Personality and Individual Differences 35 (2003) 5–17

www.elsevier.com/locate/paid

Social support, health, and well-being among the elderly:

what is the role of negative affectivity?§
Jeffrey H. Kahna,*, Robert M. Hesslingb, Daniel W. Russellc
a
Department of Psychology, Campus Box 4620, Illinois State University, Normal, IL 61790-4620, USA
b
Department of Psychology, Box 413, University of Wisconsin-Milwaukee, Milwawkee, WI 53201, USA
c
Department of Psychology and Institute for Social and Behavioral Research, Iowa State University,
2625 No Loop Drive, Suite 500, Ames, IA 50010-8296, USA

Received 15 October 2001; received in revised form 25 March 2002; accepted 13 May 2002

Abstract
We examined whether dispositional negative affectivity (NA) spuriously explains the relationships
between perceived social support and self-reports of well-being (depression, loneliness, and life satisfaction)
and physical health among the elderly. A sample of 100 elderly adults attending a senior community center
completed measures of the aforementioned variables. Maximum likelihood path analyses and commonality
analyses suggested that NA spuriously explains the relationship between social support and physical
health. The relationships between social support and the three measures of psychological well-being
remained significant even after controlling for NA. These findings suggest that NA is an important indi-
vidual difference variable to attend to when assessing the social support and physical health of the elderly.
# 2003 Elsevier Science Ltd. All rights reserved.
Keywords: Social support; Negative affectivity; Physical health; Depression; Loneliness; Life satisfaction; Elderly adults

Research studies have repeatedly found that people who report a high level of social support
enjoy enhanced health and well-being (Cohen & Wills, 1985; Pierce, Sarason, & Sarason, 1996;
Sarason, Sarason, & Pierce, 1990). For example, social support is associated with improved
physical health (Cohen & Wills, 1985), less depression (Cohen & Wills, 1985; Cutrona & Russell,
1987; Roberts & Gotlib, 1997), and less loneliness (Jones & Moore, 1987; Rook, 1987). The
process by which social support produces these benefits is complex, as studies have shown that

§
Portions of this paper were presented at the 13th Annual Convention of the American Psychological Society,
Toronto, Canada, June 2001.
* Corresponding author. Tel.: +1-309-438-7939; fax: +1-309-438-5789.
E-mail address: jhkahn@ilstu.edu (J.H. Kahn).

0191-8869/03/$ - see front matter # 2003 Elsevier Science Ltd. All rights reserved.
PII: S0191-8869(02)00135-6
6 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17

well-being is uniquely predicted by factors such as the receipt of support, the perception of the
support network, and characteristics of the social environment (Rhodes & Lakey, 1999). How-
ever, the benefits of social support are most strongly related to the perception that support is
available (Barrera, 1986; Wetherington & Kessler, 1986). In other words, the highest levels of
well-being are found among people who believe that they have a high level of social support,
regardless of how much support they receive or how many people they know.
Social support is a particularly important issue for older adults as common life events may
jeopardize the support networks of this age group. The elderly are often faced with bereavement
and the accompanying loss of support when a loved one dies (Minkler, 1985), and when older
adults make the transition from work to retirement, they often experience a geographic move that
can upend their support system (Minkler, 1985). Furthermore, older adults may have physical
impairments or chronic diseases that limit their ability to interact with others (Newsom & Schulz,
1996; Penninx, van Tilberg, Boeke, Deeg, Kriegsman, & van Eijk, 1998). Indeed, empirical work
has demonstrated that greater social support among the elderly is associated with better physical
health (Auslander & Litwin, 1991; Cutrona, Russell, & Rose, 1986), improved life satisfaction
(Aquino, Russell, Cutrona, & Altmaier, 1996), less loneliness (Russell, 1996), and lower depres-
sion (Dean, Kolody, & Wood, 1990; Kogan, Van Hasselt, Hersen, & Kabacoff, 1995; Krause,
Liang, & Yatomi, 1989; Lynch et al., 1999; Russell & Cutrona, 1991). Again, health and well-
being are most strongly predicted by older adults’ perception of available support rather than
their actual receipt of support (Auslander & Litwin, 1991; Newsom & Schulz, 1996).
Despite the apparent importance of social support for the health and well-being of the elderly,
it is possible that the observed relationships between social support and health outcomes may
simply be due to elderly individuals’ dispositional negative affectivity, or NA (also termed neu-
roticism). As described by Watson and Clark (1984), NA is a disposition to experience negative
emotions influencing cognition and self-concept. Individuals with high NA tend to view them-
selves and the world more negatively, and they tend to experience greater distress than low-NA
individuals, even in the absence of stressors (Watson & Clark, 1984). There is evidence that older
adults high in NA report more medical complaints than those with low NA (e.g. Diefenbach,
Leventhal, Leventhal, & Patrick-Miller, 1996; Leventhal, Hansell, Diefenbach, Leventhal, &
Glass, 1996) despite the fact that most studies fail to show a relationship between NA and
objective measures of health (Costa & McCrae, 1987). The implication is that self-reports of
physical health may be biased by high-NA individuals’ tendencies to overly perceive and report
physical experiences (Costa & McCrae, 1987; Watson & Pennebaker, 1989). This phenomenon
may also extend to the realm of mental health and well-being, such that high-NA individuals’
tendency to report greater psychological stress (e.g. Watson, 1988) and depression (e.g. Watson,
Clark, & Carey, 1988) may be due to their greater focus on internal psychological states.
Because of the strong influence of NA on self-reports of both physical and psychological health,
one must examine the well-known relationship between perceived social support and health
among the elderly with greater scrutiny. After all, a correlation between a health outcome and
any predictor may be spuriously inflated by dispositional NA (Bolger & Eckenrode, 1991; Wat-
son & Pennebaker, 1989). Such a phenomenon has been noted in the literature on work stress
(Brett, Brief, Burke, George, & Webster, 1990; Brief, Burke, George, Robinson, & Webster, 1988;
Burke, Brief, & George, 1993). For example, in a study of 497 managers and professionals, dis-
positional NA was found to spuriously explain much of the relationship between self-reports of
 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17 7

stress and measures of job satisfaction, somatic complaints, negative affect experienced at work,
life satisfaction, and depression (Brief et al., 1988). Empirical examinations of the nuisance effect
of NA have also been extended to correlates of social support, and they generally support the
contaminating effect of NA. Among college students taking a stressful medical school entrance
examination, Bolger and Eckenrode (1991) found that the relationship between perceived social
support and anxiety dropped from 0.28 to 0.16 when controlling for dispositional NA, sug-
gesting that NA accounts for much of the relationship between social support and anxiety.
Likewise, in a study with elderly adults, social support satisfaction was not significantly related to
chronic pain when controlling for a measure of NA (Lauver & Johnson, 1997). However, Lara,
Leader, and Klein (1997) found that among depressed adults, social support was significantly
related to the severity of depression and recovery from depression even after controlling for dis-
positional NA.
Findings regarding the confounding role of NA on the relationship between social support and
health are mixed, suggesting some benefit of further study. In particular, there is a need for
clearer theoretical models of the variables underlying the relationship between social support and
the health (both physical and mental) of older adults. It is therefore important to critically
examine how NA may affect the relationship between social support and health among the
elderly because of their unique support needs (e.g. Minkler, 1985). In addition, if NA were to
have a significant spurious effect on the relationship between social support and health, then
health-enhancing interventions with the elderly that focus on social support may need to be
reconsidered. Furthermore, it is accepted that older adults who report a low level of social sup-
port are vulnerable to mental and physical health problems. If NA influences this relationship,
social support may then be considered a poor indicator of at-risk older adults, and additional
assessment techniques will be needed (Murray, 1992). Finally, the influence of social support on
the health and well-being of older adults is a widely researched topic. If NA influences the rela-
tionships between social support and health and well-being, the validity of these studies is drawn
into question, and new techniques will be required to improve the assessment of these relationships.
We therefore tested the general hypothesis that the observed relationship between perceived
social support and health and well-being outcomes may be explained by dispositional NA. In

Fig. 1. Conceptual model illustrating how negative affectivity (NA) may spuriously explain the relationship between
perceived social support and health/well-being.
8 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17

other words, we examined whether NA spuriously explains these relationships. Fig. 1 illustrates
this conceptual model. A spurious relationship is one that only exists because a third variable
causes both variables (Cohen & Cohen, 1983). In this study, a significant correlation between
social support and health or well-being, as illustrated by the curved double-headed arrow, that
becomes non-significant (or ideally near zero) when NA is a predictor of both variables provides
evidence for a spurious relationship. On the other hand, if the correlation between social support
and health or well-being is still significant even when NA is a predictor of both variables, then
NA cannot be said to explain this relationship. Considered another way, if social support
explains very little unique variance in the health/well-being measures when controlling for NA,
then NA may be said to have a confounding role in the relationships between social support and
health/well-being.
We administered measures of dispositional NA, perceived social support, and four measures of
health/well-being—physical health, depression, loneliness, and life satisfaction—to a community
sample of elderly adults. Using these data, we addressed three sets of questions. First, is perceived
social support related to health and well-being? We hypothesized that perceived social support
would be positively correlated with self-reported physical health and life satisfaction, and per-
ceived social support would be negatively correlated with self-reported depression and loneliness.
Second, is NA related to the aforementioned variables? For a spurious relationship to exist, NA
must be correlated with these measures. We hypothesized that NA would be negatively related to
perceived social support, physical health, and life satisfaction, and positively related to depression
and loneliness. Third, does NA spuriously cause the relationships between perceived social sup-
port and health? If so, then the residual correlations between social support and health after
controlling for NA would be near zero, and social support would explain very little unique var-
iance in the health/well-being measures when controlling for NA. We did not make predictions
with respect to this third question because of the ambiguity found in the literature (e.g. Lara et
al., 1997; Lauver & Johnson, 1997).

1. Method

1.1. Participants

One hundred elderly adults participated in this research. The sample consisted of 66 women and
32 men (with two participants not reporting their sex). Forty-seven percent of the respondents
were married, 42% were widowed, and 11% were single and non-widowed. The median yearly
income was $11,000. The average age among respondents was 76.02 years (SD=7.91).

1.2. Measures

1.2.1. Perceived social support

The Social Provisions Scale (SPS; Cutrona & Russell, 1987) was used to measure respondents’
perceptions of the adequacy of their support network. The 24-item SPS was designed to assess six
dimensions of perceived social support: attachment, social integration, reassurance of worth,
reliable alliance, guidance, and opportunity for nurturance. Respondents rated each item on a
 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17 9

four-point scale ranging from 1 (strongly disagree) to 4 (strongly agree). Total scores were created
by summing the 24 items, resulting in a range of possible scores from 24 to 96. Internal con-
sistency of the SPS has been reported as 0.92 (Cutrona & Russell, 1987); alpha was 0.83 in this
study. Confirmatory factor analyses have supported one higher-order social support factor
(Cutrona & Russell, 1987). Additional construct validity of the SPS total score has been sup-
ported by positive correlations with other self-report measures of social support (Cutrona &
Russell, 1987).

1.2.2. Negative affectivity

Respondents completed the Positive and Negative Affect Schedule (PANAS; Watson, Clark, &
Tellegen, 1988) under the ‘‘general’’ instructions to assess dispositional NA. The NA subscale of
the PANAS consists of 10 emotions, and respondents rate the extent to which each emotion is
generally experienced on a five-point Likert-type scale ranging from 1 (very slightly or not at all)
to 5 (extremely). Total scores for the NA subscale range from 10 to 50, with higher scores
reflecting greater dispositional NA. Internal consistency reliability estimates for the NA subscale
have been reported as 0.87, and test–retest reliability (8-week interval) has been reported as 0.71
(Watson, Clark, & Tellegen, 1988); in this study internal consistency for the NA subscale was
0.86. Validity has been supported by a factor analysis demonstrating the existence of separate
negative and positive affectivity factors and by expected correlations with depression and global
distress (Watson et al., 1988).

1.2.3. Depression
To measure depression, respondents completed the Geriatric Depression Scale (GDS; Brink,
Yesavage, Lum, Heersema, Adey, & Rose, 1982). The GDS consists of 30 statements assessing
core features of geriatric depression including lowered affect, inactivity, irritability, withdrawal,
distressing thoughts, and negative judgments (Brink et al., 1982). The respondent responds ‘‘yes’’
or ‘‘no’’ to each item, and total scores were computed by summing the number of ‘‘yes’’ responses
(after reverse scoring 10 of the items); thus, total scores can range from 0 to 30, with higher scores
indicating greater depression. Internal consistency of the GDS has been reported as 0.94, and
test–retest reliability (1-week interval) has been reported as 0.85 (Shaver & Brennan, 1991).
Coefficient alpha in this study was 0.90. The GDS correlates very highly with other self-report
and clinician-rated measures of depression, and GDS scores can discriminate between normal,
mildly depressed, and severely depressed elderly adults (Shaver & Brennan, 1991).

1.2.4. Loneliness
The UCLA Loneliness Scale Version 3 (UCLA; Russell, 1996) was used to measure respon-
dents’ feelings of loneliness. The UCLA consists of 20 items to which the respondent rates on a
four-point scale ranging from 1 (never) to 4 (always). Total scores were computed, resulting in a
range of possible scores from 20 to 80. Among an elderly sample, internal consistency of the
UCLA has been reported to be 0.89, and test–retest reliability (1-year interval) has been reported
to be 0.73 (Russell, 1996). Coefficient alpha among this sample was 0.91. Validity of the UCLA
has been supported by negative correlations with perceived social support, life satisfaction, and
physical health, and by a positive correlation with depression (Russell, 1996). Confirmatory fac-
10 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17

tor analyses support a single loneliness factor with two method factors representing the direction
of item wording (Russell, 1996).

1.2.5. Life satisfaction

The five-item Satisfaction With Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985)
was used to measure global life satisfaction. Agreement with each item was rated on a five-point
Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Total scores were computed
by summing the responses, resulting in possible scores ranging from 5 to 25, with higher numbers
indicating greater satisfaction with life. Internal consistency for the SWLS has been estimated as
0.87, and test–retest reliability (2-month interval) has been estimated as 0.82 (Diener et al., 1985);
coefficient alpha was 0.88 in this study. The SWLS correlates strongly with other measures of well
being, and it shows a strong negative correlation with neuroticism (Diener et al., 1985).

1.2.6. Physical health

To measure physical health, participants rated the following question on a scale from 1 (very
poor) to 10 (excellent): ‘‘In general, how would you rate your physical health over the past 30
days?’’

1.3. Procedure

The research was conducted at three community senior centers located in the suburbs of a large
Southwestern city. The number of participants from each of the three centers ranged from 25 to
37. Using a Bonferroni-corrected alpha level of 0.008, no significant mean differences across the
three centers were detected for any of the six measures.
All seniors who attended a group lunch at the center on the day of the study were invited to
participate. These participants therefore represented ambulatory seniors who frequented the
senior center fairly often, with the mean number of visits to the senior center per month being
16.16 (SD=7.85). An informed consent statement was read indicating that the instrument con-
sists of ‘‘questions that address how you cope with problems you may face in your life and how
you feel about your relationships with others.’’ Potential participants were reminded that com-
pleting the questionnaire was optional. Participating seniors completed the questionnaire in a
group setting. Some respondents had assistance reading the questionnaire. Following completion
of the questionnaire, a debriefing statement was read aloud to the group.

2. Results

To address the first and second questions regarding the relationships among perceived social
support, NA, and health, we computed correlation coefficients for the six variables. Table 1 pre-
sents these correlations as well as the means and standard deviations for the study measures.
Consistent with our first hypothesis, perceived social support was significantly related to all four
health measures. Particularly strong relationships were observed between perceived social support
and depression, loneliness, and life satisfaction. Specifically, individuals with perceptions of
greater social support reported being less depressed, less lonely, and more satisfied with their
 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17 11

Table 1
Correlations, means, and standard deviations among the measures (N=100)

Measure 1 2 3 4 5 6

1. Social support
2. Negative affectivity 0.34***
3. Depression 0.48*** 0.49***
4. Loneliness 0.60*** 0.42*** 0.59***
5. Life satisfaction 0.46*** 0.21* 0.54*** 0.54***
6. Physical health 0.22* 0.30** 0.36*** 0.07 0.22*

Mean 76.31 18.55 7.00 39.23 17.25 7.12

Standard deviation 11.16 6.54 6.22 9.66 5.16 1.99

* p < 0.05.
** p < 0.01.
*** p < 0.001.

lives than individuals who perceived less social support. The relationship between perceived
social support and physical health ratings, while statistically significant, was much weaker in
magnitude.
The second question was whether NA was related to perceived social support and the four
health measures. As indicated in Table 1, NA was significantly related to perceived social sup-
port, such that individuals with high levels of NA reported less social support than low-NA
individuals. Moreover, NA was significantly related to all four health measures. High-NA indi-
viduals were more likely to report being depressed, lonely, unsatisfied with their lives, and in poor
health than low-NA individuals.
The third question addressed whether NA spuriously explains the correlations between per-
ceived social support and health. We tested four sets of path-analytic models, one for each
measure of health, to address this question. The LISREL 8.3 (Jöreskog & Sörbom, 1999) pro-
gram’s maximum likelihood procedure was employed to estimate these models. The model as
indicated in Fig. 1 was first estimated for each health/well-being measure. Specifically, NA was
specified as a cause of both perceived social support and health/well-being, and the residual
correlation between perceived social support and health/well-being was freely estimated. Because
all possible relationships among the measures are estimated in this model, this model provided a
perfect fit to the data for each measure. Next, we estimated models in which the residual corre-
lation between social support and health/well-being was fixed at 0. These models were not
expected to provide a perfect fit to the data, but to the extent that the observed residual corre-
lation is not far from zero, the chi-square value for such a model would not be significant.
Although large samples are typically required for causal models, recent Monte Carlo evidence
suggests that a sample size of 100 is sufficient for simple three-variable models such as the one in
this study when the reliability of the indicators is high (Hoyle & Kenny, 1999).
The results for depression, loneliness, and life satisfaction all failed to support the spurious
effect of NA. For depression, the residual correlation was estimated in the full model to be 0.31,
as compared with the zero-order correlation of 0.48. Although the magnitude of the correlation
was less when NA was specified as a causal agent of both social support and depression, the
12 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17

restricted model in which this correlation was constrained to be zero provided a significantly
worse fit to the data than the full model, w2(1, N=100)=15.17, p <0.001. This indicates that the
residual correlation after controlling for NA is significantly different from zero. For loneliness,
the residual correlation in the full model was estimated at r= 0.45 (versus a zero-order corre-
lation of 0.60). However, like depression, the restricted model for loneliness provided a worse fit
to the data, w2(1, N=100)=32.92, p <0.001, suggesting that this residual correlation is sig-
nificantly different from zero. Third, the residual correlation between perceived social support
and life satisfaction was 0.39 in the full model (as compared to a zero-order correlation of 0.46).
The restricted model again provided a worse fit to the data, w2(1, N=100)=19.35, p <0.001.
Thus, in summary, NA did not spuriously explain the relationship between perceived social sup-
port and either depression, loneliness, or life satisfaction.
The model for physical health provided a different result. The residual correlation between
perceived social support and self-ratings of physical health was only 0.12 (versus a zero-order
correlation of 0.22). Moreover, the restricted model did not provide a significantly worse fit to the
data, w2(1, N=100)=1.84, p >0.10. This indicates that the residual correlation is not significantly
different from zero, and we therefore conclude that NA did spuriously cause the observed rela-
tionship between perceived social support and ratings of physical health.
An alternative way to test the spuriousness hypothesis is with a commonality analysis. A com-
monality analysis determines the proportion of variance in the criterion explained by each pre-
dictor. In this case, we determined to what extent NA and social support jointly and uniquely
explain variance in each of the four criterion measures. Table 2 presents the percentage of the
total variance explained by NA and social support jointly, NA uniquely, and social support
uniquely (the percentage of the explained variance is presented in parentheses to allow compar-
ison across criterion measures). The percentage of variance in each criterion due to the joint effect
of social support and NA was generally consistent across the four measures. However, the per-
centage of variance in each criterion uniquely due to NA varied widely; NA uniquely explained
52% of the explained variance of physical health, 35% of the explained variance of depression,
and very little of the explained variance of either loneliness and life satisfaction. By contrast,
social support was uniquely responsible for very little of the explained variance of physical health,
but social support was uniquely responsible for most of the explained variance of loneliness and
life satisfaction. Thus, the commonality analysis revealed that (a) NA had a much stronger
explanatory role than social support did predicting physical health, (b) NA and social support

Table 2
Percentage of variance in the criterion measures explained jointly and uniquely by negative affectivity (NA) and social
support

NA and social support NA unique Social support Total variance

joint variance variance unique variance explained

Depression 0.12 (35%) 0.12 (35%) 0.11 (31%) 0.35

Loneliness 0.04 (20%) 0.00 (2%) 0.17 (79%) 0.22
Life satisfaction 0.12 (30%) 0.05 (13%) 0.23 (57%) 0.41
Physical health 0.03 (32%) 0.05 (52%) 0.02 (16%) 0.10

Note. Percentage of explained variance is in parentheses.

 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17 13

had approximately equal explanatory roles predicting depression, and (c) social support had a
much stronger explanatory role than NA when predicting both loneliness and life satisfaction.

3. Discussion

Studies have repeatedly found correlations between perceived social support and health and
well-being measures among the elderly (e.g. Russell & Cutrona, 1991). However, there are theo-
retical reasons to believe that NA may be a spurious cause of these relationships (i.e. Watson &
Pennebaker, 1989). Addressing this possibility was important because the relationships between
social support and health and well-being inform a wide range of theoretical models of health and
well-being among older adults. Furthermore, prevention and intervention research focuses on
social support as a curative factor. Because of this, it was necessary to determine if the relation-
ships between social support and health and well-being often observed in the literature are due to
the presence of this third variable. We found that the relationships between perceived social
support and measures of psychological well-being—namely depression, loneliness, and life satis-
faction—are quite strong even when controlling for NA. However, the relationship between
social support and self-reported physical health was not significant when controlling for NA,
suggesting that NA did spuriously explain this relationship. Commonality analyses confirmed
that NA had a much stronger role in predicting physical health than social support did. NA was
also found to be more important to the prediction of depression than it was to the prediction of
either loneliness or life satisfaction.
Before establishing that NA spuriously explains these relationships, it was necessary to establish
significant relationships between (a) perceived social support and the health measures, (b) NA
and the health measures, and (b) NA and perceived social support. Indeed, all of these relation-
ships were significant and in the predicted direction. Specifically, seniors who perceived sufficient
social support reported enjoying greater health and well-being; these findings are quite consistent
with past literature (e.g. Russell & Cutrona, 1991). In addition, respondents who reported a high
amount of NA reported perceiving less social support and poorer health and well-being than low-
NA individuals. These findings are consistent with prior literature with younger adults (e.g.
Cutrona & Russell, 1987; Watson & Clark, 1984), suggesting that NA has a similar biasing effect
among the elderly. In fact, the zero-order correlation we found between social support and NA
(r= 0.34) is quite consistent with findings from younger adults based on a variety of measures.
For example, four recent studies have found correlations between social support and NA to range
from 0.31 to 0.37 based on a general college student sample (Kahn & Hessling, 2001), a sample
of premedical students preparing for a medical school entrance exam (Bolger & Eckenrode,
1991), a sample of clients seeking counseling at a college counseling center (Kahn, Achter, &
Shambaugh, 2001), and a sample of depressed clients seeking treatment (Lara et al., 1997). Thus,
the degree of bias (i.e. NA) present in measures of perceived social support does not appear to be
a function of respondent age.
Most important to our research question, we did not find evidence to suggest that NA spur-
iously causes the relationship between perceived social support and psychological health. Rather,
even when taking dispositional NA into account, path analyses revealed that the perception of
one’s available social support was a strong predictor of well-being, at least in terms of depressive
14 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17

symptoms, loneliness, and life satisfaction. It is true that NA may bias one’s reported perception
of social support and well-being, but the bias does not appear to be strong enough to jeopardize
the significant relationships between social support and well-being. This further validates the
powerful role that social support plays in facilitating the well-being of older adults as they cope
with the stresses of aging. However, not all well-being measures were equal; based on the com-
monality analysis, depression was more strongly influenced by NA than either loneliness or life
satisfaction. While this finding was likely the result of the conceptual overlap between NA and
depression (Watson & Clark, 1984), it does suggest that even though NA does not spuriously
explain the relationship between social support and depression (see also Lara et al., 1997), self-
reports of depression may be more prone to NA bias than other measures of well-being.
Contrary to the findings for psychological well-being, NA largely explained the relationship
between perceived social support and physical health. Although the relationship between social
support and physical health was not strong to begin with, our results suggest that the reason
social support appears to have a beneficial effect on the physical health of the elderly is because
individuals high in NA report less social support and poorer physical health than low-NA indi-
viduals. When this contaminating effect of NA was statistically removed, so was much of the
support-health relationship. The commonality analysis of physical health further illustrated this
phenomenon; NA uniquely explained more variance in physical health than the joint effect of NA
and social support and the unique effect of social support combined. Thus, coupled with Lauver
and Johnson’s (1997) similar finding, our results support an extension of Watson and Penneba-
ker’s (1989) argument that NA contaminates correlations involving stress and health. Specifically,
NA also appears to contaminate the relationship between social support and physical health
among the elderly.
The veracity of our conclusions, however, must be considered in light of some key limitations of
the study. First, our measures of health and well-being were all self-report. Although it was our
intention in this research to focus on these self-reports, peer- or spouse-reports may provide a
useful complement to our measures. Future research may be particularly informative if more
objective measures of physical health were included. Second, we have some concerns about the
reliability of our single-item physical health measure. Although physical health was significantly
related to four of the other five measures, suggesting that at least some reliable variance was
present, we may have found different results with longer instruments that assess a range of health
concerns. Third, the adults in our study were all attending a day community center. As such, they
may be more homogeneous with respect to social support than the greater population of elderly
adults. Research that seeks to replicate this research with house-bound seniors would be valuable.
Finally, our correlational design did not allow us to accurately test the putative causality among
our variables. For example, it is possible that poor health causes one to report high levels of NA
or low levels of social support. Thus, future research that uses longitudinal or experimental
methods would help address the issue of NA contamination more completely.
Finally, we offer some implications for researchers and practitioners working with the elderly.
Specifically, our findings suggest that researchers may need to rethink social support interven-
tions and the use of social support instruments among older adults. While social support inter-
ventions may be effective in improving mental health, these same interventions may have little
effect on physical health. Likewise, social support instruments may not be as effective at identi-
fying older adults who are vulnerable to physical health problems as they are at identifying those
 J.H. Kahn et al. / Personality and Individual Differences 35 (2003) 5–17 15

vulnerable to mental health problems. (These hypotheses need to be tested in future research, but
they would be consistent with the data from this study.) As a consequence, researchers who exam-
ine the relationship between social support and physical health are urged to improve the validity of
these assessments to address the contaminating influence of NA. This can be accomplished through
several means. NA can be assessed in addition to social support and physical health, and it can be
incorporated as a statistical control. Additionally, researchers may wish to use measures that are
less vulnerable to the biasing impact of NA. These measures can include more objective measures
of social support such as social support behavior checklists (Barrera, Sandler, & Ramsay, 1981).
Furthermore, close friends or family members can rate a person’s support network (Cutrona,
1989), and doctors or nurses can provide more objective ratings of physical health. The use of
these methods will ideally help provide more sound theory and application with respect to the
role of social support in the health of elderly adults.

Acknowledgements

The authors wish to thank Steve Trahan, Robert Kahn, and the staff at the Mesa Senior Cen-
ters for assistance with data collection.

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