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13 The Role of Social Support in the Relationship between Physical Health Strain and Depression of Elderly Chinese Xingming Song and Iris Chi The examination s o f socia l suppor t an d o f lif e stres s ar e tw o leadin g approaches t o contemporar y socia l studie s o f depression . Durin g th e pas t several decades, considerable research effort ha s been devoted t o investigatin g the impac t o f lif e stres s o n menta l health . Ther e i s ampl e evidenc e whic h shows tha t stressors may play a causal role in depression. Yet the evidence i s also clear in suggesting that the majority o f people who are exposed to stressors do no t develo p significan t depressiv e disorders . Fo r thi s reason , researc h interest ha s shifted t o factors lik e social support tha t may modify th e impac t of lif e stress . Thus , researc h o f socia l suppor t ha s proliferated , an d man y investigations have focussed specificall y o n support for elderly people. In thi s chapter, life stress refers t o physical health problems — chroni c diseases an d medical symptoms. For aged persons, depression is often correlate d with th e decline i n physica l healt h tha t occur s frequentl y amon g olde r ag e group s (Blazer 1983 ; Himmelfarb an d Murrel l 1983) . Usin g dat a gathere d fro m a n elderly Chines e population , thi s chapte r examine s th e relationship s amon g social support , physica l healt h strai n an d depression , an d i t focusse s o n th e potential rol e o f socia l suppor t i n th e relationshi p betwee n physica l healt h strain an d depression . 190฀XING ฀MING ฀SONG฀AND฀IRIS฀CHI฀ 1฀Th e฀Conceptual฀Models฀and฀Research฀Hypotheses฀ Conceptually, socia l suppor t ma y affec t depressio n i n tw o ways . On e i s th e additive model , i n whic h socia l suppor t ha s a direc t an d positiv e influenc e on mental health (Williams , Ware and Donald 1981) . It suggests tha t stron g social suppor t i s beneficia l t o individual s independen t o f thei r exposur e t o stress. Tha t is , the stronge r th e socia l support on e ca n amass , the les s likel y he or she would experience depression. Furthermore, this negative relationship should remain even when individuals are confronted wit h significant lif e stress. The other way that social support can affect depressio n is the buffering model , which holds that social support mediates possible negative effects o f life stress on menta l healt h (Henderso n 1992) . Thi s model , attractin g b y fa r th e mos t research effort s i n th e socia l suppor t area , represent s a dominating concer n of researc h abou t th e impac t o f socia l suppor t o n moo d disorder . I t argue s that lif e stress is potentially harmful , an d if it is not buffered, i t can lead to a deterioration o f th e individual's menta l health . Based o n thes e tw o models , w e inten d t o propos e fou r researc h hypotheses. 1. Physica l health strai n i s positively relate d t o depression . 2. Socia l support i s negatively relate d t o depression . 3. I f an individua l ha s physica l healt h problems , social support wil l have a buffering effec t o n depression. That is, among people with physical health problems, thos e wit h lo w socia l suppor t ar e mor e likel y t o develo p depression. 4. Th e mor e physica l healt h problem s a n olde r perso n has , th e bigge r th e protective effec t o f social support . I฀Sourc e฀of฀Data฀and฀Measures฀ A househol d surve y usin g structure d questionnaire s wa s conducte d i n th e Chinese citie s of...

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