8

I've been researching some interpersonal theories recently, and I stumbled across one called the "interpersonal theory of depression".

I've found several articles that deal with the theory (such as A Test of Interpersonal Theory of Depression in Youth Psychiatric Inpatients, which gives a rather... short explanation ("...the combination of depressive symptoms and excessive reassurance-seeking leads to interpersonal problems..."), but this doesn't go into depth at all), but I'm having trouble understanding what exactly this theory is.

What constitutes "excessive reassurance-seeking" and "depressive symptoms"?

Or, more generally: What is this theory? What exactly does it theorize? How is it applicable to life in modern society?

12

What is this theory? What exactly does it theorize?

A theory, posing that depression and excessive reassurance seeking leads to interpersonal problems. It is nothing more than a framework used to study the interpersonal aspects of depression: How a depression influences the interpersonal interactions between a depressed person and the people they interact with.

I found a few articles that give a little more detail on the theory, amongst them one by Jeremy Gordon Stewart from 2013 1 :

Coyne’s (1976) interpersonal theory of depression proposes that individuals suffering from depressive symptoms tend to engage in excessive reassurance-seeking (ERS), defined as repetitively asking for assurances from close others about one’s lovability and worth.

Research has shown that ERS is associated with negative evaluations from close others and lower partnerreported romantic relationship satisfaction, specifically (Starr & Davila, 2008). In a recent elaboration of Coyne’s theory, Evraire and Dozois (2011) proposed that ERS might only lead to rejection among individuals who possess core beliefs about the instability and unpredictability of relationships.

It's quite scientifically written, but it proposes that depression leads some people to ask their close others repeatedly to validate their lovability and worth. These close others may eventually grow tired of doing so, and thus the interpersonal relationship with these close others or a partner will deteriorate.

From a second article 2 :

Coyne’s (1976a, 1976b) interactional theory of depression has emerged as one of the most influential frameworks for studying interpersonal aspects of depression. In this model, mildly depressed people attempt to assuage feelings of guilt and low selfworth by seeking reassurance from others. At first, others provide support, but the depressed person doubts its authenticity and continues to seek reassurance until the other person grows annoyed and rejects them. The rejection exacerbates their symptoms as the cycle continues.

They give a pretty good definition of what the excessive reassurance seeking is: asking for reassurance until the other party grows annoyed and rejects them.

As for what 'depressive symptoms' are, they are the symptoms that might indicate a depression, such as this list from the nhs:

The psychological symptoms of depression include:

  • continuous low mood or sadness
  • feeling hopeless and helpless
  • having low self-esteem
  • feeling tearful
  • feeling guilt-ridden
  • feeling irritable and intolerant of others
  • having no motivation or interest in things
  • finding it difficult to make decisions
  • not getting any enjoyment out of life
  • feeling anxious or worried
  • having suicidal thoughts or thoughts of harming yourself

Someone that's depressed and presenting symptoms of ERS is trying to remedy these feelings of low-self esteem, guilt, anxiety, worries with reassurance from others.

How is it applicable to life in modern society?

The interpersonal theory of depression is meant to give a framework to study the interpersonal aspects of depression, mostly focused on the part of depressed people seeking reassurance from their peers. So, the most direct application to life would be when you're studying depression and it's influence on interpersonal interactions.

As stated in this article: 2

Interpersonal models have guided understanding of the etiology, course, consequences, and treatment of depression.

Etiology is a medical term that means the cause, set of causes, or manner of causation of a disease or condition.

So, asides from just using the interpersonal theory of depression to better understand depression, it may also lead to an understanding of where this depression comes from, and lead to ways to prevent and treat depression (either by treating the consequences or 'curing' it).

1: Stewart, J. Testing an Integrated Interpersonal Theory of Depression: The Role of Dysphoria, Negative Relationship Cognitions and Excessive Reassurance-Seeking in Predicting Rejection, June 2013
2: Starr, L. and Davila J. Excessive Reassurance Seeking, Depression, and Interpersonal Rejection: A Meta-Analytic Review, 2008

  • 1
    Just to clarify, not everyone with depression engages in excessive reassurance seeking (and possibly there are people who do engage in excessive reassurance seeking but aren't depressed). – 1006a May 17 '18 at 17:43
  • 2
    @1006a All true :) The theory seems to focus on those people that do though :) – Tinkeringbell May 17 '18 at 18:47
6

Depression often leads to a lack of self-confidence. Though there is a human tendency to seek attention, prove our worthiness and get accepted by society, a lack of self-confidence leads people to ask if they're worthy and can be accepted. Those who are depressed often ask for worthiness and acceptance from their social relationships in order to alleviate their feelings of unworthiness and guilt, which may lead to excessively asking and more depression if they're rejected. This is what constitutes Excessive Reassurance Seeking.

From this paper,

To review, those who excessively seek reassurance unintentionally generate interpersonal negative life events and experience rejection by social supports who become frustrated from being asked to provide reassurance excessively (Coyne , 1976a, 1976b). A search for self - worth mediates the relationship between interpersonal stress and subsequent ERS behavior, which suggests that people may seek reassurance more often when they are unsure of how others feel about them (Joiner, Katz, & Lew, 1999).

What constitutes depressive symptoms?

Signs that may indicate depression are Depressive Symptoms. Here is a list of some of them (taken from here),

Sad, empty, or anxious. It will continue over time without getting better or going away.

Helpless, worthless, or guilty. You may feel bad about yourself or your life, or think a lot about losses or failures.

Hopeless. You may be pessimistic or believe that nothing good will ever happen. You may even think about suicide.

Irritable. You may get restless or more cranky than usual.

Less interest in activities. Hobbies or games you usually enjoy may not appeal to you. You may have little or no desire to eat or have sex.

Less energetic. You may feel extremely tired or think more slowly. Daily routines and tasks may seem too hard to manage.

Trouble concentrating. It could be tough to focus. Simple things like reading a newspaper or watching TV may be hard. You may have trouble remembering details. It might seem overwhelming to make a decision, whether it's big or small.

Changes in the way you sleep. You may wake up too early or have trouble falling asleep. The opposite can also happen. You may sleep much longer than usual.

Changes in appetite. You may overeat or not feel hungry. Depression often leads to weight gain or weight loss.

Aches and pains. You may have headaches, cramps, an upset stomach, or digestive problems.

What is this theory? What exactly does it theorize?

This theory is about the interpersonal aspect of depression. In other words, it is about how one in depression interacts with others.

As explained above, it theorizes that how depression could lead to asking for reassurance in order to feel worthy which may further lead to more depression and affect the relationship between a person in depression and others.

How is it applicable to life in modern society?

We make social relationships to support us in distress. This theory focuses on the part how depression can affect one's social relationships, which can lead them to exhaust all their peers in need which further leads to rejection from them which can make a person end up in depression.

This theory identifies the pathways which lead to depression and affect social relationships and interaction with them, which can help in preventing and treating depression.

5

Depression is a major subject and also a somewhat broad term. It is estimated that 1 in 6 individuals in modern western civilizations suffer from it over their lifetime in such a way that it (severely) affects their functioning. It includes major depressive disorder (single episode or recurrent), dysthymia (chronic depressive mood which may include depressive episodes or 'double depression'), disruptive depressive disorder (children), seasonal affective disorder, postpartum depression and many others. Wikipedia allocates a whole category to it. Proper diagnosis can only be done by a psychiatrist or a mental health care professional and involves a certain amount of differential diagnosis.

Other answers give those for major depressive disorder, I'll summarize the criteria for dysthymia (from DSM-V):

  1. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.
  2. Presence, while depressed, of two (or more) of the following:
    • Poor appetite or overeating.
    • Insomnia or hypersomnia.
    • Low energy or fatigue.
    • Low self-esteem.
    • Poor concentration or difficulty making decisions.
    • Feelings of hopelessness.
  3. During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months at a time.
  4. Criteria for a major depressive disorder may be continuously present for 2 years.
  5. There has never been a manic episode or a hypomanic episode, and criteria have never been met for cyclothymic disorder. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hypothyroidism).
  6. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Excessive reassurance seeking

Those with depressive symptoms, especially the intrapersonal mental ones (low self esteem, feeling of hopelessness), seek reassurance of worthiness and acceptance by others to alleviate feelings of worthlessness and guilt and do so more than others without such symptoms. When done excessively this may lead to negative responses from close ones.

The theory

Coyne's original theory (1976) proposes that the behavior of the depressed individual to seek reassurance depletes their social support networks by seeking too much support (i.e., social support erosion). Ultimately they are rejected by former social support members who become frustrated by being asked to provide reassurance excessively. Both the rejection and the erosion of the social support fuel the feelings of unworthiness and hopelessness, worsening the depression.

Another suggested pathway is through interpersonal stress (1995), where the depressed individual unintentionally generates negative life events (or perceived negative life events) through interpersonal interactions. Negative life events risk strengthening the depression.

Both pathways are typical of the vicious negative spiral of depression except that for these pathways is the interpersonal interaction that is fueling the depression and not just intrapersonal negative thought cycles. Both pathways suggest a causal relationship (first you are depressed, then you seek reassurance, then you get a negative response, which makes you more depressed for which you seek even more reassurance and so on) but there is large grey area before clinical depression. For instance, one may start out being uncertain about a certain task, seek reassurance, not receive it, causing more uncertainty and so on.

This article discusses the two pathways and attempts to correlate the four (ERS, social support group, interpersonal stress, depression) through standardized tests and finds that the coupling between ERS and depression is correlated through interpersonal stress as the main pathway. It also attempts to find a correlation with a physiological process (parasympathetic nervous system activity) but more or less fails to find evidence.

How does it impact life in modern society?

1 in 6 individuals suffer from one form or the other over their lifetime. I am such a person, suffering from mild dysthymia and having suffered two mild depressive episodes. Things are improving for me, my dysthymia was at least partially fueled by suppressed gender dysphoria. It is a virtual certainty you will meet several people suffering from depressive symptoms during your life in your social network.

Be kind, be reassuring when asked for, be patient, don't reject and do not abandon, but do not assume the position of a mental health care professional. Do suggest - with all possible precautions as they may not accept that they need help - that they might want to seek professional help.

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service, privacy policy and cookie policy

Not the answer you're looking for? Browse other questions tagged or ask your own question.