Lisa R. Starr

Excessive Reassurance Seeking, Depression, and Interpersonal Rejection : A Meta-Analytic Review

Coynes (1976a, 1976b) interactional theory of depression predicts positive associations between excessive reassurance seeking (ERS) and both depression and interpersonal rejection. A growing body of research has supported the ERS model, but this work has yet to be systematically reviewed. A meta-analysis of 38 studies (N = 6,973) revealed an aggregate effect size (r) of .32 between ERS and concurrent depression. Moderator analyses showed effect sizes were significantly stronger for studies with self-report measures, compared with interviews, and for samples with higher percentages of women and were marginally stronger for studies with community samples, compared with clinical samples. A second meta-analysis of 16 studies yielded a weighted mean effect size of .14 between ERS and concurrent rejection, with studies assessing target-reported rejection showing stronger effect sizes than studies assessing informant-reported rejection and studies examining romantic relationships yielding marginally stronger effect sizes than studies examining nonromantic relationships. Prospective studies are qualitatively reviewed. Results support the ERS model (with several important caveats) but underscore the need for methodological diversity in future research.

Clarifying co-rumination: Associations with internalizing symptoms and romantic involvement among adolescent girls

Co-rumination, or excessive discussion of problems within friendships, has been associated with internalizing symptoms and is especially prevalent among adolescent girls. Eighty-three early adolescent girls participated in a prospective study further examining this construct. Co-rumination was positively correlated with depressive symptoms and positive aspects of friendship, but did not predict longitudinal changes in depressive symptoms. Co-rumination was negatively related to social anxiety when controlling for depressive symptoms. Co-rumination correlated positively with romantic experiences, and the two interacted to predict longitudinal changes in depressive symptoms, implying that co-rumination may only be depressogenic under certain circumstances. Theoretical ramifications for the construct of co-rumination and interpersonal aspects of adolescent internalizing symptoms are discussed.

Differentiating Interpersonal Correlates of Depressive Symptoms and Social Anxiety in Adolescence: Implications for Models of Comorbidity

Research on psychosocial correlates of depression and social anxiety often has not accounted for their comorbidity. Differentiating correlates of depression and social anxiety may inform the development of comorbidity models. Building on research linking both disorders to interpersonal dysfunction, this study examined interpersonal correlates of depressive symptoms and social anxiety in nonreferred early adolescent (M age = 13.46) girls (n = 83), controlling for comorbid symptoms. Although both showed significant bivariate correlations with peer and family variables, partial correlations revealed that social anxiety (controlling for depressive symptoms) was more strongly related to peer variables (e.g., social competence and trust and communication in friendships), whereas depressive symptoms (controlling for social anxiety) were more strongly related to family variables (e.g., lower trust and greater alienation and conflict). Comorbid girls showed heightened peer and family alienation compared to purely dysphoric or anxious girls. Implications for casual models of comorbidity and for understanding poorer outcomes associated with comorbidity and discussed.

Romantic and Sexual Activities, Parent-Adolescent Stress, and Depressive Symptoms among Early Adolescent Girls.

Building on evidence that romantic experiences are associated with depressive symptoms in adolescence, we examined their bidirectional association, as well as the role of sexual activity and parent-adolescent stress in their association. Data were collected from 71 early adolescent girls (M age 13.45 years; SD=0.68) and their primary caregiver initially and one year later. Results indicated that adolescents who engaged in more romantic activities experienced increases in depressive symptoms over time. Second, greater depressive symptoms predicted romantic involvement and sexual activities, including intercourse, one year later. Third, dysphoric adolescents who were experiencing higher parent-adolescent stress were the most likely to engage in subsequent sexual intercourse. Implications for understanding how the association between depressive symptoms and romantic and sexual experiences develops and the course of this association are discussed.

Responding to Anxiety with Rumination and Hopelessness: Mechanism of Anxiety-Depression Symptom Co-Occurrence?

The current research proposes that certain anxiety response styles (specifically, responding to anxiety symptoms with rumination or hopeless cognitions) may increase risk of depressive symptoms, contributing to anxiety-depression comorbidity. We delineate preliminary evidence for this model in three studies. In Study 1, controlling for anxiety response styles significantly reduced the association between anxiety and depressive symptoms in an undergraduate sample. In Study 2, these findings were replicated controlling for conceptually related variables, and anxiety interacted with anxiety response styles to predict greater depressive symptoms. In Study 3, anxiety response styles moderated the prospective association between anxiety and later depression in a generalized anxiety disorder sample. Results support a role for anxiety response styles in anxiety-depression co-occurrence, and show that hopeless/ruminative anxiety response styles can be measured with high reliability and convergent and divergent validity.

Temporal patterns of anxious and depressed mood in generalized anxiety disorder: A daily diary study

Research suggests that anxiety disorders tend to temporally precede depressive disorders, a finding potentially relevant to understanding comorbidity. The current study used diary methods to determine whether daily anxious mood also temporally precedes daily depressed mood. 55 participants with generalized anxiety disorder (GAD) and history of depressive symptoms completed a 21-day daily diary tracking anxious and depressed mood. Daily anxious and depressed moods were concurrently associated. Daily anxious mood predicted later depressed mood at a variety of time lags, with significance peaking at a two-day lag. Depressed mood generally did not predict later anxious mood. Results suggest that the temporal antecedence of anxiety over depression extends to daily symptoms in GAD. Implications for the refinement of comorbidity models, including causal theories, are discussed.

Does relational dysfunction mediate the association between anxiety disorders and later depression? Testing an interpersonal model of comorbidity.

Anxiety disorders tend to precede onset of comorbid depression. Several researchers have suggested a causal role for anxiety in promoting depressive episodes, but few studies have identified specific mechanisms. The current study proposes an interpersonal model of comorbidity, where anxiety disorders disrupt interpersonal functioning, which in turn elevates risk for depression.

Oxytocin receptor gene polymorphism (rs53576) moderates the intergenerational transmission of depression

Maternal depression serves as a potent source of stress among offspring, greatly enhancing the risk of numerous adverse outcomes including youth depression. Several factors moderate the transmission of depression from mothers to offspring. However, the role of genetic characteristics in this process merits further exploration. Consistent with an interpersonal perspective on depression, the present study focused on a genetic polymorphism that has been shown to be relevant to social functioning, the rs53576 polymorphism of the oxytocin receptor gene (OXTR). In a community sample of 441 youth, OXTR genotype moderated the association between maternal depression in early childhood and youth depressive symptoms in adolescence, such that youth possessing at least one A allele of OXTR who also had a history of maternal depression exhibited the highest levels of depressive symptoms at age 15. In order to explore possible interpersonal mediators of this effect, conditional process analyses examined the role of youth social functioning in adolescence. Results suggest that OXTR genotype may partially account for the transmission of maternal depression to youth and support the role of dysfunctional social processes as a mechanism through which OXTR influences the development of depressive symptoms.

Sensitizing effect of early adversity on depressive reactions to later proximal stress: Moderation by polymorphisms in serotonin transporter and corticotropin releasing hormone receptor genes in a 20-year longitudinal study

Previous research supports gene-environment interactions for polymorphisms in the corticotropin hormone receptor 1 gene (CRHR1) and the serotonin transporter gene linked polymorphic region (5-HTTLPR) in predicting depression, but it has rarely considered genetic influences on stress sensitization processes, whereby early adversities (EA) increase depressive reactivity to proximal stressors later in life. The current study tested a gene-environment-environment interaction (G × E × E; specifically, gene-EA-proximal stress interaction) model of depression in a 20-year longitudinal study. Participants were assessed prospectively for EA up to age 5 and recent chronic stress and depressive symptoms at age 20 and genotyped for CRHR1 single nucleotide polymorphism rs110402 and 5-HTTLPR. EA predicted stronger associations between recent chronic stress and depression, and the effect was moderated by genes. CRHR1 A alleles and 5-HTTLPR short alleles were associated with greater stress sensitization (i.e., greater depressive reactivity to chronic stress for those also exposed to high levels of EA). The results are consistent with the notion that EA exposure results in neurobiological and cognitive-emotional consequences (e.g., altered hypothalamic-pituitary-adrenal axis functioning), leading to emotional distress in the face of recent stressors among those with certain genetic characteristics, although further research is needed to explore explanatory mechanisms.

Assessing romantic competence in adolescence: The Romantic Competence Interview

This article presents preliminary psychometric data on the reliability and validity of the newly developed Romantic Competence Interview (RCI). The RCI is an interviewer-assessed measure designed to assess competence among adolescents regardless of romantic relationship status. Eighty-three early adolescent girls (m age=13.45 years) recruited from local school districts were administered the RCI along with other measures of social competence, and peer and romantic functioning. Concurrent and 1-year predictive associations were examined. Results indicated that the RCI was reliably coded and demonstrated good construct validity. Implications for the conceptualization and measurement of romantic competence are discussed, as is the importance of attending to issues of competence early in adolescence.