Social support as a double-edged sword: the relation of positive and problematic support to depression among rheumatoid arthritis patients

Soc Sci Med. 1991;33(7):807-13. doi: 10.1016/0277-9536(91)90385-p.


This study considers social network interactions as a potential source of both stress and support for individuals coping with a chronic illness. The sample consisted of 101 recently-diagnosed rheumatoid arthritis patients. Symptoms of depression were assessed using the Center for Epidemiologic Studies Depression scale. Hierarchical multiple regression analyses examined the conjoint effects of social support and problematic interactions on symptoms of depression. Receipt of positive or helpful support from close friends and family was related to lower depression; receipt of problematic support was related to increased depression. A positive x problematic support interaction suggested that the costs of problematic support do not cancel out the benefits of positive support. Patients who reported both little support and a greater degree of problematic interactions experienced the highest level of symptoms. The findings emphasize the need to consider positive and negative aspects of support transactions conjointly in assessing their stress-reducing and health-protective potential.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Aged
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / psychology*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / etiology
  • Educational Status
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Middle Aged
  • New York City / epidemiology
  • Regression Analysis
  • Severity of Illness Index
  • Social Support*