Social
support as a protective factor against depressive symptoms: A review
Anamika Modi Jain1,
Dr. Meeta Jha2
Psychometric
laboratory, School of Studies in Psychology, Pt. Ravishankar Shukla University,
Raipur, Chhattisgarh.
anamikamodi.28@gmail.com
Abstract
INTRODUCTION – Social
support means having friends and other people, including family, to turn to in
times of need or crisis to give you a broader focus and positive self-image. Friend
ships and other people, especially family, may provide you with a larger focus
and a positive self-image in times of need or disaster. Social support improves
one's quality of life and acts as a protective shield against adversity.
Family, friends, coworkers, and others can provide you with physical and
emotional assistance in the form of social support. It knows that you're part
of a community that loves and cares for you, values you, and admires you.
Social support enhances students'
self-esteem, which, in turn, promotes their academic achievement and
relieves their emotional exhaustion. Studies have also shown that family
support can effectively help
students cope with difficult situations, reduce mental stress, and
prevent mental health problems, thereby maintaining their mental health
development (Chang et al., 2020).
METHOD-A
comprehensive systematic search of published literature and journal articles from
Google Scholar, Pub Med, MEDLINE and EBSCO was taken. Search strategy specific
to each data repository was used. During initial search 528 titles were
retrieved and finally 30 empirical researches were selected based on the
inclusion criteria.
RESULT –Total 30 articles were selected and resulted that the theoretical
efforts have also been conducted to explore the relation between social support
and depression.
CONCLUSION-The conclusion drawn from the review depicted that
perceived social support from family and friends were significantly related to
lower depressive symptoms. Social support was found to be more protective
against depressive symptoms.
Keywords –
Social support, College students, Depression
1.
Introduction
Social support is
the physical emotional comfort given to us, by our family, friends, co-workers
and others. It knows that we are part of a community of people who love and
care for us, and value and think well of us. We all need people we can depend
on during both the good times and the bad. Maintaining a healthy social support
network is hard work and something that requires ongoing effort over time.
Social support is
the belief and reality that one is cared for,
has help to be had from different persons, and that one is part
of a supportive social group. Those supportive resources may
be emotional, tangible, informational or companionship. Social support can
be measured as the perception that one has help,
actual received help, or the degree to which someone is included in
a social community. Help can come from many sources, inclusive
of circle of relatives, friends, pets, businesses,
coworkers, and so on. Social support has been studied across a huge range of
disciplines which include psychology, diagnostics, sociology,
nursing, public health and social work. Though,
Social support has been linked to many advantages for both
physical and intellectual fitness.
Two foremost models were proposed to
describe link among social support and health the
buffering assumption and the direct outcomes assumption
(Wills1991). Gender and cultural differences in
social support have additionally been observed. Social support systems are
vital part
of our
life. Those systems consist of all people we consider
and can go
to for help, recommendation, or some other sort of emotional help.
Social support system may be made from friends and family
contributors people you support each have their
own social support systems which can include, you, their direct assist professional, family
members, friends, healthcare providers, co workers, Social workers, teachers, regional center staff, all
of whom
they trust. Social support can be classified and assessed in numerous ways.
There are four general functions of social support. (Wills, 1991, Wills, 1985 and Uchino 2004).
2.
Objective
To review
systematically the characteristics of social support associated with protection
from depression among college students.
3.
Methodology:
3.1. Search strategy methods:
The depression was selected as the
area of interest and a search was conducted on online database. Google scholar,
Pub Med, MEDLINE, EBSCO to retrieve quantitative research article published
from 2003-2020 and the search was confined to only English language. The search
terms used “Social support and depression”, depressive conditions” depression
among college students and those terms were searched both in the title and in
the abstract. We included original research, prevalence and
associated characteristics of depression in general in both community and
primary care settings.
3.2. Search strategy:
Factors affecting depression among college students
[All Fields] "depression [Mesh] AND "College students"[Mesh])
AND "minor depression"[Mesh]) AND “early Adulthood"[Mesh]) AND
"Social support and depression” [Mesh].
3.3. Types of studies:
Quantitative study, Cross sectional study and
longitudinal study.
3.4. Type of participants:
College
students / early adult / late adolescents, above residing in rural and urban
area.
3.5. Settings:
Rural area, urban area and studying in college
and university.
3.6. Outcome:
The narrative review shows that social support
as the protective factor of depression was very common among the college
students and late adolescence or early adult stage, among college students and
social support as protective factor against depression.
3.7. Delivery of Intervention:
This narrative review was predetermined with
the exploration of reviews related to the topic “Social support as a protective factor against depressive symptoms: A
review” the search begins with the keywords. Online databases which were
used for the exploration of review were Google scholar, Pub Med from the year
2001-2019. The search was confined to only English language other was excluded.
Those phrases were searched both within the name and inside the abstract. We
protected authentic researches (Observational and epidemiological studies)
occurrence and related characteristics of youngster and social support and
depression in younger population in both community and primary health care
settings. Bibliography of retrieved papers changed into examined. 528 papers
have been considered. 30 studies have been selected as they had been population
based research analyzing social support and depression in well known
population. The remaining 498 papers
were disqualified because of numerous reasons: the kind of paper; research of
the psychometric properties of instruments, records excluded due to exceed
limitation of the year, restrict to
particular age ranges, evaluation of interventions.
4.
Results:
|
Researcher Name /Year
|
Objectives of the Study
|
Study Design
|
Study Site
|
Sample Size
|
Sampling Technique
|
Measures used
|
Conclusion
|
|
Kaltiala-Heino, (2001)
|
To study socio-demographic
determinants of depression and the role of perceived social support.
|
Cross
sectional
|
Finland
|
16464
adolescents aged 14-16
|
Random
|
Finnish modification of the
13-item BDI. And PSSS
|
Perceived lack of social support
increased depressive symptoms. Depression in both genders was linked to
family structure. Among girls, depression correlated to parental education.
|
|
Stice, Ragan, and Randall, (2004)
|
The perceived social support
deficit was expected to increase depression.
|
Longitudinal
study
|
|
496
girls age range 11-15
|
|
Network of Relationships Inventory
(Furman, 1996)
|
Perceived social support decreased
the risk for depression but suggested that this effect may be specific to
parental support during early adolescence.
|
|
Mansour and Dawani (2008)
|
Examined the relationship between
perception of social support and perceived stress
|
Cross
sectional
|
Jordan
|
241
university students
|
Random
|
Self-report questionnaires
including the perceived social support scale and perceived stress scale.
|
Perceived stress had a negative
correlation with perceived social support from family. The perceived social
support from family was a better predictor of perceived life event as
stressful situations than perceived social support from friends
|
|
Hefner and Eisenberg (2009)
|
Evaluated the relationship between
mental health and social support.
|
Web
based survey
|
Midwestern,
America
|
1378
students response rate 57%
|
Random
|
MSPSS
|
Found that students with lower
quality social support were more likely to experience mental health problems.
|
|
Talaei, Fayyazi and Ardani (2009)
|
Investigated the correlation
between depression and level of social support and self-esteem
|
Cross
sectional
|
Iran
|
1200
University students age ranged 25-29
|
Multi stage Random
|
BDI and Cassidy social support
scale were used to the asses variables
|
Social support and self esteem
were negatively associated with depression 57.2% of the participants had
depression, among those 36.3% had mild, 14.4% moderate and 6.5% had severe
depression.
|
|
Safree , Yasin and Dzulkifli
(2010)
|
To examine the relationship
between social support and psychological problems depression, anxiety, and stress.
|
Cross
sectional
|
Malaysia
|
120
students
|
Purposive
sampling
|
SSB scale, DASS
|
Revealed
that there were significant negative relationship between social support and
psychological problems suggesting that
higher the social support, lower the psychological problem
|
|
Simon and Barrett (2010)
|
To see the relationship between no
marital intimate (partner support or romantic) relation of male and female
and mental health
|
Cross
sectional
|
Miami,
Florida
|
1,683 Young Adults , age range 18-23
|
Random
|
CES-D; Radloff 1977).
|
Current involvements and recent
breakups were more closely associated with women’s than men’s mental health;
support and strain in an ongoing relationship were more closely associated
with men’s than women’s emotional well-being.
|
|
Tajallia, sobhib and
Ganbaripanahab (2010)
|
Identifying relationship between
daily hassles, social supports and mental health
|
Cross
sectional
|
Tehran
Islamic Azad University,
|
262
students
|
Random
|
Fleming social support Test (1982)
and Goldberg GHQ (1972)
|
Daily hassles and mental health of
university Students showed significant relation.
|
|
Auerbach, (2011), Canada
|
Goal of the current study was to examine the
relationship amongst social support, stress, and depressive symptoms
|
Longitudinal
study
|
Canada
|
258
adolescents
|
Random
|
CES-D Scale (Radloff 1977),
Multidimensional Anxiety Scale for Children Short Form (March 1997),
Adolescent Life Event Questionnaire Revise (Hankin and Abramson 2002), and
the SSS for Children and Adolescents (Harter 1985).
|
Low parental and classmate support
may play a greater role in contributing to adolescent depression as compared
to deficits in peer support.
|
|
Grav ,Hellzèn , Romild and Stordal (2011)
|
Association between perceived
social support and depression in a general population in relation to gender
and age.
|
Cross
sectional survey
|
Norway
|
40659
male and females age range 20-89.
|
Random
|
Self-rated perceived functional
social support and Hospital Anxiety and Depression Scale.
|
Social support was associated with
depression; men have a preference of tangible support where as women
preference of more emotional support.
|
|
Tahmasbipoura and
Taheri (2012)
|
Relationship between social
support, mental health
|
Cross
sectional
|
Shahid
Rajaee University
|
1242
university students
|
Random
|
GHQ-28 questionnaire and social
support scale (Stanford social scale)
|
Students with high social support
had high mental health. Social support and mental health have significant and
positive relationship
|
|
Mendieta et al.
(2013)
|
To investigate the association
between social support, loneliness and wellbeing.
|
Cross
sectional
|
Spain
|
2042
participant
|
Random
|
Questionnaire on the frequency of
and satisfaction with social support (Hombrados Mendieta et al. 2012)
|
Emotional support was significantly more
effective in reducing loneliness and increased well-being; that partner
support, family support, and support from friends, respectively,
significantly decreased romantic loneliness, family loneliness, and social loneliness.
|
|
Ramezankhani et al. (2013)
|
Investigated the relationship
between perceived social support, depression and perceived stress in
university students.
|
Cross
sectional
|
Iran
|
390
university students
|
Random
|
MSPSS and BDI
|
Present study revealed a significant
relationship between perceived social support and depression, that is
individuals receiving less social support, reported higher depression. 22.1% suffered
from mild depression 23.3% moderate depression, 4.4% severe depression.
|
|
Barger et al.
(2014 )
|
To examine quality and quantity of
social relationships are associated with depression
|
Cross
sectional
|
Switzerland
|
12,286
Adults
|
Random
|
A telephone systemic interview
(CIDI) was used to measure severe depression, while a postal survey was used
to evaluate depressive symptoms and social support dimensions.
|
Significant depression and
depressive symptoms were linked to the perceived consistency and duration of
social supports. Psychological well-being was related to a wide variety of
social support dimensions.
|
|
Colman, (2014)
|
The aim of this research was to
find variables that protect against the development or incidence of
depression in early adulthood, as well as their experiences with stressors during
this period.
|
Longitudinal
study
|
Canada
|
N
= 1,137 Age range 16-17
|
Random
|
CIDI-SF: 9 items; Past-year; Major
depressive
|
High
levels of competence in adolescent were related to a lower risk of depression
in early adulthood. When compared to those with low social support in
adolescent, those with high social support were slightly less likely to
become depressed. Physical exercise in adolescence was related to a lower
risk of depression
|
|
Bartha, Hofmanna and Schoria
(2014)
|
To evaluate the frequency of
various forms of depression and their ties to education, material and social
capital, and job/school satisfaction.
|
Cross
sectional
|
Switzerland
|
9,066
males aged between 18 and 25 years
|
Random
|
PHQ-9
|
Prevalence of depression was 3.60%
and 3.62% for sub-threshold. It reported that low social support and low
satisfaction with social relation increased the depressive symptoms.
|
|
Wang, Cai, Qian and Peng (2014)
|
To see thatSocial support has a moderating
impact on the relationship between stress and depression in university
students.
|
Cross
sectional
|
Chongqing
city China
|
632
under graduate students 315 female and 317 male, age range 18-22.
|
Random
|
PSS Scale, Self rating depression
scale. (Correlation analysis, Hierarchical regression )
|
Prevalence of depression was
18.7%.Social support moderated the correlation between stress and depression,
according to hierarchical regression analysis. Undergraduate students who
were under a lot of stress and had a poor degree of social support had higher
depression levels than students who were under a lot of stress and had a lot
of social support.
|
|
Singh and Singh (2015)
|
To investigate the effect of
parental bonding and social support on depression among adolescents
|
Cross
Sectional
|
India
|
160
Adolescents, Age range 14-19.
|
Random
|
Reynolds ADS (William Reynolds,
2002) and SSQ (Sarason, Levine, Basham and Sarason, 1983).
|
It was found that social support,
father care and mother care were negatively contributing to adolescent
depression.
|
|
Du, King and Chu (2015)
|
To investigate connections among
hope, social support, and depression.
|
Correlation study
|
Hong
Kong
|
384
Adolescents age rang 12-18
|
Random
|
Children’s Hope Scale (Snyder et
al., 1997). SS Scale (Zimet, Dahlem, Zimet and Farley, 1988), Rosenberg
self-esteem scale (Rosenberg, 1965), CES-D; Andresen, Malmgren, Carter and
Patrick, 1994; Radloff, 1977)
|
Hope and social support were
associated with higher levels of personal and relational self-esteem, which
were in turn related to decreased levels of depression.
|
|
Kugbey, Boadi and Atefoe (2015)
|
Examined the impact of social
support from family, friends and significant others on the levels of
depression,
|
Cross
Sectional
|
Ghana
|
165
university students
|
Random
|
MSPSS. (Zimet, Dahlem, Zimet and
Farley, 1988, DASS-21
|
Level of depression was
significantly predicted by support from friends and others.
13.9% mild, 20.6% moderate,
7.3% severe,
15.3% extremely severe.
|
|
Zhang, Yan,
Zhao and Youan (2014)
|
The association between perceived
stress and depression was moderated by social support.
|
Cross
sectional
|
East
Asian Country
|
1674
|
Random
|
CES-D Scale and The perceived
social support scale
|
The moderating effect of friend
support between perceived stress and depression was found.
|
|
Dafaalla et al. (2016)
|
Find out how common depression is,
and what role social support and quality of life can play in the development
of depression, anxiety, and stress.
|
Cross
sectional
|
Sudan
|
487
medical Students
|
Clustered
random sampling
|
MOS social support survey, DASS21
|
Only the positive social
interaction domain and depression were found to have a significant
relationship. 21% of students were depressed to a moderate degree.
|
|
Jayanti and Thirunavukarasu (2016)
|
To examine the relationship
between perceived social support and depression among adolescent.
|
Case
control study
|
India,
Tamil Nadu.
|
1120
Adolescent
|
Random
|
BDI and MSPSS
|
Adolescents with insufficient
perceived social support have a 1.9 times higher risk of experiencing
depression than those with appropriate perceived social support. According to
the results, 45.7 percent of the youths had moderate depression, 25.4 percent
had mild depression, 19.6 percent had major depression, and 9.3 percent had
minor depression.
|
|
Bukhari and Afzal (2017)
|
To find the impact of perceived
social support on psychological problems (depression, anxiety, and stress)
|
Cross
sectional
|
Karachi,
Pakistan
|
200
university students
|
Purposive
sampling
|
DASS-21, anxiety and stress
(Lovibond and lovibond, 1995). MSPSS
(Zimet et al. 1988)
|
Perceived social support was a
significant negative predictor of depression and anxiety. Perceived social
supports predicted 6% depression and 2% anxiety.58%, 69%, 40% have mild to
severe level of depression.
|
|
Zamani, Dehkordi,
and Shahry (2017)
|
To determine the status of
perceived social support and related personal and family characteristics.
|
Cross
sectional
|
Iran
|
763
university students
|
Cluster
random sampling
|
Vaux’s social support questionnaire
|
Depression and stress are expected
to significantly reduce by ensuring
social support and reducing sources of stress in the educational environment.
|
|
Crutcher, Moran and Covassin
(2018)
|
To examine relationship between
social support from athletes, family, and other athletic trainers and
depressive symptom
|
Cross-sectional
|
US
|
204
Athletic training students
|
Random
|
PSS Scale, Scale and CES-D
Questionnaire.
|
In athletic training students,
increased satisfaction with social support may reduce stress perceptions and
depression.
|
|
Loannou, Kassianos and Symeou
(2018)
|
To test the mediating role of
self-esteem in the relationship between social support and depressive
symptoms
|
Cross
Sectional
Observational
study
|
Cyprus
|
N=334 young adults in aged 17–26 (78% female)
|
Random
|
CES-D scale (Radloff, 1977),
Multidimensional social support scale
|
The perception of social support
from family and friends was linked to lower depressive symptoms. It was
discovered that social support is more effective against depressive symptoms.
|
|
Ren, Qin,
Zhang and Zhang
(2018)
|
Present study aimed to understand
the debate over relationship between social support and depression
|
Longitudinal
study
|
China
|
2834
students of adolescence aged range 13-17
|
Random
|
CDI; Kovacs, 2003) and Perceived
School Climate scale for teacher social support (which defined as emotional
support) and peers social support.
|
Depressive symptoms led to a
reduction in expected social support, but not from teachers. Teacher and peer
encouragement is integrally related and mutually influential.
|
|
Lee et al. (2019)
|
Examine the association of
positive and negative social support with the risk of depressive symptoms
|
Large
scale Cohort study
|
Korea
|
21208
adult men and women
|
Random
|
CES-D and self constructed social
support scale
|
Negative social support provoked
the depressive symptoms and positive social support reduced the depressive
symptoms. Inverse relationship was found between both social support and
depressive symptoms.
|
|
Alsubaie, Stain, Webster and Wadman (2019)
|
Impact of sources of social
support on student wellbeing
|
Cross
sectional
|
|
461
Students (82% female, mean age 20.62 years).
|
Random
|
PHQ-9, social support MPSS
Prevalence of depressive symptoms
was 33%.
|
Social support from family, and
friends was a significant predictor of depressive symptoms. Quality of life (psychological) was
significantly predicted by social support from family and friends. Sources of
social support represented a valuable resource for universities in protecting
the mental health of stud dents. significant negative correlation was found between all sources of social
support and depression.
|
5.
Conclusion
This review consist 30 studies which show the
relationship between social support and
depression. Social support, in
general relates to the physical and emotional comfort a person receives while comparing between the genders, it was found that depression
in both genders linked to family structure. Among the girls, depression
correlated to parental, while studies conducted among students. Current
involvements and recent breakups are more closely associated with women’s than
men’s mental health, support and strain in an ongoing relationship are more
closely associated with men’s than women’s emotional wellbeing. Whereas studies
conducted among students showed that students with lower quality social support
from family or friends were more likely to experience mental health problems
and daily hassles and mental health of university students showed a significant
relation. It is also seen that no parental and classmate support may
play a greater role in contributing depression as compared to deficit in peer
support. Social support has been shown to promote mental health and act as a
buffer against stressful life events. Social support is derived from a network
of people drawn from family, friends and community. A lack of social supports
as a determinant of mental health problems including depression symptoms among
the college going students and has a negative impact on their quality of life.
Consistent findings from these cross-sectional studies reveal the important
role of social support on students’ wellbeing. A study on college student found
students who had higher social support had lowest rate of stress and wellbeing
and adjust to college life. This is supported by a study showing social support
from friends is a significant predictor of depression in college students.
The conclusion drawn from the
review depicted that perceived social support from family and friends were
significantly related to lower depressive symptoms. Social support was found to
be more protective against depressive symptoms.
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