Social Support Questionnaire

1. Abstract

The Social Support Questionnaire (SSQ), developed by Irwin G. Sarason, Henry M. Levine, Robert B. Basham, and Barbara R. Sarason in 1983, represents one of the foundational and most extensively validated psychometric instruments designed to evaluate individual perceptions of social support. Distinguishing between the structural and evaluative dimensions of relational resources, the instrument concurrently quantifies two distinct yet interrelated facets: the perceived availability of supportive individuals (the SSQ-Number or SSQ-N score) and the degree of satisfaction with that available support (the SSQ-Satisfaction or SSQ-S score). The original full-length scale comprises 27 items, each presenting an ecologically valid scenario involving stress, emotional vulnerability, crises, or everyday personal needs. For each scenario, respondents record up to nine individuals who can provide support, followed by a six-point Likert-type evaluation ranging from 1 (“Very Dissatisfied”) to 6 (“Very Satisfied”).

The SSQ demonstrates exceptional psychometric properties across diverse clinical, non-clinical, and cross-cultural cohorts. Initial and subsequent validation studies report internal consistency estimates typically exceeding α = .90 for both subscales (α = .97 for SSQ-N and α = .94 for SSQ-S in original normative samples), alongside robust four-week test-retest reliability coefficients (r = .90 for SSQ-N and r = .83 for SSQ-S). Factor-analytic investigations consistently replicate a stable two-factor orthogonal or modestly correlated structure corresponding to the distinct cognitive operations involved in enumerating relational networks versus appraising emotional fulfillment. To facilitate broader epidemiological and clinical implementation where assessment burden is a concern, an empirically derived short form—the SSQ6—was later established, capturing the core latent dimensions with near-identical psychometric rigor. By providing an operationalized bridge between social network topology and subjective psychological appraisal, the SSQ remains an indispensable benchmark in clinical psychology, behavioral medicine, and social epidemiology.

2. Keywords

Social Support Questionnaire, SSQ, SSQ6, perceived social support, network size, support satisfaction, psychometrics, stress buffering hypothesis, coping resources, interpersonal relationships, psychometric validation, test-retest reliability, structural equation modeling, psychological well-being.

3. Authors

The Social Support Questionnaire was conceptualized, developed, and empirically validated by a seminal research team based primarily at the Department of Psychology, University of Washington, Seattle, Washington, United States:

• Irwin G. Sarason, Ph.D. – Professor Emeritus of Psychology, University of Washington. Renowned for foundational scholarship in stress, anxiety, personality psychology, and social cognitive processes.
• Henry M. Levine, Ph.D. – Clinical and research psychologist affiliated with the University of Washington during the conceptualization and psychometric scaling of the original instrument.
• Robert B. Basham, Ph.D. – Clinical psychologist and research methodologist, contributing expertise in multivariate psychometrics, interpersonal relationships, and assessment design.
• Barbara R. Sarason, Ph.D. – Research Professor Emerita of Psychology, University of Washington. An internationally acknowledged authority on interpersonal relationships, family systems, perceived social support, and developmental outcomes.

Subsequent psychometric refinements, including the creation of the abbreviated SSQ6 and the exploration of relationship-specific cognitive schemas, were conducted in collaboration with Gregory R. Pierce, Ph.D. (Hamilton College) and Edward N. Shearin, Ph.D. Inquiries regarding archival documentation and original normative datasets are traditionally directed to the Department of Psychology at the University of Washington.

4. Purpose

The central purpose of the Social Support Questionnaire is to provide an empirically grounded, dual-dimensional measurement system that operationalizes social support not merely as an objective structural reality, but as a complex cognitive appraisal. Prior to the introduction of the SSQ in 1983, psychological research was frequently encumbered by fragmented instrumentation that conflated social network density, received instrumental assistance, and subjective satisfaction, or that relied on single-item indexes lacking psychometric robustness. Sarason and colleagues sought to rectify these methodological deficits by constructing an instrument sensitive to the differential predictive validity of network availability versus affective evaluation.

Theoretical Rationale

The theoretical rationale behind the SSQ is anchored in cognitive-appraisal models of stress and coping, predominantly influenced by the works of Richard Lazarus and Susan Folkman. The authors argued that the mere presence of social ties does not invariably buffer an individual against psychological distress; rather, it is the subjective perception that dependable, trustworthy figures are accessible across a wide range of challenging circumstances, paired with an individual’s evaluation of the adequacy of those figures, that exerts protective psychological effects. Thus, the SSQ was specifically designed to capture: (a) the perceived availability of supportive interpersonal contacts across varying functional domains, and (b) the qualitative appraisal of how satisfying those support avenues are perceived to be.

Clinical Applications

In clinical settings, the SSQ serves vital diagnostic and therapeutic planning functions:

• Assessment of Interpersonal Vulnerability: The instrument identifies social isolation, deficits in perceived network availability, or deep dissatisfaction with existing relational ties, which are recognized risk factors for major depressive disorder, generalized anxiety, and suicidal ideation.
• Treatment Customization: By distinguishing between network size (SSQ-N) and satisfaction (SSQ-S), clinicians can determine whether an intervention should focus on behavioral activation and social network expansion (for low SSQ-N) or cognitive restructuring and interpersonal communication training (for adequate SSQ-N paired with markedly low SSQ-S).
• Monitoring Psychotherapeutic Outcomes: The scale functions as an evaluative measure in interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), and couples or family therapy, tracking longitudinal shifts in perceived relational trust and satisfaction.

Research Applications

In behavioral medicine, health psychology, and social epidemiology, the SSQ is extensively deployed to test the stress-buffering hypothesis versus the direct-effects hypothesis. Researchers utilize the instrument to model the psychological mediators connecting chronic illness (e.g., cardiovascular disease, oncology, autoimmune disorders) to neuroendocrine functioning, treatment compliance, and mortality. Moreover, it enables personality psychologists to investigate how individual differences in attachment style, neuroticism, extraversion, and rejection sensitivity systematically bias the perception and utilization of supportive social ties.

5. Psychological Construct

The psychological construct operationalized by the SSQ is perceived social support, conceptualized as a cognitive schema reflecting an individual’s generalized belief that they are valued, cared for, and have access to functional assistance when required. Unlike objective metrics of received support—which document specific retrospective acts of assistance that may sometimes coincide with distress or feelings of inadequacy—perceived social support represents a pervasive, stable psychological resource. The SSQ operationalizes this construct across two distinct primary dimensions:

1. SSQ-Number (SSQ-N): Perceived Network Availability

The SSQ-N dimension captures the quantitative, structural component of perceived support. It reflects the respondent’s cognitive representation of the depth and breadth of their support system. For each of the 27 items, individuals enumerate the specific persons available to assist them across diverse life scenarios, yielding an item score from 0 to 9, and an overall mean score ranging from 0.00 to 9.00.

This subscale does not assess raw social contact frequency, but rather the perceived functional availability of dependable figures. A high SSQ-N score indicates a dense cognitive schema of availability, wherein the individual perceives multiple interpersonal nodes capable of delivering aid across varying stress contexts. Conversely, a low SSQ-N score denotes relational poverty, perceived abandonment, or severe social constriction.

2. SSQ-Satisfaction (SSQ-S): Qualitative Emotional Appraisal

The SSQ-S dimension quantifies the subjective, evaluative component of social support. It measures the degree to which an individual feels emotionally gratified, secure, and content with the support available to them, regardless of the absolute number of people listed. Evaluated on a 6-point scale from “Very Dissatisfied” (1) to “Very Satisfied” (6), the overall score represents the mean satisfaction rating across all answered items.

SSQ-S captures the qualitative depth, trust, and perceived empathy inherent in the respondent’s interpersonal environment. Psychometrically, SSQ-S frequently exhibits stronger negative correlations with psychological distress, depression, and neuroticism than SSQ-N, affirming that the qualitative appraisal of interpersonal relationships often outweighs sheer network volume in mitigating psychological strain.

Functional Sub-Domains Embedded within Items

Although scored along the two primary dimensions of Number and Satisfaction, the 27 items of the SSQ systematically sample four major functional categories of social support defined in psychological literature:

• Emotional Support: Expressions of empathy, unconditional acceptance, love, and intimacy (e.g., Item 11: “With whom can you totally be yourself?”; Item 19: “Who accepts you totally, including both your worse and your best points?”; Item 24: “Whom do you feel truly loves you deeply?”).
• Esteem / Appraisal Support: Validation of personal worth, competence, and positive regard (e.g., Item 7: “Who helps you feel that you truly have something positive to contribute to others?”; Item 12: “Whom do you feel really appreciates you as a person?”).
• Informational / Cognitive Guidance: The provision of advice, constructive feedback, and reality testing (e.g., Item 13: “Whom can you really count on to give you useful suggestions that help you to avoid making mistakes?”; Item 22: “Whom can you really count on to tell you, in a thoughtful manner, when you need to improve in some way?”).
• Instrumental / Tangible Support: Concrete assistance during acute crises or disruptive life events (e.g., Item 5: “Whom could you really count on to help you out in a crisis situation, even though they would have to go out of their way to do so?”; Item 10: “Whom could you really count on to help you out if you had just been fired from your job or expelled from school?”).

6. Theoretical Framework

The architecture of the Social Support Questionnaire is grounded in the convergence of attachment theory, social cognitive theory, and the transactional model of stress and coping.

The Cognitive Schema Model of Support

Sarason, Sarason, and Pierce (1990) postulated that perceived social support functions primarily as an internal cognitive working model or schema regarding interpersonal relationships. Drawing directly from John Bowlby’s attachment theory, the authors proposed that repeated developmental experiences with responsive, caring attachment figures crystalize into generalized expectations concerning whether others are trustworthy and dependable, and whether the self is worthy of love and assistance.

Within this framework, the SSQ measures the behavioral and affective manifestation of these internal working models. When an individual reads a prompt regarding whom they can count on during a crisis, they activate an associative network of relational memories. Individuals with secure attachment orientations possess expansive, accessible representations of dependable others (producing higher SSQ-N) and view these connections with confidence and gratitude (yielding higher SSQ-S). In contrast, insecure attachment orientations (anxious or avoidant) manifest as restricted network projections or chronic dissatisfaction with relational adequacy.

The Transactional Model of Stress and the Stress-Buffering Hypothesis

The SSQ is deeply intertwined with the transactional stress paradigm formalized by Richard Lazarus and Susan Folkman (1984). According to this paradigm, psychological stress occurs when environmental demands exceed an individual’s perceived resources, endangering their well-being. This process unfolds across two stages of cognitive appraisal:

• Primary Appraisal: The assessment of an encounter as threatening, harmful, or challenging.
• Secondary Appraisal: The evaluation of coping options and available resources to manage the demand.

Perceived social support, as quantified by the SSQ, operates principally at the level of secondary appraisal. Individuals who score high on SSQ-N and SSQ-S appraise stressors as less threatening because they anticipate that tangible, informational, and emotional resources will be readily deployed on their behalf. This cognitive reappraisal dampens physiological hyperreactivity (e.g., hypothalamic-pituitary-adrenal [HPA] axis activation and autonomic arousal) and prevents the onset of maladaptive affective cascades.

Moreover, the SSQ operationalizes the stress-buffering hypothesis formulated by Sheldon Cohen and Thomas Wills (1985). This model posits that social support acts as a prophylactic buffer primarily under conditions of elevated stress, attenuating the negative health consequences of life adversity. By embedding specific situational stressors (e.g., marital separation, job loss, personal injury, acute illness) into the items themselves, the SSQ directly captures the respondent’s anticipated coping capacity under situational strain.

7. Validity

The psychometric validity of the Social Support Questionnaire has been rigorously established across decades of empirical investigation spanning clinical psychology, organizational research, behavioral medicine, and cross-cultural psychometrics.

Construct and Convergent Validity

In the seminal validation study by Sarason et al. (1983), the SSQ was administered alongside a broad battery of established personality and psychopathology scales. Convergent validity was evidenced by predictable patterns of association:

• Positive Affect and Well-Being: Both SSQ-N and SSQ-S correlated positively with measures of self-esteem (Rosenberg Self-Esteem Scale; r = .27 to .42), internal locus of control, and optimism.
• Inverse Associations with Negative Affectivity: Both scores demonstrated significant inverse correlations with indices of psychological distress. SSQ-S showed particularly pronounced negative correlations with the Beck Depression Inventory (BDI; r = -.35 to -.43) and the State-Trait Anxiety Inventory (STAI; r = -.30 to -.38), affirming that individuals who report higher satisfaction with their support network exhibit significantly lower levels of affective disturbance.
• Interpersonal Trust and Social Competence: The SSQ-N and SSQ-S subscales correlated positively with Rotter’s Interpersonal Trust Scale and self-efficacy measures in social interactions, verifying that the scale accurately indexes adaptive relational functioning.

Discriminant Validity

To establish that the SSQ does not simply measure social desirability or response bias, Sarason et al. (1983) correlated both subscales with the Marlowe-Crowne Social Desirability Scale. The correlations were minimal to non-significant (typically ranging between r = .05 and .14), demonstrating that reports of social support availability and satisfaction are largely free from social approval confounding.

Additionally, studies examining the distinctness of SSQ-N and SSQ-S from general intellectual ability, academic aptitude, and broad demographic markers confirmed that the instrument assesses unique interpersonal constructs rather than general cognitive proficiency or socioeconomic status.

Predictive and Experimental Validity

Extensive laboratory and longitudinal studies have validated the behavioral and physiological predictive utility of the SSQ:

• Laboratory Cognitive Performance Under Stress: Sarason (1981, 1983) demonstrated that subjects scoring high on perceived social support performed significantly better on challenging cognitive tasks (e.g., complex anagram solution, Stroop color-word interference) in the presence of an evaluative stressor compared to low-support peers, exhibiting fewer off-task, self-deprecating thoughts.
• Cardiovascular and Neuroendocrine Reactivity: In laboratory stress paradigms (such as the Trier Social Stress Test), high SSQ-S scores predict attenuated blood pressure reactivity, lower heart rate surges, and more rapid salivary cortisol recovery following social-evaluative threat.
• Longitudinal Health Outcomes: Longitudinal cohort studies in cardiac rehabilitation, oncology, and obstetrics have consistently confirmed that baseline SSQ scores prospectively predict reduced morbidity, lower re-hospitalization rates, and enhanced compliance with medical regimens over multi-year observation periods.

8. Reliability

The Social Support Questionnaire exhibits exceptional reliability across various psychometric parameters, including internal consistency, inter-item homogeneity, and temporal stability.

Internal Consistency

In the original normative sample of university undergraduate students (N = 602; 295 men, 307 women), Sarason et al. (1983) documented remarkably high internal consistency values computed via Cronbach’s coefficient alpha:

• SSQ-Number (SSQ-N): α = .97
• SSQ-Satisfaction (SSQ-S): α = .94

Subsequent psychometric evaluations across diverse community samples, older adult populations, and clinical cohorts have consistently yielded alpha coefficients ranging from .93 to .98 for SSQ-N and from .90 to .96 for SSQ-S. Item-total correlations across the 27 items consistently exceed .50, with the majority falling between .60 and .78, indicating substantial item homogeneity within each subscale dimension.

Test-Retest Reliability (Temporal Stability)

Sarason et al. (1983) assessed the temporal stability of the SSQ across a four-week interval in a sub-sample of respondents. The test-retest reliability coefficients were:

• SSQ-N Stability: r = .90 (p < .001)
• SSQ-S Stability: r = .83 (p < .001)

These robust correlations confirm that individual perceptions of network availability and satisfaction remain highly stable over moderate time frames, supporting the conceptualization of perceived social support as a trait-like cognitive schema rather than a transient, fluctuating mood state. Longer-term follow-up studies extending over six months to two years continue to demonstrate substantial stability coefficients (typically r = .65 to .75) in the absence of major cataclysmic life events or targeted psychosocial interventions.

Psychometric Equivalence of the Short Form (SSQ6)

In 1987, Sarason, Sarason, Shearin, and Pierce developed the abbreviated 6-item version (SSQ6). Despite the significant reduction in item length, the SSQ6 preserved the high internal consistency of the original instrument:

• SSQ6-Number: α = .90 to .93
• SSQ6-Satisfaction: α = .90 to .93

The correlation between the 6-item abbreviated scores and the 27-item full scale scores exceeded r = .95 for both Number and Satisfaction, verifying that the abbreviated version achieves outstanding psychometric fidelity with minimal loss of measurement precision.

9. Factor Analysis

The structural dimensionality of the SSQ has been exhaustively scrutinized using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) across diverse international samples.

Exploratory Factor Analytic Findings

In the foundational psychometric development study, Sarason et al. (1983) subjected the 27 items (incorporating both the number of individuals listed and the satisfaction ratings) to principal axis and principal components factor analyses with both orthogonal (Varimax) and oblique (Promax) rotations. The empirical data decisively yielded a clean two-factor solution corresponding exactly to:

1. Factor 1 (Network Availability / SSQ-N): All 27 availability items loaded heavily onto this factor (loadings ranging from .54 to .82), accounting for over 50% of the total scale variance. The satisfaction items demonstrated negligible cross-loadings (typically < .15) on this factor.
2. Factor 2 (Appraisal Satisfaction / SSQ-S): All 27 satisfaction items loaded robustly onto this factor (loadings ranging from .51 to .79), accounting for an additional substantial portion of variance, with negligible cross-loadings from the number listings.

The correlation between the two underlying factors was moderately positive (r = .34 to .41 across various samples), confirming that while individuals with larger networks generally experience greater satisfaction, network size and subjective satisfaction are structurally distinct cognitive constructs requiring independent quantification.

Confirmatory Factor Analysis and Model Fit Indices

Later investigations by Sarason, Sarason, Shearin, and Pierce (1987) and subsequent international validation teams examined competing structural models via confirmatory factor analysis (CFA) using structural equation modeling software. The models tested typically included: (a) a one-factor unipolar support model, (b) a two-factor orthogonal model, and (c) a two-factor correlated model.

The empirical findings overwhelmingly favored the two-factor correlated model:

• Comparative Fit Index (CFI): .94 – .98
• Tucker-Lewis Index (TLI): .93 – .97
• Root Mean Square Error of Approximation (RMSEA): .042 – .058 (90% CI: .038 – .064)
• Standardized Root Mean Square Residual (SRMR): .035 – .048

Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) values unequivocally demonstrated the superiority of the two-factor model over the one-factor alternative (Δχ² test p < .0001). Factor invariance testing across gender and age groups has repeatedly confirmed metric and scalar invariance, demonstrating that the SSQ measures the identical underlying constructs across men and women without structural measurement bias.

10. Instrument / Measurement Tool

• Instrument Name: Social Support Questionnaire (SSQ); short form: Social Support Questionnaire-6 (SSQ6).
• Original Authors: Irwin G. Sarason, Henry M. Levine, Robert B. Basham, and Barbara R. Sarason (1983); Short form by Irwin G. Sarason, Barbara R. Sarason, Edward N. Shearin, and Gregory R. Pierce (1987).
• Constructs Measured: Perceived Social Support Availability (SSQ-N) and Perceived Social Support Satisfaction (SSQ-S).
• Total Item Count: 27 items (Full scale) / 6 items (Abbreviated SSQ6).
• Dual-Part Structure per Item:
  • Part 1 (Number / Network): The participant lists all individuals they can count on for the specified situation (initials and relational role, e.g., ‘M.S. – Sister’). Responses range from 0 (if “No one” is selected) up to a maximum of 9 persons per item.
  • Part 2 (Satisfaction): The participant indicates how satisfied they are, in general, with the support available in that situation.
• Response Scale (Part 2 – Satisfaction): 6-point Likert scale:
  • 6 = Very Satisfied
  • 5 = Fairly Satisfied
  • 4 = A Little Satisfied
  • 3 = A Little Dissatisfied
  • 2 = Fairly Dissatisfied
  • 1 = Very Dissatisfied
• Administration Format: Paper-and-pencil self-report or computer-administered digital assessment.
• Estimated Completion Time: 15–20 minutes for the full 27-item SSQ; 3–5 minutes for the 6-item SSQ6.
• Scoring Instructions:
  • SSQ-N Score: Sum the total number of persons listed across all answered items, divided by the total number of items answered (Total N / 27). Theoretical range: 0.00 to 9.00. (If a respondent checks “No one,” that item receives a score of 0).
  • SSQ-S Score: Sum the satisfaction ratings across all answered items, divided by the total number of items answered (Total S / 27). Theoretical range: 1.00 to 6.00.
  • Missing Data Rule: Protocols with more than 3 missing items (for the full scale) or more than 1 missing item (for the SSQ6) are typically excluded from normative analysis.

11. Permissions & Fee and Test Year

• Original Publication Year: 1983 (Full 27-item SSQ); 1987 (Abbreviated 6-item SSQ6).
• Copyright & Intellectual Property: The original copyright is held by the American Psychological Association (APA) and the authors (Sarason et al.).
• Academic and Research Usage Permissions: The Social Support Questionnaire and its shortened iteration (SSQ6) were placed into the public scientific domain for scholarly, non-profit academic research and clinical use by Dr. Irwin G. Sarason and colleagues. Researchers and clinicians may utilize, reproduce, and administer the instrument free of royalty fees for non-commercial educational and research endeavors, provided that standard academic attribution and citations are maintained.
• Commercial Licensing: Utilization within commercial clinical software, corporate assessment batteries, or pharmaceutical clinical trials requires formal written permission and licensing through the original copyright holders and the American Psychological Association.
• Repository Access: Official PDF copies and scoring instructions have historically been maintained through the Department of Psychology at the University of Washington and archived scientific data repositories (e.g., Fetzer Institute).

12. References

Below are primary academic references documenting the foundational validation, psychometric evaluation, and structural analysis of the Social Support Questionnaire:

• Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357. https://doi.org/10.1037/0033-2909.98.2.310
• Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.
• Pierce, G. R., Sarason, I. G., & Sarason, B. R. (1991). General and relationship-based perceptions of social support: Are two constructs better than one? Journal of Personality and Social Psychology, 61(6), 1028–1039. https://doi.org/10.1037/0022-3514.61.6.1028
• Sarason, B. R., Sarason, I. G., & Pierce, G. R. (Eds.). (1990). Traditional and innovative approaches to the assessment of social support. John Wiley & Sons.
• Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing social support: The Social Support Questionnaire. Journal of Personality and Social Psychology, 44(1), 127–139. https://doi.org/10.1037/0022-3514.44.1.127
• Sarason, I. G., Sarason, B. R., Shearin, E. N., & Pierce, G. R. (1987). A brief measure of social support: Practical and theoretical implications. Journal of Social and Personal Relationships, 4(4), 497–510. https://doi.org/10.1177/0265407587044007

13. Items of the Scale (Questionnaire)