Social comparison, self-esteem and depression in people with intellectual disability.
Feeling less attractive than peers predicts depression in adults with mild-moderate ID—screen for it and target it in CBT.
01Research in Context
What this study did
Garcia et al. (1999) asked adults with mild to moderate intellectual disability about how they compare themselves to others. They looked at three areas: attractiveness, achievement, and social acceptance.
The team also measured self-esteem and depression. They wanted to see which type of social comparison best predicts low mood.
What they found
Only comparisons about looks predicted depression. Adults who felt less attractive than peers reported more depressive symptoms.
Comparisons about grades or popularity did not predict depression. Yet higher self-esteem did link to feeling good about personal achievements.
How this fits with other research
Symons et al. (2005) and Stancliffe et al. (2007) later widened the lens. They showed that Beck's full negative triad—harsh views of self, world, and future—also predicts depressed mood in the same population. This extends the 1999 finding beyond looks to thoughts about worth and hope.
Fullana et al. (2007) added life events, social support, and automatic negative thoughts into one model. These factors explained over half of depression variance, showing that social comparison is just one piece of a larger puzzle.
Porter et al. (2008) then turned the ideas into action. Staff ran group CBT that targeted negative self-thoughts, including appearance worries. Depression scores dropped and stayed lower at three months, proving the 1999 insight can guide real treatment.
Why it matters
When you screen an adult with ID for depression, ask how they feel about their looks, not just their skills. One simple question—"Do you think you are as good-looking as your friends?"—can flag risk fast. If the answer is "no," follow up with a full mood check and consider adding appearance-focused cognitive work to your CBT plan.
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02At a glance
03Original abstract
The present study explores the relationship between social comparison processes, self-esteem and depression in people with intellectual disability. Forty-three people with mild and moderate intellectual disability completed adapted measures of self-esteem and social comparison. The social comparison scale offers subscale scores on achievement, social attractiveness and group belonging dimensions. The self-esteem scale offers subscale scores for positive and negative self-esteem. A significant positive correlation was found between positive self-esteem and social comparison on the achievement dimension. Depression was significantly negatively correlated with social comparison on the social attractiveness and group belonging dimensions, and with positive self-esteem. Regression analysis showed that depression was significantly and independently predicted only by social comparison on the social attractiveness dimension. The present authors conclude that social comparison is associated with self-esteem and depression in people with intellectual disability in the same way as it is for people without intellectual disability. Further exploration of social comparison process in people with intellectual disability may inform cognitive behavioural interventions for this group of people.
Journal of intellectual disability research : JIDR, 1999 · doi:10.1046/j.1365-2788.1999.043005372.x