A Test of Interpersonal Theory of Depression in Youth Psychiatric Inpatients

Coyne's (1976b) interpersonal theory of depression postulated that the combination of depressive symptoms and excessive reassurance-seeking leads to interpersonal problems (e.g., loneliness, devaluation). The present study is one of the first to test this model among youth, particularly a clinical sample of youth. Sixty-eight youth psychiatric inpatients (35 girls; 33 boys; mean age = 13.34 years, SD = 2.50) completed self-report measures of excessive reassurance-seeking, depressive symptoms, and interpersonal rejection. Results conformed to the hypothesis: The statistical interaction of excessive reassurance-seeking and depressive symptoms predicted interpersonal rejection, such that high-reassurance-seeking youth with depressive symptoms reported the most interpersonal rejection. Implications of the findings for interpersonal theory of depression in youngsters are discussed.     

The Relative Specificity of Excessive Reassurance-Seeking to Depressive Symptoms and Diagnoses Among Clinical Samples of Adults and Youth

In addition to playing a role in the deterioration of depressed people's interpersonal environment, excessive reassurance-seeking may be implicated as a vulnerability factor for depression. If so, excessive reassurance-seeking should display relative specificity to depression versus other forms of psychopathology. Two studies of psychiatric inpatients (Study 1 on adults and Study 2 on children) tested this possibility. In Study 1 a Depressed group obtained higher reassurance-seeking scores than an Other Disorders group did. Similar findings were obtained in Study 2, such that depressed youth reported higher reassurance-seeking than nondepressed youth. Hence, these two studies of psychiatric inpatients provided reasonable support for the specificity of excessive reassurance-seeking to depression as compared to other forms of psychopathology.     

When does partner devaluation predict emotional distress? Prospective moderating effects of reassurance-seeking and self-esteem

Coyne's (1976b) interpersonal theory of depression asserts that devaluation and rejection by relationship partners may exacerbate depressive symptoms. We tested this assertion empirically and investigated two theoretically based moderators of this effect: reassurance-seeking and self-esteem level. Dating women (N= 134) completed measures of depression, reassurance-seeking, and self-esteem at Time 1 and a measure of depression at Time 2 six weeks later. Male partners completed a measure of devaluation of the women. Partner devaluation was not associated with increased emotional distress for women across the entire sample. However, significant moderating effects of both reassurance-seeking and self-esteem level were found. Partner devaluation predicted increased emotional distress among women who reported high levels of reassurance-seeking and among women who reported low levels of self-esteem. Results are discussed in terms of convergence with Coyne's theory.     

Searching for Positive Aspects of Excessive Reassurance-Seeking

We investigated positive aspects of excessive reassurance-seeking in interpersonal relationships. Previous studies have emphasized that excessive reassurance-seeking leads to interpersonal rejection by significant others. However, Fowler & Gasiorek (2017) suggested that excessive reassurance-seekers tend to make efforts to maintain relationships with their romantic partners, and that these efforts affect their own satisfaction with the relationships. We investigated whether the findings of Fowler and Gasiorek in students could be replicated in general heterosexual couples (N = 437 couples). Data were analyzed using the modified actor–partner interdependence model. Results indicated that excessive reassurance-seeking had no actor or partner effects on the efforts to maintain the relationships, which predicted relational satisfaction. However, the actor and partner effects of excessive reassurance-seeking on relational satisfaction through the efforts to maintain the relationships differed according to the relational duration. These findings, despite certain inconsistencies with Fowler and Gasiorek, suggest that excessive reassurance-seeking might have positive effects on relationships.     

Adolescent girls' interpersonal vulnerability to depressive symptoms: a longitudinal examination of reassurance-seeking and peer relationships

A transactional, interpersonal framework involving adolescents' reassurance-seeking and peer experiences may be useful for understanding the emergence of gender differences in depression prevalence during the adolescent transition. Sociometric nominations of peer acceptance/rejection and ratings of friendship quality provided by adolescents and their friends were used to measure peer experiences among 6th-8th-grade adolescents (N=520) over 3 annual time points. After controlling for age and pubertal development, significant but small prospective effects offered mixed support for hypotheses: (a) depressive symptoms and negative peer relations predicted increasing levels of girls' reassurance-seeking; (b) initial levels of reassurance-seeking and depressive symptoms predicted deteriorating friendship quality among girls and low friendship stability, respectively; and (c) reassurance-seeking combined with poor peer experiences predicted increases in girls' depressive symptoms.     

The Interpersonal Model of Health Anxiety: Testing predicted paths and model specificity

Health anxiety involves persistent worry about one’s health and is characterized by dysfunctional interpersonal processes such as excessive health-related reassurance-seeking and feelings of alienation from others. Cognitive-behavioral models largely ignore cyclical, interpersonally averse behaviors and social cognitions observed amongst health anxious individuals. The Interpersonal Model of Health Anxiety (IMHA) proposes health anxiety is maintained through activated anxious attachment insecurities, which drive frequent, but ineffective, health-related reassurance-seeking from others. Such excessive health-related reassurance-seeking leads to health-related alienation and beliefs others are unconcerned about one’s perceived health problems. Feeling alienated from others fuels further health-related worry, resulting in continued self-defeating attempts at health-related reassurance-seeking. The present study offers the first comprehensive articulation and test of the IMHA. Using a cross-sectional design and 107 undergraduates, path analysis supported five of six hypothesized paths in the model; all paths except that from anxious attachment to health-related reassurance-seeking were significant and in the expected direction. Specificity tests suggested anxious attachment was more central than avoidant attachment to the IMHA. The present test of the IMHA as a single, coherent model provides a conceptual foundation for future research on interpersonal processes in health anxiety. Clinical implications are discussed.     

Rumination and Excessive Reassurance Seeking: Mediators of the Relationship Between Social Anxiety and Depression?

Social anxiety and depression are highly comorbid conditions. Although this has led researchers to suggest that social anxiety may convey risk for depression, few studies have examined mechanisms of comorbidity between these two conditions. The current study tested two mechanisms of comorbidity between symptoms of these disorders: brooding and excessive reassurance seeking. The data were evaluated in an undergraduate sample assessed three times over a 2 month period. Results suggested that brooding mediated the relationship between social anxiety at Time 1 and depression at Time 3, although no evidence was found for excessive reassurance-seeking as a mediator of these two variables. These findings support recent research suggesting that brooding may be a transdiagnostic process. Theoretical and clinical implications are discussed.     

Excessive reassurance seeking: delineating a risk factor involved in the development of depressive symptoms

Six studies investigated (a) the construct validity of reassurance seeking and (b) reassurance seeking as a specific vulnerability factor for depressive symptoms. Studies 1 and 2 demonstrated that reassurance seeking is a reasonably cohesive, replicable, and valid construct, discernible from related interpersonal variables. Study 3 demonstrated that reassurance seeking displayed diagnostic specificity to depression, whereas other interpersonal variables did not, in a sample of clinically diagnosed participants. Study 4 prospectively assessed a group of initially symptom-free participants, and showed that those who developed future depressive symptoms (as compared with those who remained symptom-free) obtained elevated reassurance-seeking scores at baseline, when all participants were symptom-free, but did not obtain elevated scores on other interpersonal variables. Studies 5 and 6 indicate that reassurance seeking predicts future depressive reactions to stress. Taken together, the six studies support the construct validity of reassurance seeking, as well as its potential role as a specific vulnerability factor for depression.     

Elucidating the relation between childhood emotional abuse and depressive symptoms in adulthood: The mediating role of maladaptive interpersonal processes

ObjectiveThe purpose of this study is to assess the potential unique and relative mediating effects of three interpersonal risk factors (i.e., excessive reassurance-seeking [ERS], negative feedback seeking [NFS], and rejection sensitivity [RS]) in the relationship between childhood emotional abuse (CEA) and depressive symptoms.MethodOne hundred eighty-five undergraduates were followed over a four-month interval. Participants completed assessments of childhood abuse history, ERS, NFS, and RS, and depressive symptoms at baseline, as well as depressive symptoms at four-month followup.ResultsFindings from single-mediator analyses indicated that RS and NFS, but not ERS, mediated the relationship between CEA and prospective depressive symptoms, after accounting for childhood sexual and physical abuse, as well as baseline depressive symptoms. In our multi-mediator model, only RS remained a significant mediator of the relationship between CEA and prospective depressive symptoms.ConclusionsThe current study provides preliminary evidence that negative behavioral styles may function as a mechanism linking prior experiences of CEA to subsequent depressive symptoms. Clinical implications of these findings suggest that targeting maladaptive behavioral tendencies, particularly RS, may be an effective adjunct in behavioral modification treatments of CEA victims at risk for depression.     

Toward an Integration of Interpersonal Risk Models of Depression and Cognitive‐Behaviour Therapy

Empirical research has increasingly focused on interpersonal variables associated with the development and maintenance of depression. This article outlines some key interpersonal risk factors for depression, including anxious attachment, sociotropy, excessive reassurance seeking, interpersonal stress generation, reduced social support, social skills deficits, and social avoidance. Recommendations are made for how cognitive‐behavioural therapy may be adapted to address such factors. Specifically, suggestions are offered for how cognitive and behavioural interventions, such as cognitive restructuring, behavioural activation, behavioural experiments, and skills training, may be used with depressed clients to promote positive relationships and reduce maladaptive interpersonal behaviours.     

When depression breeds contempt: reassurance seeking, self-esteem, and rejection of depressed college students by their roommates.

To test Coyne's (1976b) theory of depression, students' levels of depressive symptoms, reassurance seeking, and self-esteem were assessed at Time 1, and their same-gender roommates' appraisals of them were assessed 5 weeks later. Mildly depressed students engaged in the type of reassurance seeking described by Coyne. Among men, but not women, mildly depressed students were rejected if they strongly sought reassurance and had low self-esteem but not if they did not seek reassurance or had high self-esteem. Although induction of depressed symptoms in roommates did occur, this contagion effect did not account for the depression-rejection relationship. The prediction that unsupportive, intolerant, or unempathic others would be particularly likely to respond with rejection to reassurance-seeking depressed students with low self-esteem received partial support. Implications for future work on the interpersonal aspects of depression are discussed.     

A Terror Management Perspective on the Role of Death-Related Anxiety in Psychological Dysfunction

Building on previous existential theorizing, terror management theory provides a unique approach to conceptualizing the development, maintenance, and impact of psychological disorders. The theory suggests that awareness of mortality creates the potential for anxiety, which is managed by an anxiety-buffering system consisting of one's cultural worldview, self-esteem, and interpersonal attachments. The pursuit of meaning, personal value, and interpersonal connections that motivates much human behavior is driven, in part, by the need to control this potential for death-related anxiety. This article provides an overview of terror management theory and a discussion of its implications for understanding clinical conditions, along with a review of research exploring the roles of death-related anxiety and the anxiety-buffering system in anxiety disorders, posttraumatic stress disorder, and depression.     

Attachment,Contemporary Interpersonal Theory and IPT: An Integration of Theoretical,Clinical, and Empirical Perspectives

Interpersonal Psychotherapy (IPT) is an effective, pragmatic treatment for depression but interpersonal explanations of its effectiveness are not fully developed. This paper presents an integration of aspects of attachment theory and contemporary interpersonal theory which explains how interpersonal interactions contribute to a clinical understanding of depression and its treatment through IPT. We test hypotheses of interpersonal change in a case series of depressed patients treated with IPT. The results demonstrate that both attachment insecurity and interpersonal problems improve significantly over a 16 week course of treatment. Further research into the interpersonal processes that alleviate depression is needed.     

A Developmental Neuroscience of Borderline Pathology: Emotion Dysregulation and Social Baseline Theory

Theoretical and empirical research has linked poor emotion regulation abilities with dysfunctional frontolimbic circuitry. Consistent with this, research on borderline personality disorder (BPD) finds that frontolimbic dysfunction is a predominant neural substrate underlying the disorder. Emotion regulation is profoundly compromised in BPD. However, BPD is also associated with broad impairment across multiple domains, including impulse control, interpersonal relationships, and cognitive functioning. To date, BPD research has focused largely on single areas of dysfunction, failing to account for overlap at either the biological or behavioral levels of analysis. We examine the literature on frontolimbic dysfunction in BPD within the context of Coan’s social baseline theory. Social baseline theory proposes that healthy human functioning is dependent upon adequate social support and that, at baseline, biological systems are adapted to operate interdependently rather than independently. The social baseline perspective is particularly useful for understanding borderline personality development because the impulsive and emotionally dysregulated behaviors common among those with BPD occur almost invariably within an interpersonal context. We discuss clinical and research implications of this work.     

Theory of mind in nonhuman primates

Since the BBS article in which Premack and Woodruff (1978) asked "Does the chimpanzee have a theory of mind?," it has been repeatedly claimed that there is observational and experimental evidence that apes have mental state concepts, such as "want" and "know." Unlike research on the development of theory of mind in childhood, however, no substantial progress has been made through this work with nonhuman primates. A survey of empirical studies of imitation, self-recognition, social relationships, deception, role-taking, and perspective-taking suggests that in every case where nonhuman primate behavior has been interpreted as a sign of theory of mind, it could instead have occurred by chance or as a product of nonmentalistic processes such as associative learning or inferences based on nonmental categories. Arguments to the effect that, in spite of this, the theory of mind hypothesis should be accepted because it is more parsimonious than alternatives or because it is supported by convergent evidence are not compelling. Such arguments are based on unsupportable assumptions about the role of parsimony in science and either ignore the requirement that convergent evidence proceed from independent assumptions, or fail to show that it supports the theory of mind hypothesis over nonmentalist alternatives. Progress in research on theory of mind requires experimental procedures that can distinguish the theory of mind hypothesis from nonmentalist alternatives. A procedure that may have this potential is proposed. It uses conditional discrimination training and transfer tests to determine whether chimpanzees have the concept "see." Commentators are invited to identify flaws in the procedure and to suggest alternatives.     

Group-based interpersonal psychotherapy for posttraumatic stress disorder: theoretical and clinical aspects

Posttraumatic stress disorder (PTSD) is a condition that engenders both symptomatic distress and severe disruption in interpersonal and social functioning. Most of the empirical research on treatment has emphasized interventions that aim to alleviate the symptoms of PTSD, despite the persisting impairments in social, occupational, and interpersonal functioning. In clinical practice, achieving relief from symptoms such as irritability or phobic avoidance is a worthwhile goal, yet significant distress and disability derived from disruptions to interpersonal attachments, social networks, and confiding intimate relationships persist. Interpersonal psychotherapy (IPT) has been shown to be efficacious in research settings for depression and eating disorders, in both group and individual formats. Recent pilot data also suggests the potential usefulness of IPT in anxiety disorders. The aim of this paper is to provide a rationale for the use of group-based IPT as an intervention for PTSD as part of a management package, arguing from theoretical and clinical viewpoints. The integration of IPT therapeutic processes with the therapeutic group process is discussed, and a detailed case discussion is presented as an illustration.     

Cognitive and Interpersonal Vulnerabilities to Adolescent Depression: Classification of Risk Profiles for a Personalized Prevention Approach

Despite interest in psychosocial vulnerabilities to depression, little is known about reliable and valid individualized risk profiles that can be used to match individuals to evidence-based interventions for depression. This study investigated well-established cognitive and interpersonal vulnerabilities to depression among youth to discern an evidence-based risk classification approach which is being used in a personalized depression prevention randomized clinical trial. Data were drawn from a general community sample of adolescents (N?=?467; ages 10–16, mean 13.14, SD?=?1.62; 57% females) who were followed prospectively for 3 years. Youth completed measures of cognitive (negative cognitive style, dysfunctional attitudes, rumination) and interpersonal (support and conflict with peers and parents, excessive reassurance seeking, social competence, co-rumination) risks to depression, and then were followed longitudinally for onset of depression. Principal axis factor analyses showed that three latent factors--cognitive vulnerability, interpersonal support, and interpersonal conflict--optimally represented the structure of these risk factors. Clinically practical and meaningful cutoffs, based on tertile cut-off scores on cognitive and interpersonal risk measures, were used to categorize youth into relatively balanced high and low cognitive and interpersonal risk groups. These risk classification groups exhibited validity (AUC?>?0.70) by predicting prospective onsets of depressive episodes at 18-months follow-ups. These findings demonstrate a reliable and valid approach to synthesize psychosocial vulnerabilities to depression, specifically cognitive and interpersonal risks. Results are discussed in terms of using these risk classifications profiles to test personalized prevention of depression during adolescence.     

Forschungsprogramm und Wissenschaftsentwicklung

For Imre Lakatos hismethodology of scientific research programmes was not only a philosophical theory of science and scientific change but also the conceptual foundation of empirical and historical studies of science. At least terminologically this view is today widely accepted: The concept of aresearch programme is used in all sorts of literature on science. In the present paper I argue that this concept can lead to serious distortions of empirical and historical studies of science if it is not detached from the Lakatosian philosophical framework. Themethodology of scientific research programmes has three main pitfalls, which may lead to disorientations of empirical and historical studies of science: (1) Contrary to what the term research programme may suggest, it offers no perspective on scientific research as an object of analysissui generis; (2) its concept of science is too narrow and covers only minor parts of what counts as science in the real world; (3) it reduces history of science to a mere sequence of research programmes and thereby eliminates the fact that there is an evolution of the structure of research programmes, too.

---

Der vorliegende Beitrag ist die überarbeitete und erweiterte Fassung eines Vortrages, den der Verfasser im Juli 1988 auf einem vomInstitut für Gesellschaft und Wissenschaft gemeinsam mit demInterdisziplinären Institut für Wissenschaftstheorie und Wissenschaftsgeschichte der Universität Erlangen-Nürnberg veranstalteten Kolloqium gehalten hat.     

An Examination of Sociotropy and Excessive Reassurance Seeking in the Prediction of Depression

The study was an examination of the relationship between sociotropy and excessive reassurance seeking in the prediction of depression. Although there is an obvious theoretical link between these constructs, little empirical work has been directed at integrating these constructs. Because it was theorized that sociotropic persons would be relatively more likely to engage in excessive reassurance seeking relative to autonomous individuals, it was predicted that sociotropy, and not autonomy, would be positively related to excessive reassurance seeking. In addition, it was predicted that excessive reassurance seeking would mediate effects of sociotropy upon depression. Overall, the results from 167 undergraduates completing measures for all variables supported these predictions. The results suggest that beyond the psychological vulnerabilities hypothesized by A. T. Beck (1983), sociotropic persons might engage in interpersonal behaviors that exacerbate their response to life stress.     

QUANTUM PHYSICS, PHILOSOPHY, AND THE IMAGE OF GOD: INSIGHTS FROM WOLFGANG PAULI

Abstract. Nobel Laureate in physics Wolfgang Pauli studied philosophy and the history of ideas intensively, especially in his later years, to form an accurate ontology vis-à-vis quantum theory. Pauli's close contacts with the Swiss psychiatrist C.G. Jung gave him special qualifications for also understanding the basic problems of empirical knowledge. After Pauli's sudden death in 1958, this work was maintained mainly in his posthumously published correspondence, which so far extends only to 1939. Because Pauli's view differs essentially from the direction physics research took after the deaths of the founding fathers of quantum theory, this article attempts to describe the main features in Pauli's revolutionary thought, which is based on nature's "epistemological lesson" as revealed by Pauli's atomic research. Pauli's conclusions have important implications for various issues in Western culture, not least with the limits of science and the relation of science to religion.