Clinical depression and day-to-day social interaction in a community sample

Journal of Consulting and Clinical Psychology, 1997

This article examined marital interactions in 50 couples with a depressed husband, 41 couples with a depressed wife, and 50 nondepressed control couples. As expected, couples with a depressed partner evidenced more disturbed marital interaction than control couples. Furthermore, couples with a depressed wife demonstrated less positive communication than couples with a depressed husband, notwithstanding the fact the depressed husbands exhibited greater depression severity than depressed wives. Findings are integrated with recent research on gender differences in affective expression. Various studies have examined the social interactions of depressed individuals on the basis of the contention that the development and maintenance of depression are intricately linked to one's interpersonal context. Results from these efforts have indicated that the interpersonal relations of depressed individuals reflect markedly negative social interactions (Jacobson & Anderson, 1982), social skill impairments (Mandal, 1986), cognitive interpretation biases , and overall social support decrements . Of particular interest, marital distress and low spousal support have been found to be predictive of depression onset , maintenance (Goering, Lancee, & Freeman, 1992), and relapse (Hooley & Teasdale, 1989). Although considerable progress has been made in understanding the interpersonal concomitants of depression (be they correlates, causes, or consequences), various areas remain relatively unexplored . Of primary importance, the vast majority of published studies have been conducted with female depressed participants, and little is known about how gender may influence the relationship between depression and marital interaction. Although several causal pathways may link depression and marital interaction (Bums, Sayers, & Moras, 1994), extant models assume that there are identifiable patterns of marital interaction that are reliably and uniquely associated with depression. In support of this assumption, several studies have described distinct patterns of marital interaction associated with depression. Hinchcliffe, Hooper, and Roberts (1978), for example, reported that depressed inpatients were socially responsive when interacting with strangers but were more tense, negative, and self-preoccupied when communicating with their spouses. A1-

Depression and Anxiety, 2002

Research suggests that negative life events and social support are associated with the course of major depressive episodes. However, the manner in which these variables may be specifically interrelated remains unclear. The present study compared two models of the relation among life events, number of social relationships, and the naturalistic course of major depression in a community sample of women. The life event profiles of 32 women were assessed during their index episode of major depression (T1) and again 1 year later (T2). Measures included the Hamilton Depression Rating Scale, the Beck Depression Inventory, and the Life Events and Difficulties Schedule. Data analysis focused on whether life events and social relationships were independent predictors of depressive symptomatology (i.e., ''main effects'' model) or whether social relationships moderated the influence of life events on the naturalistic course of participants' major depressive episodes (i.e., ''stress buffering'' model). The results only partially supported the main effects model and failed to support the buffering model of the relation among life events, social relationships, and naturalistic depression course. In particular, the present findings indicated that number of social relationships was a significantly stronger predictor of naturalistic depression course than were life events. These findings suggest that insuf ficient social support is a particularly strong prospective predictor of elevated depressive symptomatology. Determining the quality of patients' social support networks should be a regular part of clinical assessment, and efforts should be made to help depressed patients establish supportive relationships both in the therapeutic environment and in their personal lives. Depression and Anxiety 16:104-113

Supportive social relationships can help protect against depression, but few studies have examined how social relationships influence the response to depression treatment. We examined longitudinal associations between the availability of social relationships and depression severity following a 12-week intervention. In total, 946 adults aged 18–71 years with mild-to-moderate depression were recruited from primary care centres across Sweden and treated for 12 weeks. The interventions included internet-based cognitive behavioural therapy (ICBT), ‘usual care’ (CBT or supportive counselling) and exercise. The primary outcome was the change in depression severity. The availability of social relationships were self-rated and based on the Interview Schedule for Social Interaction (ISSI). Prospective associations were explored using and logistic regression models. Participants with greater access to supportive social relationships reported larger improvements in depression compared to those with ‘low’ availability of relationships (β= −3.95, 95% CI= −5.49, −2.41, p < .01). Binary logistic models indicated a significantly better ‘treatment response’ (50% score reduction) in those reporting high compared to low availability of relationships (OR= 2.17, 95% CI= 1.40, 3.36, p < .01). Neither gender nor the type of treatment received moderated these effects. In conclusion, social relationships appear to play a key role in recovery from depression.

Journal of Affective Disorders, 2002

Background: The study explored the generality of interpersonal impairments in depressed women and examined the extent of their independence of current depressive episodes or symptoms.

Objective: Social relations have become the focus of much research attention when studying depressive symptoms in older adults. Research indicates that social support and being embedded in a network may reduce the risk for depression. The aim of the review was to analyze the association of social relations and depression in older adults. Methods: Electronic databases were searched systematically for potentially relevant articles published from January 2000 to December 2012. Thirty-seven studies met the inclusion criteria for this review. Results: Factors of social relations were categorized into 12 domains. Factors regarding the qualitative aspects of social relations seem to be more consistent among studies and therefore provide more explicit results. Thus, social support, quality of relations, and presence of confidants were identified as factors of social relations significantly associated with depression. The quantitative aspects of social relations seem to be more inconsistent. Cultural differences become most obvious in terms of the quantitative aspects of social relations. Conclusion: Despite the inconsistent results and the methodological limitations of the studies, this review identified a number of factors of social relations that are significantly associated with depression. The review indicates that it is needful to investigate social relations in all their complexity and not reduce them to one dimension. Simultaneously, it is important to conduct longitudinal studies because studies with cross-sectional design do not allow us to draw conclusions on causality. Beyond that, cultural differences need to be considered.

American Journal of Community Psychology, 1990

Research on the association between social relationships and emotional functioning has emphasized the health-promoting effects of social support. Yet there is reason to believe that the absence of negative social interactions may be more important for mental health than the presence of supportive interactions. In this investigation we clarify important characteristics concerning the source, the recipient, and the combined influence of support and negativity. Data are presented regarding supportive and negative interactions with spouse, relatives, and friends; regression analyses suggest that negative interactions are more predictive of depressed mood than supportive interactions (specifically with spouse and friends). We also document several specifications suggesting directions for future research on the special importance of interactions in intimate relationships and the synergistic effects of situations in which supportive and negative interactions both occur.

The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 1998

Few investigations of the social correlates of depressive symptomatology have addressed variation in the correlates across multiple dimensions of depression scales. We examined the relationships of selected social, clinical, and demographic correlates with four dimensions of the Center for Epidemiologic Studies-Depression (CES-D) scale in 3,401 community-dwelling elders in the Piedmont area of North Carolina. These correlates explained significant variation in somatic complaints and depressed affect; effects of chronic disability and recent negative events were particularly robust. Having a confidant explained reduced symptomatology for all four dimensions, but particularly for low positive affect and interpersonal problems. Positive affect was also buttressed by helping others. These patterns have particular relevance where treatment for depression is divorced from considerations of the social environment of the elderly patient. M OST studies of the social correlates of depressive symptoms do not take into consideration the multidimensionality of depressive symptom scales. This study uses George's (1996) multistage conceptual model of the social precursors of mood impairment to examine the differential relationships between social factors and four dimensions of depressive symptomatology and to suggest implications of those differences for research and clinical practice. Factor analyses of a number of depression rating scales have repeatedly demonstrated the multidimensionality of mood states. Radloff (1977) reported a four-factor structure for the Center for Epidemiologic Studies Depression (CES-D) Scale. The four factors included depressed affect (dysphoria), low positive affect (lack of well-being), somatic complaints (retarded activity or enervation), and interpersonal problems. This first-order structure has been generally confirmed by subsequent analyses (e.g.

Journal of Counseling Psychology, 2009

Journal of Clinical Psychology, 2007

Although patients with mood disorders report interpersonal difficulties in addition to depression or anxiety, few studies have examined interpersonal patterns in those patients. Here the authors' goals were to (a) identify the interpersonal pattern in patients with major depressive disorder (MDD), (b) determine interpersonal differences between subgroups of MDD patients, and (c) examine the interpersonal patterns of comorbid MDD patients. Onehundred forty-one MDD adults participated in an ongoing randomized clinical trial of treatments for depression. Interpersonal profiles revealed that MDD patients were significantly more distressed by interpersonal problems than normative samples. Furthermore, MDD patients with depressive personality disorder reported more interpersonal distress than MDD-only patients report and were more likely to have interpersonal problems related to dominance and control than submissiveness.

Journal of Abnormal Psychology, 1982

A recently proposed model of depression has underscored the importance of considering the role of significant others in the etiology and maintenance of this disorder. The present study was designed to examine the behavior, mood, and perceptions of individuals interacting with depressed persons. Forty nondepressed female subjects participated in dyadic interactions with 20 depressed and 20 nondepressed target individuals. All subjects and target individuals were college students. Following the interaction, subjects who spoke with depressed target individuals did not differ from subjects who interacted with nondepressed target individuals with respect to either self-reported mood or willingness to engage in further contact with their partners. However, a number of group differences in both nonverbal and verbal behavior were found when videotapes of the interactions were rated by observers. More specifically, subjects who interacted with depressed targets smiled less often, demonstrated less arousal and pleasantness in their facial expressions, talked about less positive and more negative content in their conversations, and made fewer statements of direct support to the target individuals. Furthermore, several of these differences were found to exist from . the first 3 minutes of interaction. Subsequent analyses of the verbal and nonverbal behavior of the target individuals revealed that the depressed target individuals offered fewer statements of direct support to their partners and talked about more negative content in their interactions. In addition, several differences in nonverbal behavior between the two groups of target individuals were obtained, and a number of these differences, too, were found to be present in the first 3 minutes of interaction. Implications of these findings for the conceptualization and treatment of depression are discussed, and a number of directions for future research are advanced.