Longitudinal Associations of Social Support with Depression and Substance Use Problems among Permanent Supportive Housing Residents

Purpose: Social support is a well-known protective factor against depression and substance use problems, but very few studies have examined its protective effects among Permanent Supportive Housing (PSH) residents. We utilized unconditional latent growth curve (LGC) models and parallel process growth (PPG) models to describe trajectories of social support, depression, and substance use problems, and to examine their longitudinal associations in a large sample of adults residing in PSH. Methods: Participants were 653 adult PSH residents (56% female; 57% Black, 35% White, 8% others; mean age: 51 years). Health behaviors were assessed at baseline and every 6 months during a 2-year longitudinal study, which was conducted in Fort Worth, TX from 2014 to 2017. Results: Unconditional LGC models indicated that over time, social support increased whereas depressive symptoms and substance use problems decreased. However, their rate of change all slowed over time. Further, in PPG models, at baseline, greater social support was linked to less severe depression and substance use problems (coefficients: -0.21, p< 0.01; -0.06, p< 0.01, respectively). Linear slopes of social support and depression were negatively associated (coefficient: -0.01, p=0.01), indicating that faster rates of increase in social support were associated with steeper rates of reduction in depression. Linear slopes of social support and substance use problems were positively linked but statistically insignificant (coefficient: 0.01, p=0.63). Conclusions: This study suggests that increases in social support may positively impact depression and substance use problems among PSH residents, but when their positive trajectory slows, boosters may be needed.