Social expectations in depression

Abstract

Individuals with depression often exhibit distortions in interpersonal perception and behaviour that are tied to negative expectations about social outcomes or interpersonal self-efficacy. These negative social expectations connect cognitive and interpersonal facets of depression and are linked to the development and maintenance of depressive symptoms. In this Review, we summarize how social expectations form and change in individuals with depression and how they shape the onset, course and severity of depressive symptoms by influencing interpersonal perception and behaviour. In particular, we address the question of why dysfunctional social expectations tend to persist despite contradictory evidence. Drawing from contemporary research on belief updating, extinction learning and prospection, we integrate several recommendations for preparing, implementing and following up on interventions that target the revision of dysfunctional social expectations in individuals with depression. We discuss whether differences in social expectations can explain the variability of interpersonal symptoms and symptom trajectories in individuals with depression, and suggest future research directions focused on exploring dynamic changes in response to the social environment. Expectations of negative social interactions or low interpersonal self-efficacy are common among people with depression. In this Review, Kirchner et al. integrate the cognitive, social and clinical aspects of expectation formation and describe how they inform the trajectory of depressive symptoms and can boost psychological treatment.