Article logy Review Depression and Social ldentity:An Integrative Review 6831452383 SAGE Tegan Cruwys',S.Alexander Haslam',Genevieve A.Dingle', Catherine Haslam',and Jolanda Jetten' Abstract Social relationships play a key role in depression.This is apparent in its etiology,symptomatology,and effective treatment. as been little consensus about the best way to conceptualize the link bet en depression and social ore,the exten al-psy and in part oach i then used as a basisfor conceptualizing the role of social relationships in depression.operationalized in terms of six central hypotheses.Research relevant to the hypothese e preser an agenda for future research to depression,and to translate the nsigh oforetica ntity and y theory,self-categorization theory,mental health Dep he e menta health prob nent of der nn hae hed with at least 20%of people in develoned coun riencing it at some point in their lives.It is the leading 200d S e pronty area of the most ntations hins in D to treating health professionals and evidence indicates that lines the ample evidence that depression is a fundamentally social disorder,with reduced social connectednes sman, .and ta get for treatment chological).research suggests that only questions to be resoved a minority of people with depression receive adequate acute Why so al connectedness is so important in depression,how care (G nell.200 999 Simon,Fle it should be n and how it might be mos vel ap Wells 2001 Often this is due to the vides a social-n (Simon et)or the stigma associated with seeking eon group p esses that explains why social relation anti-depressant (Dwight-Johnso ships are critical for the functioning of the self.This is use 200% 1,Yang a basis for de oping six hype ses that relate to Ke that the a son with a histor of dent sion surement.mechanism.and inter ention.In the" irical expected to e ence four episodes across his or her lifes Evidence:Social Identity and Depression"section,the pan (Judd, 1997).Even among patients who receive the mpr ng a cot The University of Queensland.St Lucia.Australia Rafanelli,Grandi,Conti,&Belluardo,1998).For these rea- sons,ongoing research that contributes to our understanding 304 Personality and Social Psychology Review 2014, Vol. 18(3) 215–238 © 2014 by the Society for Personality and Social Psychology, Inc. Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1088868314523839 pspr.sagepub.com Article Depression is the second most common mental health prob￾lem, with at least 20% of people in developed countries experiencing it at some point in their lives. It is the leading cause of disability worldwide (Lopez, Mathers, Ezzati, Jamison, & Murray, 2006; World Health Organisation, 2012). Depression is one of the most common presentations to treating health professionals, and evidence indicates that its prevalence has been increasing for some time (Klerman & Weissman, 1989; Kruijshaar et al., 2005). Although evi￾dence-based treatments do exist for the condition (both phar￾macological and psychological), research suggests that only a minority of people with depression receive adequate acute care (Goldman, Nielsen, & Champion, 1999; Simon, Fleck, Lucas, & Bushnell, 2004; Young, Klap, Sherbourne, & Wells, 2001). Often, this is due to the expense of treatment (Simon et al., 2004) or the stigma associated with seeking anti-depressant medication or therapy (Dwight-Johnson, Sherbourne, Liao, & Wells, 2000; Phelan, Yang, & Cruz￾Rojas, 2006). Furthermore, relapse rates remain high, such that the average person with a history of depression is expected to experience four episodes across his or her lifes￾pan (Judd, 1997). Even among patients who receive the gold-standard treatment—comprising a combination of anti￾depressant medication and cognitive-behavioral therapy (CBT)—25% are expected to relapse within 2 years (Fava, Rafanelli, Grandi, Conti, & Belluardo, 1998). For these rea￾sons, ongoing research that contributes to our understanding of the etiology and treatment of depression has been priori￾tized by the World Health Orgnaisation (Lopez et al. 2006). In this article, we outline how a social identity approach (SIA) can address both of these priority areas. This review is divided into four broad sections. “The Important Role of Social Relationships in Depression” out￾lines the ample evidence that depression is a fundamentally social disorder, with reduced social connectedness1 impli￾cated as a cause, symptom, and target for treatment of depres￾sion. This section also draws attention to current gaps in knowledge and identifies three key questions to be resolved: Why social connectedness is so important in depression, how it should be measured, and how it might be most effectively enhanced through intervention. “The Social Identity Approach” section provides a social-psychological perspec￾tive on group processes that explains why social relation￾ships are critical for the functioning of the self. This is used as a basis for developing six hypotheses that relate to key aspects of depression and speak to these questions of mea￾surement, mechanism, and intervention. In the “Empirical Evidence: Social Identity and Depression” section, the 523839 PSRXXX10.1177/1088868314523839Personality and Social Psychology ReviewCruwys et al. research-article2014 1 The University of Queensland, St Lucia, Australia Corresponding Author: Tegan Cruwys, School of Psychology, The University of Queensland, St. Lucia, Queensland, 4072, Australia. Email: t.cruwys@uq.edu.au Depression and Social Identity: An Integrative Review Tegan Cruwys1 , S. Alexander Haslam1 , Genevieve A. Dingle1 , Catherine Haslam1 , and Jolanda Jetten1 Abstract Social relationships play a key role in depression. This is apparent in its etiology, symptomatology, and effective treatment. However, there has been little consensus about the best way to conceptualize the link between depression and social relationships. Furthermore, the extensive social-psychological literature on the nature of social relationships, and in particular, research on social identity, has not been integrated with depression research. This review presents evidence that social connectedness is key to understanding the development and resolution of clinical depression. The social identity approach is then used as a basis for conceptualizing the role of social relationships in depression, operationalized in terms of six central hypotheses. Research relevant to these hypotheses is then reviewed. Finally, we present an agenda for future research to advance theoretical and empirical understanding of the link between social identity and depression, and to translate the insights of this approach into clinical practice. Keywords social identity theory, self-categorization theory, depression, social capital, social isolation, mental health Downloaded from psr.sagepub.com at Remen University of China on September 6, 2015