Social support is defined as help in difficult life situations

Social support is a concept that is generally understood in an intuitive sense, as the help from other people in a difficult life situation. One of the first definitions was put forward by Cobb (Cobb, 1976). He defined social support as ‘the individual belief that one is cared for and loved, esteemed and valued, and belongs to a network of communication and mutual obligations’. In the MINDFUL project social support is defined as ‘the perceived availability of people whom the individual trusts and who make one feel cared for and valued as a person’ (MINDFUL, 2008).

In spite of these widely accepted definitions of social support, there is no consensus in the literature about the definition and consequently the operationalisation of the concept. There is a need for further research, especially about what kind of support is most important for health.

A distinction exists between perceived and provided support

In defining social support a distinction can be made between the quality of support perceived (satisfaction) and provided social support. Most studies are based on the measurement of subjectively perceived support, whereas others aim at measuring social support in a more objective sense. One could also distinguish between the support received, and the expectations when in need, and between event specific support and general support. The definition in terms of a subjective feeling of support raises the question whether social support reflects a personality trait, rather than the actual social environment (Pierce et al., 1997; Sarason et al., 1986). Most researchers will agree that the person as well as the situation affects perceived social support, and that the concept deals with the interaction between individual and social variables.

Various types of social support possible

Types and sources of social support may vary. House (House, 1981) described four main categories of social support: emotional, appraisal, informational and instrumental.

• Emotional support generally comes from family and close friends and is the most commonly recognized form of social support. It includes empathy, concern, caring, love, and trust.
• Appraisal support involves transmission of information in the form of affirmation, feedback and social comparison. This information is often evaluative and can come from family, friends, co-workers, or community sources.
• Informational support includes advice, suggestions, or directives that assist the person to respond to personal or situational demands.
• Instrumental support is the most concrete direct form of social support, encompassing help in the form of money, time, in-kind assistance, and other explicit interventions on the person’s behalf.

Social support is closely related to the concept of a social network

Social support is closely related to the concept of a social network, or the ties to family, friends, neighbours, colleagues, and others of significance to the person. However, when the social network is described in structural terms, like size, range, density, proximity and homogeneity, social support normally refers to the qualitative aspects of the social network Within this context, social support is the potential of the network to provide help in situations when needed. However, the social network may also be the cause of psychological problems. Halle and Wellman present the interplay between social support, the social network, and psychological health in a model: The social network as a mediating construct. This model shows that social support can be seen as resulting from certain characteristics of the social network, which are in turn caused by environmental and personal factors. The model suggests that it is important to distinguish between the structural and quantitative aspects of the social network on the one side, and social support on the other (see also: O'Reilly, 1988). However, it may be difficult to distinguish between the quality of social network and social support.

Social integration refers to supportive relationships within the community

Whereas the concept of social support mainly refers to the individual and group level, the concept of social integration can refer to the community level (Berkman & Glass, 2000). A well integrated community refers to well developed supportive relationships between people in the community, with everybody feeling accepted and included. A related concept is social capital, which is often used as the sum of supportive relationships in the community. Social capital may, however, also be used in a somewhat different meaning, such as solidarity (Kawachi & Berkman, 2000).