Berlin Social Support Scales (BSSS)

Background:

The Berlin Social Support Scales (BSSS, Schwarzer & Schulz, 2000) were developed based on theoretical considerations and reviews of established measurement instruments for social support.
All items were discussed by an expert panel and partly revised after a pilot study with cancer patients. Items of the received/provided support subscales referring to unfavorable support behavior of the partner were omitted from our study after patients expressed rejection of those statements.

The answering format is the same for all subscales: Patients rate their agreement with the statements on a four-point scale. Possible endorsements are strongly disagree (1), somewhat disagree (2), somewhat agree (3) and strongly agree (4). Negative items need to be reversed. Scale scores are obtained either by adding up item responses (sum scores) or by generating the scale mean score.

Three BSSS subscales, i.e., perceived support, received and provided support, respectively, allow for further distinction of different kinds of support. In some research contexts, a fine-grained analysis of various support types may be of great value. The perceived support subscale comprises items of emotional and instrumental support; adding up the respective items yields two discrete scores for each support type. Similarly, overall received and provided support scores can be split up by summarizing emotional, instrumental, and informational support item scores for each subscale separately.

Psychometrics:

Reliability: Internal consistency for subscales in validation sample (cancer patients, N=457): Perceived Social Support (8 items): Cronbach’s alpha = .83; Received Social Support (general score, 11 items): Cronbach’s alpha = .83; Need for Support (4 items): Cronbach’s alpha = .63; Support Seeking (5 items): Cronbach’s alpha = .81; Protective Buffering (6 items): Cronbach’s alpha = .82.
Internal consistency for Provided Social Support (general score, 11 items) in partner sample (spouses only, n=175): Cronbach’s alpha = .75.
Validity: Validity has been demonstrated in several studies (cf. Schulz & Schwarzer, 2003; Schulz & Schwarzer, 2004).

Author of Tool:

Ralf Schwarzer & Ute Schulz

Key references:

Schulz, U. & Schwarzer, R. (2003). Soziale Unterstützung bei der Krankheitsbewältigung. Die Berliner Social Support Skalen (BSSS) [Social support in coping with illness: The Berlin Social Support Scales (BSSS)]. Diagnostica, 49, 73-82.
See articles in English at: https://userpage.fu-berlin.de/~health/support/social_support_public.htm

Primary use / Purpose:

The multidimensional approach of measuring social support is a unique feature that distinguishes this inventory from other questionnaires. The 6 subscales of the BSSS (perceived, actually provided and received support, need for support, support seeking, protective buffering) measure both cognitive and behavioral aspects of social support.

Responsiveness

Measures of Perceived Social Support, Need for Support, and Support Seeking were assessed only once as they are reflect stable, general characteristics. With varying coping tasks, stress levels, and adjustment requirements over the study period, levels of Received and Provided Social Support as well as Protective Buffering changed accordingly. Within marital dyads, provided and received support were related. Higher levels of received support were associated with indicators of better psychosocial adjustment.

Strengths

The multifaceted structure of the instrument allows for a comprehensive assessment of social support in various research contexts in individuals and across dyads. The simplicity and shortness facilitate flexible use according to the particular assessment needs without compromising on reliability and validity. The items are easy to understand, the answering format is the same across all subscales. The broad spectrum of applications from laboratory research to clinical settings and across different healthy and disease populations alleviates comparisons between diverse populations. The BSSS is also suitable for repeated measurement. The scales may be applied in conjunction or separately, with or without reciprocal (dyadic) support assessment.

Weaknesses

The subscales on Actually Received and Provided Support and Protective Buffering are geared towards coping with a stressful episode. Also, the range of assessed actual support behaviors is limited with focus on a temporarily hospitalized/physically impaired population. At this time, no information is available about the usefulness of these three subscales in the absence of life stressors. Especially the aforementioned subscales may also be susceptible for distortion of measurement due to social desirability, a typical problem in social support research. The scales also do not assess negative social interaction or its consequences.

Berlin Social Support Scales (BSSS), Ralf Schwarzer & Ute Schulz (2000)

Endorsements (for all BSSS scales):

  • (1) strongly disagree
  • (2) somewhat disagree
  • (3) somewhat agree
  • (4) strongly agree

Perceived Emotional Support, Perceived Instrumental Support, Need for Support & Support Seeking

Please think of persons who are close to you.

 

 Perceived Emotional Support
1.There are some people who truly like me.
2.Whenever I am not feeling well, other people show me that they are fond of me.
3.Whenever I am sad, there are people who cheer me up.
4.There is always someone there for me when I need comforting.
 Perceived Instrumental Support
1.I know some people upon whom I can always rely.
2.When I am worried, there is someone who helps me.
3.There are people who offer me help when I need it.
4.When everything becomes too much for me to handle, others are there to help me.
 Need for Support
1.When I am down, I need someone who boosts my spirits.
2.It is important for me always to have someone who listens to me.
3.Before making any important decisions, I absolutely need a second opinion.
4.I get along best without any outside help. (-)
 Support Seeking
1.In critical situations, I prefer to ask others for their advice.
2.Whenever I am down, I look for someone to cheer me up again.
3.When I am worried, I reach out to someone to talk to.
4.If I do not know how to handle a situation, I ask others what they would do.
5.Whenever I need help, I ask for it.

Please note that in the 2001 cancer surgery study these items were presented in a mixed order. The present listing by scale has been chosen for clarity.

Actually Received Support, Recipient

Think about the person who is closest to you, such as your spouse, partner, child, friend, and so on. How did this person react to you during this past week?

 

ItemsType of Received Support
1.The person showed me that he/she loves and accepts me.emotional
2.This person comforted me when I was feeling bad.emotional
3.This person left me alone. (-)emotional
4.This person did not show much empathy for my situation. (-)emotional
5.This person criticized me. (-)emotional
6.This person made me feel valued and important.emotional
7.This person expressed concern about my condition.emotional
8.This person assured me that I can rely completely on him/her.emotional
9.This person encouraged me not to give up.emotional
10.This person was there when I needed him/her.instrumental
11.This person took care of many things for me.instrumental
12.This person took care of things I could not manage on my own.instrumental
13.This person helped me find something positive in my situation.informational
14.This person suggested activities that might distract me.informational

 

Please note that in the 2001 cancer surgery study these items were presented in a mixed order. The present listing has been chosen for clarity.

Satisfaction with Support Receipt (Recipient only)

In general, I am very satisfied with the way this person behaved.

Note: Negative items have not been used in the original 2001 cancer surgery study.

Actually Provided Support, Provider (for a Male Recipient)

 

Now think about the patient. How did you interact with him during this past week?

ItemsType of Provided Support
1.I showed him how much I cherish and accept him.emotional
2.I comforted him when he was feeling bad.emotional
3.I left him alone. (-)emotional
4.I did not have much empathy for him. (-)emotional
5.I criticized him. (-)emotional
6.I made him feel valued and important.emotional
7.I expressed my concern about his condition.emotional
8.I reassured him that he can rely completely on me.emotional
9.I encouraged him not to give up.emotional
10.I was there when he needed me.instrumental
11.I did a lot for him.instrumental
12.I took care of daily duties that he could not fulfill on his own.instrumental
13.I helped him find something positive in his situation.informational
14.I suggested an activity that might distract him.informational

 

Protective Bufferig Scale: Support Provider/Support Recipient

Items

I kept all bad news from him/her.
I avoided everything that could upset him/her.
I showed strength in his/her presence.
I did not let him/her notice how bad and depressed I really felt.
I avoided any criticism.
I pretended to be very strong, although I did not feel that way.

Note: Different forms for men and women were used in the cancer study

Bibliography

Cohen S, Underwood LG & Gottlieb BH, editors. Social support measurement and interventions: A guide for health and social scientists. New York: Oxford; 2000.

Coyne JC & Smith DAF. Couples coping with a myocardial infarction: A contextual perspective on wives’ distress. Journal of Personality and Social Psychology. 1991; 61:404-412.

Eckenrode J. The mobilization of social support: Some individual constraints. American Journal of Community Psychology. 1983; 11: 509-528.

Klauer T & Schwarzer R. Soziale Unterstützung und Depression [Social support and depression].

Verhaltenstherapie und Verhaltensmedizin.Themenheft: Soziales Netz und psychische Störungen. 2001; 22:333-352.

Laireiter A & Baumann U. Network structures and support functions: Theoretical and empirical analyses. In Veiel HOF & Baumann U, editors. The meaning and measurement of social support. New York: Hemisphere; 1992. p. 33-55.

Leppin A & Schwarzer R. Sozialer Rückhalt, Krankheit und Gesundheitsverhalten [Social support, illness, and health behavior]. In Schwarzer, R, editor. Gesundheitspsychologie. Ein Lehrbuch. Göttingen: Hogrefe; 1997. p. 349-373.

Sarason I, Sarason BR & Pierce GR. Three contexts of social support. In Veiel HOF & Baumann U, editors. The meaning and measurement of social support. New York: Hemisphere; 1992. p. 143-154.

Schulz U & Schwarzer R. Soziale Unterstützung bei der Krankheitsbewältigung. Die Berliner Social Support Skalen (BSSS) [Social support in coping with illness: The Berlin Social Support Scales (BSSS)]. Diagnostica. 2003; 49: 73-82.

Schulz U & Schwarzer R. Long-term effects of spousal support on coping with cancer after surgery. Journal of Social and Clinical Psychology. 2004; 23: 716-732.

Schwarzer R, Knoll N, & Rieckmann N. Social support. In Kaptein A & Weinman J, editors. Health Psychology. 2004, Oxford, England: Blackwell: p. 158-182.

Schwarzer R & Leppin A. Social support and health: A theoretical and empirical overview. Journal of Social and Personal Relationships. 1991; 8:99-127.

Vaux A. Assessment of social support. In Veiel HOF & Baumann U, editors. The meaning and measurement of social support 1992; New York: Hemisphere: p. 193-216.

Wills TA & Fegan MF. Social networks and social support. In Baum A, Revenson TA & Singer JE, editors. Handbook of health psychology. 2001. Mahwah: Erlbaum: p. 209-234.