Wildes Jennifer E, Harkness Kate L, Simons Anne D
Department of Psychology, 1227 University of Oregon, Eugene, OR 97403-1227, USA.
Depress Anxiety. 2002;16(3):104-13. doi: 10.1002/da.10048.
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 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 be made to help depressed patients establish supportive relationships both in the therapeutic environment and in their personal lives.
研究表明，负面生活事件和社会支持与重度抑郁发作的病程相关。然而，这些变量之间具体的相互关系仍不清楚。本研究在一个社区女性样本中，比较了生活事件、社会关系数量与重度抑郁症自然病程之间关系的两种模型。对32名女性在其重度抑郁发作的索引期（T1）以及1年后（T2）评估其生活事件概况。测量指标包括汉密尔顿抑郁量表、贝克抑郁量表以及生活事件与困难量表。数据分析聚焦于生活事件和社会关系是抑郁症状的独立预测因素（即“主效应”模型），还是社会关系调节了生活事件对参与者重度抑郁发作自然病程的影响（即“压力缓冲”模型）。结果仅部分支持主效应模型，且未能支持生活事件、社会关系与自然抑郁病程之间关系的缓冲模型。特别是，目前的研究结果表明，社会关系数量比生活事件更能显著预测自然抑郁病程。这些发现表明，社会支持不足是抑郁症状加重的一个特别强的前瞻性预测因素。确定患者社会支持网络的质量应成为临床评估的常规部分，并且应努力帮助抑郁症患者在治疗环境和个人生活中建立支持性的关系。
