Expert answer:research reports
Expert answer:6 research reports for each research report answer the following questions: 1. What were the main ideas and findings discussed in this article? 2. What importance might this research have for real life experiences? That is, how might you apply these ideas and findings to your life? 3. What questions do you have after reading the article? That is, what do you think they should research next to learn more about the topic? Each research report must be 1 ½ to 2 pages, double-spaced, 12-point font, and 1-inch margins on all sides. For each research report, your answers to the questions should clearly demonstrate that you have read the article. Credit may not be awarded if your responses fail to show familiarity with the article or do not meet the guidelines. Do not plagiarize! That is, do not copy word-for-word or just change a few words from the article. Answer these questions in your own words.
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PSYCHOLOGICAL SCIENCE
Research Article
PROVIDING SOCIAL SUPPORT MAY BE MORE BENEFICIAL
THAN RECEIVING IT:
Results From a Prospective Study of Mortality
Stephanie L. Brown,1 Randolph M. Nesse,1 Amiram D. Vinokur,1
and Dylan M. Smith2,3
1
Institute for Social Research, The University of Michigan; 2Department of Internal Medicine, The University of Michigan; and
3
VA Health Services Research & Development Center of Excellence, VA Ann Arbor Healthcare System
Abstract—This study examines the relative contributions of giving versus receiving support to longevity in a sample of older married adults.
Baseline indicators of giving and receiving support were used to predict
mortality status over a 5-year period in the Changing Lives of Older
Couples sample. Results from logistic regression analyses indicated that
mortality was significantly reduced for individuals who reported providing instrumental support to friends, relatives, and neighbors, and individuals who reported providing emotional support to their spouse.
Receiving support had no effect on mortality once giving support was
taken into consideration. This pattern of findings was obtained after
controlling for demographic, personality, health, mental health, and
marital-relationship variables. These results have implications for understanding how social contact influences health and longevity.
As demographic shifts have produced a relatively more aged population, factors that influence longevity have taken on increased prominence. The documented health benefits of social support may offer a
promising avenue for reducing mortality among older adults. Indeed,
there is a robust association between social contact and health and wellbeing (House, Landis, & Umberson, 1988). However, it is not clear that
receiving support accounts for these benefits (House et al., 1988). Tests
of the social-support hypothesis—that receiving support improves
health and well-being—have provided somewhat inconsistent results
(Kahn, 1994), demonstrating in some instances that receiving support is
harmful (e.g., S.L. Brown & Vinokur, in press; Hays, Saunders, Flint,
Kaplan, & Blazer, 1997; Seeman, Bruce, & McAvay, 1996). In fact, a
meta-analysis of the link between social support and health outcomes
produced negligible findings, leading the study’s authors to conclude
that the “small amounts of shared variance [between receiving support
and health outcomes] may not be considered significant nor generalizable” (Smith, Fernengel, Holcroft, Gerald, & Marien, 1994, p. 352).
Conceptually, it is not clear that receiving social support will always
be beneficial. For example, depending on other people for support can
cause guilt and anxiety (Lu & Argyle, 1992). And feeling like a burden
to others who presumably provide support is associated with increased
suicidal tendencies, even after controlling for depression (R.M. Brown,
Dahlen, Mills, Rick, & Biblarz, 1999; de Catanzaro, 1986). The correlation of social support with dependence may help to explain why studies
have failed to consistently confirm the social-support hypothesis.
Furthermore, the benefits of social contact may extend beyond received support to include other aspects of the interpersonal relation-
ship that may protect health and increase longevity—for example,
giving support to others. However, with few exceptions (e.g., Liang,
Krause, & Bennett, 2001), social-support studies rarely assess whether
there are benefits from providing support to others. Some measures of
social support do seem to tap giving—perhaps inadvertently—yet the
benefits are often attributed to receiving support or sometimes attributed to reciprocated support. For example, a nationwide survey of
older peoples’ support networks measured social support by a combination of what was received and what was provided to others (Antonucci, 1985). Implicit in this assessment is the recognition that
receiving social support is likely to be correlated with other aspects of
close relationships, including the extent to which individuals give to
one another. Thus, some of the benefits of social contact, traditionally
attributed to receiving support, or to reciprocated support (e.g., Antonucci, Fuhrer, & Jackson, 1991), may instead be due to the benefits of
giving support.
THE BENEFITS OF PROVIDING SUPPORT
TO OTHERS
There are both theoretical and empirical reasons to hypothesize
that giving support may promote longevity. For example, kin-selection
theory (Hamilton, 1964a, 1964b) and reciprocal-altruism theory (Trivers, 1971) suggest that human reproductive success was contingent
upon the ability to give resources to relationship partners. Social
bonds (S.L. Brown, 1999) and emotional commitment (Nesse, 2001)
have been theorized to promote high-cost giving. The resulting contribution made to relationship partners is theorized to trigger a desire for
self-preservation on the part of the giver, enabling prolonged investment in kin (de Catanzaro, 1986) and reciprocal altruists.
Although few studies have explicitly examined whether helping
others increases longevity, sociologists note the ubiquity of giving to
others (Rossi, 2001), and studies show that individuals derive benefits
from helping others, such as reduced distress (Cialdini, Darby, & Vincent, 1973; Midlarsky, 1991) and improved health (Schwartz &
Sendor, 2000). Moreover, volunteering has beneficial effects for volunteers, including improved physical and mental health (Omoto &
Synder, 1995; Wilson & Musick, 1999). Even perceptions that are
likely to be associated with giving, such as a sense of meaning, purpose, belonging, and mattering, have been shown to increase happiness and decrease depression (e.g., Taylor & Turner, 2000; see Batson,
1998, for a review).
THE PRESENT STUDY
Address correspondence to Stephanie L. Brown, Institute for Social
Research, The University of Michigan, 426 Thompson St., P.O. Box 1248, Ann
Arbor, MI 48106-1248; e-mail: stebrown@isr.umich.edu.
320
Copyright © 2003 American Psychological Society
Using data from the Changing Lives of Older Couples (CLOC)
sample, we addressed two questions: (a) Do the benefits of providing
social support account for some or all of the benefits of social contact
VOL. 14, NO. 4, JULY 2003
PSYCHOLOGICAL SCIENCE
S.L. Brown et al.
that are traditionally interpreted as due to support received from others? (b) Does receiving support influence mortality once giving support and dependence are controlled?
Traditionally, social support has been defined in numerous ways,
leading some authors to conclude that measurement issues are a
source of contradictory findings (e.g., Smerglia, Miller, & Kort-Butler,
1999). For the purpose of the present study, we focused our analyses
on items for which our measures of giving and receiving tapped similar domains of support. Similar domains of support were measured for
the exchange of emotional support between spouses and the exchange
of instrumental support with individuals other than one’s spouse.
House (1981) suggested that these two domains of support—emotional and instrumental—represent two of the functions of interpersonal transactions.
To isolate the unique effects of giving and receiving social support
on mortality, it was important to control for factors that may influence
any of these variables, including age, gender, perceived health, health
behaviors, mental health, socioeconomic status, and some individual
difference variables (personality traits). Controlling for these variables
helped to increase our confidence that any beneficial effect of giving
we observed was not due to enhanced mental or physical robustness of
the giver. We also examined variables associated with relationship
phenomena that could influence giving support, receiving support, and
dependence; these variables included perceived equity (the perception
that one receives the same amount as one provides to the relationship
partner) and relationship satisfaction. Responses at baseline were used
to predict mortality status over the ensuing 5-year period of the study.
METHOD
Sample
The CLOC study is a prospective study of a two-stage area probability sample of 1,532 married individuals from the Detroit Standard
Metropolitan Statistical Area. The husband in each household was 65
years of age or older (see Carr et al., 2000, for a complete report). Of
those individuals who were selected for participation in the CLOC
study, 65% agreed to participate, a response rate consistent with response rates in other studies in the Detroit area (Carr et al., 2000).
More than one half of the sample (n 846) consisted of married couples for whom mortality data on both members were available. These
423 married couples were the respondents in the present study.1 Baseline measures were administered in face-to-face interviews, conducted
over an 11-month period in 1987 and 1988. Of the subsample of 846
respondents, 134 died over the 5-year course of the study.
Baseline Measures
Instrumental support
Giving instrumental support to others, GISO, was measured by
four survey questions that asked respondents whether they had given
instrumental support to friends, neighbors, and relatives other than
their spouse in the past 12 months. Respondents indicated (yes/no)
whether they helped with (a) transportation, errands, shopping; (b)
housework; (c) child care; and (d) other tasks. Respondents were instructed to say “yes” to any of these questions only if they did not live
in the same household with the recipient of support and they did not
receive monetary compensation. Responses were coded so that a “0”
indicated a “no” response to all four items, and a “1” indicated a “yes”
response to at least one item.
Receiving instrumental support from others, RISO, was assessed
by a single item: “If you and your husband [wife] needed extra help
with general housework or home maintenance, how much could you
count on friends or family members to help you?” Responses were
coded on a 4-point scale.2
Emotional support
Giving and receiving emotional support was assessed with items
from the Dyadic Adjustment Scale (Spanier, 1976). Giving emotional
support to a spouse, GESS, was assessed using two items that asked
participants whether they made their spouse feel loved and cared for
and whether they were willing to listen if their spouse needed to talk
( .51). Rankin-Esquer, Deeter, and Taylor (2000) reviewed evidence to suggest that the benefits of receiving emotional support from
a spouse come from both feeling emotionally supported by a spouse
and feeling free to have an open discussion with one’s spouse. The
two-item measure of receiving emotional support from a spouse,
RESS ( .66), was identical to GESS with the exception that participants were asked whether their spouse made them feel loved and
cared for, and whether their spouse was willing to listen if they needed
to talk. Responses were coded on a 5-point scale.3
Control variables
Mortality was monitored over a 5-year period by checking daily
obituaries in three Detroit-area newspapers and monthly death-record
tapes provided by the State of Michigan. Mortality status was indicated with a dichotomous variable (1 deceased, 0 alive).
To control for the possibility that any beneficial effects of giving
support are due to a type of mental or physical robustness that underlies both giving and mortality risk, we measured a variety of demographic, health, and individual difference variables. (See Appendix A
for a description of the health, mental health, and personality variables
used.) Both age and gender (1 male, 2 female) were controlled
for in each analysis to take into account the possibilities that (a) older
people give less and are more likely to die than younger people and (b)
females give more and are less likely to die than males.
To isolate the unique effects of giving and receiving support, above
and beyond other known relationship influences on health, we included measures of social contact and dependence. Social contact was
assessed with the mean of the following three questions: “In a typical
1. For the entire sample, spousal mortality, rather than respondent mortality, was tracked, so respondent mortality could be obtained only if both members of a couple participated in the study.
2. All response options were coded so that higher values indicated higher
levels of the measured variable.
3. Unless otherwise stated, scale composites were formed by taking the
mean of the items.
Mortality Data
VOL. 14, NO. 4, JULY 2003
321
PSYCHOLOGICAL SCIENCE
Social Support and Mortality
week, about how many times do you talk on the phone with friends,
neighbors, or relatives?” “How often do you get together with friends,
neighbors, or relatives and do things like go out together or visit in
each other’s homes?” and “How often do you go out socially, by yourself, or with people other than your husband [wife]?” Scores were
standardized so that higher values indicated greater social contact (
.51). Dependence on the spouse was coded on a 4-point scale and was
measured with three items asking participants whether losing their
spouse would make them feel lost, be terrifying, or be the worst thing
that could happen to them ( .82).
Additional relationship variables
We measured additional aspects of the marital relationship in order
to examine alternative explanations for any effects of giving and receiving emotional support. Specifically, we used items from the Dyadic Adjustment Scale (Spanier, 1976) to assess equity (the absolute
value of the difference between an individual’s ratings of perceived
emotional support received from the partner and perceived emotional
support provided to the partner; higher values indicated greater discrepancy) and marital satisfaction (one item).
Additional measures of receiving and giving support
To consider the possibility that any observed benefits of giving or
receiving support were an artifact of the chosen measures, we included all of the remaining support measures from the CLOC data set
(Appendix B).
RESULTS
We examined our hypotheses using the 846 persons for whom
mortality data were available. Because this sample included the responses of both members of a couple, we computed the intraclass correlation (ICC) for the couple-level effect on mortality. We first created
a variable that grouped individual participants by couple (n 423).
We next constructed a two-level hierarchical model (Level 1 estimated
variation in mortality at the individual-participant level, Level 2 estimated variation at the couple level) using RIGLS (restricted iterative
generalized least squares) estimation for binomial models (MLwiN
ver. 1.1, Multilevel Models Project, Institute of Education, London,
2000). A significant ICC could be interpreted as indicating that the
death of one partner was significantly related to an increase or decrease in the probability of the other partner dying (within the study
period). Results of this procedure indicated that there was no couplelevel effect on mortality (ICC .00, n.s.). Thus, for all analyses, we
treated each member of a couple as an independent source of data.
Giving Support, Receiving Support, and Social Contact
Table 1 presents a correlation matrix of the focal social-support
measures. Receiving and giving were significantly and strongly correlated for measures of emotional support exchanged between spouses
(r .58, p .001), and weakly correlated for measures of instrumental support exchanged with others (r .09, p .01).
To examine whether giving instrumental support reduced risk of
mortality, we ran a hierarchical logistic regression procedure. Results
of this analysis are displayed in Figure 1, and also presented in Table
2. Step 1 of this analysis regressed mortality status on social contact,
322
Table 1. Correlation matrix of the focal social-support
measures
Measure
RISO
GISO
RESS
GESS
Social contact
RISO
GISO
RESS
.15***
.25***
.02
.05
.09**
.12***
.15***
.01
.04
.58***
Note. RISO receiving instrumental support from others; GISO
giving instrumental support to others; RESS receiving emotional
support from a spouse; GESS giving emotional support to a spouse.
**p .01. ***p .001.
age, and gender. The results were consistent with previous research in
indicating that social contact reduced the risk of mortality (b
0.21, p .05). To examine whether giving versus receiving support
accounted for this effect, we entered GISO and RISO simultaneously
in the second step. Results at this step indicated that mortality risk was
decreased by GISO (b 0.85, p .001) but marginally increased
by RISO (b 0.17, p .10). Social contact was no longer significant
at this step (b 0.13, n.s.).
Because individuals in poor health may have difficulty providing
others with instrumental support, functional health status, satisfaction
with health, health behaviors, and mental health variables were added
to the model in order to control for the alternative possibility that individuals who give support to others live longer because they are more
mentally and physically robust than those who do not give support.
Results at this step indicated that after controlling for these measures
of health, the effect of GISO was reduced, but GISO was still significantly related to mortality (b 0.56, p .01). In fact, GISO exerted
a beneficial effect on mortality even after controlling for interviewer
ratings of health, income and education level, self-reports of feeling vulnerable to stress, dispositional influences on mortality, and personality
influences on mortality. After all control variables were held constant,
GISO significantly decreased mortality risk (b 0.54, p .05), and
RISO marginally increased mortality risk (b 0.23, p .10).
These results support the hypothesis that giving support accounts
for some of the benefits of social contact. However, our findings are
based on the use of different measures to operationalize giving and receiving support. That is, the GISO variable measured support that was
actually provided to other people (i.e., enacted support), whereas the
RISO variable assessed whether others could be depended upon to
provide support (i.e., available support).4 Furthermore, it is not clear
whether the adverse effect of RISO was due to received support or to
the covariation of received support with dependence. In order to control for the difference between the giving and receiving measures, as
well as the potentially adverse effect of dependence, we examined the
exchange of emotional support between spouses. This domain of support offered virtually identical giving and receiving measures, and included measures of dependence.
4. Research suggests that structural differences in the operationalization of
received support may underlie contradictory findings in the literature (Smerglia
et al., 1999).
VOL. 14, NO. 4, JULY 2003
PSYCHOLOGICAL SCIENCE
S.L. Brown et al.
Fig. 1. Hierarchical logistic regression model of the effects of receiving instrumental support from others (RISO) and giving instrumental support to others (GISO). All effects have been adjusted for the effects of age and gender. *p .05. GESS giving emotional support to a spouse;
RESS receiving emotional support from a spouse.
Analyses With Identical Measures of Giving and
Receiving Support
To clarify the role of receiving support on mortality, we ran a hierarchical logistic regression procedure in which RESS was entered in
Step 1, along with age and gender. As can be seen in Figure 2, there
was no significant effect of RESS on the risk of mortality (b 0.17,
n.s.). However, after controlling for the effect of dependence in Step 2,
the effect of RESS became a significant predictor of reduced mortality
risk (b 0.23, p .05). Thus, the results of Step 2 replicated the
beneficial effe …
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