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.     

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.     

Physiological hyperarousal: construct validity of a central aspect of the tripartite model of depression and anxiety.

Physiological hyperarousal (PH) is an understudied component of the tripartite model of depression and anxiety. This study contributes to the literature on PH, the tripartite model, and anxiety and its disorders, using data from psychotherapy outpatients (n = 2,448), air force cadets (n = 1,335), and undergraduates (n = 284). Psychometrics and exploratory and confirmatory factor analyses showed that PH is a reliable, cohesive, discriminable, and valid construct. Compared with subjective anxiety, PH was more associated to panic versus mood disordered status, and to panic versus generalized anxiety disordered status. As hypothesized, an aspect of anxiety sensitivity (i.e., fear of body sensations) was particularly related to subjective anxiety in the presence of PH. Results support the PH construct as replicable, valid, and clinically important and support the utility of the tripartite and related models for understanding the relation of depressive and anxious syndromes.     

Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: a model of bulimic symptom development

An interactive model of perfectionism, perceived weight status, and self-esteem was tested on 342 female undergraduates to predict bulimic symptoms. Using a longitudinal design, the authors tested the model on data collected at 2 points: the spring of participants' senior year of high school and during participants' first year of college. The authors hypothesized and found that self-esteem moderates the interaction between perfectionism and perceived weight status in predicting bulimic symptoms. Women who are high in perfectionism and who consider themselves overweight exhibit bulimic symptoms only if they have low self-esteem (i.e., if they doubt they can attain their high body standards). High self-esteem women with the same diathesis-stress conditions are less likely to exhibit bulimic symptoms. These findings clarify the role of perfectionism in bulimic symptomatology.     

Warning signs for suicide: theory, research, and clinical applications

The current article addresses the issue of warning signs for suicide, attempting to differentiate the construct from risk factors. In accordance with the characteristic features discussed, a consensus set of warning signs identified by the American Association of Suicidology working group are presented, along with a discussion of relevant clinical and research applications.     

Physical Disability and Suicidal Ideation: A Community‐Based Study of Risk/Protective Factors for Suicidal Thoughts

Although the significance of poor physical health for suicide risk is well established, the potential relevance of physical disability, as distinct from diseases and traumas that give rise to disability, has received little attention. Prior evidence suggests the possible utility of the stress process theoretical model for understanding variations in risk for suicide ideation and the contribution of physical disability to such risk. In this article, we examine the independent and joint explanatory significance of physical disability and components of the stress process model for risk of suicide ideation. Data from an ethnically diverse and representative sample of disabled and nondisabled adults (n = 1,768) reveal that physical disability is associated with a greater risk of lifetime suicidal ideation.     

A Standard of Care for the Assessment of Suicide Risk and Associated Treatment: The Florida State University Psychology Clinic as an Example

The Florida State University has established a set of guidelines to be used as a standard of care for suicide. This standard of care guides therapists through a suicide risk assessment that focuses on key variables related to suicidal behavior that are among the best predictors of completed suicide. This standard of care includes necessary components of suicide risk assessment, critical steps to follow to ensure the safety of suicidal patients, treatment recommendations, and guidelines for minimizing the legal risk of the therapist. Though this standard of care was developed in a research and training clinic, these principles may be applied to all clinicians offering psychological services to patients, regardless of the nature of the clinic or setting.