In this paper, several issues in the study of social support are discussed. Although there are several different approaches to defining the concept of social support, social support measures may be divided into two categories: structural and functional. Structural support includes size, density or linkage among the network members, marital status, and other demographic indices. Functional component of social support is defined as an individual's perception of the availability of support and of the resources provided. As the concept of social support is broad, it is difficult to find one measure that covers all aspects of social support, or is suitable for all types of studies. It is highly recommended to develop a reliable measurement scale for social support which is applicable to Japanese population.
Two models of disease causation have been proposed, one in which social networks and support are seen as buffers (buffer hypothesis), and another in which lack of social ties and support are seen as potent stressors (main effect hypothesis). Studies of structural support tends to find evidence for the main effects, and studies of functional support often find evidence for buffering effect. However, physiological mechanisms through which social support affects the development of, trigger of, and recovery from disease are not fully clarified. It is important to introduce more precise measures of social support and to use reliable psychological or biological measures.
Research activity should be expanded from cardiovascular disease to other chronic diseases, from men to women, from adult to children or elderly, which will enrich the findings in social support research.

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Evidence-Based Medicine (EBM) is one of the clinical problem solving methods. EBM has two major characteristic. One is that it begins and ends with patients and the another is that the process is based behavioral science. In EBM, its process consists of the four steps as follows: 1. formulation of a clinical question of patients, 2. searching and selection for evidence, 3. critical appraisal for evidence, 4. application of evidence to patients.
It is important that EBM is not the way of thinking but the way of behavior. IN EBM, substance of learning for clinical problem solving is how doctors study or behave. Therefor the better patients' management could be realized by modification of doctor's behavior. I think that this point is the most significant in EBM.

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In order to investigate a possible link between smoking habit and cardiovascular stress responsiveness, the cardiovascular and affective responses to a cognitive problem solving task (Raven's matrix test) as the mental stress test were compared between non-smoking healthy young men (N=16) and regular smokers randomized to overnight abstinence (N=14) and to smoking 30 minutes prior to testing conditions (N=17). Subjects in the overnight abstinent condition were associated with reduced diastolic blood pressure at rest and with enhanced diastolic pressure and emotional responses to the task, as compared with subjects in the non-smoking and smoking 30 minutes prior to testing conditions. Recent smokers showed significant elevated heart rates when compared with the non-smokers and abstinent subjects, but did not differ from these groups in blood pressure responses. The behavioral performance of the abstinent subjects was impaired, and their smoking craving was greater than that of recent smokers. Both groups of smokers reported more dysphoric mood than non-smokers, and showed only limited recovery of emotional equilibrium following tests. These results indicate that habitual smoking affects cardiovascular stress responsiveness, and these stress-induced changes in blood pressure and heart rate are dependent on smoking recency or temporally abstinence for regular smokers. The results are discussed in relation to mechanisms linking among smoking, stress responsiveness and cardiovascular disease risk.

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The purposes of this study were to develop a scale which measures multiple psychological stress responses simply and easily, and to investigate its reliability and validity. First, Stress Response Scale-18 (SRS-18) was developed. Subjects were 3,841 males and females (1,316 high school students, 1,206 undergraduate students, and 1,329 adults). As a result of factor analysis, it was revealed that the scale included following three factors: “Depression-Anxiety”, “Irritability-Anger”, and “Helplessness”. Each factor included six items. The reliability of SRS-18 were investigated by Cronbach's α, test-retest method, and Spearman-Brown's coefficient.
Second, the validity of SRS-18 was investigated through content validity, discriminant validity between high and low stressed subjects, and discriminant validity between clinical and nonclinical subjects. The results of this study indicated that SRS-18 had high reliability and validity.
Finally, the application of SRS-18 in clinical and nonclinical settings was discussed from the viewpoint of stress management.

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The author observed an alteration of behavior in a 37 years-old, male patient with schizophrenia. Though the patient had not severe disturbance of thought, he neglected taking medicines in spite of every psychotherapeutic effort of the medical staff. Then, the staff made all of the other patients of his room taken medicines in the room at the same time. 3 weeks after the continuous managements, the patient came to take medicines of himself.
The considerations to this case were as follows:
1) The patient recognized the other patients belonging to a group when he saw they took medicines in the room at the same time. 2) He came to take medicines, because he wanted to take part in the group. 3) Presentation of a complete conduct produces recognition of a group, and belonging to a group is preferred. These will be general and fundamental points even in us.

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