The Interpersonal, Cognitive, and Social Nature of Depression

Thomas E. Joiner, Jessica S. Brown, Janet Kistner, Thomas E. Joiner, Jessica S. Brown, Janet Kistner

• Publisher: Routledge
• Year: 2014
• Print ISBN:
  9780805858747
• eBook ISBN:
  9781135606145
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

The true integration of interpersonal, social psychology, and cognitive-behavioral approaches is the most important theoretical issue in the field of the psychology of depression, and yet it has not been well addressed in any forum. The Interpersonal, Cognitive, and Social Nature of Depression was written to provide cutting-edge research and theoretical perspectives on this issue. Its goal is to concretize and celebrate an integrative approach to the understanding of depression, and to foster its sequelae, by bringing together primary figures from interpersonal, cognitive, and behavioral viewpoints for state-of-the-art treatment of the psychology of depression.

In addition, this book provides:

* an integration of these perspectives on depression research to help guide researchers in developing projects;

* up-to-date research findings to help researchers update their knowledge of depression research;

* a detailed review of studies evaluating the effectiveness of cognitive therapy for treatment and prevention of depression;

* focused chapters on issues related to depression in childhood and adolescence; and

* chapters presenting research focusing on both the manic and depressed phases of bipolar disorder.


This text will appeal to a diverse audience from several sources: clinical practitioners, sociology, psychology, psychiatry, researchers, and graduate students in these fields.

Chapter 1

Children’s Peer Acceptance, Perceived Acceptance, and Risk for Depression

Janet Kistner

Florida State University

Understanding the etiology of depression is one of the most important goals of depression researchers. Ingram (2001) went so far as to assert that “the future of depression research is back,” a reference to the importance of investigating characteristics and experiences of childhood as possible causes and contributors to the later development of depression. Prospective longitudinal studies that assess hypothesized childhood precursors of depression are critical for answering some of the most pressing questions about the origins of depression. In the late 1990s and into the 2000s, the number of such studies increased dramatically. Most of these studies focused on contributions of family factors to the origins of depression (cf., Goodman & Gotlib, 1999). This is an important area of study, but relationships outside the family—particularly children’s relationships with peers—also contribute to children’s risk for later psychopath-ology (Parker & Asher, 1987). This chapter focuses on children’s peer acceptance and risk for depression.

A few caveats are in order before proceeding to review research on peer acceptance and depression. First, there is strong consensus that there are multiple causes of depression; low peer acceptance is but one of many possible contributors to the development of depression. Second, the impact of low social acceptance is not specific to depression; low peer acceptance is associated with a wide range of negative outcomes. Nonetheless, studies of prospective associations between peer acceptance in childhood and risk for depression are informative, because of the central role accorded to social acceptance by leading psychosocial theories of depression (e.g., Cole, 1990; Coyne, 1976; Lewinsohn, 1974). Also, the link between children’s perceptions of their acceptance and later depression are pertinent to cognitive theories of depression (e.g., Beck, 1967).

This chapter reviews associations among peer acceptance, perceived acceptance, and depressive symptoms in the period of middle childhood. This is an important age group to target for research on these associations, for several reasons. First, there is growing evidence of increased prevalence of depression in adolescence as well as a decrease in the age of first onset of depression (Lewinsohn, Hops, Roberts, Seeley, & Andrews, 1993; Verhulst, Van Der Ende, Ferdinand, & Kasius, 1997). These statistics underscore the need to identify preadolescents who are at risk for depression, and to increase our understanding of the factors that contribute to the development of depression. Second, establishing positive peer relationships is a developmentally appropriate and important task in middle childhood, and thus is an area of competence that is likely to affect children’s risk for depression. Third, by middle childhood, children’s perceptions of their social acceptance are fairly well established and can be reliably and validly measured. Prior to age 8, children’s self-perceptions tend to be glowingly positive and unrealistic (Harter, 1998). As children’s cognitive abilities develop and they begin to rely on social comparisons to evaluate themselves, self-enhancing biases give way to more realistic self-perceptions. Still, there are individual differences in perceptual discrepancies in middle childhood, just as there are at older ages; the implications of discrepant perceptions are important for understanding the developmental origins of depression.

The emphasis in this chapter is on prospective longitudinal studies that test hypotheses about causal associations among children’s perceived and actual peer acceptance and risk for depression. For the most part, these studies investigate associations between children’s peer acceptance and depressive symptoms rather than clinically diagnosed cases of depression. Although there are differing points of view about generalizing results from research on depressive symptoms in a typical population to clinically diagnosed depression (Benazon & Coyne, 1999; Joiner, Metalsky, Katz, & Beach, 1999a), identifying childhood predictors of increases in depressive symptoms is important for understanding the origins of depression. Three questions pertaining to causal associations among children’s peer relationships and risk for depression are addressed in this chapter: Is low peer acceptance a cause or consequence of depression? What role do children’s perceptions of peer acceptance play in risk for depression? Are negatively biased perceptions of peer acceptance a cause or consequence of children’s depression? Before reviewing the research that bears on these questions, a brief description of the most commonly used measures of peer acceptance is presented.

MEASURES OF CHILDREN’S PEER RELATIONSHIPS

Obtaining reliable and valid measures of how well people are liked by persons with whom they have regular contact is a challenge for researchers, particularly when the focus of research is adults’ social acceptance. It is impractical (and probably objectionable to research participants) to gather information about acceptance from coworkers, friends, and acquaintances. This is likely the reason that researchers have relied on self-report measures of acceptance or laboratory measures of social interactions. Self-report measures are problematic because they fail to distinguish between cognitive distortions and veridical appraisals of acceptance, and the validity of observers’ ratings of brief social interactions with unfamiliar persons in laboratory settings has been challenged (Ackerman & DeRubeis, 1991). Some researchers have responded to these criticisms by gathering information about acceptance from familiar others, such as spouses, college roommates, or close friends, and much has been learned from these studies (e.g., Hammen et al., 1995; Hokanson, Rubert, Welker, Hollander, & Hedeen, 1989). Still, these ratings are typically based on a single informant who is in a unique relationship with the target individual, so the degree to which findings based on these measures generalize to relationships with others is open to question.

One advantage that child researchers have over those that conduct research with adults is the availability of reliable and valid measures of children’s social acceptance by familiar peers (Kupersmidt & Dodge, 2004). Ratings or nominations of acceptance are obtained from peers (typically classmates) or adult informants who are very knowledgeable about children’s acceptance by peers (e.g., parents, teachers). For the rating scale measures, children indicate how much they like to play or spend time with individual peers; comparable measures assess parents’ and teachers’ perceptions of children’s peer acceptance. Nomination measures ask children to identify peers they like most (LM) and those they like least (LL). Nominations may be used as separate indexes of children’s social status among peers or combined to form a single measure of peer acceptance by subtracting standardized LL from LM nominations (often referred to as social preference scores). In addition, classifications based on sociometric nominations have been developed to distinguish between “rejected” children (those who receive high numbers of LL nominations and few or no LM nominations) and “neglected” children (those who receive very few or no nominations of either type). For the purposes of this chapter, peer acceptance refers to individual differences in children’s social acceptance by peers. When distinctions among measures are important for interpreting results across studies reviewed in this chapter, they are noted.

LOW PEER ACCEPTANCE: CAUSE, CONSEQUENCE, OR CORRELATE OF DEPRESSION

There is no question that low peer acceptance is associated with depression, both elevated depressive symptoms and clinically diagnosed depression (for review, see Segrin, 2000). What is not clear is whether this association is a causal one and, if causally linked, what is the direction of the causal flow: Does low acceptance lead to depression, or does depression lead to low acceptance?

In Lewinsohn’s behavioral theory of depression (1974), social skills deficits are viewed as causal antecedents to depression (i.e., persons with social skills deficits are likely to be avoided by others, leading to low rates of social reinforcement, which in turn cause depression). Similarly, Cole (1990, 1991) posited that low social acceptance and other competence deficits causally contribute to depression in childhood. Social acceptance is also central in Coyne’s interactional model of depression (Coyne, 1976). This model argues that interpersonal behaviors of distressed and mildly depressed persons lead to social avoidance and rejection by others. These negative social consequences, in turn, exacerbate depressive symptoms, leading to more severe and chronic depression. Later revisions of Lewinsohn’s behavioral theory of depression also highlight an emphasis on the negative impact of depression on social acceptance (Lewinsohn, Hoberman, Teri, & Hautzinger, 1985). Depressive episodes were hypothesized to leave residual “scars” in the form of disrupted social relationships (Rohde, Lewinsohn, & Seeley, 1990; Zeiss & Lewinsohn, 1988).

Children’s perceptions of their peer acceptance are also important for understanding the origins of depression. In Cole’s model of depression in childhood, low peer acceptance, as well as competence deficits in other domains, increases risk for depression through its impact on children’s self-perceptions. This model posits that negative feedback experienced by children with competence deficits inhibits the emergence and differentiation of positive self-perceptions, and this then predisposes children to become depressed. Self-perceptions also play a central role in cognitive theories of depression (e.g., Beck, 1967), although these theories focus on distorted rather than accurate self-perceptions. Prospective studies of associations among children’s peer acceptance, perceptions of their acceptance, and risk for depression provide ideal opportunities to test hypotheses about whether perceived and/or actual problems of social acceptance are causal antecedents, consequences, or merely correlates of depression.

In a review of research investigating associations between social acceptance and depression, Segrin (2000) concluded that there was little empirical support for causal links. A majority of the longitudinal studies that had been conducted at the time of Segrin’s review failed to support the hypothesis that problematic social interactions predicted changes in depression among adults. Nor was there much support for the hypothesis that depression leads to impaired social acceptance. Based on results of a couple of longitudinal studies of children that were described in that review, Segrin speculated that causal associations between social acceptance and depression might be stronger in childhood. A number of prospective longitudinal studies investigating associations among children’s peer acceptance and depression have been published since Segrin’s review. Results of these studies are reviewed next.

Depression as a Cause of Children’s Low Peer Acceptance

Depressed children tend to elicit negative responses from peers, even when their social contact is limited to brief interactions with unfamiliar peers (e.g., Baker, Milich, & Manolis, 1996; Connolly, Geller, Marton, & Kutcher, 1992; Rudolph, Hammen, & Burge, 1994). For example, Baker et al. (1996) found that girls who were randomly paired to interact with a dysphoric peer were rated as being less happy and less positive toward their partners than were girls who interacted with nondsyphoric peers. These findings are consistent with results of prior research and provide support for the hypothesis that social interactions with depressed children have a negative impact on peers. The concurrent, correlational nature of these studies, however, does not allow one to draw conclusions about a causal link.

Only two prospective studies examined the contribution of depression to later acceptance by familiar peers, controlling for initial acceptance. Cole, Martin, Powers, and Truglio (1996) examined changes in depressive symptoms across a school year for children in Grades 3 and 6. Depressive symptoms at Time 1 did not predict peer acceptance at Time 2, after controlling for peer acceptance at Time 1. Similar results were reported by Nolan, Flynn, and Garber (2003) for a sample of young adolescents (Grades 6–8). Depressive symptoms, assessed via self-and parent reports, did not predict changes in peer rejection over a 3-year interval.

To date, little attention has been given to possible moderators of associations between depression and peer acceptance. Little and Garber (1995) found that predictive associations between depressive symptoms and peer acceptance among fifth and sixth graders were moderated by the level of stress that the children were experiencing. Decrements in children’s peer acceptance were found for children with elevated depressive symptoms at Time 1, but only those who reported few or no stressors. Among children who were experiencing high levels of stress at the start of the study, depression was unrelated to changes in acceptance. This moderating effect of stress on the link between depression and acceptance is consistent with results of an experimental study by Peterson, Mullins, and Ridley-Johnson (1985). Peterson et al. (1985) presented children with videotapes of confederates portraying either a depressed or nondepressed child who was experiencing few or many stressful life events. The children were then asked to rate how much they would like to interact with each confederate. The depressed confederate was more rejected than was the nondepressed confederate, but only in the low-stress condition. The depressed confederate who was depicted as experiencing major stressful events was as accepted as the nondepressed confederate and was significantly more accepted than the depressed confederate in the low-stress condition. These findings suggest that children may have greater tolerance for depressed behaviors of peers if they are experiencing stressful life events.

In addition to greater tolerance of peers, Little and Garber (1995) speculated that the moderating effect of stress on the link between depression and changes in peer acceptance in naturalistic settings may be influenced by other factors. Depressive symptoms may be mor...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Contributors
• Preface
• 1 Children's Peer Acceptance, Perceived Acceptance, and Risk for Depression
• 2 Depression and Romantic Dysfunction During Adolescence
• 3 The Consequences of Adolescent Major Depressive Disorder on Young Adults
• 4 Interpersonal Vulnerability and Depression in Young Women
• 5 Cognitive Vulnerability to Depression: Current Status and Developmental Origins
• 6 Depression and the Response of Others: A Social-Cognitive Interpersonal Process Model
• 7 Cognitive Therapy in the Treatment and Prevention of Depression
• 8 A Polarity-Specific Model of Bipolar Disorder
• Author Index
• Subject Index