https://orcid.org/0000-0002-5471-7774
ABSTRACT
This study examined associations between receiving and giving support, and their imbalance on depression symptoms in adolescents. Our sample included 2,111 young adolescents drawn from 6th Wave European Social Survey who completed measures of social support and the Centre for Epidemiologic Studies-Depression (CES-D). A hierarchical linear regression demonstrated that both receiving and giving social support were associated with a 51% and 34% reduced risk of being depressed, respectively. However, analysis of group differences indicated those high on both giving/receiving, that is, a positive balance, reported less depression, compared to those with a negative balance, that is, low on both, with the highest symptoms observed by those reporting a negative imbalance, that is, high giving and low receiving social support. While there are benefits to receiving and giving social support, there is also a cost when this is imbalanced. Our findings are discussed from an equity theory and lifespan perspective.
KEYWORDS:
Introduction
Symptoms of depression have been found to increase during adolescence (Costello et al., Citation2006; Thapar et al., Citation2012; Wesselhoeft et al., Citation2013). According to the World Health Organization, depression and mental health are some of the leading causes of disability for adolescents with 1 in 7, 10–19 years olds affected worldwide (WHO, Citation2021). While depression is a heterogeneous disorder (e.g. endogenous depression, melancholia, and dysthymia), common features and symptoms include feelings of sadness, fatigue, guilt, loss of interest or pleasure, low self-worth, disturbed sleep or appetite, and poor concentration (NICE, Citation2010; WHO, Citation2021). Further, depression is associated with exacerbation of existing as well as future mental and physical health, and has also been found to heighten risk of major depressive disorder as well as suicide risk in adolescents (Thapar et al., Citation2012; Wesselhoeft et al., Citation2013). The strongest risk factors for depression in adolescents are genetics, family history of depression, exposure to life stress interacting with developmental factors (e.g. hormones) and psychosocial adversity influencing neural pathways (Thapar et al., Citation2012). However, social factors such as social support have been found to be protective against depression and depressive symptoms (Blakemore, Citation2008; Gariépy et al., Citation2016; McPherson et al., Citation2014; Scardera et al., Citation2020). By depressive symptoms, we mean that individuals may experience depressive symptoms but are not necessarily characterized as clinically depressed and some may experience prolonged and severe symptoms which do indicate clinical depression.
Social support is one of the important functions of social relationships. It is a broad construct that can include both structure, that is, numbers of group a person belongs to or number of close contacts they have, and functional elements, that is, perceived availability and quality of emotional, information or tangible supports (Lakey & Cohen, Citation2000; Uchino, Citation2004) or as any resource that flows through and from social relationship (Waite, Citation2018). According to Langford and colleagues (Langford et al., Citation1997), some of the theoretical constructs that underpin social support include, social comparison theory, that is, where a person’s develop their self-concept by comparing themselves to others in their chosen reference groups and social exchange theory whereby an ‘exchange of mutually rewarding activities (giving support) are contingent on favours returned (receiving support). These, they argue build social competence in relation to the functional attributes of social support (e.g. instrumental/emotional support giving and receiving; Langford et al., Citation1997). Moreover, adolescence has been identified as being a critical period for ‘social brain’ development (Blakemore, Citation2008) where brain regions linked to social processes are developing and being shaped by social interactions.
Social support may be especially important during adolescence, a period characterized by major changes in social roles and responsibilities (e.g. puberty, school transitioning, establishing working and romantic relationships; Arnett et al., Citation2014). Indeed, in a recent population-based cohort study of emerging adults (M = 19 years), perceived higher levels of social support were associated with fewer symptoms of depression one year later (Gallagher et al., Citation2021). Additionally, a study in Ireland, the context for the current study, found that higher levels of social support for first year college students was associated with lower mental health symptoms (McLean, Gaul, & Penco, Citation2022). However, these studies do not account for reciprocity of support (Scardera et al., Citation2020). As such, given the protective effect of social support for depression symptoms in adolescents (Cheng et al., Citation2014; Rueger et al., Citation2016; Scardera et al., Citation2020), further research on its protective role is worthy of investigation.
Social support pathways
There are two proposed pathways in which social support is thought to influence depression: an indirect path via stress buffering mechanisms, that is, the stress buffering hypothesis (Cohen & Wills, Citation1985) whereby the effects of stress on depression are mitigated by the availability of social support from others during times of stress; the other pathway is direct, where social support influences depression independent of stressors (Uchino, Citation2004). While stress re-reappraisal, that is, challenging the negative thoughts associated with stress, is the mechanism of action behind this indirect pathway (Lakey & Cohen, Citation2000); the direct path is thought to operate through relational regulation theory (Lakey & Orehek, Citation2011) whereby the social support people get through ordinary interactions (e.g. socializing, shared activities) and not conversations about stress is what enables them to keep their emotions in check, thereby improving their mental health. (Lakey & Orehek, Citation2011). A recent meta-analytic review has found evidence for both pathways (Rueger et al., Citation2016) with higher perceived availability being health protective, that is, mitigated against the negative effects of depressive symptoms. More recent evidence confirms these associations for both indirect (Gallagher et al., Citation2022) and direct effects (Scardera et al., Citation2020) on adolescent mental health. Despite this, the majority of research on the protective role of social support on depression in adolescents has tended to concentrate on perceived availability of receiving social support, with little attention paid to the benefits of giving social support.
A central assumption in most research on social support is that the person receiving the support benefits whereas the individual providing care and support incurs some cost (Okamura et al., Citation2018). However, a growing body of evidence suggests that giving social support is also health protective (Eisenberger, Citation2013; Inagaki & Orehek, Citation2017; Poulin et al., Citation2013). For example, studies in adults found that mortality was significantly reduced for individuals who reported giving instrumental support to friends, relatives and neighbours, including individuals who reported providing emotional support to their spouse (Brown et al., Citation2003). In a study on older adults, giving social support was found to predict better mental health than receiving social support (Thomas, Citation2010). Other studies have found these effects only in women and not men (Väänänen et al., Citation2005). While another study in young adults found that participants who gave more social support reported greater received social support, greater self-efficacy, greater self-esteem, less depression, and less stress than participants who gave less support (Piferi & Lawler, Citation2006).
In a study of young adults giving support was also associated with a healthy physiological response to acute psychological stress (Gallagher et al., Citation2021). In another study with young adolescents, examining volunteering, which is often considered a way of supporting and giving to others, adolescents when assigned to a volunteer condition, that is, helping young children on a weekly basis, or control condition, that is, normal experience, were found to have better physiological health compared to the control group, demonstrating the powerful health benefits of giving for young people (Moreno et al., Citation2013). Some researchers have argued that support-giving exercises such as volunteering should be incorporated into treatment programmes for adolescent depression (Ballard et al., Citation2021). In fact, these supportive giving activities align well with the recent rise of the phenomenon of social prescribing seen in primary care settings (Cunningham et al., Citation2022). Social prescribing involves a health/social care professionals connecting or signposting individuals with community-based opportunities to improve their health (physical, mental and/or social). For example, these could be getting involved with volunteering, helping or taking part in hobby or arts club to help build social connections or reduce feelings of loneliness.
Although it is worth noting that, research has found the mental health benefits of volunteering not to be independent of other social factors (e.g. sociodemographics and social connections; Creaven et al., Citation2017); and that in fact, social connections better explained that association. This suggests that while volunteering is important for health, its effects are likely driven by social support mechanisms. Moreover, in terms of pathways to health, support giving is thought to be beneficial because it can lead to higher self-esteem and activate neural pathways that link to compassion, stress responsivity and positive affect (Inagaki & Orehek, Citation2017). Given the benefits of giving social support for health whether these effects are evident in adolescents is yet to be fully examined. In fact, it is also important to note that from a developmental perspective, it could be that adults are focused on an increased need to nurture or care for things that may outlast them (e.g. contributing to society, doing things for future generations or caring), adolescents themselves may be more focused on themselves (e.g, self-concept) and their identity (Uchino, Citation2009), so it is important to explore how giving social support in adolescents specifically.
The effect of giving and receiving social support impacts adolescents
Recent studies in young adults have found that it was better to receive than to give social support. For example, while psychometric indices of giving social support to others was associated with healthier blood pressure reactions to acute psychological stress, the association was stronger for received support (Gallagher et al., Citation2021). Moreover, the association between giving and cardiovascular stress reactions abolished when receiving support was accounted for. In contrast, another study in adults found that receiving support had no effect on mortality once giving support was taken into consideration (Brown et al., Citation2003). In contrast, research into the effects of giving and receiving social support for the mental health of older adults has found that it was better to give social support than to receive it (Thomas, Citation2010). While both these studies find that giving is good for health, there appears to be a stronger effect of receiving support for adolescents and for giving support for older adults, implying a lifespan perspective on the benefits of giving and receiving social support for health.
In addition, while there appears to be a health benefit to both giving and receiving social support, this is not the whole story and that there may be reciprocal relationships between giving and receiving. In fact, equity theories suggest that an imbalance in reciprocity norms in our day-to-day social relationships, that is, receiving more than one gives or giving more than one receives, impacts negatively on our well-being (Antonucci et al., Citation1990; Gouldner, Citation1960). While there may be situations in life that giving support to others does not require a reciprocal exchange (e.g. parenting or caregiving) but in general when one is giving more support that one receives, that is, a negative imbalance, then that would be taxing on one's resources and likely to be damaging for health, whereas a balance of both giving and receiving is healthier, that is, a positive balance. Evidence for this comes from one recent study population based study from the United States found that participants who were relatively balanced in the support they gave compared to what they received had a lower risk of all-cause mortality than those who either disproportionately received support from others or disproportionately gave support to others (Chen et al., Citation2021). Moreover, a review of the older adult literature found that both disproportionate giving and disproportionate receiving of support were associated with higher depressive symptoms (Fyrand, Citation2010). Thus, whether these (im)balanced effects are observed for adolescents are yet to be tested.
Rationale for the present study
Given the positive health effects of receiving social support for adolescent health, and the paucity of research on the health benefits of giving support the present study will test whether both receiving and giving social support are important for adolescent mental health. We anticipate that both types of social support will be associated with lower depression symptoms but, based on the above evidence for young adults, these effects will be stronger for receiving support. Further, in line with the equity theory of social support (Antonucci et al., Citation1990; Gouldner, Citation1960), those who have a positive balance between giving and receiving, that is, give the same amount of each, will have lower rates of depressive symptoms compared to those with a negative imbalance, high giving and low receipt of social support.
Aims and Hypotheses
The main aim of this study is to examine the relationship between giving and receiving support on adolescent mental health, specifically on depressive symptoms. The study also analyses differences between balance, in giving and receiving support and imbalance, giving more support than receiving. The following hypotheses will be examined:
Giving social support is negatively correlated with depressive symptoms in adolescents
Receiving social support is negatively correlated with depressive symptoms in adolescents
A positive balance between giving and receiving support will result in lower rates of depressive symptoms in adolescents in comparison to an imbalance of support, high giving and low receiving of support
Method
Design
This quantitative study based on the sixth wave of the European Social Survey (ESS, Citation2012) employs cross-sectional analysis to explore the relationship between the independent variable of social support, giving and receiving, and the dependent variable, depressive symptoms in adolescents. The ESS is a biennial multi-country survey and this sixth wave was conducted in 2012. The data is freely available at http://www.europeansocialsurvey.org/ and the study is widely regarded to be of superior rigour in its design and conduct (Kolarz, et al, (Citation2017).
Procedure
The ESS survey is conducted via an hour long interview using computer assisted personal interviewing (CAPI) or computer assisted mobile interviewing (CAMI) and employs strict random probability sampling, a minimum response rate of 70%, as is recommended survey responses (Burns et al., Citation2008) as well as rigorous translation protocols. The study in conducted in line with the highest ethical standards and aligns to the International Statistical Institutes Declaration on Professional Ethics.
Participants
This study used data for the 29 participating countries: Albania, Belgium, Bulgaria, Cyprus, Czechia, Denmark, Estonia, Finland, France, Germany, Hungary, Iceland, Ireland, Israel, Italy, Kosovo, Lithuania, Netherlands, Norway, Poland, Portugal, Russian Federation, Slovakia, Slovenia, Spain, Sweden, Switzerland, Ukraine, and United Kingdom. Sample sizes in each country ranged from 752 (Iceland) to 2958 (in Germany). Across the 29 countries, there were 54, 673 participants. We included all participants aged between 14 and 18 years who had completed measures of depression symptoms and social support indices along with complete sociodemographic below (N = 2,111).
We also selected demographic variables which are correlated with depressive symptoms: age (in years), gender (males; females), education (less than secondary; lower 1; post-secondary), ethnicity, that is, are you a member of an ethnic minority in your country (yes/no) and household income (deciles collapsed into 2 categories: 1st to 5th = 1 and 6th to 10th = 2, with the latter above €41,000. We also included an item on whether they were involved in volunteering (e.g. How often have you been involved in work for voluntary or charitable organizations over past 12 months) as potential covariates. This was scored from, 1 = At least once a week, to 6 = , Never.
Measures
Depression Symptoms
Symptoms of depression were measured using the eight-item Centre for Epidemiologic Studies Depression scale (CES-D; Radloff, Citation1977). The scale has been validated as tool for use with adolescents in a systematic review for use in Western culture (Blodgett et al., Citation2021). This scale evaluates the frequency of depressive symptoms experienced over the preceding week. Each item is scored on a 4-point scale (0, = ‘rarely or none of the time’ to 3 = ‘most or all of the time’), and a global score is calculated, with scores ranging from 0 to 24. Higher scores indicate higher depressive symptoms and a score of 9 on this scale has been used to indicate possible depression (Briggs et al., Citation2018). This study will employ both the continuous and dichotomous scores. An acceptable Cronbach’s alpha of .75 was obtained in the present study.
Social support
Regarding both giving support and receiving support, the participants were asked similar questions. These were ‘To what extent do you give/ receive support to/from people close to you when needed’ and rated on a scale from 0, = not at all to 6, = completely. Single items measures of support such as these have been used in other population based studies (RL & M, Citation1986; Slavin et al., Citation2020), with single measures found to be very reliable predictors of health outcomes (Lucas & Donnellan, Citation2012). In relation to calculating imbalance support scores, we recoded these variables with those scoring 0–3 as low, and those greater than 3 as high. From this, we created four groups: (1) positive balance: high on both receiving and giving; (2) negative balance: low on both receiving and giving; (3) negative imbalance: high on giving but low on receiving; and (4) positive imbalance: high on receiving and low on giving.
Statistical analysis
Analysis was done using SPSS version 27. Prior to analysis, the sample was weighted by design and then our initial analyses focused on checking for normality (skewness <3.0 and kurtosis <10.0), outliers, and then generating descriptives. There were no outliers found and data was normally distributed. This was then followed by correlation analysis and test of differences to examine whether any of the sociodemographics were related with our outcome variable. Given the nested nature of the data, that is, country level, and given that there are variation in depression symptoms across cultures (Kessler & Bromet, Citation2013), we examined the interclass correlation (ICC) to see if multi-level modelling would apply to our analysis. The ICC analysis revealed that only 3% of the variance in depression symptoms was explained by country level variance. For our main analysis, we conducted hierarchical linear regressions and added potential covariates (e.g. age, gender, annual income and country) were entered in Step 1, followed by each of our predictor variables (e.g. receiving social support and giving social support) individually in Step 2. We also added country as a covariate in each model given its association with our outcome. To examine the differences between social support imbalances, we conducted a univariate variance analysis of covariance (ANCOVA) with the same co-variates included as above. Cohen’s d, eta-squared and R-squared, and Odds Ratio (OR) are our effect sizes.
Results
Descriptives
An overview of the sample is available in . However, in terms of descriptives, there were 1041 boys, and 1170 girls, with a mean sample age 16.71 (1.06). Forty percent of the sample reported having a household income above €41,000 and 13.6% belonged to an ethnic minority group in their home countries (details not reported of ethnicity minority grouping) with 98% in secondary school.
Table 1. Correlations among study variables.
For our variables of interest, the average depression symptoms was 5.05 (3.52), and ranged from 0–21. In terms of possible depression, that is, ≥ 9 on the CES-D (Briggs et al., Citation2018), 11.2% (n = 248) reached this cut-off score. While for receiving social support it was, 5.18 (1.67) with a range from 1–6, and giving support, 4.99 (1.06) and range from 1 to 6. In terms of frequency of volunteering, over 50% (51.4%) indicated the never volunteered, while 8.5% reported volunteering every week and 15% less often with the remaining doing so, a few times a month to once every 6 months.
As can be seen in , older adolescents were more likely to report higher symptoms of depression. Girls reported higher mean (5.49 ± 3.61) depressive symptoms compared to boys (4.55 ± 3.33), t (2,209) = 6.29, p < .001, which was a large effect size, that is, Cohen’s = 3.48. Moreover, those adolescents who came from households with higher incomes also reported lower depression symptoms. For our main predictors, both receiving social support and giving social support were associated with less depressive symptoms with a stronger effect seen for receiving social support from those close to them.
Associations between receiving and giving social support and depressive symptoms
As can be seen in , Model 1, and Step 1, age, gender, income and country were all associated with depressive symptoms in young adolescents. Together, these explained 6% of the variance in depression symptoms. After controlling for these sociodemographics, receiving social support (Step 2) remained to be a significant predictor of depression symptoms and explained an additional 12% (delta (Δ) of the variance in adolescent depressive symptoms. Moreover, in Model 2 for giving social support, an analogous picture emerged in Step 1, age, gender, household income and country were again significantly associated with depressive symptoms and together accounted for 6% of the variance. Here, the addition of giving social support to others at Step 2 added an extra 4% (delta (Δ) of the variance to the overall model.
Table 2. Hierarchical linear regression with receiving (Model 1) and giving social support (Model 2) predicting depressive symptoms.
In supplementary analyses, we ran logistic regressions with the same covariates but here we examined CESD-8 cut off scores (≥ 9 possible depression). A broadly analogous picture emerged, except age was not predictive in this case. As found in the linear regressions those reporting greater levels of receiving social support had at a 51% less risk of being in this possible depression category; OR = 0.49 (95% confidence interval (95% CI), 0.42–0.58), p < .001. A similar pattern was observed for giving support, with age and gender non-significant in Step 1, but giving support was protective against possible depression, contributing to a 34% reduced risk; OR = 0.66 (95% confidence interval (95% CI), 0.56–0.77), p < .001
Receiving and giving support imbalance
In a univariate ANCOVA, the same covariates above were included, and analysis revealed a significant between group differences across social support imbalances, F(3,1775) = 29.55, p < .001, η2p = .048. Moreover, follow-up post-hoc paired contrasts, with Bonferonni adjustments showed that adolescents who had a negative imbalance, that is, high on giving and low on receiving (see ‘High giving’ in ) reported the highest levels depressive symptoms overall. This was in contrast to those who had a positive imbalance, that is, received high support/low on giving, i.e. , High receiving, as well as those with a positive balance, that is, high on both giving and receiving; this particular group reported the lowest levels of depression symptoms. While there were no differences between those with a negative balance, that is, low on both, and those with a negative balance, that is, ‘high giving’ they did report higher depressive symptoms compared to the other groups; all p’s <.04.
Figure 1. Social support giving and receiving imbalance.
In supplementary chi-squared analyses, we examined whether these patterns were similar for probable depression. As can be seen in , a higher proportion of adolescents who had a negative balance, that is, low on both giving and receiving, and a negative imbalance, that is, high on giving/low on receiving were more likely to have probable depression compared to those with a positive balance, that is, high on both giving and receiving, and those with a positive imbalance, that is, high on receiving support; (χ2 (3) = 140.75, p < .001).
Figure 2. Social support imbalance and probable depression.
Discussion
This study aimed to explore the relationship between giving and receiving support and their effects on a young adolescents’ reporting of depression symptoms. Specifically, we set out to examine the effect of social support, both giving and receiving on the depressive symptoms of adolescents. Furthermore, we aimed to ascertain whether a perceived balance in giving and receiving, that is, giving as much support as you received, was more beneficial for adolescents than an imbalance, that is, giving more support than you receive.
The results showed that both giving and receiving social support were protective of depressive symptoms but the direct effects of receiving were stronger. Moreover, adolescents who reported a negative imbalance, that is,, giving more support than they received, reported the highest levels of depression. Whereas, those adolescents who had a positive balance, that is, equal amount of giving support as received support reported the lowest levels of depression. Last, the results also indicated that adolescents who received more support than they gave, that is, positive imbalance, displayed less signs of depression than those with a negative imbalance, that is, low on both, as well as those with a negative balance, that is, high receiving/low giving.
The effect of social support in adolescents on depressive symptoms
The finding that higher levels of depression is associated with giving more support than receiving is in contrast with various other studies who have explored the topic. Brown et al. found that for the health benefits of social support for older adults it was better to give than to receive. Findings by Schacter & Margulin (Citation2019) also found a positive association between providing support and emotional states in depressed adolescents when controlling for received support. However, the present study, while it found that the effects of giving social support while associated with lower reporting of depressive symptoms, the effects of receiving social support on depressive symptoms were must stronger as indexed by the larger positive correlation. This stronger effect of receiving social support for health in young populations is supported by a recent study which found that the effects of receiving social support was more important for young people’s stress reactions (Gallagher et al., Citation2021). Thus, in comparison to older adults whereby giving support may have protective effects (Thomas, Citation2010), for younger populations it appears that receiving support is more health protective. Again, one interpretation for these could be due to lifespan perspectives of social processes where the focus for adolescents is on their self-concept and identity where receiving support from others is important, whereas older adults are more mature and focused towards helping others and look beyond into the future, that is, reciprocal relationships (Uchino, Citation2009).
One reason for the finding that adolescents do not derive the same benefit from giving social support as adults, could be given the developmental period of adolescence. It is possible that young people do not have the capacity or chance to provide a great deal of support at a time when they need so much of it themselves (Arnett et al., Citation2014); and studies have found they are less likely to help others if they are struggling socially themselves (Sabato et al., Citation2021). This is particularly true of adolescent–parental relationships whereby a vertical relationship is evident, in which parents have greater social power and capacity than their children and as such are expected to promote wellbeing when they provide security and support to their children (McMahon et al., Citation2020). Later in emerging adulthood they move towards a more horizontal relationship, characterized by equal, symmetrical, and reciprocal interactions (Russell et al., Citation1998). However, the adolescent years are characterized by stress and transitional change and receiving support at this age is of particular importance as adolescents strive to negotiate everyday stressors such as academic pressures, parental, peer and romantic relationships as well as manage pubertal changes (Seiffge-Krenke, Citation2011). Indeed, numerous studies highlight the importance of receiving support during adolescence (Camara et al., Citation2017; McMahon et al., Citation2020) .
The effect of balance and imbalance in social support in adolescence
While our findings confirmed a linear relationship between social support giving/receiving and lower depressive symptoms, the most informative and novel findings came from our examination of the support imbalance hypothesis. Here, and in line with equity theory (Antonucci et al., Citation1990; Gouldner, Citation1960), we found that high receiving/giving social support, that is, positive balance, was associated with reporting less depressive symptoms, as this group were also less likely to be in the probable depression category. Moreover, we also observed that when adolescents over-benefitted from social exchanges, that is, a positive imbalance receiving more support and giving less support, they also had lower depression symptoms in contrast to those who had a negative balance, that is, low on both support types, but in particular those who were high on giving and low on receiving support, a negative imbalance. While our study is the first to examine the balance of giving/receiving social support on depressive symptoms in adolescents, our findings do concur with a recent study in adults (aged 34–85 years). In that study, compared to those with positive balanced supports, those who under-benefitted (high giving/low receiving) reported higher depressive symptoms (Wang & Gruenewald, Citation2019); and similarly to our study, those who had a positive imbalance or over benefitted (High receiving/low giving) had lower symptoms of depression but these were higher compared to those with higher balanced. Further, similar observations have been found for older adults mortality outcomes, with those reporting greater support balance at baseline, having a lower risk of mortality 23 years later compared to those with greater imbalances (Chen et al., Citation2021). Taken together, these studies suggest that while receiving social support has definite health benefits for adolescents, when there is a negative balance between giving and receiving this can be damaging for their health research. Furthermore, it is interesting that the effects seen here withheld adjustment for country level factors (suggesting that despite country differences in outcomes (Ravens-Sieberer, Citation2008) adolescents have similar support needs across countries, and as such our findings could inform the development of universal adolescence support interventions.
Limitations of the study
Despite the strengths of the study (e.g, large population dataset and sample size), there are several limitations. First, from this cross-sectional design, we cannot infer causation. In fact, some studies have found evidence that depression leads to social erosion in adolescence (Ren et al., Citation2018), thus caution is warranted with interpreting the results and more longitudinal designs are needed. Second, the measures of social support were single item measured and also they did not capture important elements such as source of the social support, that is, family or peers, which has been found to be important in this context (Wang & Gruenewald, Citation2019). Another issue with our social support measurements was that we do not know what type of social support was given and received, as studies have found that receiving emotional support is important for adolescents (Camara et al., Citation2017). Similarly, giving the life stage of these adolescents, there may be differential aspects of support that come into play for adolescents who are in a life transitional phase with supports from peers, parents among others each playing out in different ways and this was not captured by this particular study. Finally, while our measure of depression uses a validated scale and our cut-off threshold for probable depression has been established, it is a self-report measure and caution must be warranted in the interpretation of the findings.
Implications of the research for theory, future research, practice, and policy
Our findings suggest that in the unique period of adolescence the importance of receiving support goes well beyond the benefits of providing support, unlike effects seen in older, adult populations (Brown et al., Citation2003). However, the finding aligns with relational regulation theory (Lakey & Orehek, Citation2011), thus providing additional evidence of the emotion regulation benefits of receiving indirect support in adolescence. Additionally, the results of this study underscore the importance of reciprocity in social support for adolescents, in line with social equity theory (Antonucci et al., Citation1990). Adolescents that were highest in giving and receiving social support had the least depressive symptoms. However, those who had a positive imbalance (i.e. high in receiving, low in providing) were also low in depressive symptoms which indicates that, for young people, the best advantage is in receiving social support. While are findings are preliminary, we could speculate that in a context of scarce mental health resources, policy and practice could encourage interventions for youth that focus on providing school, family and peer supports, above giving support interventions such as volunteering, caring, and so on, particularly for those young people most at risk of depression. In addition, given the success of social prescribing in primary care settings for improving behaviours (Cunningham et al., Citation2022), that is, social prescribing involves a health or social care professional connecting an individual with an appropriate community-based opportunity to improve that individual’s health (physical and/or mental) and wellbeing (physical, mental and/or social), for example, a local arts group to increase social connections, or a hobby club to reduce feelings of loneliness, these types of activities could also be used to improve social functioning in adolescents. Finally, future research should explore the effects seen here in cohorts longitudinally to infer cause and effect which should further enhance our understanding of how and when youth derive benefits from social support.
Conclusion
In conclusion, this research provides further evidence of the health benefits of social support in adolescents’ mental health. However, we have extended on this literature by showing that while giving social support was associated with lower depression symptoms in adolescents, when it was not reciprocated (i.e. when young people gave more support to others than they received in return), it was damaging for their mental health. This negative imbalance of support appeared to be toxic in comparison to a positive imbalance whereby they over benefitted from receiving social support. Thus, given the importance of social relationships for adolescent health, our finding suggest that these associations are not linear while underscoring the negative aspect of giving support without reciprocation.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The ESS survey and relevant documentation is made available from https://www.europeansocialsurvey.org/.
Additional information
Notes on contributors
Stephen Gallagher
Professor Stephen Gallagher, is a health psychologist, based at the University of Limerick, Ireland. He specialises in stress, social relationships and health with a particular interest in how these factors get inside the body.
Chloe Haugh
Chloe Haugh, is a primary school teacher in Limerick. She was a research intern working with Prof Stephen Gallagher, during the course of this project and is interested in health and well-being of children and young people.
Alejandro Castro Solano
Alejandro Castro-Solano is Professor of Psychology, at the University of Buenos Aires in Argentina. His research interests are individual differences, interpersonal relationships, psychometrics, and positive psychology.
Guadalupe de la Iglesia
Dr Guadalupe de la Iglesia is a lecturer at the University of Buenos Aires in Argentina. Her research interests are in psychometrics as well as how social support influences health.
Jennifer McMahon
Dr Jennifer McMahon is a senior lecturer in the Department of Psychology at the University of Limerick. Dr McMahon is Director of SCY-Lab, which focuses on the health and well-being of youth mental health with a particular focus on school-based interventions.
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