Psychological pathways linking social support to health outcomes: A visit with the “ghosts” of research past, present, and future

Contemporary models postulate the importance of psychological mechanisms linking perceived and received social support to physical health outcomes. In this review, we examine studies that directly tested the potential psychological mechanisms responsible for links between social support and health-relevant physiological processes (1980s–2010). Inconsistent with existing theoretical models, no evidence was found that psychological mechanisms such as depression, perceived stress, and other affective processes are directly responsible for links between support and health. We discuss the importance of considering statistical/design issues, emerging conceptual perspectives, and limitations of our existing models for future research aimed at elucidating the psychological mechanisms responsible for links between social support and physical health outcomes.

► Reviews almost 30 years of research that directly examined the evidence for models that propose psychological pathways linking social support and health.
► No evidence was found that psychological factors were mediators of links between social support and biological outcomes.
► Future research avenues are suggested to test these models (e.g., expanded set of mediators).
► Raises the possibility that our existing theoretical models are wrong or in need of important modifications.