Social rank theory of depression: A systematic review of self-perceptions of social rank and their relationship with depressive symptoms and suicide risk

Abstract

Background: Depression is a debilitating illness which is also a risk factor for self-harm and suicide. Social rank theory (SRT) suggests depression stems from feelings of defeat and entrapment that ensue from perceiving oneself of lower rank than others. This study aims to review the literature investigating the relationship between self-perceptions of social rank and depressive symptoms or suicidal ideation/behaviour. Methods: A keyword search of three psychological and medical databases was completed (Psychinfo, Medline, Web of Knowledge). Studies were quality assessed using established criteria. Results: An initial 1290 records were identified. After application of inclusion and exclusion criteria, 70 remained measuring depressive symptoms (n=68), self-harm (n=3) and suicidal ideation (n=3). The main measures assessing social rank were the social comparison scale (SCS; n = 32) and subjective social status (SSS, n = 32), with six additional papers including another measure of social rank. In univariate analyses, as perceptions of social rank decreased, depressive symptoms (and suicidal ideation/ self-harm) increased. Multivariate analyses indicated that social rank may act as a psychosocial mechanism to explain the relationship between social factors (in particular socioeconomic status) and depressive symptoms. Additionally, psychological variables, such as rumination or self-esteem, may mediate or moderate the relationship between social rank and depressive or suicidal symptoms. Limitations: Study quality was variable and 89% of studies were cross-sectional. Conclusions: Although more prospective research is required, this review highlights the importance of understanding an individual's perception of their social position compared to others as it may lead to an enhanced understanding of the aetiology of depression.

Exploring the association of social comparison with depression and anxiety: A systematic review and meta‐analysis

“…They also highlight the potential use of priming (dis) similarity in comparisons for appropriate targets to assist coping in medical patients, a concept that could also apply to mental health patients. Wetherall et al (2019) recently reviewed evidence for the association of depressive symptoms and suicide risk with evaluation in SC in the form of social rank. They found that lower perceived social rank is associated with increased depressive symptoms and self-harm, particularly in clinical populations, indicating that individuals with depressive symptoms are more likely to judge themselves negatively relative to others (Wetherall et al, 2019).…”

“…Wetherall et al (2019) recently reviewed evidence for the association of depressive symptoms and suicide risk with evaluation in SC in the form of social rank. They found that lower perceived social rank is associated with increased depressive symptoms and self-harm, particularly in clinical populations, indicating that individuals with depressive symptoms are more likely to judge themselves negatively relative to others (Wetherall et al, 2019). This relationship was also associated with other psychological factors such as rumination, dysfunctional attitudes, shame, and self-criticism; however, these concepts were assessed either as moderators or dependent variables in studies and thus do not provide a clear outline of the mechanisms involved.…”

Sex-Specific Differences in Severity of Depressive Symptoms, Heart Rate Variability, and Neurocognitive Profiles of Depressed Young Adults: Exploring Characteristics for Mild Depression

“…These personality characteristics may play a role in the development of MDD, possibly through aberrant emotional processing (63). One systematic review found a negative relationship between measures of social rank and symptoms of depression (65). This might be partially explained by understanding the psychosocial characteristics of female students with MDS.…”

Self-Compassion, Social Rank, and Psychological Distress in Varyingly Competitive Athletes

“…Social rank is an evolutionary model that examines how competitive motivations orient attention, appraisals, and behaviour (Gilbert, 2014;Wetherall, Robb, & O'Connor, 2019). Competitive motivations orient attention towards social comparison with others, to who is of higher or lower status, and submissive or aggressive behaviours as responses.…”

“…Competitive motivations orient attention towards social comparison with others, to who is of higher or lower status, and submissive or aggressive behaviours as responses. Social rank theory has been applied to understand depressive symptoms and clinical populations, with promising evidence supporting the model (Wetherall et al, 2019). The key vulnerability factor in social rank is how individuals are competing out of the fear of losing, to avoid inferiority, and thereby rejection or exclusion by others.…”