Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-23T00:43:59.523Z Has data issue: false hasContentIssue false
  • English
  • Français

The buffer theory of social support – a review of the literature

Published online by Cambridge University Press:  09 July 2009

Ruth Alloway  and
Paul Bebbington
Ruth Alloway
Affiliation:
Maudsley Hospital and MRC Social Psychiatry Unit, Institute of Psychiatry, London
Paul Bebbington*
Affiliation:
Maudsley Hospital and MRC Social Psychiatry Unit, Institute of Psychiatry, London
*
1Address for correspondence: Dr P. Bebbington, MRC Social Psychiatry Unit, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The buffer theory postulates that social support moderates the power of psychosocial adversity to precipitate episodes of illness. In this paper, we review the theory as applied to minor affective disturbances. Research in this area suffers because of the many disparate conceptualizations of social support and the resulting difficulty of deciding on the content of measures. Moreover, the meaning of the term buffering is itself unclear. These problems have not, however, inhibited research, and many cross-sectional and longitudinal studies have now been carried out. Our review leads to the conclusion that evidence for a buffering role of social support is inconsistent, reflecting methodological differences between studies but probably also indicating that buffering effects are not of dramatic proportions. Moreover, it is possible that the observed relationships are the result of spurious association or contamination of measures.

Type
Research Article
Information
Psychological Medicine , Volume 17 , Issue 1 , February 1987 , pp. 91 - 108
Copyright
Copyright © Cambridge University Press 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G., Tennant, C. & Abernethy, K. (1977). Some environmental determinants of psychological impairment. In The Impact of Environment and Lifestyle on Human Health (ed. Diesendorf, M. and Furnass, B.), pp. 1227–1233. Society for Social Responsibility in Science: Canberra.Google Scholar
Andrews, G., Tennant, C., Hewson, D. & Vaillant, G. E. (1978). Life event stress, social support, coping style, and risk of psychological impairment. Journal of Nervous and Mental Disease 166, 307–315.CrossRefGoogle ScholarPubMed
Aneshensel, C. S. & Frerichs, R. R. (1982). Stress, support and depression: a longitudinal causal model. Journal of Community Psychology 10, 363–376.3.0.CO;2-8>CrossRefGoogle Scholar
Aneshensel, C. S. & Stone, J. D. (1982). Stress and depression: a test of the buffering model of social support. Archives of General Psychiatry 39, 1392–1396.CrossRefGoogle ScholarPubMed
Bebbington, P. E. (1980). Causal models and logical inference in epidemiological psychiatry. British Journal of Psychiatry 136, 317–325.CrossRefGoogle ScholarPubMed
Bebbington, P. E. (1984). Inferring causes: some constraints in the social psychiatry of depressive disorders. Integrative Psychiatry 2, 69–72.Google Scholar
Bebbington, P. E. (1985). Aetiology of schizophrenia and affective disorders – psychosocial. In Psychiatry. vol. 1. Ch. 63 (ed. Michels, R.), Lippincott: Philadelphia.Google Scholar
Bebbington, P. E., Tennant, C. & Hurry, J. (1981). Life events and the nature of psychiatric disorder in the community. Journal of Affective Disorders 3, 345–366.CrossRefGoogle ScholarPubMed
Bebbington, P. E., Sturt, E., Tennant, C. & Hurry, J. (1984). Misfortune and resilience: a community study of women. Psychological Medicine 14, 347–365.CrossRefGoogle ScholarPubMed
Bell, R. A., LeRoy, J. B. & Stephenson, J. J. (1982). Evaluating the mediating effects of social support upon life events and depressive symptoms. Journal of Community Psychology 10, 325–340.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
Bowlby, J. (1971). Attachment and Loss. I: Attachment. Penguin: Harmondsworth.Google Scholar
Broadhead, W. E., Kaplan, B. H., James, S. A., Wagner, E. H., Schoenbach, V. J., Grimson, R., Heyden, S., Tibblin, G. & Gehlbach, S. H. (1983). The epidemiologic evidence for a relationship between social support and health. American Journal of Epidemiology 117, 521–537.CrossRefGoogle ScholarPubMed
Brown, G. W. (1974). Meaning, measurement and stress of life events. In Stressful Life Events: Their Nature and Effects (ed. Dohrenwend, B. S. and Dohrenwend, B. P.), pp. 217–243. John Wiley: New York.Google Scholar
Brown, G. W., Davidson, S., Harris, T., Maclean, U., Pollock, S. & Prudo, R. (1977). Psychiatric disorder in London and North Uist. Social Science and Medicine 11, 367–377.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. O. (1978). Social Origins of Depression. Tavistock: London.Google ScholarPubMed
Brown, G. W. & Prudo, R. (1981). Psychiatric disorder in a rural and an urban population: 1. Aetiology of depression. Psychological Medicine 11, 581–599.CrossRefGoogle Scholar
Brown, G. W. & Bifulco, A. (1985). Social support, life events and depression. In Social Support: Theory, Research and Application (ed. Sarason, I. G. and Sarason, B. R.), pp. 349–370. Martinus Nijhoff: Dordrecht.CrossRefGoogle Scholar
Brown, G. W., Andrews, B., Bifulco, A., Adler, Z. & Bridge, L. (1986). Social support, self-esteem and depression. Psychological Medicine 16, 813–831.CrossRefGoogle ScholarPubMed
Brugha, T., Conroy, R., Walsh, N., Delaney, W., O'Hanlon, J., Dondero, B., Daly, L., Hickey, N. & Bourke, G. (1982). Social networks, attachments and support in minor affective disorders: a replication. British Journal of Psychiatry 141, 249–255.CrossRefGoogle ScholarPubMed
Campbell, D. T. (1963). From description to experimentation interpreting trends as quasi-experiments. In Problems in Measuring Change (ed. Harris, C. W.), pp. 212–242. University of Wisconsin Press: Madison.Google Scholar
Campbell, E. A., Cope, S. J. & Teasdale, J. D. (1983). Social factors and affective disorder: an investigation of Brown and Harris's model. British Journal of Psychiatry 143, 548–554.CrossRefGoogle Scholar
Cleary, P. D. and Kessler, R. C. (1982). The estimation and interpretation of modifier effects. Journal of Health and Social Behaviour 23, 159–169.CrossRefGoogle ScholarPubMed
Clegg, C. W., Jackson, P. R. and Wall, T. D. (1977). The potential of cross-lagged correlation analysis in field research. Journal of Occupational Psychology 50, 177–196.CrossRefGoogle Scholar
Cohen, S. & Hoberman, H. M. (1983). Positive events and social supports as buffers of life change stress. Journal of Applied and Social Psychology 13, 99–125.CrossRefGoogle Scholar
Cohen, C. & Sokolovsky, J. (1978). Schizophrenia and social networks. Schizophrenia Bulletin 4, 546–560.CrossRefGoogle ScholarPubMed
Cohen, S. & Syme, L. (Ed.) (1985). Social Support and Health, Academic Press: New York.Google Scholar
Cohen, P., Struening, E. L., Genevie, L. E., Kaplan, S. R., Muhlin, G. L. & Peck, H. B. (1982). Community stressors, mediating conditions and well-being in urban neighbourhoods. Journal of Community Psychology 10, 377–391.3.0.CO;2-T>CrossRefGoogle Scholar
Cooke, D. J. (1980). Causal modelling with contingency tables. British Journal of Psychiatry 137, 582–584.CrossRefGoogle ScholarPubMed
Cooley, C. H. (1909). Social Organisation: a Study of the Larger Mind. C. Scribner's Sons: New York.CrossRefGoogle Scholar
Costello, C. G. (1982). Social factors associated with depression: a retrospective community study. Psychological Medicine 12, 329–339.CrossRefGoogle ScholarPubMed
D'Arcy, C. & Siddique, C. M. (1984). Social support and mental health among mothers of pre-school and school age children. Social Psychiatry 19, 155–162.CrossRefGoogle ScholarPubMed
Dean, A. & Lin, N. (1977). The stress-buffering role of social support: problems and prospects for systematic investigation. Journal of Nervous and Mental Disease 165, 403–417.CrossRefGoogle ScholarPubMed
Dean, A. & Ensel, W. M. (1982). Modelling social support, life events, competence and depression in the context of age and sex. Journal of Community Psychology 10, 392–408.3.0.CO;2-2>CrossRefGoogle Scholar
Dohrenwend, B. P. (1974). Problems in defining and sampling the relevant population of stressful life events. In Stressful Life Events: Their Nature and Effects (ed. Dohrenwend, B. S. and Dohrenwend, B. P.), pp. 275–310. John Wiley and Sons: New York.Google Scholar
Durkheim, E. (1951) Suicide: A Study in Sociology. Trans. Spaulding, J. A. and Simpson, G.. Free Press: New York.Google Scholar
Eaton, W. W. (1978). Life events, social supports and psychiatric symptoms: a reanalysis of the New Haven data. Journal of Health and Social Behaviour 19, 230–234.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. (1978). A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry 35, 837–844.CrossRefGoogle ScholarPubMed
Everitt, B. S. (1984) Introduction to Latent Variable Models. Chapman and Hall: London.CrossRefGoogle Scholar
Everitt, B. S. & Smith, A. M. R. (1979). Interactions in contingency tables: a brief discussion of alternative definitions. Psychological Medicine 9, 581–583.CrossRefGoogle ScholarPubMed
Fergusson, D. M. & Horwood, L. J. (1984). Life events and depression in women: a structural equation model. Psychological Medicine 14, 881–889.CrossRefGoogle ScholarPubMed
Finlay-Jones, R., Brown, G. W., Duncan-Jones, P., Harris, T., Murphy, E. & Prudo, R. (1980). Depression and anxiety in the community: replicating the diagnosis of a case. Psychological Medicine 10, 445–454.CrossRefGoogle ScholarPubMed
Frydman, M. I. (1981). Social support, life events and psychiatric symptoms: a study of direct, conditional and interaction effects. Social Psychiatry 16, 69–78.CrossRefGoogle Scholar
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire. Maudsley Monograph no. 21. Oxford University Press: London.Google Scholar
Gore, S. (1978). The effect of social support in moderating the health consequences of unemployment. Journal of Health and Social Behaviour 19, 157–165.CrossRefGoogle ScholarPubMed
Gurin, G., Veroff, J. & Feld, S. (1960). Americans View Their Mental Health: A Nationwide Survey. Basic Books: New York.Google Scholar
Hällström, T. (1986). Social origins of major depression: the role of provoking agents and vulnerability factors. Acta Psychiatrica Scandinavica 73, 383–389.CrossRefGoogle ScholarPubMed
Henderson, A. S. (1984). Interpreting the evidence on social support. Social Psychiatry 19, 49–52.CrossRefGoogle ScholarPubMed
Henderson, A. S., Duncan-Jones, P., McAuley, J. & Ritchie, K. (1978). The patient's primary group. British Journal of Psychiatry 132, 74–86.CrossRefGoogle Scholar
Henderson, A. S., Byrne, D. G. & Duncan-Jones, P. (1981). Neurosis and the Social Environment. Academic Press: Sydney.Google Scholar
Hinde, R. A. (1979). Towards Understanding Relationships. Academic Press: London.Google Scholar
Husaini, B. A. & von Frank, A. (1986). Life events, coping resources and depression: a longitudinal study of direct buffering and reciprocal effects. In Research in Community and Mental Health Vol 5 (ed. Greenley, J.). JAI: Greenwich, Conn.Google Scholar
Husaini, B. A., Neff, J. A., Newbrough, J. R. & Moore, M. C. (1982). The stress-buffering role of social support and personal competence among the rural married. Journal of Community Psychology 10, 409–426.3.0.CO;2-D>CrossRefGoogle Scholar
Kahn, R. L. & Antonucci, T. C. (1980). Convoys over the life course: attachment, roles and social support. In Life Span Development and Behaviour. Vol 3, (ed. Baltes, P. B. and Brim, O. G.). Academic Press: New York.Google Scholar
Kaplan, B. H., Cassel, J. C. & Gore, S. (1977). Social support and health. Medical Care 15, 47–58.CrossRefGoogle ScholarPubMed
Kaplan, H. B., Robbins, C. & Martin, S. S. (1983). Antecedents of psychological distress in young adults: self rejection, deprivation of social support and life events. Journal of Health and Social Behaviour 24, 230–243.CrossRefGoogle ScholarPubMed
Kessler, R. C. & MacLeod, J. (1985). Social support and mental health in community samples. In Social Support and Health (ed. Cohen, S. and Syme, L.), pp. 3–22. Academic Press: New York.Google Scholar
La Rocco, J. M., House, J. S. & French, J. R. P. (1980). Social support, occupational stress and health. Journal of Health and Social Behaviour 21, 202–218.CrossRefGoogle ScholarPubMed
Lin, N. & Dean, A. (1984). Social support and depression: a panel study. Social Psychiatry 19, 83–91.CrossRefGoogle ScholarPubMed
Lin, N., Simeone, R. S., Ensel, W. M. & Kuo, W. (1979). Social support, stressful life events and illness: a model and empirical test. Journal of Health and Social Behaviour 20, 108–119.CrossRefGoogle Scholar
McCallister, L. & Fischer, C. S. (1978). A procedure for surveying personal social networks. Sociological Methods and Research 7, 131–148.CrossRefGoogle Scholar
McFarlane, A. H., Norman, G. R., Streiner, D. L. & Roy, R. G. (1983). The process of social stress. Stable, reciprocal and mediating relationships. Journal of Health and Social Behaviour 24, 160–173.CrossRefGoogle ScholarPubMed
Markus, G. B. (1979). Analysing Panel Data. Sage Publications: Beverly Hills and London.CrossRefGoogle Scholar
Mitchell, J. C. (1969). (Ed). Social Networks in Urban Situations. Manchester University Press: Manchester.Google Scholar
Murphy, E. (1982). Social origins of depression in old age. British Journal of Psychiatry 141, 135–142.CrossRefGoogle ScholarPubMed
Myers, J., Lindenthal, J. & Pepper, J. (1975). Life events, social integration and psychiatric symptomatology. Journal of Health and Social Behaviour 16, 121–127.CrossRefGoogle ScholarPubMed
O'Connor, P. & Brown, G. W. (1984). Supportive relationships: fact or fantasy? Journal of Social and Personal Relationships 1, 159–175.CrossRefGoogle Scholar
O'Neill, M. K., Lancee, W. J. & Freeman, S. J. J. (1986). Psychosocial factors and depressive symptoms. Journal of Nervous and Mental Disease 174, 15–23.Google Scholar
Parry, G. & Shapiro, D. A. (1986). Social support and life events in working class women. Archives of General Psychiatry 43, 315–323.CrossRefGoogle ScholarPubMed
Paykel, E. S. (1974). Life stress and psychiatric disorder: applications of the clinical approach. In Stressful Life Events: Their Nature and Effects (ed. Dohrenwend, B. S. and Dohrenwend, B. P.), pp. 135–149. John Wiley: New York.Google Scholar
Paykel, E. S. (1979). Recent life events in the developments of the depressive disorders. In The Psychobiology of the Depressive Disorders: Implications for the Effects of Stress (ed. Depue, R. A.), pp. 245–262. Academic Press: New York.Google Scholar
Paykel, E. S., Myers, J. K., Dienelt, M. N., Klerman, G. L., Lindenthal, J. J. & Pepper, M. P. (1969). Life events and depression: a controlled study. Archives of General Psychiatry 21, 753–760.CrossRefGoogle ScholarPubMed
Paykel, E. S., Emms, E. M., Fletcher, J. & Rassaby, E. S. (1980). Life events and social support in puerperal depression. British Journal of Psychiatry 136, 339–346.CrossRefGoogle ScholarPubMed
Pearlin, L. I., Lieberman, M. A., Menaghan, E. G. & Mullan, J. T. (1981). The stress process. Journal of Health and Social Behaviour 22, 337–356.CrossRefGoogle ScholarPubMed
Pelz, D. C. & Andrews, F. M. (1964). Detecting causal priorities in panel study data. American Sociological Review 29, 836–848.CrossRefGoogle Scholar
Prudo, R., Brown, G. W., Harris, T. & Dowland, J. (1981). Psychiatric disorder in a rural and an urban population: 2. Sensitivity to loss. Psychological Medicine 11, 601–616.CrossRefGoogle Scholar
Rabkin, J. G. & Struening, E. L. (1976). Life events, Stress and illness. Science 194, 1013–1020.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES–D Scale: a self-report depression scale for research in general population. Applied Psychological Measurement 1 385–401.CrossRefGoogle Scholar
Rutter, M. (1983). Statistical and personal interactions: Facets and perspectives. In Human Development: An Interactional Perspective (ed. Magnusson, D. and Allen, V.), pp. 295–319. Academic Press: London.Google Scholar
Sarason, I. G. & Sarason, B. R. (1982). Concomitants of social support: attitudes, personality characteristics and life experiences. Journal of Personality 50, 333–344.CrossRefGoogle ScholarPubMed
Sarason, I. G., Levine, H. M., Bashan, R. B. & Sarason, B. R. (1983). Assessing social support: the Social Support Questionnaire. Journal of Personality and Social Psychology 44, 127–139.CrossRefGoogle Scholar
Sokolovsky, J., Cohen, C., Berger, D. & Geiger, J. (1978). Personal networks of ex-mental patients in a Manhattan SRO hotel. Human Organisation 37, 5–15.CrossRefGoogle Scholar
Solomon, Z. (1985). Stress, social support and affective disorders in mothers of preschool children: a test of the stress buffering model of social support. Social Psychiatry 20, 100–105.CrossRefGoogle Scholar
Solomon, Z. & Bromet, E. (1982): The role of social factors in affective disorders: an assessment of the vulnerability model of Brown and his colleagues. Psychological Medicine 12, 123–130.CrossRefGoogle Scholar
Tennant, C. & Bebbington, P. E. (1978). The social causation of depression: a critique of the work of Brown and his colleagues. Psychological Medicine 8, 565–575.CrossRefGoogle Scholar
Tennant, C., Bebbington, P. E. & Hurry, J. (1981). The role of life events in depressive illness: is there a substantial causal relation? Psychological Medicine 11, 379–389.CrossRefGoogle Scholar
Thoits, P. A. (1982 a). Conceptual, methodological and theoretical problems in studying social support as a buffer against life stress. Journal of Health and Social Behaviour 23, 145–159.CrossRefGoogle ScholarPubMed
Thoits, P. A. (1982 b). Life stress, social support and psychological vulnerability: epidemiological considerations. Journal of Community Psychology 10. 341–362.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Thoits, P. A. (1983). Dimensions of life events that influence psychological distress: an evaluation and synthesis of the literature. In Psychosocial Stress: Trends in Theory and Practice (ed. Kaplan, H. B.), pp. 33–103. Academic Press: New York.CrossRefGoogle Scholar
Thoits, P. A. (1984). Explaining the distribution of psychological vulnerability. Social Forces 63, 453–481.CrossRefGoogle Scholar
Thomas, P. D., Goodwin, J. M. & Goodwin, J. S. (1985). Effect of social support on stress-related changes in cholesterol level, uric acid level and immune function in an elderly sample. American Journal of Psychiatry 142, 735–737.Google Scholar
Tolsdorf, C. C. (1976). Social networks, support and coping: an exploratory study. Family Process 15, 407–417.CrossRefGoogle ScholarPubMed
Turner, R. J. (1983). Social support and psychological distress. In Psychosocial Stress: Trends in Theory and Practice (ed. Kaplan, H. B.), pp. 105–115. Academic Press: New York.CrossRefGoogle Scholar
Turner, R. J. & Noh, S. (1983). Class and psychological vulnerability among women: the significance of social support and personal Control. Journal of Health and Social Behaviour 24, 2–15.CrossRefGoogle ScholarPubMed
Veiel, H. O. F. (1985). Dimensions of social support: a conceptual framework for research. Social Psychiatry 20, 156–162.CrossRefGoogle ScholarPubMed
Warheit, G. J. (1979). Life events, coping, stress and depressive symptomatology. American Journal of Psychiatry 136, 502–507.CrossRefGoogle ScholarPubMed
Weiss, R. (1974). The provisions of social relationships. In Doing Unto Others (ed. Rubin, Z.), pp. 17–26. Prentice-Hall: Englewood Cliffs, N.J.Google Scholar
Wheaton, B. (1985). Models for the stress-buffering functions of coping resources. Journal of Health and Social Behaviour 26, 352–364.CrossRefGoogle ScholarPubMed
Williams, A. W., Ware, J. E. & Donald, C. A. (1981). A model of mental health, life events and social supports applicable to general populations. Journal of Health and Social Behaviour 22, 324–336.CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar
Wing, J. K., Bebbington, P. E. & Robins, L. N. (1981). Theory testing in psychiatric epidemiology. In What is a case? The Problem of Definition in Psychiatric Community Surveys (ed. Wing, J. K., Bebbington, P. E. and Robins, L. N.), pp. 45–61. Grant Maclntyre: London.Google Scholar