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Associations between Depressive Symptoms and Social Support in Adults with Diabetes: Comparing Directionality Hypotheses with a Longitudinal Cohort

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Individuals with diabetes are at increased risk of elevated depressive symptoms, and social support has been identified as a key factor in the health of this population. Cross-sectional associations between depressive symptoms and social support have been demonstrated. Three classes of hypotheses differentially describe the direction of this association: (1) depressive symptoms influence social support, (2) social support influences depressive symptoms, and (3) reciprocal associations exist between depressive symptoms and social support.

Purpose

The aim of this study was to compare these hypotheses.

Methods

Depressive symptoms and social support were measured via telephone survey in a large cohort study of individuals with diabetes (n = 1754) in Quebec, Canada. After baseline, data were collected annually for 4 years. Path models depicting each hypothesis, as well as a stability model containing only autoregressive effects, were generated, and model fit was compared with Akaike’s Information Criterion (AIC).

Results

The reciprocal model was selected as the best fitting model because it had the lowest AIC. This model demonstrated that depressive symptoms predicted subsequent social support at all time points and that social support predicted subsequent depressive symptoms at most time points.

Conclusions

It appears that the association between depressive symptoms and social support in people with diabetes is best characterized as reciprocal. Results underscore the importance of directly comparing competing hypotheses and offer a more accurate depiction of the association between depressive symptoms and social support among people with diabetes.

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Acknowledgments

RB is supported by a Canadian Institutes of Health Research (CIHR) fellowship (201411MFE-338860 FRN-142923). SD is supported by a postdoctoral fellowship from the Fonds de recherche du Québec. The Diabetes Health Study was funded by the Canadian Institutes of Health Research.

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Authors and Affiliations

  1. Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada

    Rachel J. Burns Ph.D., Sonya S. Deschênes Ph.D. & Norbert Schmitz Ph.D.

  2. Douglas Mental Health University Institute, 6875 Boul. Lasalle, Frank B. Common Pavilion, Montreal, H4H 1R3, QC, Canada

    Rachel J. Burns Ph.D., Sonya S. Deschênes Ph.D. & Norbert Schmitz Ph.D.

  3. Department of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, Montreal, QC, Canada

    Norbert Schmitz Ph.D.

Authors
  1. Rachel J. Burns Ph.D.
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Correspondence to Rachel J. Burns Ph.D..

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Burns, R., Deschênes, S. & Schmitz, N. Associations between Depressive Symptoms and Social Support in Adults with Diabetes: Comparing Directionality Hypotheses with a Longitudinal Cohort. ann. behav. med. 50, 348–357 (2016). https://doi.org/10.1007/s12160-015-9760-x

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  • DOI: https://doi.org/10.1007/s12160-015-9760-x

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