PERCEIVED SOCIAL SUPPORT AND AFFECTIVE DISORDERS: A COMPARISON OF INDIVIDUALS WITH DEPRESSION AND BIPOLAR DISORDER
Abstract
Background: Research on social functioning difficulties in individuals with bipolar disorder has produced inconsistent findings, ranging from significant social impairments to no differences or even superior outcomes compared to patients with depression. Current literature is limited by methodological constraints including use of non-validated self-report measures, lack of analysis of specific support sources, and absence of appropriate clinical comparison groups. These contradictory results necessitate investigation of alternative variables that may explain social support variations in affective disorders, which is crucial for developing targeted psychosocial interventions for bipolar disorder populations.
Methods: A quasi-experimental study recruited 89 participants (52 bipolar disorder, 37 depression) from online support groups across Polish, English, and Spanish-speaking populations. Perceived social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS). ANCOVA models controlled for age, gender, and psychiatric comorbidity.
Results: No significant differences emerged between diagnostic groups after controlling for covariates (p > .05). However, age was negatively correlated with global support (p = .021), friends support (r = −.28, p < .007), and significant other support (r = −.23, p = .028), while family support remained stable (r = −.06, p = .555). Both groups scored substantially below Polish population norms with large effect sizes (bipolar disorder: d = −1.11; depression: d = −1.29; p < .001).
Conclusions: Age, rather than diagnostic category, predicts perceived social support decline in affective disorders. Both groups demonstrate clinically meaningful social support deficits, suggesting common vulnerabilities requiring targeted interventions across affective disorder spectrum.
References
Antonucci, T., Akiyama, H., & Takahashi, K. (2004). Attachment and close relationships across the life span. Attachment and Human Development, 6(4), 353–370. https://doi.org/10.1080/1461673042000303136
Barrera, M., Jr., & Ainlay, S. L. (1983). The structure of social support: A conceptual and empirical analysis. Journal of Community Psychology, 11(2), 133–143. https://doi.org/10.1002/1520-6629(198304)11:2<133::aid-jcop2290110207>3.0.co;2-l
Barrera, M., Jr., Sandler, I. N., & Ramsay, T. B. (1981). Preliminary development of a scale of social support. American Journal of Community Psychology, 9(4), 435–447. https://doi.org/10.1007/BF00918174
Beyer, J. L., Kuchibhatla, M., Looney, C., Engstrom, E., Cassidy, F., & Krishnan, K. R. R. (2003). Social support in elderly patients with bipolar disorder. Bipolar Disorders, 5(1), 22–27. https://doi.org/10.1034/j.1399-5618.2003.00016.x
Buszman, K., & Przybyła-Basista, H. (2017). Polska adaptacja wielowymiarowej skali spostrzeganego wsparcia społecznego [Polish adaptation of the multidimensional scale of perceived social support]. Polskie Forum Psychologiczne, 22(4), 581–599. https://doi.org/10.14656/PFP20170404
Carstensen, L. L. (1992). Social and emotional patterns in adulthood: Support for socioemotional selectivity theory. Psychology and Aging, 7(3), 331–338. https://doi.org/10.1037//0882-7974.7.3.331
Carstensen, L. L., Pasupathi, M., Mayr, U., & Nesselroade, J. R. (2000). Emotional experience in everyday life across the adult life span. Journal of Personality and Social Psychology, 79(4), 644–655. https://doi.org/10.1037/0022-3514.79.4.644
Cassel, J. (1976). The contribution of the social environment to host resistance: The Fourth Wade Hampton Frost lecture. American Journal of Epidemiology, 104(2), 107–123. https://doi.org/10.1093/oxfordjournals.aje.a112281
Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38(5), 300–314. https://doi.org/10.1097/00006842-197609000-00003
Coury, M. S. (2009). Investigating the effects of depression and bipolar disorder on social support, stigmatization, and family burden [Master's thesis, University of Tennessee]. TRACE: Tennessee Research and Creative Exchange. https://trace.tennessee.edu/utk_gradthes/5691
Dunayevich, E., & Keck, P. E., Jr. (2000). Prevalence and description of psychotic features in bipolar mania. Current Psychiatry Reports, 2(4), 286–290. https://doi.org/10.1007/s11920-000-0069-4
Eker, D., & Arkar, H. (1995). Perceived social support: Psychometric properties of the MSPSS in normal and pathological groups in a developing country. Social Psychiatry and Psychiatric Epidemiology, 30(3), 121–126. https://doi.org/10.1007/BF00802040
Gałecki, P., & Szulc, A. (2018). Psychiatria [Psychiatry]. Edra Urban & Partner.
Haber, M. G., Cohen, J. L., Lucas, T., & Baltes, B. B. (2007). The relationship between self-reported received and perceived social support: A meta-analytic review. American Journal of Community Psychology, 39(1-2), 133–144. https://doi.org/10.1007/s10464-007-9100-9
Jesulola, E., Micalos, P., & Baguley, I. J. (2017). Understanding the pathophysiology of depression: From monoamines to the neurogenesis hypothesis model—are we there yet? Behavioural Brain Research, 341, 79–90. https://doi.org/10.1016/j.bbr.2017.12.025
Jiang, L., Drolet, A., & Kim, H. S. (2018). Age and social support seeking: Understanding the role of perceived social costs to others. Personality and Social Psychology Bulletin, 44(9), 1–13. https://doi.org/10.1177/0146167218760798
Johnson, L., Lundström, O., Åberg-Wistedt, A., & Mathé, A. A. (2003). Social support in bipolar disorder: Its relevance to remission and relapse. Bipolar Disorders, 5(2), 129–137. https://doi.org/10.1034/j.1399-5618.2003.00021.x
Johnson, S. L., Meyer, B., Winett, C., & Small, J. (2000). Social support and self-esteem predict changes in bipolar depression but not mania. Journal of Affective Disorders, 58(1), 79–86. https://doi.org/10.1016/S0165-0327(99)00133-0
Kafetsios, K., & Sideridis, G. D. (2006). Attachment, social support and well-being in young and older adults. Journal of Health Psychology, 11(6), 863–876. https://doi.org/10.1177/1359105306069084
Koenders, M. A., Giltay, E. J., Hoencamp, E., Elzinga, B. M., Spinhoven, P., & Spijker, A. T. (2015). The bidirectional impact of perceived and enacted support on mood in bipolar outpatients: A two-year prospective study. Comprehensive Psychiatry, 60, 59–67. https://doi.org/10.1016/j.comppsych.2015.03.009
Langford, C. P. H., Bowsher, J., Maloney, J. P., & Lillis, P. P. (1997). Social support: A conceptual analysis. Journal of Advanced Nursing, 25(1), 95–100. https://doi.org/10.1046/j.1365-2648.1997.1997025095.x
Li, T., Fok, H. K., & Fung, H. H. (2011). Is reciprocity always beneficial? Age differences in the association between support balance and life satisfaction. Aging & Mental Health, 15(5), 541–547. https://doi.org/10.1080/13607863.2010.551340
Maleki, N., Sadeghian, E., Shamsaei, F., Tapak, L., & Ghaleiha, A. (2019). Comparative analysis of spouse's burden and quality of life in major depressive disorder and bipolar I disorder. Current Psychiatry Research and Reviews, 15(3), 193–198. https://doi.org/10.2174/1874464812666190819151039
Marneros, A. (2009). Mood disorders: Epidemiology and natural history. Psychiatry, 8(2), 52–55. https://doi.org/10.1016/j.mppsy.2008.10.022
Marsella, A. J., & Snyder, K. K. (1981). Stress, social supports, and schizophrenic disorders: Toward an interactional model. Schizophrenia Bulletin, 7(1), 152–163. https://doi.org/10.1093/schbul/7.1.152
Melrose, K. L., Brown, G. D., & Wood, A. M. (2015). When is received social support related to perceived support and well-being? When it is needed. Personality and Individual Differences, 77, 97–105. https://doi.org/10.1016/j.paid.2014.12.047
Nierenberg, A. A., Agustini, B., Köhler-Forsberg, O., Cusin, C., Katz, D., Sylvia, L. G., Peters, A., & Berk, M. (2023). Diagnosis and treatment of bipolar disorder. JAMA, 330(14), 1370. https://doi.org/10.1001/jama.2023.18588
Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: From neurobiology to clinical practice. Psychiatry, 4(5), 35–40.
Pless, I. B., & Satterwhite, B. (1972). Chronic illness in childhood: A regional survey of care. Pediatrics, 50(6), 881–889.
Poradowska-Trzos, M., Dudek, D., Rogoz, M., & Zieba, A. (2007). Comparison of social networks of patients with unipolar and bipolar disease. Psychiatria Polska, 41(5), 665–677.
Procidano, M. E., & Heller, K. (1983). Measures of perceived social support from friends and from family: Three validation studies. American Journal of Community Psychology, 11(1), 1–24. https://doi.org/10.1007/BF00898416
Romans, S. E., & McPherson, H. M. (1992). The social networks of bipolar affective disorder patients. Journal of Affective Disorders, 25(4), 221–228. https://doi.org/10.1016/0165-0327(92)90079-L
Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing social support: The Social Support Questionnaire. Journal of Personality and Social Psychology, 44(1), 127–139. https://doi.org/10.1037/0022-3514.44.1.127
Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Houghton, Mifflin and Company.
Shippee, N. D., Shah, N. D., Williams, M. D., Moriarty, J. P., Frye, M. A., & Ziegenfuss, J. Y. (2011). Differences in demographic composition and in work, social, and functional limitations among the populations with unipolar depression and bipolar disorder: Results from a nationally representative sample. Health and Quality of Life Outcomes, 9, 90. https://doi.org/10.1186/1477-7525-9-90
Shrank, W. H., Patrick, A. R., & Brookhart, M. A. (2011). Healthy user and related biases in observational studies of preventive interventions: A primer for physicians. Journal of General Internal Medicine, 26(5), 546–550. https://doi.org/10.1007/s11606-010-1609-1
Siedlecki, K. L., Salthouse, T. A., Oishi, S., & Jeswani, S. (2013). The relationship between social support and subjective well-being across age. Social Indicators Research, 117(2), 561–576. https://doi.org/10.1007/s11205-013-0361-4
Singh, N. K., & Kishore, A. (2018). A comparative study of perceived social support among persons with schizophrenia and mania. Indian Journal of Psychiatric Social Work, 9(1), 24–28. https://doi.org/10.29120/IJPSW.2018.v9.i1.43
Soman, S., Bhat, S. M., Latha, K. S., & Praharaj, S. K. (2017). Do life events and social support vary across depressive disorders? Indian Journal of Psychological Medicine, 39(3), 316–322. https://doi.org/10.4103/0253-7176.207334
Studart, P. M., Bezerra Filho, S., Studart, A. B. D., Almeida, A. G. D., & Miranda-Scippa, Â. (2015). Social support and bipolar disorder. Archives of Clinical Psychiatry (São Paulo), 42(4), 95–99. https://doi.org/10.1590/0101-60830000000057
Studart-Botto, P., Léda-Rêgo, G., Abbade, P., Bandeira, I. D., & Miranda-Scippa, A. (2023). Social support among individuals with bipolar disorder during euthymic phase: A systematic review. Clinical Psychology & Psychotherapy, 30(2), 270–280. https://doi.org/10.1002/cpp.2805
Schulz, U., & Schwarzer, R. (2003). Soziale Unterstützung bei der Krankheitsbewältigung: Die Berliner Social Support Skalen (BSSS) [Social support in coping with illness: The Berlin Social Support Scales (BSSS)]. Diagnostica, 49(2), 73–82. https://doi.org/10.1026/0012-1924.49.2.73
Uygun, E., Cebeci, R. B., Özsoy, E., Başar, Ş., Erim, B. R., & Erkoç, N. Ş. (2020). Investigation of the relationship between perceived social support and psychological resilience in bipolar disorder: A cross-sectional study. Anatolian Journal of Psychiatry, 21(1), 37–44. https://doi.org/10.5455/apd.44293
Wang, J., Mann, F., Lloyd-Evans, B., Ma, R., & Johnson, S. (2018). Associations between loneliness and perceived social support and outcomes of mental health problems: A systematic review. BMC Psychiatry, 18, 156. https://doi.org/10.1186/s12888-018-1736-5
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52(1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2
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