The influence of attachment style on support and feedback seeking and depression severity among mothers during the COVID-19 pandemic

OBJECTIVES

The ways that people seek support during times of stress influence their mental health outcomes, including depression. Insecure attachment is a risk factor for depression and may also interfere with adaptive support and feedback-seeking behaviour during stress. The purpose of the present study was to test theorized associations between insecure attachment, support and feedback seeking, and changes in depression symptoms over 1 year, in a sample of mothers of school-age children in the context of stress elicited by the COVID-19 pandemic.

METHODS

Participants (N = 70 mothers) completed self-report measures of anxious and avoidant attachment and depression severity at baseline in spring 2020 and then completed measures of past-year engagement in direct and indirect support seeking and excessive reassurance seeking (ERS), preference for negative feedback, and depression severity at a follow-up assessment in summer 2021.

RESULTS

Greater attachment anxiety at baseline predicted more frequent direct support seeking, indirect support seeking, and ERS during the 1-year follow-up period. In turn, greater indirect support seeking predicted greater increases in depression from baseline to follow-up. Greater attachment avoidance at baseline predicted less direct support seeking during the 1-year follow-up period. Greater attachment avoidance at baseline also predicted depression severity at follow-up, particularly among mothers with moderate to high levels of attachment anxiety, although none of the examined support and feedback-seeking behaviours mediated this association.

CONCLUSIONS

These results provide support for the role of activated attachment systems in determining support and feedback-seeking behaviour during stress, as well as the role of support and feedback-seeking behaviour in the maintenance and exacerbation of depression.

Negative feedback-seeking in depression: The moderating roles of rumination and interpersonal life stress

OBJECTIVES

Swann's self-verification theory proposes that negative feedback seeking (NFS)-the solicitation of negative feedback from others that confirms one's self-views-works in a negative cycle to maintain and exacerbate depression in the face of interpersonal stress. We propose a cognitive-interpersonal integration account of NFS such that this maladaptive behavior prospectively predicts depression only among those with a trait tendency to ruminate on the causes and consequences of depressed mood and stress.

METHOD

Participants included 91 young adults who were over-sampled for a lifetime history of a unipolar depressive disorder (age 17-33; 69% women; 67% lifetime depressive disorder). At baseline, participants completed a structured diagnostic interview and self-report measures of NFS, rumination, and depression symptoms. In addition, participants engaged in an interpersonal rejection task (the Yale Interpersonal Stressor) followed by a behavioral measure of NFS. At a 3-month follow-up, depression symptoms were again assessed by self-report and exposure to stressful interpersonal life events in the intervening period were assessed with a rigorous contextual interview and independent rating system.

RESULTS

Controlling for baseline depression severity, greater self-reported, and behaviorally assessed NFS predicted greater follow-up depression severity, but only among those with higher trait tendency to ruminate. For self-reported NFS, this association was further moderated by level of interpersonal, but not noninterpersonal, life events experienced over follow-up.

CONCLUSION

These findings suggest that rumination may represent a modifiable intervention target that could break the vicious interpersonal cycle of depression and, thus, mitigate the depressogenic effects of NFS.

Linking Mild Childhood Adversity with Conflict and False Feedback Monitoring

It was proposed that dimensions of childhood adversity (i.e., deprivation and threat) have distinct effects on neural development and function. Present study examined the relationships between mild deprivation/threat and performance monitoring among undergraduate students without psychiatric diagnoses. By using event-related potentials (ERPs), 78 participants underwent a modified Flanker task in which false feedback on approximately 10% of the correct response trials was administered. The dynamic stages of performance monitoring in this task were differentiated into interference monitoring, feedback processing, and behavior adjustment. Childhood adversity was assessed by a Childhood Trauma Questionnaire (CTQ), which was further divided into subscales of neglect (as a proxy for deprivation dimension) and abuse (as a proxy for threat dimension). Our results showed that higher score of childhood neglect was associated with more interference cost indicated by longer RT to interference trials at the behavioral level, and altered interference monitoring indicated by smaller N2 amplitude to interference trials at the neural level. Meanwhile, higher score of childhood abuse was related to smaller P3 amplitude to unexpected negative feedback. These results suggested that mild childhood deprivation might be associated with altered processing of interference monitoring, while mild childhood threat might be linked to lower electrophysiological response to unexpected negative feedback among young adults without psychiatric disorders.

Life challenges and resilience: the role of perceived personality continuity

OBJECTIVES

Self-functioning, one aspect of mental health, is positive in later life. Although experiencing challenges may disrupt mental health, internal resources can foster resilience. This study examines how the frequency of recent challenges relates to current self-functioning. Perceived personality continuity, one's sense of maintaining their trait personality, is investigated as an internal resource.

METHOD

Participants (N = 99 young adults, 88 older adults) reported all challenging events experienced in the last six years. Perceived personality continuity over the same time was assessed. Multi-measurement of current self-functioning included self-concept clarity, self-esteem, and self-acceptance.

RESULTS

Older adults reported higher self-concept clarity and self-esteem; young adults reported higher self-acceptance. Experiencing more challenges related to lower self-concept clarity and self-esteem across age groups, with a stronger negative link to self-esteem for young adults. Perceived personality continuity partially mediated relations between: (i) challenges and self-concept clarity, and (ii) challenges and self-esteem. Perceived personality continuity mediated positive self-functioning for older adults only.

CONCLUSION

A late life strength, older adults report higher self-functioning overall. Challenges negatively relate to self-functioning across age groups, but younger adults' self-esteem is more vulnerable. When having faced challenges, older adults' perceived personality continuity is critical to positive current self-functioning.

Self-beneficial belief updating as a coping mechanism for stress-induced negative affect

Being confronted with social-evaluative stress elicits a physiological and a psychological stress response. This calls for regulatory processes to manage negative affect and maintain self-related optimistic beliefs. The aim of the current study was to investigate the affect-regulating potential of self-related updating of ability beliefs after exposure to social-evaluative stress, in comparison to non-social physical stress or no stress. We assessed self-related belief updating using trial-by-trial performance feedback and described the updating behavior in a mechanistic way using computational modeling. We found that social-evaluative stress was accompanied by an increase in cortisol and negative affect which was related to a positive shift in self-related belief updating. This self-beneficial belief updating, which was absent after physical stress or control, was associated with a better recovery from stress-induced negative affect. This indicates that enhanced integration of positive self-related feedback can act as a coping strategy to deal with social-evaluative stress.

Intrapersonal Emotion Regulation Difficulties and Maladaptive Interpersonal Behavior in Adolescence

Although most research conceptualizes emotion regulation as an internal process (i.e., intrapersonal), emotions are frequently regulated in an interpersonal context. Adolescents may be particularly prone to turn to peers for assistance, given that honing emotion regulation abilities is a key task and peers become increasingly important at this stage. Adolescents each participated with a self-nominated same-gender friend (total N = 186; M age = 15.68 years). All participants provided self-reports of their own emotion regulation difficulties and their engagement in interpersonal behaviors (excessive reassurance seeking, negative feedback seeking, conversational self-focus, self-disclosure) as well as their perceptions of their friends' engagement in excessive reassurance seeking and conversational self-focus. Using a cross-lagged panel model design, the current study tested associations between adolescents' intrapersonal emotion regulation difficulties and engagement in self- and friend-reported interpersonal emotion regulation behaviors at 3 time points over 6 months. Gender and age group differences were considered. Results evidenced concurrent and longitudinal associations between emotion regulation difficulties and self-reported maladaptive (excessive reassurance seeking, conversational self-focus, negative feedback seeking), but not adaptive (self-disclosure), interpersonal regulatory behaviors. Friends' reports of adolescents' excessive reassurance seeking and conversational self-focus were associated concurrently, but not longitudinally, with self-reported emotion regulation difficulties. Implications for clinical intervention with adolescents struggling to regulate emotions are discussed.

NEGATIVE FEEDBACK SEEKING AND EXCESSIVE REASSURANCE SEEKING BEHAVIOR AND DEPRESSION: A META-ANALYTIC REVIEW

Introduction: Negative feedback seeking and excessive reassurance seeking behaviors in interpersonal relationships have been shown to frequently occur in conjunction with levels of depression.

Method: We used meta-analysis to examine 102 studies (134 effects), relating depression with negative feedback seeking (k = 31) and/or excessive reassurance seeking (k = 103).

Results: Depression had positive, moderate effect sizes with both negative feedback seeking (r = .26, 95% CI [.21, .32], p < .001, k = 31) and excessive reassurance seeking (r = .33, 95% CI [.31, .36] p < .001, k = 103). Subgroup analysis revealed the effect size for negative feedback seeking was smaller in romantic relationships compared to other relationship types. Effect sizes for excessive reassurance seeking did not differ for romantic and other relationships but were smaller in romantic relationships of a longer duration. Participant gender and symptom severity did not moderate effect sizes. Studies with child and adolescent samples had larger effects for negative feedback seeking and smaller effects for excessive reassurance seeking, relative to adult samples.

Discussion: Longer closer relationships may protect against maladaptive interpersonal behaviors in individuals with depression.

Indirect Effect of Hopelessness on Depression Symptoms Through Perceived Burdensomeness

Hopelessness theory of depression posits that hopelessness due to negative inferences may serve as a proximal and sufficient cause of depression, while interpersonal theories suggest that interpersonal stress resulting from relationship problems and social rejection may lead to symptoms of depression. We propose that the two perspectives can be integrated by examining a model in which hopelessness predicts depression symptoms through two specific interpersonal stress constructs, thwarted belongingness and perceived burdensomeness, in a sample of university students from Macau (N = 350). Results of mediation analysis revealed a significant indirect effect of hopelessness on depression symptoms through perceived burdensomeness (indirect effect = .45; 95% confidence interval = .28 to .65), but not thwarted belongingness (indirect effect = .06; 95% confidence interval = -.05 to .18). Alternative models were also tested. When each interpersonal construct was treated as a separate mediator without controlling for the other, significant indirect effects of both perceived burdensomeness and thwarted belongingness were found. Moreover, when hopelessness was assigned as the mediator and interpersonal constructs as independent variables, significant indirect effects were likewise found for perceived burdensomeness and thwarted belongingness. Findings suggest that the two different yet compatible views about depression-hopelessness and interpersonal theories-may be integrated to provide a better understanding of the process of how depression symptoms occur. It also reinforces the importance of considering interpersonal factors in the study of depression, especially in societies where interpersonal relationships are highly valued.

Enhancing depression screening to identify college students at risk for persistent depressive symptoms

BACKGROUND

Depressive symptoms in college students are prevalent and are associated with considerable academic impairment. Many universities have implemented depressive symptom screening programs and the number of students identified as in need of services following screening greatly exceeds available mental health resources. The present study sought to refine depressive symptom screening programs by identifying predictors of a persistent course of depressive symptoms and developing cut-scores for accurately identifying students who will experience a persistent symptom course.

METHOD

Students (n=262) who reported elevated depressive symptoms both an initial screening and baseline assessment (n=150) were invited to participate in telephone-based follow-up assessments 4, 8, and 12 months post-baseline.

RESULTS

Two depressive symptom courses were identified: a persistently elevated depressive symptoms course and a decreasing depressive symptoms course. Baseline social disconnection and negative feedback-seeking both significantly predicted membership in the persistently elevated depressive symptoms course. Cut-scores that robustly discriminated between the two symptom courses were identified.

LIMITATIONS

The present sample was predominantly female and Hispanic; the four-month spacing of assessments may have resulted in a failure to identify individuals who experience brief, yet impairing, recurrent depressive episodes.

CONCLUSION

These findings can inform approaches to identifying college students most in need of mental health services for depressive symptoms based on the presence of social disconnection and/or negative feedback-seeking. Screening cut-points on social disconnection and negative feedback-seeking measures can reduce the number of cases identified as needing mental health services while retaining the majority of cases who will experience a persistent depressive symptom course.

Conversational Self-Focus in Adolescent Friendships: Observational Assessment of an Interpersonal Process and Relations with Internalizing Symptoms and Friendship Quality

Although youth with internalizing symptoms experience friendship difficulties, surprisingly little is known about their problematic interpersonal behaviors. The current observational study identifies a new construct, conversational self-focus, defined as the tendency to direct the focus of conversations to the self and away from others. Results indicated that youth with internalizing symptoms were especially likely to engage in self-focus when discussing problems with friends and that doing so was related to their friends perceiving the relationship as lower in quality, particularly helping. Content analyses further indicated that self-focused youth talked about themselves in ways that were distracting from their friends' problems and that they changed the subject abruptly. Last, conversational self-focus was not redundant with related constructs of rumination and self-disclosure. This research highlights the importance of intervention efforts aimed at teaching self-focused youth ways to cope with distress that are more effective and will not damage their friendships.

Feedback-seeking and depression in survivors of domestic violence

BACKGROUND

Not surprisingly, women in violent relationships often experience symptoms of depression. Although most people desire praise and positive feedback, individuals who are depressed often seek either negative or "even-handed" self-relevant information. The relative lack of positive feedback-seeking exhibited by depressed individuals may have implications for understanding the difficulty that survivors of domestic violence have leaving and remaining apart from abusive partners.

METHODS

This study was designed to assess the relative preference for self-relevant information in two groups of women: women who experienced domestic violence (DV group) and women who did not have these experiences (no-DV group).

RESULTS AND CONCLUSIONS

The DV group (n=30), relative to the no-DV group (n=28), desired less positive (or relatively more negative) feedback. Further, depression mediated the relationship between DV and seeking less positive feedback. Motivational and cognitive explanations for this pattern of results are discussed.

A context-informed approach to the study of negative-feedback seeking in depression

The purpose of the current study was to examine the link between negative-feedback seeking (NFS) and depression using a behavioural task that addressed many of the limitations of existing measures of NFS, to use a remitted-depressive design to determine whether NFS is a temporary or stable feature of depression, and to examine the role of personality and contextual variables (e.g., marital quality, spousal characteristics) in NFS. Using a sample of 59 couples (12 wife currently depressed, 20 wife remitted-depressed, and 27 wife never-depressed), we designed a task that correlated with an established measure of NFS and was able to distinguish between non-depressed and currently depressed wives. Using this behavioural task, we found that NFS is stably associated with depression and that relationship and partner characteristics may protect depressed individuals from engaging in destructive interpersonal patterns.

Reciprocal, longitudinal associations among adolescents' negative feedback-seeking, depressive symptoms, and peer relations

This study examined reciprocal associations among adolescents' negative feedback-seeking, depressive symptoms, perceptions of friendship quality, and peer-reported social preference over an 11-month period. A total of 478 adolescents in grades 6-8 completed measures of negative feedback-seeking, depressive symptoms, friendship quality, global-self-esteem, and social anxiety at two time points. Peer-reported measures of peer status were collected using a sociometric procedure. Consistent with hypotheses, path analyses results suggested that negative feedback-seeking was associated longitudinally with depressive symptoms and perceptions of friendship criticism in girls and with lower social preference scores in boys; however, depressive symptoms were not associated longitudinally with negative feedback-seeking. Implications for interpersonal models of adolescent depression are discussed.