Life events, number of social relationships, and twelve-month naturalistic course of major depression in a community sample of women

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 buffeting 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 insufficient 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 he made to help depressed patients establish supportive relationships both in the therapeutic environment and in their personal lives. (C) 2002 Wiley-Liss, Inc.