Health Psychology, 2nd Edition

COPING AND SOCIAL SUPPORT 99

Direct effects, mediation and moderation

Researchers examining coping and social support have investigated the

mechanisms by which these factors influence relationships between stressors and

outcomes such as health and well-being. There are three main types of

mechanisms that are examined in this research and in other areas of health

psychology (see Figure 5.1).

1 Direct effects. In this case coping or social support, for example, has a direct

impact on the outcome. For example, having good social support or a positive

approach to coping could lead to better health irrespective of the amount of

stress the person is experiencing. Figure 5.1a illustrates a situation where a high

level of stress and poor coping strategies would both independently act to

decrease well-being (and vice versa). This is sometimes also described as an

additive effect.

2 Mediated effects. This occurs when one variable has its effect on another via an

intervening variable. In Figure 5.1b coping acts as an intervening variable through

which the stressor exerts its effects on the level of strain. For example, the

experience of stress could result in poor coping (e.g. use of alcohol or drugs),

which leads to deteriorated well-being. Social support could be said to be a

FOCUS 5.2

a) Direct effects models

Stressor Coping

b) Mediated effects model

Well-

being

c) Moderated (buffered or interaction)

effects

Stressor

Well-

being

Coping

Stressor

Coping

Well-

being

FIGURE 5.1Direct effects, mediation and moderation: alternative models of

mechanism.