Clin Psychology and Psychoth - 2020 - McCarthy - Exploring The Association of Social Comparison With Depression and Anxiety

Received: 19 September 2019 Revised: 27 February 2020 Accepted: 23 March 2020
DOI: 10.1002/cpp.2452
COMPREHENSIVE REVIEW
Exploring the association of social comparison with depression

and anxiety: A systematic review and meta-analysis
Peter A. McCarthy | Nexhmedin Morina
Institute of Psychology, University of Münster,

Münster, Germany Research has highlighted the role of social comparison processes in varying affect
and psychological wellbeing. These processes can provide greater insight into cogni-
Correspondence
Nexhmedin Morina, Institute of Psychology, tions and behaviours related to depression and anxiety disorders. This review aimed
University of Münster, Fliednerstr.
to examine the relationship of social comparison with depression and anxiety in clini-
21, Münster 48149, Germany.
Email: morina@uni-muenster.de cally relevant samples, using a process-based approach.
Studies of clinical and subclinical populations that utilized observational or experi-
mental social comparison assessment were considered for review. A systematic liter-
ature search in Medline and PsycInfo databases produced 54 relevant studies
(49 studies on adults and five on child and adolescent populations), 14 of which were
suitable for a meta-analysis.
A meta-analysis of the association of social comparison evaluation with depression
and anxiety in clinical populations revealed weighted correlations of −0.53 and
− 0.39, respectively. No subclinical studies were included in a meta-analysis due to a
lack of comparable outcomes. Evidence suggests differences between depression
and anxiety disorders in information seeking, where frequency and diversity of social
comparisons vary; however, studies comparing disorders are lacking. Heterogeneity
of experimental studies precluded inclusion in a meta-analysis. A narrative review of
experimental data indicated depression and anxiety status is related to reactions to
upward comparisons in the domains of affect and behaviour, where individual differ-
ences in evaluation can determine affective reactions and how comparison informa-
tion is further sought.
This review suggests social comparison has a significant association with depression
and anxiety. However, the limited number of studies with clinical populations neces-
sitates further research on social comparison processes in clinical samples.
KEYWORDS
anxiety, depression, meta-analysis, social comparison, systematic review
1 | I N T RO DU CT I O N for the last 60 years (Gerber, Wheeler, & Suls, 2018). These have
evolved from Festinger's (1954) original social comparison theory
The role of social comparison (SC) in relation to the self has been (SCT), investigating the themes of personality, self-perception, health,
investigated through various methodological and theoretical avenues and psychological wellbeing in a broad field of application (Buunk &
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium,
provided the original work is properly cited.
© 2020 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd
640 wileyonlinelibrary.com/journal/cpp Clin Psychol Psychother. 2020;27:640–671.

10990879, 2020, 5, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/cpp.2452 by CAPES, Wiley Online Library on [29/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
MCCARTHY AND MORINA 641
Gibbons, 2007). This has been predominantly in the field of social psy-
chology, ranging from social status (Haught, Rose, Geers, & Key Practitioner Message
Brown, 2015; Kraus & Park, 2014; Wyatt & Gilbert, 1998) and
achievement-based comparisons (Gibbons, Blanton, Gerrard, Buunk, &
• This review examined social comparison as a process of
Eggleston, 2000), to health condition (Arigo, Smyth, Haggerty, &
acquiring, evaluating, and reacting to comparison infor-
Raggio, 2015; Buunk et al., 2009; Peck & Merighi, 2007; Van der Zee,
mation in relation to depression and anxiety.
Buunk, & Sanderman, 1995) and image-based comparisons (Cattarin,
• Self-evaluations in social comparison have a significant
Thompson, Thomas, & Williams, 2000; Mulgrew & Cragg, 2017;
association with depression and anxiety, with diagnoses
Mulgrew, Volcevski-Kostas, & Rendell, 2014; Van der Zee, Buunk,
differentiated by how information is sought and acquired.
Sanderman, Botke, & van den Bergh, 2000). Implications for SCT in
• Upward comparisons have the most detrimental effects
clinical psychology have been investigated to a lesser degree; how-
on wellbeing related to depression and anxiety, where
ever, there has been notable interest in affective disorders and associ-
comparison processes feed into dysfunctional beliefs
ated symptoms (Allan & Gilbert, 1995; Bäzner, Brömer,
about the self.
Hammelstein, & Meyer, 2006; Buunk & Brenninkmeijer, 2001; Gilbert
• Further research on social comparison processes in clini-
et al., 2010). This paper reviews empirical evidence for the association
cal populations is required, with focus on potential mod-
of SC with depression and anxiety in clinical and subclinical
erating factors at different stages to provide better
populations in order to summarize implications for SCT in clinical
insight into disorders and how interventions could
psychology.
change or utilize social comparison processes.
1.1 | Social comparison
Festinger (1954) conceived SCT to explain how individuals make self-

evaluations regarding opinions and abilities, seeking similar others as and less negative for nondepressed individuals when targets were,
upward comparison targets (superior others), to maintain a stable self- respectively, low- or high-effort copers and high in SCO. These find-
view (Corcoran, Crusius, & Mussweiler, 2011). Earlier research also ings suggest that comparison habits vary depending on mental health
suggested that individuals engage in comparisons during stressful situ- and have subsequent effects on psychological factors, such as mood,
ations to assess how well they are coping (Schachter, 1959). yet are a complex interaction of aspects of comparison. The two-way
Wills (1981) elaborated on Festinger's work by acknowledging that relationship between mental health and SC is highlighted here, where
individuals also make downward comparisons (inferior others), often identifying the processes involved is necessary to gain better under-
in reaction to a decrease in subjective wellbeing, with the goal of standing of their relationship to depression and anxiety.
improving their affect. An example of comparison direction influenc- A definition suggested by Wood (1996, p. 521) defined SC as a
ing affect could be a depressed patient comparing with a recovered process that consists of three facets: (1) acquiring social information
patient (upward target) and experiencing an improvement or deterio- (seeking, encountering, or constructing); (2) evaluating the outcome of
ration in affect due to the respective assimilation or contrast with the comparison in relation to the self (relevance and [dis]similarities); and
comparison target. The patient may also compare with a downward (3) reacting to the evaluation of comparison information via cognitive,
target (someone they see as more depressed), which again may lead affective, or behavioural responses. In context of this definition, the
to improvement or deterioration in affect dependent on whether they B. P. Buunk and Brenninkmeijer experiment involves aspects of all
assimilate or contrast with the target. Thus, SCs are a cognitive pro- three facets: the measure of SCO assesses a general level of engage-
cess that can contribute to changes in affect depending on how indi- ment with SC, relating to processes in Part 1; the experimental manip-
viduals perceive their targets, as well as themselves. ulation focuses on Part 2, where the behaviour of targets and
Buunk and Brenninkmeijer (2001) report an example of how tar- perceived similarity will affect the outcome of the comparison in rela-
get similarity can influence the comparison process in context of tion to evaluations about the self; and the experimental outcome vari-
depression. They found that individuals high in depression experi- able relates to Part 3 where reaction is assessed as change in mood. In
enced a positive mood change when exposed to examples of recov- order to identify and separate aspects of SC in publications included
ered depressed patients. However, individuals low in depression in this review, we will focus on the three facets of acquiring, evaluat-
experienced a negative mood change when exposed to the same tar- ing, and reaction, as per Wood's (1996, p. 521) definition, when cate-
gets, showing that perceived similarity with a target can determine the gorizing relevant variables.
impact of comparison. In addition, these results were moderated by an
interaction between the effort of coping of the target (low or high) 1.2 | SC and mental health
and degree of social comparison orientation (SCO; a concept regarding
the extent to which comparison information is sought; Gibbons & Depression and anxiety disorders are characterized by disturbances in
Buunk, 1999). Thus, mood change was more positive for depressed emotional, cognitive, and behaviour processes (American Psychiatric
642 MCCARTHY AND MORINA
Association, 2013). These disorders affect significant proportions of also associated with other psychological factors such as rumination,
the general population, being the most common mental health disor- dysfunctional attitudes, shame, and self-criticism; however, these con-
ders with an approximate 19.1% experiencing depression or dysthy- cepts were assessed either as moderators or dependent variables in
mia and 28.8% experiencing an anxiety disorder (including post- studies and thus do not provide a clear outline of the mechanisms
traumatic stress disorder [PTSD]) during the lifespan (Kessler involved. The social rank variables predominantly focused on mea-
et al., 2005). SC is likely to play a significant role in the development sures of self-evaluation in adult samples, particularly the Social Com-
and maintenance of depressive symptoms, with evidence suggesting parison Scale (SCS; Allan & Gilbert, 1995), which assesses how
that reductions in engaging with general SC precede improvements in individuals rate themselves on 11 bipolar constructs (e.g., unlikeable
depression (Kelly, Roberts, & Bottonari, 2007). Literature further sug- to more likeable). The SCS is the most commonly used measure of SC,
gests that major depressive episodes are more common in individuals thus features in many articles reviewed here and provides the oppor-
who negatively evaluate themselves compared with others tunity to conduct a meta-analysis, which was not covered by the
(Sturman & Mongrain, 2008). Fewer publications focus on the role of Wetherall et al. review. Additionally, a broader overview of SC beyond
SC in anxiety disorders; however, diary reports suggest that social self-other evaluations in clinically relevant samples is therefore
anxiety patients are more likely to engage in upward SC, compare on needed to increase our understanding of the role of SC in psychologi-
several dimensions at a time, and are more vulnerable to affective cal disorders.
reactions than healthy controls (Antony, Rowa, Liss, Swallow, &
Swinson, 2005). Therefore, a better understanding of the nature and
impact of SC processes in dysfunctional cognitions and behaviours 1.3 | Present study
related to depression and anxiety could benefit diagnosis and
treatment. As described above, there are a number of approaches to assess SC,
A number of reviews have assessed research on processes of SC such as SCO (Gibbons & Buunk, 1999), the SCS (Allan &
in relation to wellbeing and health (Arigo, Suls, & Smyth, 2014; Gilbert, 1995), as well as numerous experimental reaction paradigms
Myers & Crowther, 2009; Wetherall, Robb, & O'Connor, 2019). Gen- (Gerber et al., 2018). To better understand the process of SC, we use
eral effects of SC are reported in context of body dissatisfaction by Wood's definition and code how SC is approached in terms of manip-
Myers and Crowther (2009): a meta-analysis found that an increased ulation and outcome of the three facets: acquiring, evaluating, and
tendency or opportunity to make comparisons on the basis of appear- reaction. In this context, SCO would be coded as acquiring, as it
ance was related to higher levels of body dissatisfaction. In this reflects a tendency of seeking and engaging with SC. The SCS would
review, no theoretical model of SC was used to explore processes be coded as evaluating as it involves making judgements relative to
within SC as potential moderators, such as direction, preventing fur- others. Change in affect, cognitive reflections, or behavioural observa-
ther conclusions being drawn on what processes may be relevant to tions following SC would be coded as reaction. Our aim is therefore to
eating pathology. However, Myers and Crowther assessed study assess how these facets of SC have been considered in depression
design as a moderator, reporting no significant differences in effect and anxiety disorders. PTSD will also be considered in the literature
sizes between correlational and experimental studies, suggesting both review due to its classification as an anxiety disorder until the most
should be given equal consideration. Arigo et al. (2014) reviewed liter- recent DSM-5 publication (American Psychological
ature in relation to chronic physical illnesses, assessing comparison Association, 2013). Our review involves the qualitative synthesis of a
processes in terms of the identification/contrast model from Buunk broad range of literature, covering observational and experimental
and Ybema (1997), which suggests outcomes of comparisons depend paradigms. We also aimed to produce a quantitative synthesis of rele-
on how an individual perceives or expects to be (dis)similar to the tar- vant data to summarize findings via a meta-analysis.
get, as well as the direction of the comparison. Arigo et al. report that
for patients with chronic illness, there are emotional and physical ben-
efits of upward assimilation and downward contrast with others who 2 | METHOD
are, respectively, coping well or are more ill, as well as the risks of
depression and poorer physical outcomes of downward assimilation This review was registered with the PROSPERO international pro-
with the latter. They also highlight the potential use of priming (dis) spective register of systematic reviews (CRD42017067067).
similarity in comparisons for appropriate targets to assist coping in
medical patients, a concept that could also apply to mental health
patients. Wetherall et al. (2019) recently reviewed evidence for the 2.1 | Search strategy
association of depressive symptoms and suicide risk with evaluation
in SC in the form of social rank. They found that lower perceived Papers for this review were identified through literature searches of
social rank is associated with increased depressive symptoms and the PsycINFO and Medline databases on 21 November 2017 and
self-harm, particularly in clinical populations, indicating that individuals 12 December 2018. The following Boolean search phrases were used:
with depressive symptoms are more likely to judge themselves nega- [TI (“social comparison”) OR AB (“social comparison”) OR KW (“social
tively relative to others (Wetherall et al., 2019). This relationship was comparison”)] AND [TI (depress* OR dysthym* OR mdd OR mood OR
anxi* OR phobia* OR agoraphobia or panic OR stress OR distress OR required to use a quantitative assessment of an aspect of SC, such as
affect OR worry OR disorder*) OR AB (depress* OR dysthym* OR frequency- (Gibbons & Buunk, 1999) or comparison-based judge-
mdd OR mood OR anxi* OR phobia* OR agoraphobia or panic OR ments (Allan & Gilbert, 1995) alongside a measure of depression or
stress OR distress OR affect OR worry OR disorder*) OR KW anxiety. Experimental paradigms were defined as manipulating infor-
(depress* OR dysthym* OR mdd OR mood OR anxi* OR phobia* OR mation or exposure to an SC target, where participants were either
agoraphobia or panic OR stress OR distress OR affect OR worry OR instructed or invited to engage with SC information, and a relevant
disorder*)] NOT [TI (eating) OR AB (eating) OR KW (eating)]. Social outcome was measured. The focus of manipulation was coded for all
comparison was entered in quotations marks in order to reduce the included studies, as was the relevant SC observation or outcome as
number of irrelevant hits due to common use of the words separately. per Wood definition, as acquiring, evaluating, or reacting to compari-
Eating-related disorders were not of interest for this review in order sons. If comparison direction was clearly manipulated or measured as
to focus on depression and anxiety disorders. Reference lists of part of an outcome via a clear definition, this was additionally coded.
included results were scanned for additional relevant papers. All cita- Options were a specific direction (upward and/or downward), mixed
tions of the SCS (Allan & Gilbert, 1995) were also reviewed for (e.g., spectrum of worse–better), as well as if a lateral/neutral option
inclusion. was provided. Other variables known to be related to SC or depres-
sion and anxiety were also coded when provided.
2.2 | Eligibility criteria

2.5 | Statistical analysis
Publications were included in the review on the basis of the following
criteria: (1) study participants were described as clinical samples when A meta-analysis was planned for quantitative synthesis of studies. A
either assessed with a diagnostic tool (e.g., Antony et al., 2005) or rec- meta-analysis required a minimum of four publications to have a simi-
ruited as patients (e.g., Paul Gilbert, 2000), or study participants were lar design on the basis of requirements suggested in previous meta-
described as subclinical samples with moderate levels of depression analyses (Morina, Koerssen, & Pollet, 2016). Observational studies
and/or anxiety symptoms on the basis of cut-off scores were required to measure the similar concepts within the same facet
(e.g., McGillivray & McCabe, 2007) or split groups with high and low of SC, such as comparison frequency (acquiring), to be included. Exper-
scores on relevant mood and anxiety inventories (e.g., Bäzner imental studies were required to use analogous study designs focusing
et al., 2006); (2) results from an SC measure or observation were on the same facet of SC; the method of SC manipulation, target,
reported or involved an experimental paradigm manipulating SC infor- dimension, and outcome of SC was considered. Due to heterogeneity,
mation; (3) the publication provides results on the association particularly in subclinical studies, it transpired that only observational
between SC and depression and/or anxiety; (4) peer-reviewed journal clinical samples assessing evaluation could be included in the meta-
article; and (5) English language. For the purposes of this study, ‘social analysis using correlation coefficients of SC with clinical measures of
comparison’ was defined in accordance with the definition of depression or anxiety. For these studies, we required participants in
Wood (1996): ‘the process of thinking about information about one or clinical groups to consist of at least 80% depression or anxiety disor-
more other people in relation to the self” (pp. 520–521). ders to ensure effect sizes would offer a true representation of
depression and anxiety samples. This is also reflected in the study
quality assessment. Experimental studies often varied in the type of
2.3 | Selection procedure and data collection induction of SC manipulation, even when outcomes (e.g., affect) were
similar, such as explicit upward comparison instructions with someone
Search results were initially screened for abstracts and titles. For full familiar (Bäzner et al., 2006), implicit manipulation via rank-based
text assessments, full texts were reviewed for coding and qualitative competition feedback (McFarland & Miller, 1994), or exposure to indi-
synthesis. P. M. reviewed full texts with assistance from N. M., viduals with varying coping styles (Buunk & Brenninkmeijer, 2001).
extracting information regarding study objectives, study population, Experimental studies are therefore qualitatively reviewed.
study design, variables, and measures used and results. In studies Quantitative analysis was conducted with comprehensive meta-
where the necessary data were not published, data were requested analysis Version 3 (Borenstein, Hedges, Higgins, & Rothstein, 2009),
with at least two attempts to contact the corresponding authors. The using a recommended random effects model (Hunter &
final included studies for qualitative and quantitative synthesis were Schmidt, 2004). Weighted average effect sizes (r) were calculated
reviewed by P. M. and approved by N. M. Discrepancies for inclusion using Fisher's Z transformations (Hedges & Olkin, 1985), and 95%
between P. M. and N. M. were discussed and solutions agreed. confidence intervals were calculated for each correlation value. Corre-
lation coefficients may be conservatively interpreted with
2.4 | Coding of study characteristics Cohen's (1988) convention of small (0.10), medium (0.30), and large
(0.50) in size, respectively. As a test of homogeneity of effect sizes,
Studies were coded as either observational or experimental and as we calculated the Q statistic and the I2 statistic. Q assesses the pres-
clinical or subclinical population samples. Observational studies were ence or absence of heterogeneity by testing the hypothesis that
observed variance in effects is no greater than would be generated by either an experimental paradigm or observational tool. Possible scores
sampling error. Q values that are statistically significant indicate het- for each item were either 2 ( good), 1 (moderate), or 0 (poor), with final
2
erogeneity. I calculates heterogeneity as the percentage of total vari- quality scores averaged across items.
ation across the included studies that are due to heterogeneity rather
than chance (Higgins, Altman, & Sterne, 2011). Heterogeneity can be
interpreted as high if I2 is over 75%, moderate if I2 is over 50%, and 3 | RE SU LT S
2
low if I is at around 25% (Higgins, Thompson, Deeks, &
Altman, 2003). 3.1 | Selection and characteristics
The Preferred Reporting Items for Systematic Reviews and Meta-

2.6 | Quality assessment Analysis diagram in Figure 1 describes the inclusion and exclusion of
studies. The titles and abstracts of 1,213 results were reviewed, with
In line with Preferred Reporting Items for Systematic Reviews and 352 publications selected for full text review. The final selection
Meta-Analysis group guidelines (Moher et al., 2015), studies included resulted in 60 studies from 54 articles for systematic review, of which
in the meta-analysis were assessed for quality. The quality assessment 14 clinical group studies were included in a meta-analysis. No subclini-
was composed by the authors to assess for sample selection, diagnos- cal studies met criteria to be included in the meta-analysis. Only 3 of
tic validation, symptom severity measurement, and SC assessment. the 14 included studies utilized a control group (Weisman, Aderka,
For criteria, items, and scoring, see Appendix. Good quality studies Marom, Hermesh, & Gilboa-Schechtman, 2011; combined Studies
were required to sample a clinical population with reported diagnostic 1 and 2 for analyses); therefore, between-group analyses were too
rates for depression or anxiety of at least 80%, via validated diagnos- few (<4) to assess group differences; the three homogenous control
tic interview, with a clinically validated instrument to measure depres- groups are discussed below. Studies were excluded from the final
sive or anxiety symptoms. Regarding SC, good quality studies were meta-analysis predominantly due to the heterogeneity of SC mea-
required to consider comparison direction and target similarity in sures. Three studies did not provide the necessary correlation
F I G U R E 1 Flow chart of search with

inclusion and exclusion process of studies
TABLE 1 Studies included in the meta-analysis.
Depression diagnosis Anxiety diagnosis %

Participant sample % (diagnostic tool/ (diagnostic tool/ Clinical variable
Study Study focus (N, average age, % female) method) method) measures SC measure Quality rating
Allan & Gilbert, 1995 Psychometric properties of Non-psychotic depression n.r. n.r. SCL-90-R SCS (Allan & 1.25
Social Comparison Scale and anxiety disorder Gilbert, 1995)
MCCARTHY AND MORINA
and related outpatient sample

psychopathology. (N = 32, 38.9 years, 50%).
Carvalho et al., 2013 Evolutionary approach to Major depression hospital 100% (SCID-I & n.r. BDI SCS (Allan & 1.75
depressive symptomology outpatient sample DSM-IV-TR criteria) Gilbert, 1995)
investigating social rank (N = 106,
variables. 37.9 years, 74%).
Gilbert & Allan, 1998 The roles of defeat and Depressed patient sample 100% (ICD-9 criteria n.r. BDI SCS (Allan & 1.5
entrapment within the (N = 86, 40.8 years, 56%). diagnosis & BDI CES-D Gilbert, 1995)
social rank theory of score ≥ 10)
depression.
Gilbert, 2000 Uses social rank theory to Depressed inpatient sample 100% (ICD-10 criteria BDI SCS (Allan & 1.5
explore the relationship in treatment (N = diagnosis, currently Gilbert, 1995)
between shame, 50, 39 years, 52%). in treatment & BDI
depression & social score ≥ 10
anxiety.
Gilbert, Allan, Brough, The roles of defeat, Primary and secondary 100% (ICD-10 criteria n.r. BDI SCS (Allan & 1.25
Melley, & entrapment and social depressed psychiatric diagnosis) MASQ Gilbert, 1995)
Miles, 2002 rank in relevance to inpatient sample BDI
affect in depression and (N = 81, 36.8 years, 60%).
anxiety.
Gilbert, Boxall, The relationship between Non-psychotic inpatient n.r. n.r. SIAS SCS (Allan & 1.25
Cheung, & Irons, paranoid ideation and and outpatient sample BDI (data for BDI Gilbert, 1995)
2005 social anxiety, in context with mixed anxiety and correlation not
of perceptions of social depression (N = provided)
rank and power. 71, 40.9 years, 49%).
Gilbert, Irons, Olsen, Gender differences in a Depressed inpatient and 100% (ICD-10 criteria n.r. MASQ SCS (Allan & 1.25
Gilbert, & depressed population for outpatient sample diagnosis and Gilbert, 1995)
McEwan, 2006 relationships between (N = 104, currently in
sensitivity to rejection, 39.5 years, 48%). treatment)
sensitivity to criticism/
put-down and social rank.
Gilbert, McEwan, The roles of social rank, Depressed inpatient and 100% (ICD criteria n.a. DASS-21 SCS (Allan & 1.5
Bellew, Mills, & shame, inferiority and outpatient sample diagnosis) Gilbert, 1995)
Corinne, 2009 attachment style in (N = 62,
depression and anxiety. 44.3 years, 58%).
Gilbert, Allan, & The roles of social rank Depressed patient group 100% (ICD-9 criteria n.r. BDI SCS, shortened 1.5
Trent, 1995 variables in depression- undergoing treatment diagnosis & BDI to only 5 items
(N = 29, 38 years, 79%). score ≥ 10) (Allan &
645
(Continues)
TABLE 1 (Continued)
646
Depression diagnosis Anxiety diagnosis %

Participant sample % (diagnostic tool/ (diagnostic tool/ Clinical variable
Study Study focus (N, average age, % female) method) method) measures SC measure Quality rating
relevant dependency Gilbert,
behaviours. 1995)
Judge, Cleghorn, Benefits of group-based Mixed patient sample 88.9% (clinical intake 37% (clinical intake BDI SCS (Allan & 1.5
McEwan, & CFT approach and effects treated by a mental interview) interview) BAI Gilbert, 1995)
Gilbert, 2012 of associated health team (excl.
transdiagnostic processes Current alcohol abuse
for severe and enduring and psychosis) (N =
mental health difficulties. 27, 40.8 years, 59%).
Lopes, 2013 The roles of childhood Social anxiety disorder n.a. 100% (Anxiety BDI-II SCS (Allan & 1.75
bullying as a trauma in sample from an Disorders Interview FNE Gilbert, 1995)
social anxiety, paranoid outpatient clinic Schedule-Revised)
ideation and aggression (N = 30, 26.9 years, 40%).
in adulthood.
McEwan, Gilbert, & The effects of different Depressed patients from 100% (clinical n.r. DASS-21-D SCS (Allan & 1.5
Duarte, 2012 types of self-experience outpatient clinics, assessment & DASS-21-A Gilbert, 1995)
(Study 2) on competitive vs caring community mental current treatment
social mentalities in health teams or of depression)
depressed and non- self-help groups
depressed populations. (N = 48,
48.7 years, 58%).
Troop & Hiskey, 2013 Investigate constructs of Adults reporting a stressful n.r. 100% (PDS & PDS SCS (Allan & 1.5
social rank as predictors event that meets DSM-IV PTSD Gilbert, 1995)
for PTSD diagnosis. Criterion A, with PTSD criteria)
symptoms, who accessed
stress and trauma-
related websites
(N = 185, 31.6 years,
72% female).
Weisman et al., 2011 Two studies using Social anxiety disorder n.a. 100% (SCID) BDI STAI-T SCS (Allan & 1.75
(Studies 1 & interpersonal theory to patients attending a Gilbert, 1995)
2 combined) investigate the roles of clinic (N = 87,
social rank and 29.5 years, 47%)
attachment in anxiety and
depression.
Abbreviations: BDI, Beck Depression Inventory; CES-D, Centre for Epidemiological Studies Depression Scale; CFT, compassion-focused therapy; DASS, Depression Anxiety Stress Scale (−21 = short form); DSM,
Diagnostic and Statistical Manual of Mental Disorders; FNE, fear of negative evaluation; ICD, International Statistical Classification of Diseases and Related Health Problems; MASQ, Mood and Anxiety Symptoms
Questionnaire; n.a., not applicable, n.r., not reported; PDS, Post-Traumatic Diagnostic Scale; PTSD, post-traumatic stress disorder; SCID, Structured Clinical Interview for DSM Disorders; SCL-90-R, Symptom
Checklist-90-Revised; SCS, Social Comparison Scale; SIAS, Social Interaction Anxiety Scale; STAI-T, State–Trait Anxiety Inventory, Trait Subscale.
MCCARTHY AND MORINA
TABLE 2 Description of observational studies reviewed.
Relevant outcomes; SC direction

Study Sample SC observation (symptom measures) assessed? Relevant findings
Allan & Gilbert, 1995 Mixed depression & anxiety Self-evaluation. E: SCS scores; (SCL-90-R). N Significant negative correlation between depression
outpatients (N = 32). and SCS scores, suggests as depression increased,
self-evaluation was more negative. No significant
MCCARTHY AND MORINA
correlation between SCS and anxiety.

Antony et al., 2005 Social anxiety (59), SC diary for 2 weeks. A: dimension, target; M, L Social anxiety group reported more comparisons on
Control (58). E: target similarity and the dimensions of social skills, personality and signs
direction; of anxiety, as well as more multidimensional
R-a: VAS general affect comparisons.
ratings; VAS depression Most participants compared with strangers,
& anxiety ratings. acquaintances, friends and family members, rating
the targets as moderately similar.
Social anxiety group reported more upward and fewer
downward or lateral comparisons than the control
group.
Upward comparisons generally led to worsening of
affect, especially in males or those who had lower
education level. The anxiety group additionally
reported an increase of anxiety after upward
comparisons and both groups reported an increase
in depression.
The anxiety group reported a decrease in anxiety after
downward comparison, whereas the control group
reported a slight increase.
Lateral comparisons had no effect on affect.
Carvalho et al., 2013 Depression outpatients Self-evaluation. E: SCS scores; (BDI). N Significant negative correlation between depression
(106), Control (116). scores and SCS. The depression group made more
negative self-evaluations than the control group.
However, SCS scores did not account for significant
variance of depression scores in a regression model
including other social rank, entrapment and defeat
variables.
Cunha, Soares, & Pinto- Adolescents: Social phobia Self-evaluation. E: SCS scores; (SAASA). N Adolescents with social anxiety differed significantly
Gouveia, 2008 (76), Other anxiety from the other groups, scoring lower on the SCS.
disorders (28), Control (76). There was not a significant difference between
other anxiety disorders and control group.
Social comparison was also found to mediate the
effects of behavioural inhibition and attachment
to peers on social anxiety.
Flett, Vredenburg, Pliner, Females: Subclinical Academic performance. A: Number of comparisons N When given the opportunity to compare exam results
& Krames, 1987 (Study 1) Depression (21), & time taken;(BDI). with other students, the depression group sought
Non-depressed (21). fewer comparisons and spent less time viewing
scores of others than the non-depressed group.
647
(Continues)
648
TABLE 2 (Continued)

Flett et al., 1987 (Study 2) Subclinical Depression (24), Academic performance. A: Number of comparisons N When given the opportunity to compare exam results
Non-depressed (33). & time taken; (MAACL). with other students, the depression group sought
fewer comparisons, especially if they had a lower
test performance.
Gilbert & Allan, 1998 Depression patients (86). Self-evaluation. E: SCS scores; (BDI). N Significant negative correlation between depression
scores and SCS. SCS scores accounted for
significant proportion of variance of depression in a
regression model. Unclear if significance remained
when other social rank, entrapment and defeat
variables were added.
Gilbert, 2000 Depression inpatients (50). Self-evaluation. E: SCS scores; (BDI; SIAS). N Significant negative correlation between depression
& anxiety scores and SCS. SCS scores did not
account for significant variance of depression or
anxiety scores in a multiple regression model
including other social rank and shame variables.
Gilbert et al., 2002 Depression inpatients (81). Self-evaluation. E: SCS scores; (MASQ). N Significant negative correlation between depression
& anxiety scores and SCS. In a structural equation
model SCS scores failed to have a significant impact
on depression and anxiety in the presence of other
social rank, entrapment and defeat variables.
Gilbert et al., 2005 Mixed Depression & anxious Self-evaluation. E: SCS scores; (BDI; SIAS). N Significant negative correlation between anxiety
patients (71). scores and SCS while controlling for depression.
SCS scores contributed a unique contribution to
variance of anxiety scores in the presence of social
rank and power variables.
Gilbert et al., 2006 Depression inpatients and Self-evaluation. E: SCS scores; (MASQ). N Significant negative correlation between depression
outpatients (104). & anxiety scores and SCS. Female self-evaluation
was more negative than for males. In a principal
components analysis, SCS scores loaded on a factor
of internalization, which correlated with a mood
factor including anxiety and depression.
Gilbert et al., 2009 Depression inpatients and Self-evaluation. E: SCS scores; (DASS-21). N Significant negative correlation between depression
outpatients (62). & anxiety scores and SCS. SCS scores did not
account for significant variance of depression or
anxiety scores in a multiple regression model
including other social rank, shame and attachment
variables.
Gilbert et al., 2010 Self-evaluation. E: SCS scores; (HADS). N Significant negative correlation between depression
& anxiety scores and SCS. For regression analyses,
MCCARTHY AND MORINA
TABLE 2 (Continued)

Mixed nonpsychotic clinical SCS scores formed part of a composite variable of
group (73 total; 35 with social rank. Social rank was close to statistical
MCCARTHY AND MORINA
depression, 6 with anxiety). significance for contributing to depression or

anxiety scores.
Gilbert et al., 1995 Depression patient group (29). Self-evaluation. E: SCS scores; (BDI). N Significant negative correlation between depression
and SCS scores. SCS scores were shown to
contribute significant variance of depression scores
through backward elimination in hierarchical
regression.
Giordano, Wood, & Subclinical Depression (16), SC diary for 3 weeks. A: frequency and dimension M Downward comparisons were more common than
Michela, 2000 Non-depressed (46). of comparisons; upward, especially for the non-depression group.
E: target similarity/direction; Although the depression group reported fewer
R-a: mood change. comparisons overall, they reported more
comparisons that were congruent (via SC
dimension) to their personality type (sociotropic or
autonomic).
Upward comparisons led to a larger increase in
negative mood than downward comparisons. This
effect was stronger when comparisons were
congruent to personality, especially for the
depression group.
Gordon et al., 2013 Subclinical social anxiety: Self- & romantic E: Self-other discrepancy N As social anxiety scores increased, so did the
High (36), Medium (37), partner-evaluations. SCS scores; (SIAS). discrepancy between the self- and partner-
Low (35). evaluations.
Hooberman, Rosenfeld, War/torture-related Self-evaluation. A: SES scores; (HTQ). U, D Only downward comparisons were significantly
Rasmussen, & PTSD (75). correlated with HTQ scores. However the up- and
Keller, 2010 downward comparison subscales of the SES
consisted of multi-standard comparisons, not
only SC.
Judge et al., 2012 Mixed non-psychotic clinical Change in self- E: change in SCS scores; N Compassion-focused therapy led to a significant
group (27 total, 23 with evaluation via CFT (BDI; BAI). improvement in self-evaluation via SCS scores.
moderate to severe intervention. Baseline depression and anxiety were not
depression). correlated with SCS scores, the same vice-versa.
Kang et al., 2012 Subclinical Depression (46), Self-evaluation. E: SCS scores. N Depression group made significantly more negative
Non-depressed (125). self-evaluations that the control group.
Kelly et al., 2007 Depressed students (60). Occurrence of A: frequency of comparisons U, D, M At baseline, only overall comparisons were
comparisons in vwith upward targets, significantly correlated with depression. However,
individuals who experienced sudden gains
(Continues)
649
650
TABLE 2 (Continued)

relation to sudden with downward targets (improvements) over 9 weeks reported a
gains. and overall; (BDI-II). significantly lower baseline level of upward
comparisons. Reduction in overall comparisons
predicted sudden gains the following week.
Changes in upward or downward comparisons
did not precede sudden gains.
Lopes, 2013 Social anxiety outpatients (30). Self-evaluation. E: SCS scores; N Relevant data was provided on request from authors.
(BDI; SIPFNE). SCS scores did not significantly correlate with
depression or fear of negative evaluation.
MacMahon & Intellectual disability sample: Self-evaluation in E: SCS (6-item) scores; N Depression group made significantly more negative
Jahoda, 2008 Depression (18), general and with importance of specific self-evaluations than the control group for general
Control (18). specific targets. comparisons. SCS scores, as well as for comparisons with specific
targets. Depression group did not rate positive and
negative comparisons differently, however the
control group rated positive comparisons as more
important.
McEwan Depression patients (48). Self-evaluation. E: SCS scores; (DASS-21). N Significant negative correlation between depression
et al., 2012, (Study 2) & anxiety scores and SCS.
McGillivray & Subclinical Depression with Self-evaluation. E: SCS scores, (BDI). N Significant negative correlation between depression
McCabe, 2007 intellectual disability: scores and SCS for the full sample. High depression
High (48), group scored significantly lower than other groups
At risk (48), on SCS. Regression analyses did not find a
Non-depressed (55). significant contribution of SCS scores for
depression, in context of contributing social support
and wellbeing variables.
Molleman, Pruyn, & Levels of subclinical Anx: Interaction with A: preference of target for M, L Similar others or those who are slightly better off
van Knippenberg, 1986 Very high (n.r.), High (n.r.), fellow cancer interaction; R-a: Affective were most preferred for interactions. No anxiety-
Moderate (n.r.), Low (n.r.), patients. response to interaction level analyses reported for preference.
Very low (n.r.). with 5 different targets. Very high anxiety group reported the most negative
experiences from interactions, whereas the very
low anxiety group reported the least negative
experiences. The most negative interactions were
reported with patients who were worse off,
whereas the least negative interactions were
reported with patients who were similar or slightly
better off.
MCCARTHY AND MORINA
TABLE 2 (Continued)

O'Connor, Berry, Weiss, Depression inpatients (50). Self-evaluation. E: SCS scores; (BDI). N Significant negative correlation between depression
& Gilbert, 2002 scores and SCS, however this was reported only
for a combined sample of the depression group
MCCARTHY AND MORINA
and a student sample.

In regression analyses SCS scores were not predictive
of depression when survivor guilt and gender were
significant predictors.
Sacco & Graves, 1984 Children: Subclinical Interpersonal E: self-ranking on a scale N Controlling for actual task performance, the
Depression (20), problem-solving of best to worst depression group ranked themselves significantly
Non-depressed (20). task performance. performers. lower than the non-depressed group did.
Sturman & Previously or currently Self-evaluation. E: SCS scores; N Significant negative correlation between depressed
Mongrain, 2005 & 2008 depressed students (146) (CES-D; SCID). mood and SCS. Regression analyses found
depressed mood and self-criticism to be significant
predictors of SCS scores.
In the follow-up study (2008) with 81 participants,
there was a significant negative correlation
between the number of past depressive episodes
and SCS scores, where poor self-evaluation relative
to others was associated with increased risk of
major depression.
Swallow & Kuiper, 1987 Subclinical Depression (n.r.), Perceived similarity. E: similarity rating with N Increasing depression scores were associated with
Non-depressed (n.r.). others; (BDI; DAS). lower similarity ratings. This was especially true for
individuals with higher dysfunctional attitude scores.
Tabachnik, Crocker, & Subclinical Depression (20), Personal attributes. E: difference between self N The depression group generally rated themselves as
Alloy, 1983 Non-depressed (20). & average other dissimilar to the average other, also more than the
evaluations. non-depression group. However, the non-
depression group had higher dissimilarity ratings for
depression-relevant items than the depression
group.
As depression levels increased within the depression
group, depression-relevant items were rated as
more true for themselves than the average-other
student.
Thwaites & Dagnan, 2004 Cognitive therapy outpatients Self-evaluation and E: SCIS scores; important N Groups were combined for analyses. Regression
(77 total, 62 with mild/ importance of aspects of comparisons. analyses found that the relationship between
moderate to severe comparison (BDI). depression and self-evaluation in social comparison
depression), Community dimensions. was moderated by the perceived importance of
sample (97). the interest of others for each particular dimension
of comparison.
Tran, Uebelacker, Subclinical Depression (15). Narration of E: engagement with U, D More participants engaged in (maladaptive) upward
Wenze, Collins, & Facebook use. Facebook. comparisons (7) than (adaptive) downward
Broughton, 2015 comparisons (4) when using Facebook.
651
(Continues)
652
TABLE 2 (Continued)

Troop & Hiskey, 2013 Mixed-trauma PTSD (185), Self-evaluation. E: SCS scores; (PDS). N The control group data was provided on request and
Non-PTSD (90) differs to the study non-PTSD group whereby the
Control (133). control group did not report a trauma event
meeting Criterion A according to the DSM-IV.
The PTSD group reported significantly more negative
SCS scores than the other groups and there were
significant negative correlations between PDS and
SCS scores for all groups.
SCS scores were not significant predictors of PTSD
diagnosis in a regression analysis for the PTSD and
non-PTSD groups, where demographic, social rank
and trauma-related variables were included.
Weisman et al., 2011 Social anxiety (87), Other Self-evaluation. E: SCS scores, (STAI- N The social anxiety group reported significantly more
(Study 1 & Study anxiety disorder (31), T; BDI). negative SCS scores than the control and other
2 combined) Control (47). anxiety groups in study 1 and study 2 respectively.
There were significant negative correlations of
SCS scores with state anxiety and depression.
Note: Types of outcome: A = acquiring comparison information; E = evaluation of information; R = reaction to comparison (−c = cognitive; −a = affect or emotion; −b = behaviour). Comparison directions:
U = upward; D = downward; M = mixed (spectrum of up-down); L = includes lateral/neutral option; N = none. Outcome measures: BAI = Beck Anxiety Inventory; BDI = Beck Depression Inventory (-II = revised
version); CES-D = Centre for Epidemiological Studies Depression Scale; CFT = Compassion-Focused Therapy; DAS = Dysfunctional Attitude Scale; DASS = Depression Anxiety Stress Scale (−21 = short form);
FNE = Fear of Negative Evaluation; HADS = Hospital Anxiety and Depression Scale; HTQ = Harvard Trauma Questionnaire; MASQ = Mood and Anxiety Symptoms Questionnaire; PDS = Post-Traumatic Diag-
nostic Scale; PTSD = Post-traumatic stress disorder; SAASA = Social Anxiety and Avoidance Scale for Adolescents; SCID = Structured Clinical Interview for DSM Disorders; SCIS = Social comparison and Interest
Scale; SCL-90-R = Symptom Checklist-90-Revised; SCS = Social Comparison Scale; SIAS = Social Interaction Anxiety Scale; STAI-T = State–Trait Anxiety Inventory, Trait Subscale; VAS = Visual Analogue Scale.
MCCARTHY AND MORINA
coefficients upon request, and two used samples (adolescent sample 3.2.1 | Clinical findings
and intellectual disability sample) heterogeneous to the other observa-
tional studies. Experimental paradigms were not included for quantita- The 14 clinical samples (Table 1) in the meta-analysis included 998 par-
tive analysis due to heterogeneity, where there were not more than ticipants with a mean age of 37.3 years, 59.2% of which were female.
three studies sharing a similar SC manipulation paradigm and/or com- Eleven of the 14 samples were based in the United Kingdom, with the
parable outcomes. From the 60 included studies, 36 employed obser- remaining samples based in Portugal and Israel. Seven of the samples
vational measures and 24 employed experimental paradigms. There were coded as depressed, four as mixed (majority with depression and
was a noticeable difference between methodologies employed in anxiety), two with social anxiety, and one with PTSD.
studies with clinical and subclinical samples, where 25 of the 36 obser- All studies in the meta-analysis assessed the facet of evaluation
vational studies used clinical samples and 22 of the 24 experimental for SC processes using the SCS (Allan & Gilbert, 1995), a subjective
studies were conducted with subclinical samples. Results are pres- evaluation of social rank, attractiveness, and group-fit, using an
ented on the basis of the facet of SC used as an outcome in both 11-item scale of bipolar constructs as comparison dimensions. Partici-
observational and experimental studies. pants rank themselves ‘in relation to others’ (Allan & Gilbert, 1995) on
a 10-point scale of each construct, such as inferior–superior or
different–same, to calculate an overall score between 11 and 110.
3.2 | Observational studies Higher scores suggest a more positive self-evaluation compared with
others, and lower scores suggest more negative self-evaluation. The
From the 36 observational studies, 14 were rated as eligible for the sample in Gilbert and Allan (1998) did not complete the full SCS,
meta-analysis. The additional 22 are qualitatively reviewed. Table 1 instead using a total of five items: three items from the SCS (inferior–
describes all studies included in the meta-analysis, and Table 2 superior, incompetent–competent, and unlikeable–likeable) plus two
describes all other observational studies. Eight studies assessed the other bipolar constructs (reserved–outgoing and poor acceptance–
facet acquiring as an outcome for SC: three clinical and five subclinical good acceptance), which were similar to two in the full SCS
studies. Twenty-nine studies assessed the facet evaluation as an out- (unconfident–confident and left out–accepted).
come of SC: 22 clinical and 7 subclinical studies. Three studies Figure 2 shows the forest plots for the association of SC with
assessed the facet of reaction for SC: one clinical and two subclinical depression and anxiety. Results revealed that the overall correlation
studies. Four studies assessed more than one facet of SC as an out- between SC evaluation and depression (k = 12) was r = −.53. The
come, and six studies assessed outcomes in relation to some form of overall correlation between SC evaluation and anxiety symptoms
comparison direction. Results are described below in context of sam- (k = 11) was r = −.39. Heterogeneity was low to medium for the stud-
ples and outcomes, beginning with the meta-analysis and related studies assessing the association between SC evaluation and depression
ies of the SC facet evaluation, as this was the most commonly (I2 = 43.88; Q = 19.60; df = 11, p = .05) and very low for the associa-
assessed. tion between SC evaluation and anxiety (I2 = 5.15; Q = 10.54; df = 10,
FIGURE 2 Weighted average effect sizes (r) for social comparison with anxiety and depression
p = .39). Study quality was assessed independently by the authors. disengaged coping style (characterized by avoiding or disavowing
The intraclass correlation coefficient of the total score for all studies emotions), using downward comparisons (perceiving other survivors
combined was 0.87 (95% confidence interval [0.77, 0.92]), indicating as worse off) was associated with even higher PTSD symptoms.
very good interrater reliability. Results indicated an overall satisfactory An overall more robust measure of the processes involved in SC
level of quality for most publications, with 10 publications (71%) rated is the Rochester Social Comparison Diary (Wheeler & Miyake, 1992),
with an average score of 1.5 or higher. Sample selection (M = 1.9) and which was used by Antony et al. (2005) to assess acquiring, evaluation,
symptom severity measurement (M = 1.9) were rated favourably indi- and emotional reaction to comparisons over the course of 2 weeks in
cating good quality. Diagnostic validation (M = 1.2) and SC assessment a social phobia group and control group. The clinical group engaged in
(M = 1) were of moderate quality, indicating a lack of clarity regarding more upward comparisons and made comparisons across more dimen-
diagnostic tools and the use of the SCS, which does not assess com- sions than the control group. Both groups reported an increase in
parison direction or target similarity in relation to the evaluation. depression rating after upward comparisons, but the clinical group
Clinical samples that did not meet criteria for inclusion in the also reported an increase in anxiety after upward comparisons, as well
meta-analysis also provide support for the association between SC as a decrease after downward comparisons, unlike the control group.
evaluation and scores of depression and anxiety. Studies assessing This indicates that individuals with social phobia often engage in dys-
negative self-evaluation in relation to others report significant correla- functional interpersonal cognitions, seeing others as superior or more
tions of SC with anxiety in adult (Gilbert et al., 2010) and adolescent competent across various domains of comparison, which may lead to
samples (Cunha et al., 2008), as well as depression in mixed clinical increased negative emotions. Yet there is also potential for using
and nonclinical populations (Gilbert et al., 2010; O'Connor downward comparisons to regulate mood for individuals with social
et al., 2002; Sturman & Mongrain, 2005; Thwaites & Dagnan, 2004) anxiety.
and a depressed intellectual disability group (MacMahon & To summarize, observations of evaluation for SC were the most
Jahoda, 2008). Past episodes of major depression were found to be frequent outcome in clinical studies. The meta-analysis of relevant
associated with increased negative self-evaluations (Sturman & data suggests that there is a significant relationship between nega-
Mongrain, 2008), and an intervention study using group compassion- tively evaluating oneself in relation to others and the extent of
focused therapy reported improvement in self-evaluation ratings depression and anxiety symptoms. These findings are similar to stud-
alongside depression and anxiety scores at post-treatment; however, ies not included in the meta-analysis, including adolescent and intel-
change in depression and anxiety scores was not correlated with lectual disability samples. The importance of these evaluations also
baseline SCS scores (Judge et al., 2012). Thwaites and Dagnan (2004) appears to be related to the degree of symptoms; however, evidence
also reported that when the dimension of comparison is perceived as is limited. Studies that assess the process of acquiring SC information
important in attracting the attention of others, unfavourable self- are few yet suggest the extent to which individuals consciously seek
evaluations compared with others is associated with depressive symp- or engage with comparison information is not related to depression or
toms. The importance of specific comparisons was also assessed in PTSD symptoms in clinical populations. However, the frequency of
the intellectual disability sample, where the depression group rated upward comparisons and the scope of dimensions compared are rele-
positive and negative comparisons as equally important, whereas the vant to social phobia and respective affective reactions. The study
control group rated positive comparisons as more important, from Antony et al. (2005) was the only one to consider reaction and
suggesting that the salience of SC information may be related to a used the most thorough form of SC assessment, which would be use-
depression symptoms (Thwaites & Dagnan, 2004). ful to assess SC in other populations, as well as replicating findings.
Few observational studies investigated the SC facet of acquiring.
Kelly et al. (2007) assessed how often participants engaged in upward,
downward, and overall SCs in a depressed group over 9 weeks. At 3.2.2 | Subclinical findings
baseline, depressive symptoms were found to be moderately corre-
lated with overall comparison frequency only. Reductions in engaging Eleven studies with subclinical samples used observational methods
in overall comparisons were associated with improvement of depres- (Flett et al., 1987; Giordano et al., 2000; Gordon, Johnson, Heimberg,
sive symptoms; however, given that comparison processes were mea- Montesi, & Fauber, 2013; Kang et al., 2012; McGillivray &
sured using only three singular items, further detailed investigation is McCabe, 2007; Molleman et al., 1986; Sacco & Graves, 1984;
necessary. Hooberman et al. (2010) investigated acquiring as compari- Swallow & Kuiper, 1987; Tabachnik et al., 1983; Tran et al., 2015). All
son frequency in association with PTSD symptoms in a clinical sample studies formed subclinical depression groups, except for Molleman
with war-/torture-related PTSD using the Self-Evaluation Scale et al. (1986) and Gordon et al. (2013) who established low to high
(Wilson, Gil, & Raezer, 1997), which assesses upward and downward social anxiety groups. Participants were grouped as (non) depressive
comparisons for social and other comparison standards (Hooberman or (non) anxious on the basis of median splits or cut-off scores on rele-
et al., 2010). Hooberman et al. found that PTSD symptoms (measured vant psychological measures, such as the Beck Depression Inventory
by the Harvard Trauma Questionnaire) were only weakly correlated or State–Trait Anxiety Inventory. All studies investigated adult
with downward comparisons; however, Hooberman et al. also populations with the exception of two (Kang et al., 2012; Sacco &
reported an interaction with coping style. Among individuals with a Graves, 1984), where SC in high school adolescents and elementary
school children were, respectively, assessed. Participants were pre- mood, and downward comparisons lead to a better mood, which may
dominantly from academic populations or community samples, with be enhanced when making SCs congruent to personality and reinforce
the exception of McGillivray and McCabe (2007), who investigated negative self-evaluations, resulting in negative affect (Giordano
SC in a sample with mild/moderate intellectual disabilities and et al., 2000). In contrast, cancer patients report that downward com-
Molleman et al. (1986) who sampled cancer patients. In general, parisons lead to more negative mood than lateral or upward compari-
observations of SC were heterogeneous; three studies used SC ques- sons, with highly anxious cancer patients being most negatively
tionnaires (Gordon et al., 2013; Kang et al., 2012; McGillivray & affected by SC in general (Molleman et al., 1986). Thus, health status
McCabe, 2007), one used a diary record (Giordano et al., 2000), one and motivations for SC influence the target choice, direction of SC,
study assessed differences between self and other ratings of attri- and likely affective consequences.
butes (Tabachnik et al., 1983), three studies recorded participants' To summarize, evidence from subclinical studies are largely similar
engagement in SC behaviours (Flett et al., 1987; Tran et al., 2015), to those of clinical studies; however, methods for assessing SC were
and three studies used author-designed items (Molleman et al., 1986; more heterogeneous. Assessment of SC evaluation supports the con-
Sacco & Graves, 1984; Swallow & Kuiper, 1987). As with clinical stud- clusion that individuals higher in depression or anxiety are more likely
ies, SC evaluation was most commonly assessed as an outcome in to rate themselves negatively compared with others, as well as think
observational subclinical studies. of themselves as different to others. Evidence of acquiring SC sug-
Seven studies assessed SC in context of self-evaluations gests that individuals high in depression are less likely to seek or
(Giordano et al., 2000; Gordon et al., 2013; Kang et al., 2012; engage in SC but will more likely engage in upward comparisons,
McGillivray & McCabe, 2007; Sacco & Graves, 1984; Swallow & which result in negative reactions, such as decline in mood. The impor-
Kuiper, 1987; Tabachnik et al., 1983), generally reflecting results of tance or relevance attributed to the dimension of SC is also likely to
clinical samples. Two studies using the SCS support findings from the heavily influence how individuals react to SC evaluation. However,
meta-analysis, where adult groups with higher anxiety and depression evidence is lacking for the assessment of acquiring SC information and
scores made more negative evaluations relative to others than did reactions, as well as for anxiety samples.
lower scoring groups (Gordon et al., 2013; Kang et al., 2012). In addi-
tion, higher depression scores in an intellectual disability sample were
significantly associated with lower SCS scores (McGillivray & 3.3 | Experimental studies
McCabe, 2007) reflecting similar clinical findings; however, SCS scores
were not a significant predictor for Beck Depression Inventory scores A total of 24 experimental studies were included in the qualitative
in regression analyses when negative automatic thoughts, social sup- analysis. For summaries of these, see Table 3, where the type of
port, and self-esteem were also included in a model. Other studies manipulation of SC and the outcome is coded. As with observational
assessing evaluation found that depression groups were more likely to studies, results will be discussed in context of the type of SC outcome.
rate themselves as dissimilar to others when comparisons were One study assessed the facet acquiring as an outcome, 12 studies
depression relevant (Tabachnik et al., 1983), particularly in the pres- assessed evaluation as an outcome, and 17 studies assessed reaction
ence of dysfunctional attitudes (Swallow & Kuiper, 1987). Swallow as an outcome. Only two of these studies represent clinical
and Kuiper (1987) reported that both depressive and nondepressive populations.
groups predominantly characterized others as ‘positive,’ suggesting a
general upward comparison tendency. This is also reflected in a child
sample, where a depression group rated their task performance as 3.3.1 | Clinical findings
worse than others compared to a nondepression group (Sacco &
Graves, 1984). Two clinical studies included an experimental paradigm, focusing on
A small number of subclinical studies assessed acquiring of SC SC reaction. Buunk and Brenninkmeijer (2001) considered how high or
with various methods (Flett et al., 1987; Giordano et al., 2000; low depression and frequency of SC activities had an effect on mood
Molleman et al., 1986; Tran et al., 2015). Findings suggest that after exposure to low-effort or high-effort coping of a depressed
depressive groups are less likely to seek comparison information when patient. Frequency was assessed using the concept of SCO, using the
given the opportunity (Flett et al., 1987) and make fewer SCs than Iowa–Netherlands Comparison Orientation Measure (Gibbons &
nondepressive groups (Giordano et al., 2000). Yet depressive groups Buunk, 1999). They found that high depression scores were signifi-
make more upward than downward comparisons (Tran et al., 2015), cantly associated with an increase in positive affect when exposed to
which are more relevant to their personality types than nondepressive a low-effort or high-effort coping of a depressed patient, whereas low
groups, which also leads to stronger affective reactions associated depression scores were associated with a negative change in affect.
with direction of comparison (Giordano et al., 2000). This may also Despite no significant correlation with depression symptoms (r = .1) in
function as adaptive or maladaptive coping via social media platforms their clinical sample and only low correlation in the community control
(Tran et al., 2015). Only two studies assessed reactions to SC sample (r = .28), these affective changes were moderated by an inter-
(Giordano et al., 2000; Molleman et al., 1986), with mixed results. action of depression score and SCO, where higher SCO resulted in
Findings for depression suggest upward comparisons lead to a worse more positive mood change for high depression in the low-effort
TABLE 3 Description of experimental studies reviewed.
656
Focus of manipulation; Relevant outcomes; (SC

Study Sample SC Paradigm theme m (SC direction involved). direction assessed) Findings
Ahrens, 1991 Subclinical Depression (45) Task performance vs. E: score of target(s); (U, D, M). E: self-other ranking; (U, D). Upward comparison in both
Non-depressed (69) other(s). groups led to lower
self-evaluation than the
downward condition. The
depression group made lower
self-evaluations compared to
the non-depression group in
the mixed comparison
condition, suggesting a bias
for unfavourable information
when evaluating one's own
performance.
Albright & Henderson, 1995 Subclinical Depression (48) Comparative attribution E: valenced dis/similarity with E: change in self-evaluative Depression group were more
Non-depressed (107) and coping with bogus bogus other; (n/a). ratings; R-b: target choice for likely to evaluate the ‘other’
others. coping comparison; (n/a). more favourably after
comparison; self-evaluation
did not change. The opposite
was true for non-depression
group, who increased positive
self-evaluation after
comparison.
Both groups were more likely to
select a negative target for
comparison in coping with a
negative life event,
suggesting downward
comparisons are preferred as
coping strategies.
Albright, Alloy, Barch, & Subclinical Depression (75) Comparative attribute E: comparison target; (n/a). E: difference of self vs. other Depression group evaluated
Dykman, 1993 (Study 1) Non-depressed (83) ratings with average evaluation; (n/a). themselves as similar to the
other. average college student,
more favourably than a
depressed college student,
and less favourably than a
non-depressed college
student.
The depression group rated
themselves more
unfavourably than the
non-depression group,
regardless of comparison
target.
MCCARTHY AND MORINA
TABLE 3 (Continued)

Alloy & Ahrens, 1987 Subclinical Depression (224) Predicted academic E: relevance of information for E: ranking of success for others Both groups believed they were
Non-depressed (308) performance vs. others. rankings;(n/a). & self;(M). more likely to succeed than
fail, however, the depression
MCCARTHY AND MORINA
group predicted they would

be less likely to succeed and
more likely to fail than the
non-depression group. The
non-depression group
showed a self-enhancing bias
for success, whereas the
depression group showed no
positive or negative bias.
Appel, Crusius, & Subclinical Depression (44) Exposure to bogus other's E: attractiveness of profile; (N). E: happiness of other vs. self; Depression group rated both
Gerlach, 2015 Non-depressed (45) social media profile. R-a: envy; (M). ‘attractive’ and ‘unattractive’
profile owners as happier,
whereas non-depression
group rated ‘attractive’ as
slightly happier and
‘unattractive’ as unhappier.
Depression group indicated
higher levels of envy than
non-depression group,
particularly in ‘attractive’
condition.
Bäzner et al., 2006 Subclinical Depression (137) Multi-standard comparison E: dis/similarities with target; R-a: mood change; (N/a). Depression group experienced
Non-depressed (567) with familiar other. (U). a larger decrease in positive
affect after upward
comparison than healthy
controls. Both groups also
experienced decrease in
negative affect, contrary to
expectations.
SCO was correlated with
depression and associated
with stronger decrease in
negative affect in regression
analyses, but only in the
non-depression group. This
effect was negated when BDI
scores were controlled for.
SCO had no significant effect
on changes in positive affect.
Buunk & Brenninkmeijer, 2001 R-a: mood change; (n/a).
657
(Continues)
TABLE 3 (Continued)
658

Depression (40) Community Exposure to high/low active E: degree of effort for recovery Participants with higher
group (82) coping role models. of target; (n/a). scores on the BDI and
higher SCO scores
experienced a more
positive mood change in
the low-effort condition, or
a less positive mood
change in the high effort
condition. The opposite
was true for participants
with low BDI scores and
high SCO, who experienced
a more negative mood
change.
Fuhr, Hautzinger & Meyer, Depression in remission (45) Brainstorming task vs. E: better or worse performance; R-a: mood change; R-c: change After upward comparison
2015 Healthy control (41) bogus other. (U, D). in implicit self-esteem via negative affect increased and
IAT; (n/a). positive affect decreased in
both groups. After downward
comparison positive affect
increased and negative affect
decreased in both groups.
Thus no group differences
were observed. No significant
changes in implicit
self-esteem were detected in
either groups or conditions.
Gibbons, 1986 (Study 1) Subclinical Depression (22) Valenced recall of personal R-a: positive or negative mood A: Valenced choice of Higher preference for positive
Non-depressed (21) event. induction; (n/a). comparison information; ‘other’ PEQ comparison
(n/a). choices in both groups,
particularly in positive
condition. Depression group
in negative condition selected
the most negative ‘other’
PEQ statements, suggesting
preference for downward
comparison after negative
mood induction.
Gibbons, 1986 (Study 2) Subclinical Depression (28) Personal event of bogus E: negative target event; (D). R-a: Mood change; (n/a). Mood ratings for the depression
Non-depressed (27) other. group improved after
downward comparison,
however no mood change
MCCARTHY AND MORINA
TABLE 3 (Continued)

was observed in the
non-depression group.
McFarland & Miller, 1994 Subclinical Depression (108) Social perceptiveness. E: Favourable or unfavourable E: self-evaluation of social Self-evaluation ratings of the
MCCARTHY AND MORINA
(Study 1) Non-depressed (72) ranking; feedback framing; (U, perceptiveness; (n/a). depression group were
D). significantly lower than the
self-evaluations of the
non-depression group when
feedback was unfavourable
(upward) and derived from a
large distribution.
Self-evaluations within the
depression group were also
less negative when feedback
was derived from a small
distribution rather than a
large distribution.
In the favourable condition
(downward) condition, the
non-depression group made
more positive
self-evaluations than the
depression group, however
no distribution framing
effects were observed.
McFarland & Miller, 1994 Subclinical Depression (62) Social perceptiveness. E: unfavourable ranking; R-a: anxiety & sadness; (n/a). The depression group reported
(Study 2) Non-depressed (50) feedback framing; (U). higher negative affect
(anxiety & sadness) than the
non-depression group when
feedback was derived from a
large distribution.
Meyer, Dyck, & Children: Task performance. A: mixed success in E: Pre, post & future evaluation The depression group
Petrinack, 1989 Subclinical Depression (36) problem-solving; (n/a). of self and a similar other; compared themselves less
Non-depressed (36) (n/a). favourably to peers in pre,
post and future evaluations.
The depression group also
had lower expectations and
evaluations of performance
(before and after task) than
the non-depression group,
despite no performance
differences between groups
on the solvable tasks.
659
(Continues)
TABLE 3 (Continued)
660

Mitchell & Schmidt, 2014 Subclinical social anxiety (n.r) College profile of bogus E: multi-standard success of E: self-evaluation of personality High social anxiety was
Non-anxious (n.r.) other. bogus student; (U, L). and signs of anxiety relative associated with negative
to target; (M). appraisal of personality
compared to others,
regardless of comparison
condition; this was
particularly true for males.
Men with high levels of anxiety
in the upward condition
evaluated their signs of
anxiety more negatively than
highly anxious men in the
neutral condition. There was
no difference in males with
low social anxiety, and no
differences for women in
both groups and both
conditions.
Pinkley, Laprelle, Pyszczynski, Subclinical Depression (38) Social sensitivity test. E: high or low score with high R-b: Number of additional The depression group sought
& Greenberg, 1988 Non-depressed (64) or low consensus feedback; answer sheets chosen to more information from
(U, D). compare; (n/a). comparisons in the success
condition, particularly when
the achievement expectancy
was low. This is in contrast to
the non-depression group
who sought more information
after failure, particularly
when the achievement
expectancy was high.
Scanlan, 1977 Children: Visuospatial task vs. bogus E: success, moderate success or R-a: state anxiety; No anxious-group differences
Competitively anxious (41) other. failure vs. other; (U, D, L). R-c: attribution of were reported for any
Non-anxious (42) success/failure; outcomes.
R-b: choice of next opponent & Condition manipulation
player to observe; permission reflected state anxiety scores,
of public appraisal of result; with significantly higher
(M, L). scores in the upward
condition, and significantly
lower scores in the
downward condition.
No significant trends were
found for how participants
attributed their success or
failure.
MCCARTHY AND MORINA
TABLE 3 (Continued)

Participants were most likely to
choose an opponent of
similar relative ability as well
MCCARTHY AND MORINA
as choose a high-ranking
player to observe regardless
of condition.
Participants in the failure
condition were less likely to
allow their results to be
published with their name.
Swallow & Kuiper, 1990 Subclinical Depression with: Academic achievement. E: hypothetical success: high, R-b: interest in and choice for Comparison condition had no
high dysfunctional attitudes moderate or failure; (U, D, L). comparisons; (U, D, L). effect on desired comparison
(14) information.
low dysfunctional attitudes In the depression group, those
(14) high in dysfunctional
Non-depressed with: high cognitions desired more
dysfunctional attitudes (11) general social comparison
low dysfunctional attitudes information, as well as more
(80) specific target (better, equal
and worse) information, than
those low in dysfunctional
cognitions. For participants
low in dysfunctional
cognitions, the depression
group showed less interest in
general comparisons than the
Overall, participants desired
comparison information from
upward targets.
Swallow & Kuiper, 1992 Subclinical Depression (n.r.) Cognitive task performance. A: viewing of comparison R-b: number of comparisons The depression group chose to
Non-depressed (n.r.) information; (n/a). made; make frequent comparisons,
E: self-evaluation relative to particularly when they had
others; (n/a). performed poorly.
Conversely, the
non-depression group sought
less comparisons when they
performed poorly than when
they performed well. The
groups sought a similar
number of comparisons when
they had performed well.
661
(Continues)
TABLE 3 (Continued)
662

The depression group estimated
their scores to be lower than
the non-depression group,
likely due to being exposed
to more comparisons that
were negative.
Swallow & Kuiper, 1993 Subclinical Depression (26) Cognitive task performance. A: choice of comparison R-b: target category choice; High performers in both groups
(Study 1) Non-depressed (68) information; (n/a). E: self-evaluation relative to made similar choices. In low
others; (M). performers, the
non-depression group were
more likely to seek
downward comparisons,
whereas the depression
group were more likely to
choose similar-performing
quartiles.
No group differences were
observed in score
estimations, regardless of
comparison choice.
Swallow & Kuiper, 1993 Subclinical Depression (51) Cognitive task performance. A: choice of comparison R-b: target category choice & In low performers, the
(Study 2) Non-depressed (60) information; (n/a). background information; depression group requested
E: self-evaluation relative to more comparison information
others; (M). than the non-depression
group.
The depression group made less
favourable score estimations,
however this was not as a
result of comparison
information obtained.
Weary, Elbin, & Hill, 1987 Subclinical Depression (26) Similarity in attributions of E: similarity of attribution E: rating of positivity of bogus Participants in the similarity
Non-depressed (30) events. ratings with confederate other; condition made more
other; (n/a). R-a: how affected they felt by favourable evaluations of the
feedback; (n/a). confederate than those in the
dissimilarity condition,
particularly in the depression
group. The depression group
also reported being more
affected by the feedback
than the non-depression
group (no valence suggested).
Participants in both groups
from the similarity condition
MCCARTHY AND MORINA
TABLE 3 (Continued)

reported being more affected
than participants in the
dissimilarity condition.
MCCARTHY AND MORINA
Weary, Marsh, & Subclinical Depression (15) Similarity in social E: dis/similarity of 4 bogus R-b: preference of bogus others Similar others and agreeable
McCormick, 1994 Non-depressed (14) perceptiveness. others; agreeableness of 4 as prospective assignment others were preferred for
bogus others; (n/a). partner; (n/a). assignments by participants
overall.
The depression group showed
more preference for similar-
and dissimilar-disagreers than
the non-depression group.
Wenzlaff & Beevers, 1998 Subclinical Depression (19) Interview of a happy or sad E: mood of bogus other; (n/a). R-b: valence of questions The depression group was more
(Study 1) Mild Subclinical Depression bogus other. chosen to ask bogus likely to select
(41) interviewee; (N/a). negatively-valenced
Non-depressed (60) questions for the happy
interviewee, than the sad
interviewee, as well as being
more likely to do this than
the mild depression and
non-depression groups. The
depression and mild
depression group were less
likely to select positive items
for the happy interviewee
than the sad interviewee.
These groups were also less
likely to select positive items
in general, than the
Wenzlaff & Beevers, 1998 Subclinical Depression (16) Interview of a happy or sad E: mood of bogus other; (n/a). R-b: valence of questions Findings were identical to Study
(Study 2) Mild Subclinical Depression bogus other. chosen to ask bogus 1.
(40) interviewee; valence of Depression and mild depression
Non-depressed (60) self-generated questions; groups were more likely to
(n/a). formulate more negative
questions for the interviewee
than the non-depression
group. In addition, the
depression group were more
likely to formulate less
positive questions than the
Note: Types of outcome: A = acquiring comparison information; E = evaluation of information; R = reaction to comparison (−c = cognitive; −a = affect or emotion; −b = behaviour). Comparison directions:
663
U = upward; D = downward; M = mixed (spectrum of up-down); L = includes lateral/neutral option; N = none. Outcome measures: IAT = Implicit Association Task; SCO = Social comparison orientation.
condition and more negative mood change for low depression scores themselves more unfavourably than did nondepressive groups or
in the high-effort condition. This indicates that individuals who are rated others more favourably than did nondepressive groups, often
more interested in acquiring SC information will also experience regardless of comparison direction manipulations (Ahrens, 1991;
greater affective reaction to relevant stimuli that they perceive as posi- Albright et al., 1993; Albright & Henderson, 1995;Appel et al., 2015 ;
tive or negative; however, further depression-level differences are McFarland & Miller, 1994). This was also the case in a sample of chil-
limited as group differences were not reported and depression was dren, where the depressive group reported lower performance-based
treated as a continuous variable. expectations and self-evaluations and higher evaluations of peers in
Fuhr, Hautzinger, and Meyer (2015) experimentally induced comparison (Meyer et al., 1989). However, this trend of negative self-
upward or downward SC in outpatients with a lifetime diagnosis of evaluation in depressive groups could vary depending on the context
major depression and healthy controls. The paradigm used a manipu- and quantity of SC information that was provided (Swallow &
lated computer-based brainstorming task for generating ideas to pro- Kuiper, 1992, 1993) or the perceived similarity of the target (Weary
tect the environment. SC direction produced expected affective et al., 1987). Individuals in nondepressive groups in adult samples
changes in both groups (upward–more negative and downward–more appear to exhibit self-enhancing biases in reaction to unfavourable SC
positive); however, no between-group differences were observed as information (Alloy & Ahrens, 1987), whereas individuals in depressive
part of these affective changes, and implicit self-esteem decreased groups may be biased towards unfavourable information that sup-
regardless of condition or group. ports their perception of inferiority (Ahrens, 1991). High social anxiety
Experimental paradigms within clinical studies are severely lac- was also associated with more unfavourable self-evaluations regard-
king, yet the findings here provide some support for observational ing personality, particularly for males, regardless of whether the target
studies with regard to affective reactions and the relevance of com- was lateral or upward (Mitchell & Schmidt, 2014).
parison salience. The two experiments appear to contradict each Fifteen studies assessed how manipulating SC can affect reaction
other with regard to differences between depression groups and con- (Albright & Henderson, 1995; Appel et al., 2015; Bäzner et al., 2006;
trols; however, the comparison dimensions differed, where Buunk and Gibbons, 1986; McFarland & Miller, 1994; Pinkley et al., 1988;
Brenninkmeijer (2001) focused on mental health, which could be con- Scanlan, 1977; Swallow & Kuiper, 1990, 1992, 1993; Weary
sidered more salient to a depressed sample than environmental con- et al., 1987; Weary et al., 1994; Wenzlaff & Beevers, 1998). Reactions
cerns used by Fuhr et al. (2015). This suggests that the salience of the were assessed as behavioural, affective, or cognitive, with the majority
comparison dimension may determine how individuals evaluate and of studies focused on behavioural or affective responses, where evi-
react to SC information, as well as general interest in SC (e.g., SCO), dence is mixed due to the heterogeneous paradigms and outcomes.
which implicates individual differences at the stage of acquiring SC With regards to behavioural reaction, favourable SC information often
information. resulted in both depressive and nondepressive groups seeking further
comparison information (Swallow & Kuiper, 1992, 1993; Weary
et al., 1994), yet Pinkley et al. (1988) report that a nondepressive
3.3.2 | Subclinical findings group sought more SC information in light of unfavourable compari-
son on a social sensitivity task, in contrast to the depressive group.
Twenty-two subclinical studies used experimental paradigms to However, other nondepressive groups receiving unfavourable com-
manipulate SC information. The majority of studies investigated adult parison information for a cognitive task were more likely to seek
subclinical depressed samples, with the exception of one adult social downward SC information (Swallow & Kuiper, 1993) or avoid compar-
anxiety group (Mitchell & Schmidt, 2014), one subclinical depression ison information (Swallow & Kuiper, 1992). This suggests a pattern of
children sample (Meyer et al., 1989), and a sample of competitively protective SC cognitions, where in context of a threat (unfavourable
anxious schoolboys (Scanlan, 1977). Only two studies explicitly asked SC information), a downward target is sought. For example, partici-
participants to consider other people and how they may compare with pants were more likely to choose negative targets to make coping-
them on various attributes (Appel et al., 2015; Bäzner et al., 2006), based comparisons (Albright & Henderson, 1995) or prefer similar and
whereas other studies either provided comparison information indi- agreeable others to work with (Weary et al., 1994). Yet depressive
rectly via feedback or asked participants to make evaluations for groups in unfavourable conditions were also reported to have sought
others and themselves. SC information from an upward or similar target rather than a down-
Twelve studies assessed how manipulating SC can affect evalua- ward target (Swallow & Kuiper, 1990, 1992, 1993). This highlights
tions (Ahrens, 1991; Albright et al., 1993; Albright & what may be a dysfunctional aspect of continued SC engagement,
Henderson, 1995; Alloy & Ahrens, 1987; Appel et al., 2015; reflected in the amount of information sought by individuals high in
McFarland & Miller, 1994; Meyer et al., 1989; Mitchell & depressive symptoms: Swallow and Kuiper (1990) found that individ-
Schmidt, 2014; Swallow & Kuiper, 1992, 1993; Weary et al., 1987; uals in a depressive group high in dysfunctional attitudes were more
Weary et al., 1994). Outcomes focused on self and other evaluations likely to request more SC information from various sources,
related to attributes, performance, and achievements. Upward com- suggesting selection choices reflect a lack of protective comparison
parisons generally led to more unfavourable ratings than downward behaviours. Despite this, depressive groups are also more likely to
comparisons across groups, yet depressive groups often rated seek negative information from positive others (Wenzlaff &
Beevers, 1998); however, it is not clear whether this is motivated by pattern of reaction found in observational studies; however, outcomes
seeking similarity as reassurance or a type of projection of mood. are also moderated by acquiring level manipulation or variables such
With regard to anxious groups, Mitchell and Schmidt (2014) reported as SCO. Only one study considered anxiety, which was a child sample,
that anxious men, but not women, evaluated their anxiety symptoms and only another single study considered acquiring as an outcome
more negatively in reaction to upward SC information than anxious after manipulation; thus, there is not enough evidence to draw rea-
men in a neutral situation. Overall, findings for behavioural reactions sonable conclusions.
in depressive groups are mixed owing to differences in the type of SC
manipulation and comparison dimensions in focus.
Studies assessing impact of SC on affect also involved heteroge- 4 | DI SCU SSION
neous comparison paradigms and measures of affective reactions
(Appel et al., 2015; Bäzner et al., 2006; F. X. Gibbons, 1986; This review sets out to provide an overview of SC research in clinical
McFarland & Miller, 1994; Scanlan, 1977; Weary et al., 1987). Depres- and subclinical populations with depression and anxiety. A literature
sive groups generally reported more extreme affective reactions to SC search produced empirical data from 60 studies, of which 27 investi-
information than nondepressive groups (Weary et al., 1987), which gated clinical samples and 33 subclinical samples. Only five of these
followed the trend of more negative affect after perceived upward studies investigated SC in child and adolescent populations, four being
comparison (Appel et al., 2015; McFarland & Miller, 1994) and more within subclinical groups. The majority of clinical studies utilized
positive affect after downward comparison (Gibbons, 1986). The observational data, and the majority of subclinical studies utilized
effects of comparison direction on affect were moderated by various experimental paradigms. Data from these studies indicate that SC pro-
conditions. For example, Bäzner et al. (2006) reported that after cesses are associated with depression and anxiety, where the facets
upward comparison, participants reported decreases in positive affect, of SC acquiring, evaluation, and reaction have implications in the pre-
but also in negative affect, especially with higher scores in SCO; sentation and maintenance of related psychopathology. However, the
whereas McFarland and Miller (1994) report that individuals high in conceptualization and measurement of SC are largely diverse,
depressive symptoms experienced increased negative affect after resulting in a variety of outcomes and subsequent interpretations.
upward SC information but less so when this was framed with posi- Heterogeneity within the methodology of reviewed literature reflects
tive feedback features. The only study to consider reactions to SC the multidimensional nature of the concept of SC and the current lack
with an anxiety sample involved competitively anxious schoolboys, of a well-defined model of SC processes as they relate to psychologi-
where the level of competition anxiety had no effect on SC cognitive, cal disorders. We therefore attempt to summarize the findings in the
behavioural, or affective reactions and did not interact with manipula- following via synthesis of observed SC facets in relation to depression,
tion condition (Scanlan, 1977). However, state anxiety was found to anxiety, and PTSD.
be higher after upward comparison than downward comparison. The
facet of acquiring SC was only assessed as an outcome by
Gibbons (1986), which was the only study to explicitly manipulate 4.1 | Depression
mood. After negative mood induction, the depressive group chose
more negative comparison statements to view than the nondepressive Of the three SC facets, outcomes of evaluation were most commonly
group. Despite this, there was a general overall preference in both reported. The literature reviewed indicates that there is a relationship
groups for the more positive comparison statements. between SC evaluations and symptoms of depression. Observational
To summarize, there is a broad, yet heterogeneous, range of research with clinical and subclinical samples suggests that increasing
experimental methods employed to assess various processes and ele- depressive symptoms are significantly associated with negative self-
ments of SC in subclinical studies. Research primarily focuses on eval- evaluation in relation to others (e.g., Gilbert, 2000), where depression
uating and reacting to SC information in depressive samples. Findings groups are more likely to rate themselves as different (e.g., Swallow &
for evaluations are mostly similar to those of clinical studies, whereby Kuiper, 1987). This is also supported by experimental studies, where
depressive groups are more likely to self-denigrate or elevate others, depressive groups often rated others as better-off (e.g., Alloy &
unlike nondepressive groups who exhibit more protective self- and Ahrens, 1987), particularly in upward SC conditions, but even in the
other evaluations. This is still likely to be influenced by how much face of contrary or ambiguous evidence (e.g., Ahrens, 1991). However,
information is available and how it is framed; however, few studies evidence for the relationship between depression and negative self-
manipulated SC at the acquiring stage, rather manipulating informa- evaluation lacks context, such as importance of comparison dimen-
tion at the evaluation stage, using favourable or unfavourable direc- sions, which would indicate how salient specific comparisons are and
tion, target similarity, or ranking. Findings for reactions to SC what impact this has on evaluation. Only one clinical study considered
information were also predominantly based on manipulation at the the significance of the dimensions of comparison with the individual,
evaluation stage, where assessments of behaviour found depressive where perceived importance of the dimensions in attracting the atten-
groups were more likely to seek upward comparisons compared with tion of others and the degree of negative self-evaluation on those
nondepressive groups, even in unfavourable conditions. Affective dimensions predicted scores of depression (Thwaites &
reactions tend to follow the upward-negative and downward-positive Dagnan, 2004). This is supported by evidence from a depressed
sample with intellectual disabilities, who rated negative comparisons conclusions are limited and future research would benefit from more
just as important as positive comparisons (MacMahon & standardized approaches.
Jahoda, 2008). Given the cognitive nature of SC, particularly in evaluating infor-
Acquiring of SC information is therefore relevant to how individ- mation, further insight into cognitive reactions to SC is necessary as
uals evaluate themselves. Few reviewed studies assessed this facet of this is an area severely lacking in the literature. Current evidence sug-
comparison, yet evidence suggests it is pertinent to evaluating and gests that SC may play a key role in depression, where acquiring, eval-
reacting to information. Depressive groups were less likely to seek uating, and reacting to SC have different effects on the perception of
and engage in SC than nondepressive groups, unless comparisons the self, of others, and of the dimension(s) in question, which subse-
were congruent to personality traits, and thus more salient, which also quently can impact on behaviour and emotions. Future studies
led to a stronger affective impact associated with direction of compar- assessing acquiring and evaluation should provide lateral comparison
ison (Giordano et al., 2000). Information seeking in depressive groups targets as these are often lacking, thus forcing participants into choos-
thus appears to be dysfunctional, reflecting the lack of self-protective ing an upward or downward target, which can have an impact on reac-
evaluations. This is supported by Bäzner et al. (2006), where individ- tions. Experimental paradigms and control groups in clinical studies
uals with higher depressive symptoms and possible lifetime episode of should also be used where possible in order to provide more lab-
depression reported higher SCO scores than a nondepressive group. based data with healthy comparisons.
SCO may therefore reflect a more nuanced frequency or interest in
SC, whereby individuals will predominantly recall meaningful or more
salient comparisons, particularly in context of mood, as opposed to 4.2 | Anxiety and PTSD
the diary method used by Giordano et al. (2000), which captures a
broader scope of casual comparisons that only become relevant to There is notably less focus in the literature on the relationship
mood change when salience of comparisons is controlled for. The between anxiety and SC processes, with only four exclusive clinical
Buunk and Brenninkmeijer (2001) study also reflects this trend, anxiety samples. Given the common social component of anxiety dis-
whereby SCO moderated the degree to which depression and non- orders, particularly in social phobia, this highlights a scarcity in clinical
depression groups experienced a positive or negative change in mood. research of SC. The review of current evidence indicates that similarly
Therefore, elevated levels of SCO may indicate a risk factor for to depression, negative self-evaluations are also associated with
depression; however, further research is necessary to determine inter- severity of anxiety symptoms. With regard to acquiring SC, individuals
actions with other factors, such as salience, that would better high- with social phobia are identified as being particularly vulnerable to SC,
light the potential risk, as correlational evidence does not show a where they are more likely to engage in frequent upward comparisons
strong relationship between SCO and depression alone. across a broad range of dimensions and contexts than other anxiety
Reactions to SC were categorized as cognitive, behavioural, and disorders and controls (Antony et al., 2005). These comparison pro-
affective. Outcomes on the basis of reactions to SC in general were cesses are subsequently associated with affective reactions of
lacking in clinical studies; thus, most evidence comes from subclinical increased anxiety and depression; however, no research has yet
studies. Only two studies assessed cognitive reactions, with inconclu- focused on the motivations behind these processes in social phobia.
sive evidence. Behavioural reactions to SC mainly focused on informa- Given the findings of Antony et al. (2005), one may suggest that social
tion seeking or target selection in experimental studies, where phobia also reflects dysfunctional cognitions and behaviour with
depressive groups appeared to lack the self-protective behaviour of regard to upward comparison targets, as suggested for depressed indi-
nondepressive groups, often seeking or making further comparisons viduals. However, socially anxious individuals are more likely to
in unfavourable conditions. However, these findings were not consis- engage in frequent comparisons across dimensions, presumably to
tent among studies, where salience or novelty (i.e., low vs. high con- constantly assess their assumptions, thus perpetuating their negative
creteness) of dimensions of comparison (e.g., social sensitivity self-evaluations with biased upward comparisons, which may lead to
vs. cognitive performance) and subsequent degree of threat may further depressive symptoms. Future research should focus on the
determine how much further information is sought. A dysfunctional different facets of comparison, in particular experimental paradigms
bias of information seeking in depressive groups that confirms percep- to assess reactions to SC, employing various types of anxiety disorder
tions of inferiority may also determine behaviour; however, it is likely samples and control groups to further understand differences in SC
to be a complex combination of individual differences and perceptions between subtypes and healthy groups.
of the comparison dimension and possible targets. Evidence for affec- Findings that include results from anxious cancer patients, socially
tive reactions was more consistent, whereby upward and downward anxious adolescents and competitively anxious children provide a
comparisons often led to respective negative and positive changes in mixed impression of SC in association to anxiety, which prevents gen-
mood, with these effects being particularly strong for depressive eralizable conclusions. SC research in PTSD is also limited, with only
groups. However, individual differences (e.g., SCO) and mental health two published studies focusing on PTSD samples. Further investiga-
(e.g., dysfunctional attitudes) are variables found to moderate affec- tion regarding the potential mechanisms of comparison and coping
tive reactions, even within depressive groups. Unfortunately, very few style in PTSD may benefit approaches to treatment, given the interac-
studies considered similar moderator variables, thus generalizable tion effects reported by Hooberman et al. (2010). Disengagement
from emotions in PTSD coupled with downward comparison may be conditions (Arigo et al., 2014; Gerber et al., 2018; Wheeler, 2000),
a dysfunctional coping strategy in individuals experiencing which is a common issue in clinical studies reviewed here. For further
survivor guilt. insight into SC processes associated with clinical psychopathology,
observations between clinical and control groups is necessary. Per-
sonality factors, such as neuroticism, agreeableness, and openness,
4.3 | Comparison to current literature are often associated with SC behaviours and effects (Gerber, 2018;
Wheeler, 2000); however, investigation of personality in relation to
Previous literature reviews have focused on SC in rank and depression SC and psychopathology is severely lacking, despite personality fea-
(Wetherall et al., 2019), chronic illnesses (Arigo et al., 2014), body dis- tures often being related to psychosocial functioning (Shea, Widiger, &
satisfaction (Myers & Crowther, 2009), or the field of SCT as a whole Klein, 1992).
(Gerber et al., 2018). This review has attempted a synthesis of all rele-
vant SC research in context of depression and anxiety. This has
involved breaking down the process of SC into three facets according 4.4 | Limitations
to the definition of Wood (1996). It differs to the cited reviews due to
the focus on depression and anxiety, as well as attempting to consider Our literature search focused on the term ‘social comparison,’ which
all aspects of SC that fall within the broad definition rather than may have led to the omission of studies that could be deemed rele-
focusing on specific target definitions (Gerber et al., 2018) or a spe- vant to SC research but do not refer to the concept. However, other
cific outcome variable (Wetherall et al., 2019). Despite this, several systematic reviews have also relied on the term ‘social comparison’
overlapping themes exist. Many of the studies included in the meta- given the lack of other potentially useful terms (Gerber et al., 2018).
analysis and qualitative review concerning evaluation are also We used the definition of Wood (1996) to define SC; however, there
reviewed in context of social rank by Wetherall et al. (2019). The anal- is some ambivalence whether this definition could be applied to all
ysis and review here of evaluation in general, and not just in context included studies. For example Tabachnik et al. (1983) did not instruct
of social rank, support the findings by Wetherall et al., in that depres- participants to compare with the specified target but simply to evalu-
sion is associated with negative self-evaluation when considering ate themselves and then evaluate the target on individual items. This
others and that other psychological variables may account for the is encountering social information yet does not necessitate a compari-
relationship between SC and depression symptoms in clinical son, despite the likelihood. This reflects a larger issue in the research
populations. However, additional evidence suggests that salience of in how one may define explicit and implicit comparison. Implicit cogni-
comparison dimensions and individual differences (e.g., SCO) will tions have been highlighted as core elements of prominent models in
impact how they make self-evaluations. In addition, addressing other empirical research for various forms of clinical disorders including
facets of acquiring and reaction of SC helps identify what type of infor- depression and anxiety (Teachman, Clerkin, Cunningham, Dreyer-
mation in the process of SC is relevant to depression and anxiety. Oren, & Werntz, 2019), yet a recent review of SC literature consider-
Our finding of broad heterogeneity in research methods of SC is ing target selection and reaction did not find any effects of implicit
reflective of the field as a whole, where operationalising control and versus explicit instruction (Gerber et al., 2018). We did not assess or
manipulation in lab settings is difficult due to automaticity and control for implicit or explicit instruction, in particular, due to the het-
dynamicity of the SC process (Arigo et al., 2014; Gilbert et al., 1995; erogeneity at various levels of manipulation and outcomes. Some
Wood, 1996), which is also why previous reviews have limited their authors have argued that SC is best conceptualized as an implicit,
scope of SC definition (Gerber et al., 2018). Observational studies spontaneous, or automatic process (Bocage-Barthélémy et al., 2018;
have predominantly focused on unitary aspects of SC, such as evalua- Chatard, Bocage-Barthélémy, Selimbegovic, & Guimond, 2017); how-
tion in the SCS (Allan & Gilbert, 1995), which limits the insight one ever, this has only been with regard to body image for female samples,
can gain of SC processes in context of depression and anxiety. which in itself presents a limitation in the SC literature. Some studies
Our review supports some findings of Wheeler (2000), where were excluded despite reporting that they used measures of ‘social
dysphoric or depressed individuals engage in self-defeating SC, comparison,’ as we judged these measures as inappropriate measures
upward SC is more common than downward, and focus is on negative of SC, such as the SC subscale of the Social Thoughts and Beliefs
information when there is mixed information. No previous reviews Scale used in Koerner, Antony, Young, and McCabe (2013). With
have considered anxiety samples and the associations with regard to included literature, 11 out of 14 included studies in our
SC. Wheeler (2000) also reports that the role of threatening informa- meta-analysis were authored by Paul Gilbert, with the common SC
tion is unclear, which evidently still requires further research, particu- measure in all studies being the SCS (Allan & Gilbert, 1995), providing
larly with clinically vulnerable individuals. Gerber et al. (2018) report a narrow glimpse of SC in quantitative analysis, especially given that
that the choice or condition of a lateral comparison leads to less dif- the scale does not record frequency or information about the choice
ferentiable upward and downward effects. Studies with clinical and of comparison targets. Additionally, due to the prominence of one
subclinical groups featuring lateral comparison are lacking, and future researcher, it would be desirable to have a more diverse representa-
research with depression and anxiety samples should address this. tion of research groups focusing on the topic of SC in clinical psychol-
Previous reviews also report that SC paradigms lack adequate control ogy for replication and broadening of research.
5 | C O N CL U S I O N for self versus others. Journal of Personality and Social Psychology, 52

(2), 366–378. https://doi.org/10.1037//0022-3514.52.2.366
American Psychiatric Association. (2013). Diagnostic and statistical
The meta-analysis and review of (sub)clinical populations indicate that
manual of mental disorders (DSM-5®). Arlington: American Psychiat-
SC may play a role in the maintenance of symptoms for anxiety and ric Pub.
depression, as well as related cognitions, emotions, and behaviours. Antony, M. M., Rowa, K., Liss, A., Swallow, S. R., & Swinson, R. P. (2005).
Overall, the literature conveys a dysfunctional process of SC for indi- Social comparison processes in social phobia. Behavior Therapy, 36(1),
65–75. https://doi.org/10.1016/S0005-7894(05)80055-3
viduals with increasing depression and anxiety symptom severity,
Appel, H., Crusius, J., & Gerlach, A. L. (2015). Social comparison, envy, and
which may serve to maintain negative beliefs about the self. This depression on Facebook: A study looking at the effects of high com-
raises several questions for future research to answer: To what extent parison standards on depressed individuals. Journal of Social and Clini-
do individuals with depression or anxiety avoid/overengage in acquir- cal Psychology, 34(4), 277–289. https://doi.org/10.1521/jscp.2015.34.
4.277
ing SC information? To what extent is the comparison process
Arigo, D., Smyth, J. M., Haggerty, K., & Raggio, G. A. (2015). The social
reinforced by automatic or implicit processes? Which cognitive pro- context of the relationship between glycemic control and depressive
cesses are involved in seeking and appraising comparison information? symptoms in Type 2 diabetes. Chronic Illness, 11(1), 33–43. https://doi.
What individual differences influence how acquiring SC information org/10.1177/1742395314531990
Arigo, D., Suls, J. M., & Smyth, J. M. (2014). Social comparisons and chronic
leads to negative self-evaluation in depression or anxiety? What other
illness: Research synthesis and clinical implications. Health Psychology
factors relative to wellbeing interact with SC processes such as direc-
Review, 8(2), 154–214. https://doi.org/10.1080/17437199.2011.
tion and dimension to affect reactions? Can interventions 634572
addressing SC processes be employed to treat mood and affective Bäzner, E., Brömer, P., Hammelstein, P., & Meyer, T. D. (2006). Current and
disorders? former depression and their relationship to the effects of social com-
parison processes. Results of an internet based study. Journal of Affec-
To answer these and similar questions, future research needs to
tive Disorders, 93(1–3), 97–103. https://doi.org/10.1016/j.jad.2006.
address limitations in the current literature. Both depression and anxi- 02.017
ety samples would benefit from further representation in SC research, Bocage-Barthélémy, Y., Chatard, A., Jaafari, N., Tello, N., Billieux, J.,
where anxiety groups are particularly underrepresented. Observa- Daveau, E., & Selimbegovic, L. (2018). Automatic social comparison:
Cognitive load facilitates an increase in negative thought accessibility
tional prospective data exploring more than one facet of SC, as well
after thin ideal exposure among women. PLoS ONE, 13(3), e0193200.
as experimental manipulations of SC, are necessary to build a more https://doi.org/10.1371/journal.pone.0193200
concise overview of SC processes related to psychopathology. This Borenstein, M., Hedges, L. V., Higgins, J. P., & Rothstein, H. R. (2009). Soft-
would improve current knowledge regarding comparison directions, ware: 44. In Introduction to meta-analysis (pp. 391–403). Wiley-Black-
well. https://doi.org/10.1002/9780470743386.ch44
target choice, and affective and behavioural impacts as it relates to
Buunk, A. P., Brakel, T. M., Bennenbroek, F. T. C., Stiegelis, H. E.,
the development and maintenance of depression and anxiety disor- Sanderman, R., van den Bergh, A. C., & Hagedoorn, M. (2009). Neuroti-
ders. This also implies that efforts are necessary to increase standardi- cism and responses to social comparison among cancer patients.
zation and replication of research methods, which would greatly European Journal of Personality, 23(6), 475–487. https://doi.org/10.
1002/per.720
benefit the field of SC in relation to mental health complaints.
Buunk, A. P., & Gibbons, F. X. (2007). Social comparison: The end of a the-
ory and the emergence of a field. Organizational Behavior and Human
ORCID Decision Processes, 102(1), 3–21. https://doi.org/10.1016/j.obhdp.
Peter A. McCarthy https://orcid.org/0000-0002-6740-6166 2006.09.007
Buunk, B. P., & Brenninkmeijer, V. (2001). When individuals dislike expo-
Nexhmedin Morina https://orcid.org/0000-0002-2331-9140
sure to an actively coping role model: Mood change as related
to depression and social comparison orientation. European
RE FE R ENC E S Journal of Social Psychology, 31(5), 537–548. https://doi.org/10.1002/
Ahrens, A. H. (1991). Dysphoria and social comparison: Combining infor- ejsp.76
mation regarding others' performances. Journal of Social and Clinical Buunk, B. P., & Ybema, J. F. (1997). Social comparison and occupational
Psychology, 10(2), 190–205. https://doi.org/10.1521/jscp.1991.10. stress: The identification-contrast model. In B. P. Buunk, &
2.190 F. X. Gibbons (Eds.), Health, coping, and well-being: Perspectives from
Albright, J. S., Alloy, L. B., Barch, D., & Dykman, B. M. (1993). Social com- social comparison theory (pp. 359–388). Hillsdale, NJ: Erlbaum.
parison by dysphoric and nondysphoric college students: The grass Carvalho, S., Pinto-Gouveia, J., Pimentel, P., Maia, D., Gilbert, P., & Mota-
isn't always greener on the other side. Cognitive Therapy and Research, Pereira, J. (2013). Entrapment and defeat perceptions in depressive
17(6), 485–509. https://doi.org/10.1007/BF01176075 symptomatology: Through an evolutionary approach. Psychiatry, 76(1),
Albright, J. S., & Henderson, M. C. (1995). How real is depressive realism? 53–67. https://doi.org/10.1521/psyc.2013.76.1.53
A question of scales and standards. Cognitive Therapy and Research, 19 Cattarin, J. A., Thompson, J. K., Thomas, C., & Williams, R. (2000). Body
(5), 589–609. https://doi.org/10.1007/BF02230515 image, mood, and televised images of attractiveness: The role of social
Allan, S., & Gilbert, P. (1995). A social comparison scale: Psychometric comparison. Journal of Social and Clinical Psychology, 19(2), 220–239.
properties and relationship to psychopathology. Personality and Indi- https://doi.org/10.1521/jscp.2000.19.2.220
vidual Differences, 19(3), 293–299. https://doi.org/10.1016/0191- Chatard, A., Bocage-Barthélémy, Y., Selimbegovic, L., & Guimond, S.
8869(95)00086-L (2017). The woman who wasn't there: Converging evidence that sub-
Alloy, L. B., & Ahrens, A. H. (1987). Depression and pessimism for the liminal social comparison affects self-evaluation. Journal of Experimen-
future: Biased use of statistically relevant information in predictions tal Social Psychology, 73, 1–13. https://doi.org/10.1016/j.jesp.2017.
05.005
Cohen, J. (Ed.) (1988). Statistical power analysis for the behavioral sciences Gilbert, P., McEwan, K., Irons, C., Bhundia, R., Christie, R.,
(2nd ed.). New Jersey: Lawrence Erlbaum. Broomhead, C., & Rockliff, H. (2010). Self-harm in a mixed clinical pop-
Corcoran, K., Crusius, J., & Mussweiler, T. (2011). Social comparison: ulation: The roles of self-criticism, shame, and social rank. British Jour-
Motives, standards, and mechanisms. In Theories in social psychology nal of Clinical Psychology, 49, 563–576. https://doi.org/10.1348/
(pp. 119–139). Oxford, UK: Wiley-Blackwell. 014466509X479771
Cunha, M., Soares, I., & Pinto-Gouveia, J. (2008). The role of individual Giordano, C., Wood, J. V., & Michela, J. L. (2000). Depressive personality
temperament, family and peers in social anxiety disorder: A controlled styles, dysphoria, and social comparisons in everyday life. Journal of
study. International Journal of Clinical and Health Psychology, 8(3), Personality and Social Psychology, 79(3), 438–451. https://doi.org/10.
631–655. https://doi.org/10.1037/t04510-000 1037//0022-3514.79.3.438
Festinger, L. (1954). A theory of social comparison processes. Human Rela- Gordon, E. A., Johnson, K., Heimberg, R. G., Montesi, J. L., & Fauber, R. L.
tions, 7(2), 117–140. https://doi.org/10.1177/001872675400700202 (2013). Bi-directional positive illusions in romantic relationships: Possi-
Flett, G. L., Vredenburg, K., Pliner, P., & Krames, L. (1987). Depression and bilities and pitfalls for the socially anxious. Journal of Social and Clinical
social comparison information-seeking. Journal of Social Behavior and Psychology, 32(2), 200–224. https://doi.org/10.1521/jscp.2013.32.
Personality, 2(4), 473–484. 2.200
Fuhr, K., Hautzinger, M., & Meyer, T. D. (2015). Are social comparisons Haught, H. M., Rose, J., Geers, A., & Brown, J. A. (2015). Subjective social
detrimental for the mood and self-esteem of individuals with an affec- status and well-being: The role of referent abstraction. The Journal of
tive disorder? Cognitive Therapy and Research, 39(3), 279–291. https:// Social Psychology, 155(4), 356–369. https://doi.org/10.1080/
doi.org/10.1007/s10608-014-9656-2 00224545.2015.1015476
Gerber, J. P. (2018). Social comparison theory. In V. Zeigler-Hill, & Hedges, L., & Olkin, I. (1985). Statistical methods in meta-analysis (p. 20).
T. K. Shackelford (Eds.), Encyclopedia of personality and individual differ- San Diego, CA: Academic Press.
ences. Cham: Springer International Publishing. https://doi.org/10. Higgins, J. P. T., Altman, D. G., & Sterne, J. A. C. (2011). Assessing risk of
1007/978-3-319-28099-8_1182-1 bias in included studies. In J. P. T. Higgins (Ed.), Cochrane handbook for
Gerber, J. P., Wheeler, L., & Suls, J. (2018). A social comparison theory systematic reviews of interventions (5th ed.). [S.l.]). London, UK:
meta-analysis 60+ years on. Psychological Bulletin, 144(2), 177–197. Cochrane Collaboration. Retrieved from http://www.handbook.
https://doi.org/10.1037/bul0000127 cochrane.or
Gibbons, F. X. (1986). Social comparison and depression: Company's effect Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Mea-
on misery. Journal of Personality and Social Psychology, 51(1), 140–148. suring inconsistency in meta-analyses. BMJ (Clinical Research Ed.), 327
https://doi.org/10.1037/0022-3514.51.1.140 (7414), 557–560. https://doi.org/10.1136/bmj.327.7414.557
Gibbons, F. X., Blanton, H., Gerrard, M., Buunk, B., & Eggleston, T. (2000). Hooberman, J., Rosenfeld, B., Rasmussen, A., & Keller, A. (2010).
Does social comparison make a difference? Optimism as a moderator Resilience in trauma-exposed refugees: The moderating effect of
of the relation between comparison level and academic performance. coping style on resilience variables. The American Journal of Orthopsy-
Personality and Social Psychology Bulletin, 26(5), 637–648. https://doi. chiatry, 80(4), 557–563. https://doi.org/10.1111/j.1939-0025.2010.
org/10.1177/0146167200267011 01060.x
Gibbons, F. X., & Buunk, B. P. (1999). Individual differences in social com- Hunter, J. E., & Schmidt, F. L. (2004). Methods of meta-analysis: Correcting
parison: Development of a scale of social comparison orientation. Jour- error and bias in research findings (2nd ed.). Thousand Oaks, Ca: Sage
nal of Personality and Social Psychology, 76(1), 129–142. https://doi. Publications, Inc.
org/10.1037//0022-3514.76.1.129 Judge, L., Cleghorn, A., McEwan, K., & Gilbert, P. (2012). An exploration of
Gilbert, P. (2000). The relationship of shame, social anxiety and depression: group-based compassion focused therapy for a heterogeneous range
The role of the evaluation of social rank. Clinical Psychology & Psycho- of clients presenting to a community mental health team. International
therapy, 7(3), 174–189. https://doi.org/10.1002/1099-0879(200007) Journal of Cognitive Therapy, 5(4), 420–429. https://doi.org/10.1521/
7:3<174::AID-CPP236>3.0.CO;2-U ijct.2012.5.4.420
Gilbert, P., & Allan, S. (1998). The role of defeat and entrapment (arrested Kang, N.-I., Park, T.-W., Yang, J.-C., Oh, K.-Y., Shim, S.-H., & Chung, Y.-C.
flight) in depression: An exploration of an evolutionary view. Psycho- (2012). Prevalence and clinical features of thought-perception-
logical Medicine, 28(3), 585–598. https://doi.org/10.1017/ sensitivity symptoms: Results from a community survey of Korean
s0033291798006710 high school students. Psychiatry Research, 198(3), 501–508. https://
Gilbert, P., Allan, S., Brough, S., Melley, S., & Miles, J. N. V. (2002). Relation- doi.org/10.1016/j.psychres.2012.03.005
ship of anhedonia and anxiety to social rank, defeat and entrapment. Kelly, M. A. R., Roberts, J. E., & Bottonari, K. A. (2007). Non-treatment-
Journal of Affective Disorders, 71(1–3), 141–151. related sudden gains in depression: The role of self-evaluation. Behav-
Gilbert, P., Allan, S., & Trent, D. R. (1995). Involuntary subordination or iour Research and Therapy, 45(4), 737–747. https://doi.org/10.1016/j.
dependency as key dimensions of depressive vulnerability? Journal of brat.2006.06.008
Clinical Psychology, 51(6), 740–752. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., &
Gilbert, P., Boxall, M., Cheung, M., & Irons, C. (2005). The relation of para- Walters, E. E. (2005). Lifetime prevalence and age-of-onset distribu-
noid ideation and social anxiety in a mixed clinical population. Clinical tions of DSM-IV disorders in the National Comorbidity Survey Replica-
Psychology & Psychotherapy, 12(2), 124–133. https://doi.org/10.1002/ tion. Archives of General Psychiatry, 62(6), 593–602. https://doi.org/
cpp.438 10.1001/archpsyc.62.6.593
Gilbert, P., Irons, C., Olsen, K., Gilbert, J., & McEwan, K. (2006). Interper- Koerner, N., Antony, M. M., Young, L., & McCabe, R. E. (2013). Changes in
sonal sensitivities: Their links to mood, anger and gender. Psychology beliefs about the social competence of self and others following group
and Psychotherapy, 79, 37–51. https://doi.org/10.1348/ cognitive-behavioral treatment. Cognitive Therapy and Research, 37(2),
147608305X43856 256–265. https://doi.org/10.1007/s10608-012-9472-5
Gilbert, P., McEwan, K., Bellew, R., Mills, A., & Corinne, G. (2009). The dark Kraus, M. W., & Park, J. W. (2014). The undervalued self: Social class and
side of competition: How competitive behaviour and striving to avoid self-evaluation. Frontiers in Psychology, 5, 1404. https://doi.org/10.
inferiority are linked to depression, anxiety, stress and self-harm. Psy- 3389/fpsyg.2014.01404
chology and Psychotherapy: Theory, Research and Practice, 82(2), Lopes, B. C. (2013). Differences between victims of bullying and non-
123–136. https://doi.org/10.1348/147608308X379806 victims on levels of paranoid ideation and persecutory symptoms, the
presence of aggressive traits, the display of social anxiety and the
recall of childhood abuse experiences in a Portuguese mixed clinical Scanlan, T. K. (1977). The effects of success-failure on the perception of
sample. Clinical Psychology & Psychotherapy, 20(3), 254–266. https:// threat in a competitive situation. Research Quarterly, 48(1), 144–153.
doi.org/10.1002/cpp.800 https://doi.org/10.1080/10671315.1977.10762163
MacMahon, P., & Jahoda, A. (2008). Social comparison and depression: Schachter, S. (1959). The psychology of affiliation: Experimental studies of
People with mild and moderate intellectual disabilities. American Jour- the sources of gregariousness. Palo Alto, CA, US: Stanford Univer. Press.
nal of Mental Retardation: AJMR, 113(4), 307–318. https://doi.org/10. Shea, M. T., Widiger, T. A., & Klein, M. H. (1992). Comorbidity of personal-
1352/0895-8017(2008)113[307:SCADPW]2.0.CO;2 ity disorders and depression: Implications for treatment. Journal of
McEwan, K., Gilbert, P., & Duarte, J. (2012). An exploration of competitive- Consulting and Clinical Psychology, 60(6), 857–868. https://doi.org/10.
ness and caring in relation to psychopathology. The British Journal of 1037//0022-006x.60.6.857
Clinical Psychology/the British Psychological Society, 51(1), 19–36. Sturman, E. D., & Mongrain, M. (2005). Self-criticism and major depression:
https://doi.org/10.1111/j.2044-8260.2011.02010.x An evolutionary perspective. The British Journal of Clinical Psychology/-
McFarland, C., & Miller, D. T. (1994). The framing of relative performance the British Psychological Society, 44, 505–519.
feedback: Seeing the glass as half empty or half full. Journal of Person- Sturman, E. D., & Mongrain, M. (2008). Entrapment and perceived status
ality and Social Psychology, 66(6), 1061–1073. https://doi.org/10. in graduate students experiencing a recurrence of major depression.
1037/0022-3514.66.6.1061 Canadian Journal of Behavioural Science/Revue Canadienne Des Sciences
McGillivray, J. A., & McCabe, M. P. (2007). Early detection of depression Du Comportement, 40(3), 185–188. https://doi.org/10.1037/0008-
and associated risk factors in adults with mild/moderate intellectual 400X.40.3.185
disability. Research in Developmental Disabilities, 28(1), 59–70. https:// Swallow, S. R., & Kuiper, N. A. (1987). The effects of depression and cogni-
doi.org/10.1016/j.ridd.2005.11.001 tive vulnerability to depression on judgments of similarity between self
Meyer, N. E., Dyck, D. G., & Petrinack, R. J. (1989). Cognitive appraisal and and other. Motivation and Emotion, 11(2), 157–167. https://doi.org/
attributional correlates of depressive symptoms in children. Journal of 10.1007/BF00992341
Abnormal Child Psychology, 17(3), 325–336. https://doi.org/10.1007/ Swallow, S. R., & Kuiper, N. A. (1990). Mild depression, dysfunctional cog-
bf00917402 nitions, and interest in social comparison information. Journal of Social
Mitchell, M. A., & Schmidt, N. B. (2014). An experimental manipulation of and Clinical Psychology, 9(3), 289–302. https://doi.org/10.1521/jscp.
social comparison in social anxiety. Cognitive Behaviour Therapy, 43(3), 1990.9.3.289
221–229. https://doi.org/10.1080/16506073.2014.914078 Swallow, S. R., & Kuiper, N. A. (1992). Mild depression and frequency of
Moher, D., Shamsheer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., social comparison behavior. Journal of Social and Clinical Psychology, 11
… PRISMA-P Group. (2015). Preferred Reporting Items for Systematic (2), 167–180. https://doi.org/10.1521/jscp.1992.11.2.167
Review and s (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1. Swallow, S. R., & Kuiper, N. A. (1993). Social comparison in dysphoria and
https://doi.org/10.1186/2046-4053-4-1 nondysphoria: Differences in target similarity and specificity. Cognitive
Molleman, E., Pruyn, J., & van Knippenberg, A. (1986). Social comparison Therapy and Research, 17(2), 103–122. https://doi.org/10.1007/
processes among cancer patients. The British Journal of Social BF01172960
Psychology/the British Psychological Society, 25(Pt 1), 1–13. Tabachnik, N., Crocker, J., & Alloy, L. B. (1983). Depression, social compari-
Morina, N., Koerssen, R., & Pollet, T. V. (2016). Interventions for children son, and the false-consensus effect. Journal of Personality and Social
and adolescents with posttraumatic stress disorder: A meta-analysis of Psychology, 45(3), 688–699. https://doi.org/10.1037//0022-3514.45.
comparative outcome studies. Clinical Psychology Review, 47, 41–54. 3.688
https://doi.org/10.1016/j.cpr.2016.05.006 Teachman, B. A., Clerkin, E. M., Cunningham, W. A., Dreyer-Oren, S., &
Mulgrew, K. E., & Cragg, D. N. (2017). Age differences in body image Werntz, A. (2019). Implicit cognition and psychopathology: Looking
responses to idealized male figures in music television. Journal of back and looking forward. Annual Review of Clinical Psychology, 15,
Health Psychology, 22, 811–822. http://10.1177/1359105315616177 123–148. https://doi.org/10.1146/annurev-clinpsy-050718-095718
Mulgrew, K. E., Volcevski-Kostas, D., & Rendell, P. G. (2014). The effect of Thwaites, R., & Dagnan, D. (2004). Moderating variables in the relationship
music video clips on adolescent boys' body image, mood, and schema between social comparison and depression: An evolutionary perspec-
activation. Journal of Youth and Adolescence, 43(1), 92–103. https:// tive. Psychology and Psychotherapy, 77, 309–323. https://doi.org/10.
doi.org/10.1007/s10964-013-9932-6 1348/1476083041839376
Myers, T. A., & Crowther, J. H. (2009). Social comparison as a predictor of Tran, T. B., Uebelacker, L., Wenze, S. J., Collins, C., & Broughton, M. K.
body dissatisfaction: A meta-analytic review. Journal of Abnormal Psy- (2015). Adaptive and maladaptive means of using Facebook: A qualita-
chology, 118(4), 683–698. https://doi.org/10.1037/a0016763 tive pilot study to inform suggestions for development of a future
O'Connor, L., Berry, J. W., Weiss, J., & Gilbert, P. (2002). Guilt, fear, intervention for depression. Journal of Psychiatric Practice, 21(6),
submission, and empathy in depression. Journal of Affective Disor- 458–473. https://doi.org/10.1097/PRA.0000000000000109
ders, 71(1–3), 19–27. https://doi.org/10.1016/s0165-0327(01) Troop, N. A., & Hiskey, S. (2013). Social defeat and PTSD symptoms fol-
00408-6 lowing trauma. The British Journal of Clinical Psychology/the British Psy-
Peck, M. D., & Merighi, J. R. (2007). The relation of social comparison to chological Society, 52(4), 365–379. https://doi.org/10.1111/bjc.12022
subjective well-being and health status in older adults. Journal of Van der Zee, K. I., Buunk, B., Sanderman, R., Botke, G., & van den Bergh, F.
Human Behavior in the Social Environment, 16(3), 121–142. https://doi. (2000). Social comparison and coping with cancer treatment. Personal-
org/10.1300/10911350802107827 ity and Individual Differences, 28(1), 17–34. https://doi.org/10.1016/
Pinkley, R. L., Laprelle, J., Pyszczynski, T., & Greenberg, J. (1988). Depres- S0191-8869(99)00045-8
sion and the self-serving search for consensus after success and fail- Van der Zee, K. I., Buunk, B. P., & Sanderman, R. (1995). Social comparison
ure. Journal of Social and Clinical Psychology, 6(2), 235–244. https:// as a mediator between health problems and subjective health evalua-
doi.org/10.1521/jscp.1988.6.2.235 tions. The British Journal of Social Psychology/the British Psychological
Sacco, W. P., & Graves, D. J. (1984). Childhood depression, interpersonal Society, 34(Pt 1), 53–65.
problem-solving, and self-ratings of performance. Journal of Clinical Weary, G., Elbin, S., & Hill, M. G. (1987). Attributional and social compari-
Child Psychology, 13(1), 10–15. https://doi.org/10.1207/ son processes in depression. Journal of Personality and Social Psychol-
s15374424jccp1301_2 ogy, 52(3), 605–610. https://doi.org/10.1037//0022-3514.52.3.605
Weary, G., Marsh, K. L., & McCormick, L. (1994). Depression and social Wills, T. A. (1981). Downward comparison principles in social psychology.
comparison motives. European Journal of Social Psychology, 24(1), Psychological Bulletin, 90(2), 245–271. https://doi.org/10.1037/0033-
117–129. https://doi.org/10.1002/ejsp.2420240109 2909.90.2.245
Weisman, O., Aderka, I. M., Marom, S., Hermesh, H., & Gilboa- Wilson, J. J., Gil, K. M., & Raezer, L. (1997). Self-evaluation, coping, and
Schechtman, E. (2011). Social rank and affiliation in social anxiety dis- depressive affect in African American adults with sickle cell disease.
order. Behaviour Research and Therapy, 49(6–7), 399–405. https://doi. Cognitive Therapy and Research, 21(4), 443–457.
org/10.1016/j.brat.2011.03.010 Wood, J. V. (1996). What is social comparison and how should we study
Wenzlaff, R. M., & Beevers, C. G. (1998). Depression and interpersonal it? Personality and Social Psychology Bulletin, 22(5), 520–537.
responses to others' moods: The solicitation of negative information Wyatt, R., & Gilbert, P. (1998). Dimensions of perfectionism: A study
about happy people. Personality and Social Psychology Bulletin, 24(4), exploring their relationship with perceived social rank and status. Per-
386–398. https://doi.org/10.1177/0146167298244005 sonality and Individual Differences, 24(1), 71–79. https://doi.org/10.
Wetherall, K., Robb, K. A., & O'Connor, R. C. (2019). Social rank theory of 1016/S0191-8869(97)00146-3
depression: A systematic review of self-perceptions of social rank and
their relationship with depressive symptoms and suicide risk. Journal
of Affective Disorders, 246, 300–319. https://doi.org/10.1016/j.jad.
2018.12.045 How to cite this article: McCarthy PA, Morina N. Exploring
Wheeler, L. (2000). Individual differences in social comparison. In J. Suls, & the association of social comparison with depression and
L. Wheeler (Eds.), The Springer series in social clinical psychology. Hand- anxiety: A systematic review and meta-analysis. Clin Psychol
book of social comparison (pp. 141–158). Boston, MA: Springer.
Psychother. 2020;27:640–671. https://doi.org/10.1002/cpp.
Wheeler, L., & Miyake, K. (1992). Social Comparison in Everyday Life. Jour-
nal of Personality and Social Psychology, 62(5), 760–773. 2452
APPENDIX A: | Quality assessment
Quality assessment Scoring (0 to 2)

A. Did the study include a clinical sample with exclusive diagnoses? (2) Depression and/or anxiety disorder with report of diagnosis
rates (min. 80% of sample).
(1) Depression and/or anxiety disorder without report of diagnosis
rates, or less than 80% met diagnostic criteria.
(0) Subclinical, within clinical range on validated instrument.
B. Was depression and/or anxiety diagnosis assessed with a validated (2) Validated structured psychiatric interview referenced.
instrument? (1) Clinical diagnosis on the basis of validated self-reports or via
referral/recruitment from psychiatric treatment unit.
(0) Unvalidated instrument.
C. Was symptom severity of depression and/or anxiety measured with a (2) Clinically-validated instrument.
validated instrument? (1) Validated in general population only.
(0) Unvalidated instrument developed for the purpose of the study.
D. Did the assessment or manipulation of social comparison take social (2) Comparison direction (upward & downward) AND comparison
comparison dimensions (i.e., upward vs. downward and assimilation similarity (assimilation & contrast).
vs contrast) into account? (1) Only comparison direction OR comparison similarity.
(0) The measurement does not consider the dimensions of
comparison direction and similarity.
E. Other concerns No scoring, for comment only.

Clin Psychology and Psychoth - 2020 - McCarthy - Exploring The Association of Social Comparison With Depression and Anxiety

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Clin Psychology and Psychoth - 2020 - McCarthy - Exploring The Association of Social Comparison With Depression and Anxiety

Uploaded by

Copyright:

Available Formats

Received: 19 September 2019 Revised: 27 February 2020 Accepted: 23 March 2020

Exploring the association of social comparison with depression

Peter A. McCarthy | Nexhmedin Morina

Institute of Psychology, University of Münster,

anxiety, depression, meta-analysis, social comparison, systematic review

640 wileyonlinelibrary.com/journal/cpp Clin Psychol Psychother. 2020;27:640–671.

1.1 | Social comparison

Festinger (1954) conceived SCT to explain how individuals make self-

2.2 | Eligibility criteria

The Preferred Reporting Items for Systematic Reviews and Meta-

F I G U R E 1 Flow chart of search with

Depression diagnosis Anxiety diagnosis %

and related outpatient sample

Depression diagnosis Anxiety diagnosis %

Relevant outcomes; SC direction

correlation between SCS and anxiety.

Relevant outcomes; SC direction

Relevant outcomes; SC direction

depression, 6 with anxiety). significance for contributing to depression or

Relevant outcomes; SC direction

Relevant outcomes; SC direction

and a student sample.

Relevant outcomes; SC direction

Focus of manipulation; Relevant outcomes; (SC

Focus of manipulation; Relevant outcomes; (SC

group predicted they would

Focus of manipulation; Relevant outcomes; (SC

Focus of manipulation; Relevant outcomes; (SC

Focus of manipulation; Relevant outcomes; (SC

Focus of manipulation; Relevant outcomes; (SC

Focus of manipulation; Relevant outcomes; (SC

Focus of manipulation; Relevant outcomes; (SC

5 | C O N CL U S I O N for self versus others. Journal of Personality and Social Psychology, 52

APPENDIX A: | Quality assessment

Quality assessment Scoring (0 to 2)

You might also like