Advancing the Development of Social Interventions for Adult Depression

Abstract

Social interventions that promote social capital and social support have the potential to reduce depression at a population level, yet fundamental gaps in the study of social capital, and uncertainty of how social interventions should be designed act as barriers to their implementation. Uncertainty remains regarding (1) the longitudinal relationships between the dimensions of social capital and depression, (2) the complex pathways that can lead to depression in vulnerable groups, and (3) the types of social interventions that could effectively reduce depression. This dissertation included three studies to reduce these knowledge gaps and create recommendations for public health interventions. The first study investigated the longitudinal relationships among cognitive, structural, and network dimensions of social capital and depressive status in adults over a six-year period. The cognitive dimension of social capital was most strongly related to lower odds of depressive status over the study period. Findings speak to the importance of conducting community-based programs for depression, which aim to strengthen cognitive social capital, by fostering trust in neighbours and improving neighbourhood social cohesion. The second study examined the key pathways that lead to depression in a sample of low income mothers. The study found that higher parental stress partially explained the relationship between low income and depressive symptoms in mothers. Having diverse social networks was protective against the effects of high parental stress on depressive symptoms. Findings demonstrate the importance of considering network social capital as a potential buffer against stress, and also the complex factors that can lead to depression when designing social interventions. The third study included a systematic review of the literature that classified and reported on community-based social interventions that have been implemented to target depression in adults. Seventeen of the twenty-four interventions included in the review were effective in reducing depression among participants. Most interventions incorporated multiple approaches to promoting mental health. The review concluded that social interventions have the potential to be effective, can be tailored to diverse groups, and can be feasible in resource-scarce communities. The findings of this dissertation generated recommendations that can be directly applied to the design of public health interventions.