Quantity of social interactions in MDD

One major characteristic of the interpersonal functioning of individuals while they are experiencing an episode of depression is areduced overall level of social activity. Not only do depressed persons report having fewer people in their social networks than do nondepressed individuals, but they also have less frequent contact with people in their social networks (e.g., Youngren & Lewinsohn, 1980). In addition, compared with nondepressed controls, depressed persons report having fewer social intimates (Gotlib & Lee, 1989) and fewer friends (Brim et al., 1982), and experiencing fewer contacts outside their immediate families (Henderson et al., 1981). Importantly, these findings of reduced levels of social interaction in depression are obtained in studies using both self-report and interview methodologies; moreover, they are corroborated by other informants, such as family members (e.g., Billings etal., 1983; Brim etal., 1982).

It is important to note that this pattern of reduced levels of social activity appears to be a relatively stable characteristic of individuals who are vulnerable to depressive episodes. For example, investigators who have tested depressed individuals both during and after depressive episodes have found that although there was some recovery in the number of social contacts reported by depressed individuals 1 year following their depressive episode, they continued to report restricted social networks even when they were no longer symptomatic (Billings & Moos 1985a, 1985b; Gotlib & Lee, 1989). Moreover, there is strong evidence that depression is associated with such stable characteristics as low assertiveness, social withdrawal, avoidance, and shyness—all traits that have been found to be associated with reduced social activity (Alfano et al., 1994; Anderson & Harvey, 1988). In fact, both the lack of assertiveness (Ball et al., 1994) and the presence of social withdrawal (Boivin et al., 1995) have been found to predict future depression, a pattern of results that suggests that reduced social activity may serve as a risk factor for depression. Although promising, it is clear that more research using prospective designs needs to be conducted before we are able to understand fully the causal nature of the relation between reduced social activity and episodes of depression.

In this context, there are several reasons why depression may be associated with reduced social activity. One possibility is that because depressed persons do not find social activities pleasurable or reinforcing (e.g., Lewinsohn, 1974), they actively curtail or avoid social activity. Another, albeit not mutually exclusive, possibility is that the impetus for reduced social activity comes from the interaction partners of depressed persons. Indeed, it has been postulated that because partners find interacting with a depressed person to be aversive, they ultimately seek to limit further contact with him or her (Coyne, 1976; Gotlib & Robinson, 1982). Regardless of the explanation, it is clear that when depressed persons interact with strangers, friends, or family members, the interactants are often dissatisfied. Therefore, it is clear that it is not simply the quantity, but also the quality of social interactions that is reduced during episodes of depression.

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