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Published in final edited form as: Curr Opin Psychol. 2014 Dec 25;1:87–91. doi: 10.1016/j.copsyc.2014.12.021

Social Baseline Theory: The Social Regulation of Risk and Effort

James A Coan 1, David A Sbarra 2
PMCID: PMC4375548  NIHMSID: NIHMS656801  PMID: 25825706

Abstract

We describe Social Baseline Theory (SBT), a perspective that integrates the study of social relationships with principles of attachment, behavioral ecology, cognitive neuroscience, and perception science. SBT suggests the human brain expects access to social relationships that mitigate risk and diminish the level of effort needed to meet a variety of goals. This is accomplished in part by incorporating relational partners into neural representations of the self. By contrast, decreased access to relational partners increases cognitive and physiological effort. Relationship disruptions entail re-defining the self as independent, which implies greater risk, increased effort, and diminished well being. The ungrafting of the self and other may mediate recovery from relationship loss.


High quality social relationships correspond with longer, happier, and healthier lives [1]—facts that hold true, as far as anyone knows, regardless of geography or culture [2]. Although social relationships have been linked to health for decades (if not millennia), the mechanisms of this link remain speculative. Here we describe Social Baseline Theory (SBT), a perspective that integrates the study of social relationships with principles of attachment, behavioral ecology, cognitive neuroscience, and perception science [3].

According to SBT, the human brain assumes proximity to social resources—resources that comprise the intrinsically social environment to which it is adapted [4,5]. Put another way, the human brain expects access to relationships characterized by interdependence, shared goals, and joint attention [6]. Violations of this expectation increase cognitive and physiological effort as the brain perceives fewer available resources and prepares the body to either conserve or more heavily invest its own energy [7]. This increase in cognitive and physiological effort is frequently accompanied by distress, both acute and chronic, with all the negative sequelae for health and well being that implies [8,9]. Thus, the first sense in which SBT refers to a social baseline has to do with the default and intrinsically social ecology the brain expects to function within.

But reference to the social baseline also has methodological meaning. In functional magnetic resonance imaging (fMRI) research, a standard convention is to compare an experimental treatment to a “resting baseline” characterized by simply lying alone in the scanner. This convention is predicated on the reasonable assumption that experimental treatments present stimuli otherwise absent from the sensorium while participants are alone. But inspection of brain activity in several studies—elaborated on below—now suggests the brain responds to being alone as if sensory stimuli have been added, not taken away. That is, the brain looks more “at rest” when social resources are obviously available [10]. This presents a puzzle potentially resolvable by considering proximity to a familiar other the brain’s true “baseline” state, and being alone as more like an experimental treatment—a context that adds perceived work for the brain to do.

Social Relationships Decrease the Predicted Cost of the Environment

Abundant evidence suggests that the likelihood of a behavior is optimized by calculating its metabolic cost against its perceived payoff, given prevailing personal bioenergetic resources [11]. For example, human subjects tend to view hills as steeper, and distances as further away, if fatigued, sleepy, physically less fit, stressed, wearing a heavy backpack, or even simply in a low mood [12,13]. It’s thought that these perceptual shifts regulate the motivation to walk up hills. Steeper hills require higher payoffs to justify the bioenergetic investment associated with climbing them, and diminished personal resources cause hills to look steeper.

At its simplest, SBT suggests that proximity to social resources decreases the cost of climbing both the literal and figurative hills we face, because the brain construes social resources as bioenergetic resources, much like oxygen or glucose. Indeed, evidence suggests that hills literally appear less steep when standing next to a friend [14]. Moreover, socially isolated individuals consume more sugar, even after adjusting for body mass index, weight related self-image, depression, physical activity, educational level, age and income [15]. To the human brain, social and metabolic resources are treated almost interchangeably.

Risk, Effort, and the Expanded Self

SBT describes at least two reasons for the regulation of perception and effort by social proximity: risk distribution and load sharing. Colloquially speaking, risk distribution is simply safety in numbers. In a vast array of species, individual threat vigilance decreases as group size increases [16]. But social species also benefit from load sharing, which entails not only the distribution of risk but also the distribution of effort applied to shared goals [17], often to great mutual advantage. Load sharing is strongly facilitated by familiarity, preference, joint attention, and trust [18]—in short, by relationships. The distribution of risk and effort applies across levels of analysis, including neural processing.

Although the brain is highly responsive to perceived threat [19], even simple handholding can substantially attenuate threat those responses [20]. These effects are potentiated by higher relationship quality, intimacy, and higher perceived mutuality [20,21]. Individuals who experienced more maternal support behavior and higher neighborhood social capital in childhood are more receptive to social regulation as adults [22]. And a marital therapy designed to target the quality of attachment bonds increases receptivity to the social regulation of threat processing as well [23].

Critically, the likeliest mechanisms linking social support to diminished threat responding—regulatory circuits within the prefrontal cortex [24]—are not more activated by support provision as originally hypothesized, but less so [10,20,21,23,25]. During supportive handholding in particular, the threat responsive brain appears to return to a baseline state of relative calm, suggesting the difference is attributable less to the activation of regulatory circuitry and more to a decrease in perceived demand associated with the threat, a decrease proportional to the increase in resources brought to bear by the relational partner.

An important question then is how the brain perceives proximity to a relational partner as an increase in bioenergetic resources. SBT suggests the answer may lie in how the brain encodes what we subjectively experience as the self. Many theorists have suggested that the self is “expanded” by relationships with others [26]. This may be literally true at the neural level. For example, the brain encodes threats directed at familiar others very similarly to how it encodes threats directed at the self—but no such similarity obtains for strangers [27]. Representing relational partners as extensions or aspects of the self could effectively yield bioenergetic resources by influencing how the brain budgets the resources immediately at its disposal [28]. If the relational partner can be counted on to meet all or part of an environmental demand, one’s own resources can either be conserved or devoted to other problems as if personal bioenergetic resources were literally increased. This could explain how the brain construes resources available to relational partners as resources available to the self [27]. Indeed, it suggests that attachment may reflect a neural (and conceptual) conflation of self and other [29]. We see this as likely.

Relationship Loss Increases the Predicted Cost of the Environment

We have suggested that an important aspect of SBT is the neural integration of self and other [27], consistent with self-expansion views of close relationships [26]. Evidence supporting shared neural representations of self and other informs our understanding of how intact relationships economize behavior, and suggests new questions about relationship loss. Many view relationship loss as a loss of self. According to SBT, this diminishment of the self is more literal than figurative. Framed in experimental terms, the end of a relationship represents a move away from our social baseline to an alone condition. As a result, threats should look more threatening, the environment should feel more burdensome, the proverbial hills of life should steepen. This all suggests first that becoming unattached from a former partner entails re-defining one’s sense of self as independent of that partner and facing costly new environmental demands as a result [30]. Second, the extent to which this ungrafting of the self and other is successful should at least partially mediate recovery from a loss experience [31].

Non-marital romantic breakups are associated with immediate and persistent decreases in self-concept clarity [32], and recovery of an independent sense of self prospectively predicts increased psychological wellbeing following a breakup [31,33]. These findings raise additional questions. How quickly do people incorporate new social resources back into a damaged self-concept? Is the self-regulatory load associated with loss in fact correlated with the degree of self-concept disturbance? There is evidence, for example, that people who score high in attachment avoidance may be protected against the self-concept disturbances associated with relationship loss, but only to the extent that they can successfully regulate their own emotions while thinking about their ex-partner [34]. Can new social resources help here as well? Going forward, a critical question for (and informed by) SBT concerns the extent to which self-regulatory demands—and capabilities—change as people transition from partnered contexts to those that provide fewer immediate social resources.

Tentative Conclusions

SBT suggests 1) that the human brain assumes proximity to social relationships characterized by shared goals, interdependence, and trust; and 2) that the human brain construes social relationships as bioenergetic resources, encoding others as part of the self. This allows humans to, in effect, outsource everything from probabilistic risk to threat vigilance, emotional responding, and a host of other demanding neural and behavioral activities [35]. Thus, proximity to social resources regulates our propensity for engaging in neural and behavioral work, with implications for how we think, act and feel. When social resources are available, we are expanded, larger, more capable of meeting environmental demands. When social resources are absent, unreliable, or lost, our sense of self is diminished, along with both our objective and subjective efficacy.

If ultimately true, SBT holds implications not only for our understanding of conceptual perspectives like attachment theory, but also for research methodology in psychology and related disciplines. We acknowledge for example that SBT and attachment theory are strikingly similar, and do not propose that one invalidates or supplants the other. Rather, SBT describes a more generalized set of neural and ecological processes—organizational principles—that do not necessarily contradict attachment theory, but may subsume it. One exception may be the question of “attachment figures” per se, about which SBT is largely silent, at least as regards qualitative differences across types of relationships. Another concerns putative attachment styles, interpreted within SBT as prior probabilities in a Bayesian process of predicting the availability of social resources [8,36].

Interestingly, viewing social proximity as a baseline assumption of the human brain carries with it some potential methodological implications, at least insofar as most participants in psychological research are tested in relative isolation. This may not be a serious problem, but SBT does at least invite the possibility that a large range of cognitive, perceptual, emotional, developmental and clinical phenomena manifest differently—and perhaps more generalizably—in the presence of trusted and familiar others. Increasing evidence suggests to us that this may indeed be the case [3740].

With its emphasis on the optimization of resources and effort, SBT also offers novel ways to think about social relationships in the context of clinical interventions. Recent interpersonal approaches to psychotherapy suggest, for example, that couple-level interventions are not only efficacious for treating relationship distress, but also for leveraging social resources in our understanding and treatment of, for example, borderline personality disorder [41], post traumatic stress disorder [42], obsessive-compulsive disorder [43], heart disease [44,45], the suffering associated with cancer [46], and the emotional burden of caring for chronically ill child children [47]. This and related work suggest real potential for the application of social resources in prevention and treatment of a wide array of medical and psychological difficulties [48,49]. Indeed, we are optimistic that our understanding of the nature, function, and centrality of social relationships for human flourishing is steeply on the rise, and we look forward to many fruitful applications of this knowledge in the coming years.

Highlights.

  • The human brain assumes proximity to social resources

  • Social relationships are construed as bioenergetic resources available to the self

  • Relational partners are incorporated into neural representations of the self

  • Relationship loss damages self-related representations and personal efficacy

  • Recovery from relationship loss entails ungrafting of the other from the self

Footnotes

Conflict of interest statement

Nothing declared.

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Contributor Information

James A. Coan, University of Virginia

David A. Sbarra, University of Arizona

References

  • 1.Holt-Lunstad J, Smith TB, Layton JB. Social Relationships and Mortality Risk: A Meta-analytic Review. PLoS Med. 2010;7:e1000316. doi: 10.1371/journal.pmed.1000316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Tomasello M. The human adaptation for culture. Annu Rev Anthropol. 1999;28:509–529. [Google Scholar]
  • 3.Beckes L, Coan JA. Social Baseline Theory: The Role of Social Proximity in Emotion and Economy of Action. Soc Personal Psychol Compass. 2011;5:976–988. [Google Scholar]
  • 4.Bowlby J. Attachment and loss. 2. Vol. 1. Basic Books; 1969. [Google Scholar]
  • 5.Hrdy S. Evolutionary context of human development. The cooperative breeding model. Fam relationships An Evol Perspect. 2007 [Google Scholar]
  • 6.Tomasello M, Carpenter M, Call J, Behne T, Moll H. Understanding and sharing intentions: the origins of cultural cognition. Behav Brain Sci. 2005;28:675–691. doi: 10.1017/S0140525X05000129. discussion 691–735. [DOI] [PubMed] [Google Scholar]
  • **7.Clark A. Whatever next? Predictive brains, situated agents, and the future of cognitive science. Behav Brain Sci. 2013;36:181–204. doi: 10.1017/S0140525X12000477. This paper provides a powerful and comprehensive review of what is variably called the Bayesian brain hypothesis, the free energy principle, predictive coding, and other names, but which boils down to this: The brain is a prediction machine designed to mobilize the body to do more work when predictions fail. Accurate predictions indicate, colloquially speaking, that all is well. Failed predictions entail updating of future predictions, assessment of previously unpredicted environmental demands, and responses to those demands. [DOI] [PubMed] [Google Scholar]
  • *8.Bar-Kalifa E, Rafaeli E. Above and below baselines: The nonmonotonic effects of dyadic emotional support in daily life. J Soc Pers Relat. In press. This paper reports two dyadic daily-diary studies suggesting that the receipt of social support at levels that meet or exceed an empirically estimated baseline results in little or no affective response, but that receiving less emotional support than expected at baseline worsens mood and feelings about relationships. Critically, these results obtained regardless of what the baseline levels of social support actually were. That is, the same dynamic pertained to individuals with high as with low social baselines. [Google Scholar]
  • 9.Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2012;40:218–227. doi: 10.1007/s12160-010-9210-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • *10.Zhang T, Li F, Beckes L, Coan JA. A semi-parametric model of the hemodynamic response for multi-subject fMRI data. Neuroimage. 2013;75:136–45. doi: 10.1016/j.neuroimage.2013.02.048. Though primarily a methodological description of a semi-parametric model of the hemodynamic response function for use in fMRI studies, application of this alternative analytic method revealed a strikingly similar difference between alone and handholding conditions whether confronted with a potential threat or simply lying alone in the scanner at “rest.” (See Figure 3 in particular.) This suggests the brain is more “threat prone” or threat vigilant when alone, whether threats are present or not. [DOI] [PubMed] [Google Scholar]
  • 11.Davies NB, Krebs JR, West SA. An Introduction to Behavioural Ecology. 4. Wiley-Blackwell; 2012. [Google Scholar]
  • 12.Schnall S, Zadra JR, Proffitt DR. Direct evidence for the economy of action: glucose and the perception of geographical slant. Perception. 2010;39:464–82. doi: 10.1068/p6445. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Proffitt DR, Stefanucci J, Banton T, Epstein W. The role of effort in perceiving distance. Psychol Sci. 2003;14:106–112. doi: 10.1111/1467-9280.t01-1-01427. [DOI] [PubMed] [Google Scholar]
  • 14.Schnall S, Harber KD, Stefanucci JK, Proffitt DR. Social support and the perception of geographical slant. J Exp Soc Psychol. 2008;44:1246–1255. doi: 10.1016/j.jesp.2008.04.011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Henriksen RE, Torsheim T, Thuen F. Loneliness, social integration and consumption of sugar-containing beverages: testing the social baseline theory. PLoS One. 2014;9:e104421. doi: 10.1371/journal.pone.0104421. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Roberts G. Why individual vigilance declines as group size increases. Anim Behav. 1996;51:1077–1086. [Google Scholar]
  • 17.Fitzsimons GM, Finkel EJ. Goal interdependence. Curr Opin Psychol. In press. [Google Scholar]
  • 18.Warneken F, Tomasello M. The roots of human altruism. Br J Psychol. 2009;100:455–471. doi: 10.1348/000712608X379061. [DOI] [PubMed] [Google Scholar]
  • 19.Schaefer HS, Larson CL, Davidson RJ, Coan JA. Brain, body, and cognition: neural, physiological and self-report correlates of phobic and normative fear. Biol Psychol. 2014;98:59–69. doi: 10.1016/j.biopsycho.2013.12.011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Coan JA, Schaefer HS, Davidson RJ. Lending a hand: Social regulation of the neural response to threat. Psychol Sci. 2006;17:1032–1039. doi: 10.1111/j.1467-9280.2006.01832.x. [DOI] [PubMed] [Google Scholar]
  • 21.Coan JA, Kasle S, Jackson A, Schaefer HS, Davidson RJ. Mutuality and the Social Regulation of Neural Threat Responding. Attach Hum Dev. 2013;15:303–315. doi: 10.1080/14616734.2013.782656. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Coan JA, Beckes L, Allen JP. Childhood Maternal Support and Social Capital Moderate the Regulatory Impact of Social Relationships in Adulthood. Int J Psychophysiol. 2013;88:224–231. doi: 10.1016/j.ijpsycho.2013.04.006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Johnson SM, Burgess Moser M, Beckes L, Smith A, Dalgleish T, Halchuk R, Hasselmo K, Greenman PS, Merali Z, Coan JA. Soothing the threatened brain: leveraging contact comfort with emotionally focused therapy. PLoS One. 2013;8:e79314. doi: 10.1371/journal.pone.0079314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Rudebeck PH, Saunders RC, Prescott AT, Chau LS, Murray EA. Prefrontal mechanisms of behavioral flexibility, emotion regulation and value updating. Nat Neurosci. 2013;16:1140–5. doi: 10.1038/nn.3440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.Conner OL, Siegle GJ, McFarland AM, Silk JS, Ladouceur CD, Dahl RE, Coan JA, Ryan ND. Mom-It Helps When You’re Right Here! Attenuation of Neural Stress Markers in Anxious Youths Whose Caregivers Are Present during fMRI. PLoS One. 2012;7:e50680. doi: 10.1371/journal.pone.0050680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Aron A, Aron EN. Self-expansion motivation and including other in the self. In: Duck S, editor. Handbook of personal relationships: Theory, research and interventions. John Wiley & Sons; 1997. pp. 251–270. [Google Scholar]
  • *27.Beckes L, Coan JA, Hasselmo K. Familiarity promotes the blurring of self and other in the neural representation of threat. Soc Cogn Affect Neurosci. 2013;8:670–677. doi: 10.1093/scan/nss046. This paper reports an fMRI investigation of putative “self-other overlap” in the neural representation of threat. The design allowed researchers to monitor the same individuals looking at the same threat cues at the same occasion of measurement under each of three conditions: threats directed at the self, threats directed at a friend, and threats directed at a stranger. Results revealed striking similarities in responses to threats directed at the self and at friends in a number of neural regions, including the anterior insula, supramarginal gyrus, and posterior cingulate cortex. But only one region—an orbitofrontal circuit associated with valuation (likely identifying the threat as “bad”)—suggested any similarity between self- and stranger- directed threats. These findings were taken as evidence that relational partners may be non-trivially encoded as “self” in the brain, and that this self-other overlap may motivate a number of relational behaviors. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 28.Noakes TD. The central governor model of exercise regulation applied to the marathon. Sports Med. 2007;37:374–7. doi: 10.2165/00007256-200737040-00026. [DOI] [PubMed] [Google Scholar]
  • 29.Konvalinka I, Xygalatas D, Bulbulia J, Schjødt U, Jegindø E-M, Wallot S, Van Orden G, Roepstorff A. Synchronized arousal between performers and related spectators in a fire-walking ritual. Proc Natl Acad Sci U S A. 2011;108:8514–9. doi: 10.1073/pnas.1016955108. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30.Sbarra DA, Hazan C. Coregulation, dysregulation, self-regulation: an integrative analysis and empirical agenda for understanding adult attachment, separation, loss, and recovery. Pers Soc Psychol Rev. 2008;12:141–67. doi: 10.1177/1088868308315702. [DOI] [PubMed] [Google Scholar]
  • 31.Larson GM, Sbarra DA. Participating in research on romantic breakups promotes emotional recovery. Soc Psychol Personal Sci. In press. [Google Scholar]
  • 32.Slotter EB, Gardner WL, Finkel EJ. Who am I without you? The influence of romantic breakup on the self-concept. Pers Soc Psychol Bull. 2010;36:147–60. doi: 10.1177/0146167209352250. [DOI] [PubMed] [Google Scholar]
  • 33.Mason AE, Law RW, Bryan AEB, Portley RM, Sbarra DA. Facing a breakup: Electromyographic responses moderate self-concept recovery following a romantic separation. Pers Relatsh. 2012;19:551–568. doi: 10.1111/j.1475-6811.2011.01378.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34.Sbarra DA, Borelli JL. Heart rate variability moderates the association between attachment avoidance and self-concept reorganization following marital separation. Int J Psychophysiol. 2013;88:253–60. doi: 10.1016/j.ijpsycho.2012.04.004. [DOI] [PubMed] [Google Scholar]
  • 35.Fitzsimons GM, Finkel EJ. Outsourcing self-regulation. Psychol Sci. 2011;22:369–75. doi: 10.1177/0956797610397955. [DOI] [PubMed] [Google Scholar]
  • 36.Coan JA. Adult attachment and the brain. J Soc Pers Relat. 2010;27:210–217. [Google Scholar]
  • *37.Gross EB, Proffitt D. The economy of social resources and its influence on spatial perceptions. Front Hum Neurosci. 2013;7:772. doi: 10.3389/fnhum.2013.00772. This review first makes the general point that individuals scale their visual perception of the environment by referencing personal bioenergetic resources, such that, for example, physical exertion or exhaustion makes hills seem steeper. It goes on to argue that social resources directly influence visual perception because the brain implicitly includes social resources in its assessment and budgeting of personal bioenergetic capacity. The paper also provides an important discussion of how individual “social baselines” are likely to be influenced by attachment style and other dimensions of personality. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Kraus MW, Huang C, Keltner D. Tactile communication, cooperation, and performance: an ethological study of the NBA. Emotion. 2010;10:745–9. doi: 10.1037/a0019382. [DOI] [PubMed] [Google Scholar]
  • 39.Maresh EL, Beckes L, Coan JA. The social regulation of threat-related attentional disengagement in highly anxious individuals. Front Hum Neurosci. 2013;7:515. doi: 10.3389/fnhum.2013.00515. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40.Woolley AW, Chabris CF, Pentland A, Hashmi N, Malone TW. Evidence for a collective intelligence factor in the performance of human groups. Science. 2010;330:686–8. doi: 10.1126/science.1193147. [DOI] [PubMed] [Google Scholar]
  • 41.Hughes AE, Crowell SE, Uyeji L, Coan JA. A developmental neuroscience of borderline pathology: emotion dysregulation and social baseline theory. J Abnorm Child Psychol. 2012;40:21–33. doi: 10.1007/s10802-011-9555-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42.Johnson SM. Emotionally focused couple therapy with trauma survivors: Strengthening attachment bonds. The Guilford Press; 2002. [Google Scholar]
  • 43.Belus JM, Baucom DH, Abramowitz JS. The effect of a couple-based treatment for OCD on intimate partners. J Behav Ther Exp Psychiatry. 2014;45:484–8. doi: 10.1016/j.jbtep.2014.07.001. [DOI] [PubMed] [Google Scholar]
  • 44.Sher T, Braun L, Domas A, Bellg A, Baucom DH, Houle TT. The partners for life program: a couples approach to cardiac risk reduction. Fam Process. 2014;53:131–49. doi: 10.1111/famp.12061. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 45.Coyne JC, Rohrbaugh MJ, Shoham V, Sonnega JS, Nicklas JM, Cranford JA. Prognostic importance of marital quality for survival of congestive heart failure. Am J Cardiol. 2001;88:526–529. doi: 10.1016/s0002-9149(01)01731-3. [DOI] [PubMed] [Google Scholar]
  • 46.Naaman S, Radwan K, Johnson S. Coping with early breast cancer: Couple adjustment processes and couple-based intervention. Psychiatry Interpers Biol Process. 2009;72:321–345. doi: 10.1521/psyc.2009.72.4.321. [DOI] [PubMed] [Google Scholar]
  • 47.Clothier PF, Manion I, Gordon-Walker J, Johnson SM. Emotionally focused interventions for couples with chronically ill children: A two year follow-up. J Marital Fam Ther. 2002;28:391–398. doi: 10.1111/j.1752-0606.2002.tb00364.x. [DOI] [PubMed] [Google Scholar]
  • *48.Baucom DH, Belus JM, Adelman CB, Fischer MS, Paprocki C. Couple-based interventions for psychopathology: a renewed direction for the field. Fam Process. 2014;53:445–61. doi: 10.1111/famp.12075. This review offers a theoretical and empirical argument in favor of couple-based interventions in the treatment of individual psychopathology. The authors note that individual psychopathology often occurs in a context of relationship distress, but also that social systems can contribute to both the maintenance and resolution of individual psychopathology even in the absence of such distress. The perspective the authors offer does not focus on, but is consistent with, the view that relational partners can also offset part of the emotional burden of psychological and medical interventions. [DOI] [PubMed] [Google Scholar]
  • 49.The PLoS Medicine Editors: Social relationships are key to health, and to health policy. PLoS Med. 2010;7:2. doi: 10.1371/journal.pmed.1000334. [DOI] [PMC free article] [PubMed] [Google Scholar]

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