Assessment & Research

Relationships of assertiveness, depression, and social support among older nursing home residents.

Segal (2005) · Behavior modification 2005
★ The Verdict

For nursing-home residents, assertiveness and feeling healthy predict lower depression, while social support does not.

✓ Read this if BCBAs serving older adults in skilled-nursing or assisted-living settings.
✗ Skip if Clinicians focused only on young children or community ASD programs.

01Research in Context

01

What this study did

Shook (2005) asked 50 nursing-home residents to fill out short surveys.

The surveys measured assertiveness, social support, self-rated health, and depression.

The goal was to see which factors best predicted lower depression scores.

02

What they found

Residents who said they were more assertive also reported less depression.

The same was true for people who felt their health was good.

Surprisingly, how much social support they had did not link to depression at all.

03

How this fits with other research

Lunsky et al. (2001) found a similar null result in adults with mild ID. Social support raised quality of life but still did not touch depression scores.

Whitehouse et al. (2014) looked at a larger national ID sample and saw the opposite: low support did raise mental-health risk. The difference may be age and setting—nursing-home elders versus younger community adults.

Davison et al. (1991) showed assertiveness training can be taught and actually improves adaptive behavior in adults with mild ID, giving a ready-made intervention you can borrow.

04

Why it matters

If you work with older adults in residential care, do not assume more visitors or group activities will lift mood. Instead, run brief assertiveness lessons: practice saying no, asking for help, or making choices about daily routines. Pair this with quick health checks—vision, pain, hearing—because feeling physically better also cut depression in this study. These small moves target the two factors that really mattered.

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→ Action — try this Monday

Start a 5-minute choice routine—let residents pick snack, chair, or music—and praise each request to build assertiveness.

02At a glance

Intervention
not applicable
Design
survey
Sample size
50
Population
not specified
Finding
not reported

03Original abstract

This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age = 75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r = -.33), but the correlations between social support and depression (r = -.15) and between social support and assertiveness (r = -.03) were small and nonsignificant. The correlation between overall physical health (a subjective self-rating) and depression was strong and negative (r = -.50), with lower levels of health associated with higher depression. An implication of this study is that an intervention for depression among nursing home residents that is targeted at increasing assertiveness and bolstering health status may be more effective than the one that solely targets social support.

Behavior modification, 2005 · doi:10.1177/0145445503259391