Social Psychiatry and Psychiatric Epidemiology

, Volume 48, Issue 12, pp 1971–1982 | Cite as

Social support and physical activity as moderators of life stress in predicting baseline depression and change in depression over time in the Women’s Health Initiative

  • Lisa A. UebelackerEmail author
  • Charles B. Eaton
  • Risa Weisberg
  • Megan Sands
  • Carla Williams
  • Darren Calhoun
  • JoAnn E. Manson
  • Natalie L. Denburg
  • Teletia Taylor
Original Paper



To determine whether social support and/or physical activity buffer the association between stressors and increasing risk of depression symptoms at baseline and at 3-year follow-up.


This is a secondary analysis of data from the Women’s Health Initiative Observational Study. 91,912 community-dwelling post-menopausal women participated in this prospective cohort study. Depression symptoms were measured at baseline and 3 years later; social support, physical activity, and stressors were measured at baseline.


Stressors at baseline, including verbal abuse, physical abuse, caregiving, social strain, negative life events, financial stress, low income, acute pain, and a greater number of chronic medical conditions, were all associated with higher levels of depression symptoms at baseline and new onset elevated symptoms at 3-year follow-up. Social support and physical activity were associated with lower levels of depressive symptoms. Contrary to expectation, more social support at baseline strengthened the association between concurrent depression and physical abuse, social strain, caregiving, and low income. Similarly, more social support at baseline increased the association between financial stress, income, and pain on new onset depression 3 years later. Physical activity similarly moderated the effect of caregiving, income, and pain on depression symptoms at baseline.


Stressors, social support, and physical activity showed predicted main effect associations with depression. Multiplicative interactions were small in magnitude and in the opposite direction of what was expected.


Depression Risk factors Acute stress Chronic stress Protective factors Effect moderation 



The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services through contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32, and 44221.

Conflict of interest

C. Eaton has grant funding with Pfizer, Merck, Amylin and Roche Pharmaceuticals. R. Weisberg has grant funding with Pfizer Pharmaceuticals. L. Uebelacker, M. Sands, C. Williams, D. Calhoun, J. Manson, N. Denburg, T. Taylor do not have any conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Lisa A. Uebelacker
    • 1
    Email author
  • Charles B. Eaton
    • 1
  • Risa Weisberg
    • 2
  • Megan Sands
    • 3
  • Carla Williams
    • 4
  • Darren Calhoun
    • 5
  • JoAnn E. Manson
    • 6
  • Natalie L. Denburg
    • 7
  • Teletia Taylor
    • 4
  1. 1.Alpert Medical School of Brown University, Center for Primary Care and PreventionMemorial Hospital of Rhode Island and Brown UniversityPawtucketUSA
  2. 2.Department of Psychiatry and Human Behavior, Brown University Program for Anxiety Research, Behavioral Health ResearchCenter for Primary Care and PreventionPawtucketUSA
  3. 3.Clinical Epidemiology, Center for Sleep and Circadian NeurobiologyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaUSA
  4. 4.Howard University Cancer CenterWashington, DCUSA
  5. 5.Phoenix Field Office, MedStar Research InstitutePhoenixUSA
  6. 6.Division of Preventive Medicine, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  7. 7.Department of NeuroscienceThe University of IowaUniversity HeightsUSA

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