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.     

Interpersonal Neurobiology and Couple Relationship Quality: A Longitudinal Model

Interpersonal neurobiology is an interdisciplinary theory that is being used by couple and family therapists. However, more investigation is needed to determine if this theory can accurately explain family relationships over time. In this study, we used the nationally representative National Longitudinal Study of Adolescent to Adult Health (Add Health) dataset to examine key elements of interpersonal neurobiology theory. Using structural equation modeling, we explored how maternal and paternal support and self-acceptance during adolescence are related to emotional stability and adult couple relationship satisfaction 13 years later (N = 7864). Results indicate that self-acceptance and emotional stability are factors that contribute to couple relationship satisfaction. We conclude with clinical implications of this study, including how to use mindfulness practices to promote healthy relationships.     

Explaining Gender Differences in Depression: an Interpersonal Contingent Self-Esteem Perspective

The quality of interpersonal relationships may be a key factor in the etiology of depression. An interpersonal depressive vulnerability has been proposed to interact with interpersonal stressors to predict depressive symptoms. Research examining gender differences in this link has been inconclusive. We propose that research should focus on whether one’s self-esteem is based on the quality of interpersonal relationships. We propose a model of gender differences in depression that examines the role of interpersonal contingent self-esteem (ICSE) in the development of depression. Specifically, we propose that ICSE interacts with gender in the face of interpersonal stress to promote decreases in momentary self-esteem. Decreases in momentary self-esteem, in turn, lead to rumination, maladaptive interpersonal behaviors, and depressive symptoms.     

Stress Generation and Adolescent Depression: Contribution of Interpersonal Stress Responses

This research examined the proposal that ineffective responses to common interpersonal problems disrupt youths’ relationships, which, in turn, contributes to depression during adolescence. Youth (86 girls, 81 boys; M age = 12.41, SD = 1.19) and their primary female caregivers participated in a three-wave longitudinal study. Youth completed a measure assessing interpersonal stress responses; youth and caregivers completed semi-structured interviews assessing youths’ life stress and psychopathology. Consistent with the hypothesized model, ineffective stress responses (low levels of effortful engagement, high levels of involuntary engagement and disengagement) predicted the generation of subsequent interpersonal stress, which partially accounted for the association between stress responses and depression over time. Moreover, results revealed that self-generated interpersonal, but not noninterpersonal stress, predicted depression, and that this explanatory model was specific to the prediction of depression but not anxiety. This research builds on interpersonal stress generation models of depression, and highlights the importance of implementing depression-focused intervention programs that promote effective stress responses and adaptive interpersonal relationships during adolescence.     

Interpersonal psychological well-being among coach-athlete-sport psychology practitioner triads

The importance of psychological well-being (PWB) is widely acknowledged in global policy and has important ramifications for health, performance, and engagement among sport performers. Despite this compelling knowledge, little is known about PWB in close sport relationships. We aimed to explore the interpersonal antecedents, transfer mechanisms, and outcomes of PWB within and among athletes, coaches, and sport psychology practitioners (SPPs). Underpinned by an interpretative paradigm, we conducted individual and triadic interviews with three coach-athlete-SPP triads from individual sports and analyzed data using abductive reasoning applied to reflexive thematic analysis. The themes we constructed relating to antecedents of PWB were situational properties of stressors, factors relating to the organization, shared values and characteristics, and interpersonal resilience. PWB was transferred among the triad via interpersonal coping, emotional contagion, and social appraising. PWB was cyclic in nature and, thus, we constructed themes (i.e., psychological safety, meaningful experiences of growth and development, and relational dynamics), which represented those factors that acted as both antecedents and outcomes. Our findings transcend individual understandings of PWB in sport by representing the first interpersonal examination of PWB among coach-athlete-SPP triads. This shift is crucial for informing how performers can collectively evaluate and manage PWB in the context of their close sport relationships. These findings implicate two primary recommendations: first, we recommend that researchers extend conceptual understanding of PWB among those in close sport relationships. Second, organizations and practitioners are encouraged to consider how mentoring and relationship-building schemes can be tailored within wider education and support programs to bolster PWB among athletes, coaches, and practitioners.     

Interpersonal loss in the context of family caregiving: Implications of communal relationships theory

Abstract

Much is known about the emotional costs of providing care to an ill or disabled family member. However, surprisingly little attention has been devoted to investigating how caregiver distress is related to interpersonal loss (i.e., reactions to changes in the typical day-to-day support behaviors that formerly characterized the caregiver–care recipient relationship). Drawing on the theory of communal relationships (e.g., Clark & Mills, 1979, 1993), this study proposes that the magnitude of interpersonal loss that caregivers experience, as well as its contributions to depressed affect, both directly and indirectly (through impact of interpersonal loss on perceived caregiving burden) are likely to depend on the type of relationship that existed between caregiver and care recipient prior to the onset of illness or disability. In this context, several hypotheses and directions for further research are proposed. It is hoped that future researchers will incorporate loss measures into their research and consider how aspects of preexisting relationships influence associations among interpersonal loss and variables (e.g., burden, social support) known to predict caregiver well-being.     

Multisurface Interpersonal Assessment in a Cognitive-Behavioral Therapy Context

The interpersonal paradigm of personality assessment provides a rich nomological net for describing and assessing constructs of interpersonal functioning. The aim of this article is to demonstrate for clinicians how the use of a multisurface interpersonal assessment (MSIA) battery can augment psychotherapy (e.g., cognitive-behavioral therapy). We present 2 clinical case examples and specify interpretative guidelines for MSIA that integrate multiple circumplex profiles (e.g., problems, traits, sensitivities, strengths, values, and efficacies) for each patient. Subsequently, we demonstrate how this approach provides a context to better understand patient symptoms and difficulties, and discuss how it can inform case conceptualization, treatment planning, and intervention.     

The Associations Between Intensive Residential Couple Therapy and Change in a Three-Year Follow-Up Period

This Norwegian couple therapy effectiveness therapy study explored the course and prediction of relationships between depressive symptoms, interpersonal problems, and dyadic adjustment during residential treatment and over a 3-year post-treatment period (N = 117). All measures indicated significant improvement (p < .001) between admission and discharge (effect sizes .25 to .67), and improvement was maintained at 3-year follow-up. The proportion of recovered patients during treatment was stable at follow-up. Finding that initial levels of the Inventory of Interpersonal Problems (IIP) predicted dyadic adjustment change in the follow-up period, we discuss how such interpersonal problems may influence the course of couple therapy.     

Informative Disagreements: Associations Between Relationship Distress,Depression, and Discrepancy in Interpersonal Perception Within Couples

This study evaluated the associations between relationship distress, depression symptoms, and discrepancy in interpersonal perception within couples. After completing a series of discussion tasks, couples (N = 88) rated their behavior using the circumplex‐based Structural Analysis of Social Behavior Model (SASB; Benjamin, 1979, 1987, 2000). Overall, couple members were strikingly similar in their interpersonal perceptions, and tended to see themselves as friendly, reciprocal in their focus, and balanced between connection and separateness. As hypothesized, however, perceptual discrepancy was related to relationship distress and depression. Relationship distress was associated with discrepancy regarding transitive behavior focused on the partner, while depression was associated with disagreement about intransitive, self‐focused behavior. Analysis of affiliation and autonomy revealed that relationship distress was associated with seeing oneself as reacting with more hostility than the partner sees, and perceiving one's partner as more hostile, more controlling, and less submissive than he or she does. Partners of depressed individuals viewed themselves as more controlling than their mate did. Men's depression was associated with disagreement between partners regarding men's self‐focused behavior. Results underscore the importance of considering interpersonal perception when conceptualizing relationship distress and depression within intimate relationships.     

The Findings of a Cochrane Meta-Analysis of Couple Therapy in Adult Depression: Implications for Research and Clinical Practice

The association between depressive symptoms and distressed intimate relationships supported the assumption that couple therapy, by focusing on the interpersonal context of depression, might be more effective as a treatment for depression than individual psychotherapy or drug therapy. This issue was addressed by a Cochrane meta-analysis assessing the evidence from clinical trials of couple therapy for depression in comparison with individual psychotherapy, drug therapy, and no/minimal intervention, including fourteen studies with 651 participants. No study was found free of bias and the quality of the evidence was low, with major problems of small sample sizes, missing outcome data, selective reporting, lack of information on random sequence generation and allocation concealment, recruitment of people not representative of clinical practice, and allegiance bias. The meta-analysis showed that both couple therapy and individual psychotherapy improved depressive symptoms at end of treatment and after 6 months or longer, with moderate effect sizes, without any difference between the two treatments. Couple therapy was more effective in reducing couple distress. This effect was larger in studies with distressed couples only and should be considered as relevant in its own right. Couple therapy is a viable option for the treatment of a depressed partner, especially in discordant couples. Future research should address several issues left open to provide a sound empirical foundation for clinical practice.     

Couple Therapy in the Presence of Mental Disorders

Abstract

Mental disorders and relationship discord commonly occur together and couples where one or both parties suffer from a mental disorder are commonly seen in couple therapy. Symptoms of mental disorders can usefully be conceptualized cybernetically and viewed as part of negative feedback loops that couples become trapped in without denying the potential contribution of biological or other types of knowledge. Most of the existing research focuses on couples and depression and couple therapy has been found to have efficaciousness as a treatment of depression especially when depression occurs along with relationship discord. There is less research on couple therapy and other mental disorders but general guidelines are offered that couple therapists can use with any of the mental disorders.     

Video Game Therapy: Application of the Couple and Family Technology Framework

The couple and family technology framework outlines how technology affects couple and family relationships. This framework has been applied to understanding the impact of technology on infidelity, contributed to our understanding of online gaming issues in couple relationships, and sexting. The purpose of this paper is to outline how to implement video gaming as a disciplinary tool for youth congruent with the couple and family technology framework. Specifically, we identify the elements of video games that can be applied as an intervention in family treatment with youth in a token economy. This proposed technique focuses on utilizing technology (and specifically video games) as a strategy to improve youth’s behavior. Consistent with the couple and family technology framework, this paper outlines how accessibility, affordability, accommodation, and approximation can be used to improve behavior as well as improve parent–child relationships. Implications are included.     

The Impact of Early Interpersonal Experience on Adult Romantic Relationship Functioning: Recent Findings from the Minnesota Longitudinal Study of Risk and Adaptation

Adopting an organizational view on social development, we have investigated how interpersonal experiences early in life prospectively predict how well individuals resolve relationship conflicts, recover from conflicts, and have stable, satisfying relationships with their romantic partners in early adulthood. We have also identified specific intervening interpersonal experiences during middle childhood and adolescence that mediate the connection between how individuals regulated their emotions with their parents very early in life and as young adults in their romantic relationships. We discuss the many advantages of adopting an organizational view on social development.     

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.     

Dialectical Behavior Therapy for Managing Interpersonal Relationships

Dialectical Behavior Therapy (DBT) is a treatment designed for individuals having borderline personality disorder (BPD), patients having binge eating disorder, co-morbid substance dependence and BPD, and depressed older adults. This paper aims to explore the use of DBT and to ascertain the status of DBT education in treating difficulties in handling interpersonal relationships among clients seeking counseling and psychotherapy. The skills training mode can be employed for teaching skills to solve relationship problems. Validation and acceptance strategies can lessen rejection sensitivity and negative feelings that make interpersonal situations chaotic. Black and white thinking can be resolved by finding a middle path through acceptance and change. This paper suggests the possible utility of DBT for enhancing psychological well-being in clients.     

Interpersonal constructs and friendship form and structure

Abstract

Two studies examined the relationships between indices of interpersonal construct development and friendship form and structure. In the first study respondents listed activities that they shared with two friends and wrote free-response accounts about why they shared these particular activities with their friends. The accounts were content analyzed. Subsequent analyses showed that both interpersonal construct differentiation and abstractness were positively related to the number of interpersonal attributions made about friendships.

The second study examined the relationship between construct differentiation and structural characteristics of a person's friendship network. Initial correlation analyses showed that construct differentiation was associated with somewhat more segmented friendship networks. Further analyses showed that this effect was limited to ties between friends beyond the inner core.

Together the studies suggest that interpersonal construct development is associated with qualitative differences in how persons define their personal relationships, and with quantitative characteristics of their friendship networks.     

Metacognitive Interpersonal Therapy for Treating Auditory Verbal Hallucinations in First-onset Schizophrenia

Auditory verbal hallucinations (AVHs) are perceptive-like experiences happening without appropriate stimuli, occurring in two thirds of schizophrenia patients, where they often cause emotional suffering and dangerous behaviors, and interfere with social relationships. Patients with schizophrenia involving AVHs can also be drug-resistant or they may discontinue medications. The most well-known psychotherapeutic intervention for voice-hearing is cognitive behavioral therapy (CBT), which focuses on reducing distress by modifying hearers’ beliefs about their voices. We hypothesize that it is possible to reinforce the clinical approach to AVHs by taking into consideration (a) that patients generally hear voices in particular interpersonal contexts where they experience negative emotions; (b) the relationship between AVHs and metacognition, namely the ability to make sense of mental states. On this basis, AVHs can be seen not just as a cause of emotional distress as CBT postulates, but the outcome of difficulties in meta-cognitively making sense of interpersonal exchanges. In this paper, we describe the treatment of a young man at the onset of schizophrenia with pervasive negative AVHs. The patient was treated with metacognitive interpersonal therapy (MIT), aimed to promote the patient’s metacognition. With this aim, in the first part of the treatment, each time AVHs emerged, the patient’s level of arousal was high and his metacognitive ability very low, the therapist treated AVHs helping the patient to understand and cope with the emotional suffering connected with AVHs. At a more advanced stage of therapy, the therapist helped the patient reach the point of understanding the social triggers which, together with the patient’s self-schemas, ignited his auditory hallucinations; this created the conditions for a significant reduction of the pervasiveness of AVHs.     

Exploring Personality with the Interpersonal Circumplex

The interpersonal circumplex can serve as both companion and guide for those interested in exploring the interpersonal domain of personality. This article offers a relatively nontechnical overview of the model and its various applications in the study of personality. I begin by defining the interpersonal circumplex, its structure and in what sense it is 'interpersonal'. As part of that, I will briefly consider how circumplex measures of personality, such as the Interpersonal Adjective Scales, are typically evaluated for fit to the model. I will next describe applications of the model for exploring both the idiographic (person-centered) and nomothetic (variable-centered) realms of personality. In person-centered research, the circumplex leads to useful ways of summarizing the basic interpersonal features of a given individual. In variable-centered research, the circumplex can help elucidate the essential interpersonal meaning of personality constructs such as traits, problems, and motives. To explain how the circumplex can help us explore personality – idiographically and nomothetically – I will draw on a variety of studies, including several recent studies that extend the model in new ways.     

Interpersonal patterns in close relationships: The role of sociotropy–autonomy

Sociotropy and autonomy are conceptualized as two personality dimensions that relate to an individual's vulnerability to depression. Sociotropy is characterized as an excessive investment in interpersonal relationships and autonomy is characterized as an excessive concern with personal achievement and control over the environment. The present research project consisted of two studies examining the relationships between sociotropy–autonomy and interpersonal patterns in close relationships. Data collected via self‐report and behavioural observations suggested that highly sociotropic individuals have a tendency to be high in control and low in affiliation towards individuals who are close to them. In contrast, the data suggested that highly autonomous individuals may be low in both control and affiliation towards people who are close to them. These findings are discussed in the context of the literature regarding the interpersonal characteristics of sociotropic and autonomous individuals.     

Interpersonal predictors of onset of depression during the transition to adulthood

There is evidence that depression during adolescence and early adulthood is marked by deficits in interpersonal functioning. However, few studies have prospectively examined whether interpersonal difficulties are a risk factor for depression onset, so it is unclear whether these deficits in interpersonal functioning are products or predictors of depression. The present study aimed to clarify the direction of association between interpersonal factors and depression by examining whether social factors longitudinally predicted onset of depression in a diverse sample of young women with no history of depression. Hierarchical multiple regression analyses controlling for baseline depressive symptoms indicated that poorer family relationship quality and anxious attachment cognitions predicted onset of depressive episodes during the 2‐year period. Further, a wide variety of interpersonal factors predicted depressive symptoms over 6 months, including poor peer and family relationship quality, difficulty being close to others, and difficulty depending on others, controlling for baseline depressive symptoms and college attendance. The results provide evidence for the importance of an interpersonal perspective on vulnerability to depression.