Cultural differences in social support seeking: The mediating role of empathic concern.

Prior research has found that East Asians are less willing than Westerners to seek social support in times of need. What factors account for this cultural difference? Whereas previous research has examined the mediating effect of relational concern, we predicted that empathic concern, which refers to feeling sympathy and concern for people in need and varies by individuals from different cultures, would promote support seeking. We tested the prediction in two studies. In Study 1, European Canadians reported higher empathic concern and a higher frequency of support seeking, compared to the Japanese participants. As predicted, cultural differences in social support seeking were influenced by empathic concern. In Study 2, both empathic concern and relational concern mediated cultural differences in support seeking. Japanese with lower empathic concern but higher relational concern were more reluctant than European Americans to seek social support during stressful times. Finally, loneliness, which was more prevalent among the Japanese than among the European Americans, was partially explained by social support seeking.

Introduction

Social support involves perceiving or experiencing that one is valued and cared for, is loved, and belongs to a network of communication and mutual obligation [1]. The benefits of social support to mental and physical health, such as relieving daily stress, improving well-being, and reducing the severity of health disorders [2-4], have long been known. Researchers have suggested that seeking social support from close others (e.g., family, friends) is one of the most effective ways to deal with stressful events in daily life [2, 5]. Although accepting social support helps the recipient maintain positive physical and mental health, various factors influence individuals’ social support seeking. Culture, which is a collective-level phenomenon comprising both socially shared meanings and associated scripted behavioral patterns [6], is an important factor that affects support seeking. Assumptions on views of self and relationships, which are shared among individuals in a given cultural group, manifest as a set of psychological tendencies. For instance, East Asians were more reluctant to seek social support from others than Westerners [7-9].

Building on earlier findings, we examined the cultural underpinnings of using social support and the feeling of loneliness. Specifically, to address the limitations of previous research regarding what factors account for cultural differences in social support seeking, we tested whether social support would be related to individual differences in empathic concern, which reflect cultural norms about relationships and cultural practices about emotional suppression and expressivity and cognitive styles. We report findings from two studies using questionnaires consisting of attitudinal self-report scales. Note that some researchers have expressed skepticism about the cross-cultural validity of attitudinal self-report scales due to issues including translation, response bias, and reference groups, which we will return to and discuss in our general discussion. Caution, therefore, is needed in terms of the interpretation of cultural differences demonstrated in this research, because attitudinal self-report scales often fail to accurately reflect individuals’ mental processes, although all the scales used in this research were reliable within a culture. In fact, disconnections between verbal reports and mental processes often occur [10]. In addition to using self-report scales, researchers have reconsidered an over-reliance of East-West differences reflecting on the dimension of independence and interdependence (or individualism and collectivism). Such a dichotomic comparison often fails to find expected cultural differences along the dimension, particularly in studies relying on attitudinal self-report scales (e.g., [11]), which suggests limited cultural sensitivity and predictive power [12]. The constructs of independence and interdependence (or individualism and collectivism) have been criticized in terms of their validity (e.g., [13]). Thus, we have to admit that this research, which uses self-report scales and relies on the West-East dichotomy, has theoretical and methodological flaws in the context of cultural psychology work. However, this research mainly aims to describe whether, and to what extent, cultures influence relationships among a set of variables and what factors account for the cultural differences—rather than just reporting what individuals think self-reflectingly about themselves. We conducted this research in line with the view of culture as a system of many elements [14].

Culture and social support seeking

In Western cultural contexts, the self is often considered independent and separate from other people, whereas, in Eastern cultural contexts, it is viewed as being interdependent and connected to other people [15]. Specifically, in Western cultural contexts, people are encouraged to search for desirable internal traits and attributes and to express them. They are likely to share the assumption that the thoughts of each individual are unknowable in principle, unless expressed explicitly. Conversely, in Eastern cultural contexts, people are encouraged to find a meaningful position in social networks, with the emphasis being placed on social adjustment and accommodating others. At first glance, this East Asian emphasis on social networks and accommodating others could be confused with an inherent reliance on social support seeking to cope with stressful events. However, previous findings do not support this intuition.

What aspects of East Asian cultures lead people to rely less on social support for coping with stress? In previous studies, concern for the potential cost of support seeking in social relationships, which is known as relational concern, has been examined as an important factor in explaining cross-cultural differences in support seeking tendencies (e.g., [7, 16]). In Western cultural contexts, because people are likely oriented toward expressing their thoughts to achieve their goals, it is considered natural to disclose their problems and share them with others to achieve their goals of coping with them. In contrast, social support recruits another person’s resources (e.g., time) to help relieve one’s own stress, which may potentially threaten the harmony established in an existing relationship. In East Asian cultural contexts, the emphasis on social networks and accommodation to others can lead people to maintain harmony within the networks and avoid matters that disrupt this harmonious relationship. Thus, it is reasonable to assume that people in East Asian cultural contexts would be more cautious about disclosing personal problems to enlist the support or assistance of others. This assumption was supported by Taylor et al. [7], who demonstrated that Asians are more concerned with how asking for others’ help may negatively affect their current relationships and, thus, are more hesitant to seek social support. In addition, utilizing a hypothetical situation in which a person needs help, Miller et al. [17] conducted interviews and tested Indian, Japanese, and North American participants by asking questions about reliance on exchange norms, relationship maintenance concerns, and social support (e.g., comfort in asking for help). They demonstrated that Indians were less likely to endorse exchange norms than Japanese and North Americans, and that the cultural difference in exchange norms accounted for more positive social support outlooks in Indians than Japanese and North Americans. Additionally, when comparing the Japanese and North Americans, relationship maintenance concerns mediated the cultural differences in social support.

However, the current literature still falls short in identifying the other factors that account for those cultural differences. Given that both independence and interdependence are multifaceted concepts [18], and that people acquire a set of psychological tendencies linked to independence and interdependence through daily practices in a non-uniform manner within a culture [19], other factors related to culturally sanctioned ways of self and relationships can also contribute to cultural differences in social support seeking. Although few studies have examined this possibility, in the present research, we explored whether individual differences in empathic concern would provide an alternative explanation for cultural differences in seeking social support. We also examined whether the association between empathic concern and seeking social support further contributes to cultural differences in loneliness.

Empathic concern unpackaging cultural differences in social support seeking

Empathic concern is an “other-oriented” affective empathy characterized by feelings of sympathy and concern for people in distress [20]. Empathic concern involves an orientation to attenuating or alleviating others’ distress [21], which can be the primary motivation for helping behaviors [22]. People with high empathic concern were found to be more willing to help others in need (e.g., [23, 24]) and to devote more effort to volunteer activities (e.g., [25]).

Although many studies have examined the influence of empathic concern in regard to providing help, little research has considered the potential impact of empathic concern on asking for help. Research that has investigated the topic of empathy has found that higher empathic concern is accompanied by a stronger belief in the principle of care—that is, that people should help others in need [26, 27]. Evidence has also shown that a high endorsement of the caring principle not only encourages more prosocial behaviors [27] but also motivates individuals to seek social support [28]. Thus, high empathic concern, characterized by a strong belief in the caring principle, can lead individuals to seek social support in times of need. Indeed, prior research on coping found that empathy facilitated problem-focused coping, including support seeking (e.g., [29, 30]). Across four studies that employed three different survey panels, Sun et al. [31] consistently found that having higher levels of empathic concern was positively correlated with the frequency of seeking social support. Extending from the positive association between empathic concern and social support seeking, the present research aimed to explore whether empathic concern could explain cultural differences in support seeking.

From the perspective of self-construal, East Asians with higher interdependent self-construal are traditionally expected to attend more to others and thus show more empathic concern (e.g., [32]). Indeed, country-level evidence from 63 countries suggests that collectivism, which is usually higher in East Asian countries, is positively associated with empathic concern [33]. However, in the majority of previous studies investigating individual differences in empathy assessed by a self-report scale (e.g., the interpersonal reactivity index), Westerners (compared to East Asians) are more likely to empathize with people in distress by exhibiting sympathy (e.g., [34]). These findings, however, require some speculation due to possible issues involving cross-cultural validity of a self-report scale, as mentioned earlier. For instance, Chung et al. [35] found that East Asian adolescents reported lower empathic concern than Western adolescents, whereas mainland Chinese university students scored lower in empathic concern assessments than German undergraduates [36, 37]. Moreover, American counselor trainees showed greater empathic concern than their Thai counterparts [38]. In addition to dispositional empathic concern, Atkins et al. [39] found that, compared to individuals of East Asian backgrounds, individuals of White British backgrounds exhibited more empathic concern while observing others suffering from social or physical pain. Why do East Asians show less empathic concern than Westerners? We speculated that the answer might lie in cultural differences in norms regarding emotional suppression and expressivity and cognitive styles.

Empathic concern involves emotional response (e.g., sympathy) toward unfortunate others. As mentioned previously, one of the prominent features of East Asian cultures is the pursuit of interpersonal harmony [15]. In many East Asian cultural contexts, people tend to value emotional suppression and emotional restraint more due to the goal of maintaining interpersonal harmony [15, 40, 41]. Prior research has found that, compared to Westerners, Japanese people evaluated their emotional events in daily life more moderately [42], and they expressed less emotion (e.g., [43]), especially when in the presence of others [44]. Low levels of empathic concern found among East Asians may be related to their emphasis on emotional suppression, which results in less emotional expressivity.

In addition to the variations in emotional suppression and expressivity, the cross-cultural differences in cognitive styles can also help explain the cultural differences in support seeking. Westerners tend to perceive every single object independently and attend to the object itself, whereas East Asians tend to consider the relations between objects and perceive the whole context unitarily (e.g., [45]). Accordingly, in empathic contexts, it might be less likely for people from East Asian cultures to take the unfortunate other’s side and fully and exclusively empathize with them, without considering other situational factors (e.g., why or how the misfortune happened). Atkins [46] found that, compared to Americans, the Japanese tend to avoid taking a specific side in conflict situations, which also partially explains their lower affective empathy. Additionally, East Asians were more likely than Westerners to interpret suffering as the result of violating social norms and to perceive unfortunate people as being responsible for their suffering [47, 48]. Along these lines, in the context of empathy, East Asians, compared to Westerners, tend to attribute more responsibility to those suffering from misfortune, rather than fully siding with them—and thus show less empathic concern.

Given the positive association between empathic concern and social support seeking, lower empathic concern might also prevent Asians from seeking social support. That is, in addition to relational concern, empathic concern may also mediate cross-cultural variations in support seeking. We conducted two studies to examine this issue in detail.

Culture, social support seeking, and loneliness

As previously noted, current literature contains abundant evidence supporting cultural differences in social support seeking tendencies; however, scant research has further investigated the psychological consequences. Thus, the current study focused on loneliness as a potential social‒emotional outcome of cultural differences in social support seeking. Loneliness refers to a distressing situation in which individuals subjectively perceive deficiencies in certain social relationships [49]. In most cases, loneliness arises when individuals fail to satisfy the need for belonging and intimacy. By reminding individuals that they still have supportive relationships, social support can help individuals restore their sense of belonging [50] and, thus, reduce the feeling of loneliness [51]. Prior research has revealed that not only receiving social support but also practicing support seeking behaviors can effectively relieve the state of loneliness (e.g., [52-54]). Along these lines, a high degree of hesitancy toward seeking social support may be associated with a higher level of loneliness. If cultural differences exist in social support seeking, they may be reflected in the level of loneliness. Indeed, loneliness not only emerges as an outcome of personal experiences but also occurs as a pervasive social phenomenon within a larger context (e.g., culture; [55]). For example, previous research indicates that compared to Americans, Japanese and Chinese individuals reported greater degrees of loneliness [56-58]. Considering these factors, we explored the possibility that a high degree of hesitancy toward seeking social support might affect the level of loneliness varying across cultures.

The current research

The main purpose of the current research was to examine whether individual differences in empathic concern as well as relational concern, which reflect differences in cultural norms about relationships and cultural practices about emotional suppression and expressivity and cognitive styles, can account for cultural differences in social support seeking tendencies. In Study 1, we examined social support seeking and empathic concern by testing Japanese and European Canadian participants. We hypothesized that European Canadians would be more likely than Japanese people to seek explicit social support, and that empathic concern, which would be higher in European Canadians than Japanese, would account for the cultural difference in social support seeking. In Study 2, we further tested whether empathic concern and relational concern mediate cultural differences in social support seeking by administering a separate survey to a sample population of Japanese and European American respondents. We anticipated that, compared to European Americans, Japanese participants would report lower levels of empathic concern, higher levels of relational concern, and lower frequencies of social support seeking. We further predicted that empathic concern and relational concern would mediate the cultural differences in social support seeking simultaneously. In addition, Study 2 also explored whether cultural differences in social support seeking are linked to cultural differences in the degree to which feelings of loneliness are experienced. We expected that Japanese participants would report higher degrees of loneliness than European American participants and that the cultural differences in loneliness could be explained by the cultural differences in empathic concern/relational concern and social support seeking.

Study 1

Method

Ethics statement

This study was reviewed and approved by the ethics committees at Nagoya University, Kobe University, and the University of Alberta. The study participants provided written informed consent at the beginning of the study. All responses were kept confidential.

Participants

A total of 407 Japanese undergraduate students participated, including students from Nagoya University, Japan (94 men and 110 women, Mage = 19.82, SD = 1.36) and from Kobe University, Japan (98 men and 105 women, Mage = 19.70, SD = 1.42). Also recruited for participation were 381 European Canadian undergraduate students from the University of Alberta, Canada (125 men, 254 women, and 2 unspecified, Mage = 19.45, SD = 2.16). The Canadian participants were prescreened based on their self-defined ethnicity. Based on cultural differences between Japanese and American individuals in their means of seeking support (elicited through four items on the Brief-COPE questionnaire) observed in Mojaverian et al. [9], we anticipated that a sample of 358 from each culture was needed to ensure 95% power to detect effect size (d) = 0.27. Of the 788 participants recruited, 17 did not complete all the measurements (six Japanese and 11 European Canadians), and thus, these participants were excluded, yielding a final sample size of 771 (401 Japanese and 370 European Canadians).

Measures

Empathic concern. We assessed empathic concern using the 7-item empathic concern subscale from the Interpersonal Reactivity Index (IRI; [20]). The empathic concern subscale measures an individual’s general ability to feel concern and sympathy toward people suffering misfortunes. Participants were asked to rate how well each item described them using a 5-point scale ranging from does not describe me well (1) to describes me very well (5). Sample items included “Sometimes I do not feel very sorry for other people when they are having problems” (reverse scored), and “I would describe myself as a pretty soft-hearted person.” In this study, we used the Japanese translated version of the IRI developed by Himichi et al. [59], using the back-translation method, which confirmed adequate reliability and construct validity, for the Japanese participants. Cronbach’s alphas were 0.80 for the Japanese sample and 0.67 for the European Canadian sample.

Support seeking. We assessed support seeking using the 2-item emotional support subscale and the 2-item instrumental support subscale from the Brief-COPE questionnaire [60], which is a short version of the COPE instrument [61]. Participants were asked to rate how often they tried to employ the practice or behavior described by each item using a 5-point Likert-scale ranging from not at all (1) to very much (5). Sample items included “I try to get emotional support from others” (emotional support) and “I get help and advice from other people” (instrumental support). These subscales have been used in several prior studies to examine cultural differences in social support seeking (e.g., [9]). Given the high consistencies reported for the four Brief-COPE support seeking items, we used the average scores of these four items as an indicator of support seeking. The Japanese participants were presented with the Japanese translated items developed by Mojaverian et al. [9] asking a Japanese-English bilingual to translate the original items and additional Japanese-English bilinguals to check the translated ones for accuracy. Cronbach’s alpha coefficients for all four items were 0.91 for the Japanese sample and 0.91 for the European Canadian sample.

Statistical analysis

First, we examined the cultural differences in support seeking and empathic concern with independent sample t-tests. Subsequently, we estimated the Pearson correlation coefficient between empathic concern and support seeking. Finally, we used the SPSS PROCESS macro (Model 4) developed by Hayes (2013) to test empathic concern as a mediator of cultural differences in support seeking. Before conducting the mediation analysis, the scores of empathic concern and support seeking were centering by using the means across all individuals, and culture was coded as European Canadian = 1 and Japanese = 0. The indirect effect was estimated using 10,000 bootstrapping samples and presented as 95% bias-corrected confidence intervals (CI).

Results and discussion

Consistent with previous work, the results of the independent sample t-tests showed there were significant cultural differences in support seeking (t(769) = –2.11, p = .035, Cohen’s d = 0.15) and empathic concern (t(769) = –7.92, p < .001, Cohen’s d = 0.57). Compared to the Japanese sample (M = 3.24, SD = 1.02), European Canadians (M = 3.40, SD = 1.02) sought social support more frequently. European Canadians (M = 3.83, SD = 0.83) also reported higher empathic concern than Japanese participants (M = 3.40, SD = 0.68). Empathic concern significantly correlated to support seeking in both the Japanese (r = 0.24, p < .001) and European Canadian (r = 0.28, p < .001) samples.

The results of the mediation model analysis indicated that the total effect of culture (Canadian = 1 and Japanese = 0) on social support seeking (b = 0.15, SE = 0.07, t(769) = 2.11, p = .035) was reduced when empathic concern was included in the model (b = 0.00, SE = 0.07, t(768) = 0.06, p = .950). The effect of culture on empathic concern was significant: b = 0.43, SE = 0.05, t(769) = 7.92, p < .001. Additionally, empathic concern positively predicted support seeking: b = 0.35, SE = 0.05, t(768) = 7.41, p < .001. More importantly, the indirect effect of empathic concern on the cultural differences in support seeking was significant: indirect effect = 0.15, SE = 0.03, 95% CI = [0.10, 0.21] (see Fig 1).

Fig 1

Mediation model in Study 1.

Note. Culture was coded as European Canadian = 1 and Japanese = 0. *p < .05, ***p < .001.

We also conducted another mediation model analysis with gender and age as covariates to test the robustness of this finding. The indirect effect of empathic concern remained significant, indirect effect = 0.12, SE = 0.03, 95% CI = [0.07, 0.18], indicating that the mediating effect of empathic concern was robust, even after controlling for the effects of gender and age. In addition, after controlling for the effect of gender and age, the mediating effects of empathic concern on the cultural differences in emotional support seeking and instrumental support seeking were both significant (S1 Table).

The cultural differences observed in social support seeking and empathic concern were consistent with those found in previous studies. Compared to the Japanese participants, the European Canadian participants reported higher degrees of empathic concern toward unfortunate others and sought social support during stressful times more frequently. More importantly, as predicted, empathic concern significantly mediated the cultural differences in social support seeking.

Study 2

In Study 2, we aimed to replicate the findings of Study 1 by surveying a nonstudent sample population of Japanese and European American participants. Because most previous research has focused on relational concern in explaining cultural differences in social support seeking, in Study 2, we examined whether relational concern and empathic concern mediated the cultural differences in social support seeking simultaneously. In addition, given the association between social support seeking and loneliness [53], we also examined whether cultural differences in the degree to which loneliness is experienced would be partly due to differences in social support seeking tendencies.

We predicted the following: (a) European American participants would report higher levels of empathic concern, lower levels of relational concern, more frequent social support seeking, and less loneliness than Japanese participants; (b) social support seeking tendencies would negatively correlate with loneliness; (c) empathic concern and relational concern would both mediate the cultural differences in social support seeking; and (d) the cultural differences in loneliness would be mediated by the cultural differences in empathic concern/relational concern and social support seeking, in that order.

This study was reviewed and approved by the ethics committee at Nagoya University. All responses were kept confidential.

Participants and procedure

We recruited a total of 496 Japanese participants (274 men and 222 women, Mage = 40.29, SD = 9.83) and 469 European Americans (233 men, 233 women, and three unspecified, Mage = 38.00, SD = 12.60) through online crowdsourcing marketplaces (Lancers for Japanese participants and Prolific for American participants). The American participants were recruited with filters on self-defined ethnicity (European American) and nationality (American). Based on the average effect size of Study 1 and Mojaverian et al. [9] on cultural differences in support seeking, we expected that a sample of roughly 478 for each culture would be appropriate to detect an effect size (d) = 0.21. Nine participants (one Japanese and eight European Americans) were excluded because they did not complete the whole questionnaire. Therefore, the final sample size was 956 (495 Japanese and 461 European Americans). After consenting, the participants completed a questionnaire used to measure stressful events, support seeking, relational concern, empathic concern, and loneliness. They were then asked to report their demographic information.

Stressful events. As performed in previous research on support seeking (e.g., [16, 62]), participants were asked to first briefly describe the biggest stressful event they had come across within the previous three months and then choose the most relevant type from nine options for their own stressors (family relationship, friend relationship, romantic relationship, academic, health, financial, job, future, or other). After recalling their stressful events, participants were asked to rate the extent to which they perceived the events as stressful, negative, solvable, and controllable and the extent to which they felt responsible for the event by responding to five statements (e.g., “I felt responsible for this event”) using a 7-point Likert scale (1 = not at all, 7 = very much).

Support seeking. As in Study 1, the participants indicated how often they tried to cope with their stressors by seeking social support using 5-point scales ranging from not at all (1) to very much (5) for two emotional support items and two instrumental support items from the Brief-COPE questionnaire [60]. Cronbach’s alphas for all four items were 0.86 for the Japanese sample and 0.88 for the European American sample.

Relational concern. Relational concern was assessed using an 11-item scale utilized in previous research (e.g., [16]). Because the current research only focused on relational concern, we did not include the items (two items) assessing the expectation of unsolicited social support in the original scale (13 items) for the main analyses. Even if the full scale (13 items) was used, the overall trends of the results remained (see S1 Text for more information). These items include several potentially negative implications of seeking support from others regarding interpersonal relationships, such as disrupting interpersonal harmony, making the problems worse, being criticized, and losing face. Sample items included “I am concerned that if I tell the people I am close to about my problems, they would be hurt or worried for me” and “I would be embarrassed to share my problems with the people I am close to.” Participants rated how important each of the concerns would be for them in deciding whether to ask for support from others using 5-point scales ranging from not at all (1) to very much (5). The items were translated and back-translated between Japanese and English by two Japanese‒English bilinguals. Japanese participants were presented with the Japanese translated items. Cronbach’s alphas were 0.84 for the Japanese sample and 0.92 for the European American sample.

Empathic concern. As in Study 1, the measurement used for empathic concern was the 7-item empathic concern subscale from the IRI [20, 23]. Participants were asked to indicate how well each statement described them. Each item was rated using a 5-point Likert-scale ranging from does not describe me well (1) to describes me very well (5). Cronbach’s alphas were 0.81 for the Japanese sample and 0.88 for the European Americans.

Loneliness. Loneliness was assessed using the Revised UCLA Loneliness Scale (R-UCLA; [63]). The R-UCLA is a 20-item scale designed to measure the experience of social isolation and loneliness in daily life. Sample items included “I feel in tune with the people around me” and “I do not feel alone” (reverse scored). Participants were asked to indicate how often they felt the way described by the statements using a 4-point Likert-scale ranging from never (1) to often (4). Japanese participants were presented with the Japanese translated version developed by Moroi [64] that confirmed adequate reliability and construct validity. Cronbach’s alpha coefficients were 0.95 for the Japanese sample and 0.95 for the European American sample.

Demographic variables. Participants reported their demographic information (age and gender) and their socioeconomic status (SES). SES was assessed using the MacArthur scale of subjective SES [65]. Participants were asked to look at a picture of a ladder with 10 rungs, representing the positions of people in their communities, and choose their own place on the ladder. The description of the ladder is as follows: “At the top of the ladder are the people who have the highest standing in their community (1). At the bottom are the people who have the lowest standing in their community (10).” The answers were reversely scored in the following analyses. A higher score represented a higher SES.

First, following previous research, we examined cultural differences in the characteristics of stressful events. Second, as in Study 1, we examined cultural differences in the mean scores for empathic concern, relational concern, support seeking, and loneliness by conducting a series of independent sample t-test analyses. Then, we estimated the correlation coefficients among the variables under study.

As for the mediation analyses, we first examined the independent mediating effects of empathic concern and relational concern on the cultural differences in support seeking by conducting a mediational analysis with empathic concern and relational concern as simultaneous mediators (PROCESS v3.4 Model 4). Then, we ran a serial mediation analysis to further examine the indirect effects of cultural differences on loneliness through empathic concern/relational concern and then support seeking (PROCESS v3.4 Model 80). All mediation analyses were conducted using Hayes’s (2018) SPSS macro PROCESS v3.4, with 95% bias corrected CI based on 10,000 bootstrapping samples. As in Study 1, before the mediation analyses, the scores of all related variables were centering and culture was coded as European American = 1 and Japanese = 0. Demographic variables and feelings related to stressful events were included in all mediation models as control variables.

Characteristics of stressful events

The results indicating the cultural differences in the types of stressors are depicted in Fig 2. Japanese participants were more inclined to describe stressful events related to family relationships (U.S. = 14.1%; Japan = 21.8%; χ2(1, N = 956) = 9.59, p = .002) and jobs (U.S. = 21.3%; Japan = 28.3%; χ2(1, N = 956) = 6.30, p = .013) than European Americans. European American participants were more likely to mention stressful events related to romantic relationships (U.S. = 5.2%; Japan = 1.4%; χ2(1, N = 956) = 10.94, p = .001) and academic issues (U.S. = 4.3%; Japan = 0.8%; χ2(1, N = 956) = 12.16, p < .001) than Japanese participants.

Fig 2

Cultural differences in the types of stressors in Study 2.

In addition to the cultural differences in the types of stressors reported, Japanese participants perceived the events as more stressful (t(881) = 3.56, p < .001, Cohen’s d = 0.23) and negative (t(837) = 3.35, p = .001, Cohen’s d = 0.22) than the European American participants did. Furthermore, the Japanese respondents were also more inclined to perceive the stressful events as controllable (t(891) = 5.29, p < .001, Cohen’s d = 0.35) and to believe they were responsible for the event (t(888) = 7.45, p < .001, Cohen’s d = 0.49). No cultural differences were observed in the participants’ responses regarding their ability to resolve stressful events (t(873) = 0.64, p = .525, Cohen’s d = 0.04). Table 1 displays the mean scores by cultures.

Table 1

Means by culture in Study 2.

	Japanese (N = 495)		European Americans (N = 461)
	Mean	SD	Mean	SD	t	df	p	Cohen’s d
Empathic concern	3.31	0.66	3.76	0.82	-9.34	885	< .001	0.609
Relational concern	2.93	0.69	2.54	0.92	7.44	847	< .001	0.486
Support seeking	2.53	0.94	2.95	1.03	-6.73	929	< .001	0.437
Loneliness	2.45	0.61	2.04	0.64	10.09	954	< .001	0.653
Stressful	6.22	0.82	6.00	1.02	3.56	881	< .001	0.232
Negative	5.88	1.19	5.57	1.64	3.35	837	.001	0.220
Responsible	4.07	1.83	3.08	2.25	7.45	888	< .001	0.486
Solvable	3.14	1.58	3.06	2.01	0.64	873	.525	0.042
Controllable	3.20	1.47	2.64	1.80	5.29	891	< .001	0.345

Cultural differences in variables under study

The results of the independent sample t-tests (Table 1) showed that the European Americans tended to report higher levels of empathic concern (t(885) = –9.34, p < .001, Cohen’s d = 0.61) and more frequent support seeking (t(929) = –6.73, p < .001, Cohen’s d = 0.44), whereas the Japanese tended to report higher levels of relational concern (t(847) = 7.44, p < .001, Cohen’s d = 0.49) and show more loneliness (t(954) = 10.09, p < .001, Cohen’s d = 0.65).

We conducted Study 2 in March 2020. Thus, some participants mentioned issues related to COVID-19 in their description of the stressful event. However, whether or not participants mentioned COVID-19 did not influence either support seeking or loneliness, regardless of culture (see S2 Table for more detail).

Correlational analyses

In both the Japanese and European American samples, empathic concern positively correlated with support seeking (Japan: r = 0.23, p < .001; U.S.: r = 0.24, p < .001), whereas relational concern negatively correlated with support seeking (Japan: r = –0.11, p = .020; U.S.: r = –0.21, p < .001). Moreover, significant negative correlations between support seeking and loneliness were observed in the Japanese (r = –0.28, p < .001) and in the European American (r = –0.37, p < .001) samples. Table 2 presents the results of the correlational analyses for both samples. Given that the dependent variables were significantly correlated with demographic variables and perceived characteristics of the stressful events, we included the demographic variables and the feelings related to the stressful events (i.e., stressful, negative, responsible, solvable, and controllable) as control variables in the mediation analyses.

Table 2

Pearson correlations by cultures in Study 2.

	1	2	3	4	5	6	7	8	9	10	11	12
Demographic variables
1 Age	-	0.19***	-0.10	-0.07	0.05	-0.12*	-0.11*	-0.08	-0.20***	0.14**	-0.12*	-0.10*
2 Gender (1 = woman, 0 = man)	-0.04	-	0.07	0.17**	0.08	-0.08	-0.08	-0.09	-0.09	0.29***	0.07	-0.07
3 Subjective SES	0.03	0.07	-	-0.01	0.01	-0.03	-0.01	0.02	-0.09	-0.03	-0.00	0.02
Feelings for the stressful event
4 Stressful	0.03	0.08	-0.02	-	0.46***	-0.11*	-0.16***	-0.19***	0.06	0.16**	0.25***	-0.04
5 Negative	0.06	0.01	-0.08	0.44***	-	-0.28***	-0.36***	-0.34***	0.06	0.10*	0.03	0.12**
6 Responsible	-0.07	0.14**	0.02	0.06	-0.12**	-	0.37***	0.54***	0.28***	-0.11*	-0.12**	0.26***
7 Solvable	-0.14**	0.05	0.11*	-0.10*	-0.27***	0.22***	-	0.54***	0.08	-0.20***	-0.01	-0.04
8 Controllable	-0.07	0.08	0.12**	-0.11*	-0.29***	0.21***	0.72***	-	0.18***	-0.17***	-0.09	0.06
Variables under study
9 Relational concern	-0.02	-0.04	-0.10*	0.00	0.08	0.03	-0.05	-0.04	-	-0.25***	-0.21***	0.44***
10 Empathic concern	0.12**	0.15**	0.15**	0.10*	0.05	0.12**	0.05	0.08	0.01	-	0.24***	-0.26***
11 Support seeking	-0.07	0.17***	0.15**	0.13**	0.02	0.11*	0.09*	0.07	-0.11*	0.23***	-	-0.37***
12 Loneliness	0.01	-0.13**	-0.35***	0.01	0.12**	-0.02	-0.24***	-0.22***	0.23***	-0.34***	-0.28***

Note. Correlations for the Japanese sample (N = 495) are below the diagonal, and correlations for the European American sample (N = 461) are above the diagonal. +p = .05,

*p < .05,

**p < .01,

***p < .001.

Mediation analyses

First, we ran a multiple mediation analysis (Model 4) to examine whether empathic concern and relational concern could independently mediate cultural differences in support seeking. The results (Fig 3) showed that the effects of culture (European American = 1 and Japanese = 0) on empathic concern (b = 0.45, SE = 0.05, t(946) = 8.89, p < .001) and on relational concern (b = –0.25, SE = 0.06, t(946) = –4.54, p < .001) were both significant. Empathic concern positively predicted support seeking (b = 0.26, SE = 0.04, t(944) = 6.14, p < .001), whereas relational concern negatively predicted support seeking (b = –0.18, SE = 0.04, t(944) = –4.62, p < .001). Moreover, the total effect of culture on support seeking (b = 0.37, SE = 0.07, t(946) = 5.39, p < .001) was reduced when empathic concern and relational concern were included in the model (b = 0.20, SE = 0.07, t(944) = 2.96, p = .003). Both empathic concern and relational concern were found to significantly mediate the cultural differences in support seeking: indirect effect = 0.12, SE = 0.02, 95% CI = [0.07, 0.17] for empathic concern; indirect effect = 0.05, SE = 0.02, 95% CI = [0.02, 0.08] for relational concern (Table 3). Additionally, the results of the mediation analyses revealed that, with 95% confidence, the difference in these two indirect effects (d) was significant, d = 0.07, SE = 0.03, 95% CI = [0.02, 0.13]. This indicated that the mediating effect of empathic concern was stronger than that of relational concern.

Fig 3

Mediation model in Study 2.

Note. Culture was coded as European American = 1 and Japanese = 0. Gender, age, SES, and five related feelings for the stressful events were included as control variables. *p < .05, **p < .01, ***p < .001.

Table 3

Indirect effects in Study 2.

	Indirect effect	SE	95% CI
culture → empathic concern → support seeking	0.117	0.025	[0.073, 0.171]
culture → relational concern → support seeking	0.045	0.015	[0.021, 0.081]
culture → empathic concern → support seeking → loneliness	-0.017	0.005	[-0.027, -0.009]
culture → relational concern → support seeking → loneliness	-0.007	0.002	[-0.012, -0.003]
culture → support seeking → loneliness	-0.029	0.011	[-0.053, -0.009]
culture → empathic concern → loneliness	-0.086	0.016	[-0.120, -0.056]
culture → relational concern → loneliness	-0.047	0.013	[-0.073, -0.024]

We then ran a serial mediation analysis (Model 80) to further examine whether empathic concern/relational concern and support seeking could jointly mediate the cultural differences in loneliness. The results (see Fig 3) indicated that both empathic concern (b = –0.19, SE = 0.02, t(943) = –7.70, p < .001) and support seeking (b = –0.14, SE = 0.02, t(943) = –7.72, p < .001) significantly reduced loneliness, whereas relational concern was positively associated with loneliness (b = 0.18, SE = 0.02, t(943) = 8.19, p < .001). Additionally, the total effect of culture on loneliness (b = –0.29, SE = 0.04, t(946) = –6.69, p < .001) was reduced when empathic concern, relational concern, and support seeking were included in the model (b = –0.10, SE = 0.04, t(943) = –2.50, p = .013). More importantly, two serial mediating effects were supported: indirect effect = –0.02, SE = 0.00, 95% CI = [–0.03, –0.01] for culture → empathic concern → support seeking → loneliness; indirect effect = –0.01, SE = 0.00, 95% CI = [–0.01, –0.00] for culture → relational concern → support seeking → loneliness (see Table 3). Furthermore, the indirect effect of cultural differences on loneliness through support seeking was also significant: indirect effect = –0.03, SE = 0.01, 95% CI = [–0.05, –0.01].

As in Study 1, we also performed the mediation analyses (Model 80, Bootstrap = 10,000) for emotional support seeking and instrumental support seeking, respectively. The results showed that all four serial mediating effects were significant (see S1 Table).

Consistent with our hypotheses, the European American participants indicated more concern for unfortunate others, less concern about the relational implication of seeking social support, a greater likelihood of seeking social support during stressful times, and less loneliness compared to the Japanese participants. In addition, more social support seeking was significantly associated with less loneliness. More importantly, Study 2 found that empathic concern and relational concern jointly mediated the cultural differences in social support seeking. Finally, consistent with our prediction, the cultural differences in empathic concern/relational concern partly explained the cultural differences in loneliness through social support seeking.

In Study 2, compared to American participants, Japanese participants perceived the stressful events they described as more stressful, negative, and controllable and felt more responsible for the events. Although we controlled the levels of participants’ feelings related to the events in a series of the multiple mediation analyses, the unexpected differences in the feelings across cultures suggest that a follow-up study is warranted for the examination of the associations among empathic concern/relational concern, support seeking, and loneliness in a more controlled setting—such as a hypothetical vignette including a commonly experienced stressful event. Together, the findings of Studies 1 and 2 suggest that, in addition to higher levels of relational concern about the negative implications of seeking social support, lower empathic concern for unfortunate others also helps explain why Japanese individuals are less willing than Westerners (European Canadians and European Americans) to seek social support during stressful times.

General discussion

Although many researchers have explained the cultural differences in social support seeking tendencies based on cultural differences in relational concern, few researchers have investigated other factors to explain the cultural differences in social support seeking. Across two studies, we found evidence to suggest that, in addition to relational concern, empathic concern also explains cultural differences in social support seeking. Through Study 1, we found that European Canadians sought social support more frequently than Japanese individuals, when coping with stressful events, which was explained by cultural differences in the levels of empathic concern reported by the two groups. Specifically, compared to the Japanese, European Canadians were generally more concerned about unfortunate others and more willing to seek social support during stressful times. Consistent with Study 1’s findings, Study 2 showed that relational concern and empathic concern mediated the cultural differences in social support seeking simultaneously. Compared to European Americans, Japanese individuals with higher levels of relational concern but lower levels of empathic concern sought social support less frequently during stressful times. The results thus replicated the previous findings and supported Study 1’s initial findings. In addition, Study 2’s findings revealed that Japanese participants exhibited higher loneliness than European Americans. The cultural differences in loneliness can be attributed, in part, to cultural differences in social support seeking.

Consistent with prior research, the current findings demonstrate that, compared to people from Western cultures (e.g., European Canadians and European Americans), individuals from Japan display less empathic concern for people in distress. After following the examples of previous research, we assessed the cultural difference in empathic concern by utilizing a self-report scale; however, future work should follow up the findings in a more controlled manner. Additionally, although previous research suggests that both emotional suppression and expressivity and cognitive styles might be potential candidates for explaining cultural differences in empathic concern, to date, little empirical research has directly examined the mechanisms behind these cultural differences. Future research is needed to clarify what underlies cultural differences in empathic concern.

The current work is one of the few studies that examines the effects of empathic concern on social support seeking. Considering that empathic concern is positively associated with the belief that people should help others in need [27], those who have higher levels of empathic concern may turn to others for help more naturally when they, themselves, are in distress. We also found that European Americans with higher levels of empathic concern tended to be less concerned about the negative impact of seeking support on interpersonal relationships (r = –0.25, p < .001). Recent research has shown that people with higher levels of empathic concern seek more social support for help in dealing with daily stress [31]. Our findings provide more empirical evidence supporting the positive association between empathic concern and social support seeking among multicultural samples (Japanese, European Canadians, and European Americans). These findings contribute to an understanding of individual differences in social support seeking tendencies. Social support helps people cope with daily stressful events, reduces the severity of mental and physical illness, and helps individuals adapt to new environments (e.g., [66, 67]). Thus, it is important to understand why some people are reluctant to ask for help when they are in need. Based on the current findings, it appears that possessing a low degree of empathic concern is an important factor preventing people from asking for support. Future work can further investigate whether belief in the care principle mediates the positive association between empathic concern and social support seeking.

In addition to our successful replication of the effect of relational concern, our new findings of empathic concern mediating cultural differences in social support seeking are noteworthy. Past research has suggested that, compared to Westerners, East Asians are more concerned with how explicitly enlisting support may detrimentally affect harmonious relationships and, thus, they are more reluctant to actively seek help from others [7]. Our research extends this prior work by examining the mediating effects of relational concern and empathic concern on cultural differences in social support seeking. It suggests that lower levels of sympathy for unfortunate others is another important reason why East Asians are more reluctant to seek social support than Westerners. To clarify the mediating roles of empathic concern and relational concern, future work will need to address the possibility that the underlying effects would depend on the forms of social support seeking. Whereas this research demonstrated that empathic concern and relational concern mediated the cultural difference in explicit forms of social support seeking such as getting emotional support and advice from other people, it is unclear whether the mediating effects can be applied to more implicit forms of support seeking—defined as the emotional comfort experienced without disclosing one’s problems and stress. Asians and Asian Americans likely benefit from implicit support seeking [68], and those who tend to endorse adjustment goals are likely to emphasize relational concern as a motivating factor in deciding to seek implicit social support [62]. These previous findings imply a positive association between relational concern and implicit support seeking. In contrast, does empathic concern lead people to seek implicit support as well as explicit support when they have to cope with stressful events? Future work is necessary to address this question and expound upon our findings.

This research represents one of the first scholarly efforts to examine possible social‒emotional outcomes of the cultural differences in social support seeking. Our findings demonstrate that active social support seeking behaviors are effective in relieving loneliness [53], and that cultural differences in feelings of loneliness are partly due to cultural differences in social support seeking tendencies. Specifically, compared to European Americans, Japanese individuals with higher levels of relational concern but lower levels of empathic concern were more hesitant to seek social support in stressful times and, thus, suffered more loneliness. Accumulating evidence suggests that loneliness can trigger adverse outcomes on mental and physical health, such as depression [69] and alcoholism [70]. Moreover, both suicide ideation and incidents of parasuicide increased with the levels of subjective loneliness [71]. Loneliness is one of the highest risk factors for mortality [72]. Given that unsolicited support is not always available, it is important to discuss how to encourage people to seek social support actively when they are in need. For instance, it might be useful to encourage Japanese individuals who are motivated to maintain positive relationships—and, thus, have relationship maintenance concerns—to build a communal system where they can receive social support without any relational concerns. Additionally, according to our findings, encouraging people to express sympathy for unfortunate others and helping to build a more caring environment can help reduce people’s hesitation to ask for social support.

In this research, we offer a new explanation for cultural differences in social support seeking. However, several limitations should be addressed. First, the present research used a cross-sectional design. Thus, we cannot exclude the possibility that higher levels of loneliness tend to cause Japanese people to cope with stress alone. Although the positive effects of support seeking on relieving loneliness have been proven repeatedly (e.g., [73]), longitudinal research is needed to further elucidate the association between support seeking and loneliness. Second, our findings lend support to prior work suggesting that East Asians have lower sympathy for people in distress than Westerners. However, we did not examine the reason for the cultural differences in empathic concern. Although we proposed possible explanations for these differences, future research is necessary to further examine the psychological mechanisms behind cultural differences in empathic concern. Third, because we only used Japanese participants, this may raise an issue regarding generalizability. There is no doubt that Japanese people cannot represent all East Asians. Miller et al. [17] suggested that the assumption that relational concern results in hesitation in social support seeking would be supported in the case that people are likely to follow exchange norms based on costs and benefits in terms of relationships with other people, including friends and siblings. Given that collectivism is positively associated with communal norms [11], however, the assumption may be exceptional; rather it may be applied to a limited group of East Asians. To gain a more integrated understanding, future work is needed to test the assumption at various sites in Asian cultures. Through comparisons among Indian, Japanese, and North American participants, Miller et al. [17] effectively demonstrated that Indians have a more positive outlook on social support seeking than Japanese, reflecting differences in the extent to which they rely on communal norms and exchange norms. The method of triangulation [74] to identify explanatory factors of cultures by comparing subgroups will enable researchers to provide an advanced view of how the mind is shaped by cultural content beyond the dichotomy of individualism and collectivism. Additionally, given regional variations based on the history of voluntary settlement [75] and socio-ecological variations based on relational mobility [76] and residential mobility [77] in the single national culture of Japan, which can lead to differences in the extent to which individuals adhere to the dominant value of interdependence, further work is needed to examine variations in the use of social support within the specific nation. By doing so, we can specify the ways of social support seeking that emerge as adaptations to norms about relationships and emotional suppression and expressivity shared and assumed among individuals in a given sociocultural context.

Finally, although the current findings provided some preliminary evidence for the role of empathic concern in cross-cultural differences in support seeking, they were based on the usage of self-report Likert scales. Mean-level cross-cultural comparisons can be problematic for several reasons. For instance, the effects of culturally biased ideas participants rely on [13] are inescapable regardless of the careful implementation of translation and back-translation. For instance, when “my own opinion” and “directly” are used, there is no absolute standard about the concepts of these words across various cultures. Rather, participants interpret these words based on their own ideas acquired through their daily experiences in a given culture. This suggests that participants’ ratings for items reflect the ideas based on their experiences, which should vary across cultures and thus are not comparable cross-culturally [78]. Additionally, ambiguity in the meaning of words used in an item often cause participants’ evaluations relative to the feature of the group the participants belong to, which is called the reference group effect [79]. Due to the relative judgment by participants who use the feature of their group as a standard, self-report Likert scales have little predictable validity. Furthermore, people often present themselves in a socially desirable way when being asked about themselves. The motive for social desirability causes a response bias. Previous research found that cultural orientations were associated with tendencies to respond to questions in a socially desirable way: individualism was associated with self-deceptive enhancement, whereas collectivism was associated with impression management based on normative responses in a given culture [80]. The previous finding suggests that Westerners’ higher scores for social support seeking and empathic concern and their lower level of loneliness may result from their positive views of themselves. In contrast, Japanese’ lower scores of support seeking may reflect their expected normative responses, not their actual attitudes. Although the cross-cultural differences in each variable we used have been examined repeatedly with various methods (e.g., [7, 39]), the use of Likert-style questionnaires does not allow us to draw any strong inferences. Given the drawbacks of mean-level cross-cultural comparisons on Likert scales, future research is necessary to further replicate these findings by using various measurements and experimental designs.

In short, with both of our studies, we identified the mediating role of empathic concern in the cultural differences regarding social support seeking. In light of our findings, compared to European Canadians/Americans, lower empathic concern and higher relational concern discourage Japanese people from seeking social support to help cope with stress, and this reduced support seeking and worsened feelings of loneliness.

Scales used in this research.

(PDF)

Click here for additional data file.

Results of emotional support seeking and instrumental support seeking.

(PDF)

Click here for additional data file.

Means of support seeking and loneliness by COVID-19 in Study 2.

(PDF)

Click here for additional data file.

Results using the whole scale of relational concern (13 items).

(PDF)

Click here for additional data file.

(XLSX)

Click here for additional data file.

(XLSX)

Click here for additional data file.

9 Apr 2021

PONE-D-20-40124

Cultural Differences in Social Support Seeking: The Mediating Role of Empathic Concern

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Reviewer #1: Zheng et al, Social support seeking

This is an interesting set of studies on an extremely important topic, with data from three nations (I wouldn’t call them three ‘cultures’). The studies are generally well conceived and well analyzed.

However, I recommend that the paper be rewritten. First, while the authors’ summary of the the health effects of loneliness vs. social support are valid, their sources are out of date and exclude a number of important meta-analyses. That is easy to fix; I list three important sources below, but there are others as well.

Second, like many others, the authors frame their conceptualization and design in terms of the constructs of individualism and collectivism. Research shows that these are at best orthogonal dimensions, and certainly not dichotomous discrete categories. Indeed, meta-analyses strongly indicate that neither construct is valid. For one critique, see Fiske (2002) and the other comments in that issue.

Third, any time one reports studies using translations of scales, one needs to report the precise items in each language, then discuss and carefully consider the implications for data analyses of the differences in meanings of the items in the respective languages.

Finally while many researchers infer differences between nations (or cultures) by comparing means on Likert scales, such inferences are invalid. There are several reasons for this invalidity, including the fact that one cannot meaningfully compare the means of items written in different languages. Respondents in different cultures are also likely to anchor their responses differently – e.g., basing their responses on comparison of their beliefs about themselves with their beliefs about others in their own culture. Making meaningful comparisons between nations (or cultures) requires systematic ethnological research based on analyses of ethnographies, as well as consultation with social scientists who study both of the two cultures. At a bare minimum, one needs to use scenario items (Peng, Nisbett & Wong 1997; Heine, Lehman, Peng, & Greenholtz 2002). In short, I recommend that the authors not use previous studies or their own data to infer mean international differences in any of their variables.

So I strongly urge the authors to reframe their conceptualization and analyses as replications in three nations showing that social support seeking is affected by relational concerns, mediated by empathic concern and “social norms.” And I encourage a deeper conceptualization of “social norms” and how they operate in this case. This would make a solid and valuable article.

Barth, J, Schneider, S, & von Kanel, R. 2010. Lack of Social Support in the Etiology and the Prognosis of Coronary Heart Disease: A Systematic Review and Meta–analysis. Psychosomatic Medicine 72:229–238.

Chida, Yoichi, Mark Hamer, Jane Wardle, & Andrew Steptoe, J. 2008. Do Stress–Related Psychosocial Factors Contribute to Cancer Incidence and Survival? Nature Clinical Practice Oncology 5:466–475.

Fiske, A. P. 2002. Using Individualism and Collectivism to Compare Cultures: A Critique of the Validity and Measurement of the Constructs: Comment on Oyserman et al.. Psychological Bulletin, 128, 78-88. Reprinted in Deborah Cai, Ed., 2010, Intercultural Communication. London: Sage Publications.

Heine, S. J., Lehman, D. R., Peng, K., & Greenholtz, J. 2002. What's wrong with cross-cultural comparisons of subjective Likert scales?: The reference-group effect. Journal of personality and social psychology, 82(6), 903-918.

Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. 2015 PerspectPsychol Sci. Mar;10(2):227-37.

Peng, K., Nisbett, R. E., & Wong, N. Y. 1997. Validity problems comparing values across cultures and possible solutions. Psychological methods, 2(4), 329-344.

Reviewer #2: This paper examines the effects of culture on empathic and relational concern, and the combined effects of these two measures on support seeking behaviors. The authors conduct two survey studies to address these issues, and on the whole the results support their hypothesis that empathic concern is an important factor in support seeking (and outcomes that come from lack of support seeking, such as loneliness).

The framing of the paper could use improvement. First, it is important to be specific about the cultures being investigated. The literature review moves back and forth between different conceptualizations, the connections among which are not clear. For example, are the phenomena in question specific to Japan? To all East Asian countries? Do they also include those in other countries of East Asian descent, such as Chinese Americans? Similarly, the comparison groups vary widely, including Canadians of European descent, Americans of British descent, etc. (The latter is not the majority of U.S. citizens, so this comparison is not particularly relevant to understanding country level differences in help-seeking.) Care should also be taken not to use “Canadians” or “Americans” when what is meant is a subgroup of the population.

The underlying arguments regarding culture and empathic concern are quite interesting, and as the authors note, some of the prior findings would appear on the surface to be contradictory. However, the line of argument is likely to be hard to follow without a more general introduction to the cultural attributes of the cultures under comparison (e.g., individualism/collectivism, self-concept, etc.). This could make subsequent discussion of possible reasons for cultural differences in help seeking easier to follow, particularly for readers who do not work in this area of research.

The paper would also be easier to follow if all key terms and phrases were defined on first use, including “empathic concern” in the first paragraph and abstract; “implicit social support” in paragraph 2, and so on.

The two studies are entirely survey based, using adequate sample sizes of 407 Japanese and 3 European Canadians in Study 1 and 496 Japanese and 469 European Americans in Study 2. Average age of participants was around 20 for Study 1 and closer to 40 for Study 2.

The survey analysis is robust, with one limitation discussed below. The findings support the hypotheses and provide some new insights into cultural difference in empathic concern, help-seeking, and outcomes such as loneliness.

My main concern is that comparing surveys distributed to different cultural groups is tricky and the authors do not seem to have considered cultural differences in the ways in which people respond to subjective scales. There is a large literature showing that simply translating a scale between languages does not ensure that the respondents are conceptualizing the different values on the scale in the same way. There are also related issues pertaining to social desirability in responses, which also varies across cultures.

In the literature, there are several recommended solutions to this problem of comparability of response samples, including centering, testing patterns of results within samples, and so forth. Janet Harkness’ book on Cross-Cultural Survey Methods provides a good overview of the problems that arise in this kind of research and possible ways to handle them. I would strongly urge the authors to address this problem in future versions of this paper.

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21 May 2021

Editor comments:

Journal Requirements

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Following the instruction on the journal webpage, we reformatted our manuscript.

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Following this suggestion, we revised the participants section of each study (lines 200-203 on page 10 and lines 299-300 on page 14) and Table 2.

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Reviewer 1

However,

1）First, while the authors' summary of the health effects of loneliness vs. social support are valid, their sources are out of date and exclude a number of important meta-analyses. That is easy to fix; I list three important sources below, but there are others as well.

Thank you for your suggestion. We added some new reviews/ meta-analyses of the health effects of social support and loneliness (Barth et al. [2010]; Chida et al., [2008]; Chu et al., [2010]; Holt-Lunstad et al., [2015]), which include ones you suggested (see [2], [3], [4], and [68] in the main text).

2) Second, like many others, the authors frame their conceptualization and design in terms of the constructs of individualism and collectivism. Research shows that these are at best orthogonal dimensions, and certainly not dichotomous discrete categories. Indeed, meta-analyses strongly indicate that neither construct is valid. For one critique, see Fiske (2002) and the other comments in that issue.

Previous research of culture and social support assumes the negative implications of social support seeking for interpersonal relationships, such as bothering others and losing face, in cultures (or nations) emphasizing social networks and accommodation to others. Particularly, disclosing problems and bringing personal matters to others are relatively inappropriate in Eastern cultures, because such a disclosure implies a demand for help from others, which may damage a harmonious relationship. This assumption is thus based on the norm of interpersonal relationships reflecting the interdependent orientation. On the other hand, according to Miller, Akiyama, and Kapadia (2017, Journal of Personality and Social Psychology), hesitation in seeking social support, reflecting relational concern on disrupting harmonious relationships, seems to be inconsistent with communal norms that have been considered as a core feature of collectivism (Oyserman et al., 2002). Miller et al. (2017) thus call into question two claims: one is that collectivism is associated with hesitation in seeking social support, and the other one is that the feature of hesitation in seeking social support, reflecting the interdependent orientation, is generalized in Asians (indeed, they found Indians who likely to engage in communal norms less hesitate social support seeking compared to Japanese). Given your comment and the findings of Miller et al. (2017), we reframed the introduction of our manuscript along with the previous research on culture and social support, not mentioning the dimension of individualism-collectivism (on pages 3-5). Additionally, based on Miller et al. (2017), we mentioned a possibility that the association between relational concern and hesitation in social support seeking may be applied to a limited group of East Asians on page 28.

3) Third, any time one reports studies using translations of scales, one needs to report the precise items in each language, then discuss and carefully consider the implications for data analyses of the differences in meanings of the items in the respective languages.

Based on this comment, we included the English and Japanese versions of all the scales we used in Supporting Information (S1 Appendix) to make them public so that people who are interested in the scales can evaluate the validity. Also, we added some words to support cross-cultural validity for each scale (on pages 11, 16 and 17). Furthermore, we mentioned an issue of culturally biased item wordings by referring tot Fiske (2002) on page 28.

4) Finally while many researchers infer differences between nations (or cultures) by comparing means on Likert scales, such inferences are invalid. There are several reasons for this invalidity, including the fact that one cannot meaningfully compare the means of items written in different languages. Respondents in different cultures are also likely to anchor their responses differently - e.g., basing their responses on comparison of their beliefs about themselves with their beliefs about others in their own culture. Making meaningful comparisons between nations (or cultures) requires systematic ethnological research based on analyses of ethnographies, as well as consultation with social scientists who study both of the two cultures. At a bare minimum, one needs to use scenario items (Peng, Nisbett & Wong 1997; Heine, Lehman, Peng, & Greenholtz 2002). In short, I recommend that the authors not use previous studies or their own data to infer mean international differences in any of their variables.

As you pointed out, we admit that the problem of mean-level cross-cultural comparison using Likert scales is one of the limitations of this research. We mentioned the problem by referring to Heine et al. (2002) and Peng et al. (1997) on page 28. However, please note that our hypothesis is not based on cultural differences in traits and thoughts themselves people support. Rather, we focus on how a set of variables related to relationships and emotional experiences are functionally related and whether culture moderates the functional relationships. Following Kitayama (2002), which is one of the comments to Oyserman et al. (2002), we take a stand for the system view of culture.

So I strongly urge the authors to reframe their conceptualization and analyses as replications in three nations showing that social support seeking is affected by relational concerns, mediated by empathic concern and "social norms." And I encourage a deeper conceptualization of "social norms" and how they operate in this case. This would make a solid and valuable article.

In this revision, reframing the introduction of culture and social support seeking by addressing the assumption of the previous research, we emphasized the roles of relational concern and empathic concern as mediators. For example, we mentioned that the results (i.e., compared to European Americans, Japanese individuals with higher levels of relational concern less frequently sought social support during stressful times) replicated the previous findings on page 24 (see also page 25). Moreover, given that independence and interdependence are multifaceted, we clarified our argument that to see a possibility that other factors related to culturally sanctioned ways of self and relationships can also contribute to cultural differences in social support seeking, we explore the role of empathic concern, which differs reflecting cultural norms regarding emotional expressivity and cognitive styles (pages 5-7). Furthermore, we referred to Miller et al. (2017) to address a possibility that norms about relationships reflecting an interdependent view of self and emphasis on either communal norms or exchange norms interact to affect hesitation and discomfort in social support seeking (page 28), because we think that future work addressing it is crucial to gain more integrated understanding about the cultural underpinnings of using social support. Finally, we also referred to potential effects of regional variations and socio-ecological variations, which can lead to differences in the extent to which individuals adhere to the dominant value of interdependence on page 28.

Reviewer2

1) First, it is important to be specific about the cultures being investigated. The literature review moves back and forth between different conceptualizations, the connections among which are not clear. For example, are the phenomena in question specific to Japan? To all East Asian countries? Do they also include those in other countries of East Asian descent, such as Chinese Americans? Similarly, the comparison groups vary widely, including Canadians of European descent, Americans of British descent, etc. (The latter is not the majority of U.S. citizens, so this comparison is not particularly relevant to understanding country level differences in help-seeking.) Care should also be taken not to use "Canadians" or "Americans" when what is meant is a subgroup of the population.

Following this suggestion, we revised the framing of the introduction section to focus on East Asian culture and Western culture. And we also added some sentences to make the connection between different conceptualization clearer. Second, the reviewer pointed out that European Americans cannot represent “Americans.” Following this, we replaced the terms of “Canadians” and “Americans” with “European Canadians” and “European Americans” respectively.

2) The underlying arguments regarding culture and empathic concern are quite interesting, and as the authors note, some of the prior findings would appear on the surface to be contradictory. However, the line of argument is likely to be hard to follow without a more general introduction to the cultural attributes of the cultures under comparison (e.g., individualism/collectivism, self-concept, etc.). This could make subsequent discussion of possible reasons for cultural differences in help seeking easier to follow, particularly for readers who do not work in this area of research.

You pointed out that the arguments regarding cultural variations in empathic concern may be hard to follow without a more general introduction to the cultural attributes of the cultures under comparison. Following this suggestion, we added some sentences (line 55-64 on page 3-4) to introduce the distinct attributes of social relationship in each culture to help understand the cultural variations in relational concern. And we also described the attributes of each culture in emotional expressivity and cognitive thinking styles briefly at the beginning of 8th (line 122-125 on page 6) and 9th paragraph (line 131-134 page 7).

3) The paper would also be easier to follow if all key terms and phrases were defined on first use, including "empathic concern" in the first paragraph and abstract; "implicit social support" in paragraph 2, and so on.

Following this suggestion, we added the definition of empathic concern in the abstract (the 3rd sentence, line 23 on page 2). We deleted “implicit social support” in this revised manuscript. And the definition of social support was moved to the first sentence in the first paragraph (line 37-38 on page 3). The definition of loneliness is on line 154-155 (page 8).

4) My main concern is that comparing surveys distributed to different cultural groups is tricky and the authors do not seem to have considered cultural differences in the ways in which people respond to subjective scales. There is a large literature showing that simply translating a scale between languages does not ensure that the respondents are conceptualizing the different values on the scale in the same way. There are also related issues pertaining to social desirability in responses, which also varies across cultures.

As you pointed out, researchers have proposed several methods to improve the comparability of cross-cultural questionnaires. However, those statistical methods cannot effectively solve the major problems of cross-cultural comparison on Likert scales that Reviewer 1 mentioned (i.e., the reference group effect). There is only one way to address this issue that is to examine these findings with multiple methods in future. Therefore, combined with Reviewer 1’s last comment, we extended our argument on page 28.

Submitted filename: Response to Reviewers.doc

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5 Jul 2021

PONE-D-20-40124R1

Cultural Differences in Social Support Seeking: The Mediating Role of Empathic Concern

PLOS ONE

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Submitted filename: Social support seeking & empathic concern.pdf

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7 Sep 2021

Reviewer #1

This revision is responsive to many of the issues raised in the review of the original submission, and hence is much improved. However, the two most fundamental issues are not resolved. Since both of these issues are common to most research in cultural psychology, perhaps the best course of action is to acknowledge that them frankly from the beginning, and simply publish the paper. But I must say that what I see as the fundamental validity problems of most research in cultural psychology are salient in this paper.

The issue of cross-national comparison of Likert scale values is frankly, though all too briefly, addressed in the next to last paragraph, though I suggest that the authors add a few sentences about better methods.

Thank you for the comments that shed light on the issues our manuscript could not handle. Following this suggestion by Reviewer 1, we revised the paragraph by adding sentences to raise the issue of the usage of self-report Likert scale and discuss the details (pages 30-31, lines 625-646).

However, the authors continue to rely on the individualism – collectivism dichotomy, despite all the evidence that these are invalid constructs, that there is too much heterogeneity within nations to allow inferences as the national level, that different measures of the do not agree, that measures of them find dimensions rather than distinct categories, and that most studies that measure both constructs find little correlation between them (so they are not opposite ends of one dimension). Why do the authors base their metatheory on these invalidated constructs? My opinion is that they should at least acknowledge the many respects in which the constructs are problematic. However, I can also accept an editorial decision that doing so is beyond the scope of this paper. Even if this is the decision, however, there are component problems that I favor addressing.

Could the starting point for the whole paper be wholly or partially a methodological artifact? The authors indicate that East Asian cultures (all? some? there are a great many East Asian cultures) are characterized by the judgment that presenting distress to another person typically(?) is an unwarranted or at least unwelcome imposition. If so, then one would expect social desirability effects such that survey respondents would under-report support-seeking. This likelihood needs to be carefully addressed.

Following this suggestion by Reviewer 1, in the second half of the introduction section, addressing the issues of the usage of self-report Likert scale and the West-East dichotomy, we stated that this research, which uses self-report scales and relies on the West-East dichotomy, has theoretical and methodological flaws in the context of cultural psychology work (pages 3-4, lines 35-55). Additionally, in this research, we failed to address potential differences within East Asian cultures. We added sentences to mention that by adopting the method of triangulation to identify explanatory factors of cultures by comparing subgroups, researchers can provide an advanced view of how the mind is shaped by cultural content beyond the dichotomy of individualism and collectivism (pages 29-30, lines 610-616). Furthermore, we also addressed the issue of social desirability in details (page 31, lines 637-646).

Let me return to the issue of comparing distributions of responses on items in different languages. In the wording of a question, even small differences within a language may yield large quantitative differences in responses. But here we are comparing responses to items in different languages. The differences in social support-seeking in these studies and those reported in previous studies are based on comparing scales anchored by English words such as rarely, very much, and so forth, with scales in Mandarin, Cantonese, Japanese, Malay, Vietnamese, Thai, or Korean lexemes with similarly indeterminate meanings that surely do not align perfectly with the English frequency terms anchoring the scales for the North Americans. Back-translation is a start, but what one inevitably discovers doing back translation is that it is just not possible to “ensure cross-cultural equivalence” of the purportedly corresponding items in two languages. Hence differences between nations in the distributions of responses cannot be used to make valid inferences about the difference in the absolute distribution of responses in the samples (including their means).

Furthermore, the lexemes used to describe forms of “social support-seeking”, or the term for “stress”, or the term “solvable” or “responsible”, or the lexeme for “close to” in a scale in English cannot possibly have denotations (nor connotative valuation) identical to the lexemes used to describe those constructs in any other language – here, Japanese. Languages simply do not have lexicons that that construe the world according to any universal ontology or taxonomy: lexicons do not align in one-to-one correspondence.

As Reviewer 1 mentioned, the effects of culturally biased ideas participants rely on are inescapable regardless of the careful implementation of translation and back-translation, which we stated on page 30. Following your suggestion, we deleted the phrase “ensure cross-cultural equivalence,” which had been originally used to explain the scale of relational concern in Study 2.

In addition, in Study 2 the authors found substantial differences in the problems for which US respondents potentially sought social support, compared to the Japanese respondents; in particular, the Japanese respondents reported more negative and more stressful events (though one does not know whether these are true differences, or result from differences in the meanings of the scales in the respective languages). Given that finding, how meaningful is it to compare the social support-seeking of the two samples? Surely the nature of the problems one faces has a large effect on whether one seeks support, what support one seeks, and from whom.

As Reviewer 1 pointed out, in Study 2, compared to American participants, Japanese participants perceived the stressful events they described as more stressful, negative, and controllable and felt more responsible for the events. Although we controlled the levels of participants’ feelings related to the events in a series of the multiple mediation analyses, the unexpected differences in the feelings across cultures suggest that a follow-up study is warranted for the examination of the associations among empathic concern/relational concern, support seeking, and loneliness in a more controlled setting—such as a hypothetical vignette including a commonly experienced stressful event. In this revision, we mentioned the limitation of Study 2 (pages 24-25, lines 496-502).

Beyond that, the words, gestures, facial expressions and other actions that comprise “support-seeking” in Japan are doubtless different from those that are typical in Canada, or in the US. That is, the very acts of support-seeking differ between the two nations, meaning that the studies compare apples in North America to oranges in Japan. Furthermore, the “support” that is sought surely differs across cultures, nations, and regions. For example, Adams & Plaut (2003) found that, in contrast to European Americans, West Africans expect financial support from friends, but rarely seek advice and even less often expect sympathetic listening to expressed emotions. (My own informal observations in the course of over 4 years in West Africa support this.) So, in sum, just what were the Japanese respondents reporting that they were seeking, and how were they seeking it? What were the Canadian and what were the US respondents seeking (not necessarily the same thing, as the two nations contain somewhat different sets of cultures), and what did seeking consist of?

All in all, I believe that the authors need to assiduously unpack and discuss the meanings of the prompts and of the scale anchors in the respective languages. A Likert self-report scale is not a caliper that can be reliably calibrated so as to yield objective and truly comparable measurements, and Likert self-report scales in (very) different languages simply do not measure the exact same behaviors, let alone absolute frequency distributions of behaviors in any of the samples. In short, can one truly conclude that there are, in fact, between-nation differences in the rates of behaviors related to the construct of “social support-seeking” – especially if people in the respective nations are not seeking exactly the same sort of support in the same way?

As Reviewer 1 pointed out, this research, which relies on self-report Likert scales, failed to address what support people seek. Although this research focused on explicit forms of social support seeking such as getting emotional support and advice from other people, people may seek more implicit forms of support defined as the emotional comfort experienced without disclosing one’s problems and stress. Previous research suggests that Asians and Asian Americans likely benefit from implicit support seeking, and those who tend to endorse adjustment goals are likely to emphasize relational concern as a motivating factor in deciding to seek implicit social support. Given the previous findings, it is not clear whether both empathic concern and relational concern are associated with not only explicit forms of social support seeking, but also implicit forms of social support seeking. As we added sentences on pages 27-28 (lines 559-573), future work will need to address the possibility that the mediating roles of empathic concern and relational concern would depend on the forms of social support seeking.

In any case, I do not have great confidence in the validity of claims such as, “compared to Americans, Japanese and Chinese individuals reported greater degrees of loneliness”. And if Japanese are more lonely, how does that comport with the notion that Japanese culture is more ‘collectivist’ than North America? Likewise, I doubt the validity of the evidence that, “compared to East Asians, Westerners are more likely to empathize with people in distress by exhibiting sympathy (e.g., [27]). For instance, Cassels et al. [28] found that East Asian adolescents reported lower empathic concern than did Western adolescents, whereas mainland Chinese university students scored lower in empathic concern assessments than German undergraduates [29, 30]. Moreover, American counselor trainees showed greater empathic concern than their Thai counterparts [31] . . . . East Asians show less empathic concern than do Westerners.” Simply running Student’s t-tests and ANOVAs on Likert scales in two different languages does not constitute evidence for such conclusions. The authors have added a short penultimate paragraph to acknowledge this, but then, why do they make the inferences they do make throughout the paper?

In this revision, we emphasized that this research mainly aimed to describe whether, and to what extent, cultures influence relationships among a set of variables and what factors account for the cultural differences—rather than just reporting what individuals think self-reflectingly about themselves (on page 4). To do so, we revised the abstract and the title of the section (page 6, lines 100-101) and added some sentences in the main text (page 3, lines 31-34, page 5, lines 63-68, page 6, lines 90-94, and page 10, lines 192-193). As Reviewer 1 pointed out repeatedly, we assessed cultural differences in social support seeking, empathic concern, relational concern, and loneliness in an inappropriate manner, and we admit the methodological flaw. To figure out the relationships among these variables, however, we firstly have to show these cultural differences based on the results of t-tests. Thus, while we still report cultural differences in social support seeking, empathic concern, relational concern, and loneliness in this revision, we tried to avoid phrases to emphasize these cultural differences (e.g., page 10, lines 178-179 and 183-184) and draw attention to the usage of self-report Likert scale when mentioning the previous findings (page 7, lines 125-129).

Again, let me say that I realize that this critique applies to most research in the cross-cultural psychology paradigm. Yes.

These issues are probably somewhat less vitiating for mediational analyses (so long as one does not compare the magnitudes of mediations in samples studied with instruments in different languages). Hence there remains a lot of value in these studies. I would suggest that the authors could greatly strengthen the interesting but unsupported inference that people (in general) are less disposed to seek social support when they view support-seeking as an imposition on relationships, and hence potentially deleterious to them. To explore this, why not ask informants if this is indeed what they think? It would be very illuminating to do 20-30 interviews and a couple of focus groups in Japan, and the same in North America. My intuition is that, for the most part, North American recipients of requests for social support feel that such requests are flattering, even moving, indicators of trust and closeness. I believe that in my own North American subculture, support-seeking strengthens friendships and family bonds.

Due to the limited time in revision and the current situation of COVID-19, we could not conduct an interview survey that Reviewer 1 proposed. However, Miller et al. (2017) conducted interviews and tested Indian, Japanese, and North American participants by utilizing a hypothetical situation in which a person needs help and asking questions about reliance on exchange norms, relationship maintenance concerns, and social support (e.g., comfort in asking for help). They demonstrated that Indians were less likely to endorse exchange norms than Japanese and North Americans, and that the cultural difference in exchange norms accounted for more positive social support outlooks in Indians than Japanese and North Americans. Additionally, when comparing the Japanese and North Americans, relationship maintenance concerns mediated the cultural differences in social support. In this revision, we mentioned the results (pages 5-6, lines 82-89).

What is the evidence that East Asians “are less likely to experience emotion more intensively”? That claim astonishes me. And how does this mesh, for example, with the fact that suicide rates in Japan are nearly twice as high as in, say, the United Kingdom? Or with, say, the Japanese preoccupation with kawaii? Suicide and kawaii-related practices manifest themselves quite publicly, so how does this comport with the claim that East Asians are less likely to “express their emotion publicly”? At baseball games?

We revised sentences referring to emotional suppression and expressivity (page 8, lines 145-147).

How were non-European participants excluded from the Alberta sample – and what definition of “European Canadian” was used to do so? Likewise for study 2, how were non-European Americans defined and how were they excluded?

To explain the detail, we added sentences “The Canadian participants were prescreened based on their self-defined ethnicity” in Study 1 (page 11, lines 217-218) and “The American participants were recruited with filters on self-defined ethnicity (European American) and nationality (American)” in Study 2 (page 16, lines 320-321).

In the general discussion, the authors write that “individuals from Japan display less empathic concern for people in distress. These cultural differences result from the cultural differences in emotional expressivity and cognitive thinking styles. On the one hand, East Asians, with their strong motivation to maintain interpersonal harmony, compared to Westerners, are more cautious about their emotional responses in interpersonal contexts (e.g., [10]). The high tendency to restrain and suppress emotion in daily life may hinder East Asians from empathizing with unfortunate others”. As far as I can see, their studies do not address the claims that I underline, nor do the authors offer any other evidence for these causal inferences. (And what does “more cautious” mean?) Is this claim about all emotions?

As Reviewer 1 pointed out, our argument regarding emotion suppression and expressivity was not appropriate in this context. We thus deleted it in this revision.

The authors note that “compared to Americans, Chinese people are more likely to perceive unfortunates as responsible for and deserving of their misfortune, and they reported less overall sympathy [41]. In Study 2, we also consistently found that, compared to European Americans, Japanese people reported more responsibilities for their own stressors”. To me these results seem completely at odds with the characterization of Chinese or Japanese as ‘collectivist’ and European Americans as ‘individualist’. Individualists should believe that people are individually responsible for what happens to them, while collectivists should believe that misfortunes and stressors are due to the overall circumstances, roles and relationships, not the individual, personally. Indeed, Joan Miller found precisely this contrast between explanations for real events offered by her samples in Chicago and Orissa, India (sorry, I can’t recall the reference – from the 1970’s, I believe). I find that I don’t understand what construct of ‘collectivism’ the authors are using.

As Reviewer 1 pointed out, we admit that this argument on the perception of responsibilities was insufficient. We thus deleted it in this revision.

It seems to me that “turning to others in times of need helps restore one’s sense of belonging” would be especially true, or at least especially prevalent, among ‘collectivists. In any case, if turning to others in times of need helps restore one’s sense of “belonging,” how does belonging differ from a “relationship”? Why does such support-seeking strengthen belonging but threaten relationships?

I reiterate that the authors of this paper operate in a paradigm that I find problematic – I have essentially the same problems with nearly all research in cultural psychology. So an editorial decision to put aside my critique would be reasonable. On the other hand, paradigms only change when they are challenged study by study, method by method, findings by findings.

Given the Reviewer 1’s concern, we deleted the phrase “turning to others in times of need helps restore one’s sense of belonging” in this revision.

Again, thank you for the valuable comments and providing us with a chance to revise our manuscript along them.

Reviewer #2

While this revision fixes minor issues raised in prior reviews, the authors have not done any new analyses to address the problem of cultural differences in scale use, and the results are still stated as if differences on these scales correspond to actual cultural differences. Yet as both R1 and I mentioned in the first round of reviews, there is a lot of evidence that this is not the case. There are techniques the authors could have used to examine this issue (e.g., centering). The results may or may not have been the same. But since they did not conduct such analyses and their explanation in the cover letter for this is not compelling, my recommendation is to reject the paper.

We apologize for our mistake that we failed to address the last point raised by Reviewer 2 in the previous review. In this review, we confirmed that we found the same results even if the scores of all related variables were centering. In this revision, we mentioned explicitly that the scores of all related variables were centering before the mediation analyses (page 13, lines 256-257 and page 19, lines 394-395).

Submitted filename: cover letter plosone_revised2.doc

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16 Dec 2021

Cultural Differences in Social Support Seeking: The Mediating Role of Empathic Concern

PONE-D-20-40124R2

Dear Dr. Zheng,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Additional Editor Comments (optional):

Thanks for the revisions made to the paper. After a careful review, I believe the authors addressed well the remaining comments. Therefore, the paper can be considered as publishable in PLOS ONE.

19 Dec 2021

PONE-D-20-40124R2

Cultural Differences in Social Support Seeking: The Mediating Role of Empathic Concern

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