Quality of social interactions in MDD

Depressed persons report lower quality in a wide variety of social relationships relative to nondepressed persons. These differences appear to be pervasive and are observed when depressed individuals report on their relationships with their parents (Gotlib et al., 1988), their spouses (Whisman, 2001), their friends (Gotlib & Lee, 1989), or their children (Goodman et al., 1994). Moreover, evidence indicates that these differences are veridical, and not the simple result of a negative reporting bias in depression (Gotlib et al., 1988; Gotlib & Lee, 1989).

Not surprisingly, therefore, a significant body of literature has examined impairments in the quality of social interactions in depression. For example, early behavioral formulations of depression viewed depression as resulting from a lack of environmental reinforcement (e.g., Lewinsohn, 1974). According to this perspective, depressed persons lack the skills that are critical in eliciting reinforcement from others in social situations. Subsequent studies have demonstrated that, in both dyadic and group interactions with strangers, depressed individuals do indeed exhibit a number of behaviors that are indicative of social-skill deficits. For example, when engaging in conversation, depressed individuals have been found to smile less frequently than do nondepressed individuals (Gotlib, 1982; Gotlib & Robinson, 1982). Compared with nondepressed controls, depressed persons tend to make less eye contact with those with whom they are interacting (Gotlib, 1982); they speak more slowly and more monotonously (Gotlib & Robinson, 1982; Libet & Lewinsohn, 1973; Youngren & Lewinsohn, 1980), and with less volume and voice modulation; and they have longer pauses in their speech patterns, and take longer to respond when someone else addresses them

(e.g., Talavera et al., 1994; Teasdale et al., 1980; Youngren & Lewinsohn, 1980). Depressed individuals also take longer to respond to others in a conversation and offer responses that are inappropriately timed (Gotlib & Robinson, 1982; Jacobson & Anderson, 1982; Libet & Lewinsohn, 1973). They are also more self-centered in the interactions and tend to direct the conversations to negative content, often communicating themes of self-devaluation and helplessness (Biglan et al., 1985; Hokanson et al., 1980). Understandably, as a result of these behaviors, many individuals will express a desire to withdraw from interactions with depressed partners (Segrin, 2000).

While these effects are clearly observable in interactions of depressed individuals with strangers, it is apparent that depression affects meaningful social relationships to a greater extent than it does more superficial relationships. For example, Segrin and Flora (1998) found that depressed individuals were more likely to disclose negative topics when talking with a friend than when talking with a stranger. Perhaps the most dramatic effects, however, are found in the marital relationships of depressed persons. Beach and Jones (2002) present considerable data indicating that the marital interactions of depressed persons are characterized by high levels of anger, conflict, and negative affect. Depressed spouses have been found to derogate themselves and their partners, and both spouses escalate their negative affect and behaviors over the course of the interactions. Interestingly, expressions of sad affect in the depressed spouse appear to have the effect of suppressing anger and aggression in the partner, suggesting that depression may play a functional albeit maladaptive role in the marriage (e.g., Hops et al., 1987). With respect to their children, depressed individuals report that they find it difficult to be warm and consistent parents, that they do not derive satisfaction from their children, and that they feel inadequate in their parenting role (Goodman et al., 1994). Consistent with these self-reports, in interactions with their children depressed mothers display sad and irritable affect (e.g., Cohn et al., 1990), and are either unresponsive or intrusive (see Gotlib & Goodman, 1999, for a more detailed review of this literature). Interestingly, depressed individuals report experiencing their own relationships with their parents as children as being relatively low in quality, and characterize their parents as being cold and overprotective (Gotlib et al., 1988). These findings suggest that later problems in relating to significant others may be a consequence of earlier attachment difficulties.

In sum, there is evidence that depressed persons have difficulties in their relationships with both intimates and nonintimates, and are generally less engaged in social activity. Undoubtedly, these patterns of problematic interpersonal functioning are complex and stem from a number of sources. However, a number of recent findings increasingly point to the possibility that disturbances in emotion processing can explain several aspects of dysfunctional social behavior in this disorder. To clarify the role that emotion plays in depressed persons' social dysfunction, we now briefly review the emerging literature on emotional functioning in depression.

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