Social support and physical activity as moderators of life stress in predicting baseline depression and change in depression over time in the Women’s Health Initiative (original) (raw)

Abstract

Purpose

To determine whether social support and/or physical activity buffer the association between stressors and increasing risk of depression symptoms at baseline and at 3-year follow-up.

Methods

This is a secondary analysis of data from the Women’s Health Initiative Observational Study. 91,912 community-dwelling post-menopausal women participated in this prospective cohort study. Depression symptoms were measured at baseline and 3 years later; social support, physical activity, and stressors were measured at baseline.

Results

Stressors at baseline, including verbal abuse, physical abuse, caregiving, social strain, negative life events, financial stress, low income, acute pain, and a greater number of chronic medical conditions, were all associated with higher levels of depression symptoms at baseline and new onset elevated symptoms at 3-year follow-up. Social support and physical activity were associated with lower levels of depressive symptoms. Contrary to expectation, more social support at baseline strengthened the association between concurrent depression and physical abuse, social strain, caregiving, and low income. Similarly, more social support at baseline increased the association between financial stress, income, and pain on new onset depression 3 years later. Physical activity similarly moderated the effect of caregiving, income, and pain on depression symptoms at baseline.

Conclusion

Stressors, social support, and physical activity showed predicted main effect associations with depression. Multiplicative interactions were small in magnitude and in the opposite direction of what was expected.

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Acknowledgments

The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services through contracts N01WH22110, 24152, 32100-2, 32105-6, 32108-9, 32111-13, 32115, 32118-32119, 32122, 42107-26, 42129-32, and 44221.

Conflict of interest

C. Eaton has grant funding with Pfizer, Merck, Amylin and Roche Pharmaceuticals. R. Weisberg has grant funding with Pfizer Pharmaceuticals. L. Uebelacker, M. Sands, C. Williams, D. Calhoun, J. Manson, N. Denburg, T. Taylor do not have any conflicts of interest.

Author information

Authors and Affiliations

  1. Alpert Medical School of Brown University, Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA
    Lisa A. Uebelacker & Charles B. Eaton
  2. Department of Psychiatry and Human Behavior, Brown University Program for Anxiety Research, Behavioral Health Research, Center for Primary Care and Prevention, Pawtucket, USA
    Risa Weisberg
  3. Clinical Epidemiology, Center for Sleep and Circadian Neurobiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
    Megan Sands
  4. Howard University Cancer Center, Washington, DC, USA
    Carla Williams & Teletia Taylor
  5. Phoenix Field Office, MedStar Research Institute, Phoenix, USA
    Darren Calhoun
  6. Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
    JoAnn E. Manson
  7. Department of Neuroscience, The University of Iowa, University Heights, USA
    Natalie L. Denburg

Authors

  1. Lisa A. Uebelacker
  2. Charles B. Eaton
  3. Risa Weisberg
  4. Megan Sands
  5. Carla Williams
  6. Darren Calhoun
  7. JoAnn E. Manson
  8. Natalie L. Denburg
  9. Teletia Taylor

Corresponding author

Correspondence toLisa A. Uebelacker.

Additional information

Prior Presentation: Uebelacker LA, Eaton CB, Weisberg R, Sands M, Williams C, Calhoun D, Manson JE, Denberg NL, Taylor T (2012, December) Social support and physical activity: do they buffer the effect of life stress on depression. In: The 40th annual meeting of the North American Primary Care Research Group, New Orleans, Louisiana.

Appendix

Appendix

WHI Investigators

Program Office: (National Heart, Lung, and Blood Institute, Bethesda, Maryland) Elizabeth Nabel, Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, and Nancy Geller.

Clinical Coordinating Center: (Fred Hutchinson Cancer Research Center, Seattle, WA).

Ross Prentice, Garnet Anderson, Andrea LaCroix, Charles L. Kooperberg, Ruth E. Patterson, Anne McTiernan; (Medical Research Labs, Highland Heights, KY) Evan Stein; (University of California at San Francisco, San Francisco, CA) Steven Cummings.

Clinical Centers: (Albert Einstein College of Medicine, Bronx, NY) Sylvia Wassertheil-Smoller; (Baylor College of Medicine, Houston, TX) Aleksandar Rajkovic; (Brigham and Women’s Hospital, Harvard Medical School, Boston, MA) JoAnn E. Manson; (Brown University, Providence, RI) Charles B. Eaton; (Emory University, Atlanta, GA) Lawrence Phillips; (Fred Hutchinson Cancer Research Center, Seattle, WA) Shirley Beresford; (George Washington University Medical Center, Washington, DC) Lisa Martin; (Los Angeles Biomedical Research Institute at Harbor, UCLA Medical Center, Torrance, CA) Rowan Chlebowski; (Kaiser Permanente Center for Health Research, Portland, OR) Yvonne Michael; (Kaiser Permanente Division of Research, Oakland, CA) Bette Caan; (Medical College of Wisconsin, Milwaukee, WI) Jane Morley Kotchen; (MedStar Research Institute/Howard University, Washington, DC) Barbara V. Howard; (Northwestern University, Chicago/Evanston, IL) Linda Van Horn; (Rush Medical Center, Chicago, IL) Henry Black; (Stanford Prevention Research Center, Stanford, CA) Marcia L. Stefanick; (State University of New York at Stony Brook, Stony Brook, NY) Dorothy Lane; (The Ohio State University, Columbus, OH) Rebecca Jackson; (University of Alabama at Birmingham, Birmingham, AL) Cora E. Lewis; (University of Arizona, Tucson/Phoenix, AZ) Cynthia A Thomson; (University at Buffalo, Buffalo, NY) Jean Wactawski-Wende; (University of California at Davis, Sacramento, CA) John Robbins; (University of California at Irvine, CA) F. Allan Hubbell; (University of California at Los Angeles, Los Angeles, CA) Lauren Nathan; (University of California at San Diego, LaJolla/Chula Vista, CA) Robert D. Langer; (University of Cincinnati, Cincinnati, OH) Margery Gass; (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher; (University of Hawaii, Honolulu, HI) J. David Curb; (University of Iowa, Iowa City/Davenport, IA) Robert Wallace; (University of Massachusetts/Fallon Clinic, Worcester, MA) Judith Ockene; (University of Medicine and Dentistry of New Jersey, Newark, NJ) Norman Lasser; (University of Miami, Miami, FL) Mary Jo O’Sullivan; (University of Minnesota, Minneapolis, MN) Karen Margolis; (University of Nevada, Reno, NV) Robert Brunner; (University of North Carolina, Chapel Hill, NC) Gerardo Heiss; (University of Pittsburgh, Pittsburgh, PA) Lewis Kuller; (University of Tennessee Health Science Center, Memphis, TN) Karen C. Johnson; (University of Texas Health Science Center, San Antonio, TX) Robert Brzyski; (University of Wisconsin, Madison, WI) Gloria E. Sarto; (Wake Forest University School of Medicine, Winston-Salem, NC) Mara Vitolins; (Wayne State University School of Medicine/Hutzel Hospital, Detroit, MI) Michael Simon.

Women’s Health Initiative Memory Study: (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker.

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Uebelacker, L.A., Eaton, C.B., Weisberg, R. et al. Social support and physical activity as moderators of life stress in predicting baseline depression and change in depression over time in the Women’s Health Initiative.Soc Psychiatry Psychiatr Epidemiol 48, 1971–1982 (2013). https://doi.org/10.1007/s00127-013-0693-z

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