Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses

The extent to which loneliness is a unique risk factor for depressive symptoms was determined in 2 population-based studies of middle-aged to older adults, and the possible causal influences between loneliness and depressive symptoms were examined longitudinally in the 2nd study. In Study 1, a nationally representative sample of persons aged 54 and older completed a telephone interview as part of a study of health and aging. Higher levels of loneliness were associated with more depressive symptoms, net of the effects of age, gender, ethnicity, education, income, marital status, social support, and perceived stress. In Study 2, detailed measures of loneliness, social support, perceived stress, hostility, and demographic characteristics were collected over a 3-year period from a population-based sample of adults ages 50-67 years from Cook County, Illinois. Loneliness was again associated with more depressive symptoms, net of demographic covariates, marital status, social support, hostility, and perceived stress. Latent variable growth models revealed reciprocal influences over time between loneliness and depressive symptomatology. These data suggest that loneliness and depressive symptomatology can act in a synergistic effect to diminish well-being in middle-aged and older adults.     

The relationship of marital satisfaction and social support to depressive symptomatology

The relationship between depressive symptomatology, as measured by the short-form Beck Depression Inventory (BDI), and two social support variables was assessed. Based on a sample of 131 married men and 136 married women, the results indicated that the quality of the marital relationship and the frequency of positive social contact with adults other than the spouse were significantly related to depressive symptomatology for both men and women. These two variables accounted for 16% of the variance in BDI scores. Further, analyses of risk for high BDI scores showed that individuals having the least support were 13 times more likely to be in the high-BDI group than individuals with the highest levels of social support. These results suggest that social isolation and marital discord are related to high BDI scores among married adults.     

Interpersonal factors and perinatal depressive symptomatology in a low-income Latina sample

Interpersonal factors are among the risk factors that predispose women to experiencing mood disturbances during the childbearing years. This study investigates the trajectory of change in depressive symptomatology over the course of the perinatal period as related to interpersonal risk factors (marital quality and social support) in a sample of 69 low-income, mostly immigrant Latina mothers at high and low risk for depression. We found a significant linear change in depressive symptomatology from baseline (pregnancy) through the postpartum period. This decline was steeper for high-risk women who reported high levels of social support compared with those who reported low levels of social support. In addition, a greater decline in depressive symptom scores was found for women who reported better postnatal marital quality, irrespective of risk group status. The results suggest the importance of considering marital quality and social support in estimations of risk for depression. These findings also have implications for targeting social support and marital quality in preventive interventions for perinatal depression in Latinas.     

Positive Events and Social Supports as Buffers of Life Change Stress1

A perceived availability of social support measure (the ISEL) was designed with independent subscales measuring four separate support functions. In a sample of college students, both perceived availability of social support and number of positive events moderated the relationship between negative life stress and depressive and physical symptomatology. In the case of depressive symptoms, the data fit a “buffering” hypothesis pattern, i.e., they suggest that both social support and positive events protect one from the pathogenic effects of high levels of life stress but are relatively unimportant for those with low levels of stress. In the case of physical symptoms, the data only partially support the buffering hypothesis. Particularly, the data suggest that both social support and positive events protect one from the pathogenic effects of high levels of stress but harm those (i.e., are associated with increased symptomatology) with low levels of stress. Further analyses suggest that self-esteem and appraisal support were primarily responsible for the reported interactions between negative life stress and social support. In contrast, frequency of past social support was not an effective life stress buffer in either the case of depressive or physical symptomatology. Moreover, past support frequency was positively related to physical symptoms and unrelated to depressive symptoms, while perceived availability of support was negatively related to depressive symptoms and unrelated to physical symptoms.     

Does differential social support cause sex differences in bereavement outcome?

A study of a sample of bereaved and married individuals tested the prediction from stress theory that sex differences in bereavement outcome are due to differences in social support extended to the bereaved. Previous research had established that compared to same‐sex married controls, widowers suffer greater health deterioration following the death of a spouse than widows. Although there is some evidence that widows receive more social support than widowers, it has never been tested empirically whether differential social support is responsible for the sex difference in bereavement outcome. Two sets of tests were conducted to examine these hypotheses: first, sex differences in bereavement outcome and in the social support perceived by the bereaved were assessed by means of sex×marital status ANOVAs on depressive symptomatology, loneliness and social support; second, an ANCOVA was used to assess whether the marital status×sex interaction on distress was substantially reduced or eliminated when social support was used as a covariate. Although there was evidence of the expected sex differences in bereavement outcome and social support, there was no evidence that social support mediates the sex differences in bereavement outcome. Copyright © 1999 John Wiley & Sons, Ltd.     

Effects of Illness Representation,Perceived Quality of Information Provided by the Health-Care Professional,and Perceived Social Support on Depressive Symptoms of the Caregivers of Children with Leukemia

The present study examined the effects of illness representation, perceived quality of information provided by the health-care professional, and perceived social support on the depressive symptoms of the caregivers of children with leukemia. The sample was composed of 71 caregivers of children with leukemia living in Turkey. The obtained data were analyzed by path analysis. The results show that caregivers of children with leukemia experience higher levels of depressive symptoms when they have negative illness representation and lower levels of depressive symptoms when they perceive higher levels of social support. Moreover, they perceive higher social support when they perceive high quality of information provided by health-care professionals. It can be suggested that intervention programs which aim to increase caregivers’ social support and change their illness representation in a positive way would be helpful for the caregivers showing depressive symptoms.     

Depressive Symptomatology among HIV-Positive Women in the Era of HAART: A Stress and Coping Model

Objective: An enhanced stress and coping model was used to explain depression among HIV-positive women in healthcare and community settings where highly active anti-retroviral treatment (HAART) was commonplace. Method: HIV-infected women in four cities (N=978) were assessed, cross-sectionally, for mental and physical health, stress, social support, and other background factors. Results: Self-reported level of depressive symptomatology was high. Number of physical symptoms, illness intrusiveness, and perceived stress were positively associated with depressed mood, while coping self-efficacy and social support were negatively associated. Stress mediated the effect of health status on depression and coping self-efficacy mediated the effect of psychosocial resources on depression. Our enhanced stress and coping model accounted for 52% of variance in depressive symtpomatology. Conclusions: Interventions focused on improving coping self-efficacy, bolstering social supports, and decreasing stress in the lives of HIV-positive women may help to reduce the negative effects of HIV disease on mood.     

Economic Adversity and Depressive Symptoms in Mothers: Do Marital Status and Perceived Social Support Matter?

Over the past decade there has been increasing interest in the idea that marriage and perhaps other forms of interpersonal support can buffer the negative effects of poverty. The current study tests the hypothesis that marital status, perceived social support and neighborhood collective efficacy can moderate the effects of economic adversity on depressive symptoms among parents. Hierarchical Linear Modeling was used to analyze data from the Project on Human Development in Chicago Neighborhoods. Participants were 1,957 mothers of minor children. Analysis of main effects revealed associations between neighborhood SES (β = ?0.69, SE (0.15), p < .001), family income (β = ?0.11, SE (0.05), p = .02) financial strain (β = 0.51, SE (0.18), p = .004), being single (β = 0.63, SE (0.24), p = .009) and perceived social support (β = ?0.22, SE (0.03), p < .001) on depressive symptoms. The hypothesis that interpersonal resources can buffer the effects of economic adversity was not supported. There were no significant interactions between marital status and economic adversity. There was a significant interaction between perceived social support and neighborhood level socioeconomic status (β = ?0.07, SE (0.03), p = .04) but the effects of social support were weakest in neighborhoods characterized by low socioeconomic status.     

The relationships between negative life events, perceived support in the school environment and depressive symptoms among Norwegian senior high school students: a prospective study

The present study prospectively explored the main and interactive effect of negative life events and social support from teachers and classroom peers on depressive symptoms in a sample of 198 (111 females, 87 males) students in a Norwegian senior high school. In the longitudinal multivariate analyses, self-reported depressive symptom levels at time-point two (T₂) were predicted by initial levels of depressive symptomatology, teacher support, and gender. Support from classroom peers at time-point one (T₁) was not associated with symptoms of depression at (T₂). Multivariate cross-sectional analysis also detected a significant positive association between negative life events and depressive symptoms. Finally, results suggest that perceived teacher support may buffer against negative life events leading to symptoms of depression.     

Presentation of Depression and Response to Group Cognitive Therapy with Older Patients

Concerned with response prediction, this research examines the relationships between pre-treatment components of depressive symptomatology and outcome of short-term group cognitive therapy for depression with older adults. Aspects of depressive symptomatology under examination were initial intensity of self-reported depressive symptomatology, profile of melancholic depression, perceived health status, perceived social support, and intensity of negative view of self. Findings indicate that perceived social support is not related to outcome but that a more intense depressive symptomatology, a more negative health evaluation, and a more negative view of self are variables associated with a less favorable outcome. Despite showing a sizable decrease in depressive symptoms over the course of intervention, severely depressed subjects still presented residual depressive symptoms at the conclusion of intervention. There was a tendency for subjects with a melancholic profile to show a poorer response to this intervention.     

Examining the effects of perceived social support on momentary mood and symptom reports in asthma and arthritis patients

Objective: Social support has been linked to beneficial effects on health directly (main effect) and as a buffer to stress. Most research, however, has examined these relationships using global and retrospective assessments of health and stress, which may be subject to recall biases. This study used ambulatory ecological momentary assessment (EMA) methods to test the main and stress-buffering effects of social support on the daily health and well-being of asthma and rheumatoid arthritis (RA) patients.

Design: Community volunteers with asthma (n?=?97) or RA (n?=?31) responded to EMA prompts five times daily for one week.

Main outcomes: Baseline perceived social support was obtained, and then, participants reported mood, stress and symptoms using EMA. Multilevel mixed-modelling examined whether social support predicted mood and symptoms directly or via stress-reducing effects.

Results: Supporting a main effect, more perceived social support predicted decreased negative mood and stress severity. Supporting a stress-buffering effect, more perceived social support resulted in fewer reported symptoms when stress was present.

Conclusion: Results suggest perceived social support directly relates to better ambulatory status and dynamically buffers individuals against the negative effects of stressors, and highlight the importance of studying social support across different temporal and contextual levels.     

The Relationship Between Marital Satisfaction,Marital Stability,Nuclear Family Triangulation,and Childhood Depression

This study was to examine the effect of triangulation on depression in children. Clinical samples and nonclinical samples were taken from Utah and Illinois. Families were assessed for marital satisfaction and stability, family triangulation, and children's depression levels by the Marital Adjustment Test, Marital Status Inventory, Nuclear Family Triangulation, and Children's Depression Inventory. Results showed children's depressive symptoms to be most strongly linked to fathers' level of marital satisfaction, marital stability, and perceived family triangulation. Mothers' variables did not affect children's depressive symptoms .     

Reviewers for Special Issue

Objective: An enhanced stress and coping model was used to explain depression among HIV‐positive women in healthcare and community settings where highly active anti‐retroviral treatment (HAART) was commonplace. Method: HIV‐infected women in four cities (N=978) were assessed, cross‐sectionally, for mental and physical health, stress, social support, and other background factors. Results: Self‐reported level of depressive symptomatology was high. Number of physical symptoms, illness intrusiveness, and perceived stress were positively associated with depressed mood, while coping self‐efficacy and social support were negatively associated. Stress mediated the effect of health status on depression and coping self‐efficacy mediated the effect of psychosocial resources on depression. Our enhanced stress and coping model accounted for 52% of variance in depressive symtpomatology. Conclusions: Interventions focused on improving coping self‐efficacy, bolstering social supports, and decreasing stress in the lives of HIV‐positive women may help to reduce the negative effects of HIV disease on mood.     

Prospective investigation of postpartum depression: factors involved in onset and recovery

We examined the role of a number of psychosocial variables in the onset of postpartum depression and in recovery from depression that occurs during pregnancy. Women (N = 730) were recruited during pregnancy and were followed through 1 month postpartum. They were assessed on demographic variables and on measures of depressive symptomatology and diagnostic status, perceived stress, marital satisfaction, perceptions of their own parents, dysfunctional cognitions, and coping style. Onset of depression in the postpartum was predicted by the levels during pregnancy of depressive symptomatology and perceived maternal and paternal care during childhood. In contrast, recovery in the postpartum from depression during pregnancy was not predicted by the variables examined in this study. These results are discussed with reference to previous investigations that have examined depression that occurs outside the context of childbirth.     

Contextualizing Health Outcomes: Do Effects of Network Structure Differ for Women and Men?

Although previous research demonstrated that networks matter for health-related outcomes, few studies have investigated the possibility that network effects may differ between women and men. In a multivariate regression analysis of a US sample of 548 hurricane victims, we ask whether effects of network composition, density, and size affect perceived adequacy of social support and depressive symptoms more strongly among women than among men. We find evidence for these moderating effects, for direct effects of density on support adequacy and size on depressive symptoms. Our examination of indirect effects of network structure on depressive symptoms, in the pathway through perceived adequacy of social support, suggests that gender may exert more substantial moderating effects than previous health studies suggest.     

Perceived social support,coping, and symptoms of distress in American and Spanish students

Abstract

The aim of this study was to test whether coping responses mediated the influence of perceived social support on symptoms of anxiety/depression, social withdrawal, and aggressive behavior in American (N=349) and Spanish students (N=437). Participants completed measures of perceived support, social stress, coping, and distress. Coping partially mediated relations between perceived support and distress, with coping mediation most evident in individuals facing high levels of social stress. Decreased use of disengagement coping by individuals with high perceived support appears to partially explain the protective value of perceived social support. Multiple group covariance structure analysis showed that models linking perceived support, coping, and distress were very similar across cultures, suggesting that the mechanisms underlying decreased risk for individuals with high perceived support may be relatively independent of cultural context, and that interventions designed to increase perceived support and decrease disengagement could be appropriate in both cultures.     

Social anxiety and interpersonal stress generation: the moderating role of interpersonal distress

Background and Objectives: Existing models of social anxiety scarcely account for interpersonal stress generation. These models also seldom include interpersonal factors that compound the effects of social anxiety. Given recent findings that two forms of interpersonal distress, perceived burdensomeness and thwarted belongingness, intensify social anxiety and cause interpersonal stress generation, these two constructs may be especially relevant to examining social anxiety and interpersonal stress generation together.

Design: The current study extended prior research by examining the role of social anxiety in the occurrence of negative and positive interpersonal events and evaluated whether interpersonal distress moderated these associations.

Methods: Undergraduate students (N?=?243; M?=?20.46 years; 83% female) completed self-report measures of social anxiety, perceived burdensomeness, and thwarted belongingness, as well as a self-report measure and clinician-rated interview assessing negative and positive interpersonal events that occurred over the past six weeks.

Results: Higher levels of social anxiety were associated only with a higher occurrence of negative interpersonal dependent events, after controlling for depressive symptoms. This relationship was stronger among individuals who also reported higher levels of perceived burdensomeness, but not thwarted belongingness.

Conclusions: It may be important to more strongly consider interpersonal stress generation in models of social anxiety.     

Infertility and Adjustment in Women: The Effects of Attachment Style and Social Support

The moderating effects of two psychological resources—attachment style and perceived social support—on adjustment were studied in 109 infertile women, examining the effects of duration of infertility and of primary (the woman has no child of her own) versus secondary (the woman already has a child of her own) infertility. Subjects were administered questionnaires measuring marital adjustment, psychological distress, and well-being. A model viewing attachment style and social support as moderators between stress psychological well-being was explored. The results showed that among the objective characteristics, only duration of infertility had any impact on the psychological measures. Furthermore, the psychological resources were highly associated with the adjustment scores in general. A hierarchical regression analysis showed that attachment style and social support both were related to marital quality and to psychological well-being and that these two resources function as stress moderators. It was concluded that attachment style and social support are important resources for individuals in times of stress, as exemplified in the infertility situation.     

Latent Class Typologies for Emotional Support Among Midlife and Aging Americans: Evidence from the National Health and Human Nutrition Examination Survey

Using data from 40-year-old and older respondents in the 2007–2008 National Health and Nutrition Examination Study, this study sought to identify variations in emotional support networks among midlife and older adults and examine how those variations were related to depressive symptoms and to perceptions of inadequate support. Latent class analyses were used to identify six typologies of emotional support networks. Typologies were labeled, and multinomial logistic regression was used to examine how membership in typologies was related to variations in depressive symptoms and perceived adequacy of emotional support. The findings indicate that when the focus is emotional support, social support from spouses is related to fewer depressive symptoms and less perceived need for increased emotional support. The results of this study suggest that access to family members, especially spouses, for emotional support is related to fewer depressive symptoms and a decreased probability of reporting inadequate social support. Overall, this study suggests that emotional support networks that include family members, especially spouses, are supportive of older persons’ quality of life.