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 problem, 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 evidence-based treatments do exist for the condition (both pharmacological 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, & CruzRojas, 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 lifespan (Judd, 1997). Even among patients who receive the gold-standard treatment—comprising a combination of antidepressant medication and cognitive-behavioral therapy (CBT)—25% are expected to relapse within 2 years (Fava, Rafanelli, Grandi, Conti, & Belluardo, 1998). For these reasons, ongoing research that contributes to our understanding of the etiology and treatment of depression has been prioritized 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” outlines the ample evidence that depression is a fundamentally social disorder, with reduced social connectedness1 implicated as a cause, symptom, and target for treatment of depression. 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 perspective on group processes that explains why social relationships 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 measurement, 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
216 Personality and Social Psychology Review 18(3) exist literature is reviewed to assess the degr sline for hatter)within a day of the str available evidence supports each of these It therefore appears that people are uniquely sensitive to Finally,"An Agenda for Research Into Social Identity and social forms of stress(such as rejection or conflict)relative Depression"highlights current gaps in the evidence and s to of e events theore cal und rstandin ific ep ness and depression but also to enhancing clinical interven (Tennant,2002).Most commonly,this is a social loss of tions that target its prevention and treatment.In this,our goa some kind such as the death of a loved one,but it may als s to present a novel anal the r le of social conne from othe venues of investigation and of informing clinical practice of depression but also appears to have a causal rolen t The Im ortant Role of Social development n Depression a third way inw hich s ocial connectedne Clinical depression is understood by nd p remission and recovery.Here,there is evidence that impaire tioners alike to be more than simply low mood.n addition social functioning often persists long after remission(C orvel tofeeling miserable,apathetic, and self- 1993;Kennedy,Foy,Sherazi,Mcdor ough,M ng an epis of major de pression als 1989:pa which is social withdrawal.Depression is typically charac Rassaby. 1980)Low social support also predicts terized by social isolation and reduced social connectedness response to treatment and early dropout(Trivedi etal,200 5 of thi has箱 dia gno of el ymntoms and is a core c ent of effective der essio treatment.More specifically CBT for depression (Beck 2011)acknowledges that social isolation isa central featur formally (e.g h pre RT cha impairment in this domain is significantly more common in condition than in other physical and mental illnesses n tha ngfu in her rities that also a sense of pleasure or success,particularly activities that strong risk actor for reppomoonhEn9ealgotevah e approac no ppo. social functioning relative to pharmacological .Kiecol-Gaser,)Fore treatments(Scott et al,2012). Hawkley,and Thisted (2010) found tha a broad foc lation was a goodn val o s on al nd date social connectedness specificallyea by helping a physical health.stress,and a number of objecti e indicator patient rejoin a sports team)rather than other kinds of acti ofs cial-relationship quality;Cacioppo et al ,2010).Lack (e.g.,by daily wall supp ial in but is rather th to be analysis.Bolger.DeLongis.Kessler. ncreased rate of positive reinforcement(Dimidjian,Martell (1989)found that interpersonal conflict was the most impor Addis,Herman-Dunn,2008).Lack of effective social for pre licting daily fluctuatic th nflict had individual (i.e.."me")rather than as a p roblem that i over a number of days.whereas for other kinds of stressor associated with the sense of the self derived from member there was evidence of habituation such that mood returned to ship in a social group ("us).For this reason,a range of
216 Personality and Social Psychology Review 18(3) existing literature is reviewed to assess the degree to which available evidence supports each of these hypotheses. Finally, “An Agenda for Research Into Social Identity and Depression” highlights current gaps in the evidence and sets out an agenda for future research, with a view not only to formulating a theoretical understanding of social connectedness and depression but also to enhancing clinical interventions that target its prevention and treatment. In this, our goal is to present a novel analysis of the role of social connectedness in depression capable of stimulating new and fruitful avenues of investigation and of informing clinical practice. The Important Role of Social Relationships in Depression Clinical depression is understood by researchers and practitioners alike to be more than simply low mood. In addition to feeling miserable, apathetic, and self-critical, a person experiencing an episode of major depression also exhibits a cluster of cognitive and behavioral changes, chief among which is social withdrawal. Depression is typically characterized by social isolation and reduced social connectedness (Wade & Kendler, 2000). One of its core symptoms (which is as central to diagnosis as low mood) is anhedonia—loss of interest or pleasure in previously enjoyed activities (American Psychiatric Association, 2000). This most typically manifests as withdrawal from social relationships, both formally (e.g., quitting sporting groups) and informally (e.g., seeing friends less often). Reduced social connectedness is thus a key characteristic of depression, such that impairment in this domain is significantly more common in this condition than in other physical and mental illnesses (Hirschfeld et al., 2000). Critically, marked differences in social connectedness also emerge prior to the development of depression symptoms. Social isolation has therefore been observed to be a strong risk factor for the development and recurrence of depression (Cacioppo, Hughes, Waite, Hawkley, & Thisted, 2006; Glass, De Leon, Bassuk, & Berkman, 2006; Uchino, Cacioppo, & Kiecolt-Glaser, 1996). For example, in one study, Cacioppo, Hawkley, and Thisted (2010) found that perceived social isolation was a good longitudinal predictor of depression symptoms even after controlling for key candidate variables (demographic characteristics, personality, physical health, stress, and a number of objective indicators of social-relationship quality; Cacioppo et al., 2010). Lack of social support has also been found to predict suicidal ideation 1 year later (Handley et al., 2012). In a more finegrained analysis, Bolger, DeLongis, Kessler, and Schilling (1989) found that interpersonal conflict was the most important stressor for predicting daily fluctuations in negative mood. In addition, these researchers observed that interpersonal conflict had escalating effects on mood if it continued over a number of days, whereas for other kinds of stressors, there was evidence of habituation such that mood returned to baseline (or better) within a day of the stressor commencing. It therefore appears that people are uniquely sensitive to social forms of stress (such as rejection or conflict) relative to other stressful life events. Taken a step further, an episode of depression is often triggered by a specific negative event in the social sphere (Tennant, 2002). Most commonly, this is a social loss of some kind such as the death of a loved one, but it may also result from other factors such as family conflict, workplace bullying, or a relationship breakdown (Paykel, 1994). As a result, reduced social connectedness is not only symptomatic of depression but also appears to have a causal role in its development. There is also a third way in which social connectedness is implicated in depression, and this pertains to processes of remission and recovery. Here, there is evidence that impaired social functioning often persists long after remission (Coryell et al., 1993; Kennedy, Foy, Sherazi, Mcdonough, & Mckeon, 2007) and increases the risk of relapse (George, Blazer, Hughes, & Fowler, 1989; Paykel, Emms, Fletcher, & Rassaby, 1980). Low social support also predicts poor response to treatment and early dropout (Trivedi et al., 2005). As a corollary of this, social connectedness has also been found to play a role in the alleviation of depression symptoms and is a core component of effective depression treatment. More specifically, CBT for depression (Beck, 2011) acknowledges that social isolation is a central feature of presentation and often requires targeted intervention. In this regard, behavioral activation is a key CBT strategy that directly targets social connectedness (Cuijpers, Van Straten, & Warmerdam, 2007; Veale, 2008). This technique is predicated on the assumption that withdrawal from meaningful activities maintains depressive symptoms. Patients are therefore encouraged to schedule activities that bring them a sense of pleasure or success, particularly activities that were previously important to them. Speaking to the value of this approach, although it has not been a focus for research attention, there is some evidence that CBT improves social functioning relative to pharmacological treatments (Scott et al., 2012). However, behavioral activation has a broad focus on all kinds of withdrawal or inactivity, and therefore each treatment and practitioner varies in the degree to which they target social connectedness specifically (e.g., by helping a patient rejoin a sports team) rather than other kinds of activity (e.g., by helping a patient recommence daily walks). This is because the proposed mechanism of behavioral activation is not social in nature but is rather theorized to be an increased rate of positive reinforcement (Dimidjian, Martell, Addis, & Herman-Dunn, 2008). Lack of effective social functioning in depression is also typically conceptualized as an individual-level deficit—associated with the individual as an individual (i.e., “me”) rather than as a problem that is associated with the sense of the self derived from membership in a social group (“us”). For this reason, a range of Downloaded from psr.sagepub.com at Remen University of China on September 6, 2015
Cruwys et a 217 individual-focused interventions-including social skills This section has outlined evidence that compromised training,assertivenes sor conflict resolution training.and social conn ness can precipitate,characterize,and main socia are linical depressio h ial rim,2000:ysa Kashdan.2009:Trivedi et al.2005) ceptualized and measured social connectedness.It is clea Although such inte entions are incr asingly pres for example,that an abundance of terms are used within the (Lewinsohn Clarke, currently,there is no relat the phenomena that we have collectively shins that might allow treating professionals to address these These include social supp ort (Cohen Wills 1985) cemns in a consistent and theoretically informed way loneliness(Cacioppo etal,26),social capital (Putnam only a han ful of studies directly me 、soc1 al net rks (F hrista i,2008) an oc nging (Ba ister itis unelear whether CBT might be enhanced through suring a person's living situation.their number of clo greater focus on social connectedness, or indeed,to wha friends,their employment status,their formal membership of such as mmunity and the in anhat the h about (Collins Do ig3008 ,Auerbach.Derubeis.01) Smith.&Layt tion.a wide variety of formal scales have been used to mea arly,it is unc whether the ett 1y group CBT sure the subjective quality of social exper such CRT of depre the nts of the treatn absence of a unifying frar ork or model that migh researchers have reported that patients atribute much of th lend coherence to the analysis of social connectedness in 9824 ers have rec epre the critical relat T Weissman Research Question 1(RQ1):How should social con- witz speaks R h o tion 2 RO2)Why and how does he outcor in at le of four int affect de that is the mecha role disputes. role transitions or inter nism of action)? Klerman, that Research Question3(RQ3):What types of socialco a in treating 100 addressing social factors in de it doe offer ally derived n del of social relationships in depres- It is with a view to providing a coherent and integrated erbal t was ed as a co e questions n th we the tha ive Res thnthe field of social psychology 1995),it is relatively weak in terms of theory.It espouse nedical "symptom' model of depressic and the goals o The Social Identity Approach re to symptoms ch (SIA)en saville Ch 1984.Weissma n et al.2000).Yet izatio IPT focuses on individual ties rather than group member- theory (Tumer.Hogg.Oakes.Reicher.Wetherell.1987 and no social factors are theorized o routinely mor r,Oakes,Haslam,McGarty,1994).O althoug ope to explanatory model that might account for the central role of 970).the a dominant social-psychological model of groun processe symptomatology,and that has been influential in the study of social and organiza effective tr s10n. ective action (e.g.,see 30
Cruwys et al. 217 individual-focused interventions—including social skills training, assertiveness or conflict resolution training, and increased social activity—are variously recommended as adjuncts to standard treatment (Nilsen, Karevold, Røysamb, Gustavson, & Mathiesen, 2012; Segrin, 2000; Steger & Kashdan, 2009; Trivedi et al., 2005). Although such interventions are increasingly prescribed (Lewinsohn & Clarke, 1999), currently, there is no coherent framework to understand these changes to social relationships that might allow treating professionals to address these concerns in a consistent and theoretically informed way. Furthermore, only a handful of studies have directly measured social functioning in relation to CBT for depression (e.g., Evans & Connis, 1995; Luk et al., 1991). Consequently, it is unclear whether CBT might be enhanced through a greater focus on social connectedness, or indeed, to what extent the success of strategies such as behavioral activation is in any sense attributable to the improvements in connectedness that they may bring about (Collins & Dozois, 2008; Cuijpers et al., 2007; Webb, Auerbach, & Derubeis, 2012). Similarly, it is unclear whether the efficacy of group CBT (which is just as effective in the treatment of depression as individual CBT, see Oei & Dingle, 2008) is attributable to the social components of the treatment. Nevertheless, researchers have reported that patients attribute much of their improvement to group factors (Covi, Roth, & Lipman, 1982). Another key intervention for depression that has proven efficacy is interpersonal psychotherapy (IPT; Elkin et al., 1995). This approach places more emphasis on the critical role of social relationships than CBT (Weissman & Markowitz, 1994) and therefore speaks more directly to the evidence reviewed above. IPT proposes that depression is the outcome of problems in at least one of four interpersonal domains: grief, role disputes, role transitions, or interpersonal deficits (Weissman, Markowitz, & Klerman, 2000). However, we argue that although the efficacy of IPT (Weissman & Markowitz, 1994) speaks to the importance of addressing social factors in depression, it does not offer a theoretically derived model of social relationships in depression. In fact, because IPT was originally developed as a control verbal therapy condition for CBT in the Treatment of Depression Collaborative Research Project (Elkin et al., 1995), it is relatively weak in terms of theory. It espouses a medical “symptom” model of depression, and the goals of therapy are to alleviate symptoms and improve the social functioning of the individual (Klerman, Weissman, Rounsaville, & Chevron, 1984; Weissman et al., 2000). Yet, IPT focuses on individual ties rather than group memberships, and no social factors are theorized or routinely monitored to show treatment outcome. Therefore, although IPT orients treatment toward social factors, it does not provide an explanatory model that might account for the central role of social relationships in the etiology, symptomatology, and effective treatment of depression. Below, we expand on what such a model might look like. This section has outlined evidence that compromised social connectedness can precipitate, characterize, and maintain clinical depression. The fact that the literature has consistently found these effects is all the more surprising in light of the many different ways in which researchers have conceptualized and measured social connectedness. It is clear, for example, that an abundance of terms are used within the literature to capture the phenomena that we have collectively referred to as “social connectedness” or “social relationships.” These include social support (Cohen & Wills, 1985), loneliness (Cacioppo et al., 2006), social capital (Putnam, 2001), social networks (Fowler & Christakis, 2008), and belonging (Baumeister & Leary, 1995). Moreover, these constructs have been operationalized in ways as diverse as measuring a person’s living situation, their number of close friends, their employment status, their formal membership of community groups, and the frequency and intensity of their contact with family (Berry & Welsh, 2010; Holt-Lunstad, Smith, & Layton, 2010; Kikuchi & Coleman, 2012). In addition, a wide variety of formal scales have been used to measure the subjective quality of social experiences such as perceived support (Harpham, Grant, & Thomas, 2002; Heitzmann & Kaplan, 1988). This diversity in turn speaks to the absence of a unifying framework or model that might lend coherence to the analysis of social connectedness in depression. Indeed, although many researchers have recognized the importance of this relationship, it is apparent that there has been little agreement regarding three central issues: Research Question 1 (RQ1): How should social connectedness be measured? Research Question 2 (RQ2): Why and how does social connectedness affect depression (i.e., what is the mechanism of action)? Research Question 3 (RQ3): What types of social connectedness are likely to be the most beneficial in treating (or reducing the likelihood of) depression? It is with a view to providing a coherent and integrated answer to these questions that, in the following section, we outline a body of theory that has addressed similar issues within the field of social psychology. The Social Identity Approach The Social Identity Approach (SIA) encompasses both social identity theory (Tajfel & Turner, 1979) and self-categorization theory (Turner, Hogg, Oakes, Reicher, & Wetherell, 1987; Turner, Oakes, Haslam, & McGarty, 1994). Originally developed to explain intergroup phenomena, particularly discrimination and prejudice (Tajfel, 1970), the approach has become a dominant social-psychological model of group processes that has been influential in the study of social and organizational topics as diverse as leadership, communication, motivation, and collective action (e.g., see S. A. Haslam, Ellemers, Downloaded from psr.sagepub.com at Remen University of China on September 6, 2015
218 Personality and Social Psychology Review 18(3) Reicher Revnolds Schmitt 2010)It has also be From an SIA social relationshins ingly used as a framework for understanding health phenom fore not between ena(S.A.Haslam,Jetten,Postmes,&Haslam,2009:Jetten. individuals(e.g.friendships)that provide a pleasant accom Has Haslam 2012 ngoing personal act Instead,they hav ed in the SIA was not develoned to exnlain the nennd as a connectedness.and it did not emerge from a bio-medically above example.then.it is jane's relationshin with janet and oriented tradition (e.g.,psychiatry).Instead,the approach is and her capacity to define the three of them (and oth -psychological in social identity (as us Io ballers Th er.1999).For thisr on the n why identity-based relationships in the home,in the workplace,and in society at large are critical no in this regard,offers a well-established and long-standin only for self-definition but also for meaningful social 2010).The ga of this sction is to ouine the he。 an be se n that the sia is distin core tenets of the SIA to clarify the relevance of these for emphasis on the power of social group memberships to depression a ely,to formulate a se ructure a person self-conce and,through this, the this condition (). thatindividuals ceive themselves and their place in the world.Indeed.mon Key Premise I:Social Relationships Structure starkly,it suggests that it is social identities that give peopl Individuals'SelfConcebt and.Through This.Their plac in the wo with Behavior A key theoretical pre emise of the SIA is that people's sense of es et).A social identity is meaningful whenever self i comprised of both person and socio t has significance or importance to the individua hat .this e an group see this in o terms of interests attitudes and hehaviors that differ in ball tean meaning to her relationshin with mporta r individuals.On the othe a sense of common direc there are of context which we de This is clearly dan aligned with those of other members of the groups to which generally,it can be seen that in the world at large.social den tties (e.g.. ong (out-groups grou ne's neig A key idea here is that.to the extent that a given g activity that bind people together and allow for coordinated membership is contextually salient or provide s an ongoin goal-oriented endeavor. basis for les a basis for n light of the ising that s nd Jane)not only needs to be able to differentiate be ion it generally feels good to identify str onoly with a g Jill,say）and those s to bl people to defin hat is she ds to be able tos If and which s cial ide is a motiva usindeed,in this way,a sense of shared social identity ional preference (Tajfel&Tumer,1979:see also Elleme l fou ation for De Gil ,Haslam,2004).Here,social iden tification lit ng part o kes or (p.21;see also S.A. eations for self-esteem (Bettencourt Dorr,1997:S.A Haslam,Postmes,&Ellemers,2003). Haslam Reicher.2006:Ellemers.Kortekaas.Ouwerkerk
218 Personality and Social Psychology Review 18(3) Reicher, Reynolds, & Schmitt, 2010). It has also been increasingly used as a framework for understanding health phenomena (S. A. Haslam, Jetten, Postmes, & Haslam, 2009; Jetten, Haslam, & Haslam, 2012). Unlike the models reviewed in the previous section, the SIA was not developed to explain the health benefits of social connectedness, and it did not emerge from a bio-medically oriented tradition (e.g., psychiatry). Instead, the approach is social-psychological in origin and is first and foremost a theory of social relationships grounded in a social model of self (Turner, 1999). For this reason, the approach, although not specific to depression, is relevant to its social dimensions and in this regard, offers a well-established and long-standing model supported by four decades of empirical research (and thousands of publications; for details, see Postmes & Branscombe, 2010). The goal of this section is to outline the core tenets of the SIA to clarify the relevance of these for depression and, ultimately, to formulate a series of testable predictions that might advance our understanding of the role of social connectedness in this condition (see Table 1). Key Premise 1: Social Relationships Structure Individuals’ Self-Concept and, Through This, Their Behavior A key theoretical premise of the SIA is that people’s sense of self is comprised of both personal and social identities. On one hand, this means that we can define and understand ourselves in terms of our personal identity—seeing ourselves in terms of interests, attitudes, and behaviors that differ in important ways from those of other individuals. On the other hand, there are also a range of contexts in which we define and understand ourselves in terms of one or more social identities—seeing our interests, attitudes, and behaviors as aligned with those of other members of the groups to which we belong (i.e., in-groups) but as different from those of groups to which we do not belong (out-groups; Turner & Oakes, 1997). A key idea here is that, to the extent that a given group membership is contextually salient or provides an ongoing basis for social identification, it provides a basis for selfcategorization whereby the group becomes “self.” For example, to play a game of football, a woman (let us call her Jane) not only needs to be able to differentiate between those players who are on her team (Janet and Jill, say) and those who are not, but she also needs to be able to see her teammates as interchangeable representatives of a common ingroup; that is, she needs to be able to see herself and them as “us.” Indeed, in this way, a sense of shared social identity can be seen to provide the psychological foundation for most meaningful forms of social behavior. In simple terms, this is because, as Turner (1982) puts it, “social identity is what makes group behavior possible” (p. 21; see also S. A. Haslam, Postmes, & Ellemers, 2003). From an SIA perspective, social relationships are therefore conceptualized not only as bonds of affiliation between individuals (e.g., friendships) that provide a pleasant accompaniment to ongoing personal activity. Instead, they have a fundamental bearing on a person’s understanding of who they are and, as a result, on what they are able to do. In the above example, then, it is Jane’s relationship with Janet and Jill—and her capacity to define the three of them (and others) in terms of a shared social identity (as “us footballers”)— that allows her to play and enjoy a game of football. The same logic explains why identity-based relationships in the home, in the workplace, and in society at large are critical not only for self-definition but also for meaningful social functioning. From this example, it can be seen that the SIA is distinguished from other models of social connectedness by its emphasis on the power of social group memberships to restructure a person’s self-concept and, through this, their behavioral repertoire. The approach argues that social identification fundamentally affects the way that individuals perceive themselves and their place in the world. Indeed, more starkly, it suggests that it is social identities that give people a place in the world, and thereby also furnish them with a sense of purpose and meaning (Dingle, Brander, Ballantyne, & Baker, 2012; S. A. Haslam, Jetten, & Waghorn, 2009; Jones et al., 2011). A social identity is meaningful whenever it has significance or importance to the individual—that is, when he or she identifies with the group. We see this in our example, where it is Jane’s sense of herself as a member of a football team that gives meaning to her relationship with Janet and Jill and also gives them a sense of common direction and purpose—by virtue of the fact that this social identity specifies a constellation of shared norms, goals, and aspirations. This is clearly a mundane example, but more generally, it can be seen that in the world at large, social identities (e.g., where “us” encompasses one’s family, one’s workgroup, one’s church, one’s neighborhood community, etc.) provide the basis for networks of shared meaning and activity that bind people together and allow for coordinated goal-oriented endeavor. In light of the above points, it is not surprising that social identities have a profound impact on well-being. Indeed, precisely because they engender a sense of purpose and direction, it generally feels good to identify strongly with a group. This is particularly true, however, to the extent that socialstructural features of the world allow people to define ingroup identity as positive, distinct, and enduring—something for which social identity theory suggests there is a motivational preference (Tajfel & Turner, 1979; see also Ellemers, De Gilder, & Haslam, 2004). Here, social identification literally entails being part of something bigger and better, and a large body of research confirms that this has positive implications for self-esteem (Bettencourt & Dorr, 1997; S. A. Haslam & Reicher, 2006; Ellemers, Kortekaas, & Ouwerkerk, Downloaded from psr.sagepub.com at Remen University of China on September 6, 2015
Cruwys et a 219 Table I.Depression-Specific Hypotheses Derived From the Social ldentity Approach. Is of dep H3.The benefit of oup membership for depression symptoms will be moderated by relevant normative content ve in tors of social relations ships will be better pred of depr ymptoms than objective indicator H.Social inte tions for tent th cated in depression 1999:Phinney.Cantu.Kurtz.1997:Wann Branscomb Therefore.in addition to the a tion of how stronely 1990).This,then,is the basis for an initial hypothesis regard- pe rson identifies with a group,and how many groups they ing depression: identify with,to predict the implications of mental Hypothesis 1(H1):Social identification with meaningful ttend to the ups will predict lower levels of depression. the nature and basis of social identification).Accordingly third hypothesis is as follows: Fo ple,as well as being a member of a recreational football mative conten team,Jane may be a psychologist,a mother,a churchgoer and Ins r as each of these socia identitie Key Premise 2:Individuals'Self-Concept and se.and direction.cach can make a unigu and no Social Behavior Are Structured by Perceived contribution to mental health(tt,Hasam Social Relationships Has rch has sho n that,as well as having the i m, poor gene lack me Postmes.&Haslam.2009:Jetten.Haslam.Iyer.&Haslam. 2009).This therefore leads to a second hypothesis: and observation context incr ou con denc the link is real, important,and causa of the in which the life depression. connections,degree of contact,actual support)are represented qul,the process of s ing on John were a prof and only playing SIA is that,in the case of groups,other things are often no connected to his teammates.However,another player,James rs,Haslam,2010;Tajfel Tu outonaplace n the m very not the c identiti On the contrary.there is evidence that.at times.groups can ing one e might say that John(but not James)is amember of the be harmful and impede recovery(Crabtree,Haslam,Postmes football team.However,psycho logically speaking,it is James &Haslm,300nEelL20o:HeesoaCoh (but not hn)who ide the m,anc is this pro 2011.h des ntal healt vehicles for self-definition and social influence Turne outcomes associated with being a member of the team should 991),strong identification with a group that is negatively be more apparent for James than for John,despite the former's enined (e.g.,stigm ial group men heing a fo al tean member might might be apeer group with norms that drug-taking increase the likelihood that social identification is present or self-harm wher the shared it is only ever a crude indicator of individu actors'psy Hill,Borland.2001) on the soc he 30
Cruwys et al. 219 1999; Phinney, Cantu, & Kurtz, 1997; Wann & Branscombe, 1990). This, then, is the basis for an initial hypothesis regarding depression: Hypothesis 1 (H1): Social identification with meaningful groups will predict lower levels of depression. Yet, although any particular social identity has the capacity to be a valuable psychological resource, it is also the case that such identities are rarely mutually exclusive. For example, as well as being a member of a recreational football team, Jane may be a psychologist, a mother, a churchgoer, and an Australian. Insofar as each of these social identities has the capacity to provide a person with a sense of meaning, purpose, and direction, each can make a unique and potentially additive contribution to mental health (Jetten, Haslam, Haslam, Dingle, & Jones, 2014; Jones & Jetten, 2011; Ysseldyk, Haslam, & Haslam, 2013). This is particularly true if the identities are compatible (Iyer, Jetten, Tsivrikos, Postmes, & Haslam, 2009; Jetten, Haslam, Iyer, & Haslam, 2009). This therefore leads to a second hypothesis: Hypothesis 2 (H2): Social identification with a greater number of meaningful groups will predict lower levels of depression. Other things being equal, the process of seeing oneself as a member of a valued group (or groups) should generally be beneficial to health. However, a fundamental insight of the SIA is that, in the case of groups, other things are often not equal (S. Reicher, Spears, & Haslam, 2010; Tajfel & Turner, 1979). Accordingly, it is not the case that all social identities are beneficial as a basis for preventing or treating depression. On the contrary, there is evidence that, at times, groups can be harmful and impede recovery (Crabtree, Haslam, Postmes, & Haslam, 2010; Finfgeld, 2000; Helgeson, Cohen, Schulz, & Yasko, 2000; see also Molero, Fuster, Jetten, & Moriano, 2011). In particular, because social identities are powerful vehicles for self-definition and social influence (Turner, 1991), strong identification with a group that is negatively defined (e.g., stigmatized) or whose identity incorporates damaging norms and practices (e.g., anti-social behavior) has the potential to increase health vulnerability. Examples might be a peer group with norms that encourage drug-taking or self-harm—where the shared behavior on which group membership is based is itself deleterious to mental health (Schofield, Pattison, Hill, & Borland, 2001). Therefore, in addition to the question of how strongly a person identifies with a group, and how many groups they identify with, to predict the implications of internalized group memberships for a person’s mental health, it is also critical to attend to the content of those social identities (i.e., the nature and basis of social identification). Accordingly, a third hypothesis is as follows: Hypothesis 3 (H3): The benefit of group membership for depression symptoms will be moderated by relevant normative content. Key Premise 2: Individuals’ Self-Concept and Social Behavior Are Structured by Perceived Social Relationships A large body of research has shown that, as well as having poor general health, individuals who lack meaningful social relationships are far more prone to depression. The fact that this relationship is robust to differences in researcher perspective, sample population, and observation context increases our confidence that the link is real, important, and causal. What the SIA offers that goes beyond other models is a specification of the way in which the realities of social life (e.g., number of connections, degree of contact, actual support) are represented psychologically and internalized by perceivers. For example, if John were a professional footballer and only playing with his teammates for financial incentive, he might play on his football team without particularly valuing the team or feeling connected to his teammates. However, another player, James, might miss out on a place in the team but attend training every week, avidly supporting the team, and valuing both the football community and his place within it. Sociologically speaking, one might say that John (but not James) is a member of the football team. However, psychologically speaking, it is James (but not John) who identifies with the team, and it is this process of identification that is critical in shaping behavior, attitudes, and self-concept. As a result, any mental health outcomes associated with being a member of the team should be more apparent for James than for John, despite the former’s lack of official group member status. The point here, then, is that although objective group membership (e.g., being a formal team member) might increase the likelihood that social identification is present, it is only ever a crude indicator of individual actors’ psychological perspective on the social world. To ascertain individuals’ social connectedness, the most relevant social Table 1. Depression-Specific Hypotheses Derived From the Social Identity Approach. H1. Social identification with meaningful groups will predict lower levels of depression. H2. Social identification with a greater number of meaningful groups will predict lower levels of depression. H3. The benefit of group membership for depression symptoms will be moderated by relevant normative content. H4. Subjective indicators of social relationships will be better predictors of depressive symptoms than objective indicators. H5. Social identification will determine the impact of the various social factors (e.g., social support) that are implicated in depression. H6. Social interventions for depression will be more effective to the extent that they increase social identification. Downloaded from psr.sagepub.com at Remen University of China on September 6, 2015