Relationship Distress and Depression

To better understand the role of interpersonal processes in depression, researchers have focused specifically on the quality of depressed individuals' romantic relationships. This focus is warranted in light of evidence suggesting that the interpersonal difficulties of depressed individuals are most likely to manifest in the context of their long-term, committed relationships, such as marriage. Furthermore, there is consistent and robust evidence to suggest that marital distress and depression tend to co-occur. This finding has been replicated using different methods of assessment and across different samples (e.g., samples recruited from the community, treatment-seeking samples). The purpose of this entry is to describe how marital distress and depression relate to each other causally and to describe some mechanisms that explain why these phenomena are related.

The robust cross-sectional association between depression and marital distress has prompted researchers to examine whether these variables are [Page 1347]causally related using longitudinal designs. Most of the early studies focused on testing two contrasting causal models: Does marital distress lead to depression or, conversely, does depression lead to marital distress? The findings from these studies were discrepant, with some evidence suggesting that initial marital distress predicts the development of depression symptoms in depressed wives, whereas initial symptoms of depression predict later marital distress in depressed husbands. More recent theoretical developments have shifted away from determining the causal primacy of either variable and have conceptualized the longitudinal association between these variables as bidirectional and reciprocal. Subsequent research has supported a dynamic and bidirectional association between these variables. However, these findings are limited by the use of samples characterized by subclinical symptoms of depression.

Research with clinical samples has tended to focus on the role of interpersonal processes in influencing the course of depressive illness. These studies suggest that marital difficulties predict a more severe and chronic form of the illness and can increase the risk of relapse for both men and women. Some researchers have noted that, in light of epidemiological data suggesting that the age of onset of depression is continuing to decrease while age of first marriage is continuing to increase, longitudinal studies that examine the link between depression and marital dysfunction are most likely investigating cases of recurrent or chronic depression, rather than cases of first onset. However, depression is a recurrent and progressive condition: Most individuals diagnosed with major depressive disorder will experience multiple episodes, and the risk of recurrence increases with each successive episode. Thus, examining the factors that influence the course of recurrent/chronic depression is an important public health priority.

To understand how interpersonal factors affect the course of depressive illness, researchers have focused on the mechanisms of this prospective association. According to Steven Beach and his colleagues, marital distress may decrease available social support, thus increasing an individual's vulnerability to external stressors and increasing his or her risk for developing depression. Consistent with this, researchers have found that a perceived lack of spousal support is a prospective predictor of depressive symptomatology. However, it has yet to be established whether the prospective association between marital dysfunction and depression operates, in part, through perceptions of diminished spousal support. It is important to note here that the evidence suggests that perceived rather than observed social support is more strongly related to depression, and it may be particularly fruitful to examine perceptions of spousal support in models of depression and relationship dysfunction.

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