A Proposed Model for the Role of Fear of Intimacy and Social Support in Behavioral Activation: A Cross-Sectional Analysis

Curr Psychol. 2023 Feb;42(5):4243-4253. doi: 10.1007/s12144-021-01766-9. Epub 2021 Apr 29.

Abstract

Behavioral theories of depression posit that depression results from the environment not adequately reinforcing non-depressive behaviors. One commonly used treatment based on the behavioral model of depression is Behavioral Activation. While many implementations of Behavioral Activation emphasize social interactions, there is limited empirical investigation into the contribution of specific facets of social engagement in the behavioral model of depression. Fear of intimacy, an indicator of willingness to engage in specific types of social interactions, may play an important role in understanding at a functional level what aspects of social engagement are important in behavioral activation. The current study (N = 353) proposes a model, anchored in functional outcomes of behavioral interactions, to explain the development and utilization of social support as environmental enrichment. The proposed model accounted for 55% of the variance of depressive symptoms. Findings were consistent with a model where fear of intimacy was directly and indirectly associated with depression via activation, social support, and environmental enrichment. Notably, social support was not directly associated with depression. Findings suggest the importance of incorporating vulnerable self-disclosure in behavioral activation treatments to foster environmental enrichment.

Keywords: Behavioral Activation; Depression; Environmental Reward; Intimacy; Social Relationships.