Kane, J. C., Rapaport, C., Zalta, A. K., Canetti, D., Hobfoll, S. E., & Hall, B. J. (2014). Regular drinking may strengthen the beneficial influence of social support on depression: Findings from a representative Israeli sample during a period of war and terrorism. Drug and alcohol dependence.
Background: Social support is consistently associated with reduced risk of depression. Few studies haveinvestigated how this relationship may be modified by alcohol use, the effects of which may be particularlyrelevant in traumatized populations in which rates of alcohol use are known to be high.Methods: In 2008 a representative sample of 1622 Jewish and Palestinian citizens in Israel were inter-viewed by phone at two time points during a period of ongoing terrorism and war threat. Twomultivariable mixed effects regression models were estimated to measure the longitudinal association ofsocial support from family and friends on depression symptoms. Three-way interaction terms betweensocial support, alcohol use and time were entered into the models to test for effect modification.Results: Findings indicated that increased family social support was associated with less depression sym-ptomatology (p = <.01); this relationship was modified by alcohol use and time (p = <.01). Social supportfrom friends was also associated with fewer depression symptoms (p = <.01) and this relationship wasmodified by alcohol use and time as well (p = <.01). Stratified analyses in both models revealed that theeffect of social support was stronger for those who drank alcohol regularly than those who did not drinkor drank rarely.Conclusions: These findings suggest that social support is a more important protective factor for depres-sion among regular drinkers than among those who do not drink or drink rarely in the context ofpolitical violence. Additional research is warranted to determine whether these findings are stable inother populations and settings.