Norbeck Social Support Questionnaire (NSSQ)

Abstract

The Norbeck Social Support Questionnaire (NSSQ), developed by Norbeck, Lindsey, and Carrieri in 1981, is a widely utilized self-report instrument designed to measure both the functional and structural aspects of an individual’s social support network. The scale assesses the perceived quality of support (functional components such as Affect, Affirmation, and Aid) provided by network members, as well as characteristics of the network itself (e.g., frequency of contact, duration of relationships, and loss of relationships). The NSSQ is highly valued in clinical and nursing research settings for its robust psychometric properties, offering a comprehensive assessment tool for researchers studying the relationship between social resources and various health outcomes, particularly stress and anxiety.

Keywords

Norbeck Social Support Questionnaire, NSSQ, Social Support, Affect, Affirmation, Aid, Network, Psychometrics, Nursing Research, Stress, Anxiety.

Authors

J.S. Norbeck, A.M. Lindsey, V.L. Carrieri

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Purpose

The primary purpose of the Norbeck Social Support Questionnaire (NSSQ) is to provide a standardized, quantitative measure of perceived social support within an individual’s personal network. It was specifically developed to capture the multidimensional nature of support, moving beyond simple network size to evaluate the quality and availability of functional support types.

A secondary, crucial purpose is to track changes in the support network over time, particularly the loss of significant relationships due to life events such as death, divorce, or moving. This feature makes the NSSQ highly valuable in studies examining the buffering effects of social support against negative life stress and in populations experiencing significant life transitions, such as pregnancy or chronic illness.

Construct

The NSSQ measures two primary components of social support: Functional Support and Network Properties. Functional support is further broken down into three specific subscales, reflecting the type of assistance provided:

• Affect: Measures the extent to which network members provide feelings of being liked, loved, respected, or admired.
• Affirmation: Measures the extent to which network members agree with or support the respondent’s actions or thoughts (e.g., parenting choices).
• Aid: Measures the provision of tangible or instrumental assistance, such as immediate help (e.g., borrowing money, transportation) or long-term help (e.g., assistance during confinement).

Network Properties include quantifiable characteristics of the respondent’s social ties, such as the duration of the relationship, the frequency of contact, the closeness of the relationship, and geographical distance. The instrument also assesses recent loss of relationships and the overall amount of support those lost individuals provided, which is critical when analyzing the impact of life events.

Validity

The validity of the NSSQ has been explored through various studies since its inception. Early research established strong construct validity, demonstrating that the instrument effectively differentiates levels of social support across diverse populations. Studies have shown that the NSSQ scores correlate predictably with measures of life stress and psychological well-being, confirming its ability to measure the theoretical construct of social support as a stress buffer.

Research confirming the factor structure (see Factor Analysis) further supports the instrument’s validity, showing that the items reliably group into the intended subscales of Affect, Affirmation, and Aid. For instance, Byers and Mullis (1987) confirmed the reliability and validity of the NSSQ specifically when used with psychiatric inpatients, demonstrating its applicability across clinical settings.

Reliability

The NSSQ exhibits excellent internal consistency and high test-retest reliability, confirming its stability and precision in measuring social support. Multiple studies have reported strong reliability metrics:

• Internal Consistency: Researchers have consistently calculated high Cronbach’s alpha values. For the overall 6-item NSSQ functional measure, an alpha of .97 was reported (Gigliotti, 2002). Subscale alphas are similarly high: Affect subscale (.98), Affirmation subscale (.97), and the Aid subscale (.91). The Emotional Support subscale (combining Affect and Affirmation) also demonstrated an alpha of .97 (Zachariah, 1996).
• Test-Retest Reliability: Stability was confirmed across different time intervals. At one week (n=67), correlations were strong: Affect=.89, Affirmation=.88, and Aid=.86 (Norbeck et al., 1981). Furthermore, stability remained high even over a longer period; at seven months (n=44), correlations ranged from .58 to .78, indicating a high degree of stability for a measure of a dynamic social construct (Norbeck et al., 1983).

Factor Analysis

The factor structure of the Norbeck Social Support Questionnaire has been subject to specific investigation to confirm its theoretical foundations. The structure is designed to reflect the three distinct functional types of support: Affect, Affirmation, and Aid. Gigliotti (2002) conducted a confirmation of the factor structure and successfully validated the three-factor model, supporting the use of the instrument’s subscales as distinct measures of functional social support.

This confirmation allows researchers to analyze specific types of support rather than just a total score, providing nuanced insights into which aspects of the social network are most influential for specific outcomes, such as anxiety reduction or coping with chronic illness. The confirmed factor structure reinforces the robust psychometric properties of the NSSQ.

Instrument

Test Type: Self-report questionnaire, Quantitative measure of social support structure and function.

Format: Multi-item questionnaire requiring respondents to list members of their support network and rate the characteristics and quality of support provided by each member. Functional items are rated on various Likert scales.

Language Available: Primarily English; translated versions are available in various languages based on research needs (e.g., Spanish translations have been used in research with Dominican populations in the US).

Population Group: General adult population; widely used in clinical and vulnerable populations.

Age Group: Adults (generally 18+).

Population Details: Frequently used in populations experiencing high stress or transition, including pregnant women (low-income women specifically noted in Norbeck & Anderson, 1989), psychiatric inpatients, and individuals dealing with chronic disease.

Test Methodology: Respondents first identify significant individuals in their lives (e.g., family, friends, professionals). They then answer a series of questions regarding the nature of the support provided by each person. Items related to functional support (Affect, Affirmation, Aid) typically utilize a 5-point scale where 0 = not at all, 1 = a little, 2 = moderately, 3 = quite a bit, and 4 = a great deal. Other items, such as closeness or geographical distance, use different scales (e.g., 3-point or 7-point scales).

Keywords

Norbeck, Lindsey, Carrieri, Affect Subscale, Affirmation Subscale, Aid Subscale, Social Network, Psychometric Scale, Cronbach’s Alpha, Test-retest reliability, Life Stress.

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Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Not provided in source material.

Permissions & Fee and Test Year

The Norbeck Social Support Questionnaire was initially published in 1981 (Norbeck, Lindsey & Carrieri). Permissions often rely on contacting the original authors or the publisher (Nursing Research). The full instrument can often be found in academic dissertations and theses for research use. The original PDF of a related thesis utilizing the NSSQ can be downloaded here: http://ufdcimages.uflib.ufl.edu/UF/E0/02/20/29/00001/stevens_m.pdf. Another online resource is available at: https://etd.ohiolink.edu/!etd.send_file?accession=ucin1367937810&disposition=inline.

Reference’s

• Byers, Patricia H., & Mullis, Marcia R. (1987). Reliability and Validity of the Norbeck Social Support Questionnaire in Psychiatric Inpatients. Educational and Psychological Measurement, 47(2), 445-448.
• Gigliotti, E. (2002). A confirmation of the factor structure of the Norbeck Social Support Questionnaire. Nursing Research, 51(5), 276-284.
• La Roche, M. & Turner, C. (1997). Self-orientation and depression level among Dominicans in the United States. Hispanic Journal of Behavioral Sciences, 19(4), 479-488.
• La Roche, M. (1999). The association of social relations and depression levels among Dominicans in the United States. Hispanic Journal of Behavioral Sciences, 21(4), 420-430.
• Norbeck, J.S., Lindsey, A.M. and Carrieri, V.L. (1981). The development of an instrument to measure social support. Nursing Research, 30, 264-269.
• Norbeck, J.S., Lindsey, A.M. and Carreiri, V.L. (1983). Further development of the Norbeck social support questionnaire: Normative data and validity testing. Nursing Research, 32, 4-9.
• Norbeck, J.S. (1984). Modification of a recent life event questionnaire for use with female respondents. Research in Nursing and Health, 7, 61-71.
• Norbeck, J.S. (1984). The Norbeck Social Support Questionnaire. Birth defects original article series, 20(5), 45-57.
• Norbeck, J.S. and Anderson, N.J. (1989). Life stress, social support, and anxiety in mid and late-pregnancy among low income women. Research in Nursing and Health, 12(5), 281-287.
• Stevens, Monica Leah. (2008). Psychometric Properties of the Norbeck Social Support Questionnaire. University of Florida. Master’s (M.S. Thesis).
• Zachariah, R. (1996). Predictors of psychological well-being of women during pregnancy: Replication and extension. Journal of Social Behavior and Personality, 2(1), 127-140.
• Zachariah, R. (2009). Social support, life stress, and anxiety as predictors of pregancy complications in low-income women. Research in Nursing and Health, 32, 391-404.

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Items of the Norbeck Social Support Questionnaire (NSSQ)

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

• 1. How much does this person make you feel loved? (Functional Type: Affect)
• 2. How much does this person make you feel respected or admired? (Functional Type: Affect)
• 3. How much can you confide in this person? (Functional Type: Affirmation)
• 4. How much does this person agree with or support your actions or thoughts? (Functional Type: Affirmation)
• 5. If you needed to borrow $10, a ride to the doctor, or some other immediate help, how much could this person usually help? (Functional Type: Aid)
• 6. If you were confined to bed for several weeks, how much could this person help you? (Functional Type: Aid)
• 7. How long have you known this person? (Network Property: Duration of relationship)
• 8. How frequently do you usually have contact with this person? (phone calls, emails, visits, or letters) (Network Property: Frequency of contact)

Loss of Relationships Items:

• 9. During the past year, have you lost any important relationships due to moving, a job change, divorce or separation, death, or some other reason?
• 9. a. Please indicate the number of persons from each category who are no longer available to you.
• 9. b. Overall, how much of your support was provided by these people who are no longer available to you?

Note on Functional Item Scoring (Items 1-6):

• 0 = none at all
• 1 = a little
• 2 = a moderate amount
• 3 = quite a bit
• 4 = a great deal

Note on Alternate Items (Used in some versions, e.g., parenting-focused):

• *1. How much does this person make you feel liked or loved? Affect
• *2. How much does this person make you feel respected or admired as a parent? Affect
• *3. How much can you confide in this person? Affirmation
• *4. How much does this person agree with or support your parenting? Affirmation
• *5. If you needed babysitting, a ride to the doctor, or some other immediate help, how much could this person usually help? Aid
• *6. If you were confined to bed for several weeks, how much could this person help with your parenting responsibilities? Aid
• 7. How long have you known this person?* Duration of relationship
• 8. How frequently do you have contact with this person? Frequency of contact
• 9. How close do you feel to this person? Closeness of relationship (Rated on a 3-point Likert-type scale)
• 10. How close does this person live to you? Geographical distance (Rated on a 7-point Likert-type scale)