Stress, social support, health and human-animal bond in single mothers
TABLE OF CONTENTS COPYRIGHT NOTICE ii APPROVAL iii ABSTRACT iv ACKNOWLEDMENTS v LIST OF TABLES viii CHAPTER 1: INTRODUCTION 1 Overview 1 Background 4 Statement of the Problem 6 Purpose 7 Significance 10 Definition of Terms 10 Highlights of Methodology 11 Limitations of Study 11 CHAPTER 2: LITERATURE REVIEW 13 Overview of Single Mothers 13 Stress 17 Overview 17 Physiological aspects 17 Environmental aspects 18 Perceived stress 20 Social Support and Social Support Models 21 vi
History 21 Overview 23 Measurements of Support 25 Human-Animal Bond 29 Historical overview 29 Theoretical perspectives 32 Human-Animal Bond, Social Support, Stress, and Health 36 Human-Animal Bond and Social Support Models 44 Summary of Literature Review 47 CHAPTER 3: METHODOLOGY 48 Overview 48 Operational Definition of Variables 51 Description of Instrumentation 53 Discussion of Statistical Analysis 58 Participants 59 Procedures 60 Methodological Assumptions and Limitations 61 Power Analysis 64 Ethical Assurances 64 CHAPTER 4: FINDINGS 66 Overview 66 Results 67 Research Question 1 76 vi
Research Question 2 78 Research Question 3 80 Research Question 4 84 Additional Findings 88 Analysis and Evaluation of Findings 90 Summary 95 CHAPTER 5: IMPLICATIONS, CONCLUSIONS, AND RECOMMENDATIONS 98 Implications 98 Conclusion 102 Recommendations 107 REFERENCES 109 APPENDIXES 121 Appendix A: Introduction And Consent Form 121 Appendix B: General Information 123 Appendix C: Perceived Stress Scale—10 Item 125 Appendix D: Pet Ownership Questionnaire 127 Appendix E: Pet Information Questionnaire 128 Appendix F: Comfort From Companion Animal Scale 129 Appendix H: General Health Self-Assessment 133 Appendix I: Human Support 134 vii
LIST OF TABLES Table 1 Frequency Counts for Selected Variables 68 Table 2 Association of Pet Ownership with Age and Racial/Ethnic Background 72 Table 3 Psychometric Characteristics for Summated Scale Scores 73 Table 4 Frequency Counts for Health Outcome Variables 73 Table 5 Pearson Product-Moment Correlations for Pet Ownership and Selected Scales 77 Table 6 Association of Pet Ownership with Selected Health Outcomes 79 Table 7 Partial Correlations for Selected Variables Controlling for Human Support. Pet Owner Subgroup Only 80 Table 8 One-Way ANOVA Models for Health Assessment Scores Based on Attachment and Support Grouping. Pet Owner Subgroup Only 82 Table 9 ANCOVA Model for Description of Health Based on Attachment and Support Grouping 84 Table 10 One-Way ANOVA Models for Health Assessment Scores Based on Attachment and Stress Grouping. Pet Owner Subgroup Only 86 Table 11 ANCOVA Model for Description of Health Based on Attachment and Stress Grouping Controlling for Age, Income and Human Support. Pet Owner Subgroup Only88 Table 12 Intercorrelations Among Selected Variables 89 viii
1 CHAPTER 1: INTRODUCTION Overview It is not absolute as to whether pets might reduce stress, promote positive health, and provide social support for single mothers. It is known that pets in general do play an important role in facilitating healthy outcomes and providing support among diverse populations. Their assistance seems to be blind to every human caveat, including ethnicity, gender, socioeconomic status, age and predisposition. Groups who have flourished from pet ownership include older adults (Banks & Banks, 2002; Colombo, Buono, Smania, Raviola & Leo, 2006; Darrah, 1996; Friedmann, Katcher, Thomas, Lynch & Messent, 1983; Garrity, Stallones, Marx, & Johnson, 1989; Keil; 1998; Kuehn, 2002; Lago, Connell & Knight 1983; Netting, Wilson, & New, 1984; Siegel, 1990), Latinos (Faver & Cavazds, 2008; Johnson & Meadows, 2002), children (Heath, & McKenry, 1989), Alzheimer's patients (Laun, 2003; Motomura, Yagi & Ohyama, 2004; Sellers, 2004), those with multiple sclerosis (Loven, 2004), women (Allen, Blascovich, Tomaka, & Kelsey, 1991; Watson & Weinstein, 1993; Zasloff & Kidd, 1994) and cardiovascular patients (Friedmann & Thomas, 1995). Animals have shown their capacity to participate in various companion relationships (see Cutt, Giles-Corti, Wood, & Knuiman, 2008; Nagasawa, Kikusui, Onaka, & Ohta, 2009). Although studies documenting the benefits of pet attachment have been scarce (Garrity & Stallones, 1998; Nagasawa, et al., 2009), it has been established that individuals who perceive themselves as having little or no human support, those void of human social confidants, and those living alone benefit most from companion animals (Garrity et al., 1989; Siegel, 1990; Zasloff & Kidd, 1994). Accordingly, past research in
2 human-animal interaction has focused on populations that are challenged by physical, psychological, emotional, or supportive boundaries (Banks & Banks 2002; Colombo et al., 2006; Darrah, 1996; Friedmann et al., 1983; Friedmann & Thomas, 1995; Motomura et al., 2004; Keil, 1998; Kuehn, 2002; Lago et al., 1983; Laun, 2003; Loven, 2004; Netting et al., 1984; Sellers, 2004; Siegel, 1990). One group that might be categorized as tolerating a variety of obstacles is single mothers. It is important to understand stress burdens and potential avenues of support for single mothers because this population is markedly prominent. In the United States, the two-parent "traditional" family structure is rapidly diversifying (Bramlett & Mosher, 2002). Emerging from this diversification is the influx of single parent households. During the first half of the 1990s, the increase in the number of households headed by single mothers rose three times faster than those headed by married couples (U.S. Census Bureau, 2007). Although this increase seems to have subsided, single-parent families are still common. In the United States, there are currently 12.9 million households headed by single parents; of those, approximately 10.4 million, or 80%, are run by single mothers (Bergman, 2007; U.S. Census Bureau, 2007). Avison and Davies (2005) argued that although single parents do not face a higher number of challenges than their two-parent counterparts, the challenges single parents do face are of higher intensity. Compounding these challenges is the prevalence of stress. Studies have demonstrated that the negative impact of stress can have an overall impact on health (e.g., Cohen & Wills, 1985; Cohen et al., 1998; Cohen, Janicki-Deverts & Miller, 2007; Cohen, Kamarck & Mermelstein, 1983; Cohen, Tyrrell & Smith, 1993; DeLongis, Folkman & Lazarus, 1988; Epel et al., 2004). The perils of stress have been
3 attributed to consequences such as flu, sore throat, headaches, and backaches (DeLongis et al., 1988). Further, perceived stress, a cognitive accounting of stress that may or may not be accurate, can yield a pathway for anxiety, depression and depletion of general psychological health (Cohen & Williamson, 1988). Certain mental illnesses are directly stress induced (i.e., posttraumatic stress disorder and acute stress disorder; American Psychological Association [APA], 2000). It has been difficult, if not impossible, to determine the exact financial burden stress has created. The American Institute of Stress (AIS, 2008) estimates the price at over $300 billion per year nationwide. However, closer scrutiny at this figure suggests that it is arrived at purely through guessing (AIS, 2008). The primary confusion that limits accurate figures is the delineation between causality and correlation. There have been no studies that directly link exact overall health-care costs to stress (AIS, 2008). The conclusion seems to be that stress can be a reliable predictor of general health (Cassel, 1976). Thus, much attention has been directed toward evaluating and alleviating stress (see Cohen & Hamrick, 2003; Cohen & Hoberman, 1983; Cohen & Williamson, 1988; Cassel, 1976; Cohen et al., 2007; Epel et al., 2004; Farag & Mills, 2004; Feldman, Cohen, Hamrick & Lepore, 2004; Selye, 1974). It is understandable that topics of stress maintenance and stress prevention continue to generate interest. Many researchers strongly argue that perceived availability of social support can mediate the effects of stress (i.e., Cohen & Hamrick, 2003; Cohen & Hoberman, 1983; Cohen & Williamson, 1988; Cassel, 1976; Cohen et al., 2007; Epel et al., 2004; Farag & Mills, 2004; Feldman etal., 2004; Selye, 1974).
4 There is evidence to suggest that social support can be a buffering mechanism against certain types of stress (Cohen & Hoberman, 1983; Cohen, Underwood & Gottlieb 2000; Cohen & Wills, 1985). How does social support protect people from the impending harmful effects of stress? One theory is that social support can facilitate the coping process, acting as a buffer to impede negative cognitive appraisals that provoke stress (Lazarus, 1990; Lazarus & DeLongis, 1983). But what exactly is social support? Although the consensus regarding the exact definition of social support is mixed (House, Umberson & Landis, 1988; McGrath et al., 2000; Sarason, Sarason, Shearin, Shearin & Pierce, 1987), some contend that the foundation of social support relies on positive confirmation of one's worth, proof that an individual is valued and cared for (Cobb, 1976). Researchers have studied social support and found that, in general, social support can create cohesiveness in family units (Cobb, 1976). Studies have also found that, in particular, single mothers may greatly benefit from the comfort and affirmation others provide (Avison, 1996, 1997; Avison & Davies, 2005; Cairney, Boyle, Offord & Racine, 2003). In contrast, studies have also revealed that social networks, embedded within the family, can elevate stress levels in single mothers. Single mothers may encounter societal isolation when attempting to establish positive, reassuring and protective support structures (Avison, 1996,1997; Avison & Davies, 2005). Companion animals may bridge this divide and facilitate an unconditional type of support focused toward inhibiting the inherent consequences of stress. Background The American Pet Product Industries (APPI, 2007) estimates that 71.1 million homes in the United States currently own a pet. In 2007, Americans spent over $40
5 billion dollars on pets and pet care. This number is forecasted to increase $3 billion in subsequent years (APPI, 2007). These numbers are staggering considering that pets are not a necessity. Although people do not "need" pets, some research suggest that the positive socialization component that pets provide can provide more fulfillment for some than a human to human connection (Cavanaugh, Leonard, Scammon, 2008). A recent survey revealed that 75% of pet owners develop a parent-child bond with their animals (Nagasawa, et al., 2009). Why do people attribute human characteristics to their pets? The concept of anthropomorphism is defined as attributing human characteristic to nonhuman entities (Serpell, 2003). Could the belief that a pet is conveying unconditional love, loyalty, affection and understanding equate to perceived social support? Researchers are trying to answer this question. Companion animals, also known as pets, have provided comfort to various populations (see Akiyama, Holtzman & Britz, 1986; Allen, 2003; Allen, Blascovich, & Mendes, 2002; Brown & Rhodes, 2006; Friedmann, Katcher, Lynch & Thomas, 1980; Friedmann & Thomas, 1995; Garrity et al., 1989; Lago, Delaney, Miller & Grill, 1989; Patronek & Glickman, 1993; Straede & Gates, 1993; Wells & Perrine, 2001). Older adults have greatly benefited from animal companionship, specifically with regard to stress, health, and health-related concerns (Banks & Banks 2002; Colombo et al., 2006; Darrah, 1996; Friedmann et al., 1983; Garrity et al., 1989; Keil, 1998; Kuehn, 2002; Lago et al., 1983; Netting et al., 1984; Siegel, 1990). Recent studies have shown that dog ownership is directly linked to higher levels of physical activity, which is associated with better health and lower stress levels (Brown & Rhodes, 2006; Curt, et al., 2008; Kushner, Blatner, Jewell & Rudloff, 2006;). Studies have also shown that for some people owning a pet may be an integral necessity
6 in the battle against stress and subsequent disorders (Allen, et al., 2002; Allen, et al., 1991). Statement of the Problem Studies suggest that women who head single-parent households are prone to elevated levels of stress (Davies, Avison & McAlpine, 1997; Doherty, Su, & Needle, 1991; Hetherington, Cox & Cox, 1981; Turner, 2006). Heightened stress levels may increase health issues (Cohen et al., 1998; Cohen et al., 2007 Cohen et al., 1983; Cohen & Wills, 1985; DeLongis et al., 1988; Epel et al., 2004). Great interest has been directed toward understanding sources of social support and how social support can act as a coping mechanism for single mothers (Avison, 1996; Avison & Davies, 2005). Owning a pet has been shown to reduce stress and promote comfort in various populations (Garrity et al, 1989; Siegel, 1990). Alleviating stress among single mothers is important because developed countries, such as the United States, have the highest rates of marriage and divorce. This is compounded by the fact that since 1980, live births to single mothers in the U.S. have risen by 32% (Avison & Davies, 2005). The increase in the number of life stressors that single mothers endure may be intensified by their limited social support (Avison & Davies, 2005). Although attention has been directed toward the epidemiological aspect of stress and its implications in single mothers, while other studies have examined the benefits of pet ownership, to date there are no published studies that have bridged these variables. The lack of understanding related to stress, social support, and pet attachment (commonly referred to as the human-animal bond), as it relates to single mothers prompts the
7 following research questions: To what extent might pets mitigate stress levels, promote perceptions of social support and potentially promote positive general health in single mothers? Purpose The purpose of this dissertation was to uncover relationships, if any, that exist among pet ownership, pet attachment, perceived social support, perceived stress and general health in a sample of single mothers. The following research questions were addressed in this study: 1. Is there evidence of a relationship between pet ownership and outcomes? In other words, do single mothers who own a pet have better stress and health outcomes than those who do not own a pet? Hypothesis (la) Single mothers who own a pet will report lower levels of perceived stress, as measured by the Perceived Stress Scale (PSS) (Cohen et al., 1983) than single mothers who do not own a pet, controlling for age of mother and annual income. Hypothesis (lb) Single mothers who own a pet will report better health than single mothers who do not own a pet, as measured by the following factors: 1. The number of chronic health issues, as diagnosed by a physician, 2. The number of visits to the doctor in the past 6 months, 3. The number of hospitalizations within the past year, 4. If illness has restricted activity in the past year, 5. The number of different types of prescription drugs currently being taken,
8 6. Respondents were asked to address the following question, compared with other people your age, how would you describe your health? (Garrity et al., 1989; Ory& Goldberg, 1983), 7. How are pet attachment and perceived support related? To address this question, pet attachment was correlated to perceived support to demonstrate that a link exists, and that they were synonymous. Perceived support is highly related to stress (Zimet et al., 1988). Those who perceive that they have a support system do far better at coping than people who feel they have no one, even if this perception is distorted. Perceived support has been prevalently studied in humans, but has not been thoroughly evaluated in the human animal bond. Hypothesis (2): Among single mothers who own a pet, higher levels of pet attachment, as measured by the Comfort from Companion Animal Scale (CCAS) (Zasloff, 1996), will positively correlate with perceived social support from the pet, as measured by the Multidimensional Scale of Perceived Social Support Significant Other Subscale (MSPSS; SO; Zimet, Dahlem, Zimet, & Farley, 1988), controlling for human support as measured by the MSPSS Family and Friends Subscale. 1. Based on the outcomes of Hypothesis 2, is there evidence of a direct relationship between pet attachment (and support) and stress and health outcomes? Hypothesis (3 a): Based on the outcomes of Hypothesis 2 among single mothers who own a pet, high pet attachment scores (and/or high support scores), as measured by the CCAS and MSPSS (SO), will negatively correlated with high perceived stress scores,
9 as measured by the PSS, controlling for human support, as measured by the MSPSS Family and Friends Subscales. Hypothesis (3b): Among single mothers who own a pet, high pet attachment (and/or high support) scores, as measured by the CCAS and MSPSS, will negatively correlated with high general health assessment scores, as measured by the following factors: 1. The number of chronic health issues, as diagnosed by a physician, 2. The number of visits to the doctor in the past 6 months, 3. The number of hospitalizations within the past year, 4. If illness has restricted activity in the past year, 5. The amount of different types of prescription drugs currently being taken, 6. Respondents were asked to address the following question, compared with other people your age, how would you describe your health? (Garrity et al., 1989; Ory & Goldberg, 1983), controlling for age of mother, annual income and human support, as measured by the MSPSS Family and Friends Subscales. 7. Among single mothers who own a pet, does pet attachment buffer stress? Hypothesis (4): Among single mothers who own a pet, pet attachment, as measured by the CCAS, will buffer stress, as measured by the PSS. That is, those reporting high levels of stress and high levels of pet attachment will have better health outcomes (low general health assessment scores) than those with high levels of stress and low pet attachments, as measured by the following factors: 1. The number of chronic health issues, as diagnosed by a physician, 2. The number of visits to the doctor in the past 6 months,
10 3. The number of hospitalizations within the past year, 4. If illness has restricted activity in the past year, 5. The amount of different types of prescription drugs currently being taken. Respondents were asked to address the following question, compared with other people your age, how would you describe your health? (Garrity et al., 1989; Ory & Goldberg, 1983), controlling for age of mother, annual income and human support, as measured by the MSPSS Family and Friends Subscales. Significance The outcome of a study of this type could have pertinent application in terms of stress relief for single mothers. Primary preventative measures of stress are currently focused toward psychopharmacological methodologies (DeGrandpre, 2004). Serious side effects of different medications may compound or create new medical issues. Other alternatives to reducing stress may include therapy; however, these alternatives may not be feasible for single mothers due to financial constraints or scheduling barriers (Karkaria. 2006). Outcomes from pet ownership research as it relates to single mothers may offer another viable alternative. Definition of Terms Although the construct of stress is prevalent in research, the definition of the term is elusive (Selye, 1974). Stress has been characterized as appraising a situation as intimidating or challenging and not having an appropriate coping response (Cohen & Wills, 1985). This subjective analysis of stress is considered by Cohen et al. (1983) to be perceived stress.
11 Like stress, social support has no universal definition (McGrath et al., 2000). Cobb (1976) defines social support as a confirmation that an individual is valued and cared for. In instances when social support is correlated to pet ownership, two models are embraced: (a) the direct effect paradigm, which depicts social support as providing an unmediated direct impact on characteristics of human health and wellbeing; and (b) the buffering model, which is more of a protective intervention, distracting individuals from stressful or threatening life events (Cobb, 1976). Zasloff (1996) operationally defined pet attachment in terms of "perceived comfort received from a pet" (p. 43). Highlights of Methodology The existing scales measured perceived stress, perceived support (human and animal), pet attachment and general health. Demographic information (i.e., age, race, income, education level, etc.) was also collected. The specific population targeted was single mothers. Single mothers were recruited through links on various Web sites (i.e., socialpsychology.org, learner.ncu.edu, list servers for single mothers, single mother support groups, ASPCA Web site, Humane Society, etc.). A total of 202 single mothers participated in the survey; over half of the respondents (57%) owned a pet. Limitations of Study Wilson and Barker (2003) suggest that control is a key issue for any research design. For human-animal interaction analysis, the issue of control can be especially challenging. Each entity of demographic information compiled from survey research reflects a potential confounding variable. Controlling for each specific characteristic can be difficult, if not impossible. Avison (1996, 1997) proposed that age and economic status are profound contributing factors when considering a single mother's quality of
12 life. Thus, extraneous variables, such as age of mother, annual income, human support and chronic health issues were addressed. Other limitations such as anxiety level, number and type of pet, number and age of children are all valid considerations but proved too overwhelming to control for in a correlational study. Other correlational studies that have evaluated pet ownership and attachment as it relates to stress and health have addressed few if any confounding elements (see Kraus, 2007; Loven, 2004; Siegel, 1990; Watson & Weinstein, 1993; Zasloff & Kidd, 1994). Finally, the primary goal of this project is to identify potential relationships that exist. It is important that the outcomes not be interpreted the same as in experimental designs, which elicit predictions based on causality. In other words, correlation is not causation.
13 CHAPTER 2: LITERATURE REVIEW Overview of Single Mothers Single-parent households have emerged as a prevalent family structure (Avison, 1996, 1997; Avison & Davies, 2005; Cairney et al., 2003; McLanahan, 1985). Women typically head households of this type (U.S. Census Bureau, 2007). Consistency in the literature seems to document a concern for the emotional and mental health of single mothers (Avison, 1996, 1997; Avison & Davies, 2005; Cairney et al., 2003; McLanahan, 1985). Most concerning are the higher levels of psychological distress, psychiatric morbidity and premature aging associated with this demographic. For example, Epel et al. (2004) evaluated the impact stress has on cellular aging. They concluded that women with the highest perceived stress levels age more quickly than women with low levels of perceived stress. Foundational disorders, such as depression, seem to be the manifestation of stress (Avison, 1997). Those who are most vulnerable to the impact of daily stressors are individuals with unsupportive social relationships and low self-esteem (Delongis et al., 1988). There has been increased interest in exploring plausible interventions to prevent and decrease debilitating stress among single mothers. Avison (1996) evaluated the effects social networks and social support can have on inhibiting stress. Avison found that certain types of support and certain types of social networks can actually promote stressors. Brown et al. (1994) found that in a sample of working-class women, family adversities, including, but not limited to, parental indifference, family violence, and sexual abuse, were linked to chronic depression, and lifelong stress, demonstrating that some family systems can be related to detrimental outcomes. Other research concurs that there may be a connection between weak social
14 support networks and vulnerability to depression (Avison, 1996; Brown & Moran, 1994). These findings speak volumes about understanding and being able to differentiate between the various types of social support and recognizing appropriate social networks. Rook (1984) has explored the negative aspect of social interaction. Rook argued that research on the harmful aspects of social support is often neglected. The primary focus of support interaction, Rook contended, has been to reap its positive effect on mediating or buffering stress. Rook suggested that nonsupportive or negative support systems can provide just as much insight on well-being. Individuals' well being can be compromised by their limited opportunity to obtain help from others. This may conflict with the stipulations of social exchange theory. Social exchange theory requires that people choose their social ties based on the understanding that rewards are relative to costs (Homans, 1958). This would indicate that individuals seek out predominately rewarding social ties. This is not the case, however, when individuals are limited by their choices (Rook, 1984). Rook (1984) theorized that the enhancement gained from positive social ties can be greatly overshadowed by the detrimental effects of negative social experiences. Her claim is substantiated by perception studies. According to person-perception research, individuals give more weight to negative rather than positive information (Hamilton & Zanna, 1972; Hodges, 1974; Richey, McClelland, & Shimkunas, 1967). Researchers hypothesized that because negative experiences are more infrequent, they are more salient and thus have a greater impact (Rook, 1984). Based on this insight, it is easy to deduce that numerous positive social exchanges may not compensate for the inevitable few negative interactions. But, just how injurious are problematic interactions?
15 To answer this question, Rook (1984) interviewed 120 single women (widows) between the ages of 60 and 89. Using a multiple regression analysis, Rook found that relative to positive social outcomes, negative social outcomes were consistently related to decreased psychological well-being. This seems to reiterate the findings of Evans, Palasano, Lepore and Martins (1989) that there is a direct link between interpersonal conflict, depression and social withdrawal. Another potentially debilitating challenge for single mothers with regards to social integration is the challenge of fulfilling a multitude of roles, each with different expectations (Goode, 1960). Goode referred to this phenomenon as role strain and suggested that there are two components: role conflict, which is the result of discrepancy among the different social expectations, and role overload, which happens when an over abundance of roles requires difficult prioritizing and inevitable sacrificing. Although Goode's work had initial intuitive appeal, Marks (1977) and Sieber (1974) disputed his findings and offered their own model known as role accumulation theory. Sieber (1974) maintained that embracing multiple roles is complementary to psychological well-being. He stipulated that rewards outnumber the benefits associated with multiple roles. These rewards include enhanced self-esteem, status security, and amassing privileges. Marks (1977) added that role accumulation leads to potential sources of wealth, sympathy, and prestige. This disagreement between the assets and drawbacks of social integration, and the timeliness of studies, suggested that more research is needed to insure a better understanding of the advantages as well as the disadvantages single mothers may face when they inevitably endure challenging social requirements.
16 Perceived social support has been found to be a mitigating factor in combating anxiety and distress experienced by single mothers (see Avison, 1996, 1997; Avison & Davies, 2005; Cairney et al., 2003; Davies et al., 1997; Doherty et al., 1991; McLanahan, 1985; Turner, 2006). Considering this research is important because the amount of perceived social support a pet conveys will determine its capacity to act as a stress buffer. In terms of exploring stress levels among single mothers, Avison (1996, 1997) has compiled a plethora of research on the heath factors related to single parenting (see Avison & Davies, 2005; Davies et al., 1997). He has outlined an increase in the number of families headed by single mothers and pinpointed specific societal challenges this particular demographic faces (Avison, 1997). Avison suggested that there is a strong relationship between the high levels of psychological distress and psychiatric morbidity. Avison's (1996) work on social networks, as they relate to single mothers, revealed that social support buffers individuals from major depressive illness. Social networks can also have a paradoxical effect by being a source of stressors. This negative influence may contribute to the onset of psychiatric disorders. Thus the crucial part of developing a social support system is determining healthy buffers from nonhealthy buffers. Avison and Davies (2005) concluded that gender and age play a significant role in determining social support mechanisms. For example, young, single mothers are more prone to alcohol consumption than both their male counterparts and older single mothers. This type of strategy of buffering stress with alcohol may contribute to a cyclical coping style in which the debilitating consequences of liquor intensify stress and vice versa.