A loved one's support can backfire, study finds

People who receive high levels of emotional support from their partner have an increased risk of death if they perceive their partner as not caring, understanding and validating, reports a Cornell study published in Health Psychology (Vol. 32:2) this month.

The study found this paradoxical association disappeared completely for individuals who perceive their partner as responsive to their needs, suggesting that the effect of emotional support depends on the perceptions of the recipient rather than the amount of actual support provided.

"Intuitively, one would expect that receiving emotional support would be associated with better health outcomes, but prior research shows this is not always the case—in fact, it is frequently associated with worse health outcomes," said first author Emre Selcuk, a graduate student in the field of human development. He conducted the study with Anthony Ong, associate professor of human development in the College of Human Ecology.

"To our knowledge, this is the first study to document the conditions under which received emotional support increases mortality risk," said Selcuk.

To better understand the health consequences of received support, the authors analyzed data from a national sample of more than 1,800 married or cohabitating adults in midlife in the United States who completed a 1995-96 survey that included measures of received support, perceived partner responsiveness and physical health status. Of the original group, 102 were identified as deceased allowing the authors to analyze mortality risk. After controlling for health status, health behaviors, personality traits and demographic factors, they found perceived partner responsiveness was responsible for the link between mortality and received support, thus shedding light on the mixed effects of emotional support in prior research.

The well-intentioned provision of support may backfire and lead to worse outcomes when the supportive behavior doesn't match the needs of the recipient or if it threatens the recipient's sense of self-efficacy and independence, the authors say.

"The received support may ultimately be harmful if the recipient thinks 'he does not understand me, this is not what I need,' 'her support does not solve my problem' or 'she is trying to provide support because she thinks I am not capable,'" Ong said.

"Our findings add to a growing body of research suggesting that people's attempts to provide social support are most likely to be health promoting when such support is perceived as responsive to the needs of the recipient," Ong added. "Conversely, support that is not quite paired with compassion is likely to be perceived as incomplete and full of risks. Over time, such perceptions can have big trade-offs for our health and well-being."

"Future research should test the effect of perceived partner responsiveness on other physical health indicators, mental health outcomes and relationship quality," said Selcuk. "If similar results are obtained, this body of work may have therapy implications for improving individuals' health and relationship well-being."