lournal of Social and Clinical Psychology, Vol.

9, No J, 19911, pp i- 14

STRESS AND SOCIAL SUPPORT-

IN SEARCH OF OPTIMAL MATCHING
CAROLYN E. CUTRONA

University of Iowa

Theoretical and practical advantages are discussed of a model that specifies the type
of social support that is most beneficial (i.e., most effective in preventing deleterious
physical or mental health consequences) following different kinds of stressful life
evenls. Prior attempts to specify such optimal combinations of stress and social

support are reviewed, and a new optimal matching model is proposed. Issues thai

must be addressed in the validation of optimal stress-support models are discussed,

and methodological suggestions for future research endeavors in this area are offered.

No one would think of

offering money to console a wealthy man who
hadjust suffered the loss of his wife, or of offering esteem support to
someone who had won the Nobel Prize.
just Clearly, different situations
call for different kinds of interpersonal behavior. Although we know
this intuitively, research
social support has tended to ignore potential
on

differences in the helpfulness of specific kinds of social support in the

context of different types of stressful life circumstances (Cohen & Wills,
1985; Heller, Swindle, & Dusenbury, 1986; House, 1981).
One reason for our lack of insight into specific matches between

types of stress and social support is methodological. Early research tended

to treat social support as a unidimensional construct or to analyze only

aggregate support scores, thus obscuring the differential impact of specific

components. Another design feature of most research in the area of
social support has also obscured the effects of specific components of
support in the context of specific stressful events. Most researchers have
tested the effects of social support in broad community samples, without

regard for the specific types of stress that individuals have encountered.
Only severity or number of events is coded, using cumulative life event
measures (e.g., Holmes & Rahe, 1967). In 1985, Cohen and Wills estimated

that 90% of the published social support studies used this approach.

Although such methods are useful in establishing the average effects of

Requests for reprints and other correspondence should be addressed to the author at the
Department of Psychology, E-231 Seashore Hall, University of Iowa, Iowa City, IA 52242
Preparation of this article was facilitated by grant P01-AG7094 from the National Institute
on
Aging and grant R01-APR000931 from the Office of Population Affairs.

3
4 CUTRONA

support in protecting individuals who have experienced a wide range

of stressful events, this epidemiological approach cannot advance our
understanding of optimal matches between types of stress and types of
support.
There are obvious clinical reasons for seeking insight into the most
beneficial forms of social support for different kinds of stressful events.
If optimal matches between types of stressful events and types of social

support were known, leaders of support groups, designers of friendly

visitor programs, psychotherapists, and concerned family and friends
would know how best to tailor their attempts to help individuals facing
such crises as bereavement, divorce, cancer, unemployment, or victim
izationby crime. Research shows that family, friends, and professionals
frequently offer well-intentioned, but highly distressing "support" that
derives its aversiveness from alack of congruence with the target in
dividual's current needs (e.g., Lehman, Ellard, & Wortman, 1986). Thus,
considerable practical benefit might accrue from a valid model that matches

support type with type of stress.

In this paper, prior work in the area of social support and stress
specificity will be briefly summarized and critiqued, followed by an
optimal matching model of stress and social support that is currently
under development by my research group. The purpose of this paper
is not to present the "correct" model of optimal matching between stress
and social support, but to describe one preliminary model to illustrate
the many complexities that arise in the development of theory in the
area of social
support and stress and to stimulate research regarding
patterns of optimal matching.

PRIOR SPECIFICITY MODELS

A theme that is common to virtually all specificity models is that different

stressful events pose different coping requirements (e.g., Cohen & McKay,
1984; Thoits, 1986). Researchers categorize coping demands in somewhat
different ways, with different degrees of specificity, but implied in all
models is the assumption that social support has its beneficial effects by

facilitating or
augmenting psychological and environmental processes
that the individual must set in motion to overcome the objective problem
that is taxing his or her resources, or to decrease the magnitude of
aversive emotions that are
generated by the problem (Lazarus & Folkman,
1984).
In 1984, Cohen and McKay outlined a stressor-support specificity
model of the buffering hypothesis. Buffering effects for individuals facing
stressors involving resource deficits would be seen primarily for tangible
STRESS AND SOCIAL SUPPORT 5

social support (e.g., money, transportation, help with household chores).

Stressors in which the individual's distress is generated by his or her
subjective interpretation of the situation rather than by the objective
threat posed by the event would require appraisal support. Stressors
that can lead to internal attributions of failure or inadequacy may best
be buffered by esteem support. The loss of significant relationships require
social support that will restore or maintain a feeling of belonging or

being cared for.

Cohen and Wills (1985) conducted a major review of the literature

regarding circumstances in which specific components of support were

beneficial in maintaining positive health and adjustment. On the basis
of their review, they concluded that esteem support and information
support were beneficial across a wide range of circumstances. However,
buffering effects were
only belonging and tangible assistance
found for
when the stress entailed relationship loss (belonging) or a loss of
a

tangible assets (tangible assistance). Thoits (1986) divided events broadly

into those that imposed coping demands for appraisal, problem solution,
and emotion management and argued that only social support that fa
cilitates the appropriate coping demands should be effective.
The evolutionary nature of many life crises has been emphasized

by several writers who argue that different coping demands are char
acteristic of different phases of the experience of stress (Jacobson, 1986;
Lazarus & Folkman, 1984; Weiss, 1976). Weiss (1976) described different
phases of coping with bereavement. The first phase he termed "crisis"
and hypothesized a primary need for emotional support. In the second
"

phase, termed "transition, the individual attempts to build a new identity

without the lost partner, and takes on responsibilities previously borne
by the lost partner. During this phase, cognitive support (i.e., information
and feedback on appropriateness and capability) is key. Very often, an
extended period of deficit follows the transition stage, as the consequences
of lost income and services are experienced, and during this phase,
tangible support is viewed as most beneficial.

CRITIQUE OF PRIOR SPECIFICITY MODELS

One problem inherent in some of the stress-support matching models

described above is a lack of objective defining characteristics of event
classes that require different kinds of social support to promote optimal
coping and adjustment. For example, Cohen and McKay (1984) define
two categories of stressful events in terms of abstract
psychological pro
cesses. Events hypothesized to require appraisal support are "those
stressors involving primarily psychological as opposed to universal sources
6 CUTRONA

of stress" (p. 262). Events hypothesized to require esteem support are

those "that can result in a self-attribution of failure or inadequacy" (p.

262). Although these hypotheses may well be correct, they suffer from
a lack of operational definition. For example, who determines whether
the cause of a given stressor is likely to be attributed internally? The
individual experiencing the stress could provide his or her perception
of causality, but such a judgment is likely to be contaminated by the
effects of the stressor, such as depression (Hamilton & Abramson, 1983).
An alternative approach has been to define stressor classes in terms
of objective characteristics of the event. For example, Cohen and Wills
(1985) concluded, based on their review of the relevant literature, that
events characterized by a loss oftangible assets would require tangible
forms of social support. However, Wethington and Kessler (1986) argue
that even if tangible resources are needed to resolve a problem, their

provision bv members of the social network is required only if the target

individual cannot obtain these herself. Furthermore,
resources himself or

it has been argued that tangible support may have the undesirable effect
of undermining self-efficacy (Kahn & Antonucci, 1982; Krause, 1987).
Thus, it appears that objective characteristics of stressful situations alone
may be insufficient as determinants of the type of social support that
will be maximally beneficial.

AN OPTIMAL MATCHING MODEL OF STRESS

AND SOCIAL SUPPORT

Motivation for developing a specificity model of stress and social support

developed out of a series of field studies we conducted to investigate
the contribution of social support to two kinds of stresses: the transition
to parenthood (Cutrona, 1984; Cutrona, 1989; Cutrona & Troutman,

1986); and stress in the workplace (Constable & Russell, 1986; Russell,
Altmaier, & Van Velzen, 1987). For each of these stresses, we tested the
contribution to mental health of each of Weiss's (1974) six provisions of
social relationships in at least two independent samples. Our results,
which were quite similar across samples, indicated that different support
components ("provisions" in Weiss's
terminology) predicted a positive
adjustment parenthood (guidance
to and network
support) than predicted
a
positive adjustment to work stress (esteem support). Given that these
patterns replicated across
independent samples with diverse demographic
characteristics (e.g., adult and adolescent mothers; teachers and nurses),
it seemed worthwhile to pursue a systematic model of stress-support
matching.
STRESS AND SOCIAL SUPPORT 7

COMPONENTS OF SOCIAL SUPPORT

A review of the most frequently cited social support classification systems

revealed high degree of convergence across authors, although termi
a

nology differed (Cutrona & Russell, in press). We derived a set of five

basic support dimensions that appear in most of these models: (a) emotional
support (expressions of comfort and caring); (b) social integration or netivork
support (membership in a group where members share common interests
and concerns); (c) esteem support (bolstering of the person's sense of

competence or self-esteem); (d) tangible aid (services or resources); and

(e) informational support (advice or guidance). A study by Rose (1986) has
provided empirical support for the parallels across these models in support
components.
One psychometric issue in the measurement of social support will
be briefly addressed. For a number of measures of social support, sizeable
correlations among the dimensions that are assessed have been reported
(see discussion by Brown, 1986; House, Kahn, McLeod, & Williams,
1985) suggesting significant overlap among dimensions. However, three
recent studies have employed confirmatory factor analysis to test for the
existence of multiple dimensions of social support (Brookings & Bolton,
1988; Cutrona & Russell, 1987; Vaux, Riedel, & Stewart, 1987). Results
were consistent across studies, in that distinct dimensional factors were
confirmed. Cutrona and Russell (1987) further reported that a single
second-order factor, reflecting the existence of global social support
a

construct, could be identified. Thus, just as in the case of

intelligence,
these results suggest the existence of a general support factor that is
further differentiated into the specific dimensions of support that are
reflected by individual support components.

DIMENSIONS OF STRESS

A valid categorization system for stressful life events is critical to an

optimal matching model of stress and social support. Four dimensions
of stressful life events were abstracted based on a review of the stress

categorization literature (Cutrona & Russell, in press): desirability, con

trollability, duration of consequences, and life domain affected by the

event. Life domains were subdivided into assets, relationships, achieve

ment, and social roles. All four of these dimensions emerged from both
theoretical (Lazarus, 1966, 1981) and empirically based taxonomies of
life events (Fava et al., 1981; Paykel, 1974, 1979; Brown & Harris, 1978;
Redfield & Stone, 1979; Ruch, 1977).
8 CUTRONA

Each of these dimensions was viewed determinant of the psy

as a

chological demands and coping needs imposed by stressful life events.

However, the two dimensions that were viewed as most influential in
this regard were
controllability and life domain affected by the event,
as will be described below.

Controllability. In our conceptual model, the most influential dimension

with regard to needed social support is that of controllability. When an
event is uncontrollable, that is, nothing can be done to prevent the event
or lessen its
consequences, the most important task for the individual
is to recover from the negative emotions elicited by the event. This is
termed "emotion-focused coping" by Lazarus and Folkman (1984). Thus,
we
predict that uncontrollable events will require social support com
ponents that serve primarily to minimize the intensity of the individual's
negative emotional reactions to the event. Thus, emotional support (re
assurance of
caring and concern) is hypothesized to be optimally beneficial
following uncontrollable negative life events.
By contrast, when an event is controllable, that is, the individual
can
prevent its occurrence or consequences, the most beneficial social
support will foster effective instrumental action ("problem-focused coping,"
Lazarus & Folkman, 1984). We predict that controllable events will require
either or both of the instrumental support components: informational
and tangible support. However, as Cobb (1979) argues, instrumental
behavior may also be facilitated by noninstrumental support. In particular,
we
predict that esteem support, which communicates belief in the in
dividual's ability and competence, is of considerable utility in promoting
effective problem-focused coping. Borrowing from Bandura (1982), it is

hypothesized that esteem support bolsters the self-efficacy beliefs of the

individual, thereby promoting more effective instrumental behavior (see
Cutrona & Troutman, 1986). Thus, a third prediction is that esteem

support will be associated with better outcomes following controllable

events.

Life Domain Affected by Stress. We have based our

hypotheses regarding
the dimension of life domain Stroebe and Stroebe's (1985) deficit
on

model and Hobfoll's (1989) resource conservation model, in which the

nature of the loss affects the nature of the
required replacement. The
life domain dimension is viewed as most relevant for uncontrollable
events, especially those involving loss. Controllable events may be as
sociated with temporary replacements in the life domain affected by the
stress, but the amounts and duration of needed replacements should be
less than for uncontrollable events where a
permanent deficit has been
created.
Specifically, a loss of assets (tangible resources and
physical capa
bilities) would be associated with a need for tangible support. For example,
STRESS AND SOCIAL SUPPORT 9

an individual experiencing a financial crisis would need a loan. Loss of

a
relationship would leave a deficit in attachment or social integration
(network support), depending on the nature of the threatened or lost

relationship. If an intimate
relationship were lost, emotional support
(expressions of caring) would be most crucial. If group membership were
lost (for example, moving with one's family to a new community), network
support would be most crucial (Weiss, 1974). When the loss is primarily
in the achievement domain (e.g., loss of standing in the work or school

setting), esteem support (reassurance of capabilities and worth) would

most directly address the individual's deficit. Finally, when a valued

social role is lost or threatened (e.g., retirement, empty nest), we would

hypothesize that a particular need for network support arises. Membership
in role-related networks has been identified as an important source of

identity and role-relevant affirmation (Cohen & Wills, 1985; Pearlin, 1983;
Thoits, 1986). The predictions of the specificity model are summarized
in Table 1.

Desirability and Duration of Consequences. Neither desirability nor du

ration of consequences was viewed as orthogonal to controllability. Un
controllable events are likely to be less desirable and to have longer

lastingconsequences than controllable events. Thus, neither of these

dimensions was included in the model.

TABLE 1
Optimal Matching Model of Stress and Social Support

Type of Stressful Event Optimal Social Support

Controllable a. Instrumental support (especially
(Instrumental behavior can
prevent event information support)
from occurring or lessen or eliminate its h Esteem support (reassurance of
consequences.) competence, ability)
Uncontrollable a. Emotional support (expressions of
(Instrumental behavior cannot prevent caring and concern)
event from occurring or lessen or

eliminate is consequences.)
Life domain in which loss occurs:

Assets (tangible resources and

physical capacity) b. Tangible support
Relationships
a. Intimate c. Attachment

b. Casual, group d. Network support

Achievement (work, school, or other e. Esteem support
of productivity or
arena

competition)
Social role (loss, gain, or change) f. Network support
10 CUTRONA

EMPIRICAL SUPPORT FOR THE OPTIMAL

MATCHING MODEL

Specific predictions from our optimal matching model were tested in a

review of all published literature that could be located in which specific

components of social support were tested as predictors of mental or

physical health outcomes in the context of specific stressful life events
(Cutrona & Russell, in press). A total of 39 such studies were located.
For approximately two-thirds of the life events covered in these studies,
results were consistent with the predictions of the model. That is, sig
nificant correlations were found between outcome measures (e.g., de

pressive symptoms) and the component of social support predicted to

have maximal effectiveness given the life stress faced by the study par

ticipants. However, in the context of some events, such as bereavement,

multiple components of social support correlated significantly with health
outcomes. Our review of the empirical literature suggests that for some

events, specific components of social support can be identified that facilitate

optimal adjustment, but that for other events (most notably bereavement,
medical illness, unemployment, and Vietnam combat exposure), a broad
range of social support components are required for recovery. Clearly,
a means to
distinguish between these classes of events is needed. Some
clues have been provided regarding this distinction. When the stressful
event involves the loss of a key source of social support (e.g., the spouse),

support deficits will occur in the areas of support that were previously
provided by the lost individual (Stroebe & Stroebe, 1985). When capacity
to function in a wide range of life domains is impaired, as in the case
of medical illness, posttraumatic stress syndrome (experienced bv many
Vietnam era veterans), or unemployment, needs associated with each
of those domains will be created.

REMAINING ISSUES AND QUESTIONS

As stated previously, the model outlined above was presented as a

starting point for discussion and research. It has not been prospectively
tested, and many unresolved issues and questions remain regarding
optimal matching between types of stress and social support. One set
of issues is methodological in nature, and concerns how we should

proceed in developing and testing models. The second set of issues can
only be resolved empirically, through systematic testing of theoretical
models.
STRESS AND SOCIAL SUPPORT 11

Methodological categorize social support

issues include how best to

components and stressful life events. As mentioned

previously, measures
of support components are highly intercorrelated. Although confirmatory
factor analyses have shown that items assessing the same component
intercorrelate more highly than those assessing different components,
some criterion is needed to determine whether indeed some components
should be combined into larger categories. Regarding the categorization
of stressful life events, different categories emerge depending on the
purpose of the categorization scheme (e.g., to identify depressogenic
events, to identify events that co-occur). Ideally, events would be assigned
to categories based directly on the needs they generate for different types
of social support. However, it may be difficult to obtain this kind of

empirical grouping. First, if standard multidimensional scaling or cluster

analysis procedures are used, it is necessary to communicate the basis
for categorization to the subjects, which may be difficult. Subjects may
have limited experience with some kinds of social support, and they will
certainly have limited experience with many kinds of stressful life events.
Thus, subjects will be forced to rely on stereotypes or prototypes in their
responses. To derive categories of stressful events from studies of in
dividuals who have actually experienced each stress would be ideal.
However, such field studies pose significant recruitment challenges, and
to sample a sufficient range of groups who have experienced different

kinds of stressful events would be extraordinarily time consuming.

One approach that has been used in field studies is to interview
individuals with respect to the kinds of social support they have found
most beneficial, but it is not clear that people know what benefits them

most. For example, individuals who are recovering from a surgical pro
cedure may be grateful for the sympathy they receive, but may actually
benefit most from network members who foster recovery by encouraging
independence and encouraging them to push physical limits to rebuild
physical capacity.
A related methodological question concerns how social support should
be operationalized in the context of testing an optimal matching model.
For example, if social support instruments assess subjective satisfaction
with support, does high satisfaction imply that the support provided

corresponded to the individual's needs? Once again, we do not know

if people are able to discern the nature of their actual support needs.
Thus, ambiguity exists regarding the meaning of such support ratings.
A number of writers have noted that different psychological needs
arise at different times over the course of a stressful life event (Jacobson,
1986; Lazarus & Folkman, 1984; Weiss, 1976). One methodological challenge
is to incorporate this dynamic process into our
optimal matching models.
12 CUTRONA

likely that we can do no better than to make rough temporal distinctions

It is

(e.g., anticipation, confrontation, immediate and long-term aftermath),

which will vary in their implications for social support depending on
the nature of the stress and the personality of the individual.

Empirical questions in this area abound. For example, to what extent

does the personality of the individual experiencing the stress shape his
or her
support needs? Can particular personality dimensions be identified
that interact predictably with type of stress in determining the type of

support that will be maximally beneficial? Which is more important, the

type of social support that is provided, or the quality of the supportive
interaction on other dimensions (e.g., warmth, empathy, duration of
the interaction)? Are there contextual variables that contribute to the
effectiveness of supportive intervention (e.g., closeness of the relationship
a

between provider and recipient; whether or not the recipient had to ask
for support)? Are there differences in the types of social support that
are
provided by members of the social network and professional helpers?

RESEARCH IN PROGRESS

To avoid contamination of controllability ratings by the emotional state

of the individual experiencing the stress, we have opted to use normative
ratings of the controllability of stressful events. Work is currently underway
to develop a reliable and valid measure of the perceived controllability
of events. Both controllability of the cause and controllability of the
consequences of events will be assessed with this tool. As with con
trollability, it is our intention to gather normative data regarding the
dimension of life domain. We developing a method for assessing the
are

degree to which different domains of

peoples' lives are affected by various
stressful life events, and normative data will be collected regarding the
life domains affected bv a range of events. After completion of the measures
to assess dimensions of stressful life events, a series of prospective studies
is planned. Some will involve longitudinal studies of individuals who
are
facing specific stressful events (e.g., the diagnosis of Alzheimer's
disease in a family member). A second series will assess the immediate
impact on mood and satisfaction of receiving support from one's spouse
that provides either a match or a mismatch to the particular life event
with which the couple is currently coping.

Clearly, many questions must be addressed before we can usefully

predict the outcome of interactions between individuals who have ex
perienced a stressful life event and those who are attempting to provide
assistance. Type of social support is one dimension that merits inves

tigation, but at this time, we have much to learn methodologically and

STRESS AND SOCIAL SUPPORT 13

substantively before an
optimal matching model of stress and social

support can be validated.

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