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Dimensions of Social Support and Depression in Patients at Increased Psychosocial Risk Recovering from Myocardial Infarction

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Abstract

Background

There is considerable evidence that depression and low social support are associated with increased morbidity and mortality for patients with coronary heart disease (CHD). However, there is a lack of consensus regarding the measurement of social support and its relation to depression.

Purpose

The primary purpose of the present study was to identify key dimensions of existing social support and depression measures for patients with CHD using factor analysis.

Method

Seven hundred-five patients with a recent acute myocardial infarction and either depression, low social support, or both, completed measures of several types of social support and depression. Exploratory and confirmatory factor analysis were used to examine the underlying dimensions of the existing social support and depression measures, and to compare theoretically plausible models specifying the relation between the social support and depression factors.

Results

Confirmatory factor analysis indicated that an approach in which smaller facets of depression are measured (somatic, cognitive/affective, anxious) and social support (perceived emotional support from intimate relationships; perceived tangible support from peripheral contacts; and the number of children, relatives, and friends in a patient’s support network), may be the most optimal way to measure social support and depression in this population RMSEA = 0.05; CFI = 0.81; TLI = 0.88).

Conclusion

Efforts to identify patients at increased psychosocial risk may be improved by screening for these subcomponents of social support and depression.

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Notes

  1. Detailed results of this analysis are available at http://www.duke.edu/web/behavioralmed/invariance.pdf

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Acknowledgments

Supported by contracts NO1-HC-55140, NO1-HC-55141, NO1-HC-55142, NO1-HC-55143, NO1-HC-55144, NO1-HC-55145, NO1-HC-55146, NO1-HC-55147, NO1-HC-55148 and by a grant HL 080664 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. This work was based upon the doctoral dissertation of the first author (HSL) under the direction of the second author (JAB); all data analyses were overseen by the third author (MAB). The authors wish to thank all of the co-investigators of the ENRICHD trial for making this study possible.

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Authors and Affiliations

  1. Duke University Medical Center, Durham, NC, USA

    Heather S. Lett, James A. Blumenthal & Michael A. Babyak

  2. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Diane J. Catellier

  3. Washington University, St. Louis, MO, USA

    Robert M. Carney

  4. Harvard University, Cambridge, MA, USA

    Lisa F. Berkman

  5. Yale-New Haven Veterans Administration Hospital, New Haven, CT, USA

    Matthew M. Burg

  6. University of Washington, Seattle, WA, USA

    Pamela Mitchell

  7. Mayo Clinic, Rochester, MN, USA

    Allan S. Jaffe

  8. University of Miami, Coral-Gables, FL, USA

    Neil Schneiderman

  9. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3119, Durham, NC, 27710, USA

    James A. Blumenthal

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  1. Heather S. Lett
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Correspondence to James A. Blumenthal.

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Lett, H.S., Blumenthal, J.A., Babyak, M.A. et al. Dimensions of Social Support and Depression in Patients at Increased Psychosocial Risk Recovering from Myocardial Infarction. Int.J. Behav. Med. 16, 248–258 (2009). https://doi.org/10.1007/s12529-009-9040-x

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