Social support, hopelessness, and depression in HIV+ injecting drug users

Abstract

This study investigated whether lack of social support is negatively associated with depressive symptoms and diagnoses through the mediation of hopelessness. Measures of social support, hopelessness, and depression were administered to 103 HIV+ and HIV- male and female injecting drug users and readministered six months later. The mediational model was tested both cross-sectionally and longitudinally. Results were mixed. Findings were consistent with the mediational hypothesis in the cross-sectional model predicting diagnosis of major depression, indicating that hopelessness completely accounted for the significant negative relationship between social support and likelihood of depressive diagnosis. When hopelessness was controlled, the significant relationship between social support and depressive diagnosis was eliminated. Findings were consistent with the mediational hypothesis in the cross-sectional model predicting depressive symptoms, indicating that hopelessness partially accounted for the significant negative relationship between social support and depressive symptoms. When hopelessness was controlled, the relationship between social support and depressive symptoms was considerably attenuated, though not eliminated.;Evidence for mediation was less strong in the longitudinal findings. In the longitudinal model predicting depressive symptoms, findings indicated that change in hopelessness partially accounted for the relationship between change in social support and change in depressive symptoms, but the attenuation in the relationship due to change in hopelessness was modest. No evidence of mediation was found in the longitudinal model predicting diagnosis of depression.;These findings suggest that hopelessness accounts at least in part for the impact of low levels of support on depression. They also provide evidence for the direct impact of social support on depression, and suggest that some additional unexplained mechanism or mechanisms may similarly have a direct effect on depression. Clinical, theoretical, and research implications of these findings are discussed.