Forty-four caregivers to spouses with a diagnosis of Alzheimer's disease provided a stressed subject population considered at high risk for depression. Unlike more typical unidirectional measures of perceived social support quality, subject ratings were elicited separately as to how helpful as well as how upsetting each network member was in five different support categories. Correlations between perceived network "upset" and depression (Beck Depression Inventory) were highly significant, while in no case did perceived "helpfulness" relate to depression. Using stepwise multiple regression, the set of five support category Upset ratings predicted depression better than did helpful/upset ratios, which in turn predicted depression better than the Helpfulness ratings as a group. The implications of these findings for the conceptualization of social support and its measurement are discussed.

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Four commonly used operationalizations of the social support concept: network contact frequency, satisfaction with support (including nine dimensions), perceived availability of support, and use of support, were related to two measures of psychological adjustment (Beck Depression Inventory and Symptom Checklist-90) and to one measure of physical adjustment (Cornell Medical Index). Subjects were 68 45- to 85-year-old, highly stressed care-givers to spouses with Alzheimer's disease. Results indicate that of the four operationalizations, Satisfaction with Support was the only significant predictor of depression and general psychopathology. The set of four support variables showed the strongest relationship to depression level, next strongest to general psychopathology, and least to physical health. The satisfaction with nine social support dimensions related differentially to the types of adjustment. Results suggest the importance of specificity (sample, support operationalization, dimensions, adjustment measures) in social support research.

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