The impact of social support on depressive symptoms among adolescents in the child welfare system: A propensity score analysis

Background Observational studies consistently have identified that social support is negatively associated with depression among adolescents. The causal connections between these two factors, however, are not well understood. Does the relationship between social support and depression indicate that social support protects against depression, or that characteristics of these less depressed adolescents make it easier for them to obtain social support? To address this, this study examines whether social support predicts later depressive symptoms, controlling for earlier clinical presentation.Methods The sample comprised adolescents (n = 777) who were assessed as part of the National Survey of Child and Adolescent Well-Being. Caregivers and youth provided information about children's clinical characteristics and family background. Propensity scoring was used to adjust for baseline covariates when examining the impact of social support at eighteen months post-baseline on depressive symptoms at three years post-baseline.Results Children who received more social support at eighteen months post-baseline had fewer depressive symptoms at three years post-baseline, even after adjusting for baseline covariates using the propensity score; however, the adjusted effect size was small.Conclusion Previous attempts to study the impact of social support without adjusting for possible confounders have likely inflated the independently predictive role of social support.