Sources of Social Support Scale

Abstract

The Sources of Social Support Scale (SSSS) was developed by Charles S. Carver, Mike Antoni, and colleagues to address perceived limitations in existing measures of social support. The primary objective of the SSSS is to empirically differentiate between various sources of support (e.g., partner, friends, healthcare providers) and distinct aspects of support, particularly emphasizing the differential impact of positive versus negative support. The scale emerged from research focusing on the effects of a multi-modal cognitive-behavioral stress management intervention among patients diagnosed with breast cancer and has subsequently been utilized in longitudinal studies involving both breast and prostate cancer populations.

The SSSS structure involves using a core set of 10 items, which are repeated verbatim across several different potential sources of support (e.g., husband/partner, family members, friends). This standardized structure allows for direct comparison of the type and valence of support received from each specific source regarding the individual’s illness.

Keywords

Social Support, Sources of Support, Negative Support, Positive Support, Cancer Patients, Psychosocial Well-being, Carver SSSS, Stress Management, Longitudinal Studies.

Authors

Charles S. Carver, Mike Antoni, and colleagues.

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Purpose

The primary purpose of the SSSS is to provide a nuanced measurement tool capable of resolving two critical, interconnected questions concerning social support in health contexts. Firstly, the scale investigates whether distinct sources of support—such as a partner, family members, friends, or health care providers—exert different types or levels of influence on an individual’s psychosocial well-being, particularly when coping with a major illness like cancer.

Secondly, the SSSS is designed to capture different aspects of support, moving beyond traditional measures that focus solely on positive supportive behaviors. A key innovation of the scale is its inclusion of items specifically targeting negative support (e.g., criticism, arguments, withdrawal). This focus is crucial, as the developers recognized a growing literature suggesting that negative interactions might be significantly more impactful on psychological outcomes than positive supportive interactions.

Construct

The SSSS measures the multidimensional construct of social support, operationalized across two main axes: the source of the support and the valence/type of the interaction. The scale conceptualizes support as encompassing several specific behavioral categories, including the provision of advice/information, tangible assistance, emotional support/reassurance, and active listening. These positive behaviors are contrasted directly with items measuring negative interactions.

By applying the same set of items (both positive and negative) across different relationship categories, the SSSS allows researchers to generate separate subscale scores for support received from specific sources, such as a partner, adult female family members, other family members, friends, and health care providers, thereby quantifying source-specific support profiles related to managing a serious illness.

Validity

Specific detailed validity studies (e.g., construct validity, criterion validity) are typically documented in subsequent academic publications referencing the scale’s use. The initial development and application of the SSSS were rooted in empirical observations derived from research into cognitive-behavioral stress management interventions for cancer patients, suggesting strong initial face validity concerning the stress and coping domain. The structure, which explicitly differentiates between positive and negative behaviors across specified sources, aims to increase the scale’s discriminant validity compared to measures that treat social support as a monolithic concept.

Reliability

While specific internal consistency coefficients (e.g., Cronbach’s alpha) are not detailed in the source description, the scale’s successful implementation in at least two rigorous, multi-year longitudinal studies of cancer patients implies that the item sets demonstrated adequate internal reliability within those specific research contexts. The consistent application of the same core item set (with only necessary pronoun adjustments) across all assessed sources is a methodological choice intended to maximize structural reliability and comparability across subscales.

Factor Analysis

The inherent design of the SSSS suggests a factor structure that should clearly separate items based on both the source of support (e.g., Partner factor, Friend factor) and the valence/type of interaction (e.g., Positive Emotional Support factor, Negative Interaction factor). The 10 items applied to each source are hypothesized to load onto two primary dimensions: factors representing positive, helpful support behaviors (such as assistance, listening, and reassurance) and factors representing negative, unhelpful behaviors (such as criticism, arguments, and withdrawal), thereby supporting the developers’ goal of measuring both positive and negative aspects independently.

Instrument

Test Type: Self-report questionnaire / Psychological scale

Format: Multi-section Likert-type rating scale. The response options utilize a 5-point scale:

1. 1 = Not at all
2. 2 = A little
3. 3 = A moderate amount
4. 4 = A pretty large amount
5. 5 = A lot

Language Available: English (Original development language).

Population Group: Clinical population (initially cancer patients) and general adult populations.

Age Group: Adults.

Population Details: Primarily developed and validated in studies involving women diagnosed with breast cancer and men diagnosed with prostate cancer, focusing specifically on coping mechanisms and psychosocial well-being following diagnosis and treatment.

Test Methodology: Used frequently in longitudinal studies to track changes in perceived support over time in response to the progression of illness or the introduction of therapeutic intervention (such as cognitive-behavioral stress management).

Keywords

Carver, Antoni, Social Support Measurement, Cancer Coping, Negative Social Support, Dyadic Relationships, Psychological Assessment.

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Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: Not provided in source content.

Correspondence Address: University of Miami (Affiliation inferred from citation URL).

Permissions & Fee and Test Year

The scale was formally cited and published online in 2006. The original source documentation was made available via Charles S. Carver’s faculty webpage. The SSSS is typically used freely for non-commercial academic research; however, researchers should confirm specific permissions and any potential fees directly with the primary author.

Reference’s

Carver, C. S. (2006). Sources of Social Support Scale. Retrieved from: http://www.psy.miami.edu/faculty/ccarver/sclSSSS.html

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Items of the Sources of Social Support Scale

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Here are the instructions for the SSSS, and the items as they would be applied to husband/partner.

These items concern the kinds of help and support you get from various people regarding your illness. The items ask about several different sets of people, but apply the same questions to each. Use the following choices for these items:

1 = Not at all

2 = A little

3 = A moderate amount

4 = A pretty large amount

5 = A lot

A. The first items concern your husband/partner. [If you do not have a husband/partner, leave these items blank and skip to section B].

1. How much does your husband/partner give you advice or information about your breast cancer (whether you want it or not)?
2. How much does your husband/partner give you assistance with things related to your breast cancer (for example, helping you with daily chores, driving you places, dealing with bills and paperwork)?
3. How much does your husband/partner give you reassurance, encouragement, and emotional support (affection) concerning your breast cancer?
4. How much does your husband/partner listen to and try to understand your worries about your breast cancer?
5. How much can you relax and be yourself around your husband/partner?
6. How much can you open up to your husband/partner if you need to talk about your worries about your cancer?
7. How often does your husband/partner argue with you relating to your cancer?
8. How often does your husband/partner criticize you relating to your cancer?
9. How often does your husband/partner let you down when you are counting on him?
10. How often does your husband/partner withdraw from discussions about your illness or try to change the topic away from your illness?

B. The next items concern adult women in your family (sisters, mother, aunts or adult daughters). [If you do not have adult women in your family, leave these items blank and skip to section C].

Subsequent sections in this particular application are other family members, friends, and health care providers.