Depression, Isolation, and Social Connectivity Online (DISCO)

Social isolation represents a risk factor for major depression across the lifespan. The COVID-19 pandemic has contributed to unprecedented disruption in social networks, as a result both of the disease itself and the measures required to contain it. Vulnerable and underserved communities have been particularly impacted in both of these regards, with greater rates of COVID-19 infection as well as greater economic and social impact of closures and restrictions. It is not surprising, then, that rates of major depressive symptoms in the United States have approached levels 3 to 4 times those observed before the pandemic. Beginning to address the rise of social disconnection and its contribution to depression requires a better understanding of the aspects of social networks most disrupted by the pandemic, and how they relate to depression, especially among individuals in vulnerable communities. Identifying targets for intervention also requires understanding how online social behavior may compensate for, or exacerbate, effects of social disconnection. Furthermore, it is necessary to understand how external factors in a community such as containment policies may contribute to or moderate social disconnection and depression. To address these critical questions, this study will use data from the Covid States Project, a 50-state survey conducted approximately every 8 weeks since April 2020, which has enrolled more than 260,000 unique individuals, including 125,000 from households earning less than $50,000 per year. Beyond symptoms of depression, the survey asks detailed questions about social networks and social support, as well as online activity, impact of COVID-19, and a range of other topics. The first aim of the study will characterize, in well-powered analysis of individual subgroups, the relationship between specific aspects of social networks and depressed mood, and identify features that may moderate these effects. In aim 2, using an innovative browser extension, the study will characterize online behavior among 1200 individuals completing the survey. In aim 3, the study will integrate survey data with longitudinal data at the state and census tract level regarding pandemic containment policies, mobility, and COVID-19 cases and death. These latter two aims will provide a novel understanding of how online behavior, and external factors, impact social networks and moderate their relationship with depression. The study will build on a highly productive collaboration for the past 2 years between the PI, with expertise in informatics methods for studying mood disorders, and the Northeastern PI, a computational social scientist with expert in large-scale surveys and investigation of social networks. The consultants, who have worked closely with the PIs on the survey, bring additional expertise in survey design and analysis, investigation of time series data including mobility data, and policy analysis. The study will identify targets for interventions to address social disconnection and its impact on depression, particularly among vulnerable populations, providing critical guidance regarding where to focus such interventions.