PERCEIVED SOCIAL SUPPORT MEDIATES ANXIETY AND DEPRESSIVE SYMPTOM CHANGES FOLLOWING PRIMARY CARE INTERVENTION: Research Article: Social Support Mediates Symptom Change
Open accessAbstract
BACKGROUND: The current study tested whether perceived social support serves as a mediator of anxiety and depressive symptom change following evidence-based anxiety treatment in the primary care setting. Gender, age, and race were tested as moderators. METHODS: Data were obtained from 1004 adult patients (age M = 43, SD = 13; 71% female; 56% White, 20% Hispanic, 12% Black) who participated in a randomized effectiveness trial (coordinated anxiety learning and management [CALM] study) comparing evidence-based intervention (cognitive-behavioral therapy and/or psychopharmacology) to usual care in the primary care setting. Patients were assessed with a battery of questionnaires at baseline, as well as at 6, 12, and 18 months following baseline. Measures utilized in the mediation analyses included the Abbreviated Medical Outcomes (MOS) Social Support Survey, the Brief Symptom Index (BSI)-Somatic and Anxiety subscales, and the Patient Health Questionnaire (PHQ-9). RESULTS: There was a mediating effect over time of perceived social support on symptom change following treatment, with stronger effects for 18-month depression than anxiety. None of the mediating pathways were moderated by gender, age, or race. CONCLUSIONS: Perceived social support may be central to anxiety and depressive symptom changes over time with evidence-based intervention in the primary care setting. These findings possibly have important implications for development of anxiety interventions.
AI snapshot
Written from the paper’s full text.
TL;DR
In the CALM primary care trial, perceived social support mediated changes in anxiety and depressive symptoms following evidence-based anxiety treatment, with stronger mediation for 18-month depression than anxiety. Gender, age, and race did not moderate the mediating pathways.
Key findings
- Three of four combined indirect pathways were statistically significant; only the indirect effect of intervention on 18-month perceived social support via anxiety was non-significant.
- Indirect effects involving depression accounted for the greatest percentages of total effect: 11% of total change in 18-month depressive symptoms and 9% of total change in 18-month anxious symptoms were due to changes in perceived social support.
- Perceived social support and depression showed bidirectional relations, whereas perceived social support and anxiety were unidirectional: social support predicted 6- and 12-month anxiety, but anxiety did not predict subsequent perceived social support.
- None of the mediating pathways were moderated by gender, age, or race; all but two moderation tests were non-significant, and these were non-significant after adjusting for multiple comparisons.
Methods
- Data came from 1004 adults (age M=43, SD=13; 71% female; 56% White, 20% Hispanic, 12% Black) in the randomized CALM effectiveness trial comparing evidence-based intervention (CBT and/or psychopharmacology) with usual care in primary care; patients were assessed at baseline, 6, 12, and 18 months.
- Measures included the abbreviated MOS Social Support Survey, BSI-18 Somatic and Anxiety subscales, and PHQ-9 depression items.
- Mediation was tested with path analysis including 30 direct pathways and 12 covarying pathways; missing data were handled with full information maximum likelihood, and indirect effects were tested using 95% bias-corrected bootstrap confidence intervals from 10,000 bootstrapped samples.
Limitations
- The paper states the social support measure was rudimentary, heterogeneous in content, and subjective, and may not have captured the complexity of social support.
- The paper states the comparison group was a mixture of no treatment, various psychotherapies, or psychopharmacology, and the intervention group was a mixture of CBT and/or pharmacology, so conclusions about each treatment alone cannot be made.
- The paper states the sample excluded individuals with current suicidality, bipolar disorder, psychosis, and substance abuse/dependence, and included only adults aged 18–75 with most below age 50, limiting generalizability; it also notes moderation tests may have been underpowered and that multilevel modeling was not conducted for site/clinic clustering.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 55 cited sources checked · 0 supported · 0 flagged
- Findingown data
The mediating effect of perceived social support on symptom change is stronger for 18-month depression than for anxiety.
“There was a mediating effect over time of perceived social support on symptom change following treatment, with stronger effects for 18-month depression than anxiety.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Data were missing at random.
- Findingown data
Perceived social support mediates the effect of evidence-based intervention on later anxiety and depressive symptom changes over time.
“There was a mediating effect over time of perceived social support on symptom change following treatment, with stronger effects for 18-month depression than anxiety.”
- Also stated in: § Indirect Effects · plain
“Three out of four combined indirect pathways were statistically significant from zero (Table 1).”
Quote in the paperSubstantial claim- The authors state this as an assumption: Data were missing at random.
- Also stated in: § Indirect Effects · plain
- Findingown data
9% of total change in 18-month anxious symptoms was due to changes in perceived social support.
“as was 9% of total change in 18-month anxious symptoms (reported as ratios in Table 1).”
Quote in the paperSubstantial claim - Findingown data
Effects of social support on 6- and 12-month anxiety were significant.
“Effects of social support on 6- and 12-month anxiety were significant”
Quote in the paperSubstantial claim - Findingown data
The indirect effect of intervention on 18-month perceived social support via anxiety was non-significant.
“Only the indirect effect of intervention on 18-month perceived social support via anxiety was non-significant.”
Quote in the paperNot a substantial claim
- Findingown data
Indirect effects with depression accounted for the greatest percentages of the total effect.
“Indirect effects with depression accounted for the greatest percentages of the total effect.”
Quote in the paperNot a substantial claim - Findingown data
11% of total change in 18-month depressive symptoms was due to changes in perceived social support.
“Nevertheless, 11% of total change in 18-month depressive symptoms was due to changes in perceived social support”
Quote in the paperSubstantial claim - Findingown data
The intervention did not have significant direct effects on 18-month outcomes over and above 12-month scores.
“That is, the intervention (versus usual care) did not have significant direct effects on outcomes at the later time point of 18 months over and above 12-month scores on the outcomes.”
Quote in the paperSubstantial claim - Findingown data
None of the direct pathways from anxiety to subsequent perceived social support were statistically different from zero.
“none of the direct pathways from anxiety to subsequent perceived social support were statistically different from zero.”
Quote in the paperSubstantial claim - Findingown data
Three out of four combined indirect pathways were statistically significant from zero.
“Three out of four combined indirect pathways were statistically significant from zero (Table 1).”
Quote in the paperSubstantial claim - Findingown data
All pathways between depression and perceived social support were significant.
“All pathways between depression and perceived social support were significant.”
Quote in the paperSubstantial claim - Findingown data
All direct pathways within each variable across time points were significant, meaning depression, anxiety, and perceived social support were related to their previous and subsequent time points.
“All direct pathways within each variable across time points were significant, meaning that the depression, anxiety, and perceived social support were related to depression, anxiety, and perceived social support at previous and subsequent time points respectively.”
Quote in the paperNot a substantial claim - Premisecitation
The evidence-based CALM intervention had greater effects on 12- and 18-month outcomes than usual care, as reported in primary outcome publications.
“Primary outcome publications2,31 already reported that the evidence-based CALM intervention had greater effects on 12- and 18-month outcomes than did usual care.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [2] Craske, 2010
Not checked in the free run.
- cites [31] Roy-Byrne, 2010, Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial, JAMA source
Not checked in the free run.
- Premisecitation
Most evaluation of treatment mediation of CBT has focused on cognitions and beliefs around anxiety and depression mediating symptom change.
“To date, most evaluation of treatment mediation of cognitive behavioral therapy (CBT) has focused on the extent to which cognitions and beliefs around anxiety and depression mediate symptom change.2”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [2] Craske, 2010
Not checked in the free run.
- Premisecitation
There is evidence for bidirectional relationships between perceived social support and symptoms of anxiety and depression.
“Finally, there is some evidence for bidirectional relationships between perceived social support and symptoms of anxiety and depression.”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [9] Stice, 2004, Prospective relations between social support and depression: differential direction of effects for parent and peer support, J Abnorm Psychol source
Not checked in the free run.
- cites [10] Leskela, 2006, The influence of adversity and perceived social support on the outcome of major depressive disorder in subjects with different levels of depressive symptoms, Psychol Med source
Not checked in the free run.
- cites [28] Leskela, 2008, The influence of major depressive disorder on objective and subjective social support: a prospective study, J Nerv Ment Dis source
Not checked in the free run.
- cites [29] Haeffel, 2010, Inside thoughts and outside influences: cognitive vulnerability moderates the effect of decreases in percieved social support on depressive sympotms, J Soc Clin Psychol source
Not checked in the free run.
- Premisecitation
Treatment responders for depression are more likely to have better social support at baseline than nonresponders.
“and treatment responders for depression are more likely to have better social support at baseline than nonresponders.26,27”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [26] Saghafi, 2007, Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder, Int J Geriatr Psychiat source
Not checked in the free run.
- cites [27] Sherbourne, 2004, Characteristics, treatment patterns, and outcomes of persistent depression despite treatment in primary care, Gen Hosp Psychiat source
Not checked in the free run.
- Premisecitation
Poor social support at baseline reduces the effect of treatment for depression.
“Poor social support at baseline reduces the effect of treatment for depression,24,25 and treatment responders for depression are more likely to have better social support at baseline than nonresponders.26,27”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [24] Oxman, 2001, Social support and treatment response in older depressed primary care patients, J Gerontol B Psychol Sci Soc Sci source
Not checked in the free run.
- cites [25] Carter, 2012, Comprehensive review of factors implicated in the heterogeneity of response in depression, Depress Anxiety source
Not checked in the free run.
- Premisecitation
Social support predicts depression.
“Specifically, there is evidence that social support predicts depression and depression predicts social support.9,10,28,29”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [9] Stice, 2004, Prospective relations between social support and depression: differential direction of effects for parent and peer support, J Abnorm Psychol source
Not checked in the free run.
- cites [10] Leskela, 2006, The influence of adversity and perceived social support on the outcome of major depressive disorder in subjects with different levels of depressive symptoms, Psychol Med source
Not checked in the free run.
- cites [28] Leskela, 2008, The influence of major depressive disorder on objective and subjective social support: a prospective study, J Nerv Ment Dis source
Not checked in the free run.
- cites [29] Haeffel, 2010, Inside thoughts and outside influences: cognitive vulnerability moderates the effect of decreases in percieved social support on depressive sympotms, J Soc Clin Psychol source
Not checked in the free run.
- Premisecitation
Minority status and perceived social support interact to predict depressive symptoms.
“Minority status and perceived social support interact to predict depressive symptoms.36,38”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [36] Mikolajczyk, 2007, Correlates of depressive symptoms among Latino and Non-Latino White adolescents: findings from the 2003 California Health Interview Survey, BMC Public Health source
Not checked in the free run.
- cites [38] Plant, 2004, Racial and ethnic differences in depression: the roles of social support and meeting basic needs, JCCP
Not checked in the free run.
- Premisecitation
Depression predicts social support.
“Specifically, there is evidence that social support predicts depression and depression predicts social support.9,10,28,29”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [9] Stice, 2004, Prospective relations between social support and depression: differential direction of effects for parent and peer support, J Abnorm Psychol source
Not checked in the free run.
- cites [10] Leskela, 2006, The influence of adversity and perceived social support on the outcome of major depressive disorder in subjects with different levels of depressive symptoms, Psychol Med source
Not checked in the free run.
- cites [28] Leskela, 2008, The influence of major depressive disorder on objective and subjective social support: a prospective study, J Nerv Ment Dis source
Not checked in the free run.
- cites [29] Haeffel, 2010, Inside thoughts and outside influences: cognitive vulnerability moderates the effect of decreases in percieved social support on depressive sympotms, J Soc Clin Psychol source
Not checked in the free run.
- Interpretationown data
Relative to usual care, the evidence-based intervention led to changes in perceived social support that in turn led to subsequent changes in depression and anxiety.
“These findings suggest that, relative to usual care, the evidence-based intervention led to changes in perceived social support, that in turn lead to subsequent changes in depression and anxiety.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Data were missing at random.
- Premisecitation
FIML yields unbiased estimates both when data are missing completely at random and missing at random.
“FIML yields unbiased estimates both when the data are missing completely at random and missing at random.49”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [49] Enders, 2001, The relative performance of full information maximum likelihood estimation for missing data in structural equation models, Struct Equ Modeling source
Not checked in the free run.
- Premisereasoning
This is the first study to demonstrate that perceived social support functions as a mediator of symptom improvement following evidence-based intervention for anxiety disorders.
“However, this is the first study to demonstrate that perceived social support functions as a mediator of symptom improvement following evidence-based intervention for anxiety disorders.”
Quote in the paperSubstantial claim - Interpretationown data
The intervention led to changes in depression that in turn led to changes in perceived social support.
“Similarly, the intervention led to changes in depression that in turn led to changes in perceived social support.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Data were missing at random.
- Interpretationown data
These results are the first to suggest that perceived availability of global social support is associated with change in depression and anxiety over time following evidence-based intervention.
“These results are the first to suggest that perceived availability of global social support is associated with change in depression and anxiety over time following evidence-based intervention.”
Quote in the paperSubstantial claim - Premisecitation
Most prior studies have examined social support as a moderator or outcome of treatment.
“Most prior studies have examined social support as a moderator or outcome of treatment.22,25”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [22] Cowan, 2008, Predictors of treatment response for depression and inadequate social support - The ENRICHD randomized clinical trial, Psychother Psychosom source
Not checked in the free run.
- cites [25] Carter, 2012, Comprehensive review of factors implicated in the heterogeneity of response in depression, Depress Anxiety source
Not checked in the free run.
- Interpretationown data
Changes in perceived social support mediate changes in subsequent depressive and anxious symptomatology 12- to 18-months following baseline of an evidence-based treatment for anxiety.
“Results suggest that changes in perceived social support mediate changes in subsequent depressive and anxious symptomatology 12- to 18-months following baseline of an evidence-based treatment for anxiety.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Data were missing at random.
- Interpretationown data
Perceived social support has an important role in evidence-based interventions for anxiety and depression for most patients.
“None of our pathways were moderated by gender, age, or race, suggesting that perceived social support has an important role in evidence-based interventions for anxiety and depression for most patients.”
Quote in the paperSubstantial claim
- May combine two claims. 16
- Classified as probably not a substantial claim. 14
May combine two claims.
Findingown dataGender, age, and race do not moderate the mediating pathways.
“None of the mediating pathways were moderated by gender, age, or race.”
- Also stated in: § Moderation · plain
“Thus, gender, race, nor age moderated the mediating effects.”
Quote in the paperNot a substantial claim- The authors state this as an assumption: Data were missing at random.
- Also stated in: § Moderation · plain
May combine two claims.
Findingown dataThe intervention had significant direct effects on 6- and 12-month anxiety and depression and 6-month social support.
“The intervention had significant direct effects on 6- and 12-month anxiety and depression and 6-month social support.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataDepression but not anxiety was associated bidirectionally with social support in the current study.
“Similarly, depression but not anxiety was associated bidirectionally with social support in the current study.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataAll but two moderation tests were not significant, and these results were nonsignificant after adjusting for multiple comparisons.
“All but two tests were not significant, but these results also were nonsignificant after adjusting for multiple comparisons.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataRelations between perceived social support and depression were bidirectional, whereas relations between perceived social support and anxiety were unidirectional.
“That is, relations between perceived social support and depression were bidirectional, whereas they were unidirectional between perceived social support and anxiety.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe risk and protective effects of perceived social support on depression have been widely studied.
“The risk7–10 and protective effects11–15 of percieved social support on depression have been widely studied.”
Quote in the paperNot a substantial claim0 of 9 sources checked- cites [7] Lynch, 1999, Perceived social support among depressed elderly, middle-aged, and young-adult samples: cross-sectional and longitudinal analyses, J Affect Disorders source
Not checked in the free run.
- cites [8] Cohen, 2004, Social relationships and health, Am Psychol source
Not checked in the free run.
- cites [9] Stice, 2004, Prospective relations between social support and depression: differential direction of effects for parent and peer support, J Abnorm Psychol source
Not checked in the free run.
- cites [10] Leskela, 2006, The influence of adversity and perceived social support on the outcome of major depressive disorder in subjects with different levels of depressive symptoms, Psychol Med source
Not checked in the free run.
- cites [11] Cohen, 1986, Social skills and the stress-protective role of social support, J Pers Soc Psychol source
Not checked in the free run.
- cites [12] Rowe, 2006, Social support and suicidal ideation in older adults using home healthcare services, Am J Gastroenterol
Not checked in the free run.
- cites [13] Bonanno, 2007, What predicts psychological resilience after disaster? The role of demographics, resources, and life stress, JCCP
Not checked in the free run.
- cites [14] Heinrich, 2006, The clinical significance of loneliness: a literature review, Clin Psychol Rev source
Not checked in the free run.
- cites [15] Hourani, 2012, Longitudinal study of resilience and mental health in Marines leaving military service, J Affect Disorders source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPerceived social support is a better predictor of mental health and support utilization than other measures of social support.
“Perceived social support is the most commonly measured index of social support,4 given its ease of measurement and evidence that it is a better predictor of mental health and support utilization than other measures.5,6”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [5] Wethington, 1986, Perceived support, received support, and adjustment to stressful life events, J Health Soc Behav source
Not checked in the free run.
- cites [6] Taylor, 2011
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationFewer studies have demonstrated relations between perceived social support and anxiety, but observed effects parallel findings with depression.
“Fewer studies have demonstrated these relations with anxiety as well, but the observed effects parallel the findings with depression.16–20”
Quote in the paperNot a substantial claim0 of 5 sources checked- cites [16] Hart, 1991, Irrational beliefs, percieved availability of social support, and anxiety, J Clin Psychol source
Not checked in the free run.
- cites [17] Torgrud, 2004, Deficits in perceived social support associated with generalized social phobia, Cognit Behav Ther source
Not checked in the free run.
- cites [18] Rueger, 2010, Relationship between multiple sources of perceived social support and psychological and academic adjustment in early adolescence: comparisons across gender, J Youth Adolescence source
Not checked in the free run.
- cites [19] Simeon, 2005, Dissociation and posttraumatic stress one year after the world trade center disaster: follow-up of a longitudinal study, J Clin Psychiatry source
Not checked in the free run.
- cites [20] Hyde, 2011, Perceived social support moderates the link between threat-related amygdala reactivity and trait anxiety, Neuropsychologia source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationPerceived social support is the most commonly measured index of social support.
“Perceived social support is the most commonly measured index of social support,4 given its ease of measurement and evidence that it is a better predictor of mental health and support utilization than other measures.5,6”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Ibarra-Rovillard, 2011, Social support and social negativity findings in depression: perceived responsiveness to basic psychological needs, Clin Psychol Rev source
Not checked in the free run.
May combine two claims.
PremisecitationPerceived social support changes following treatment and has been studied as a moderator of treatment.
“Perceived social support changes following treatment, and it has been studied as a moderator of treatment.21–23”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [21] McCall, 2001, Social support increases in the year after inpatient treatment of depression, J Psychiatr Res source
Not checked in the free run.
- cites [22] Cowan, 2008, Predictors of treatment response for depression and inadequate social support - The ENRICHD randomized clinical trial, Psychother Psychosom source
Not checked in the free run.
- cites [23] Stice, 2011, Relation of depression to perceived social support: results from a randomized adolescent depression prevention trial, Behav Res Ther source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationFindings regarding the interaction effect of age and perceived social support on depression and anxiety have been mixed.
“Findings regarding the interaction effect of age and perceived social support on depression and anxiety have been mixed.7,39”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [7] Lynch, 1999, Perceived social support among depressed elderly, middle-aged, and young-adult samples: cross-sectional and longitudinal analyses, J Affect Disorders source
Not checked in the free run.
- cites [39] Barefoot, 2000, Moderators of the effect of social support on depressive symptoms in cardiac patients, Am J Cardiol source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductcitationRandomization was conducted using an automated computer program at RAND and stratified by clinic and by presentation of major depressive disorder comorbidity.
“Randomization was conducted using an automated computer program at RAND and stratified by clinic and by presentation of major depressive disorder comorbidity.31”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [31] Roy-Byrne, 2010, Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial, JAMA source
Not checked in the free run.
May combine two claims.
Study design and conductcitationThe CALM and usual care groups did not differ in age, gender, race, education, number of medical conditions, level of insurance, or diagnosis.
“The evidence-based CALM intervention and usual care groups did not differ in age, gender, race, education, number of medical conditions, level of insurance, or diagnosis.31”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [31] Roy-Byrne, 2010, Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial, JAMA source
Not checked in the free run.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationGender and perceived social support interact to predict depression, such that only among females does perceived social support predict the disorder.
“Similarly, gender and perceived social support interact to predict depression, such that only among females does perceived social support predict the disorder.32,34”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [32] Lewinsohn, 1988, A prospective study of risk factors for unipolar depression, J Abnorm Psychol source
Not checked in the free run.
- cites [34] Kendler, 2005, Sex differences in the relationship between social support and risk for major depression: a longitudinal study of opposite-sex twin pairs, Am J Psych source
Not checked in the free run.
May combine two claims.
InterpretationreasoningThe meditational changes were not the result of time alone or following any treatment, given that effects were stronger in the evidence-based intervention compared to usual care.
“These meditational changes were not the result of time alone or following any treatment given that these effects were stronger in the evidence-based intervention compared to usual care.”
Quote in the paperSubstantial claim- The authors state this as an assumption: Data were missing at random.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningThe measure of social support was rudimentary, heterogeneous in content, and subjective, and may not have adequately captured the complexity inherent in social support.
“First, our measure of social support was rudimentary, heterogeneous in content, and subjective, and therefore may not have adequately captured some of the complexity inherent in social support.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductreasoningSignificance tests of indirect effects were based on 95% bias-corrected bootstrap confidence intervals from 10,000 bootstrapped samples.
“Because the distribution of indirect effects is known to be non-normal, significance tests of indirect effects were based on 95% bias-corrected bootstrap confidence intervals from 10,000 bootstrapped samples, which yields more accurate coverage and Type I error rates.35”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [35] MacKinnon, 2004, Confidence limits for the indirect effect: distribution of the product and resampling methods, Multivar Behav Res source
Not checked in the free run.
May combine two claims.
Interpretationown dataPerceived social support accounted for some but not all treatment change.
“While perceived social support accounted for some treatment change, it did not account for all change nor was this expected.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductown dataModels were estimated using MPlus Version 6.12 with full information maximum likelihood to address missing data.
“Models were estimated using MPlus Version 6.12 with full information maximum likelihood (FIML) to address missing data (approximately 0% at baseline, 13% at 6-months, 19% at 12-months, and 20% at 18-months).”
Quote in the paperSubstantial claim- The authors state this as an assumption: Data were missing at random.
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationcitationThe current findings are consistent with prior studies that found direct predictive relations among variables.
“The current findings are consistent with prior studies that found direct predictive relations among variables.11,22”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [11] Cohen, 1986, Social skills and the stress-protective role of social support, J Pers Soc Psychol source
Not checked in the free run.
- cites [22] Cowan, 2008, Predictors of treatment response for depression and inadequate social support - The ENRICHD randomized clinical trial, Psychother Psychosom source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductown dataMulti-level modeling was not conducted to account for potential clustering effects within site and clinic because estimates would not be stable with small numbers of sites and clinics.
“Note, consistent with statistical methods of primary outcome publications,31,40 multi-level modeling was not conducted to account for potential clustering effects within site and clinic, given that estimates would not be stable with our small numbers of sites and clinics.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [31] Roy-Byrne, 2010, Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial, JAMA source
Not checked in the free run.
- cites [40] Craske, 2011, Disorder specific impact of CALM treatment for anxiety disorders in primary care, Arch Gen Psychiat source
Not checked in the free run.
May combine two claims.
Study design and conductown dataThe sample did not include individuals with current suicidality, bipolar disorder, psychosis, and substance abuse/dependence, so results may be limited in generalizing to these clinical populations.
“Third, although the current sample was relatively diverse in ethnicity, age, socioeconomic status, and clinical severity, the sample did not include individuals with current suicidality, bipolar disorder, psychosis, and substance abuse/dependence. Thus, the current results may be limited in the degree to which they can generalize to these types of clinical populations.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataThe sample included only adults between 18-75, with majority below 50, so generality to younger or older populations is unknown.
“Further, the current sample included only adults between the ages of 18–75, with the majority of participants below the age of 50. Therefore, the generality of these results to younger or older populations is unknown.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataThe evidence-based intervention group was a mixture of CBT and/or pharmacology, such that conclusions about mediational effects of each treatment alone cannot be made.
“Our evidence-based intervention group also was a mixture of CBT and/or pharmacology, such that conclusions about the mediational effects of each treatment alone on symptom change cannot be made.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Interpretationnone givenThe treatment setting location suggests current results likely generalize to most populations who visit their PCP.
“However, a strength of the current study is the location of the treatment setting in that the current results likely generalize to most populations who visit their PCP.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe comparison group represented a mixture of no treatment, various psychotherapies, or psychopharmacology.
“Second, our comparison group represented a mixture of no treatment, various psychotherapies, or psychopharmacology.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Many patients with anxiety remain symptomatic and do not achieve full remission despite established treatments.
“However, many patients remain symptomatic and do not achieve full remission.”
The paper relies on this without support.
Cognitive and behavioral therapies and pharmacotherapies are well established as efficacious anxiety treatments.
“Cognitive and behavioral therapies and pharmacotherapies are well established as efficacious anxiety treatments.”
The paper relies on this without support.
Perceived social support is a malleable construct.
“Given that perceived social support is a malleable construct, it is conceivable that enhanced perceptions of social support during an intervention may result in larger symptom change.”
The authors state this as an assumption.
Data were missing at random.
“To test the assumption that data were missing at random, we predicted when participants dropped out of the study using baseline variables theorized to be related to dropout (e.g., symptom severity levels, demographic variables).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Previous studies have found a strong positive relationship between social interaction and mental health.
“Previous studies have found a strong positive relationship between social interaction and mental health (Dour et al., 2014;Bekele et al., 2015).”
From The relationship between physical and mental health: A mediation analysis (2017) · cites this paper as Dour et al., 2014
One anxiety study found that lower perceived social support was predictive of more severe anxiety (beta = − 0.15, CI [− 0.30, − 0.06], Ratios 8.85%) and depressive symptoms (beta = − 0.16, CI [− 0.28, − 0.08], Ratios 10.51%) at subsequent time points.
“One study found that lower perceived social support was predictive of more severe anxiety (beta = − 0.15, CI [− 0.30, − 0.06], Ratios 8.85%) and depressive symptoms (beta = − 0.16, CI [− 0.28, − 0.08], Ratios 10.51%) at subsequent time points [33]”
From Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review (2018) · cites this paper as [33]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Eight CBT modules stated, but only seven listed
MinorThe text says CBT consisted of eight modules, but the parenthetical list names seven.
“CBT consisted of 8 modules”
“(self-monitoring, psychoeducation, fear hierarchy, breathing retraining, relapse prevention, cognitive restructuring, exposure)”
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods
MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004) · Multivariate Behavioral Research · doi:10.1207/s15327906mbr3901_4 · Cited by 7,806 · cited 1× · see citing works
“to be non-normal, significance tests of indirect effects were based on 95% bias-corrected bootstrap confidence intervals from 10,000 bootstrapped samples, which yields more accurate coverage and Type I error rates.[35] Effects are considered statistically significant if the confidence interval does not contain zero.”
MethodSherbourne, C. D., & Stewart, A. L. (1991) · Social Science & Medicine · doi:10.1016/0277-9536(91)90150-b · Cited by 6,643 · cited 1× · see citing works
“The Medical Outcomes (MOS) Social Support Survey— Abbreviated[47].”
MethodSelf-citationEnders, C., & Bandalos, D. (2001) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1207/s15328007sem0803_5 · Cited by 4,978 · see citing works
Social Relationships and Health.
Cohen, S. (2004) · American Psychologist · doi:10.1037/0003-066x.59.8.676 · Cited by 4,852 · see citing works
Mediators and Mechanisms of Change in Psychotherapy Research
Kazdin, A. E. (2007) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.3.022806.091432 · Cited by 2,504 · cited 1× · see citing works
“, moderators).[1] A better understanding of these factors can inform which therapy components are catalysts for symptom change, facilitating shedding of unnecessary therapeutic strategies and enhancement of essential elements.”
BackgroundThe clinical significance of loneliness: a literature review
Heinrich, L. M., & Gullone, E. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.04.002 · Cited by 1,986 · see citing works
Löwe, B., Kroenke, K., Herzog, W., & Gräfe, K. (2004) · Journal of Affective Disorders · doi:10.1016/s0165-0327(03)00198-8 · Cited by 1,558 · cited 1× · see citing works
“It demonstrated high levels of validity in the primary care setting[45] with excellent test–retest reliability.[46]”
BackgroundPerceived support, received support, and adjustment to stressful life events
Wethington, E., & Kessler, R. C. (1986) · Journal of Health and Social Behavior · doi:10.2307/2136504 · Cited by 1,431 · cited 1× · see citing works
“Perceived social support is the most commonly measured index of social support,[4] given its ease of measurement and evidence that it is a better predictor of mental health and support utilization than other measures.[5, 6] The risk[7–10] and protective effects[11–15] of percieved social support on depression have bee…”
BackgroundBonanno, G. A., Galea, S., Bucciarelli, A., & Vlahov, D. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.5.671 · Cited by 1,371 · see citing works
Development and validation of an Overall Anxiety Severity and Impairment Scale (OASIS)
Norman, S. B., Hami Cissell, S., Means-Christensen, A. J., & Stein, M. B. (2006) · Depression and Anxiety · doi:10.1002/da.20182 · Cited by 770 · cited 1× · see citing works
“Eligibility criteria were between the ages of 18– 75, met diagnostic criteria for at least one of the aforementioned anxiety disorders, and scored at least an 8 on the Overall Anxiety Severity and Impairment Scale (OASIS).[41] Ineligibility included ongoing CBT or psychiatric medication, limited fluency in English or…”
BackgroundSelf-citationStice, E., Ragan, J., & Randall, P. (2004) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.113.1.155 · Cited by 736 · cited 2× · see citing works
“Specifically, there is evidence that social support predicts depression and depression predicts social support.[9, 10, 28, 29] Less is known about the directionality of perceived social support and anxiety.”
BackgroundResultMeasuring Perceived and Received Social Support
Wills, T. A., & Shinar, O. (2000) · Oxford University Press eBooks · doi:10.1093/med:psych/9780195126709.003.0004 · Cited by 688 · cited 1× · see citing works
“, feedback on the community’s behavioral expectations).[3] It is measured as perceived support, received support (i.”
BackgroundRueger, S. Y., Malecki, C. K., & Demaray, M. K. (2010) · Journal of Youth and Adolescence · doi:10.1007/s10964-008-9368-6 · Cited by 591 · see citing works
Baum, A., Revenson, T. A., & Singer, J. (2012) · Psychology Press eBooks · doi:10.4324/9780203804100 · Cited by 569 · see citing works
Kendler, K. S., Myers, J., & Prescott, C. A. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.2.250 · Cited by 544 · cited 1× · see citing works
“[36, 38] Similarly, gender and perceived social support interact to predict depression, such that only among females does perceived social support predict the disorder.[32, 34] Findings regarding the interaction effect of age and perceived social support on depression and anxiety have been mixed.”
BackgroundRoy-Byrne, P., Craske, M. G., Sullivan, G., Rose, R. D., Edlund, M. J., Lang, A. J., Bystritsky, A., Welch, S. S., Chavira, D. A., Golinelli, D., et al. (2010) · JAMA · doi:10.1001/jama.2010.608 · Cited by 452 · see citing works
Self-citationA prospective study of risk factors for unipolar depression.
Lewinsohn, P. M., Hoberman, H. M., & ROSENBAUM, M. S. (1988) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.97.3.251 · Cited by 404 · see citing works
A prospective study of risk factors for unipolar depression
Lewinsohn, P. M., Hoberman, H. M., & Rosenbaum, M. (1988) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.97.3.251 · Cited by 404 · cited 1× · see citing works
“[36, 38] Similarly, gender and perceived social support interact to predict depression, such that only among females does perceived social support predict the disorder.[32, 34] Findings regarding the interaction effect of age and perceived social support on depression and anxiety have been mixed.”
BackgroundSocial skills and the stress-protective role of social support.
Cohen, S., Sherrod, D. R., & Clark, M. S. (1986) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.50.5.963 · Cited by 314 · see citing works
Social skills and the stress-protective role of social support.
Cohen, S., Sherrod, D. R., & Clark, M. S. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.50.5.963 · Cited by 233 · see citing works
A Confirmatory Factor Analysis of an Abbreviated Social Support Instrument: The MOS-SSS
Gjesfjeld, C. D., Greeno, C. G., & Kim, K. H. (2008) · Research on Social Work Practice · doi:10.1177/1049731507309830 · Cited by 195 · cited 4× · see citing works
“version assessed companionate support using the item “someone to get together with for relaxation”, Gjesfjeld et al.[48] instead included the following item: “someone to do something enjoyable with”.”
MethodInfluentialHyde, L. W., Gorka, A., Manuck, S. B., & Hariri, A. R. (2011) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2010.08.025 · Cited by 188 · see citing works
Ibarra-Rovillard, M. S., & Kuiper, N. A. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.01.005 · Cited by 184 · cited 1× · see citing works
“Perceived social support is the most commonly measured index of social support,[4] given its ease of measurement and evidence that it is a better predictor of mental health and support utilization than other measures.”
BackgroundRacial and Ethnic Differences in Depression: The Roles of Social Support and Meeting Basic Needs.
Plant, E. A., & Sachs‐Ericsson, N. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.1.41 · Cited by 182 · cited 1× · see citing works
“[7, 32–37] Minority status and perceived social support interact to predict depressive symptoms.[36, 38] Similarly, gender and perceived social support interact to predict depression, such that only among females does perceived social support predict the disorder.”
BackgroundCraske, M. G., Rose, R. D., Lang, A., Welch, S. S., Campbell-Sills, L., Sullivan, G., Sherbourne, C., Bystritsky, A., Stein, M. B., & Roy-Byrne, P. P. (2009) · Depression and Anxiety · doi:10.1002/da.20542 · Cited by 170 · see citing works
Self-citationSocial support and suicidal ideation in older adults using home healthcare services
Rowe, J. L., Conwell, Y., Schulberg, H. C., & Bruce, M. L. (2006) · The American Journal of Geriatric Psychiatry · doi:10.1097/01.jgp.0000218324.78202.25 · Cited by 153 · see citing works
Gender, Social support and recovery from depressive disorders: a prospective clinical study
Brugha, T. S., Bebbington, P. E., MacCarthy, B., Sturt, E., Wykes, T., & Potter, J. (1990) · Psychological Medicine · doi:10.1017/s0033291700013325 · Cited by 135 · see citing works
Craske, M. G., Stein, M. B., Sullivan, G., Sherbourne, C., Bystritsky, A., Rose, R. D., Lang, A. J., Welch, S., Campbell-Sills, L., Golinelli, D., et al. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.25 · Cited by 132 · cited 3× · see citing works
“Participants were 1004 adults with diagnoses of panic, generalized anxiety, social anxiety, and/or posttraumatic stress disorder.[31,40]”
Self-citationCarter, G. C., Cantrell, R. A., Zarotsky, V., Haynes, V. S., Phillips, G., Alatorre, C. I., Goetz, I., Paczkowski, R., & Marangell, L. B. (2012) · Depression and Anxiety · doi:10.1002/da.21918 · Cited by 109 · cited 2× · see citing works
“Most prior studies have examined social support as a moderator or outcome of treatment.[22, 25] Although informative in its own right, moderation and outcome analyses fail to capture the role of perceived social support as a potential change agent in treatments.”
BackgroundSullivan, G., Craske, M. G., Sherbourne, C. D., Edlund, M. J., Rose, R. D., Golinelli, D., Chavira, D. A., Bystritsky, A., Stein, M. B., & Roy‐Byrne, P. (2007) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2007.04.005 · Cited by 109 · cited 1× · see citing works
“Using path analysis, we examined meditational effects of perceived social support on anxiety and depressive symptom changes in 1004 patients with anxiety disorders in primary care settings who were randomized to an evidence-based treatment of CBT and/or pharmacotherapy (coordinated anxiety learning and management [CAL…”
MethodSelf-citationMeijer, R. R., de Vries, R. M., & van Bruggen, V. (2011) · Psychological Assessment · doi:10.1037/a0021292 · Cited by 106 · cited 1× · see citing works
“This measure has demonstrated good psychometric properties[44] with excellent interitem reliability in the current sample (α = .”
BackgroundLESKELÄ, U., RYTSÄLÄ, H., KOMULAINEN, E., MELARTIN, T., SOKERO, P., LESTELÄ-MIELONEN, P., & ISOMETSÄ, E. (2006) · Psychological Medicine · doi:10.1017/s0033291706007276 · Cited by 105 · cited 1× · see citing works
“Specifically, there is evidence that social support predicts depression and depression predicts social support.[9, 10, 28, 29] Less is known about the directionality of perceived social support and anxiety.”
BackgroundSocial support and treatment response in older depressed primary care patients
Oxman, T. E., & Hull, J. G. (2001) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/56.1.p35 · Cited by 95 · cited 1× · see citing works
“[21–23] Poor social support at baseline reduces the effect of treatment for depression,[24, 25] and treatment responders for depression are more likely to have better social support at baseline than nonresponders.”
BackgroundCowan, M. J., Freedland, K. E., Burg, M. M., Saab, P. G., Youngblood, M. E., Cornell, C. E., Powell, L. H., & Czajkowski, S. M. (2008) · Psychotherapy and Psychosomatics · doi:10.1159/000110057 · Cited by 93 · cited 2× · see citing works
“Most prior studies have examined social support as a moderator or outcome of treatment.[22, 25] Although informative in its own right, moderation and outcome analyses fail to capture the role of perceived social support as a potential change agent in treatments.”
BackgroundResultMikolajczyk, R. T., Bredehorst, M., Khelaifat, N., Maier, C., & Maxwell, A. E. (2007) · BMC Public Health · doi:10.1186/1471-2458-7-21 · Cited by 91 · see citing works
Simeon, D., Greenberg, J., Nelson, D., Schmeidler, J., & Hollander, E. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0212 · Cited by 84 · see citing works
Lewis, K. M., Byrd, D. A., & Ollendick, T. (2012) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.08.007 · Cited by 82 · see citing works
Longitudinal study of resilience and mental health in Marines leaving military service
Hourani, L., Bender, R. H., Weimer, B., Peeler, R., Bradshaw, M., Lane, M., & Larson, G. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.01.008 · Cited by 81 · see citing works
Stice, E., Rohde, P., Gau, J., & Ochner, C. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.02.009 · Cited by 79 · see citing works
Lynch, T. R., Mendelson, T., Robins, C. J., Krishnan, K. R. R., George, L. K., Johnson, C. S., & Blazer, D. G. (1999) · Journal of Affective Disorders · doi:10.1016/s0165-0327(99)00017-8 · Cited by 74 · cited 1× · see citing works
“[32, 34] Findings regarding the interaction effect of age and perceived social support on depression and anxiety have been mixed.[7, 39] Given the importance of peers, it is expected that younger age groups would demonstrate the greatest effect of social support on depression and anxiety.”
BackgroundDeficits in perceived social support associated with generalized social phobia
Torgrud, L. J., Walker, J. R., Murray, L., Cox, B. J., Chartier, M., & Kjernisted, K. D. (2004) · Cognitive Behaviour Therapy · doi:10.1080/16506070410029577 · Cited by 66 · see citing works
Sherbourne, C., Schoenbaum, M., Wells, K. B., & Croghan, T. W. (2004) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2003.08.009 · Cited by 47 · cited 1× · see citing works
“[21–23] Poor social support at baseline reduces the effect of treatment for depression,[24, 25] and treatment responders for depression are more likely to have better social support at baseline than nonresponders.[26, 27] Finally, there is some evidence for bidirectional relationships between perceived social support…”
BackgroundSelf-citationSaghafi, R., Brown, C., Butters, M. A., Cyranowski, J., Dew, M. A., Frank, E., Gildengers, A., Karp, J. F., Lenze, E. J., Lotrich, F., et al. (2007) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1804 · Cited by 47 · cited 1× · see citing works
“[21–23] Poor social support at baseline reduces the effect of treatment for depression,[24, 25] and treatment responders for depression are more likely to have better social support at baseline than nonresponders.[26, 27] Finally, there is some evidence for bidirectional relationships between perceived social support…”
BackgroundModerators of the effect of social support on depressive symptoms in cardiac patients
Barefoot, J. C., Brummett, B. H., Clapp-Channing, N. E., Siegler, I. C., Vitaliano, P. P., Williams, R. B., & Mark, D. B. (2000) · The American Journal of Cardiology · doi:10.1016/s0002-9149(00)00961-9 · Cited by 42 · see citing works
Gatchel, R. J., & Rollings, K. H. (2011) · Elsevier eBooks · doi:10.1016/b978-0-323-07293-9.00021-0 · Cited by 42 · see citing works
Leskelä, U., Melartin, T., Rytsälä, H., Sokero, P., Lestelä-Mielonen, P., & Isometsä, E. (2008) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e31818ec6cf · Cited by 33 · cited 1× · see citing works
“Specifically, there is evidence that social support predicts depression and depression predicts social support.[9, 10, 28, 29] Less is known about the directionality of perceived social support and anxiety.”
BackgroundSocial support increases in the year after inpatient treatment of depression
McCall, W. V., Reboussin, B. A., & Rapp, S. R. (2001) · Journal of Psychiatric Research · doi:10.1016/s0022-3956(01)00009-7 · Cited by 20 · see citing works
Haeffel, G. J., & Mathew, A. R. (2010) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2010.29.3.281 · Cited by 18 · cited 2× · see citing works
“Specifically, there is evidence that social support predicts depression and depression predicts social support.[9, 10, 28, 29] Less is known about the directionality of perceived social support and anxiety.”
BackgroundResultHart (1991) · doi:10.1002/1097-4679(199107)47:4
Flagged first, then by citations
3 of the 53 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Derogatis, 1993, BSI Brief Symptom Inventory. Administration, Scoring, and Procedures Manual
Cited by
Sorted by citations
Wang, J., Mann, F., Lloyd-Evans, B., Ma, R., & Johnson, S. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1736-5 · Cited by 1,494 · see citing works
“51%) at subsequent time points [33], and”
BackgroundInfluentialHandbook of Religion and Health
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · doi:10.1093/oso/9780190088859.001.0001 · Cited by 1,150 · see citing works
Major depressive disorder: hypothesis, mechanism, prevention and treatment
Cui, L., Li, S., Wang, S., Wu, X., Liu, Y., Yu, W., Wang, Y., Tang, Y., Xia, M., & Li, B. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-01738-y · Cited by 1,061 · see citing works
“335 ,339 Studies have reported that when controlling for all other variables, each aspect of social support is clearly associated with MDD, and to some extent, the occurrence of panic disorder in patients with MDD is more strongly associated with poor functional support.”
BackgroundThe relationship between physical and mental health: A mediation analysis
Ohrnberger, J., Fichera, E., & Sutton, M. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.11.008 · Cited by 967 · see citing works
Li, F., Luo, S., Mu, W., Li, Y., Ye, L., Zheng, X., Xu, B., Ding, Y., Ling, P., Zhou, M., et al. (2021) · BMC Psychiatry · doi:10.1186/s12888-020-03012-1 · Cited by 573 · see citing works
“Although social support can be measured in many ways, perceived social support is the most commonly measured index of social support [4], given its ease of measurement and evidence that it is a better predictor of mental health than other measures [5, 6].”
BackgroundSocial isolation in mental health: a conceptual and methodological review
Wang, J., Lloyd-Evans, B., Giacco, D., Forsyth, R., Nebo, C., Mann, F., & Johnson, S. (2017) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-017-1446-1 · Cited by 462 · see citing works
Mann, F., Bone, J. K., Lloyd-Evans, B., Frerichs, J., Pinfold, V., Ma, R., Wang, J., & Johnson, S. (2017) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-017-1392-y · Cited by 346 · see citing works
“[105] k Hupcey [106] 628 Soc Psychiatry Psychiatr Epidemiol (2017) 52:627–638”
BackgroundCapturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2
Domains, B. (2015) · Cited by 299 · see citing works
Locus of control, health and healthcare utilization
Kesavayuth, D., Poyago-Theotoky, J. A., Tran, D. B., & Zikos, V. (2019) · Economic Modelling · doi:10.1016/j.econmod.2019.06.014 · Cited by 148 · see citing works
Capturing Social and Behavioral Domains in Electronic Health Records: Phase 1
Domains, B. (2014) · Cited by 128 · see citing works
Itzchakov, G., DeMarree, K. G., Kluger, A. N., & Turjeman‐Levi, Y. (2018) · Personality and Social Psychology Bulletin · doi:10.1177/0146167217747874 · Cited by 115 · see citing works
“Congruent with this, feeling understood and validated by partners, which reduces anxiety (Dour et al., 2014), leads people to consider information they typically do not—their shortcomings (Caprariello & Reis, 2011).”
BackgroundCOVID-19: exploring impacts of the pandemic and lockdown on mental health of Pakistani students
Baloch, G. M., Sundarasen, S., Chinna, K., Nurunnabi, M., Kamaludin, K., Khoshaim, H. B., Hossain, S. F. A., & Sukayt, A. (2021) · PeerJ · doi:10.7717/peerj.10612 · Cited by 95 · see citing works
“Studies have shown a direct association between societal interaction and psychological wellbeing (Dour et al., 2014).”
BackgroundThe Science of Health Care Worker Burnout: Assessing and Improving Health Care Worker Well-Being
Rehder, K. J., Adair, K. C., & Sexton, J. B. (2021) · Archives of Pathology & Laboratory Medicine · doi:10.5858/arpa.2020-0557-ra · Cited by 99 · see citing works
Shi, L., Xu, R. H., Xia, Y., Chen, D.-X., & Wang, D. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.800183 · Cited by 101 · see citing works
Wang, L., Feng, Z., Yang, G., Yang, Y., Wang, K., Dai, Q., Zhao, M., Hu, C., Zhang, R., Liu, K., et al. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.09.050 · Cited by 87 · see citing works
“negative life events, poor support)(Dour et al., 2014).”
BackgroundBi, X.-B., He, H.-Z., Lin, H., & Fan, X.-Z. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.835110 · Cited by 59 · see citing works
Wongpakaran, N., Wongpakaran, T., Lerttrakarnnon, P., Jiraniramai, S., Sirirak, T., Assanangkornchai, S., Taemeeyapradit, U., Tantirangsee, N., Lertkachatarn, S., Arunpongpaisal, S., et al. (2018) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2018.10.007 · Cited by 43 · see citing works
The effect of cash transfers on mental health: Opening the black box – A study from South Africa
Ohrnberger, J., Anselmi, L., Fichera, E., & Sutton, M. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.113181 · Cited by 44 · see citing works
Depressive and anxiety symptoms in first generation college students
Noel, J. K., Lakhan, H. A., Sammartino, C. J., & Rosenthal, S. R. (2021) · Journal of American College Health · doi:10.1080/07448481.2021.1950727 · Cited by 46 · see citing works
Reduced autobiographical memory specificity affects general distress through poor social support
Barry, T. J., Vinograd, M., Boddez, Y., Raes, F., Zinbarg, R. E., Mineka, S., & Craske, M. G. (2019) · Memory · doi:10.1080/09658211.2019.1607876 · Cited by 41 · see citing works
“Individual differences in perceived social support from peers and parents has been found to predict changes in depressive symptoms among both adolescents and adults (Dour et al., 2014; Leskelä et al., 2006; Stice, Ragan, & Randall, 2004).”
BackgroundInfluentialSelf-citationBirkeland, M. S., Nielsen, M. B., Hansen, M., Knardahl, S., & Heir, T. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1302692 · Cited by 35 · see citing works
“Another study found that following an evidence-based intervention for anxiety, perceived availability of global social support was associated with a change in depression over time (Dour et al., 2014).”
BackgroundFadiji, A. W., Yendork, J. S., & Somhlaba, N. Z. (2016) · Child Indicators Research · doi:10.1007/s12187-016-9367-1 · Cited by 40 · see citing works
“…of social support in individuals’ lives has spurred research on the relationship between support and coping (Cheng et al. 2014; Cohen and Wills 1985; Dour et al. 2014; Wethington and Kessler 1986), mental health (Hefner and Eisenberg 2009; Kessler and McLeod 1985; Stewart and Suldo 2011) and…”
BackgroundMorgan, A. J., Reavley, N. J., Jorm, A. F., & Beatson, R. (2017) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-017-1391-z · Cited by 38 · see citing works
“6 problems, and support from friends and family can increase the likelihood of recovery [20,21].”
BackgroundLambert, C. C., Westfall, A. O., Modi, R. A., Amico, K. R., Golin, C. E., Keruly, J. C., Quinlivan, E. B., Crane, H. M., Zinski, A., Turan, B., et al. (2019) · AIDS Care · doi:10.1080/09540121.2019.1622635 · Cited by 37 · see citing works
“Measured using the 4-item abbreviated Medical Outcomes Study Social Support Survey (MOS-4) (Dour et al., 2014; Gjesfjeld, Greeno, & Kim, 2008).”
MethodPerrins, S. P., Varanasi, U., Seto, E., & Bratman, G. N. (2021) · Urban forestry & urban greening · doi:10.1016/j.ufug.2021.127404 · Cited by 34 · see citing works
“I’m Here for You”: Can Social Chatbots Truly Support Their Users? A Literature Review
van Wezel, M. M. C., Croes, E. A. J., & Antheunis, M. L. (2021) · Lecture notes in computer science · doi:10.1007/978-3-030-68288-0_7 · Cited by 36 · see citing works
The Impact of Maternal Anxiety on Early Child Development During the COVID-19 Pandemic
Jeličić, L., Sovilj, M., Bogavac, I., Drobnjak, A., Gouni, O., Kaźmierczak, M., & Subotić, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.792053 · Cited by 33 · see citing works
“On the other hand, although there is large evidence that social support predicts depression and vice versa, there is little evidence to explain the directionality of perceived social support and anxiety (Dour et al., 2014).”
BackgroundRathakrishnan, B., Singh, S. S. B., & Yahaya, A. (2022) · Sustainability · doi:10.3390/su14063250 · Cited by 34 · see citing works
“Focusing on the aspect of anxiety, based on the study of Dour et al. [34], they assumed that their discoveries through the research could have a significant impact on the development of anxiety treatments.”
Küchler, A., Schultchen, D., Dretzler, T., Moshagen, M., Ebert, D. D., & Baumeister, H. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043208 · Cited by 30 · see citing works
“Finally, the lack of superiority of the GoD compared with the UG version suggests that factors such as social support [77] or therapeutic alliance [78], which are important mechanisms of change in face-to-face therapy, might be less crucial to the effectiveness of mindfulness-based IMIs.”
BackgroundLi, Q., Liu, L., Gu, Z., Li, M., Liu, C., & Wu, H. L. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04792-y · Cited by 30 · see citing works
“A study suggested that the relationship between PSS and depression was bidirectional [25].”
BackgroundRisk factors for occupational stress among Greek police officers
Galanis, P., Fragkou, D., Καϊτελίδου, Δ., Kalokairinou, A., & Katsoulas, T. A. (2018) · Policing An International Journal · doi:10.1108/pijpsm-09-2018-0131 · Cited by 32 · see citing works
Birkeland, B., Weimand, B. M., Ruud, T., Maybery, D. J., & Vederhus, J. (2021) · Addiction Science & Clinical Practice · doi:10.1186/s13722-021-00252-8 · Cited by 32 · see citing works
“Thus, lack of family cohesion and social support would make patients with MDs and SUDs vulnerable in the recovery phase.”
BackgroundInfluentialHornstein, E. A., & Eisenberger, N. I. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104101 · Cited by 30 · see citing works
“Indeed, as mentioned above, individuals with anxiety or PTSD who are also high in loneliness or who report poor quality social bonds have poorer treatment outcomes (Price et al., 2013; Price et al., 2018; Thrasher, Power, Morant, Marks, & Dalgeish, 2010; Dour et al., 2014; Lindfors et al., 2014).”
BackgroundAnalyzing factors affecting quality of life in patients hospitalized with chronic wound
Yan, R., Yu, F., Strandlund, K., Han, J., Lei, N., & Song, Y. (2020) · Wound Repair and Regeneration · doi:10.1111/wrr.12870 · Cited by 32 · see citing works
“Perceived social support refers to people's beliefs of how much potential support there is in their relationships and social interactions and the quality of such support.(30) Many researchers believe that perceived social support is more important than objective support, because it is the perceived social support that…”
BackgroundGan, S. K., Wong, S. W.-Y., & Jiao, P.-D. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043620 · Cited by 36 · see citing works
“Perceived social support could predict mental health better than many other measures [38] and is frequently measured [39].”
BackgroundВачиковна, П. Н., Boytsov, S. A., Bacquer, D. D., Sokolova, O. Y., Аушева, А. К., Kursakov, A. A., & Saner, H. E. (2021) · Global Heart · doi:10.5334/gh.1017 · Cited by 27 · see citing works
Perceived Social Support in Multi-era Veterans With Posttraumatic Stress Disorder
Sripada, R. K., Lamp, K. E., Defever, M. E., Venners, M. R., & Rauch, S. A. M. (2016) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000476 · Cited by 26 · see citing works
“Furthermore, high social support predicts better treatment response (Dour et al., 2014; Price et al., 2013).”
BackgroundParkes, K. R. (2015) · Applied Ergonomics · doi:10.1016/j.apergo.2015.11.009 · Cited by 23 · see citing works
“While the present study does not identify intervening variables these relationships, high support plays a role in reducing anxiety and depression (Clark et al., 2012; Dour et al., 2014), and promoting mastery at work (Ljoså et al.”
BackgroundStewart, R. A., Patel, T. A., McDermott, K. A., & Cougle, J. R. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.026 · Cited by 22 · see citing works
Coady, A., Godard, R., & Holtzman, S. (2023) · Journal of Health Psychology · doi:10.1177/13591053231191919 · Cited by 22 · see citing works
“This is consistent with research showing that lower levels of social support are associated with higher levels of negative affect in general (Dour et al., 2013) and that illness-related shame is linked with social withdrawal and diminished quality of social relationships (Trindade et al., 2018).”
ResultWell-Being and Physical Health: A Mediation Analysis
Kesavayuth, D., Shangkhum, P., & Zikos, V. (2022) · Journal of Happiness Studies · doi:10.1007/s10902-022-00529-y · Cited by 21 · see citing works
Kieu, P. T., Vuong, N. L., & Dung, D. V. (2023) · AIDS and Behavior · doi:10.1007/s10461-022-03974-1 · Cited by 21 · see citing works
“Perceived social support is the most pronounced influence on psychological health and wellbeing [8].”
BackgroundYan, H., Sang, L., Liu, H., Li, C., Wang, Z., Chen, R., Ding, H. S., Hu, Z., & Chen, G. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06270-1 · Cited by 23 · see citing works
“Perceived social support refers to people’s beliefs about the amount and quality of support they receive from their relationships and social contacts [23, 24].”
BackgroundPeng, S., Peng, R., Lei, H., & Liu, W. (2023) · Personality and Individual Differences · doi:10.1016/j.paid.2023.112156 · Cited by 21 · see citing works
Understanding the Mechanisms of Change in a Lifestyle Intervention for Older Adults
Juang, C., Knight, B., Carlson, M., Niemiec, S. L. S., Vigen, C., & Clark, F. (2018) · The gerontologist · doi:10.1093/geront/gnw152 · Cited by 21 · see citing works
“Because social relationships mediate the effectiveness of a variety of interventions for older adults (Barrera, Toobert, Angell, Glasgow, & Mackinnon, 2006; Dour et al., 2014; Oh & Ell, 2015), increased connectedness with others may at least partially explain how intervention-based activity changes augment psychologic…”
BackgroundDarragh, M., Yow, B., Kieser, A., Booth, R. J., Kydd, R. R., & Consedine, N. S. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415621390 · Cited by 21 · see citing works
“Perceived social support can ameliorate symptoms of anxiety (Dour et al., 2014) and attenuate the impact of stressors in laboratory contexts (Thorsteinsson and James, 1999).”
BackgroundFong, C.-P., & To, S.-M. (2024) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-022-00819-7 · Cited by 21 · see citing works
“Numerous studies have been undertaken in academia on the relationship between social support and different constructs such as anxiety and depression (Dour et al., 2014; Holahan & Holahan, 1987), resilience (Sippel et al.”
Dai, W., Zeng, Y., Liang, E., Zhou, Q., Zhang, L., & Peng, J. (2021) · Nursing Open · doi:10.1002/nop2.946 · Cited by 20 · see citing works
Xu, H., Peng, L., Wang, Z., & Liu, X. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.991239 · Cited by 18 · see citing works
“, 2020; Yang and Lu, 2022), and depression (Dour et al., 2014).”
BackgroundLong, E., Thomson, M., Milicev, J., Goodfellow, C., Letina, S., Bradley, S. M., & McCann, M. (2024) · Journal of Public Health · doi:10.1007/s10389-024-02236-9 · Cited by 20 · see citing works
“Perceived social support, while related to loneliness, refers to people’s beliefs about how much support is available from their relationships, and the quality of this support (Dour et al. 2014; Hupcey 1998).”
Olashore, A. A., Akanni, O. O., & Oderinde, K. O. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06358-8 · Cited by 21 · see citing works
“Psychological resilience characterizes a method of adapting well in the face of stressprovoking events such as the COVID-19 pandemic, and it is a function of high-quality positive social support [39].”
BackgroundMethodKoenders, M. A., Giltay, E. J., Hoencamp, E., Elzinga, B. M., Spinhoven, P., & Spijker, A. T. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2015.03.009 · Cited by 18 · see citing works
“This is supported by a recent study among unipolar depressed and anxious patients [49], that found that perceived support had a mediating role in symptom change after treatment interventions.”
ResultDissociating emotional and cognitive empathy in pre-clinical and clinical Huntington’s disease
Maurage, P., Lahaye, M., Grynberg, D., Jeanjean, A. P., Guettat, L., Verellen‐Dumoulin, C., Halkin, S., Heeren, A., Billieux, J., & Constant, E. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.01.070 · Cited by 18 · see citing works
“Moreover, at a clinical level, it has been shown in several psychiatric and medical conditions that the quality of social support and interpersonal environment has a crucial impact on treatment compliance (Dour et al., 2014), underlining the role of affective and social factors on treatment response.”
Dong, Y., Xu, L., Wu, S., Qin, W., Hu, F., Li, M., & Xu, Y. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192214756 · Cited by 17 · see citing works
“Perceived social support is the most commonly measured index of social support [19].”
BackgroundDing, S., Liu, G., Xu, F., Ji, K., Zhao, L., Zheng, X., Otsen, B., Wang, Z., Yang, S., & Chen, R. (2023) · BMC Public Health · doi:10.1186/s12889-023-15951-x · Cited by 16 · see citing works
“Previous studies have suggested that anxiety is negatively associated with social support, implying that low perceived social support may heighten anxiety levels [21, 22].”
BackgroundNearchou, F., Davies, A., & Hennessy, E. (2019) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2019.54 · Cited by 17 · see citing works
“Received social support refers to the frequency with which any aspect of social assistance is received (Dour et al. 2014), while perceived support refers to an individual’s perception of received and available assistance from support network members, created by numerous experiences of support over time (Thoits, 2011).”
BackgroundPsychosocial impairment following mild blast-induced traumatic brain injury in rats
Race, N. S., Andrews, K. D., Lungwitz, E. A., Vega‐Alvarez, S., Warner, T. R., Acosta, G., Cao, J., Lu, K., Liu, Z., Dietrich, A. D., et al. (2021) · Behavioural Brain Research · doi:10.1016/j.bbr.2021.113405 · Cited by 16 · see citing works
Kim, J., Kang, H., Bae, K., Kim, S., Shin, I., Yoon, J., Hong, Y. J., Ahn, Y., Jeong, M. H., & Kim, J.-M. (2018) · The International Journal of Psychiatry in Medicine · doi:10.1177/0091217418791439 · Cited by 12 · see citing works
“These types of studies have been performed, largely, in major depressive patients, and poor SS is associated with exacerbation of depressive symptoms following treatment with antidepressants or cognitive behavioral therapy in these patients.(4,5) In depressive patients with ACS, depression outcomes were independently…”
InfluentialLu, W.-H., Ko, N., Chang, Y., Yen, C., & Wang, P. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17217974 · Cited by 16 · see citing works
“Studies have described that perceived social support is a protective factor for anxiety [51], and that it has a central role in anxiety reduction [52].”
BackgroundSubjective well-being and healthcare utilization: A mediation analysis
Kesavayuth, D., Shangkhum, P., & Zikos, V. (2021) · SSM - Population Health · doi:10.1016/j.ssmph.2021.100796 · Cited by 16 · see citing works
Positive relations mediate the bidirectional connections between depression and anxiety symptoms
Barber, K. E., Zainal, N. H., & Newman, M. G. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.082 · Cited by 17 · see citing works
Mental health and social support among Royal Canadian Mounted Police cadets
Nisbet, J., Jamshidi, L., Andrews, K. L., Stewart, S. H., Shields, R. E., Teckchandani, T. A., Maguire, K. Q., & Carleton, R. N. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1092334 · Cited by 20 · see citing works
Childhood Neglect and Psychological Distress Among Pregnant Women
Zhang, X., Li, J., Wang, J., Li, J., Long, Z., & Cao, F. (2020) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001210 · Cited by 15 · see citing works
“The results of the present study showed that higher perceived social support was significantly associated with lower psychological distress, which is consistent with the findings of previous research (Dour et al., 2014; Stewart et al., 2014).”
ResultCognitive behavioral stress management effects on prenatal anxiety among low-income women.
Ponting, C., Chavira, D. A., Schetter, C. D., & Urizar, G. G. (2021) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000699 · Cited by 15 · see citing works
Bones, S., Norris, K., & Quinn, M. G. (2019) · Clinical Psychologist · doi:10.1111/cp.12190 · Cited by 14 · see citing works
Wei, J., Bai, Z., Bu, M., et al. (2025) · BMC Psychology · doi:10.1186/s40359-025-02403-x · Cited by 14 · see citing works
“PSS is defined as an individual’s subjective evaluation and personal experience regarding the support they perceive [13].”
Zhang, H., Xia, Y., Fu, P., Li, C., Shi, K., & Yang, Y. (2025) · Journal of Medical Internet Research · doi:10.2196/76913 · Cited by 16 · see citing works
“Conversely, SS, which includes emotional, informational, and instrumental assistance from others, serves as a protective buffer against psychological distress [9,16,17].”
Ciułkowicz, M., Misiak, B., Szcześniak, D. M., Grzebieluch, J., Maciaszek, J., & Rymaszewska, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191912962 · Cited by 13 · see citing works
“One scenario is that low-perceived social support may increase the level of anxiety [20].”
BackgroundRESILIENCE, PERCEIVED SOCIAL SUPPORT, AND LIFE SATISFACTION AMONG MALAYSIAN COLLEGE STUDENTS
Khalid, N. M. (2021) · Journal of Nusantara Studies (JONUS) · doi:10.24200/jonus.vol6iss2pp21-40 · Cited by 16 · see citing works
“These include their social contacts and the quality of that support (Dour et al., 2014).”
BackgroundCognitive-Behavioral Therapy for Depressive Symptoms in Persons of African Descent: A Meta-Analysis
Gregory, V. L. (2015) · Journal of Social Service Research · doi:10.1080/01488376.2015.1084973 · Cited by 13 · see citing works
Hernandez, D. B., Kalichman, S. C., Katner, H. P., Burnham, K., Kalichman, M. O., & Hill, M. (2018) · Journal of Behavioral Medicine · doi:10.1007/s10865-018-9912-0 · Cited by 13 · see citing works
“Important factors that could also mediate and/or moderate these associations include, but are not limited to social support (Dour et al., 2014; Gibbie et al., 2007; Lehavot et al., 2011), trauma (Adewuya et al., 2009; Breet et al., 2014), and food insecurity (Kapulsky et al., 2015; Tsai et al.,…”
Li, S., & Wang, Y. (2023) · Psychology Research and Behavior Management · doi:10.2147/prbm.s422982 · Cited by 12 · see citing works
“The analysis of cognitive reappraisal through distraction theory found that attention is the pointing and focusing of mental activity on a certain object, which has the characteristics of both pointing and focusing, and when an individual points and focuses his or her consciousness on a certain activity, his or her aw…”
BackgroundHunt, C., Vinograd, M., Glynn, L. M., Davis, E. P., Baram, T. Z., Stern, H. S., Nievergelt, C. M., Cuccurazzu, B., Napan, C., Delmar, D., et al. (2023) · Journal of Mood and Anxiety Disorders · doi:10.1016/j.xjmad.2023.100045 · Cited by 11 · see citing works
“…has been linked to prosocial behavior in adulthood [40,48] and social support has been found to mediate broad range of evidence-based treatment effects on symptom change in depression, suggesting that factors that influence social support may consequently influence depression symptoms [20].”
Cucciare, M. A., Han, X., Curran, G., & Booth, B. (2016) · Substance Use & Misuse · doi:10.3109/10826084.2016.1155611 · Cited by 12 · see citing works
“Indeed, SS can take many forms including support that is emotional (i.e., someone acting as a confidant), instrumental (i.e., providing tangible help or assistance), and companionate (i.e., a group with whom to socialize) (Dour et al., 2014).”
BackgroundKoenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780190088859.003.0001 · Cited by 11 · see citing works
Cognitive-Behavioral Therapy for Anxious Symptoms in Persons of African Descent: A Meta-Analysis
Gregory, V. L. (2018) · Journal of Social Service Research · doi:10.1080/01488376.2018.1479344 · Cited by 11 · see citing works
“The remaining 16 potentially eligible studies did not meet inclusion criteria because the study: did not have relevant data pertaining exclusively to persons of African descent (Dour et al., 2014; Gellis & Gehrman, 2011; Glueckauf et al., 2012; Green et al., 2006; Himle et al., 2014; Horrell et al., 2014; Jones et al.…”
BackgroundEidelman, P., Jensen, A., & Rappaport, L. M. (2018) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2018.1490809 · Cited by 11 · see citing works
“…level of perceived social support enhances an individual’s response to treatment (e.g. Brown, Alpert, Lent, Hunt, & Brady, 1988; LaRocca & Scogin, 2015) and have suggested that changes in social support may mediate improvements in depression and anxiety occurring in treatment (Dour et al., 2014).”
BackgroundZhang, Q., Ruan, Y., Hu, W., Li, J., Zhao, J., Peng, M., Wan, R., Min, X., He, S., & Liu, Z. (2021) · BMC Public Health · doi:10.1186/s12889-021-11787-5 · Cited by 11 · see citing works
Zhang, X., Xiao, Y., Xu, P., & Dong, S. (2025) · Journal of Pacific Rim Psychology · doi:10.1177/18344909251324571 · Cited by 15 · see citing works
“Six, PSS is the most commonly assessed measure of social support (Ibarra-Rovillard & Kuiper, 2011), largely because it is easy to quantify and has been shown to be a more effective predictor of mental health than other measures (Brissette et al., 2002; Dour et al., 2014; Levendosky et al., 2002).”
Cebrino, J., & de la Cruz, S. P. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9072199 · Cited by 10 · see citing works
“Perceived social support refers to people’s beliefs about how much support is potentially available from their relationships and social contacts and about the quality of this support [83,84].”
BackgroundNguyen, N. P., Kim, S. Y., Daheim, J., & Neduvelil, A. (2020) · Journal of Aging and Health · doi:10.1177/0898264320947293 · Cited by 11 · see citing works
Connolly, R. D., Lamont, A., & Speed, D. (2022) · Journal of Attention Disorders · doi:10.1177/10870547221136227 · Cited by 10 · see citing works
“Strategies to bolster positive social interactions may include providing family psychoeducation and interpersonal skill training (Dour et al., 2014).”
BackgroundFactors associated with COVID-19 vaccination behaviour in Latvian population: cross-sectional study
Šuriņa, S., Mārtinsone, K., Upesleja, G., & Perepjolkina, V. (2022) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2022.2085108 · Cited by 10 · see citing works
“Perceived social support is a cognitive perception of an individual, that they have established reliable links with others, and that in a case of need it is possible to get support (Dour et al., 2014).”
BackgroundSanders, S. M., Williams, T. R., Gao, F., Muwele, C., Mitchell, J. M., & Mitchell, T. (2024) · Journal of Black Psychology · doi:10.1177/00957984241309166 · Cited by 9 · see citing works
“Although perceived social support can function as a mediator for depression and anxiety (Dour et al., 2014; Wang et al., 2018), the sense of being rejected by others is associated with a lack of perceived social support (Sarason et al., 1991).”
Naughton‐Doe, R., Nowland, R. A., Tierney, S., Webber, M., & Wittkowski, A. (2025) · BMC Public Health · doi:10.1186/s12889-024-20788-z · Cited by 9 · see citing works
An in-depth analysis of the relation of health and poverty in Europe
Apostu, S. A., Dimian, G. C., & Vasilescu, M. D. (2022) · Panoeconomicus · doi:10.2298/pan210622006a · Cited by 11 · see citing works
Bi, Y., Xiao, Y., Pan, X., Zhang, Y., Yang, Q., & Hu, L. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115523 · Cited by 9 · see citing works
Green Care as Psychosocial Intervention for Depressive Symptoms: What Might Be the Key Ingredients?
Salomon, R. E., Salomon, A., & Beeber, L. S. (2017) · Journal of the American Psychiatric Nurses Association · doi:10.1177/1078390317723710 · Cited by 9 · see citing works
“The authors were supported by multiple experts in the field while preparing the review, including a health sciences librarian who assisted with the creation of the search terms and a researcher who has focused on developing psychosocial interventions aimed at improving depressive Mediator: Behavioral activation Losada…”
BackgroundMethodInfluentialPredictive Model for Quality of Life in Patients 1 Year After First Stroke
Kim, S. R., Yoo, S., Kim, H. Y., & Kim, G.-G. (2021) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000814 · Cited by 9 · see citing works
Gebe Okulu Eğitimlerinin Doğum Korkusu Üzerine Etkisi
Yazıcıoğlu, B., & Yavuz, E. (2022) · Turkish Journal of Family Practice · doi:10.54308/tahd.2022.98608 · Cited by 8 · see citing works
Nano, J. P., Ghaly, M. H., & Fan, W. (2022) · International Journal of Public Health · doi:10.3389/ijph.2022.1604806 · Cited by 8 · see citing works
Huang, H., Wu, H., Luo, L., Jiao, B., Wu, Y., Zou, G., Lin, J., Wang, W., & Ma, L. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1538390 · Cited by 7 · see citing works
Incidence of panic disorder in patients with non-cardiac chest pain and panic attacks
Heppell, J.-L., Denis, I., Turcotte, S., Fleet, R. P., Dionne, C. E., & Foldes‐Busque, G. (2019) · Journal of Health Psychology · doi:10.1177/1359105319859062 · Cited by 7 · see citing works
“Younger age, a high level of anxiety sensitivity, a high level of psychological distress, a low level of social support, and the presence of other anxiety and mood disorders have also been associated with PD (Deacon and Abramowitz, 2006; Dour et al., 2014; Hart and Hittner, 1991; Kessler et al., 2006; Mantar et al., 2…”
BackgroundKinser, P., Jallo, N., Huberty, J. L., Jones, E., Thacker, L., Moyer, S., Laird, B., Rider, A., Lanni, S., Drozd, F., et al. (2020) · Research in Nursing and Health · doi:10.1002/nur.22092 · Cited by 8 · see citing works
Sivaratnam, J., Cabano, E. P., & Erickson, T. M. (2021) · Anxiety Stress & Coping · doi:10.1080/10615806.2021.1967333 · Cited by 7 · see citing works
“social support, which predicts lower distress (Dour et al., 2014).”
Şahin, Ş., & Özhanlı, Y. (2025) · BMC Nursing · doi:10.1186/s12912-025-04010-y · Cited by 6 · see citing works
A systematic review of the factors that contribute towards mental health in the fire service
Garmon-Jones, L., Hanna, P., & John, M. (2023) · International Journal of Emergency Services · doi:10.1108/ijes-02-2021-0005 · Cited by 6 · see citing works
Keller, Y., David, Y., & Trachtenberg, E. (2024) · New Media & Society · doi:10.1177/14614448241302312 · Cited by 7 · see citing works
“Perceived social support is understood as a subjective appraisal of how family and friends receive and provide emotional and instrumental types of support (Dour et al., 2014) and is positively associated with mental health (Ju et al., 2023; Thoits, 2011).”
Animal Models to Investigate Social Support Induced Anxiety Reductions
Majumdar, S., Lungwitz, E. A., Andrews, K. D., Chambers, J. E., & Truitt, W. A. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-813693-5.00012-5 · Cited by 5 · see citing works
Obezite Hastalarında Sağlık Okuryazarlığı ile Sağlıklı Beslenme Tutumu İlişkisinin Değerlendirilmesi
Çın, A., Akkan, T., Dağdeviren, M., Şengezer, T., & Altay, M. (2022) · Turkish Journal of Family Practice · doi:10.54308/tahd.2022.42104 · Cited by 6 · see citing works
- Authors
- Dour, H. J., Wiley, J. F., Roy-Byrne, P., Stein, M. B., Sullivan, G., Sherbourne, C. D., Bystritsky, A., Rose, R. D., & Craske, M. G.
- Affiliations
- University of California, Los Angeles (US)
- Department of Psychiatry and Behavioral Sciences; University of Washington School of Medicine at Harborview Medical Center; Seattle WA
- University of California San Diego (US)
- RAND Corporation (US)
- Corresponding author
- Craske, Michelle G.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2013-12-12
- Volume
- 31
- Issue
- 5
- Pages
- 436-442
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC4136523
- OpenAlex
- W1779313770
- Semantic Scholar
- 3e760a3822666ed3c0f7b9af634901477bcc3dcc
- Cited by
- 243
- References
- 53
- Citations by year
- 2026: 12 · 2025: 20 · 2024: 12 · 2023: 62 · 2022: 49 · 2021: 28 · 2020: 16 · 2019: 7 · 2018: 14 · 2017: 8 · 2016: 5 · 2015: 8 · 2014: 1 · 2013: 1
- FWCI
- 6.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- Funders
- National Institute of Mental Health (U01MH057835, MH065324, MH-64122, K24MH065324, UO1 MH057858, K24MH064122, MH058915, K24MH64122, MH057858, U01MH070022, U01MH070018, U01MH057858, MH070022, U01MH058915, MH057835)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- perceived social support, anxiety symptoms, depressive symptoms, mediation, primary care, cognitive behavioral therapy, psychopharmacology, usual care
- MeSH terms
- Adult, Anxiety Disorders, Combined Modality Therapy, Depressive Disorder, Female, Humans, Male, Middle Aged, Phobic Disorders, Primary Health Care, Surveys and Questionnaires, Social Perception, Social Support, Stress Disorders, Post-Traumatic, Anti-Anxiety Agents, Cognitive Behavioral Therapy, Panic Disorder, Evidence-Based Medicine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
