Social support from friends and depression among African Americans: The moderating influence of education

Background: This cross-sectional study examined the association between various characteristics of friendships and 12-month major depressive disorder (MDD) and whether these associations vary by education level among African Americans. Methods: The analytic sample included 3434 African American respondents drawn from the National Survey of American Life: Coping with Stress in the 21st Century. Logistic regression analyses were performed to test the associations between friendship characteristics (i.e., frequency of contact, subjective closeness, receipt of support, provision of support) and 12-month MDD. Interaction terms between education and each of the four friendship variables were used to test whether these associations varied by education level. Analyses adjusted for sociodemographic factors and chronic health problems. Results: Frequency of contact and subjective closeness were negatively associated with 12-month MDD. An interaction between education and contact indicated that contact was negatively associated with MDD among high education respondents but unrelated to MDD among low education respondents. The interactions between education and receipt of support and education and provision of support demonstrated that receipt and provision of support were negatively associated with MDD among high education respondents but was positively associated with MDD among low education respondents. Limitations: Given the cross-sectional design, it is not possible to make causal inferences. Conclusion: This investigation provides an important first step to understanding within-group differences in how social relationships function as both a risk and protective factor for MDD among African Americans.