Dimensions of social support and depression in patients at increased psychosocial risk recovering from myocardial infarction

Background: There is considerable evidence that depression and low social support are associated with increased morbidity and mortality for patients with coronary heart disease (CHD). However, there is a lack of consensus regarding the measurement of social support and its relation to depression. Purpose: The primary purpose of the present study was to identify key dimensions of existing social support and depression measures for patients with CHD using factor analysis. Method: Seven hundred-five patients with a recent acute myocardial infarction and either depression, low social support, or both, completed measures of several types of social support and depression. Exploratory and confirmatory factor analysis were used to examine the underlying dimensions of the existing social support and depression measures, and to compare theoretically plausible models specifying the relation between the social support and depression factors. Results: Confirmatory factor analysis indicated that an approach in which smaller facets of depression are measured (somatic, cognitive/affective, anxious) and social support (perceived emotional support from intimate relationships; perceived tangible support from peripheral contacts; and the number of children, relatives, and friends in a patient's support network), may be the most optimal way to measure social support and depression in this population RMSEA=0.05; CFI=0.81; TLI=0.88). Conclusion: Efforts to identify patients at increased psychosocial risk may be improved by screening for these subcomponents of social support and depression.