; Sarason et al., 1997 ; Uchino, 2009 ; Uchino et al., 1996 ; Vaux, 1988 ), which are important components of thriving. As mentioned above, in this literature social support is typically assessed via self-reports of perceived available support or support received within a certain time period. Few studies have included observations of support behaviors (and related interpersonal dynamics) as they unfold during support interactions with close relationship partners, and almost none have followed people over time to assess the extent to which these relational dynamics predict health outcomes. Social support, although an interpersonal construct, has been examined more from an intrapersonal perspective.

This may explain why there have been inconsistencies in the literature regarding effects of social support on health (see also Uchino, 2009 ). One of the most widely reported findings is that perceived available support (the relatively stable belief that help will be available if needed), as opposed to received or enacted support (help that is actually received), is the aspect of social support that is most strongly related to health outcomes ( Blazer, 1982 ; Cohen & Wills, 1985 ; Helgeson, 1993 ; Kessler & McLeod, 1984 ; Uchino, 2004 , 2009 ). Reviews of this literature have concluded that the majority of studies find no relation between self-reports of received support and mental health outcomes (e.g., Barrera, 1986 ; Dunkel-Schetter & Bennett, 1990 ; Sarason, Sarason, & Pierce, 1990 ), and when such a link is found there is inconsistency across studies in the specific pattern of results (for a review see Uchino, 2009 ). Some studies show that received support is clearly linked to better health (e.g., Collins et al., 1993 ; Costanza, Derlega, & Winstead, 1988 ; Winstead et al, 1992 ), whereas others find that it is associated with worse health (e.g., Forster & Stoller, 1992 ; Krause, 1997 ; Pennix et al., 1997 ).

The current conceptual framework may both help explain why perceived available support has emerged as such an important predictor of health and well-being, and help make sense of the conflicting findings regarding received support. First, as depicted in Figure 2 , the support-recipient’s subjective perception of a specific support interaction should be an important intermediary between enacted support (support behavior provided) and the recipient’s outcomes. Support that is delivered sensitively and responsively will be more likely to be subjectively perceived as supportive. However, measures of received support typically do not assess support quality, or the extent to which those behaviors were responsive to the support-receiver’s needs (for an exception, see Rini et al., 2006 ). This is an important oversight given that daily diary research finds that enacted social support is beneficial only when it is perceived as responsive to the recipient’s needs ( Maisel & Gable, 2009 ). This emphasis on perceived responsiveness is consistent with the matching hypothesis ( Cohen & McKay, 1984 ; Cohen & Wills, 1985 ), which states that the stress buffering effects of social support occur only when there is a match between the needs elicited by the stressful event and the functions of support that are perceived to be available, and with the optimal matching model of stress and social support ( Cutrona, 1990 ; Cutrona & Russell, 1990 ; Cutrona & Suhr, 1992 ), which states that the effectiveness (and perceived supportiveness) of a specific support attempt depends on the match between the enacted behavior and the context in which it is enacted.

Second, inconsistency in the consideration of received support from close versus non-close others is likely to explain inconsistency in the literature linking received support to health outcomes. Measures of received support rarely assess the sources of support, or differentiate support received from close versus non-close others. The presence or absence of support from close social ties (e.g., friends, family, intimate partners), and within relationships that are highly interdependent, is likely to be more influential than support from peripheral social ties ( Thoits, 2011 ). Moreover, the support, affection, and acceptance (or lack thereof) from close vs. non-close others is more likely to affect one’s overall sense of security and well-being ( Bowlby, 1982 ). Thus, we suspect that health (and thriving) is more strongly affected by support processes that occur within one’s closest relationships than by those that occur with strangers or non-close others, and this may be a reason why so many social support interventions have been inconclusive (see Cohen, Gottlieb, & Underwood, 2000 , Helgeson & Cohen, 1996 , and Helgeson, Cohen, Schulz, & Yasko, 2000 , for discussions of social support interventions).

Third, inconsistencies in the literature may have arisen because measures of received support focus almost exclusively on support received during times of stress or adversity and have largely ignored support received during non-adverse times, such as support received for goal strivings and personal growth (e.g., secure base support; Feeney & Thrush, 2010 ) or support received in response to positive life events and successes (e.g., capitalization support; Gable & Reis, 2010 ). By focusing on a very narrow definition of social support, research on received support has likely underestimated links between enacted support and well-being. In contrast, measures of perceived available support tend to encompass a broader range of life contexts and are more likely to recognize that social support occurs in both good and bad times. For example, in addition to support during times of adversity, such measures also include more general aspects of social connection such as companionship, shared community, reassurance of worth, and the perception that one is valued and accepted by others (e.g., Cohen, Mermelstein, Kamarck, & Hoberman, 1985 ; Cutrona & Russell, 1987 ; Sarason, Sarason, Shearin, & Pierce, 1987 ).

Finally, our view is that the link between social support and any thriving outcome (including health) cannot be adequately assessed without careful attention to the relational dynamics surrounding specific instances of received support. Thus, social support must be viewed as part of an interpersonal process such that specific instances of enacted support are assessed within the context of actual support interactions that are embedded within particular relationship contexts. This is consistent with Uchino’s (2009) emphasis on the current context as being important to consider when examining effects of received support. One implication is that self-report methodologies are not sufficient for understanding social support processes as they unfold in dyadic interaction, or for understanding how these processes shape thriving outcomes. Studies of received support may have underestimated links between enacted support and health because they have relied too heavily on self-report methods.

Consistent with this idea, laboratory studies have solidly documented beneficial effects of received support on physiological or neural reactivity during acute stressors (e.g., Allen et al., 1991 ; Collins et al., 2014 ; Feeney & Kirkpatrick, 1996 ; Gerin, Pieper, Levy, & Pickering, 1992 ; Lepore, Allen, & Evans, 1993 ). These studies are important not only because they document significant benefits of enacted support but also because they speak to underlying mechanisms by which social support might translate into long-term thriving outcomes. In these studies, support provision typically is operationalized as the presence of a close, non-evaluative, and supportive other. Compared to self-report studies, these studies offer more rigorous tests of the effects of received support because the stressful situations are held constant, support behavior is standardized across participants, and effects are observed in real-time instead of reported retrospectively. In addition, it is noteworthy that most of these effects have been obtained with close others. Although there are studies that show buffering effects on physiological or neural reactivity with non-close others (i.e., study confederates; Gerin et al., 1992 ; Lepore et al., 1993 ), the few studies that have included both close and non-close support providers (e.g., Coan et al., 2006 ) indicate a more limited attenuation of activation when supported by a non-close other.

Observational research that examines received support from close others in the context of dyadic interaction (e.g., Collins & Feeney, 2000 ; Cutrona & Suhr, 1992 ; Feeney & Thrush, 2010 ; Simpson et al., 1992 ) also has shown beneficial effects of received support on outcomes relevant to thriving. This is most likely because support behaviors in observational studies are coded by trained observers who take into account the degree to which enacted behaviors seem sensitive and responsive to the recipient’s needs. Likewise, studies that experimentally manipulate responsive support provision show that caring support from a romantic partner during an acute stressor has immediate benefits on personal and relational well-being (e.g., Collins et al., 2014 ; Collins & Feeney, 2004 ; Feeney, 2004 ; Kane, et al., 2012 ). Taken together, then, the literature suggests that both perceived and received support play an important role in shaping thriving outcomes (see Uchino, 2009 , for discussion of the unique antecedents and consequences of perceived versus received support for health).

Given the well-established links between perceived social support and health, where does perceived support fit within the thriving framework outlined here, in which social support is conceptualized as an interpersonal process? Perceived support is integrated into our model in three important ways. First, general perceptions of support are conceptualized as a long-term thriving outcome – a key indicator of social well-being – that arises from many specific interactions with significant others in which SOS and RC support is enacted ( Figure 1 , paths c and f ). In our prior work, we have shown that people’s perceptions of the support they received from significant others during a laboratory interaction were clearly rooted in the objective features of their significant other’s behavior ( Collins & Feeney, 2000 , 2004 ). We suggest that, over time, these specific perceptions form the building blocks of more general perceptions of social support – just as specific support interactions (earlier in life) are presumed to form the basis of one’s internal working models of self and others ( Ainsworth et al., 1978 ; Bowlby, 1982 ). This idea is consistent with Uchino’s (2009) suggestion that general perceptions of support begin to emerge from interactions within the family, and become part of a relatively stable psychosocial profile in adolescence and adulthood (see also Sarason, Sarason, & Shearin, 1986 ).

A second way in which perceived support is incorporated into our model concerns the influence of thriving outcomes (personal and relational fortitudes) on subsequent life experiences ( Figure 2 , paths o and p ). Our model assumes that perceptions of available support (one of many personal fortitudes) will shape responses to subsequent life stressors and life opportunities. For example, individuals who perceive support to be readily available should be less psychologically and physiologically affected by stressors and should be more willing to approach opportunities for growth compared to those who do not possess this fortitude. Finally, a third way in which general perceptions of support are incorporated into our model concerns their role in shaping the interpersonal support processes depicted in Figure 2 . Perceived available support is an important individual difference factor that can influence any of the variables in the dyadic model, or moderate any of the paths in the model. For example, individuals who feel confident that they can rely on others for responsive support (high perceived support) should be more willing to seek support when needed, and more likely to interpret a support-provider’s behavior in ways that are consistent with their positive interpersonal expectancies (e.g., Collins & Feeney, 2004 ; Lakey & Cassady, 1990 ; Sarason, Sarason, & Pierce, 1994 ).

Roadmap for Future Research

By conceptualizing social support as an interpersonal process and viewing thriving as the desired end-state, the perspective advanced here has important implications for future research on social support, including (a) focusing on actual support behaviors that are enacted in dyadic interaction and the degree to which those behaviors are responsive to the needs of the recipient, (b) recognizing that social support in adverse life circumstances can do much more than buffer against negative effects of the stressor, (c) highlighting the importance of investigating social support in non-adverse life circumstances, (d) emphasizing the need to understand mediating pathways and mechanisms of action, and (e) focusing on close relationships as being central to facilitating or hindering thriving. Next, we provide a roadmap for advancing research on relational support for thriving.

A first step involves measurement of key constructs. In arguing for a consideration of thriving as an ultimate outcome, it is important to specify how this multi-faceted construct might be operationalized and assessed. One means of doing so involves comprehensive measures that assess each component of well-being. For example, we have developed a Thriving Assessment Questionnaire (TAQ, Feeney & Collins, 2014 ) that asks respondents to report (on multi-item subscales) the extent to which they have grown or prospered over the last year in each area of their lives relevant to thriving (e.g., movement toward one’s full potential, the development of skills/talents, self-discovery, wisdom gained, relationships with others, views of self, views of others, mental health, and physical health). Likewise, Ahrens and Ryff (2006 , see also Ryff & Keyes, 1995 ) developed a measure that assesses specific dimensions of well-being ( Ahrens & Ryff, 2006 ; Ryff & Keyes, 1995 ), including environmental mastery, purpose in life, personal growth, and autonomy (eudaimonic well-being), positive relations with others (social well-being), and self-acceptance (psychological well-being). Thriving can also be assessed with a combination of individually validated measures of (1) happiness ( Diener & Diener, 1996 ) and life satisfaction ( Diener, 1994 ) for hedonic well-being, (2) goal pursuit/self-growth ( Ebner et al., 2006 ; Feeney, 2004 , 2007 ; Scheier et al., 2006 ) and mastery/efficacy ( Ahrens & Ryff, 2006 ; Sherer et al., 1982 ) for eudaimonic well-being, (3) self-views ( Rosenberg, 1965 ), optimism ( Scheier, Carver, & Bridges, 1994 ), and psychological symptoms ( Derogatis & Melisaratos, 1983 ; Hu, Stewart-Brown, Twigg, & Weich, 2007 ) for psychological well-being, (4) relationship quality/functioning measures ( Rempel, Holmes, & Zanna, 1985 ; Rusbult, Martz, & Agnew, 1998 ; Spanier, 1976 ) for social well-being, and (5) health symptoms ( Brodman, Erdmann, & Wolff, 1974 ), physician visits, health-related behaviors, and sleep quality ( Buysse et al., 1989 ) for physical well-being. Observational and biological assessments of these components of thriving could be assessed as well.

It is also important to specify how the multi-faceted constructs of SOS and RC support might be operationalized and assessed in laboratory and survey research. One important means of doing this, as we advocate throughout, is by using observational methods that enable researchers to observe support interactions as they unfold during dyadic interaction. For example, researchers obtain video-recordings of individuals as they deal with life adversities or life opportunities (either naturalistic ones or ones that are presented to them in the lab) in the presence of particular relationship partners; see Collins & Feeney, 2000 , 2004 ; Cutrona & Suhr, 1992 ; Feeney, 2004 ; Feeney & Thrush, 2010 ; Simpson et al., 1992 , for examples. The proposed components of SOS and RC support (and related behaviors) can be coded from such interactions by independent observers who have been trained to reliability. This method can be supplemented by dyad member reports of support behaviors that were enacted during a specific interaction (obtained immediately after the interaction). In addition to observational methods, theory testing will be facilitated by the development of valid and reliable self-report measures of perceived and enacted/received SOS and RC support. Toward this end, we have developed measures for assessing the extent to which a specific significant other typically enacts responsive SOS and RC support behaviors in relevant life contexts ( Feeney & Collins, 2014 ); these measures can be adapted for daily diary research. Finally, the field will be advanced by the development of effective laboratory manipulations of SOS and RC support for use in experimental research. We have developed methods for operationalizing components of SOS and RC support in prior research on secure base and safe haven support ( Collins & Feeney, 2004 ; Collins et al., 2014 ; Feeney, 2004 ), and Reis and colleagues ( Reis et al., 2010 ) have developed methods for manipulating capitalization support. These tools can be expanded or adapted to manipulate other components of SOS and RC support in specific laboratory contexts. We see great value in experimental methods for testing causal mechanisms, which have been elusive in the social support literature in part because of the field’s heavy reliance on questionnaire methods. A multi-method approach will be imperative in the next generation of research on social support.

Aside from measurement, the proposed models highlight many specific, testable research questions and hypotheses for which evidence must accumulate. One key hypothesis is that the two support functions make unique contributions to thriving. Preliminary evidence for this hypothesis was provided in a longitudinal study of newlyweds ( Van Vleet & Feeney, 2012 ), which found that support received in times of adversity and support received in non-adverse times (for goal strivings) predicted unique variance in marital satisfaction, general perceptions of partner responsiveness, and generalized anxiety over the first year of marriage. However, research is needed to establish the unique links between each support function and each thriving component. In particular, we need many more studies on support in non-adverse circumstances and how support in this context uniquely contributes to health and well-being. For example, aspects of thriving such as hedonic and eudaimonic well-being may be most strongly predicted by RC support (i.e., having close others who validate/facilitate/celebrate goals and dreams).

Also important to establish are the pathways by which the two support functions promote long-term thriving. The model makes predictions about specific emotional, motivational, behavioral, cognitive, neural, and physiological states that are likely to result from each support function. Research is needed to explore these immediate outcomes, the complex inter-relations among them, and their unique associations with specific thriving outcomes. Because research on how relational support can promote health is lacking, it will be especially important to test specific biological and lifestyle mediators that have implications for health (see Miller et al., 2009 , and Eisenberger & Cole, 2012 , for discussion of biologically plausible models linking social relationships to health). In doing so, it will be important to examine the immediate consequences of support received during the two types of support interactions in order to determine how these concrete interactions and immediate solutions shape longer-term outcomes. This will require a range of methodologies including experimental research to test causal pathways, observational studies of dyadic interaction, daily diary and experience sampling studies, and longitudinal research.

The processes depicted in Figure 2 represent normative or prototypical social support dynamics. However, it is important to acknowledge that individual difference factors are likely to influence any of the variables in the model, or moderate any of the paths in the model. Not all individuals are willing to show vulnerability in times of stress, pursue life opportunities, and seek support when needed, and not all support-providers are skilled at providing SOS or RC support, nor motivated to so do so. Moreover, pre-existing beliefs, expectations, and norms that individuals bring into their interactions may act as interpretative filters and shape the way they perceive and react to one another’s behavior. Examples of individual difference variables likely to influence these processes include attachment security, (e.g., Collins & Feeney, 2000 ; Elliot & Reis, 2003 ; Kunce & Shaver, 1994 ; Mikulincer & Shaver, 2009 ; Simpson et al., 2007 ), general perceptions of available support (e.g., Lakey & Cassidy, 1990 ; Pierce, Sarason, & Sarason, 1992 ), personality variables that reflect perseverance toward goals, such as conscientiousness and grit ( Duckworth, Peterson, Matthews, & Kelly, 2007 ; Hough, 1992 ), rejection sensitivity ( Downey & Feldman, 1996 ), agreeableness ( Graziano, Habashi, Shees, & Tobin, 2007 ), dispositional optimism ( Carver & Scheier, 2009 ; Scheier & Carver, 1993 ), dispositional coping styles ( Carver & Scheier, 1994 ; Carver, Scheier, & Weintraub, 1989 ), as well as gender role norms ( Barbee et al., 1993 ; Burleson, 2003 ) and cultural norms ( Burleson & Mortenson, 2003 ; Kim, Sherman, & Taylor, 2009 ; Schoebi, Wang, Ababkov, & Perrez, 2010 ). These individual difference variables involve cognitive structures that enable individuals to anticipate the responsiveness and availability of others, judge the worthiness and acceptability of the self, and develop strategies for regulating affect and maintaining security. Our hope is that this framework will inspire researchers to explore a variety of important dispositional, situational, relationship, and cultural influences on both SOS and RC support processes.

Relatedly, because theory and research has historically neglected the interpersonal aspect of social support, coping, and thriving in favor of the intrapersonal, an important contribution of this conceptual framework is that it emphasizes that interpersonal and intrapersonal processes are connected (with relational support functions at the core in underlying paths to both personal and relational well-being). That is, the interpersonal social support process is predicted to have an important influence on immediate and long-term outcomes that are both personal and interpersonal in nature – and these personal and relational outcomes are posited to influence future responses to life adversities and opportunities. In the next generation of research on social support, it will be important to empirically establish the ways in which interpersonal and intrapsychic processes work together to determine thriving outcomes.

It is also important to consider how the current perspective applies across socioeconomic and demographic groups. Is the notion of thriving limited to privileged segments of society? Our perspective is that thriving, in the ways outlined here, is not limited in this way – just as Maslow (2011) argued that all people, rich or poor, educated or not, can achieve self-actualization (see also Koltko-Rivera, 2006 ). In related work, scores on dimensions of well-being identified by Ryff and Singer (2006 , autonomy, environmental mastery, personal growth, positive relations, purpose in life, self-acceptance) were positively linked with socioeconomic status, suggesting that opportunities for self-realization may occur via the allocation of resources that enable those who have them to make the most of their talents and capacities. However, there is also evidence for resilience among those who lack socioeconomic advantage ( Ryff, Singer, & Palmersheim, 2004 ), suggesting that self-realization is not exclusive to privileged segments of society.

Of course, it is important to acknowledge that individuals from disadvantaged environments confront stressors and challenges that make it more difficult for them to thrive compared to their more advantaged counterparts; and socioeconomic disparities in health and well-being are well-documented (e.g., Krieger, Chen, Waterman, Rehkopf, & Subramanian, 2005 ; Mensah, Mokdad, Ford, Greenlund, & Croft, 2005 ). However, our perspective is that individuals from all socioeconomic backgrounds will be most likely to thrive and reach their potential when they have caring social partners who offer support in both good times and bad times. These supports are equally important – and may be even more important – for children and adults who confront significant economic disadvantage, who may depend even more on family, friends, and mentors for security, hope, and inspiration. For example, Chen and Miller (2012) show that adolescents from socioeconomically disadvantaged backgrounds are able to maintain healthy patterns of coping (acceptance, optimism, persistence, hope) and healthy physiological profiles (as indicated by cardiovascular, immune, and metabolic markers) when they have caring social partners (nurturing mothers, caring mentors, and other positive role models) who provide support and inspiration (see also Miller et al., 2011 for related work on adults). Thus, while caring relationships cannot remove socioeconomic adversity (or take away illness or loss), they can increase the chances that individuals will flourish in whatever ways are afforded by the environments in which they are situated. Thus, in future work, it will be important to investigate the role of SOS and RC support within specific sociodemographic groups. Given similar environmental contexts, our model predicts that individuals with responsive close relationship partners (who offer effective SOS and RC support) will be more likely to thrive than those who lack these interpersonal resources. Guided by this perspective, future empirical work could inform interventions that increase SOS and RC support in the lives of individuals who face economic disadvantage. Interventions may focus on building close supportive relationships (e.g., through mentors), and training support-providers to deliver responsive support that fosters growth and thriving.

Finally, future research should examine how the two support functions are concentrated or dispersed across core network members. Although our model focuses on functional aspects of social support, it is important to consider these functions in combination with structural aspects of social support (e.g., the number of social ties an individual has or how integrated the individual is within his or her social network). For example, it will be useful to examine who people turn to for these support functions, the degree to which their support network is specialized (e.g., an individual goes to some relational partners for SOS support and others for RC support) or generalized (e.g., an individual has one or more relational partners who provide both SOS and RC support), and resulting implications for thriving outcomes. By specifying two distinct support functions, we hope that future work on structural aspects of support will examine not only who provides support, but the different functions they might serve. Consistent with research indicating that health is best predicted by complex measures of social integration ( Holt-Lunstad & Smith, 2012 ), we propose that complex networks provide access to caring social partners who fulfill needs for both SOS and RC support – and promote thriving in both the presence and absence of adversity.

Relatedly, although our theoretical framework focuses on close relationships, we believe that the dyadic processes and mechanisms described in our model are applicable to other types of relationships including teacher-student relationships, therapist-client relationships, mentor-mentee relationships, and pastor-parishioner relationships. We hope that our proposed model will lead to new ways of thinking about social support and helping in these other types of relationships by highlighting issues not typically addressed in their respective literatures.

Ultimately, our hope is that this perspective will be useful in developing and testing theory-based interventions for enhancing SOS and RC support and thriving outcomes. Prior research is clear in showing that good quality relationships protect health and well-being, and poor quality relationships hinder optimal well-being; but we still know relatively little about when, how, and why relationships have the impact they do. In a review of research on relationships and health, Uchino et al. (2012) concluded that “the weight of the evidence regarding what we know about social support and health versus its psychological mechanisms is so unbalanced as to hinder attempts at theoretical modeling or the design of well-informed interventions” (p. 954). A lack of consideration of the specific interpersonal processes that underlie the effects of relationships on well-being, and a lack of grounding in a strong theoretical foundation, may be reasons why so many social support interventions have not had their intended effects ( Cohen et al., 2000 ; Helgeson et al., 2000 ). We hope that this framework will provide one such foundation for the development of relationship-based interventions aimed at promoting public health. This seems especially important given that the United Nations’ World Happiness Report ( Helliwell, Layard, & Sachs, 2013 ), which was offered as a contribution to the policy debate regarding the world’s Sustainable Development Goals for the period 2015–2030, identified social support as one of the main contributors to the world’s mental health.

Concluding Statement

The goal of this manuscript was to present a theoretical perspective on thriving through relationships that highlights the importance of relational support in both adverse and non-adverse contexts. In doing so, we propose that researchers take a new look at social support and conceptualize it as an interpersonal process with the promotion of thriving as the ultimate objective. This perspective contributes to the literature by (1) providing an integrated conceptualization of thriving, (2) describing two support functions that work together to promote thriving, (3) considering social support within a life context (engagement in life opportunities for exploration and growth) that has been neglected in decades of research on social support, and within in a life context (dealing with life adversity) that has historically focused on buffering negative effects instead of promoting positive ones, (4) identifying mechanisms that explain the links between support and thriving, (5) emphasizing the importance of support within an interpersonal context and within one’s closest relationships, (6) focusing attention on the nature and quality of support provided, and (7) offering insight into how support-providers and recipients may cultivate responsive support. Whereas other perspectives on thriving compartmentalize relationships as one domain in which people may thrive, this perspective puts relationships at the forefront in facilitating or hindering thriving in each domain of well-being.

Although it requires effort to provide responsive SOS and RC support, the rewards of such care are likely to be great: Individuals who are supported in these ways are likely to be happy and healthy, confident in their abilities, self-reliant and bold in their explorations of the world, effective citizens who are unlikely to break down in adversity, active contributors to society, sympathetic and helpful to others, and capable of maintaining healthy and prospering relationships. They will not merely survive, but they will thrive, and they will do so with some passion, some compassion, some humor, and some style (Maya Angelo).

Acknowledgments

This manuscript was supported by grants from the National Institute of Health (NIA, 1R01AG032370 - 01A2) and the National Science Foundation (BCS0424579) to the first author, and by grants from the Fetzer Institute (2347.04) and the National Science Foundation (SBR0096506) to the second author. We are grateful for the feedback of Jennifer Crocker, Ed Lemay, and anonymous reviewers during the development of this manuscript.

Contributor Information

Brooke C. Feeney, Carnegie Mellon University.

Nancy L. Collins, University of California, Santa Barbara.

• Acitelli LK. The neglected links between marital support and marital satisfaction. In: Pierce GR, Sarason BR, Sarason IG, editors. Handbook of social support and the family. New York: Plenum Press; 1996. pp. 83–103. [ Google Scholar ]
• Ainsworth MDS, Blehar MC, Waters E, Wall S. Patterns of attachment: psychological study of the strange situation. Hillsdale, NJ: Erlbaum; 1978. [ Google Scholar ]
• Ahrens CJC, Ryff CD. Multiple roles and well-being: Sociodemographic and psychological moderators. Sex Roles. 2006; 55 :801–815. [ Google Scholar ]
• Aknin LB, Barrington-Leigh CP, Dunn EW, Helliwell JF, Burns J, Biswas-Diener R, et al. Journal of Personality and Social Psychology 2013 [ PubMed ] [ Google Scholar ]
• Aldwin CM, Sutton KJ, Lachman M. The development of coping resources in adulthood. Journal of Personality. 1996; 64 :837–871. [ PubMed ] [ Google Scholar ]
• Allen KM, Blascovich J, Tomaka J, Kelsey RM. Presence of human friends and pet dogs as moderators of autonomic responses to stress in women. Journal of Personality and Social Psychology. 1991; 61 :582–589. [ PubMed ] [ Google Scholar ]
• Allen JP, Land D. Attachment in adolescence. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical applications. New York: Guilford Press; 1999. pp. 319–335. [ Google Scholar ]
• Antonucci T, Okorodudu C, Akiyama H. Well-being among adults on different continents. Journal of Social Issues. 2002; 58 :617–626. [ Google Scholar ]
• Aron A, Aron EN, Smollan D. Inclusion of the other in the self scale and the structure of interpersonal closeness. Journal of Personality and Social Psychology. 1992; 63 :596–612. [ Google Scholar ]
• Aron A, Aron EN, Tudor M, Nelson G. Close relationships as including other in the self. Journal of Personality and Social Psychology. 1991; 60 :241–253. [ Google Scholar ]
• Aron A, Fisher H, Mashek DJ, Strong G, Li H, Brown LL. Reward, Motivation, and Emotion Systems Associated With Early-Stage Intense Romantic Love. Journal of Neurophysiology. 2005; 94 :327–337. [ PubMed ] [ Google Scholar ]
• Aron A, Ketay S, Riela S, Aron EN. How close others construct and reconstruct who we are and how we feel about ourselves. In: Wood JV, Tesser A, Holmes JG, editors. The self and social relationships. New York, NY: Psychology Press; 2008. pp. 209–229. [ Google Scholar ]
• Baldwin MW. Relational schemas and the processing of social information. Psychological Bulletin. 1992; 3 :461–484. [ Google Scholar ]
• Baldwin KM, Haddad R. Skeletal Muscle Plasticity: Cellular and Molecular Responses to Altered Physical Activity Paradigms. Journal Musculoskelet Neuronal Interact. 2002; 5 :41–52. [ PubMed ] [ Google Scholar ]
• Barbee AP, Cunningham MR. An experimental approach to social support communications: Interactive coping in close relationships. Communication Yearbook. 1995; 18 :381–413. [ Google Scholar ]
• Barbee AP, Cunningham MR, Winstead BA, Derlega VJ, Gulley MR, Yankeelov PA, Duren PB. Effects of gender role expectations on the social support process. Journal of Social Issues. 1993; 49 :175–190. [ Google Scholar ]
• Bardwell WA, Berry CC, Ancoli-Israel S, Dimsdale JE. Psychological correlates of sleep apnea. Journal of Psychosomatic Research. 1999; 47 :583–596. [ PubMed ] [ Google Scholar ]
• Barrera M., Jr Distinctions between social support concepts, measures, and models. AmericanJournal of Community Psychology. 1986; 14 :413–445. [ Google Scholar ]
• Batson CD, Shaw LL. Evidence for altruism: Toward a pluralism of prosocial motives. Psychological Inquiry. 1991; 2 :107–122. [ Google Scholar ]
• Beckes L, Coan JA. Social baseline theory: The role of social proximity in emotion and economy of action. Social and Personality Psychology Compass. 2011; 5 :976–988. [ Google Scholar ]
• Belsky J, Rovine M, Taylor DG. The Pennsylvania Infant and Family Development Project: III. The origins of individual differences in infant–mother attachment: Maternal and infant contributions. Child Development. 1984; 55 :718–728. [ PubMed ] [ Google Scholar ]
• Benson PL, Scales PC. The definition and preliminary measurement of thriving in adolescence. The Journal of Positive Psychology. 2009; 4 :85–104. [ Google Scholar ]
• Blascovich J. Challenge and threat. In: Elliot AJ, editor. Handbook of approach and avoidance motivation. New York, NY: Psychology Press; 2008a. [ Google Scholar ]
• Blascovich J. Challenge, threat, and health. In: Shah JY, Gardner WL, editors. Handbook of motivation science. New York, NY: Guilford Press; 2008b. pp. 481–493. [ Google Scholar ]
• Blazer DG. Social support and mortality in an elderly community population. American Journal of Epideiology. 1982; 115 :684–694. [ PubMed ] [ Google Scholar ]
• Bolger N, Amarel D. Effects of support visibility on adjustment to stress: Experimental evidence. Journal of Personality and Social Psychology. 2007; 92 :458–475. [ PubMed ] [ Google Scholar ]
• Bowlby J. Attachment and loss: Vol. 1. Attachment. New York: Basic Books; 1982. [ Google Scholar ]
• Bowlby J. Attachment and loss: Separation, anxiety and anger. New York: Basic Books; 1973. [ Google Scholar ]
• Bowlby J. A secure base. New York: Basic Books; 1988. [ Google Scholar ]
• Bretherton I. New perspectives on attachment relations: Security, communication, and internal working models. In: Osofsky JD, editor. Handbook of infant development. 2. New York: Wiley; 1987. pp. 1061–1100. [ Google Scholar ]
• Brock RL, Lawrence E. Too much of a good thing: Underprovision versus overprovision of partner support. Journal of Family Psychology. 2009; 23 :181–192. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Brodman K, Erdmann AJ, Jr, Wolff HG. Cornell Medical Index, health questionnaire. New York, NY: Cornell University Medical College; 1974. [ Google Scholar ]
• Brooks K, Dunkel Schetter C. Social negativity and health. Social and Personality Psychology Compass. 2011; 5 :904–918. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Brown SL, Nesse RM, Vinokur AD, Smith DM. Providing social support may be more beneficial than receiving it: Results from a prospective study of mortality. Psychological Science. 2003; 14 :320–327. [ PubMed ] [ Google Scholar ]
• Brown SL, Smith DM, Schulz R, Kabeto M, Ubel P, Yee J, Kim C, Langa K. Caregiving and Decreased Mortality in a National Sample of Older Adults. Psychological Science. 2009; 20 :488–494. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Brunstein JC. Personal goals and subjective well-being: A longitudinal study. Journal of Personality and Social Psychology. 1993; 65 :1061–1070. [ Google Scholar ]
• Brunstein JC, Dangelmayer G, Schultheiss OC. Personal goals and social support in close relationships: Effects on relationship mood and marital satisfaction. Journal of Personality and Social Psychology. 1996; 71 :1006–1019. [ Google Scholar ]
• Brunstein JC, Schultheiss OC, Grassman R. Personal goals and emotional well-being: The moderating role of motive dispositions. Journal of Personality and Social Psychology. 1998; 75 :494–508. [ PubMed ] [ Google Scholar ]
• Bundick MJ, Yeager DS, King PE, Damon W. Thriving across the life span. In: Overton WF, Lerner RM, editors. The handbook of life-span development, Vol 1: Cognition, biology, and methods. Hoboken, NJ: John Wiley & Sons; 2010. [ Google Scholar ]
• Burleson BR. Comforting messages: Features, functions, and outcomes. In: Daley JA, Wiemann JM, editors. Strategic interpersonal communication. Hillsdale, NJ: Erlbaum; 1994. pp. 135–161. [ Google Scholar ]
• Burleson BR. The experience and effects of emotional support: What the study of cultural and gender differences can tell us about close relationships, emotion, and interpersonal communication. Personal Relationships. 2003; 10 :1–23. [ Google Scholar ]
• Burleson BR. Understanding the outcomes of supportive communication: A dual process approach. Journal of Social and Personal Relationships. 2009; 26 :21–38. [ Google Scholar ]
• Burleson BR, Mortenson SR. Explaining cultural differences in evaluations of emotional support behaviors: Exploring the mediating influences of value systems and interaction goals. Communication Research. 2003; 30 :113–146. [ Google Scholar ]
• Burman B, Margolin G. Analysis of the association between marital relationships and health problems: An interactional perspective. Psychological Bulletin. 1992; 112 :39–63. [ PubMed ] [ Google Scholar ]
• Buysse DJ, Reynolds CF, Monk TH, Berman SR. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research. 1989; 28 :193–213. [ PubMed ] [ Google Scholar ]
• Calhoun LG, Tedeschi RG. Handbook of posttraumatic growth: Research & practice. Lawrence Erlbaum Associates Publishers; 2006. [ Google Scholar ]
• Canevello A, Crocker J. Creating good relationships: Responsiveness, relationship quality, and interpersonal goals. Journal of Personality and Social Psychology. 2010; 99 :78–106. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Caprariello PA, Reis HT. Perceived partner responsiveness minimizes defensive reactions to failure. Social Psychological and Personality Science. 2011; 2 :365–372. [ Google Scholar ]
• Carnelley KB, Pietromonaco PR, Jaffe K. Attachment, caregiving, and relationship functioning in couples: Effects of self and partner. Personal Relationships. 1996; 3 :257–278. [ Google Scholar ]
• Carver CS. Resilience and thriving: Issues, models, and linkages. Journal of Social Issues. 1998; 54 :245–266. [ Google Scholar ]
• Carver CS. Approach, avoidance, and the self-regulation of affect and action. Motivation and Emotion. 2006; 30 :105–110. [ Google Scholar ]
• Carver CS. Coping. In: Contrada RJ, Baum A, editors. The handbook of stress science: Biology, psychology, and health. New York, NY: Springer Publishing; 2011. pp. 221–229. [ Google Scholar ]
• Carver CS, Scheier MF. Situational coping and coping dispositions in a stressful transaction. Journal of Personality & Social Psychology. 1994; 66 :184–195. [ PubMed ] [ Google Scholar ]
• Carver CS, Scheier MF. Handbook of individual differences in social behavior. New York, NY: Guilford Press; 2009. Optimism; pp. 330–342. [ Google Scholar ]
• Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology. 1989; 56 :267–283. [ PubMed ] [ Google Scholar ]
• Cassidy J, Shaver P, editors. Handbook of attachment: Theory, research, and clinical applications. Guilford Press; 2008. [ Google Scholar ]
• Chen E, Miller GE. “Shift-and-persist” strategies: Why being low in socioeconomic status isn’t always bad for health. Perspectives on Psychological Science. 2012; 7 :135–158. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Clark MS, Mills J. The difference between communal and exchange relationships: What it is and is not. Personality and Social Psychology Bulletin. 1993; 19 :684–691. [ Google Scholar ]
• Coan JA, Schaefer HS, Davidson RJ. Lending a hand: Social regulation of the neural response to threat. Psychological Science. 2006; 17 :1032–1039. [ PubMed ] [ Google Scholar ]
• Cobb S. Social support as a moderator of life stress. Psychosomatic Medicine. 1976; 38 :300–314. [ PubMed ] [ Google Scholar ]
• Cohen S. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology. 1988; 7 :269–297. [ PubMed ] [ Google Scholar ]
• Cohen S. Social relationships and health. American Psychologist. 2004; 59 :676–684. [ PubMed ] [ Google Scholar ]
• Cohen S. The Pittsburgh common cold studies: Psychosocial predictors of susceptibility to respiratory infectious illness. International Journal of Behavioral Medicine. 2005; 12 :123–131. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Cohen S, Gottlieb BH, Underwood LG. Social relationships and health. In: Cohen S, Underwood LG, Gottlieb BH, editors. Social support measurement and intervention: A guide for health and social scientists. New York, NY: Oxford University Press; 2000. pp. 3–25. [ Google Scholar ]
• Cohen S, Mermelstein R, Kamarck T, Hoberman H. Measuring the functional components of social support. In: Sarason IG, Sarason BR, editors. Social support: Theory, research, and application. The Hague, Holland: Martinus Nijhoff; 1985. [ Google Scholar ]
• Cohen S, McKay G. Social support, stress and the buffering hypothesis: A theoretical analysis. Handbook of Psychology and Health. 1984; 4 :253–267. [ Google Scholar ]
• Cohen S, Pressman SD. Positive affect and health. Current Directions in Psychological Science. 2006; 15 :122–125. [ Google Scholar ]
• Cohen S, Syme SL. Social support and health. San Diego, CA: Academic Press; 1985. [ Google Scholar ]
• Cohen S, Tyrrell DA, Smith AP. Psychological stress and susceptibility to the common cold. The New England Journal of Medicine. 1991; 325 :606–612. [ PubMed ] [ Google Scholar ]
• Cohen S, Williamson GM. Stress and infectious disease in humans. Psychological Bulletin. 1991; 109 :5–24. [ PubMed ] [ Google Scholar ]
• Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychological Bulletin. 1985; 98 :310–357. [ PubMed ] [ Google Scholar ]
• Collins NL, Dunkel-Schetter C, Lobel M, Scrimshaw SCM. Social support in pregnancy: Psychosocial correlates of birth outcomes and postpartum depression. Journal of Personality and Social Psychology. 1993; 65 :1243–1258. [ PubMed ] [ Google Scholar ]
• Collins NL, Feeney BC. A safe haven: An attachment theory perspective on support-seeking and caregiving in adult romantic relationships. Journal of Personality and Social Psychology. 2000; 78 :1053–1073. [ PubMed ] [ Google Scholar ]
• Collins NL, Feeney BC. Working models of attachment shape perceptions of social support: Evidence from experimental and observational studies. Journal of Personality and Social Psychology. 2004; 87 :363–383. [ PubMed ] [ Google Scholar ]
• Collins NL, Feeney BC. Attachment processes in intimate relationships: Support- seeking and caregiving behavior in daily interaction. Paper presented at the meeting of the American Psychological Society; Los Angeles, CA. 2005. May, [ Google Scholar ]
• Collins NL, Ford MB, Guichard AC, Kane HS, Feeney BC. Responding to need in intimate relationships: Social support and caregiving processes in couples. In: Mikulincer M, Shaver PR, editors. Prosocial motives, emotions, and behavior: The better angels of our nature. Washington, DC: American Psychological Association; 2010. pp. 367–389. [ Google Scholar ]
• Collins NL, Guichard AC, Ford MB, Feeney BC. Responding to need in intimate relationships: Normative processes and individual difference. In: Mikulincer M, Goodman GS, editors. Dynamics of romantic love: Attachment, caregiving, and sex. New York, NY: Guilford Press; 2006. pp. 149–189. [ Google Scholar ]
• Collins NL, Kane HS, Metz MA, Cleveland C, Khan C, Winczewski L, Bowen J, Prok T. Psychological, physiological, and behavioral responses to a partner in need: The role of compassionate love. Journal of Social and Personal Relationships in press. [ Google Scholar ]
• Collins NL, Jaremka LM, Kane HS. Social support during a stressful task reduces cortisol reactivity, promotes emotional recovery, and builds caring relationships. University of California; Santa Barbara: 2014. Unpublished manuscript. [ Google Scholar ]
• Contrada RJ. Type A behavior, personality hardiness, and cardiovascular responses to stress. Journal of Personality and Social Psychology. 1989; 57 :895–903. [ PubMed ] [ Google Scholar ]
• Cooper DM. Evidence for and mechanisms of exercise modulation of growth--an overview. Medicine and Science in Sports and Exercise. 1994; 26 :733–740. [ PubMed ] [ Google Scholar ]
• Costanza RS, Derlega VJ, Winstead BA. Positive and negative forms of social support: Effects of conversational topics on coping with stress among same-sex friends. Journal of Experimental Social Psychology. 1988; 24 :182–193. [ Google Scholar ]
• Coyne JC, DeLongis A. Going beyond social support: The role of social relationships in adaptation. Journal of Consulting and Clinical Psychology. 1986; 54 :454–460. [ PubMed ] [ Google Scholar ]
• Coyne JC, Wortman CB, Lehman DR. The other side of support: Emotional overinvolvement and miscarried helping. In: Gottlieb B, editor. Marshaling social support: Formats, processes, and effects. Thousand Oaks, CA: Sage Publications; 1988. pp. 305–330. [ Google Scholar ]
• Cracchiolo JR, Mon T, Nazian SJ, Tan J, Potter H, Arendash GW. Enhanced cognitive activity--over and above social or physical activity--is required to protect Alzheimer’s mice against cognitive impairment, reduce Aβ deposition, and increase synaptic immunoreactivity. Neurobiology of Learning and Memory. 2007; 88 :277–294. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Creswell JD, Welch WT, Taylor SE, Sherman DK, Gruenewald TL, Mann T. Affirmative of personal values buffers neuroendocrine and psychological stress responses. Psychological Science. 2005; 16 :846–851. [ PubMed ] [ Google Scholar ]
• Crocker J, Niiya Y, Mischkowski D. Why Does Writing About Important Values Reduce Defensiveness? Self-Affirmation and the Role of Positive Other-Directed Feelings. Psychological Science. 2008; 19 :740–747. [ PubMed ] [ Google Scholar ]
• Crowell J, Treboux D, Gao Y, Fyffe C, Pan H, Waters E. Assessing secure base behavior in adulthood: Development of a measure, links to adult attachment representations and relations to couples’ communication and reports of relationships. Developmental Psychology. 2002; 38 :679–693. [ PubMed ] [ Google Scholar ]
• Cutrona CE. Behavioral manifestations of social support: A microanalytic investigation. Journal of Personality and Social Psychology. 1986; 51 :201–208. [ PubMed ] [ Google Scholar ]
• Cutrona CE. Stress and social support: In search of optimal matching. Journal of Social and Clinical Psychology. 1990; 9 :3–14. [ Google Scholar ]
• Cutrona CE. Social support in couples: Marriage as a resource in times of stress. Thousand Oaks, CA: Sage; 1996a. [ Google Scholar ]
• Cutrona CE. Social support as a determinant of marital quality: The interplay of negative and supportive behaviors. In: Pierce GR, Sarason BR, Sarason IG, editors. Handbook of social support and the family. New York: Plenum Press; 1996b. pp. 173–194. [ Google Scholar ]
• Cutrona CE, Russell D. The provisions of social relationships and adaptation to stress. In: Jones WH, Perlman D, editors. Advances in personal relationships. Vol. 1. Greenwich, CT: JAI Press; 1987. pp. 37–67. [ Google Scholar ]
• Cutrona CE, Russell DW. Social support: An interactional view. Oxford: John Wiley & Sons; 1990. Type of social support and specific stress: Toward a theory of optimal matching; pp. 319–366. [ Google Scholar ]
• Cutrona CE, Suhr JA. Controllability of stressful events and satisfaction with spouse support behaviors. Communication Research. 1992; 19 :154–174. [ Google Scholar ]
• Dakof GA, Taylor SE. Victims perceptions of social support: What is helpful from whom? Journal of Personality and Social Psychology. 1990; 58 :80–89. [ PubMed ] [ Google Scholar ]
• Deci EL, LaGuardia JG, Moller AC, Scheiner MJ, Ryan RM. On the benefits of giving as well as receiving autonomy support: Mutuality in close friendships. Personality and Social Psychology Bulletin. 2006; 32 :313–327. [ PubMed ] [ Google Scholar ]
• Deci EL, Ryan RM. The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry. 2000; 11 :227–268. [ Google Scholar ]
• Deci EL, Ryan RM. Handbook of self-determination research. Rochester, NY: University of Rochester Press; 2002. [ Google Scholar ]
• DeLongis A, Folkman S, Lazarus RS. The impact of daily stress on health and mood: Psychological and social resources as mediators. Journal of Personality and Social Psychology. 1988; 54 :486–495. [ PubMed ] [ Google Scholar ]
• Denson TF, Spanovic M, Miller N, Denson TF. Cognitive appraisals and emotions predict cortisol and immune responses: A meta-analysis of acute laboratory social stressors and emotion inductions. Psychological Bulletin. 2009; 135 :823–853. [ PubMed ] [ Google Scholar ]
• Derogatis L, Melisaratos N. The Brief Symptom Inventory: An introductory report. Psychological Medicine. 1983; 13 :595–605. [ PubMed ] [ Google Scholar ]
• Dickerson SS, Gruenewald TL, Kemeny ME. When the social self is threatened: Shame, physiology, and health. Journal of Personality. 2004; 72 :1191–1216. [ PubMed ] [ Google Scholar ]
• Deiner E. Assessing subjective well-being: Progress and opportunities. Social Indicators Research. 1994; 31 :103–157. [ Google Scholar ]
• Diener E, Diener C. Most people are happy. Psychological Science. 1996; 7 :181–4. [ Google Scholar ]
• Diener E, Fujita F. Resources, personal strivings, and subjective well-being: A nomothetic and idiographic approach. Journal of Personality and Social Psychology. 1995; 68 :926–935. [ PubMed ] [ Google Scholar ]
• Diener E, Lucas R, Scollon CN. Beyond the hedonic treadmill: Revising the adaptation theory of well-being. American Psychologist. 2006; 61 :305–314. [ PubMed ] [ Google Scholar ]
• Diener E, Suh EM, Lucas R, Smith HL. Subjective well-being: Three decades of progress. Psychological Bulletin. 1999; 125 :276–302. [ Google Scholar ]
• Diener E, Wirtz D, Tov W, Kim-Prieto C, Choi D, Oishi S, Biswas-Diener R. New well-being measures: Short scales to assess flourishing and positive and negative feelings. Social Indicators Research. 2010; 97 (2):143–156. [ Google Scholar ]
• Ditzen B, Hoppmann C, Klumb P. Positive couple interactions and daily cortisol: On the stress-protective role of intimacy. Psychosomatic Medicine. 2008; 70 :883–889. [ PubMed ] [ Google Scholar ]
• Ditzen B, Neumann ID, Bodenmann G, von Dawans B, Turner RA, Ehlert U, Heinrichs M. Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. Psychoneuroendocrinology. 2007; 32 :565–574. [ PubMed ] [ Google Scholar ]
• Dowling EM, Gestsdottir S, Anderson PM, von Eye A, Lerner RM. Spirituality, Religiosity, and Thriving Among Adolescents: Identification and Confirmation of Factor Structures. Applied Developmental Science. 2003; 7 :253–260. [ Google Scholar ]
• Downey G, Feldman SI. Implications of rejection sensitivity for intimate relationships. Journal of Personality and Social Psychology. 1996; 70 :1327–1343. [ PubMed ] [ Google Scholar ]
• Drigotas SM. The Michelangelo phenomenon and personal well-being. Journal of Personality. 2002; 70 :59–77. [ PubMed ] [ Google Scholar ]
• Drigotas SM, Rusbult CE, Wieselquist J, Whitton SW. Close partner as sculptor of the ideal self: Behavioral affirmation and the Michelangelo Phenomenon. Journal of Personality and Social Psychology. 1999; 77 :293–323. [ PubMed ] [ Google Scholar ]
• Duckworth AL, Peterson C, Matthews MD, Kelly DR. Grit: Perseverance and passion for long-term goals. Journal of Personality and Social Psychology. 2007; 92 :1087–1101. [ PubMed ] [ Google Scholar ]
• Dunkel-Schetter C, Bennett TL. Social support: An interactional view. Oxford: John Wiley & Sons; 1990. Differentiating the cognitive and behavioral aspects of social support; pp. 267–296. [ Google Scholar ]
• Dunkel Schetter C, Blasband DE, Feinstein LG, Herbert TB. Elements of supportive interactions: When are attempts to help effective? In: Spacapan S, Oskamp S, editors. Helping and being helped: Naturalistic studies. The Claremont Symposium on Applied Psychology. Newbury Park, CA: Sage; 1992. pp. 83–114. [ Google Scholar ]
• Dunkel Schetter C, Folkman S, Lazarus R. Correlates of social support receipt. Journal of Personality and Social Psychology. 1987; 53 :71–80. [ PubMed ] [ Google Scholar ]
• Dunn EW, Aknin LB, Norton MI. Spending money on others promotes happiness. Science. 2008; 319 :1687–1688. [ PubMed ] [ Google Scholar ]
• Dunn J, Occhipinti S, Campbell A, Ferguson M, Chambers SK. Benefit finding after cancer: The role of optimism, intrusive thinking and social environment. Journal of Health Psychology. 2011; 16 :169–177. [ PubMed ] [ Google Scholar ]
• Ebner NC, Freund AM, Baltes PB. Developmental changes in personal goal orientation from young to late adulthood: From striving for gains to maintenance and prevention of losses. Psychology and Aging. 2006; 21 :664–678. [ PubMed ] [ Google Scholar ]
• Eisenberger NI, Cole SW. Social neuroscience and health: neurophysiological mechanisms linking social ties with physical health. Nature Neuroscience. 2012; 15 :669–674. [ PubMed ] [ Google Scholar ]
• Eisenberger NI, Taylor SE, Gable SL, Hilmert CJ, Lieberman MD. Neural pathways link social support to attenuated neuroendocrine stress responses. Neuroimage. 2007; 35 :1601–1612. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Eisenberger NI, Master SL, Inagaki TK, Taylor SE, Shirinyan D, Lieberman MD, Naliboff BD. Attachment figures activate a safety signal-related neural region and reduce pain experience. Proc Natl Acad Sci. 2011; 108 :11721–11726. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Elliot AJ. Handbook of approach and avoidance motivation. New York, NY: Psychology Press; 2008. [ Google Scholar ]
• Elliot AJ, Reis HT. Attachment and exploration in adulthood. Journal of Personality and Social Psychology. 2003; 85 :317–331. [ PubMed ] [ Google Scholar ]
• Emmons RA. Personal strivings: An approach to personality and subjective well-being. Journal of Personality and Social Psychology. 1986; 51 :1058–1068. [ Google Scholar ]
• Emmons RA. Personal strivings, daily life events, and psychological and physical well-being. Journal of Personality. 1991; 59 :453–472. [ PubMed ] [ Google Scholar ]
• Emmons RA, King LA. Conflict among personal strivings: Immediate and long-term implications for psychological and physical well-being. Journal of Personality and Social Psychology. 1988; 54 :1040–1048. [ PubMed ] [ Google Scholar ]
• Emmons RA, McCullough ME. Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology. 2003; 84 :377–389. [ PubMed ] [ Google Scholar ]
• Epel ES, McEwen ES, Ickovics JR. Embodying psychological thriving: Physical thriving in response to stress. Journal of Social Issues. 1998; 54 :301–322. [ Google Scholar ]
• Feeney BC. A secure base: Responsive support of goal strivings and exploration in adult intimate relationships. Journal of Personality and Social Psychology. 2004; 87 :631–648. [ PubMed ] [ Google Scholar ]
• Feeney BC. The dependency paradox in close relationships: Accepting dependence promotes independence. Journal of Personality and Social Psychology. 2007; 92 :268–285. [ PubMed ] [ Google Scholar ]
• Feeney BC, Cassidy J, Ramos-Marcuse F. The generalization of attachment representations to new social situations: Predicting behavior during initial interactions with strangers. Journal of Personality and Social Psychology. 2008; 95 :1481–1498. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Feeney BC, Collins NL. Predictors of caregiving in adult intimate relationships: An attachment theoretical perspective. Journal of Personality and Social Psychology. 2001; 80 :972–994. [ PubMed ] [ Google Scholar ]
• Feeney BC, Collins NL. Motivations for caregiving in adult intimate relationships: Influences on caregiving behavior and relationship functioning. Personality and Social Psychology Bulletin. 2003; 29 :950–968. [ PubMed ] [ Google Scholar ]
• Feeney BC, Collins NL. The Thriving Assessment Questionnaire and the Source of Strength and Relational Catalyst Support Survey. Carnegie Mellon University; 2014. Unpublished research instruments. [ Google Scholar ]
• Feeney BC, Collins NL, Van Vleet, Tomlinson Motivations for providing a secure base: Links with attachment orientation and secure base support behavior. Attachment & Human Development. 2013; 15 :261–280. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Feeney BC, Kirkpatrick LA. Effects of adult attachment and presence of romantic partners on physiological responses to stress. Journal of Personality and Social Psychology. 1996; 70 :255–270. [ PubMed ] [ Google Scholar ]
• Feeney BC, Lemay EP. Surviving Relationship Threats: The role of emotional capital. Personality and Social Psychology Bulletin. 2012; 38 :1004–1017. [ PubMed ] [ Google Scholar ]
• Feeney BC, Thrush RL. Relationship influences on exploration in adulthood: The characteristics and function of a secure base. Journal of Personality and Social Psychology. 2010; 98 :57–76. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Feeney BC, Van Vleet M. Growing through attachment: The interplay of attachment and exploration in adulthood. Journal of Social and Personal Relationships. 2010; 27 :226–234. [ Google Scholar ]
• Feeney JA. Attachment, caregiving, and marital satisfaction. Personal Relationships. 1996; 3 :401–416. [ Google Scholar ]
• Fincham FD, Bradbury TN. Social support in marriage: The role of social cognition. Journal of Social and Clinical Psychology. 1990; 9 :31–42. [ Google Scholar ]
• Fitzsimons GM, Finkel EJ. Outsourcing self-regulation. Psychological Science. 2011; 22 :369–375. [ PubMed ] [ Google Scholar ]
• Fitzsimons GM, Fishbach A. Shifting closeness: Interpersonal effects of personal goal progress. Journal of Personality and Social Psychology. 2010; 98 :535–549. [ PubMed ] [ Google Scholar ]
• Fitzsimons GM, Shah JY. How goal instrumentality shapes relationship evaluations. Journal of Personality and Social Psychology. 2008; 95 :319–337. [ PubMed ] [ Google Scholar ]
• Folkman S, Lazarus RS, Dunkel-Schetter C, DeLongis A, Gruen RJ. Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology. 1986; 50 :92–103. [ PubMed ] [ Google Scholar ]
• Folkman S, Moskowitz JT. Stress, positive emotion, and coping. Current Directions in Psychological Science. 2000; 9 :115–118. [ Google Scholar ]
• Forbes EE, Dahl RE. Neural Systems of Positive Affect: Relevance to Understanding Child and Adolescent Depression? Development and Psychopathology. 2005; 17 :827–850. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Forster LE, Stoller EP. The Impact of Social Support or Mortality: A Seven-Year Follow- Up of Older Men and Women. Journal of Applied Gerontology. 1992; 11 :172–186. [ Google Scholar ]
• Fredrickson BL. Cultivating positive emotions to optimize health and well-being. Prevention & Treatment. 2000; 3 :1–25. [ Google Scholar ]
• Fredrickson BL. The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist. 2001; 56 :218–226. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Fredrickson BL. Positivity: Groundbreaking research reveals how to embrace the hidden strength of positive emotions, overcome negativity, and thrive. Crown Publishers; New York, NY: 2009. [ Google Scholar ]
• Fredrickson BL, Mancuso RA, Branigan C, Tugade MM. The undoing effect of positive emotions. Motivation and Emotion. 2000; 24 :237–258. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Friedman EM, Ryff CD. Living well with medical comorbidities: A biopsychosocial perspective. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 2012; 67 :535–544. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Gable SL. Approach and avoidance social motives and goals. Journal of Personality. 2006; 74 :175–122. [ PubMed ] [ Google Scholar ]
• Gable SL, Gonzaga GC, Strachman A. Will you be there for me when things go right? Supportive responses to positive event disclosures. Journal of Personality and Social Psychology. 2006; 91 :904–917. [ PubMed ] [ Google Scholar ]
• Gable SL, Gosnell CL, Maisel NC, Strachman A. Safely testing the alarm: Close others’ responses to personal positive events. Journal of Personality and Social Psychology. 2012; 103 :963–981. [ PubMed ] [ Google Scholar ]
• Gable SL, Reis HT. Good news! Capitalizing on personal events in an interpersonal context. Advances in Experimental Social Psychology. 2010; 42 :195–257. [ Google Scholar ]
• Gable SL, Reis HT, Impett EA, Asher ER. What do you do when things go right? The intrapersonal and interpersonal benefits of sharing positive events. Journal of Personality and Social Psychology. 2004; 87 :228–245. [ PubMed ] [ Google Scholar ]
• Gailliot MT. The effortful and energy-demanding nature of prosocial behavior. In: Mikulincer M, Shaver PR, editors. Prosocial motives, emotions, and behavior: The better angels of our nature. Washington, DC: American Psychological Association; 2010. pp. 169–180. [ Google Scholar ]
• Gerin W, Pieper C, Levy R, Pickering TG. Social support in social interaction: A moderator of cardiovascular reactivity. Psychosomatic Medicine. 1992; 54 :324–336. [ PubMed ] [ Google Scholar ]
• Giuliani NR, McRae K, Gross JJ. The up- and down-regulation of amusement: Experiential, behavioral, and autonomic consequences. Emotion. 2008; 8 :714–719. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Gleason MJ, Iida M, Bolger N, Shrout PE. Daily supportive equity in close relationships. Personality and Social Psychology Bulletin. 2003; 29 :1036–1045. [ PubMed ] [ Google Scholar ]
• Gleason MEJ, Iida M, Shrout PE, Bolger N. Receiving support as a mixed blessing: Evidence for dual effects of support on psychological outcomes. Journal of Personality and Social Psychology. 2008; 94 :824–838. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Gore JS, Cross SE. Pursuing goals for us: Relationally autonomous reasons in long-term goal pursuit. Journal of Personality and Social Psychology. 2006; 90 :848–861. [ PubMed ] [ Google Scholar ]
• Gore JS, Cross SE. Relational self-construal moderates the link between goal coherence and well-being. Self And Identity. 2010; 9 :41–61. [ Google Scholar ]
• Graziano WG, Habashi MM, Sheese BE, Tobin RM. Agreeableness, empathy, and helping: A person x situation perspective. Journal of Personality and Social Psychology. 2007; 93 :583–599. [ PubMed ] [ Google Scholar ]
• Hawkley LC, Cacioppo JT. Loneliness and pathways to disease. Brain, Behavior, and Immunity. 2003; 17 :98–105. [ PubMed ] [ Google Scholar ]
• Heaphy ED, Dutton JE. Positive social interactions and the human body at work: Linking organizations and physiology. The Academy of Management Review. 2008; 33 :137–162. [ Google Scholar ]
• Helgeson VS. Two important distinctions in social support: Kind of support and perceived versus received. Journal of Applied Social Psychology. 1993; 23 :825–845. [ Google Scholar ]
• Helgeson VS, Cohen S. Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. Health Psychology. 1996; 15 :135–148. [ PubMed ] [ Google Scholar ]
• Helgeson VS, Cohen S, Schulz R, Yasko J. Group support interventions for people with cancer: Who benefits from what? Health Psychology. 2000; 19 :107–114. [ PubMed ] [ Google Scholar ]
• Helgeson VS, Lopez LC. Social support and growth following adversity. In: Reich JW, Zautra AJ, Hall JS, editors. Handbook of adult resilience. New York: Guilford Publications; 2010. pp. 309–330. [ Google Scholar ]
• Helgeson VS, Reynolds KA, Tomich PL. A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology. 2006; 74 :797–816. [ PubMed ] [ Google Scholar ]
• Helliwell JF, Layard R, Sachs J. World happiness report. The Earth Institute: Columbia University; 2013. [ Google Scholar ]
• Henderson LW, Knight T. Integrating the hedonic and eudaimonic perspectives to more comprehensively understand wellbeing and pathways to wellbeing. International Journal of Wellbeing. 2012; 2 (3):196–221. doi: 10.5502/ijw.v2i3.3. [ CrossRef ] [ Google Scholar ]
• Herbert TB, Cohen S. Stress and immunity in humans: A meta-analytic review. Psychosomatic Medicine. 1993; 55 :364–379. [ PubMed ] [ Google Scholar ]
• Higgins ET. Beyond pleasure and pain. American Psychologist. 1997; 52 :1280–1300. [ PubMed ] [ Google Scholar ]
• Holt-Lunstad J, Smith TB. Social relationships and mortality. Social and Personality Psychology Compass. 2012; 6 :41–53. [ Google Scholar ]
• Hough LM. The ‘Big Five’ personality variables—construct confusion: Description versus prediction. Human Performance. 1992; 5 :139–155. [ Google Scholar ]
• Howland M, Simpson JA. Getting in under the radar: A dyadic view of invisible support. Psychological Science. 2010; 21 :1878–1885. [ PubMed ] [ Google Scholar ]
• Hu Y, Stewart-Brown S, Twigg L, Weich S. Can the 12-item General Health Questionnaire be used to measure positive mental health? Psychological Medicine. 2007; 37 :1005–1013. [ PubMed ] [ Google Scholar ]
• Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging. 2004; 26 :655–672. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Impett EA, Gable SL, Peplau L. Giving up and giving in: The costs and benefits of daily sacrifice in intimate relationships. Journal of Personality and Social Psychology. 2005; 89 (3):327–344. [ PubMed ] [ Google Scholar ]
• Inagaki TK, Eisenberger NI. Neural correlates of giving support to a loved one. Psychosomatic Medicine. 2012; 74 :3–7. [ PubMed ] [ Google Scholar ]
• Jakubiak BK, Feeney BC. Keep in touch: The effects of imagined touch support on exploration and pain reactivity. 2014 Manuscript submitted for publication. [ Google Scholar ]
• Johnson R, Hobfoll SE, Zalcberg-Linetzy A. Social support knowledge and behavior and relational intimacy: A dyadic study. Journal of Family Psychology. 1993; 6 :266–277. [ Google Scholar ]
• Joseph S, Murphy D, Regel S. An Affective–Cognitive Processing Model of Post-Traumatic Growth. Clinical Psychology & Psychotherapy 2012 [ PubMed ] [ Google Scholar ]
• Julien D, Markman HJ. Social support and social networks as determinants of individual and marital outcomes. Journal of Social and Personal Relationships. 1991; 8 :549–568. [ Google Scholar ]
• Kane HS, McCall C, Collins NL, Blascovich JA. Mere presence is not enough: Responsive support in a virtual world. Journal of Experimental Social Psychology. 2012; 48 :37–44. [ Google Scholar ]
• Kaplan M, Maddux JE. Goals and marital satisfaction: Perceived support for personal goals and collective efficacy for collective goals. Journal of Social and Clinical Psychology. 2002; 21 :157–164. [ Google Scholar ]
• Kashdan TB, McKnight PE, Fincham FD, Rose P. When curiosity breeds intimacy: Taking advantage of intimacy opportunities and transforming boring conversations. Journal of Personality. 2011; 79 :1067–10099. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Kashdan TB, Silvia PJ. Curiosity and interest: The benefits of thriving on novelty and challenge. In: Lopez SJ, Snyder CR, editors. Oxford handbook of positive psychology. New York, NY: Oxford University Press; 2009. pp. 367–374. [ Google Scholar ]
• Kawachi I, Berkman LF. Social ties and mental health. Journal of Urban Health. 2001; 78 :458–467. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Kessler RC, McLeod JD. Sex differences in vulnerability to undesirable life events. American Sociological Review. 1984; 49 :620–631. [ Google Scholar ]
• Keyes CLM. Flourishing: Positive psychology and the life well-lived. Washington, DC: American Psychological Association; 2003. Complete mental health: An agenda for the 21st century; pp. 293–312. [ Google Scholar ]
• Keyes CLM. Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology. 2005; 73 :539–548. [ PubMed ] [ Google Scholar ]
• Keyes CLM. Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist. 2007; 62 :95–108. [ PubMed ] [ Google Scholar ]
• Kiecolt-Glaser JK, Newton TL. Marriage and health: His and hers. Psychological Bulletin. 2001; 127 :472–503. [ PubMed ] [ Google Scholar ]
• Kim HS, Sherman DK, Taylor SE. The irony of cultural psychology research. American Psychologist. 2009; 64 :564–565. [ Google Scholar ]
• King PE, Dowling EM, Mueller RA, White K, Schultz W, Osborn P. Thriving in adolescence: The voices of youth-serving practitioners, parents, and early and late adolescents. Journal of Early Adolescence. 2005; 25 :94–112. [ Google Scholar ]
• Kjaer M, Langberg BF, Miller R, Boushel R, Crameri S, Koskinen K, et al. Metabolic activity and collagen turnover in human tendon in response to physical activity. American Journal of Physical Medicine & Rehabilitation. 2005; 81 :40–51. [ PubMed ] [ Google Scholar ]
• Koltko-Rivera ME. Rediscovering the later version of Maslow’s hierarchy of needs: Self-transcendence and opportunities for theory, research, and unification. Review of General Psychology. 2006; 10 :302–317. [ Google Scholar ]
• Krause N. Anticipated support, received support, and economic stress among older adults. Journal of Gerontology: Psychological Sciences. 1997; 52 :284–293. [ PubMed ] [ Google Scholar ]
• Krieger N, Chen JT, Waterman PD, Rehkopf DH, Subramanian SV. Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: The public health disparities geocoding project. American Journal of Public Health. 2005; 95 :2, 312–323. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Kubzansky LD, Cole SR, Kawachi I, Vokonas P, Sparrow D. Shared and unique contributions of anger, anxiety, and depression to coronary heart disease: A prospective study in the normative aging study. Annals of Behavioral Medicine. 2006; 31 :21–29. [ PubMed ] [ Google Scholar ]
• Kumashiro M, Rusbult CE, Finkenauer C, Stocker SL. To think or to do: The impact of assessment and locomotion orientation on the Michelangelo phenomenon. Journal of Social and Personal Relationships. 2007; 24 :591–611. [ Google Scholar ]
• Kumashiro M, Sedikides C. Taking on board liability-focused information: Close positive relationships as a self-bolstering resource. Psychological Science. 2005; 16 :732–739. [ PubMed ] [ Google Scholar ]
• Kunce LJ, Shaver PR. An attachment-theoretical approach to caregiving in romantic relationships. In: Bartholomew K, Perlman D, editors. Advances in personal relationships. Vol. 5. London: Jessica Kingsley; 1994. pp. 205–237. [ Google Scholar ]
• Lakey B, Cassady B. Cognitive processes in perceived social support. Journal of Personality and Social Psychology. 1990; 59 :337–343. [ Google Scholar ]
• Lakey B, Cronin A. Low social support and major depression: Research, theory and methodological issues. In: Dobson KS, Dozois DJA, editors. Risk factors in depression. San Diego, CA: Elsevier Academic Press; 2008. pp. 385–408. [ Google Scholar ]
• Lakey B, Heller K. Social support from a friend, perceived support, and social problem solving. American Journal of Community Psychology. 1988; 16 :811–824. [ PubMed ] [ Google Scholar ]
• Lakey B, Orehek E. Relational regulation theory: A new approach to explain the link between perceived social support and mental health. Psychological Review. 2011; 118 :482–495. [ PubMed ] [ Google Scholar ]
• Lakey B, Orehek E, Hain KL, VanVleet M. Enacted support’s links to negative affect and perceived support are more consistent with theory when social influences are isolated from trait influences. Personality and Social Psychology Bulletin. 2010; 36 :132–142. [ PubMed ] [ Google Scholar ]
• Lambert NM, Clark MS, Durtschi J, Fincham FD, Graham SM. Benefits of expressing gratitude: Expressing gratitude to a partner changes one’s view of the relationship. Psychological Science. 2010; 21 :574–580. [ PubMed ] [ Google Scholar ]
• Lang FR, Carstensen LL. Close emotional relationships in later life: Further support for proactive aging in the social domain. Psychology and Aging. 1994; 9 :315–324. [ PubMed ] [ Google Scholar ]
• Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984. [ Google Scholar ]
• Lehman DR, Hemphill KJ. Recipients’ perceptions of support attempts and attributions for support attempts that fail. Journal of Social and Personal Relationships. 1990; 7 :563–574. [ Google Scholar ]
• Lelorain S, Tessier P, Florin A, Bonnaud-Antignac A. Posttraumatic growth in long-term breast cancer survivors: Relation to coping, social support and cognitive processing. Journal of Health Psychology. 2012; 17 :627–639. [ PubMed ] [ Google Scholar ]
• Lepore SJ, Allen KM, Evans GW. Social support lowers cardiovascular reactivity to an acute stressor. Psychosomatic Medicine. 1993; 55 :518–524. [ PubMed ] [ Google Scholar ]
• Lepore SJ, Kernan WD. Positive life change and the social context of illness: An expanded social-cognitive processing model. In: Park CL, Lechner SC, Antoni MH, Stanton AL, editors. Medical illness and positive life change: Can crisis lead to personal transformation? Washington, DC: American Psychological Association; 2009. pp. 139–152. [ Google Scholar ]
• Lerner RM, Dowling EM, Anderson PM. Positive youth development: Thriving as the basis of personhood and civil society. Applied Developmental Science. 2003; 7 :172–180. [ PubMed ] [ Google Scholar ]
• Lerner RM, von Eye A, Lerner JV, Lewin-Bizan S, Bowers EP. Special issue introduction: The meaning and measurement of thriving: A view of the issues. Journal of Youth and Adolescence. 2010; 39 :707–719. [ PubMed ] [ Google Scholar ]
• Leung YW, Gravely-Witte S, Macpherson A, Irvine J, Stewart DE, Grace SL. Post-traumatic growth among cardiac outpatients. Journal of Health Psychology. 2010; 15 :1049–1063. [ PubMed ] [ Google Scholar ]
• Linley PA, Joseph S. Positive change following trauma and adversity: A review. Journal of Traumatic Stress. 2004; 17 :1, 11–21. [ PubMed ] [ Google Scholar ]
• Little BR, Salmela-Aro K, Phillips SD. Personal project pursuit: Goals, action, and human flourishing. Mahwah, NJ: Lawrence Erlbaum Associates; 2007. [ Google Scholar ]
• Luszczynska A, Mohamed NE, Schwarzer R. Self-efficacy and social support predict benefit finding 12 months after cancer surgery: The mediating role of coping strategies. Psychology, Health & Medicine. 2005; 10 :365–375. [ Google Scholar ]
• Lyubomirsky S, Sheldon KM, Schkade D. Pursuing happiness: The architecture of sustainable change. Review of General Psychology. 2005; 9 :111–131. [ Google Scholar ]
• Maisel NC, Gable SL. The paradox of received social support: The importance of responsiveness. Psychological Science. 2009; 20 :928–932. [ PubMed ] [ Google Scholar ]
• Marazziti D, Bani A, Casamassima F, Catena M, Consoli G, Gesi C, Iovieno N, Massei GJ, Muti M, Ravani L, Romano A, Roncaglia I, Scarpellini P. Oxytocin: An old hormone for new avenues. Clinical Neuropsychiatry: Journal of Treatment Evaluation. 2006; 3 :302–321. [ Google Scholar ]
• Martin RA. Is laughter the best medicine? Humor, laughter, and physical health. Current Directions in Psychological Science. 2002; 11 :216–220. [ Google Scholar ]
• Maslow AH. Some basic propositions of growth and self-actualization psychology. In: Cooper CL, Pervin LA, editors. Personality: Critical concepts in Psychology. London: Routledge; 1998. pp. 189–204. [ Google Scholar ]
• Maslow AH. Towards a psychology of being. Radford, VA: Wilder Publications; 2011. [ Google Scholar ]
• Master SL, Eisenberger NI, Taylor SE, Naliboff BD, Shirinyan D, Lieberman MD. A picture’s worth: Partner photographs reduce experimentally induced pain. Psychological Science. 2009; 20 :1316–1318. [ PubMed ] [ Google Scholar ]
• Mensah GA, Mokdad AH, Ford ES, Greenlund KJ, Croft JB. State of disparities in cardiovascular health in the United States. Circulation. 2005; 111 :1233–1241. [ PubMed ] [ Google Scholar ]
• Mikulincer M, Florian V. Appraisal of and coping with a real-life stressful situation: The contribution of attachment styles. Personality And Social Psychology Bulletin. 1995; 21 :406–414. [ Google Scholar ]
• Mikulincer M, Gillath O, Shaver PR. Activation of the attachment system in adulthood: Threat-related primes increase the accessibility of mental representations of attachment figures. Journal of Personality and Social Psychology. 2002; 83 :881–895. [ PubMed ] [ Google Scholar ]
• Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change. New York: Guilford Press; 2007. [ Google Scholar ]
• Mikulincer M, Shaver PR. An attachment and behavioral systems perspective on social support. Journal of Social and Personal Relationships. 2009; 26 :7–19. [ Google Scholar ]
• Miller WR, Brown JM. Self-regulation as a conceptual basis for the prevention and treatment of addictive behaviors. In: Heather N, Miller WR, Greeley J, editors. Self-control and the addictive behaviors. Sydney: Maxwell Macmillan Publishing Australia; 1991. pp. 3–79. [ Google Scholar ]
• Miller GE, Chen E, Cole SW. Health psychology: Developing biologically plausible models linking the social world and physical health. Annual Review of Psychology. 2009; 60 :501–524. [ PubMed ] [ Google Scholar ]
• Miller GE, Lachman ME, Chen E, Gruenewald TL, Karlamangla AS, Seeman TE. Pathways to resilience: Maternal nurturance as a buffer against the effects of childhood poverty on metabolic syndrome at midlife. Psychological Science. 2011; 22 :1591–1599. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Mills Clark, Ford, Johnson Measurement of communal strength. Personal Relationships. 2004; 11 :213–230. [ Google Scholar ]
• Monin JK, Schulz R, Feeney BC, Cook TB. Attachment insecurity and perceived partner suffering as predictors of personal distress. Journal of Experimental Social Psychology. 2010; 46 :1143–1147. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Moore D. Parent–adolescent separation: The construction of adulthood by late adolescents. 1987. [ Google Scholar ]
• Moore KA, Lippman LH. What Do Children Need to Flourish? Conceptualizing and Measuring Indicators of Positive Development. New York: Springer Science+Business Media; 2005. [ Google Scholar ]
• Morris BA, Campbell M, Dwyer M, Dunn J, Chambers SK. Survivor identity and post- traumatic growth after participating in challenge-based peer-support programmes. British Journal of Health Psychology. 2011; 16 :660–674. [ PubMed ] [ Google Scholar ]
• Mortenson ST. Interpersonal trust and social skill in seeking social support among Chinese and Americans. Communication Research. 2009; 36 :32–53. [ Google Scholar ]
• Muraven M, Tice D, Baumeister RF. Self-control as a limited resource: Regulatory depletion patterns. Journal of Personality and Social Psychology. 1998; 74 :774–789. [ PubMed ] [ Google Scholar ]
• Murray SL. Regulating the risks of closeness: A relationship-specific sense of felt security. Current Directions in Psychological Science. 2005; 14 :74–78. [ Google Scholar ]
• Murray SL, Bellavia G, Feeney B, Holmes JG, Rose P. The contingencies of interpersonal acceptance: When romantic relationships function as a self affirmational resource. Motivation and Emotion. 2001; 25 :163–189. [ Google Scholar ]
• Murray SL, Holmes JG, Griffin DW. Self-esteem and the quest for felt security: How perceived regard regulates attachment processes. Journal of Personality and Social Psychology. 2000; 78 :478–498. [ PubMed ] [ Google Scholar ]
• Neff LA, Karney BR. Stress and reactivity to daily relationship experiences: How stress hinders adaptive processes in marriage. Journal of Personality and Social Psychology. 2009; 97 :435–450. [ PubMed ] [ Google Scholar ]
• Newsom JT, Mahan TL, Rook KS, Krause N. Stable negative social exchanges and health. Health Psychology. 2008; 27 :78–86. [ PubMed ] [ Google Scholar ]
• Nils F, Rimé B. Beyond the myth of venting: Social sharing modes determine the benefits of emotional disclosure. European Journal of Social Psychology. 2012; 42 :672–681. doi: 10.1002/ejsp.1880. [ CrossRef ] [ Google Scholar ]
• Noom MM, Dekovic M, Meeus WHJ. Autonomy, attachment and psychosocial adjustment during adolescence: A doubleedged sword? Journal of Adolescence. 1999; 22 :771–783. [ PubMed ] [ Google Scholar ]
• Ognibene TC, Collins NL. Adult attachment styles, perceived social support and coping strategies. Journal Of Social And Personal Relationships. 1998; 15 :323–345. [ Google Scholar ]
• Omodei MM, Wearing AJ. Need satisfaction and involvement in personal projects: Toward an integrative model of subjective well-being. Journal of Personality and Social Psychology. 1990; 59 :762–769. [ Google Scholar ]
• O’Reilly D, Connolly S, Rosato M, Patterson C. Is caring associated with an increased risk of mortality? A longitudinal study. Social Science & Medicine. 2008; 67 :1282–90. [ PubMed ] [ Google Scholar ]
• Palys TS, Little BR. Perceived life satisfaction and the organization of personal project systems. Journal of Personality and Social Psychology. 1983; 44 :1221–1230. [ Google Scholar ]
• Park CL. Stress-related growth and thriving through coping: The roles of personality and cognitive processes. Journal of Social Issues. 1998; 54 :267–277. [ Google Scholar ]
• Pasch LA, Bradbury TN. Social support, conflict, and the development of marital dysfunction. Journal of Consulting and Clinical Psychology. 1998; 66 :219–230. [ PubMed ] [ Google Scholar ]
• Pennix BWJH, van Tilburg T, Kriegsman DMW, Deeg DJH, Boeke AJP, van Eijk J. Effects of Social Support and Personal Coping Resources on Mortality in Older Age: The Longitudinal Aging Study Amsterdam. American Journal of Epidemiology. 1997; 146 :510–519. [ PubMed ] [ Google Scholar ]
• Pierce GR, Baldwin MW, Lydon JE. A relational schema approach to social support. In: Pierce GR, Lakey B, Sarason IG, Sarason BR, editors. Sourcebook of social support and personality. New York: Plenum Press; 1997. pp. 19–47. [ Google Scholar ]
• Pierce GR, Sarason BR, Sarason IG. General and specific support expectations and stress as predictors of perceived supportiveness: An experimental study. Journal of Personality and Social Psychology. 1992; 63 :297–307. [ PubMed ] [ Google Scholar ]
• Pietromonaco PR, Uchino B, Dunkel Schetter C. Close relationship processes and health: Implications of attachment theory for health and disease. Health Psychology. 2013; 32 :499–513. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Piferi RL, Lawler KA. Social support and ambulatory blood pressure: An examination of both receiving and giving. Int J Psychophysiology. 2006; 62 :328–336. [ PubMed ] [ Google Scholar ]
• Powell T, Gilson R, Collin C. TBI 13 years on: factors associated with post-traumatic growth. Disability and Rehabilitation. 2012; 34 :1461–1467. [ PubMed ] [ Google Scholar ]
• Prati G, Pietrantoni L. Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma. 2009; 14 :364–388. [ Google Scholar ]
• Pressman SD, Cohen S. Does positive affect influence health? Psychological Bulletin. 2005; 131 :925–971. [ PubMed ] [ Google Scholar ]
• Pressman SD, Matthews KA, Cohen S, Martire LM, Scheier M, Baum A, et al. Association of enjoyable leisure activities with psychological and physical well-being. Psychosomatic Medicine. 2009; 71 :725–732. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Rafaeli E, Gleason MJ. Skilled support within intimate relationships. Journal of Family Theory and Review. 2009; 1 :20–37. [ Google Scholar ]
• Rasmussen HN, Scheier MF, Greenhouse JB. Optimism and physical health: A meta-analytic review. Annals of Behavioral Medicine. 2009; 37 :239–256. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Reis H. Perceived partner responsiveness as an organizing theme for the study of relationships and well-being. In: Campbell L, Loving TJ, editors. Interdisciplinary research on close relationships: The case for integration. Washington, DC: American Psychological Association; 2012. pp. 27–52. [ Google Scholar ]
• Reis HT, Clark MS, Holmes JG. Perceived partner responsiveness as an organizing construct in the study of intimacy and closeness. In: Mashek DJ, Aron A, editors. Handbook of closeness and intimacy. Mahwah, NJ: Lawrence Erlbaum Associates; 2004. [ Google Scholar ]
• Reis HT, Patrick BC. Attachment and intimacy: Component processes. In: Higgins ET, Kruglanski AW, editors. Social psychology: Handbook of basic principles. New York: Guilford Press; 1996. pp. 523–563. [ Google Scholar ]
• Reis HT, Shaver P. Intimacy as an interpersonal process. In: Duck S, Hay DF, editors. Handbook of personal relationships: Theory, research, and interventions. Chichester, England: Wiley; 1988. pp. 367–389. [ Google Scholar ]
• Reis HT, Smith S, Carmichael C, Caprariello P, Tsai F, Rodrigues A, Maniaci MR. Are you happy for me? How sharing positive events with others provides personal and interpersonal benefits. Journal of Personality and Social Psychology. 2010; 99 :311–329. [ PubMed ] [ Google Scholar ]
• Rempel JK, Holmes JG, Zanna MP. Trust in close relationships. Journal of Personality and Social Psychology. 1985; 49 :95–112. [ PubMed ] [ Google Scholar ]
• Revenson TA. Scenes from a marriage: Examining support, coping and gender within the context of chronic illness. In: Suls J, Wallston KA, editors. Social psychological foundations of health and illness. Malden: Blackwell Publishing; 2003. pp. 530–559. [ Google Scholar ]
• Rini C, Dunkel Schetter C. The effectiveness of support attempts in intimate relationships. In: Sullivan KT, Davila J, editors. Support processes in intimate relationships. New York: Oxford University Press; 2010. pp. 26–67. [ Google Scholar ]
• Rini C, Dunkel Schetter C, Hobel CJ, Glynn LM, Sandman CA. Effective social support: Antecedents and consequences of partner support during pregnancy. Personal Relationships. 2006; 13 :207–229. [ Google Scholar ]
• Robbins SB, Lee RM, Wan TTH. Goal continuity as a mediator of early retirement adjustment: Testing a multidimensional model. Journal of Counseling Psychology. 1994; 41 :18–26. [ Google Scholar ]
• Rogers CR. On becoming a person. Oxford, England: Houghton Mifflin; 1961. [ Google Scholar ]
• Rook KS. The negative side of social interaction: Impact on psychological well-being. Journal of Personality and Social Psychology. 1984; 45 :1097–1108. [ PubMed ] [ Google Scholar ]
• Rook KS, Mavandadi S, Sorkin DH, Zettel LA. Optimizing social relationships as a resource for health and well-being in later life. In: Aldwin CM, Park CL, editors. Handbook of health psychology and aging. New York, NY: Guilford Press; 2007. pp. 267–285. [ Google Scholar ]
• Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965. [ Google Scholar ]
• Ruehlman LS, Wolchik SA. Personal goals and interpersonal support and hindrance as factors in psychological distress and well-being. Journal of Personality and Social Psychology. 1988; 55 :293–301. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Rusbult CE, Finkel EJ, Kumashiro M. The Michelangelo phenomenon. Current Directions in Psychological Science. 2009; 18 :305–309. [ Google Scholar ]
• Rusbult CE, Kumashiro M, Stocker SL, Kirchner JL, Finkel EJ, Coolsen MK. Self processes in interdependent relationships: Partner affirmation and the Michelangelo phenomenon. Interaction Studies. 2005; 6 :375–391. [ Google Scholar ]
• Rusbult CE, Martz JM, Agnew CR. The investment model scale: Measuring commitment level, satisfaction level, quality of alternatives, and investment size. Personal Relationships. 1998; 5 :357–391. [ Google Scholar ]
• Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist. 2000; 55 :68–78. [ PubMed ] [ Google Scholar ]
• Ryff CD. In the eye of the beholder: Views of psychological well-being among middle-aged and older adults. Psychology and Aging. 1989; 4 :195–210. [ PubMed ] [ Google Scholar ]
• Ryff CD, Keyes CLM. The structure of psychological well-being revisited. Journal of Personality and Social Psychology. 1995; 69 :719–727. [ PubMed ] [ Google Scholar ]
• Ryff CD, Singer BH. The contours of positive human health. Psychological Inquiry. 1998; 9 :1–28. [ Google Scholar ]
• Ryff CD, Singer BH. Interpersonal flourishing: A positive health agenda for the new millenium. Personality and Social Psychology Review. 2000; 2000 :30–44. [ Google Scholar ]
• Ryff CD, Singer BH. Best news yet on the six-factor model of well-being. Social Science Research. 2006; 35 (4):1103–1119. [ Google Scholar ]
• Ryff CD, Singer BH. Know thyself and become what you are: A eudaimonic approach to psychological well-being. Journal of Happiness Studies. 2008; 9 :13–39. [ Google Scholar ]
• Ryff CD, Singer BH, Dienberg Love G. Positive health: Connecting well-being with biology. Philosophical Transactions of the Royal Society of London Series B, Biological Sciences. 2004; 359 :1383–1394. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Ryff CD, Singer BH, Palmersheim KA. How healthy are we?: A national study of well-being at midlife. Chicago: The University of Chicago Press; 2004. Social inequalities in health and well- being: The role of relational and religious protective factors; pp. 90–123. [ Google Scholar ]
• Sarason BR, Pierce GR, Shearin EN, Sarason IG, Waltz JA, Poppe L. Perceived social support and working models of self and actual others. Journal of Personality and Social Psychology. 1991; 60 :273–287. [ Google Scholar ]
• Sarason BR, Sarason IG, Gurung RAR. Close personal relationships and health outcomes: A key to the role of social support. In: Duck S, editor. Handbook of personal relationships. New York: Plenum Press; 1997. pp. 547–573. [ Google Scholar ]
• Sarason BR, Sarason IG, Pierce GR. Social support: An interactional view. Oxford: John Wiley & Sons; 1990. Social Support: The sense of acceptance and the role of relationships; pp. 97–128. [ Google Scholar ]
• Sarason IG, Sarason BR, Pierce GR. Social support: Global and relationship-based levels of analysis. Journal of Social and Personal Relationships. 1994; 11 :295–312. [ Google Scholar ]
• Sarason BR, Sarason IG, Shearin EN. Social support as an individual difference variable: Its stability, origins, and relational aspects. Journal of Personality and Social Psychology. 1986; 50 :845–855. [ Google Scholar ]
• Sarason IG, Sarason BR, Shearin EN, Pierce GR. A brief measure of social support: Practical and theoretical implications. Journal of Social and Personal Relationships. 1987; 4 :497–510. [ Google Scholar ]
• Scales PC, Benson PL, Leffert N, Blyth DA. Contribution of Developmental Assets to the Prediction of Thriving Among Adolescents. Applied Developmental Science. 2000; 4 :27–46. [ Google Scholar ]
• Scheier MF, Carver CS. On the power of positive thinking: The benefits of being optimistic. Current Directions in Psychological Science. 1993; 2 :26–30. [ Google Scholar ]
• Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A re-evaluation of the Life Orientation Test. Journal of Personality and Social Psychology. 1994; 67 :1063–1078. [ PubMed ] [ Google Scholar ]
• Scheier MF, Wrosch C, Baum A, Cohen S, Martire LM, Matthews KA, Schulz R, Zdaniuk B. The Life Engagement Test: Assessing purpose in life. Journal of Behavioral Medicine. 2006; 29 :291–298. [ PubMed ] [ Google Scholar ]
• Schnall S, Harber KD, Stefanucci JK, Proffitt DR. Social support and the perception of geographical slant. Journal of Experimental Social Psychology. 2008; 44 :1246–1255. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Schneider IK, Konijn EA, Righetti F, Rusbult CE. A healthy dose of trust: The relationship between interpersonal trust and health. Personal Relationships. 2011; 18 :668–676. [ Google Scholar ]
• Schoebi D, Wang Z, Ababkov V, Perrez M. Affective interdependence in married couples’ daily lives: Are there cultural differences in partner effects of anger? Family Science. 2010; 1 :83–92. [ Google Scholar ]
• Schultz W. Multiple reward systems in the brain. Nat Rev Neurosci. 2000; 1 :199–207. [ PubMed ] [ Google Scholar ]
• Scrignaro M, Barni S, Magrin ME. The combined contribution of social support and coping strategies in predicting post-traumatic growth: A longitudinal study on cancer patients. Psycho-Oncology. 2011; 20 :823–831. [ PubMed ] [ Google Scholar ]
• Seeman TE. Health promoting effects of friends and family on health outcomes in older adults. American Journal of Health Promotions. 2000; 14 :362–370. [ PubMed ] [ Google Scholar ]
• Seery MD, Holman EA, Silver RC. Whatever does not kill us: Cumulative lifetime adversity, vulnerability, and resilience. Journal of Personality and Social Psychology. 2010; 99 :1025–1041. [ PubMed ] [ Google Scholar ]
• Seligman MEP. Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment. New York, NY: Free Press; 2002. [ Google Scholar ]
• Seligman MEP. Positive health. Applied Psychology. 2008; 57 :3018. [ Google Scholar ]
• Seligman MEP, Steen TA, Park N, Peterson C. Positive Psychology Progress: Empirical Validation of Interventions. American Psychologist. 2005; 60 :410–421. [ PubMed ] [ Google Scholar ]
• Shah J, Higgins ET. Expectancy × value effects: Regulatory focus as determinant of magnitude and direction. Journal of Personality and Social Psychology. 1997; 73 :447–458. [ PubMed ] [ Google Scholar ]
• Sheldon KM, Abad N, Ferguson Y, Gunz A, Houser-Marko L, Nichols CP, Lyubomirsky S. Persistent pursuit of need-satisfying goals leads to increased happiness: A 6-month experimental longitudinal study. Motivation and Emotion. 2010; 34 :39–48. [ Google Scholar ]
• Sherer M, Maddux JE, Mercandante B, Prentice-dunn S, Jacobs B, Rogers RW. The self-efficacy scale: Construction and validation. Psychological Reports. 1982; 51 :663–671. [ Google Scholar ]
• Sherman DK, Cohen GL. The psychology of self-defense: Self-affirmation theory. In: Zanna MP, editor. Advances in experimental social psychology. Vol. 38. San Diego, CA: Elsevier Academic Press; 2006. pp. 183–242. [ Google Scholar ]
• Simpson JA, Rholes WS, Nelligan JS. Support seeking and support giving within couples in an anxiety-provoking situation: The role of attachment styles. Journal of Personality and Social Psychology. 1992; 62 :434–446. [ Google Scholar ]
• Simpson JA, Rholes WS, Orina MM, Grich J. Working models of attachment, support giving, and support seeking in a stressful situation. Personality and Social Psychology Bulletin. 2002; 28 :598–608. [ Google Scholar ]
• Simpson JA, Winterheld HA, Rholes WS, Orina MM. Working models of attachment and reactions to different forms of caregiving from romantic partners. Journal of Personality and Social Psychology. 2007; 93 :466–477. [ PubMed ] [ Google Scholar ]
• Sirois BC, Burg M. Negative emotion and coronary heart disease: A review. Behavior Modification. 2003; 27 :83–102. [ PubMed ] [ Google Scholar ]
• Slavich GM, Way BM, Eisenberger NI, Taylor SE. Neural sensitivity to social rejection is associated with inflammatory responses to social stress. Proc Natl Acad Sci. 2010; 107 :14817–14822. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Smith AW, Baum A. The influence of psychological factors on restorative function in health and illness. In: Suls J, Wallston KA, editors. Social psychological foundations of health and illness. Malden: Blackwell Publishing; 2003. pp. 432–457. [ Google Scholar ]
• Smith TW, Ruiz JM, Uchino BN. Mental activation of supportive ties, hostility, and cardiovascular reactivity to laboratory stress in young men and women. Health Psychology. 2004; 23 :476–485. [ PubMed ] [ Google Scholar ]
• Smith TW, Uchino BN, Berg CA, Florsheim P, Pearce G, Hawkins M, Henry NJM, Beveridge RM, Skinner MA, Hopkins PN, Yoon H. Associations of self-reports versus spouse ratings of negative affectivity, dominance, and affiliation with coronary artery disease: Where should we look and who should we ask when studying personality and health? Health Psychology. 2008; 27 :676–684. [ PubMed ] [ Google Scholar ]
• Snyder CR, Irving LM, Anderson JR. Hope and health. Handbook of social and clinical psychology: The health perspective. In: Snyder CR, Forsyth DR, editors. Handbook of social and clinical psychology: The health perspective, Pergamon general psychology series 162. Elmsford, NY: Pergamon Press; 1991. pp. 285–305. [ Google Scholar ]
• Solcova I, Sykora J. Relation between psychological hardiness and physiological response. Homeostasis in Health and Disease. 1995; 36 :30–34. [ Google Scholar ]
• Spanagel R, Weiss F. The dopamine hypothesis of reward: Past and current status. Trends in Neurosciences. 1999; 22 :521–527. [ PubMed ] [ Google Scholar ]
• Spanier GB. Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family. 1976; 38 :15–28. [ Google Scholar ]
• Spiegel D, Kimerling R. Group psychotherapy for women with breast cancer: Relationships among social support, emotional expression, and survival. In: Ryff CD, Singer B, editors. Emotion, social relationships, and health. New York: Oxford University Press; 2001. [ Google Scholar ]
• Sprecher S, Fehr B. Compassionate love for close others and humanity. Journal of Social and Personal Relationships. 2005; 22 :629–651. [ Google Scholar ]
• Sroufe LA, Waters E. Attachment as an organizational construct. Child Development. 1977; 48 :1184–1199. [ Google Scholar ]
• Sullivan KT, Pasch LA, Johnson MD, Bradbury TN. Social Support, Problem Solving and the Longitudinal Course of Newlywed Marriage. Journal of Personality and Social Psychology. 2010; 98 :631–644. [ PubMed ] [ Google Scholar ]
• Theokas C, Almerigi JB, Lerner RM, Dowling EM, Benson PL, Scales PC, von Eye Alexander. Conceptualizing and Modeling Individual and Ecological Asset Components Of Thriving in Early Adolescence. Journal of Early Adolescence. 2005; 25 :113–143. [ Google Scholar ]
• Thoits PA. Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior. 2011; 52 (2):145–161. [ PubMed ] [ Google Scholar ]
• Thriving. Merriam-Webster.com. 2013 From http://www.merriam-webster.com/dictionary/thriving .
• Tice DM, Baumeister RF, Shmueli D, Muraven M. Restoring the self: Positive affect helps improve self-regulation following ego depletion. Journal of Experimental Social Psychology. 2007; 43 :3, 379–384. [ Google Scholar ]
• Tsang JA, McCullough ME, Fincham FD. The longitudinal association between forgiveness and relationship closeness and commitment. Journal of Social and Clinical Psychology. 2006; 25 :448–472. [ Google Scholar ]
• Uchino BN. Social support and physical health: Understanding the health consequences of Relationships. New Haven: Yale University Press; 2004. [ Google Scholar ]
• Uchino BN. Understanding the links between social support and physical health: A lifespan perspective with emphasis on the separability of perceived and received support. Perspectives on Psychological Science. 2009; 4 :236–255. [ PubMed ] [ Google Scholar ]
• Uchino BN, Bowen K, Carlisle M, Birmingham W. Psychological pathways linking social support to health outcomes: A visit with “ghosts” of research past, present, and future. Social Science & Medicine. 2012; 74 :949–957. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Uchino BN, Cacioppo JT, Kiecolt-Glaser JK. The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychological Bulletin. 1996; 119 :488–531. [ PubMed ] [ Google Scholar ]
• Uchino BN, Uno D, Holt-Lunstad J. Social support, physiological processes, and health. Current Directions in Psychological Science. 1999; 8 :145–148. [ Google Scholar ]
• Uvnäs-Moberg K. Oxytocin may mediate the benefits of positive social interaction and emotions. Psychoneuroendocrinology. 1998; 23 :819–835. [ PubMed ] [ Google Scholar ]
• Van Vleet M, Feeney BC. A longitudinal investigation of the consequences of secure base support in close relationships. Carnegie Mellon University; 2011. Unpublished Manuscript. [ Google Scholar ]
• VanVleet M, Feeney BC. A comparison of long-term consequences afforded by safe haven and secure base support among newlywed couples. Paper presented at the conference for the Society for Personality and Social Psychology; San Diego, CA. 2012. [ Google Scholar ]
• Vaux A. Social support. New York: Praeger; 1988. [ Google Scholar ]
• Verhofstadt LL, Buysse A, Ickes W, Davis M, Devoldre I. Support provision in marriage: The role of emotional similarity and empathic accuracy. Emotion. 2008; 8 :792–802. [ PubMed ] [ Google Scholar ]
• Verhofstadt LL, Ickes W, Buysse A. “I know what you need right now”: Emapthic accuracy and support provision in marriage. In: Sullivan KT, Davila J, editors. Support processes in intimate relationships. New York: Oxford University Press; 2010. pp. 71–88. [ Google Scholar ]
• Vohs KD, Heatherton TF. Self-regulatory failure: A resource-depletion approach. Psychological Science. 2000; 11 :249–254. [ PubMed ] [ Google Scholar ]
• Wang J, Rao H, Wetmore GS, Furlan PM, Korczykowski M, Dinges DF, Detre JA. Perfusion functional MRI reveals cerebral blood flow pattern under psychological stress. Proc Natl Acad Sci. 2005; 102 :17804–17809. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Waters E, Cummings E. A secure base from which to explore close relationships. Child Development. 2000; 71 :164–172. [ PubMed ] [ Google Scholar ]
• Williamson GM, Clark MS. Providing help and desired relationship type as determinants of changes in moods and self-evaluations. Journal of Personality and Social Psychology. 1989; 56 :722–734. [ PubMed ] [ Google Scholar ]
• Williamson GM, Clark MS, Pegalis LJ, Behan A. Affective consequences of refusing to help in communal and exchange relationships. Personality and Social Psychology Bulletin. 1996; 22 :34–47. [ Google Scholar ]
• Winstead BA, Derlega VJ. Benefits of same-sex friendships in a stressful situation. Journal of Social and Clinical Psychology. 1985; 3 :378–384. [ Google Scholar ]
• Winstead BA, Derlega VJ, Lewis RJ, Sanchez-Hucles J, Clarke E. Friendship, social interaction, and coping with stress. Communication Research. 1992; 19 :193–211. [ Google Scholar ]
• Witvliet CvO, Ludwig TE, Vander Laan KL. Granting forgiveness or harboring grudges: Implications for emotion, physiology, and health. Psychological Science. 2001; 12 :117–123. [ PubMed ] [ Google Scholar ]
• Woodard CR. Hardiness and the concept of courage. Consulting Psychology Journal: Practice and Research. 2004; 56 :173–185. [ Google Scholar ]
• Worthington EL, Scherer M. Forgiveness is an emotion-focused coping strategy that can reduce health risks and promote health resilience: Theory, review, and hypotheses. Psychology & Health. 2004; 19 :385–405. [ Google Scholar ]
• Wrosch C, Scheier MF, Miller GE, Schulz R, Carver CS. Adaptive self-regulation of unattainable goals: Goal disengagement, goal reengagement, and subjective well-being. Personality and Social Psychology Bulletin. 2003; 29 :1494–1508. [ PubMed ] [ Google Scholar ]
• Yetim U. Life satisfaction: A study based on the organization of personal projects. Social Indicators Research. 1993; 29 :277–289. [ Google Scholar ]
• Zaleski Z. Behavioral effects of self-set goals for different time ranges. International Journal of Psychology. 1987; 22 :17–38. [ Google Scholar ]
• Zubieta JK, Smith YR, Bueller JA, Xu Y, Kilbourn MR, Jewett DM, Meyer CR, Koeppe RA, Stohler CS. Regional mu opioid receptor regulation of sensory and affective dimensions of pain. Science. 2001; 293 :311–315. [ PubMed ] [ Google Scholar ]

• Subject List
• Take a Tour
• For Authors
• Subscriber Services
• Publications
• African American Studies
• African Studies
• American Literature
• Anthropology
• Architecture Planning and Preservation
• Art History
• Atlantic History
• Biblical Studies
• British and Irish Literature
• Childhood Studies
• Chinese Studies
• Cinema and Media Studies
• Communication
• Criminology
• Environmental Science
• Evolutionary Biology
• International Law
• International Relations
• Islamic Studies
• Jewish Studies
• Latin American Studies
• Latino Studies
• Linguistics
• Literary and Critical Theory
• Medieval Studies
• Military History
• Political Science
• Public Health
• Renaissance and Reformation
• Social Work
• Urban Studies
• Victorian Literature
• Browse All Subjects

How to Subscribe

• Free Trials

In This Article Expand or collapse the "in this article" section Social Support

Introduction, overview and history.

• Theoretical Perspectives
• Social Support and Physical Health
• Social Support and Mental Health
• Mechanisms and Pathways
• Moderating and Mediating Factors in Social Support
• Receiving and Providing Support: Costs and Benefits
• Interventions
• Export Citations
• Share This Facebook LinkedIn Twitter

Social Support by Robert G. Kent de Grey , Bert N. Uchino , Ryan Trettevik , Sierra Cronan , Jasara Hogan LAST REVIEWED: 11 January 2018 LAST MODIFIED: 11 January 2018 DOI: 10.1093/obo/9780199828340-0204

Social support is a broad construct comprising both the social structure of an individual’s life and the specific functions served by various interpersonal relationships. Structural aspects of support are often measured by assessing social integration, indicating the extent to which an individual is a part of social networks. Researchers usually divide functional support into two domains: perceived support, or people’s subjective construal of the support they believe to be available to them, and received (or enacted) support, which is aid actually rendered by other persons. Perceived and received support take a number of forms. Informational support involves the provision of recommendations, advice, and other helpful information. Tangible (or instrumental) support is the furnishing of financial, material, or physical assistance, such as the provision of money or labor. Emotional (or appraisal) support involves the expression of affection, empathy, caring, and so on. Belonging (or companionship) support creates a sense of belonging and can involve the presence or availability of others for social engagement. The different facets of social support often have distinct implications for psychological well-being and physical health. For example, higher perceived support is usually associated with preferable mental and physical health outcomes, including lower risk of cardiovascular disease (an association for which the evidence is particularly robust) and all-cause mortality. The proposed mechanisms by which social support influences health typically fall into one of two theoretical frameworks: the buffering model, which contends that support protects against the negative impacts of stressors, and the direct effects model, which holds that social support can also be beneficial in the absence of stressors. Not all support is beneficial; links between received support and health are fraught with complex moderators, such that received support that is beneficial in one circumstance may be ineffective or even detrimental under other conditions. More recent research has examined the factors that determine the direction and magnitude of the effects of received social support. Some evidence suggests support may be most beneficial when it is unobtrusive and matches the receiver’s needs. In contrast, unhelpful or unsolicited received support may feel controlling, frustrate receivers, or lower self-esteem and self-efficacy. Research has also started to consider the costs and benefits of providing social support, especially in the context of serving as a caregiver for a family member with chronic disease. Intervention attempts, especially for caregivers and individuals with unmet needs, increasingly recognize the importance of social support. A more recently emerging literature explores the ways in which computer-mediated communication and online social networks relate to social support.

Thoits 1995 provides a classic overview of the study of social support and the direction of the field at that time. A thorough and more current presentation of the development of social support and its implications for individuals is given by Taylor 2011 . Ditzen and Heinrichs 2014 provides a concise, more recent introduction. Cohen and Wills 1985 presents the two main competing hypotheses on how social support may influence health outcomes, and House, et al. 1988 uses relevant literature to establish a causal link between social support and health. Gottlieb 1985 expands the construct of social support to include the transactional process of giving and receiving support that occurs in interpersonal relationships. This bidirectional process is further discussed in Sarason and Sarason 2009 , with particular emphasis on the fit of an individual to his or her social support environment. Explorations of the potential pathways through which social support affects physiology and health are found in Uchino 2006 .

Cohen, S., and T. A. Wills. 1985. Stress, social support, and the buffering hypothesis. Psychological Bulletin 98.2: 310–357.

DOI: 10.1037/0033-2909.98.2.310

A seminal work examining the potential mechanisms through which social support influences physical health. Authors provide a thorough review of the literature on how social support is conceptualized and measured, as well as support for and against both the main effect and buffering hypotheses of social support.

Ditzen, B., and M. Heinrichs. 2014. Psychobiology of social support: The social dimension of stress buffering. Restorative Neurology and Neuroscience 32.1: 149–162.

DOI: 10.3233/rnn-139008

A brief but broad introduction to various subtopics in social support research. The structured organization renders this paper accessible to nonexperts, though the emphasis on health may make it more suitable for advanced readers. Includes citations of many classic papers in the field.

Gottlieb, B. H. 1985. Social support and the study of personal relationships. Journal of Social and Personal Relationships 2.3: 351–375.

DOI: 10.1177/0265407585023007

An exploration of the form and function of social support in both initiating and maintaining relationships. The author posits an expansion of the idea of social support from an intrapersonal, psychological construct to an interpersonal interaction, with an emphasis on the ways in which social support influences primary and secondary appraisals and coping processes. Additionally, the author provides a unique discussion of unintentional and indirect forms of social support.

House, J. S., K. R. Landis, and D. Umberson. 1988. Social relationships and health. Science 241.4865: 540–545.

DOI: 10.1126/science.3399889

A causal analysis of the association between low levels of social relationships and negative health outcomes. The authors argue that low-quality social support is a risk factor for, rather than a consequence of, poor health.

Sarason, I. G., and B. R. Sarason. 2009. Social support: Mapping the construct. Journal of Social and Personal Relationships 26.1: 113–120.

DOI: 10.1177/0265407509105526

This article provides a discussion on how social support is and should be both conceptualized and operationalized. Particular attention is paid to the bidirectional perspective of social support wherein an individual’s level of social support is the result of an interaction between the individual and his or her environment. The relative importance of fit in supportive relationships is discussed, and suggestions for future directions are given.

Taylor, S. E. 2011. Social support: A review. In The Oxford handbook of health psychology . Edited by H. S. Friedman, 189–214. Oxford: Oxford Univ. Press.

Comprehensive overview of social support. The author details the forms of social support and its benefits, as well as potential negative responses to social support efforts. Particular attention is paid to pathways by which social support influences health. Key factors that influence who receives social support and how it is received are discussed, as are implications for social support interventions.

Thoits, P. A. 1995. Stress, coping, and social support processes: Where are we? What next? In Special issue: Forty years of medical sociology: The state of the art and directions for the future . Edited by Mary L. Fennell. Journal of Health and Social Behavior 35 (extra issue): 53–79.

DOI: 10.2307/2626957

Comprehensive overview of previous literature examining social support in the context of coping with stress, for which a general introduction is also given. Summarizes then-current innovations in the field and suggests future directions.

Uchino, B. N. 2006. Social support and health: A review of physiological processes potentially underlying links to disease outcomes. Journal of Behavioral Medicine 29.4: 377–387.

DOI: 10.1007/s10865-006-9056-5

Thorough review of relevant literature examining which physiological mechanisms may bridge the relationship between social support and health outcomes. The author discusses differential functioning as a result of social support across the cardiovascular, neuroendocrine, and immune systems. Literature supports better functioning in all three systems in individuals with higher levels of social support.

back to top

Users without a subscription are not able to see the full content on this page. Please subscribe or login .

Oxford Bibliographies Online is available by subscription and perpetual access to institutions. For more information or to contact an Oxford Sales Representative click here .

• About Psychology »
• Meet the Editorial Board »
• Abnormal Psychology
• Academic Assessment
• Acculturation and Health
• Action Regulation Theory
• Action Research
• Addictive Behavior
• Adolescence
• Adoption, Social, Psychological, and Evolutionary Perspect...
• Advanced Theory of Mind
• Affective Forecasting
• Affirmative Action
• Ageism at Work
• Allport, Gordon
• Alzheimer’s Disease
• Ambulatory Assessment in Behavioral Science
• Analysis of Covariance (ANCOVA)
• Animal Behavior
• Animal Learning
• Anxiety Disorders
• Art and Aesthetics, Psychology of
• Artificial Intelligence, Machine Learning, and Psychology
• Assessment and Clinical Applications of Individual Differe...
• Attachment in Social and Emotional Development across the ...
• Attention-Deficit/Hyperactivity Disorder (ADHD) in Adults
• Attention-Deficit/Hyperactivity Disorder (ADHD) in Childre...
• Attitudinal Ambivalence
• Attraction in Close Relationships
• Attribution Theory
• Authoritarian Personality
• Bayesian Statistical Methods in Psychology
• Behavior Therapy, Rational Emotive
• Behavioral Economics
• Behavioral Genetics
• Belief Perseverance
• Bereavement and Grief
• Biological Psychology
• Birth Order
• Body Image in Men and Women
• Bystander Effect
• Categorical Data Analysis in Psychology
• Childhood and Adolescence, Peer Victimization and Bullying...
• Clark, Mamie Phipps
• Clinical Neuropsychology
• Clinical Psychology
• Cognitive Consistency Theories
• Cognitive Dissonance Theory
• Cognitive Neuroscience
• Communication, Nonverbal Cues and
• Comparative Psychology
• Competence to Stand Trial: Restoration Services
• Competency to Stand Trial
• Computational Psychology
• Conflict Management in the Workplace
• Conformity, Compliance, and Obedience
• Consciousness
• Coping Processes
• Correspondence Analysis in Psychology
• Counseling Psychology
• Creativity at Work
• Critical Thinking
• Cross-Cultural Psychology
• Cultural Psychology
• Daily Life, Research Methods for Studying
• Data Science Methods for Psychology
• Data Sharing in Psychology
• Death and Dying
• Deceiving and Detecting Deceit
• Defensive Processes
• Depressive Disorders
• Development, Prenatal
• Developmental Psychology (Cognitive)
• Developmental Psychology (Social)
• Diagnostic and Statistical Manual of Mental Disorders (DSM...
• Discrimination
• Dissociative Disorders
• Drugs and Behavior
• Eating Disorders
• Ecological Psychology
• Educational Settings, Assessment of Thinking in
• Effect Size
• Embodiment and Embodied Cognition
• Emerging Adulthood
• Emotional Intelligence
• Empathy and Altruism
• Employee Stress and Well-Being
• Environmental Neuroscience and Environmental Psychology
• Ethics in Psychological Practice
• Event Perception
• Evolutionary Psychology
• Expansive Posture
• Experimental Existential Psychology
• Exploratory Data Analysis
• Eyewitness Testimony
• Eysenck, Hans
• Factor Analysis
• Festinger, Leon
• Five-Factor Model of Personality
• Flynn Effect, The
• Forensic Psychology
• Forgiveness
• Friendships, Children's
• Fundamental Attribution Error/Correspondence Bias
• Gambler's Fallacy
• Game Theory and Psychology
• Geropsychology, Clinical
• Global Mental Health
• Habit Formation and Behavior Change
• Health Psychology
• Health Psychology Research and Practice, Measurement in
• Heider, Fritz
• Heuristics and Biases
• History of Psychology
• Human Factors
• Humanistic Psychology
• Implicit Association Test (IAT)
• Industrial and Organizational Psychology
• Inferential Statistics in Psychology
• Insanity Defense, The
• Intelligence
• Intelligence, Crystallized and Fluid
• Intercultural Psychology
• Intergroup Conflict
• International Classification of Diseases and Related Healt...
• International Psychology
• Interviewing in Forensic Settings
• Intimate Partner Violence, Psychological Perspectives on
• Introversion–Extraversion
• Item Response Theory
• Law, Psychology and
• Lazarus, Richard
• Learned Helplessness
• Learning Theory
• Learning versus Performance
• LGBTQ+ Romantic Relationships
• Lie Detection in a Forensic Context
• Life-Span Development
• Locus of Control
• Loneliness and Health
• Mathematical Psychology
• Meaning in Life
• Mechanisms and Processes of Peer Contagion
• Media Violence, Psychological Perspectives on
• Mediation Analysis
• Memories, Autobiographical
• Memories, Flashbulb
• Memories, Repressed and Recovered
• Memory, False
• Memory, Human
• Memory, Implicit versus Explicit
• Memory in Educational Settings
• Memory, Semantic
• Meta-Analysis
• Metacognition
• Metaphor, Psychological Perspectives on
• Microaggressions
• Military Psychology
• Mindfulness
• Mindfulness and Education
• Minnesota Multiphasic Personality Inventory (MMPI)
• Money, Psychology of
• Moral Conviction
• Moral Development
• Moral Psychology
• Moral Reasoning
• Nature versus Nurture Debate in Psychology
• Neuroscience of Associative Learning
• Nonergodicity in Psychology and Neuroscience
• Nonparametric Statistical Analysis in Psychology
• Observational (Non-Randomized) Studies
• Obsessive-Complusive Disorder (OCD)
• Occupational Health Psychology
• Olfaction, Human
• Operant Conditioning
• Optimism and Pessimism
• Organizational Justice
• Parenting Stress
• Parenting Styles
• Parents' Beliefs about Children
• Path Models
• Peace Psychology
• Perception, Person
• Performance Appraisal
• Personality and Health
• Personality Disorders
• Personality Psychology
• Person-Centered and Experiential Psychotherapies: From Car...
• Phenomenological Psychology
• Placebo Effects in Psychology
• Play Behavior
• Positive Psychological Capital (PsyCap)
• Positive Psychology
• Posttraumatic Stress Disorder (PTSD)
• Prejudice and Stereotyping
• Pretrial Publicity
• Prisoner's Dilemma
• Problem Solving and Decision Making
• Procrastination
• Prosocial Behavior
• Prosocial Spending and Well-Being
• Protocol Analysis
• Psycholinguistics
• Psychological Literacy
• Psychological Perspectives on Food and Eating
• Psychology, Political
• Psychoneuroimmunology
• Psychophysics, Visual
• Psychotherapy
• Psychotic Disorders
• Publication Bias in Psychology
• Reasoning, Counterfactual
• Rehabilitation Psychology
• Relationships
• Reliability–Contemporary Psychometric Conceptions
• Religion, Psychology and
• Replication Initiatives in Psychology
• Research Methods
• Risk Taking
• Role of the Expert Witness in Forensic Psychology, The
• Sample Size Planning for Statistical Power and Accurate Es...
• Schizophrenic Disorders
• School Psychology
• School Psychology, Counseling Services in
• Self, Gender and
• Self, Psychology of the
• Self-Construal
• Self-Control
• Self-Deception
• Self-Determination Theory
• Self-Efficacy
• Self-Esteem
• Self-Monitoring
• Self-Regulation in Educational Settings
• Self-Report Tests, Measures, and Inventories in Clinical P...
• Sensation Seeking
• Sex and Gender
• Sexual Minority Parenting
• Sexual Orientation
• Signal Detection Theory and its Applications
• Simpson's Paradox in Psychology
• Single People
• Single-Case Experimental Designs
• Skinner, B.F.
• Sleep and Dreaming
• Small Groups
• Social Class and Social Status
• Social Cognition
• Social Neuroscience
• Social Support
• Social Touch and Massage Therapy Research
• Somatoform Disorders
• Spatial Attention
• Sports Psychology
• Stanford Prison Experiment (SPE): Icon and Controversy
• Stereotype Threat
• Stereotypes
• Stress and Coping, Psychology of
• Student Success in College
• Subjective Wellbeing Homeostasis
• Taste, Psychological Perspectives on
• Teaching of Psychology
• Terror Management Theory
• Testing and Assessment
• The Concept of Validity in Psychological Assessment
• The Neuroscience of Emotion Regulation
• The Reasoned Action Approach and the Theories of Reasoned ...
• The Weapon Focus Effect in Eyewitness Memory
• Theory of Mind
• Therapy, Cognitive-Behavioral
• Thinking Skills in Educational Settings
• Time Perception
• Trait Perspective
• Trauma Psychology
• Twin Studies
• Type A Behavior Pattern (Coronary Prone Personality)
• Unconscious Processes
• Video Games and Violent Content
• Virtues and Character Strengths
• Women and Science, Technology, Engineering, and Math (STEM...
• Women, Psychology of
• Work Well-Being
• Wundt, Wilhelm
• Privacy Policy
• Cookie Policy
• Legal Notice
• Accessibility

Powered by:

• [66.249.64.20|185.80.150.64]
• 185.80.150.64

Click through the PLOS taxonomy to find articles in your field.

For more information about PLOS Subject Areas, click here .

Loading metrics

Open Access

Peer-reviewed

Research Article

A new buffering theory of social support and psychological stress

Roles Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Resources, Software, Supervision, Writing – review & editing

* E-mail: [email protected] , [email protected] , [email protected]

Affiliations LSE Health Centre & Department of Health Policy, London School of Economics and Political Science (LSE), London, United Kingdom, Faculty of Economics &Management (FEMA), University of Malta, Msida, Malta

Roles Data curation, Investigation, Methodology, Software, Visualization, Writing – original draft

Affiliation Department of Mechanical Engineering, University of Manitoba, Winnipeg, Canada

Roles Data curation, Methodology, Software, Validation, Writing – original draft

Affiliation Faculty of Electronics Sciences, Benemerita Universidad Autonoma de Puebla, Puebla, Mexico

• Stelios Bekiros, 
• Hadi Jahanshahi, 
• Jesus M. Munoz-Pacheco

• Published: October 12, 2022
• https://doi.org/10.1371/journal.pone.0275364
• Reader Comments

A dynamical model linking stress, social support, and health has been recently proposed and numerically analyzed from a classical point of view of integer-order calculus. Although interesting observations have been obtained in this way, the present work conducts a fractional-order analysis of that model. Under a periodic forcing of an environmental stress variable, the perceived stress has been analyzed through bifurcation diagrams and two well-known metrics of entropy and complexity, such as spectral entropy and C0 complexity. The results obtained by numerical simulations have shown novel insights into how stress evolves with frequency and amplitude of the perturbation, as well as with initial conditions for the system variables. More precisely, it has been observed that stress can alternate between chaos, periodic oscillations, and stable behaviors as the fractional order varies. Moreover, the perturbation frequency has revealed a narrow interval for the chaotic oscillations, while its amplitude may present different values indicating a low sensitivity regarding chaos generation. Also, the perceived stress has been noted to be highly sensitive to initial conditions for the symptoms of stress-related ill-health and for the social support received from family and friends. This work opens new directions of research whereby fractional calculus might offer more insight into psychology, life sciences, mental disorders, and stress-free well-being.

Citation: Bekiros S, Jahanshahi H, Munoz-Pacheco JM (2022) A new buffering theory of social support and psychological stress. PLoS ONE 17(10): e0275364. https://doi.org/10.1371/journal.pone.0275364

Editor: Mohammed S. Abdo, Hodeidah University, YEMEN

Received: March 10, 2022; Accepted: September 15, 2022; Published: October 12, 2022

Copyright: © 2022 Bekiros et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

1. Introduction

Stressful events are strongly connected to social factors [ 1 ]. Moreover, since the highly influential Cohen’s study [ 2 ], social support and its interaction with stress have been tightly tied to factors affecting health and well-being. More precisely, social support received from family and friends has proven to positively impact health by moderating the adverse effects of stress. In fact, the more social support an individual receives, the better overall mental and physical health he or she will have [ 3 , 4 ]. In this respect, some studies also suggest that social support affects mental health rather than physical health, and those diverse kinds of support can have different effects on perceived stress [ 5 , 6 ].

So far, a variety of mathematical models have been used to understand and predict real-world phenomena [ 7 – 14 ]. Thus, finding a model accurately describing psychological dynamics could pave the way for long and short-term predictions of mental diseases, as well as for designing appropriate therapies [ 15 ]. In other words, mathematical modeling aims to anticipate the dynamics of psychological systems and control them as effectively as possible concomitant diseases. Some seminar studies dealing with the modelling of psychological phenomena can be found in [ 16 , 17 ].

So far, a lot of research has been done on psychological stress [ 18 – 20 ]. In [ 21 ], the effects of long-lasting psychological stress on social behaviours is investigated using a predator stress model. In [ 22 ], Kapasia et al. attempt to examine factors associated with psychological stress as well as academic satisfaction and future academic risk during the COVID-19 epidemic. In another study, various stressors related to covid-19, including risk exposure, limited medical treatment access, reduced income, and perceived discrimination, and their association with psychological distress were investigated [ 23 ]. They found that social support in the neighborhood can reduce psychological distress and buffer the effects of stressors. This is while the support of family and friends has a limited effect on coping with stress. Stress-buffering hypothesis has been introduced to interpret the effect of stress moderation [ 24 ]. This hypothesis states that stress moderation may happen by processes associated with the value of social support (main effects), as well as by processes associated with the value of social support and stress (which is called buffering effect). In other words, buffering represents the interaction of the stressor levels with the social support received from friends and family. Thus, when the level of stress increases, the buffering effect becomes more critical. This stress moderation hypothesis has provided a fruitful situation for the advent of more complex models that investigate the relationships between stress, support, and illness. Hence, psychological models considering factors that are related to the buffering effect have attracted considerable attention in the last years [ 25 , 26 ].

As a matter of fact, the development of trustable tools is the most critical challenge in the modeling of real-world, practical systems [ 27 – 31 ]. To reach this goal, fractional calculus has been recently proposed as a useful alternative [ 32 , 33 ]. Indeed, fractional calculus is an excellent tool for the description of hereditary properties and memory of systems, which has been applied in a wide variety of scenarios in the last years [ 34 – 38 ]. Also, recently, the application of fractional calculus in social events and even disease dynamics have attracted a lot of attention. In [ 39 – 41 ] various fractional-order models of the transmission dynamics of COVID-19 have been proposed and studied.

In [ 42 ], a fractional-order dynamic model of love has been examined and its chaotic behaviour has been studied by investigating different orders. Additionally, in [ 43 ], the rich dynamics of a fractional-order love system with the fractional order derivative and model parameters have been studied. Furthermore, the control problem has been theoretically investigated. In [ 44 ], through fractional-order differential equations, dynamical model of happiness has been studied. By classifying persons of different personalities and impact factors of memory (IFM) with a distinct set of model parameters, it has been illustrated that such fractional-order models might display multiple behaviors with and without external situations. In [ 45 ], chaos control and dynamical synchronization model of happiness with fractional order have been studied.

Nonetheless, no study has used these fractional techniques to investigate the influence of social support buffering on stress. Despite the fact that fractional calculus gives a helpful and practical viewpoint in the modeling of real-world systems, publications that employ fractional calculus to describe psychological dynamics are rare. As a result, there is still an opportunity for improvement in nonlinear models that take into account the impacts of social support buffering on physiological stress. Motivated by this, the current study introduces for the first time a fractional-order analysis of a previously published dynamic model of stress-related processes.

The suggested modelling, which provides a generalization dynamic of social support and psychological stress, is justified by the fact that the time evolution of psychological interactions, like other fractional systems, is inherently affected by memory. The fractional-order model is introduced, and its parameters are delineated. Then, in addition to bifurcation diagrams, analyses of entropy and complexity are also conducted in terms of spectral entropy and C 0 complexity. Considering a periodic variation in environmental stress, as well as a self-kindling in the subject’s stress response, new and interesting insights into the relationships between stress, social support, and health are obtained. For instance, it is shown that stress experienced by an individual is strongly affected by initial conditions for physical or mental symptoms, as well as for the received social support.

The rest of the study is planned as follows. Section 2 describes the mathematical model of socially buffered stress processes and some basic concepts about fractional calculus. Afterward, the fractional-order model of the socially buffered stress processes is proposed as a new approach, and some of its properties are delineated. Section 3 outlines entropy and complexity analyses conducted on the resulting time series from the proposed approach. Finally, the main conclusions of the present study are summarized in Section 4.

2. Stress-buffering hypothesis

The model is quite similar to the one presented by Oregonator [ 50 ], which is a successful model of the oscillatory Belousov–Zhabotinsky chemical reaction. The matching of the model with real-world results has been clearly demonstrated by Epstein and Pojman [ 51 ]. Also, it has been shown that selecting suitable values for the described parameters results in psychologically reasonable outcomes, thus exhibiting oscillation, multiple stationary states, spatial pattern formation, bursting, and chaos [ 46 ]. Moreover, for most parameters, states of the system exhibit unchanging stationary values, suggesting that the model converges to “normal” dynamics of stress and symptoms of illness, and moreover, demonstrating recent interpretations of homeostasis [ 47 ].

2.1. Fractional-order modeling

• PPT PowerPoint slide
• PNG larger image
• TIFF original image

https://doi.org/10.1371/journal.pone.0275364.t001

2.1.1. Introducing the Caputo fractional operator.

2.2. Equilibrium points of the stationary states

Lemma 1: The equilibrium point E 1 of the fractional-order socially buffered response model described in Eqs ( 9 – 11 ) with B ∈[1,2.2] and the parameters included in Table 1 is unstable for all q ∈[0, 1) [ 60 ].

Proof . The characteristic equation of the fractional-order socially buffered response model is described in Eqs ( 9 – 11 ) at equilibrium point (2.58, 2.58,0.90) is given as λ 3 +4.016λ 2 −1.306λ+0.033 = 0. Here, λ 2,3 are positive, real numbers. Therefore, the equilibrium point E 1 , considering B ∈[1,2.2], is unstable for all q ∈ [0, 1].

2.3. The chaotic effect of memory in stress-related fractional-order social buffering

Regarding the previously presented integer-order version of the socially buffered response model, we have added the effect of memory in the mathematical model to analyze people’s stress-related processes. As well-known, if two Markovian processes (integer-order) start at two different times, the evolution of both processes is identical. However, the scenario is completely different for a non-Markovian approach (fractional-order), in which the memory plays the main role [ 61 , 62 ]. In the proposed model, the strength (through the “length”) of the memory is controlled by the fractional-order. As q tends to 0, the influence of memory increases and vice-versa. It is important to point out that we only analyze the commensurate case, i.e., all the fractional orders are identical. For the scenario whereby incommensurate orders are needed, the stability analysis in section 2.2 should be derived using Theorem 4.6, page 79, given in [ 60 ]. In the commensurate framework, we hypothesize that the perceived psychological stress, X ( t ), should change as time evolves. For instance, the perceived stress could be lower when a person faces taxing life events at early stages than when he or she is initially stressed. Indeed, the symptoms of stress-related ill-health, Y ( t ), may get worse due to the accumulative stress effects. Finally, the received social support, Z ( t ), could reduce the stress impact as time evolves. It means the support has no immediate results, but as the person continues receiving such support (memory), it could be more motivated, and then the stress effects could be reduced.

Within the described context, the parameter of the environmental stress A is represented as a periodic forcing, and chaos behavior can then be founded as a function of the fractional-order. In this case, we set A = A 0 + ρ sin ω t , where A 0 = 1, and the parameters ρ and ω are the amplitude and angular frequency of the modulation, respectively. We have conducted several numerical simulations under the external perturbation using the algorithm described in Eqs ( 12 – 14 ). Fig 1A–1D show the bifurcation diagrams for B = 2.2, B = 2.0, B = 1.5, and B = 1.0, respectively, and for different values of the fractional-order q. As can be seen, the fractional-order q can be considered as a control parameter for the chaos behavior. Therefore, the stress model can alternate between chaos, periodic oscillations, and stable behaviors as the fractional-order q varies. Fig 1E and 1F present the behavior of the force of the periodic perturbation and its frequency when q = 0.99. In this case, the perturbation frequency ω has a narrow interval for the chaotic oscillations, while the force q may set with different values indicating a low sensitivity regarding chaos generation.

Bifurcation diagrams as a function of the fractional-order q with ρ = 11, ω = 1.5, for a) B = 2.2, b) B = 2.0, c) B = 1.5, and d) B = 1.0. e) Bifurcation diagram for ω with q = 0.99, ρ = 11, and B = 2.2. f) Bifurcation diagram for ρ with q = 0.99, ω = 1.5, and B = 2.2. g) Bifurcation diagram varying q with ρ = 1, B = 2.2 and ω = 0.45. h) Chaotic attractor obtained from parameters in the subfigure a) when q = 0.99. i) Chaotic attractor obtained from parameters in the subfigure a) when q = 0. 98. j) Lyapunov exponents for the chaotic attractor in subfigure h) resulting in LE1 = 0.203, LE2 = 0, LE3 = -12.707 (magnified area from 940s to 1000s). k) and l) k) and l) Bifurcation diagrams showing the switching between chaos and stable dynamics.

https://doi.org/10.1371/journal.pone.0275364.g001

An interesting result was also found when the fractional-order q varies in the range (0.8,1), then originating complex stability regions characterized by multiple alternations between periodic and chaotic oscillations, such as Fig 1G displays. The chaotic and periodic attractors are illustrated in Fig 1H and 1I , when q = 0.99 and q = 0.98, respectively. The validation of the chaotic oscillations in the fractional-order stress model was performed by the Lyapunov exponent method. For the case of chaotic behavior, the Lyapunov spectrum was LE1 = 0.203, LE2 = 0, and LE3 = −12.707 by applying the Benettin–Wolf algorithm modeled by Caputo’s derivative [ 63 ]. The Dimension Kaplan-Yorke is DKY = 2.984, which is computed by considering the definition 1 presented in [ 64 ]. Finally, the multi-stability in the fractional-order system for different values of arbitrary initial conditions for Y and Z , respectively, was also discovered. This result suggests that stress analyzed with the proposed fractional-order social support buffered response model is affected not only by the system parameters, but also by the initial conditions. More specifically, Fig 1K and 1L show switching between chaos and stable dynamics, thus highlighting that the psychological stress perceived by an individual can be affected by the initial conditions for the symptoms of stress-related ill-health, as well as for the initial conditions of the received social support.

It is worth noting that bifurcation diagrams were also conducted for q in (0,0.8); however, the results are not shown since they tend to either periodic behaviors or unbounded solutions, respectively. In this manner, we focus on the interval q ∈[0.8,1] as given in Fig 1(A) – 1(D) and Fig 1(G) . This finding agrees with the literature on fractional-order systems, where the fractional orders for detecting chaos phenomena are typically q≥ 0.8 [ 65 ].

3. Complex nonlinear dynamics

The study of complex systems is often addressed by characterizing their resulting empirical time series in search of patterns and laws that rule their main dynamics. A variety of measures of entropy, relative entropy, complexity, fractal dimensions, etc., have been used for that purpose [ 66 , 67 ]. In general terms, these metrics can be divided into two groups, i.e., those estimating the global structure of a time series, and those quantifying its time behavior. Whereas the former measure entropy or complexity of a sequence through its spectral distribution, the latter estimate regularity or predictability of a time series by analyzing its time distribution of samples. Although both kinds of indices have reported interesting results in diverse scenarios [ 68 , 69 ], those based on the spectral transformation of the data provide a global statistical significance and then an easier interpretation. Indeed, these metrics analyze global energy features of a time series without paying special attention to specific local sequences [ 70 ]. Two common indices within this group are spectral entropy (SE) and C 0 complexity. Both metrics have been used here to characterize the system described in Eqs ( 9 – 11 ).

Clearly, the larger the value of C 0 , the larger the complexity of x ( n ) [ 73 ].

In the present work, both SE and C 0 have been computed from the variable x ( n ) obtained for the system described in Eqs ( 9 – 11 ) by considering the conditions analyzed in the previous section. Thus, Fig 2 shows how dynamics change under the perturbation described in Eq ( 21 ) with ω = 1.5, ρ = 11, and different values of B and fractional orders q. As can be seen, the results presented by both metrics in Fig 2(A) – 2(D) agree with those displayed by Fig 1 (A)– 1(D) , thus clearly discerning between stable and chaotic behaviors. In fact, values of SE and C 0 about 0.4 and 0.12 successfully discriminate between both states. Moreover, according to these thresholds, Fig 2(E) and 2(F) only exhibit chaos for a limited region, defined by values of B between 1.5 and 2.3 and fractional orders q between 0.9875 and 1. Nonetheless, it should be noted that the area showing chaos is wider when q increases.

In all cases, SE and C 0 were computed from the variable x ( n ) and the parameters ρ = 11 and ω = 1.5 were used. In the first four panels the parameter B took values of (a) 2.2, (b) 2.0, (c) 1.5, and (d) 1.0. The two last panels show contour plots for (e) SE, and (f) C 0 , when values of B and q range from 1 to 3, and from 0.97 to 1, respectively.

https://doi.org/10.1371/journal.pone.0275364.g002

On the other hand, Fig 3 shows the variation of SE and C 0 as a function of both the force (ρ) and the frequency ( ω ) of the perturbation, when the fractional order q is set to 0.99. As can be seen in Fig 3(A) and 3(B) , in both cases, the evolution is consistent with the bifurcation diagrams presented in Fig 1(E) and 1(F) . Indeed, when ρ is fixed to 11, chaotic behavior is only noticed when ω ranges from 1.5 to 1.7 (see Fig 3(A)) . Similarly, when ω is established to 1.5, stable behavior is observed for most values of ρ, apart from those between 11 and 14 (see Fig 3(B)) . According to these findings, Fig 3(C) and 3(D) also display a narrow area where the system exhibits chaotic behavior. This region is roughly delimited by values of ω between 1.28 and 1.65, and values of ρ between 10.5 and 20.

In all cases, SE and C 0 were computed from the variable x ( n ) and the parameters B = 2.2 and the fractional order q = 0.99 were used. In the first two panels the parameters (a) ω and (b) ρ were varied when ρ = 11 and ω = 1.5, respectively. The two last panels show contour plots for (c) SE, and (d) C 0 , when values of ρ and ω range from 0 to 20, and from 0 to 2.5, respectively.

https://doi.org/10.1371/journal.pone.0275364.g003

Regarding the different initial conditions tested for Y and Z, values of SE and C 0 displayed by Fig 4(A) and 4(B) were also in agreement with the bifurcation diagrams shown by Fig 1(k) and 1(l) , thus presenting a multi-stable behavior of the system. Thus, chaotic behavior is only observed for a narrow range of initial values of Y from 0 to 2.5, approximately. Contrarily, a broader range of initial conditions of Z from 6 to 35 exhibit chaos. According to these results, contour plots of SE and C 0 displayed in Fig 4(C) and 4(D) also present a chaotic region limited by a few initial values of Y (between 0 and 7) and most values of Z (between 0 and 50). Nonetheless, it should be noted that the larger the initial value of Z, the wider the region of initial values of Y exhibiting chaos.

Variation of SE and C 0 as a function of the initial conditions of y and z . In all cases, SE and C 0 were computed from the variable x ( n ) and the parameters q = 0.99, ρ = 11, and ω = 1.5 were used. In the first two panels the values of initial conditions of (a) y and (b) z were ranged from 0 to 50, whereas in the two last panels contour plots for (c) SE, and (d) C 0 are shown.

https://doi.org/10.1371/journal.pone.0275364.g004

Finally, it is worth noting that in all conducted analyses of SE and C 0 have reported similar results. Nonetheless, C 0 has proven to have a slightly higher sensitivity to small changes in the system dynamics, thus better discerning between chaotic and stable behaviors.

4. Conclusions

A fractional-order analysis of a dynamic system modelling people’s stress-related processes has been for the first time conducted in the present work. Thus, the stress perceived by an individual under a periodic environmental perturbation has been widely analyzed, and some novel insights have been obtained about how this emotional state relates to external stressors and social support. More precisely, the subject’s behavior has proven to be unstable and evolve from a stable stage to chaos for a narrow set of frequency and amplitude values of the external perturbation, when different fractional orders were analyzed. Moreover, our numerical simulations have also conspicuously confirmed that, in some cases, a small deviation in derivative order could result in a completely different dynamical behavior of the system. This finding has been previously unseen since assuming derivative orders to have only integer values restricts simulations and predictions to a limited manner. On the other hand, it has also been shown that not only the system parameters affect stress analyzed with the fractional-order social support buffered response model, but also the initial conditions could considerably affect it. These findings could be helpful in better understanding how an individual reacts to different levels of stressors and social-support recruitment and then taking preventive measures to avoid further health problems. Overall, this study is pioneering research in using fractional calculus for the analysis of stress, which has demonstrated the importance of considering a fractional framework for such kind of physiological model. As future work, the case where the memory contributions are distinct, i.e., incommensurate fractional orders, could be analyzed.

• View Article
• PubMed/NCBI
• Google Scholar
• 43. Gu R, Xu Y. Chaos in a fractional-order dynamical model of love and its control. Nonlinear Mathematics for Uncertainty and Its Applications: Springer; 2011. p. 349–56.
• 48. Lazarus RS, Folkman S. Stress, appraisal, and coping: Springer publishing company; 1984.
• 51. Epstein IR, Pojman JA. An introduction to nonlinear chemical dynamics: oscillations, waves, patterns, and chaos: Oxford University Press; 1998.

Social support: a conceptual analysis

Affiliation.

• 1 School of Nursing, University of South Carolina at Aiken, USA.
• PMID: 9004016
• DOI: 10.1046/j.1365-2648.1997.1997025095.x

Using the methodology of Walker and Avant, the purpose of this paper was to identify the most frequently used theoretical and operational definitions of social support. A positive relationship between social support and health is generally accepted in the literature. However, the set of dimensions used to define social support is inconsistent. In addition, few measurement tools have established reliability and validity. Findings from this conceptual analysis suggested four of the most frequently used defining attributes of social support: emotional, instrumental, informational, and appraisal. Social network, social embeddedness, and social climate were identified as antecedents of social support. Social support consequences were subsumed under the general rubric of positive health states. Examples were personal competence, health maintenance behaviours, effective coping behaviours, perceived control, sense of stability, recognition of self-worth, positive affect, psychological well-being, and decreased anxiety and depression. Recommendations for future research were made.

Publication types

• Aged, 80 and over
• Nursing Assessment / methods*
• Nursing Methodology Research*
• Nursing Theory*
• Social Support*
• Surveys and Questionnaires
• Terminology as Topic

• Open access
• Published: 22 April 2024

Patient mistreatment, social sharing of negative events and emotional exhaustion among Chinese nurses: the combined moderating effect of organizational support and trait resilience

• Wei Yan 1 ,
• Xiu Chen 1 ,
• Di Xiao 2 ,
• Huan Wang 3 , 4 ,
• Chunjuan Xu 7 &
• Caiping Song 8  

BMC Nursing volume  23 , Article number:  260 ( 2024 ) Cite this article

39 Accesses

Metrics details

As a primary form of work-related violence in the healthcare sector, patient mistreatment negatively impacts nurses’ well-being. To date, there has yet reached a definitive conclusion on the mediating mechanism and boundary conditions behind the influence of patient mistreatment on nurses’ emotional exhaustion.

This study employed a convenience sampling method to recruit a sample of 1672 nurses from public hospitals in Western China. The data were collected through anonymous self-report questionnaires and analyzed using hierarchical regression and conditional processes to investigate a theoretical framework encompassing patient mistreatment, emotional exhaustion, social sharing of negative events, organizational support, and trait resilience.

Patient mistreatment led to emotional exhaustion among nurses (β = 0.625, p  <.001), and social sharing of negative events mediated this positive relationship (effect = 0.073, SE = 0.013). The combined effects of organizational support and resilience moderated the mediating effect of the social sharing of negative events between patient mistreatment and emotional exhaustion (β=-0.051, p  <.05). Specifically, nurses with a high level of resilience would benefit from organizational support to alleviate emotional exhaustion caused by patient mistreatment.

Conclusions

This study validated a significant positive association between patient mistreatment and emotional exhaustion, which aligns with previous research findings. Integrating conservation of resources theory and goal progress theory, we addressed previous contradictory findings on the impact of social sharing of negative events on emotional exhaustion. Social sharing of negative events served as a mediator between patient mistreatment and emotional exhaustion. Additionally, the moderating effect of organizational support on the relationship between social sharing of negative events and emotional exhaustion depended on individual trait of resilience.

Peer Review reports

Introduction

Workplace violence is a worldwide concern and a major risk in healthcare work. It was defined as incidents in which staff members are mistreated, threatened, or assaulted in circumstances related to their work [ 1 ]. Over the last decades, it has been well documented that healthcare professionals around the world are at significant risk of violence exposure [ 2 ]. Studies have shown that the most vulnerable healthcare workers victimized are nurses and paramedics [ 3 , 4 ], with the most common perpetrators being patients, their relatives, or visitors [ 5 ]. A recent survey of 4263 nurses in the healthcare sector showed that 54% of respondents had experienced verbal violence by patients [ 6 ], including negative emotional behaviors exhibited by patients or their families, such as anger, swearing, insults, yelling, and speaking rudely toward nurses [ 7 , 8 , 9 ]. All these negative emotional behaviors are known as “patient mistreatment”. A considerable amount of research conducted in healthcare organizations has shown that exposure to patient mistreatment is a strong predictor of stress, emotional exhaustion, turnover intention and obstacles to career development among nurses [ 6 , 7 , 10 , 11 , 12 , 13 ]. Specifically, emotional exhaustion, characterized by intense fatigue, lack of interest, low mood, and less enthusiasm for jobs, is not only a key outcome resulting from patient mistreatment but also serves as a significant predictor of nurse turnover and a decline in nursing job performance. The conservation of resources (COR) theory provides a theoretical framework for understanding emotional exhaustion caused by patient mistreatment. The COR theory indicates that people strive to retain, protect, and build resources which are needed in fulfilling job responsibilities and are threatened by the potential or actual loss of those valued resources [ 14 , 15 , 16 ]. Despite increasing research interest, the existing literature has yet reached a definitive conclusion on the mechanism how patient mistreatment impacts nurses’ emotional exhaustion. Therefore, this study developed and examined a theoretical model regarding the influence of patient mistreatment on nurses’ emotional exhaustion and explored the mechanisms and boundary conditions behind this relationship.

Social sharing of negative events refers to talking to others about negative events and one’s emotional reactions to them and can occur hours to months after the event [ 17 , 18 ]. It is often seen as a response to emotional experiences to release negative emotions, alleviate work-related stress, and restore resources. However, there is no consensus on the impact of this behavior on emotional exhaustion [ 19 , 20 , 21 ]. Social sharing of negative events sometimes fails to bring new insights into emotional experiences, and disrupts nurses’ goal-related cognitive processes. Goal progress theory illustrates that goal failure (e.g. receiving customer mistreatment) [ 22 ] is associated with cognitive rumination [ 23 ], which may lead to the further loss of resources. Therefore, we examined the social sharing of negative events as a mediating mechanism in the relationship between patient mistreatment and emotional exhaustion in this study.

Furthermore, studies of organizational support have shown that it provides a supportive environment for individuals in coping with stress caused by customer mistreatment [ 24 ]. The COR theory also explicates that supportive environments and contexts create fertile ground for creation of individual resources [ 15 ]. However, some evidence has revealed that organizational support is not consistently beneficial, yielding inconclusive findings [ 25 , 26 , 27 ]. Besides, it is crucial to understand why some people are able to handle negative experiences at work more functionally than others. Consistent with COR theory, individual resources may be contained or embodied in traits and capabilities [ 14 ]. Resilience is a personal trait that can help individuals better cope with adversity and stress [ 28 ]. Therefore, this study introduces organizational support as a crucial moderating variable to explore its moderating effect on the mediating pathway of the social sharing of negative events between patient mistreatment and emotional exhaustion and examines whether trait resilience serves as a boundary condition to the effectiveness of organizational support.

In summary, drawing upon the conservation of resources theory and goal progress theory, this study attempts to answer the following questions: Is patient mistreatment related to emotional exhaustion through the social sharing of negative events? Is organizational support always beneficial or not? And who will benefit from it?

Patient mistreatment and emotional exhaustion

Among all occupational groups, healthcare workers are ranked as one of the most likely to experience workplace aggression [ 29 , 30 , 31 , 32 ]. Patient mistreatment refers to negative emotional behaviors such as expressed anger, swearing, insulting, yelling, and speaking rudely directed toward healthcare providers by patients or their families [ 9 , 33 , 34 ]. Existing studies have extensively explored the adverse consequences of patient mistreatment on healthcare staff and found that it can negatively impact their psychological and physical well-being, leading to increased anxiety, burnout, and negative emotions [ 35 , 36 , 37 ]. The psychological harm caused by patient mistreatment can also result in stress, which is defined as a reaction to an environment in which there is a threat or net loss of resources [ 34 ].

The conservation of resources (COR) theory constructs a framework for comprehending the origins and coping strategies of stress and is frequently used to interpret the process of emotional exhaustion. Individual resources are defined as any element that is valuable for an individual’s survival and development. Individuals strive to retain, protect, and build the resources they value [ 14 , 15 , 16 ], and suffer salient impacts when they lose resources. Moreover, the availability of resources determines the impact of workplace stressors (such as unfair treatment) on employees [ 38 , 39 ]. Healthcare professionals may experience emotional exhaustion, which refers to energy depletion or the draining of emotional resources [ 38 ], as a consequence of mistreatment by patients [ 35 ]. Therefore, we propose the following hypothesis:

Patient mistreatment is positively related to emotional exhaustion.

The mediating role of social sharing of negative events

Researchers have identified social sharing of negative events as talking to others about a negative event and one’s emotional reactions to it and can occur hours to months after the event [ 17 , 18 , 40 ]. Individuals voluntarily share their negative emotional experiences and feelings with others in social settings to release negative emotions, alleviate work-related stress, and restore psychological resources. Despite research on this topic, there is no consensus on the impact of social sharing on negative emotions. Delroisse et al. suggested that it can reduce job burnout by helping employees make sense of work situations and reinforcing relationships with others [ 19 ]. By contrast, Nolen-Hoeksema posited that sharing could potentially be detrimental if it involves ruminating on or immersing oneself in negative feelings, potentially exacerbating or prolonging feelings of sadness [ 20 ]. Drawing upon the conservation of resources theory and goal progress theory, we aimed to clarify the effect of social sharing of negative events between patient mistreatment and emotional exhaustion.

COR theory stated that individuals should proactively invest resources to protect themselves against potentially stressful situations, recover from losses, and accumulate additional resources to brace themselves for future challenges [ 14 , 15 , 16 ]. Social sharing of negative events has been conceptualized as a social and interpersonal process of repetitively seeking proactive social opportunities to verbalize experiences of stressful events [ 40 , 41 ]. Strongman et al. argued that social sharing of emotions activates the interconnectedness between individuals and their respective social networks or support systems [ 42 ]. Supportive actions by recipients, such as listening, understanding, and consolation, help sharers replenish depleted resources and foster their ability to cope with stressors in the sharing process [ 43 ], ultimately equipping them with the necessary resources to address adverse situations. For example, Zech highlighted that social sharing of negative events can provide informational support (e.g. advice) and facilitate reevaluation for individuals [ 17 ]. Laurens’s study revealed that nurses are inclined to engage in emotional social sharing with professionals, such as colleagues or counselors, when confronted with emotional issues involving their patients [ 44 ]. Therefore, drawing upon conservation resources theory, we anticipated that nurses who experience resource depletion due to patient mistreatment may seek to obtain the necessary resources through social sharing of negative events to manage stressful events.

Social sharing of negative events can facilitate cognitive-affective processing of shared events [ 45 ]. However, it carries “sharing risks” [ 46 ], particularly when negative emotions are involved. When it comes to repeated negative events, deliberate thoughts oriented towards the implications of a given event may alternate with unwanted, intrusive thoughts [ 40 ]. Martin and Tesser defined a class of conscious thoughts that revolve around a common instrumental theme as cognitive rumination [ 23 ], which is associated with goal progress theory [ 22 ] to illustrate the impact of goal failure (e.g., receiving customer mistreatment) [ 47 ]. Patient mistreatment serves as a pivotal emotional event and an original disruption. It fails to bring new insights into emotional experiences, disrupts nurses’ goal-related cognitive processes, and triggers rumination [ 40 , 47 ] when nurses share negative events with others [ 20 ]. The more nurses ruminate, the longer they experience intrusive thoughts linked to unachieved goals [ 22 ]. Moreover, loss of resources or the threat of such loss is a crucial factor in predicting psychological distress and leading to investing more resources, making those already lacking resources even more vulnerable to loss spirals [ 14 ]. Emotional exhaustion occurs when individuals are confronted with dual stressors of resource depletion and goal failure. Consequently, we propose the following hypothesis:

Social sharing of negative events mediates the relationship between patient mistreatment and emotional exhaustion.

The moderating role of organizational support

Hobfoll et al. further clarified those resources, which are central to survival and goal attainment, operate depending on the ecological context [ 48 , 49 ].They further theorized that resources do not exist individually but travel in packs, or caravans for both individuals and organizations [ 15 , 50 ]. Organizational support, which is the overall belief that the organization values contributions and cares about the well-being of its employees [ 51 ], is a vital aspect of work resources. Crossover acts as one of the mechanisms of resource exchange within resource caravans [ 15 ] and states that organizational support can be effectively transferred from organizational context to individuals. Studies have suggested that the crossover of resources is also very important for gaining spirals because it can increase a partner’s engagement, potentially triggering a chain of crossover of engagement processes [ 52 ]. Moreover, global research has also identified organizational support as a new buffer-type resource that can counter the resource-depleting effect of high workload and high emotional demands in a large sample of Dutch health professionals [ 53 ]. Therefore, these important work resources, including concern, recognition, and respect inherited in organizational support, would compensate for individuals’ resources, foster the accomplishment of personal work objectives [ 54 ], and enhance employees’ self-efficacy and sense of self-worth, consequently elevating their positive emotions [ 55 , 56 ]. Thus, we anticipated that organizational support would not only alleviate the adverse effects of mistreatment experienced by employees within the organization [ 57 , 58 , 59 ], but also effectively moderate the relationship between social sharing of negative events and emotional exhaustion.

The combined effect of organizational support and trait relicense

Conventionally, studies have demonstrated that organizational support constitutes a valuable work resource. However, COR theory posited that the transfer of resources across social entities (individuals and organizations) is slower. Mounting evidence suggested that organizational support may, at times, not be helpful or even worsen situations [ 60 , 61 , 62 ]. Perhaps the effects of crossover depend on certain traits of the individuals or groups. Evidence continued to mount regarding those with greater resources being less vulnerable to resource loss and more capable of gaining resources [ 15 , 63 ]. Luthans and Avolio [ 64 ] pointed out that both psychological capital and organizational support are necessary for employees to achieve high performance. Resilience, an individual’s ability to cope effectively with adversity and stress when facing difficulties and setbacks [ 65 , 66 ], can be a key personal resource for understanding how individuals break loss spirals [ 67 , 68 ]. Resilience enables individuals to adapt better to changing environments [ 69 , 70 ] and shapes their perception of stress [ 71 , 72 ].

This study found that trait resilience acts as a boundary condition for the moderating role of organizational support in the relationship between social sharing of negative events and emotional exhaustion. Furthermore, the interactive effects among various resources, such as psychological and organizational resources [ 73 ], do not simply add up, but rather enhance the assets necessary for individuals to accomplish their objectives. Consequently, it facilitates individuals with higher levels of resilience by employing both personal psychological resources and organizational resources to develop effective strategies to handle challenges like patient mistreatment [ 74 ]. In conclusion, this study proposes the following hypotheses:

The moderating effect of organizational support on the relationship between social sharing of negative events and emotional exhaustion depends on trait resilience.

The interaction between organizational support and trait resilience moderates the indirect effect of patient mistreatment on emotional exhaustion via the social sharing of negative work events.

We summarize our theoretical model in Fig.  1 .

Hypothesized theoretical model

Participants and data collection procedures

Convenience sampling was employed in this study. We initiated a call for nursing mistreatment research based on the Hematology Specialty Alliance platform in Chongqing, a major city in Southwest China. Furthermore, we used one-on-one communication to invite the clinical department nurses to participate in the survey. The inclusion criteria for recruiting participants in our study were as follows: ① Certified nurses; ② Clinical nursing positions; ③ Informed consent and voluntary participation. The exclusion criteria were as follows: ① student nurses in rotation, ② student nurses on internships, ③ nursing residents in training programs, and ④ off-duty nurses (on leave, sick leave, or attending external training).

To minimize the risks posed by the COVID-19 pandemic, this study employed a structured online questionnaire to facilitate ease of participation. To ensure the credibility and fairness of the collected data, all responses were submitted anonymously. The questionnaires were completed anonymously to ensure the acquisition of objective and unbiased data. The initial page of the questionnaire presented a clear statement of the study’s objectives and confidentiality of the responses. All questions were designed to be mandatory, and each unique IP address was allowed a single submission to uphold the integrity of the data and avoid duplicate entries. In preparation for the main study, a preliminary survey was conducted to validate the logic of the questions and the accuracy of their responses. The formal survey was conducted from October 9th, 2022 to November 1st, 2022. (Questionnaire link: https://wj.qq.com/mine.html ), ultimately yielding 1627 valid responses.)

We employed the translation and back-translation processes recommended by Brislin [ 75 ] in both surveys prior to the administration. This was done to ensure the validity and appropriateness of all the scales in the Chinese context.

• Patient mistreatment

We used the 18-item scale developed by Wang et al. [ 21 ] to measure patient mistreatment, replacing the word “customers” with “patients” in each item. The scale divides patient mistreatment into two dimensions: aggressive mistreatment and demand-oriented mistreatment. Participants rated the items on a five-point Likert scale from 1 = never to 5 = frequently. Example items were “Patients demanded special treatment,” “Patients spoke aggressively to you,” and “Patients asked you to do things even if they can do them themselves.” The Cronbach’s alpha of the scale was 0.953.

• Social sharing of negative events

Social sharing of negative events scale was adapted from Gable et al. [ 76 ]. In the past month, participants were asked how often they had talked to significant others, other family members, friends, and colleagues about unpleasant things that had happened at work, creating a four-item scale. Responses ranged from 1 = never to 5 = often. Cronbach’s α coefficient was 0.862.

• Emotional exhaustion

Emotional exhaustion was measured using the Chinese version of the Maslach Burnout Inventory (MBI), which was developed by Maslach and Jackson [ 77 ] and is the most widely used tool for evaluating job burnout. Emotional exhaustion included nine items, with sample items such as, “I feel emotionally drained from my work.” Responses ranged from 1 = strongly disagree to 5 = strongly agree. All the items scored positively, with higher scores indicating greater emotional exhaustion. Cronbach’s α coefficient was 0.925.

• Organizational support

In this study, we employed the Organizational Support Perception Scale originally developed and validated by Shen and Benson in 2016 [ 78 ] to assess the perceptions of organizational support. This scale consists of eight items (e.g. “My organization values my contributions to the organization”) and used a 7-point Likert scale. Among these items, four were positively worded and four were reverse-scored. Respondents indicated their agreement on a scale ranging from 1 = strongly disagree to 7 = strongly agree, with higher scores indicating a stronger perception of organizational support. Cronbach’s alpha for the scale was 0.907.

We used the Brief Resilience Scale (BRS) developed by Smith et al. [ 79 ], which consists of six items. Sample items included statements such as “I tend to bounce back quickly after difficulties.” Responses ranged from 1 = strongly disagree to 5 = strongly agree. Three items scored positively and three scored negatively. It is specifically used to measure an individual’s ability to recover their health or well-being in response to stress. Cronbach’s α coefficient was 0.826.

Control variables

Sex, age, education, marital status, years of work, and sports were included as control variables to control for confounding effects on emotional exhaustion.

Data analysis

SPSS23.0 and Mplus7 were used for the statistical analysis. We adopted confirmatory factor analysis to test validity and common method variance. Additionally, we conducted a descriptive statistical analysis of the variables and analyzed each variable using the Pearson’s correlation test to comprehend the characteristics and correlations between the variables. We performed hierarchical regression analysis and conditional process analysis to examine the mediating and moderating effects. Moderating variables were mean-centered to construct the interaction term, mitigating potential multi-collinearity problems. In this study, patient mistreatment served as a predictor variable, social sharing of negative events as a mediator variable, organizational support and resilience as two moderators, and emotional exhaustion as the outcome variable.

Participants

A total of 1627 valid responses were included after a strict review of the collected survey data. The majority of the participants were female (94.7%), while males accounted for only 5.3% of the sample, which is similar to the composition of nurses in other public hospitals in China. Most nurses (87.7%) were between 20 and 39 years old, with two under 20 years old, and 6.9% were over 40 years old. The participants’ years of work experience ranged from less than one year to 36 years, with an average of 9.26 years (SD = 6.40). The majority of nurses (62.6%) were married, and only 36.5% of the total participants reported exercise habits.

Common method variance

Data collected from a single source require querying for possible interference caused by common method variance (CMV). Harman’s single-factor method was used to detect the common method variance. The results of the exploratory factor analysis of the 45 items showed that there were seven factors with eigenvalues greater than 1, and the variance explanation rate of the first factor was 31.579% (< 50%). Therefore, the results suggested that CMV is not a significant problem in this study [ 80 , 81 ].

Confirmatory factor analysis

We conducted confirmatory factor analysis (CFA) to assess the discriminant validity of the scale. As shown in Table  1 , the five-factor model, consisting of patient mistreatment, social sharing of negative events, organizational support, resilience, and emotional exhaustion, demonstrated satisfactory discriminant validity and good fit (χ²/df = 11.276, RMSEA = 0.079, CFI = 0.819, TL = 0.809, SRMR = 0.057). Each variable had a factor loading greater than 0.600 and the internal consistency was good, indicating satisfactory reliability and validity of the scale.

Descriptive statistics

Table  2 presents the means, standard deviations, and correlation coefficients for the variables used in this study. The correlation coefficients were consistent with our expectations, showing that patient mistreatment was significantly positively correlated with emotional exhaustion ( r  =.361, p  <.01) and with the social sharing of negative events ( r  =.198, p  <.01). Additionally, the social sharing of negative events was positively correlated with emotional exhaustion ( r  =.253, p  <.01). Some of the hypotheses of this study were tentatively supported.

Hierarchical regression was used to test the relevant hypotheses and the results are presented in Table  3 . Model 4 indicated a positive correlation between patient mistreatment and emotional exhaustion (β = 0.625, p  <.001), which supported Hypothesis 1. The test for the mediating effect followed the recommended stepwise approach [ 82 ]. First, Model 2 revealed a significant positive correlation between patient mistreatment and the social sharing of negative events (β = 0.275, p  <.001). Second, Model 5 showed that social sharing of negative events was positively correlated with emotional exhaustion (β = 0.264, p  <.001). Finally, while the effect of patient mistreatment on the dependent variable, emotional exhaustion, remained significant (β = 0.552, p  <.001), it was somewhat weaker (0.552 < 0.625) after introducing the mediating variable, suggesting a partial mediating effect.

Following Preacher and Hayes [ 83 ], this study further tested the mediating effect of the social sharing of negative events on the relationship between patient mistreatment and emotional exhaustion. We employed the bias-corrected method with a sample size of 5000 and a 95% confidence interval to perform multiple mediating effect analysis using Process3.2, a software for conditional process analysis. The test results are presented in Table  4 . The results showed that the indirect effect was 0.073, with a 95% confidence interval of [0.049, 0.100], demonstrating that the social sharing of negative events played a mediating role in the relationship between patient mistreatment and emotional exhaustion. Therefore, H2 was supported.

The combined moderating effect of organizational support and trait resilience

Table  5 presents the results of moderation analysis. In Model 2, both organizational support and resilience were found to be significantly negatively correlated with emotional exhaustion (βos=-0.348, p  <.001; βre = − 0.569, p  <.001). However, in Model 3, neither organizational support nor resilience showed any interaction with social sharing of negative events in predicting emotional exhaustion. Nevertheless, the three-way interaction between social sharing of negative events, organizational support, and resilience was significant in predicting emotional exhaustion and negatively correlated with emotional exhaustion (β=-0.051, p  <.05), thus supporting H3. Figure  2 shows the results of the three-way interaction, in which it is evident that higher levels of organizational support and resilience weaken the positive impact of the social sharing of negative events on emotional exhaustion.

Simple slope test

We also conducted a moderated mediation model in Process 3.2, using 95% bias-corrected bootstrap confidence interval analyses with 5,000 bootstrap samples to examine the moderating effect of the interaction term of organizational support and resilience on the mediating role of social sharing of negative events between patient mistreatment and emotional exhaustion. As shown in Table  6 , the index of moderated moderated mediation was − 0.0152, which was statistically significant, with a 95% bias-corrected confidence interval of [-0.0286, − 0.0031]. Therefore, H4 was supported.

Specifically, the 95% confidence interval for the indices of conditional moderated mediation was [-0.0120, 0.0240] for individuals with high resilience and [-0.0291, -0.0012] for those with low resilience. Therefore, H3 was supported, indicating that individual resilience served as a boundary condition for the moderating effect of organizational support on the relationship between the social sharing of negative events and emotional exhaustion.

This study combined conservation of resources theory with goal progress theory to investigate the mediating role of the social sharing of negative events in the association between patient mistreatment and nurses’ emotional exhaustion. We also explored whether the moderating effect of organizational support on the relationship between the social sharing of negative events and emotional exhaustion depended on individual resilience. First, this study confirmed a significant positive correlation between nurses’ experiences of patient mistreatment and emotional exhaustion, which is consistent with previous studies [ 6 , 7 , 84 , 85 , 86 ]. The findings once again underscore the detrimental impact of patient mistreatment on nurses’ emotional and psychological well-being. Given that the rates of different forms and sources of aggression vary considerably between nations [ 3 , 87 ], it is crucial to direct our attention towards the patient mistreatment experiences of nurses in China, especially in the post-epidemic era.

Second, this study revealed that the social sharing behavior of negative events mediates the relationship between patient mistreatment and emotional exhaustion. Previous studies have produced mixed findings regarding the impact of the social sharing of negative events on emotional exhaustion among employees or nurses [ 19 , 20 , 21 ]. However, limited research has examined the role of social sharing of negative emotions as a mediating mechanism between patient mistreatment and nurses’ emotional exhaustion. This study integrated the conservation of resources theory and goal progress theory to establish a theoretical foundation for the mediating model. It indicated that sharing negative work events was a strategy for nurses to cope with resource loss resulting from patient mistreatment. Meanwhile, rumination about negative events was closely associated with goal failure, thereby triggering emotional exhaustion among nurses.

Third, the interaction between resilience and organizational support served as a moderator in the relationship between the social sharing of negative events and emotional exhaustion. Studies have identified organizational support as a crucial resource for mitigating the negative effects of stressors [ 24 ]. However, our findings demonstrated that there was no significant two-way interaction between social sharing of negative events and organizational support in predicting emotional exhaustion. This finding is in line with some research on organizational support [ 25 , 28 ], which suggested that organizational support may fail to alleviate the adverse effects of work stressors. Furthermore, this study responded to the call for conservation resources theory [ 28 ] to explore whether trait resilience serves as a boundary to the effectiveness of organizational support. The significant three-way interaction between the social sharing of negative events, organizational support, and trait resilience revealed that individuals with high levels of resilience will benefit from organizational support. Specifically, individuals with high resilience and organizational support showed lower levels of emotional exhaustion than those with low resilience and high organizational support. The implication for managers, therefore, was that organizational support alone cannot solve all problems. Instead, individualized organizational support should be considered in the light of nurses’ resilience.

Practical implications

The findings of this study have significant practical implications for medical management. First, the findings of this study once again validated the significant influence of patient mistreatment on nurses’ emotional exhaustion. Consequently, it is imperative for healthcare administrators to prioritize the establishment of a secure working environment for nurses while providing comprehensive training programs that could enhance their ability to react more effectively to navigate complex nurse-patient relationships. Second, the study further showed that the social sharing of negative events predicted emotional exhaustion among nurses. Therefore, finding ways to eliminate negative rumination originating from patient mistreatment is essential for reducing emotional exhaustion among nurses. Mindfulness thinking, meditation or psychological detachment from work are potential means that nurses could adopt to take a different perspective on negative events. Although the current study indicates that organizational support may not always be beneficial, we suggest that management consider developing workplace interventions that facilitate supportive relationships between organizations and nurses. Third, it is noted that the effect of organizational support depended on resilience. Resilience-related training programs may help nurses acquire psychological resources, enabling them to effectively navigate through mistreatment and adverse experiences. For instance, professional provider resilience training (PPRT) conducted by the medical department of the US military provides knowledge and skills to assist in stress management [ 88 ], such as developing positive cognition, emotional regulation, and mind-body techniques, which enhances the psychological resilience of medical professionals and alleviates fatigue and burnout.

Limitations and further study

This study has some limitations worth addressing. First, the study design was cross-sectional, which may have limited its ability to capture unexamined longitudinal associations. Thus, experience-sampling method should be employed to study the fluctuations of the relationship examined in this study on daily or week basis. Second, all variables investigated were self-reported, which may raise concerns regarding common method variance (CMV) [ 89 ]. Therefore, future studies should employ objective measures or measures reported by others to reduce same-source bias. Third, we found that the social sharing of negative events only partially mediated the relationship between patient mistreatment and emotional exhaustion. Further investigations should be conducted to explore other pathways linking patient mistreatment with nurses’ emotional exhaustion, as well as the moderating variables influencing these mediating mechanisms.

This study, involving 1672 healthcare nurses from public hospitals in Western China, revealed a notable prevalence of patient mistreatment, which led to emotional exhaustion among all participants. The findings of this study suggest that the sharing of negative events plays a mediating role in the relationship of patient mistreatment and the subsequent emotional drain experienced by nurses. These results serve as a critical alert to medical managers about the profound impact of negative emotional sharing within healthcare settings. Furthermore, the study highlights the importance of valuing and fostering certain personal traits of nurses, such as resilience, which can buffer the effects of patient mistreatment on emotional exhaustion, particularly when coupled with high levels of organizational support. Consequently, it is suggested to combine a supportive organizational culture in healthcare sector with training programs that aims to enhance nurses’ resilience.

Data availability

Data supporting the findings of this study are available upon request from the corresponding author.

Wynne R, Clarkin N, Cox T, Griffith A. Guidance on the prevention of violence at work. Office for Official Publications of the European Communities; 1997.

Goussinsky R. The moderating role of rumination and social sharing in the relationship between mistreatment and service sabotage and depersonalization: a cross-sectional study of hospital nurses. Int J Nurs Stud. 2020;110:103705. https://doi.org/10.1016/j.ijnurstu.2020.103705 .

Article   PubMed   Google Scholar  

Di Martino V. Workplace violence in the health sector. Country case studies Brazil, Bulgaria, Lebanon, Portugal, South Africa, Thailand and an additional Australian study. Ginebra: Organización Internacional del Trabajo; 2002. pp. 3–42.

Google Scholar  

Lim MC, Jeffree MS, Saupin SS, Giloi N, Lukman KA. Workplace violence in healthcare settings: the risk factors, implications and collaborative preventive measures. Annals Med Surg. 2022;78:103727. https://doi.org/10.1016/j.amsu.2022.10372 .

Article   Google Scholar  

Hadi AA. Bully And Harassment In Healthcare Industry: What Are Our Roles In Prevention, Powerpoint Slides, 2019. https://www.aoemm.org.my/wp-content/uploads/2019/07/Bully-Harassment-in-Healthcare-Industry-What-are-Our-Roles-in-Prevention-.pdf (Accessed 14 February 2022).

Liu B, Zhu N, Wang H, Li F, Men C. Protecting nurses from mistreatment by patients: a cross-sectional study on the roles of Emotional Contagion susceptibility and emotional regulation ability. Int J Environ Res Public Health. 2021;18(12):6331. https://doi.org/10.3390/IJERPH18126331 .

Article   PubMed   PubMed Central   Google Scholar  

Yan W, Bao N, Zheng S, Wang H, Yue D, Chen L. The impacts of patient mistreatment on healthcare workers’ role behaviors: a study in Chinese Fangcang shelter hospitals. BMC Nurs. 2023;22(1):444.

Goussinsky R, Livne Y. (2016). Coping with interpersonal mistreatment: The role of emotion regulation strategies and supervisor support. Journal of nursing management, 24 (8), 1109–1118. https://doi.org/10.1111/jonm.12415 .

Grandey A, Foo SC, Groth M, Goodwin RE. Free to be you and me: a climate of authenticity alleviates burnout from emotional labor. J Occup Health Psychol. 2012;17(1):1. https://doi.org/10.1037/a0025102 .

Bonner G, McLaughlin S. The psychological impact of aggression on nursing staff. Br J Nurs. 2007;16(13):810–4. https://doi.org/10.12968/bjon.2007.16.13.24248 .

Zampieron A, Galeazzo M, Turra S, Buja A. Perceived aggression towards nurses: study in two Italian health institutions. J Clin Nurs. 2010;19(15–16):2329–41. https://doi.org/10.1111/j.1365-2702.2009.03118.x .

Ahmad M, Al-Rimawi R, Masadeh A, Atoum M. Workplace violence by patients and their families against nurses: literature review. Int J ofNursing Health Sci. 2015;2(4):46–55. http://www.openscienceonline.com/journal/ijnhs .

Choi S, Cheong K, Feinberg RA. Moderating effects of supervisor support, monetary rewards, and career paths on the relationship between job burnout and turnover intentions in the context of call centers. Managing Service Qual. 2012;22:492–516. https://doi.org/10.1108/09604521211281396 .

Hobfoll SE. Conservation of resources: a new attempt at conceptualizing stress. Am Psychol. 1989;44(3):513. https://doi.org/10.1037//0003-066x.44.3.513 .

Article   CAS   PubMed   Google Scholar  

Hobfoll SE, Halbesleben J, Neveu JP, Westman M. Conservation of resources in the organizational context: the reality of resources and their consequences. Annual Rev Organizational Psychol Organizational Behav. 2018;5:103–28. https://doi.org/10.1146/annurev-orgpsych-032117-104640 .

Hobfoll SE. The influence of culture, community, and the nested-self in the stress process: advancing conservation of resources theory. Appl Psychol. 2001;50(3):337–421. https://doi.org/10.1111/1464-0597.00062 .

Zech E, Rimé B, Nils F. Social sharing of emotion, emotional recovery, and interpersonal aspects. In: Philippot P, Feldman RS, editors. The regulation of emotion. Lawrence Erlbaum Associates; 2004. pp. 157–85.

Spencer L. Social sharing of negative emotional events: whether or not sharing helps depends on the Listener’s response. The Pennsylvania State University; 2019.

Delroisse S, Rimé B, Stinglhamber F. Quality of social sharing of emotions alleviates job burnout: the role of meaning of work. J Health Psychol. 2023;28(1):61–76. https://doi.org/10.1177/13591053221091039 .

Nolen-Hoeksema S, Larson J, Grayson C. Explaining the gender difference in depressive symptoms. J Personal Soc Psychol. 1999;77(5):1061. https://doi.org/10.1037//0022-3514.77.5.1061 .

Article   CAS   Google Scholar  

Wang M, Liao H, Zhan Y, Shi J. Daily customer mistreatment and employee sabotage against customers: examining emotion and resource perspectives. Acad Manag J. 2011;54(2):312–34. https://doi.org/10.5465/amj.2011.60263093 .

Martin LL, Tesser A. (1989). Toward a motivational and structural theory of ruminative thought.

Martin LL, Tesser A. Some ruminative thoughts. Ruminative Thoughts. 1996;9(1996):1–47.

Zhao S, Liu H, Ma H, Jiao M, Li Y, Hao Y, Qiao H. Coping with workplace violence in healthcare settings: social support and strategies. Int J Environ Res Public Health. 2015;12(11):14429–44. https://doi.org/10.3390/ijerph121114429 .

Mathieu M, Eschleman KJ, Cheng D. Meta-analytic and multiwave comparison of emotional support and instrumental support in the workplace. J Occup Health Psychol. 2019;24(3):387. https://doi.org/10.1037/ocp0000135 .

Nahum-Shani I, Bamberger PA, Bacharach SB. Social support and employee well-being: the conditioning effect of perceived patterns of supportive exchange. J Health Soc Behav. 2011;52(1):123–39. https://doi.org/10.1177/0022146510395024 .

Willemse BM, de Jonge J, Smit D, Depla MF, Pot AM. The moderating role of decision authority and coworker-and supervisor support on the impact of job demands in nursing homes: a cross-sectional study. Int J Nurs Stud. 2012;49(7):822–33. https://doi.org/10.1016/j.ijnurstu.2012.02.003 .

Egozi Farkash H, Lahad M, Hobfoll SE, Leykin D, Aharonson-Daniel L. Conservation of resources, psychological distress, and resilience during the Covid-19 pandemic. Int J Public Health. 2022;67:1604567. https://doi.org/10.3389/ijph.2022.1604567 .

Hahn S, Zeller A, Needham I, Kok G, Dassen T, Halfens RJ. Patient and visitor violence in general hospitals: a systematic review of the literature. Aggress Violent Beh. 2008;13(6):431–41. https://doi.org/10.1016/j.avb.2008.07.001 .

Bourn J. A safer place to work: protecting NHS hospital and ambulance staff from violence and aggression. London: The National Audit Office; 2003.

Chappell D, Di Martino V. Violence at work. International Labour Organization; 2006.

Wells J, Bowers L. How prevalent is violence towards nurses working in general hospitals in the UK? J Adv Nurs. 2002;39(3):230–40. https://doi.org/10.1046/j.1365-2648.2002.02269.x .

Karaeminogullari A, Erdogan B, Bauer TN. Biting the hand that heals: mistreatment by patients and the well-being of healthcare workers. Personnel Rev. 2018;47(2):572–91. https://doi.org/10.1108/PR-03-2016-0054 .

Rupp DE, Spencer S. When customers lash out: the effects of customer interactional injustice on emotional labor and the mediating role of discrete emotions. J Appl Psychol. 2006;91(4):971. https://doi.org/10.1037/0021-9010.91.4.971 .

Groth M, Grandey A. From bad to worse: negative exchange spirals in employee–customer service interactions. Organizational Psychol Rev. 2012;2(3):208–33. https://doi.org/10.1177/2041386612441735 .

Lanctôt N, Guay S. The aftermath of workplace violence among healthcare workers: a systematic literature review of the consequences. Aggress Violent Beh. 2014;19(5):492–501. https://doi.org/10.1016/j.avb.2014.07.010 .

Viotti S, Gil-Monte PR, Converso D. Toward validating the Italian version of the Spanish burnout inventory: a preliminary study. Revista Da Escola De Enfermagem Da USP. 2015;49:819–25. https://doi.org/10.1590/S0080-623420150000500016 .

Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB. A model of burnout and life satisfaction amongst nurses. J Adv Nurs. 2000;32(2):454–64. https://doi.org/10.1046/j.1365-2648.2000.01496.x .

Bakker AB, Demerouti E. The job demands-resources model: state of the art. J Managerial Psychol. 2007;22(3):309–28. https://doi.org/10.1108/02683940710733115 .

Rimé B, Mesquita B, Boca S, Philippot P. Beyond the emotional event: six studies on the social sharing of emotion. Cognition Emot. 1991;5(5–6):435–65. https://doi.org/10.1080/02699939108411052 .

Rose AJ. Co–rumination in the friendships of girls and boys. Child Dev. 2002;73(6):1830–43. https://doi.org/10.1111/cdev.2002.73.issue-6 .

Consedine N, Strongman K, Magai C. Emotions and behaviour: data from a cross-cultural recognition study. Cogn Emot. 2003;17(6):881–902. https://doi.org/10.1080/02699930244000246 .

Burleson BR. The experience and effects of emotional support: what the study of cultural and gender differences can tell us about close relationships, emotion, and interpersonal communication. Personal Relationships. 2003;10(1):1–23. https://doi.org/10.1111/1475-6811.00033 .

Laurens F, Herbette G, Rimé B. (2000). Le partage social des épisodes émotionnels vécus en milieu hospitalier par le personnel infirmier [Social sharing of emotion among nurses working in the hospital]. Unpublished manuscrit, University of Louvain, Belgium.

Lepore SJ, Ragan JD, Jones S. Talking facilitates cognitive–emotional processes of adaptation to an acute stressor. J Personal Soc Psychol. 2000;78(3):499. https://doi.org/10.1037//0022-3514.78.3.499 .

Clark MS, Finkel EJ. (2004). Does expressing emotion promote well-being? It depends on relationship context. The social life of emotions, 105–126. https://doi.org/10.1017/CBO9780511819568.007 .

Baranik LE, Wang M, Gong Y, Shi J. Customer mistreatment, employee health, and job performance: cognitive rumination and social sharing as mediating mechanisms. J Manag. 2017;43(4):1261–82. https://doi.org/10.1177/0149206315580581 .

Hobfoll SE. (1988). The ecology of stress. Taylor & Francis. https://doi.org/10.1002/smi.2460050415 .

Hobfoll SE. Stress, culture, and community: the psychology and physiology of stress. New York: Plenum; 1998. https://doi.org/10.1007/978-1-4899-0115-6 .

Book   Google Scholar  

Hobfoll SE. Conservation of resource caravans and engaged settings. J Occup Organizational Psychol. 2011;84(1):116–22. https://doi.org/10.1111/j.2044-8325.2010.02016.x .

Eisenberger R, Huntington R, Hutchison S, Sowa D. Perceived organizational support. J Appl Psychol. 1986;71(3):500. https://doi.org/10.1037/0021-9010.71.3.500 .

Westman M. Stress and strain crossover. Hum Relat. 2001;54(6):717–51. https://doi.org/10.1177/0018726701546002 .

Van Woerkom M, Mostert K, Els C, Bakker AB, De Beer L, Rothmann S Jr. Strengths use and deficit correction in organizations: development and validation of a questionnaire. Eur J Work Organizational Psychol. 2016;25(6):960–75.

Bakker AB, Demerouti E, Euwema MC. Job resources buffer the impact of job demands on burnout. J Occup Health Psychol. 2005;10(2):170. https://doi.org/10.1037/1076-8998.10.2.170 .

Eisenberger R, Armeli S, Rexwinkel B, Lynch PD, Rhoades L. Reciprocation of perceived organizational support. J Appl Psychol. 2001;86(1):42. https://doi.org/10.1037/0021-9010.86.1.42 .

George JM, Brief AP. Feeling good-doing good: a conceptual analysis of the mood at work-organizational spontaneity relationship. Psychol Bull. 1992;112(2):310. https://doi.org/10.1037/0033-2909.112.2.310 .

Denney D, O’Beirne M. Violence to probation staff: patterns and managerial responses. Social Policy Adm. 2003;37(1):49–64. https://doi.org/10.1111/1467-9515.00323 .

Schat AC, Kelloway EK. Reducing the adverse consequences of workplace aggression and violence: the buffering effects of organizational support. J Occup Health Psychol. 2003;8(2):110. https://doi.org/10.1037/1076-8998.8.2.110 .

Wasco SM, Campbell R, Clark M. A multiple case study of rape victim advocates’ self-care routines: the influence of organizational context. Am J Community Psychol. 2002;30:731–60. https://doi.org/10.1111/1467-9515.00323 .

Verquer ML, Beehr TA, Wagner SH. A meta-analysis of relations between person–organization fit and work attitudes. J Vocat Behav. 2003;63(3):473–89. https://doi.org/10.1016/S0001-8791(02)00036-2 .

Bowling NA, Beehr TA. Workplace harassment from the victim’s perspective: a theoretical model and meta-analysis. J Appl Psychol. 2006;91(5):998. https://doi.org/10.1037/0021-9010.91.5.998 .

Deelstra JT, Peeters MC, Schaufeli WB, Stroebe W, Zijlstra FR, Van Doornen LP. Receiving instrumental support at work: when help is not welcome. J Appl Psychol. 2003;88(2):324. https://doi.org/10.1037/0021-9010.88.2.324 .

Dohrenwend BS. Social stress and community psychology. Am J Community Psychol. 1978;6(1):1. https://doi.org/10.1007/bf00890095 .

Luthens F, Avolio BJ. (2003). Authentic Leadership: a positive Developmental Approach. Posit Organizational Scholarsh San Francisco: Barrettt-Koehler, 241–61.

Youssef CM, Luthans F. Positive organizational behavior in the workplace: the impact of hope, optimism, and resilience. J Manag. 2007;33(5):774–800. https://doi.org/10.1177/0149206307305562 .

Lahad M. From victim to victor: the development of the BASIC PH model of co** and resiliency. Traumatology. 2017;23(1):27. https://doi.org/10.1037/trm0000105 .

Chen S, Westman M, Hobfoll SE. The commerce and crossover of resources: resource conservation in the service of resilience. Stress Health. 2015;31(2):95–105. https://doi.org/10.1002/smi.2574 .

Hobfoll SE, Stevens NR, Zalta AK. Expanding the science of resilience: conserving resources in the aid of adaptation. Psychol Inq. 2015;26(2):174–80. https://doi.org/10.1080/1047840x.2015.1002377 .

Bonanno GA. Loss, trauma, and human resilience: have we underestimated the human capacity to Thrive after extremely aversive events? Am Psychol. 2004;59(1):20–8. https://doi.org/10.1037/0003-066X.59.1.20 .

Wagnild GM, Young HM. Development and psychometric. J Nurs Meas. 1993;1(2):165–17847. https://doi.org/10.1891/1061-3749.25.3.400 .

Abolghasemi A, Varaniyab ST. Resilience and perceived stress: predictors of life satisfaction in the students of success and failure. Procedia-Social Behav Sci. 2010;5:748–52. https://doi.org/10.1016/j.sbspro.2010.07.178 .

Tung KS, Ning WW, Kris LEE. Effect of resilience on self-perceived stress and experiences on stress symptoms a surveillance report. Univers J Public Health. 2014;2(2):64–72. https://doi.org/10.13189/ujph.2014.020205 .

Halbesleben JR, Neveu JP, Paustian-Underdahl SC, Westman M. Getting to the COR understanding the role of resources in conservation of resources theory. J Manag. 2014;40(5):1334–64. https://doi.org/10.1177/0149206314527130 .

Moodley J, Cooper D, Mantell JE, Stern E. Health care provider perspectives on pregnancy and parenting in HIV-positive individuals in South Africa. BMC Health Serv Res. 2014;14(1):1–8. https://doi.org/10.1186/1472-6963-14-384 .

Brislin RW. (1980). Translation and content analysis of oral and written materials. Methodology, 389–444.

Gable SL, Reis HT, Impett EA, Asher ER. What do you do when things go right? The intrapersonal and interpersonal benefits of sharing positive events. J Personal Soc Psychol. 2004;87(2):228. https://doi.org/10.1037/0022-3514.87.2.228 .

Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory. Scarecrow Education; 1997.

Shen J, Benson J. When CSR is a social norm: how socially responsible human resource management affects employee work behavior. J Manag. 2016;42(6):1723–46. https://doi.org/10.1177/0149206314522300 .

Smith SE, Read DJ. Mycorrhizal symbiosis. Academic; 2010.

Fuller CM, Simmering MJ, Atinc G, Atinc Y, Babin BJ. Common methods variance detection in business research. J Bus Res. 2016;69(8):3192–8. https://doi.org/10.1016/j.jbusres.2015.12.008 .

Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP. Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol. 2003;88(5):879. https://doi.org/10.1037/0021-9010.88.5.879 .

Baron RM, Kenny DA. The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Personal Soc Psychol. 1986;51(6):1173. https://doi.org/10.1037//0022-3514.51.6.1173 .

Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40(3):879–91. https://doi.org/10.3758/brm.40.3.879 .

Dormann C, Zapf D. Customer-related social stressors and burnout. J Occup Health Psychol. 2004;9(1):61. https://doi.org/10.1037/1076-8998.9.1.61 .

Anjum MA, Liang D, Durrani DK, Parvez A. Workplace mistreatment and emotional exhaustion: the interaction effects of self-compassion. Curr Psychol. 2020;1–12. https://doi.org/10.1007/s12144-020-00673-9 .

Kaur P, Islam N, Tandon A, Dhir A. Social media users’ online subjective well-being and fatigue: a network heterogeneity perspective. Technol Forecast Soc Chang. 2021;172:121039. https://doi.org/10.1016/j.techfore.2021.121039 .

Estryn-Behar M, Van Der Heijden B, Camerino D, Fry C, Le Nezet O, Conway PM, Hasselhorn HM. Violence risks in nursing—results from the European ‘NEXT’study. Occup Med. 2008;58(2):107–14. https://doi.org/10.1093/occmed/kqm142 .

Adams S, Camarillo C, Lewis S, McNish N. Resiliency training for medical professionals. US Army Medical Department Journal; 2010.

Podsakoff PM, Organ DW. Self-reports in organizational research: problems and prospects. J Manag. 1986;12(4):531–44.https://psycnet.apa.org/doi/10.1177/014920638601200408

Download references

Acknowledgements

The authors thank all participants who showed great patience in answering the questionnaire.

This study was supported by the National Social Science Foundation of China (Grant number: 19BJY052, 22BGL141), National Natural Science Foundation of China (Grant number: 72110107002, 71974021), Natural Science Foundation of Chongqing (Grant number: cstc2021jcyj-msxmX0689), the Fundamental Research Funds for the Central Universities (Grant number: 2022CDJSKJC14), and Chongqing Social Science Planning Project (Grant number: 2018PY76).

Author information

Authors and affiliations.

School of Economics and Business Administration, Chongqing University, Chongqing, China

Wei Yan & Xiu Chen

Medical Insurance Office, Hospital of Chongqing University, Chongqing, China

School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China

Development and Planning Department, Chongqing Medical University, Chongqing, China

Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Chongqing, China

Human Resources Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Department of Burn Plastic and Microsurgery, The No. 987 Hospital of Joint Logistic Support Force of PLA, Baoji, China

Chunjuan Xu

Xinqiao Hospital, Army Medical University, No. 83 Xinqiao Main Street, Shapingba District, Chongqing, China

Caiping Song

You can also search for this author in PubMed   Google Scholar

Contributions

All authors contributed to the conception and design of the study. Study design, questionnaire collection, data acquisition were performed by WY, HW and CJX. Data analysis and the first draft of the manuscript was written by WY and XC. DX, XD, LL and CPS commented on the manuscript and revised it critically for important intellectual content.

Corresponding authors

Correspondence to Chunjuan Xu or Caiping Song .

Ethics declarations

Ethics approval and consent to participate.

This study was approved by the Ethics Review Committee of the School of Economics and Business Administration, Chongqing University (IRB No. SEBA201906). All methods were carried out in accordance with relevant guidelines and regulation. Informed consent was obtained from all subjects.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Yan, W., Chen, X., Xiao, D. et al. Patient mistreatment, social sharing of negative events and emotional exhaustion among Chinese nurses: the combined moderating effect of organizational support and trait resilience. BMC Nurs 23 , 260 (2024). https://doi.org/10.1186/s12912-024-01924-x

Download citation

Received : 18 November 2023

Accepted : 08 April 2024

Published : 22 April 2024

DOI : https://doi.org/10.1186/s12912-024-01924-x

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Resilience trait
• Combined effects

BMC Nursing

ISSN: 1472-6955

• General enquiries: [email protected]

Why do people enjoy hitchhiking in teams? A moderated serial mediated study on social loafing

• Original Article
• Published: 23 April 2024

Cite this article

• Lihu Sun 1 ,
• Xin Gao   ORCID: orcid.org/0000-0001-9487-7628 1 &
• Yang Li 1  

Drawing on social information processing theory, this study explored the formation mechanism of social loafing and the outcomes of emotional attitudes from a team perspective, revealing the boundary conditions associated with this process. By conducting a time-lagged field study of 223 employees and 75 leaders working in a large Chinese enterprise, we found support that team task visibility is negatively related to team social loafing and that team contribution identifiability fully mediates the relationship between team task visibility and team social loafing. We also examined a moderated serial mediation model according to which team task interdependence moderates this serial mediating effect, thus suggesting that team task interdependence moderates the serial mediating effect according to which team task visibility influences team job satisfaction through team contribution identifiability and team social loafing. These findings enrich relevant research and can help leaders address the phenomenon of social loafing more effectively in organizational contexts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price includes VAT (Russian Federation)

Instant access to the full article PDF.

Rent this article via DeepDyve

Institutional subscriptions

Data availability

The data that support the findings of this study are available from the corresponding author by request.

Bartko, J. J. (1976). On various intraclass correlation reliability coefficients. Psychological Bulletin, 83 (5), 762–765.

Article   Google Scholar  

Bluhm, D. J. (2009). Adaptive consequences of social loafing. Academy of Management Annual Meeting Proceedings, 2009 (1), 1–6.

Google Scholar  

Byun, G., Lee, S., Karau, S. J., & Ye, D. (2020). Sustaining collaborative effort in work teams: Exchange ideology and employee social loafing. Sustainability, 12 (15), 1–14.

Castro, S. L. (2002). Data analytic methods for the analysis of multilevel questions: A comparison of intraclass correlation coefficients, r wg (j), hierarchical linear modeling, within- and between-analysis, and random group resampling. The Leadership Quarterly, 13 (1), 69–93.

Chae, H., Park, J., & Choi, J. N. (2019). Two facets of conscientiousness and the knowledge sharing dilemmas in the workplace: Contrasting moderating functions of supervisor support and coworker support. Journal of Organizational Behavior, 40 (4), 1–42.

Chang, Y., Hou, R. J., Wang, K., Cui, A. P., & Zhang, C. B. (2020). Effects of intrinsic and extrinsic motivation on social loafing in online travel communities. Computers in Human Behavior, 109 (8), 106360.

Chiu, S. I., Chen, T. Y., Chang, T. L., & Chen, C. Y. (2020). Procrastination, dependence and social loafing: Comparison in high/low task visibility between active/passive procrastinators. International Journal Psychiatry Research, 3 (2), 1–11.

Courtright, S. H., Thurgood, G. R., Stewart, G. L., & Pierotti, A. J. (2015). Structural interdependence in teams: An integrative framework and meta-analysis. Journal of Applied Psychology, 100 (6), 1825–1846.

Cremer, D. D., Snyder, M., & Dewitte, S. (2001). The less I trust, the less I contribute (or not)? The effects of trust, accountability and self-monitoring in social dilemmas. European Journal of Social Psychology, 31 (1), 93–107.

Dai, W. L., & Lu, W. L. (2021). The trickle-down effect of responsible leadership on employees’ responsible innovation: An explanation based on social information processing theory. Science of Science and Management of S&t, 42 (7), 121–138.

Díaz-Carrión, R., Navajas-Romero, V., & Casas-Rosal, J. C. (2020). Comparing working conditions and job satisfaction in hospitality workers across Europe. International Journal of Hospitality Management, 90 (5), 102631.

Drach-Zahavy, A., & Somech, A. (2013). Linking task and goal interdependence to quality service: The role of the service climate. Journal of Service Management, 24 (2), 151–169.

Elshaer, I. A., Algezawy, M., Ghaleb, M. M. S., Mohamed, S. A., & Azazz, A. M. S. (2023). The impact of social loafing on turnover intention for tourism employees post COVID-19: The mediating role of mental health. International Journal of Environmental Research and Public Health, 20 (9), 5702.

Gammage, K. L., Carron, A. V., & Estabrooks, P. A. (2001). Team cohesion and individual productivity: The influence of the norm for productivity and the identifiability of individual effort. Small Group Research, 32 (1), 3–18.

George, J. M. (1992). Extrinsic and intrinsic origins of perceived social loafing in organizations. The Academy of Management Journal, 35 (1), 191–202.

Glomb, T. M., & Tews, M. J. (2004). Emotional labor: A conceptualization and scale development. Journal of Vocational Behavior, 64 (1), 1–23.

Heneman, R. L., & Hippel, C. V. (1995). Balancing group and individual rewards: Rewarding individual contributions to the team. Compensation and Benefits Review, 27 (4), 63–68.

Hou, R. J., Han, S. H., & Zhang, C. B. (2021). The effects of psychological ownership on social loafing of online brand community: A moderated mediation model. Commercial Research, 2 (1), 1–11.

Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling Multidisciplinary Journal, 6 (1), 1–55.

Jones, G. R. (1984). Task visibility, free riding, and shirking: Explaining the effect of structure and technology on employee behavior. The Academy of Management Review, 9 (4), 684–695.

Karau, S. J., & Wilhau, A. J. (2020). Social loafing and motivation gains in groups: An integrative review. In S. J. Karau (Ed.), Individual motivation within groups: Social loafing and motivation gains in work, academic, and sports teams (pp. 3–51). Elsevier Academic.

Chapter   Google Scholar  

Karau, S. J., & Williams, K. D. (1993). Social loafing: A meta-analytic review and theoretical integration. Journal of Personality & Social Psychology, 65 (4), 681–706.

Karau, S. J., & Williams, K. D. (1995). Social loafing: Research findings, implications, and future directions. Current Directions in Psychological Science, 4 (5), 134–140.

Khan, H., Rehmat, M., Butt, T. H., Farooqi, S., & Asim, J. (2020). Impact of transformational leadership on work performance, burnout and social loafing: A mediation model. Future Business Journal, 6 (40), 1–13.

Kidwell, R. E., & Bennett, N. (1993). Employee propensity to withhold effort: A conceptual model to intersect three avenues of research. The Academy of Management Review, 18 (3), 429–456.

Kim, J. Y., Jeung, W., Kang, S. W., & Paterson, T. A. (2023). An empirical study of social loafing behavior among public officers in South Korea: The role of trust in a supervisor, perceived organizational support, and perceived organizational politics. Behavioral Science, 13 (6), 498.

Kline, R. B. (2015). Principles and practice of structural equation modeling . Guilford Press.

Lanaj, K., & Hollenbeck, J. R. (2015). Leadership over-emergence in self-managing teams: The role of gender and countervailing biases. Academy of Management Journal, 58 (5), 1476–1494.

Latané, B., Williams, K., & Harkins, S. (1979). Many hands make light the work: The causes and consequences of social loafing. Journal of Personality and Social Psychology, 37 (6), 822–832.

Lepine, J. A., Piccolo, R. F., Jackson, C. L., Mathieu, J. E., & Saul, J. R. (2008). A meta-analysis of teamwork processes: Tests of a multidimensional model and relationships with team effectiveness criteria. Personnel Psychology, 61 (2), 273–307.

Liden, R. C., Wayne, S. J., Jaworski, R. A., & Bennett, N. (2004). Social loafing: A field investigation. Journal of Management, 30 (2), 285–304.

Liu, C., Spector, P. E., & Shi, L. (2007). Cross-national job stress: A quantitative and qualitative study. Journal of Organizational Behavior, 28 (2), 209–239.

Liu, X. Y., & Liu, J. (2013). Effects of team leader emotional intelligence and team emotional climate on team member job satisfaction. Nankai Business Review International, 4 (3), 180–198.

Mihelič, K. K., & Culiberg, B. (2019). Reaping the fruits of another’s labor: The role of moral meaningfulness, mindfulness, and motivation in social loafing. Journal of Business Ethics, 160 (3), 713–727.

Monzani, L., Ripoll, P., Peiró, J. M., & Van Dick, R. (2014). Loafing in the digital age: The role of computer mediated communication in the relation between perceived loafing and group affective outcomes. Computers in Human Behavior, 33 (4), 279–285.

Ni, D., Zheng, X. M., Liu, X., & Zhang, M. Y. (2021). How and when does team mindfulness influence team effectiveness? Using company A in the manufacturing industry as an example. Science of Science and Management of S&t, 42 (06), 164–186.

Pearce, J. L., & Gregersen, H. B. (1991). Task interdependence and extra role behavior: A test of the mediating effects of felt responsibility. Journal of Applied Psychology, 76 (6), 838–844.

Peñarroja, V., Orengo, V., & Zornoza, A. (2017). Reducing perceived social loafing in virtual teams: The effect of team feedback with guided reflexivity. Journal of Applied Social Psychology, 47 (8), 424–435.

Peng, H., & Wei, F. (2020). How and when does leader behavioral integrity influence employee voice? The roles of team independence climate and corporate ethical values. Journal of Business Ethics, 166 , 505–521.

Podsakoff, P. M., Mackenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88 (5), 879–903.

Podsakoff, P. M., & Organ, D. W. (1986). Self-reports in organizational research: Problems and prospects. Journal of Management, 12 , 531–544.

Price, K. H., Harrison, D. A., & Gavin, J. H. (2006). Withholding inputs in team contexts: Member composition, interaction processes, evaluation structure, and social loafing. Journal of Applied Psychology, 91 (6), 1375.

Rego, A., Owens, B., Kai, C. Y., Bluhm, D., Cunha, M. P. E., Silard, A., Gonçalves, L., Martins, M., & Simpson, A. V. (2019). Leader humility and team performance: Exploring the mediating mechanisms of team PsyCap and task allocation effectiveness. Journal of Management, 45 (3), 1009–1033.

Robert, L. P. (2020). Behavior-output control theory, trust and social loafing in virtual teams. Multimodal Technologies and Interaction, 4 (3), 39.

Rousseau, D. M. (1985). Issues of level in organizational research: Multi-level and cross-level perspectives. Research in Organizational Behavior, 7 , 1–37.

Saavedra, R., Earley, P. C., & Dyne, L. V. (1993). Complex inter-dependence in task-performing groups. Journal of Applied Psychology, 78 (1), 61–72.

Salancik, G. R., & Pfeffer, J. (1978). A social information processing approach to job attitudes and task design. Administrative Science Quarterly, 23 (2), 224–253.

Shih, H. A., & Susanto, E. (2017). Perceived identifiability, shared responsibility and innovative work behavior. The International Journal of Human Resource Management, 28 (22), 3109–3127.

Tosuntaş, ŞB. (2020). Diffusion of responsibility in group work: Social loafing. Journal of Pedagogical Research, 4 (3), 344–358.

Van der Vegt, G. S., & Janssen, O. (2003). Joint impact of interdependence and group diversity on innovation. Journal of Management, 29 (5), 729–751.

Wagner, J. A. (1995). Studies of individualism–collectivism: Effects on cooperation in groups. Academy of Management Journal, 38 (1), 152–173.

Wang, Y. F., Lin, S. Y., Zheng, L. X., & Zhu, Y. (2022). The double-edged sword effect of ethical leadership on employee innovative behavior from the perspective of social information processing. Chinese Journal of Management, 19 (7), 1006–1015.

Williams, K., Harkins, S. G., & Latané, B. (1981). Identifiability as a deterrent to social loafing: Two cheering experiments. Journal of Personality and Social Psychology, 40 (2), 303–311.

Wong, M. N., Cheng, B. H., Lam, L. W. Y., & Peter, A. B. (2022). Pay transparency as a moving target: A multi-step model of pay compression, i-deals, and collectivist shared values. Academy of Management Journal, 66 (2), 489–520.

Wyer, R. S., & Srull, T. K. (1986). Human cognition in its social context. Psychological Review, 93 (3), 322–359.

Xu, L. N., & Zhang, Z. X. (2022). Managing people work and task work: The interaction process and outcome in self-managing teams. Psychological Research Psychologische Forschung, 15 (4), 336–347.

Yam, K. C., Christian, M. S., Wei, W., Liao, Z. Y., & Nai, J. (2018). The mixed blessing of leader sense of humor: Examining costs and benefits. Academy of Management Journal, 61 (1), 348–369.

Yan, Y. L., Zhao, P., & Zha, X. J. (2023). Transactive memory system (TMS) and knowledge sharing: The effects of social capital and task visibility. Library and Information Science Research, 45 (2), 101233.

Ye, Y., Chen, M., Wu, L. Z., & Kwan, H. K. (2023). Why do they slack off in teamwork? Understanding frontline hospitality employees’ social loafing when faced with exploitative leadership. International Journal of Hospitality Management, 109 , 103420.

Yong, Y. (2020). The relationship between workplace ostracism, TMX, task interdependence, and task performance: A moderated mediation model. International Journal of Environmental Research and Public Health, 17 (12), 4432.

Zhou, J. T., & Liao, J. Q. (2018). Study on the influencing mechanism of humble leader behaviors on employee job performance based on social information processing theory. Chinese Journal of Management, 15 (12), 1789–1798.

Zhu, M., Singh, S., & Wang, H. (2019). Perceptions of social loafing during the process of group development. International Journal of Organization Theory and Behavior, 22 (4), 350–368.

Download references

Acknowledgements

All authors sincerely thank the reviewers and editors for their enthusiastic and patient work during the review procedure.

The authors were supported by Ministry of Education Humanities and Social Sciences Research Project (18YJA630099).

Author information

Authors and affiliations.

Shanxi University of Finance and Economics, Taiyuan, 030006, Shanxi, China

Lihu Sun, Xin Gao & Yang Li

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Xin Gao .

Ethics declarations

Conflict of interest.

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Sun, L., Gao, X. & Li, Y. Why do people enjoy hitchhiking in teams? A moderated serial mediated study on social loafing. Asian Bus Manage (2024). https://doi.org/10.1057/s41291-024-00267-4

Download citation

Received : 21 September 2022

Revised : 24 December 2023

Accepted : 09 January 2024

Published : 23 April 2024

DOI : https://doi.org/10.1057/s41291-024-00267-4

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Team social loafing
• Team task visibility
• Team contribution identifiability
• Team task interdependence
• Team job satisfaction
• Find a journal
• Publish with us
• Track your research

Advertisement

Supported by

A Life Overtaken by Conspiracy Theories Explodes in Flames as the Public Looks On

Friends of Max Azzarello, who set himself on fire outside Donald J. Trump’s trial, said he was a caring person whose paranoia had led him down a dark path.

• Share full article

By Michael Wilson ,  Tracey Tully and Jan Ransom

The journey that ended with a man setting himself on fire on Friday outside the Manhattan courthouse where Donald J. Trump was being tried seemed to have begun in Florida, with a series of increasingly bizarre outbursts.

Standing in the afternoon chill, the man, Max Azzarello, 37, of St. Augustine, Fla., threw pamphlets into the air before dousing himself with an accelerant and setting his body ablaze. The police hurried to extinguish the flames, and he was taken to a hospital burn unit, gravely injured. He died on Friday night.

The fire just a block or two from the courthouse appeared calculated to draw widespread attention, horrifying bystanders and temporarily overshadowing the momentous trial of a former president.

But a closer look at the path the man had traveled to this moment of self-destruction revealed a recent spiral into volatility, one marked by a worldview that had become increasingly confusing and disjointed — and appeared to be unattached to any political party. His social media postings and arrest records suggest the immolation stemmed instead from a place of conspiracy theories and paranoia.

Until last summer, Mr. Azzarello seemed to have lived a relatively quiet life. After high school, where he was a member of a bowling team, he graduated from the University of North Carolina at Chapel Hill in 2009, with degrees in anthropology and public policy.

As a student at Rutgers University in New Brunswick, N.J., where he received a master’s degree in city and regional planning in 2012, he was known for leaving supportive Post-it notes for classmates in the hallways and for his karaoke performances of Frank Sinatra and Disney tunes, said a former classmate, Katie Brennan.

“He was super curious about social justice and the way things ‘could’ be,” Ms. Brennan said. “He was creative and adventurous.”

He began a career in which, according to his LinkedIn profile, he moved among jobs in marketing, sales and technology. In 2013, he worked on the campaign of Representative Tom Suozzi of Long Island, who was then running for Nassau County executive.

An old friend from high school, Steven Waldman, called Mr. Azzarello one of the smartest people he knew.

“He was a good friend and person and cared about the world,” he said.

But there was cause for concern, too.

By last year, he had apparently settled in St. Augustine, where he lived in a modest apartment near the Matanzas River in that historic city. He was a pleasant if sometimes peculiar neighbor.

“An extremely nice person,” said Larry Altman, the property manager at his apartment building, who added: “He had political views that I would not consider mainstream. He called our government and the world government a Ponzi scheme.”

But there were no signs that he was harboring an urge to harm himself, Mr. Altman said.

“If you met Max, he’d shake your hand, and you’d have a nice conversation,” he said. “He’d treat you with respect.”

He was clearly deeply affected by the loss of his mother, however. Elizabeth Azzarello died on April 6, 2022, near Sea Cliff, N.Y., on Long Island, where she had fought pulmonary disease, Mr. Azzarello wrote on Instagram in April 2022.

“I am immensely proud to say that she navigated the awful challenges of this disease with strength, dignity and spirit through the very end,” he wrote.

After this loss, his old friends saw a change. “That was around the time when he became more outspoken,” Mr. Waldman said. “They were close, and they had a good relationship. He was heartbroken.”

By the following year, the clarity Mr. Azzarello had shown in writing of his grief was gone, and a troubled image emerged.

In March 2023, he listed his profession on LinkedIn as “Research Investigator,” self-employed. In June of that year, he tagged Ms. Brennan and several others to make sure they had seen something he had written. She described it as a “manifesto” and called him immediately and tried to intervene. Eventually she wrote to one of his family members to make sure that they were aware that he was in crisis, she said.

About five months later, in early August 2023, he posted on Facebook about visiting a mental health treatment facility: “Three days in the psych ward, and all I got were my new favorite socks.”

Days later, in picturesque St. Augustine, he went for dinner at the Casa Monica Hotel on Cordova Street. Afterward, Mr. Azzarello walked into the lobby, approached an autograph left by former President Bill Clinton, who had signed the wall several years earlier, and threw a glass of wine at it, the police said. He admitted what he had done to officers, the police said. The episode was most likely written off as one man’s bad night.

Two days later, he was back, standing outside the hotel in just his underwear, ranting and cursing into a bullhorn, the police said. And just three days after that, he vandalized a sign outside a nearby United Way office before climbing into the bed of a stranger’s truck and rifling its contents, the police said.

All these events played out within walking distance of the apartment where even his most far-afield views had only recently been delivered politely.

In the months that followed, Mr. Azzarello promoted his disjointed preoccupations in a document he posted on Facebook. The pages attacked fascism and the general complacency of the public. They espoused general anti-government sentiment but did not seem directed at a discernible political party.

“Like frogs in water coming to a boil, the public didn’t notice the rotten truth behind the illusion of freedom,” the writings state. The man who had written fondly of his mother just a year earlier — “gracious and warm, silly and catty, compassionate and supportive” — and their time together seemed to have disappeared.

His greatest vexation appeared to be cryptocurrency, which he cast as a threat to humanity.

It was unclear when he arrived in New York, taking a room at the Soho 54 Hotel on Watts Street in Lower Manhattan and making his way to the running sideshow outside the downtown criminal courthouse.

The area he chose, Collect Pond Park, has been an on-and-off stage for supporters and opponents of Mr. Trump for months. Mr. Azzarello was there by Thursday, holding a sign and speaking in ways that, perhaps bizarre elsewhere, fit in with the disparate voices of the park.

On Friday, the crowd in the park had thinned. At about 1:35 p.m., people began to scream. A blur followed: a man on fire, bright flames licking his clothing and hair; officers scrambling over barricades; a departing ambulance.

His oldest friends were left struggling to make sense of this act.

“He was kind and a gentle soul,” said Carol Waldman, the mother of his childhood friend. “A real wonderful, terrific young guy. Who had his whole life ahead of him.”

If you are having thoughts of suicide, you can call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

Nate Schweber , Stefanos Chen , Nichole Manna , Nicholas Fandos , Chelsia Rose Marcius and Claire Fahy contributed reporting. Susan C. Beachy contributed research.

Michael Wilson , who covers New York City, has been a Times reporter for more than two decades. More about Michael Wilson

Tracey Tully is a reporter for The Times who covers New Jersey, where she has lived for more than 20 years. More about Tracey Tully

Jan Ransom is an investigative reporter on the Metro desk focusing on criminal justice issues, law enforcement and incarceration in New York. More about Jan Ransom

Our Coverage of the Trump Hush-Money Trial

News and Analysis

Prosecutors accused Donald Trump of violating a gag order four additional times , saying that he continues to defy the judge’s directions  not to attack witnesses , prosecutors and jurors in his hush-money trial.

Trump’s criminal trial in Manhattan is off to an ominous start for the former president, and it might not get any easier  in the days ahead. Here’s why.

The National Enquirer  was more than a friendly media outlet  for Trump’s presidential campaign in 2016. It was a powerful, national political weapon that was thrust into the service of a single candidate , in violation of campaign finance law.

More on Trump’s Legal Troubles

Key Inquiries: Trump faces several investigations  at both the state and the federal levels, into matters related to his business and political careers.

Case Tracker:  Keep track of the developments in the criminal cases  involving the former president.

What if Trump Is Convicted?: Could he go to prison ? And will any of the proceedings hinder Trump’s presidential campaign? Here is what we know , and what we don’t know .

Trump on Trial Newsletter: Sign up here  to get the latest news and analysis  on the cases in New York, Florida, Georgia and Washington, D.C.

We've detected unusual activity from your computer network

To continue, please click the box below to let us know you're not a robot.

Why did this happen?

Please make sure your browser supports JavaScript and cookies and that you are not blocking them from loading. For more information you can review our Terms of Service and Cookie Policy .

For inquiries related to this message please contact our support team and provide the reference ID below.

ORIGINAL RESEARCH article

This article is part of the research topic.

Modelling Approaches for Climate Variability and Change Mitigation and Adaptation in Resource Constrained Farming Systems

Uptake of climate-smart agricultural technologies and practices: A Three-phase Behavioral Model Provisionally Accepted

• 1 Science and Research Branch, Islamic Azad University, Iran

The final, formatted version of the article will be published soon.

Climate change due to human activities is a reality and a growing threat to global food security. The trend of increasing temperature and decreasing rainfall in Iran shows climate warming, the result of climate change in Iran. Climate-smart agriculture (CSA) is an approach to developing new agricultural practices that support food security against climate change. The purpose of this study was to design a behavioral model for using CSA technologies in three phases: cognitive, motivational, and volitional, using the theories of planned behavior, self-determination, and social cognition. This research is the first to combine behavioral models to understand the application of CSA technologies. The research method in this study was quantitative and non-experimental. The statistical population included 800 wheat farmers from the city of Nazarabad in the Alborz province of Iran. A sample size of 260 people was determined using the Cochran formula. Appropriate stratified sampling was selected as the sampling method. Wheat farmers were then randomly selected in each village through proportional assignment. The research data was collected through a cross-sectional survey and a questionnaire. The models and hypotheses were tested using structural equation modeling. The statistical results confirmed the theoretical model and fifteen research hypotheses. Additionally, the estimated field model explained about 62% of the variance in the behavior of using CSA technologies. Therefore, cognition, motivation, and volition effectively shape the behavior of using CSA technologies. In the cognitive phase, environmental concerns have the greatest impact on attitude towards the behavior of using CSA technologies (β = 0.714). In the motivational phase, personal norms have the most impact on the intention to use CSA technologies (β= 0.643). Finally, in the volitional phase, the intention to use CSA technologies has the highest impact on the behavior of using CSA technologies (β = 0.386). The increase in the guaranteed purchase price of wheat and paying soft and long-term loans by the policymakers will lead to an increase in the intention of wheat farmers to use CSA technologies.

Keywords: Climate change 1, Climate-smart agriculture 2, Theory of Planned Behavior 3, Self-Determination theory 4, social cognition theory 5

Received: 21 Feb 2024; Accepted: 25 Apr 2024.

Copyright: © 2024 Khademi Noshabadi, Omidi Najafabadi and Mirdamadi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Maryam Omidi Najafabadi, Science and Research Branch, Islamic Azad University, Tehran, 1477893855, Tehran, Iran

People also looked at