Social support, stress, and depressive symptoms among the elderly: Test of a process model.

Abstract

Effects of social support, negative life events, and daily hassles on depressive symptoms were assessed in 301 adults aged 65 or older, in person 3 times at 6-month intervals and by mail questionnaires every month over a 12-month period. Initial social support predicted severity of depressive symptoms 12 months later. Social support and initial levels of depressive symptomatology predicted number of daily hassles but not number of major life events. Effects of social support, depression, and major life events on the incidence of daily hassles remained significant without the inclusion of hassles reflecting depressive symptomatology or problems in relationships or whose content overlapped with major life events. Daily hassles mediated the effects of major life events on subsequent depression. Results did not differ for men and women. Implications for models of the relations among social support, stress, and depression are discussed. In a substantial body of literature that has accumulated over the past 15 years, researchers have evaluated the relations among social support, stressful life events, and physical and mental health status. Two models of these relations have been proposed. According to the first, the buffering hypothesis, social support serves a protective role primarily during times of stress by enhancing adaptive coping behavior (Cobb, 1979). Thus an interaction is hypothesized between stress and social support in predicting physical and mental health, whereby the effect of stress on health-related variables varies depending on the level of social support. According to the second model, social support has positive effects on health and well-being in both the presence and the absence of stress. This direct effects model predicts that there is a positive relation between social support and physical and mental health that is independent of the effects of stress. Empirical research on the relations among stress, social support, and health has provided mixed support for the buffering hypothesis (for a recent review, see S. Cohen & Wills, 1985). Although some researchers have found that high levels of social support protect a person from the negative effects of high levels of stress, others have found that supportive relationships are associated with good physical and mental health regardless of the presence or absence of stress. In a relatively small number of studies, investigators have examined the effects of social support and stressful life events