Relating Styles

In the model I am suggesting, social contexts and relating styles (mediated by self-other schema) that make it difficult to elicit or maintain a flow of positive affiliative relationships, or achieve evolutionarily meaningful biosocial goals (McGuire & Troisi, 1998b), as well as disruptions of relationships that recruit perceptions of inferiority and low rank, are likely to be vulnerability factors for depression (Sloman et al., 2003). Brown et al. (1995) found that social losses associated with humiliation (perceptions of reduced social rank) were more depressogenic than loss events alone. In a study of grief-triggered depression, Horowitz et al. (1980) found that some people had negative latent self-schema (associated with feelings of worthlessness and inferiority), which their spouse had helped to keep latent. When the spouse died, these negative self-schema become reactivated (self as inferior and helpless), complicating grief and increasing the risk of depression. Some limited research on monkeys has also shown that low rankers show a more intense and prolonged response to separation and attachment disruption than high rankers (e.g., Rasmussen & Reite, 1982).

Attachment theorists have illuminated some key interpersonal styles that increase vulnerability to depression. Collins and Feeney (2000) summarise these:

Adult attachment researchers typically define four prototypic attachment styles derived from two underlying dimensions; anxiety and avoidance The anxiety dimension refers to one's sense of self worth and acceptance (vs. rejection) by others and the avoidance dimension refers to the degree to which one approaches (vs. avoids) intimacy and interdependence with others. Secure adults are low in both attachment-related anxiety and avoidance; they are comfortable with intimacy, willing to rely on others for support, and confident that they are valued by others. Preoccupied (anxious-ambivalent) adults are high in anxiety and low in avoidance; they have an exaggerated desire for closeness and dependence, coupled with a heightened concern with being rejected. Dismissing avoidant individuals are low in attachment-related anxiety but high in avoidance; they view close relationships as relatively unimportant and they value independence and self-reliance. Finally, fearful avoidant adults are high in both attachment anxiety and avoidance; although they desire close relationships and the approval of others, they avoid intimacy because they fear being rejected. (p. 1054)

In a number of studies, Mario Mikulincer, a prominent researcher on attachment relations, has found that securely attached people see others as relatively benevolent and can regulate stress by appropriate support seeking and self-management, while anxiously attached people show typical 'protest' behaviour to stress and become clingy and controlling. Avoidant attached people do not seek help for stress, do not have views of others as benevolent, use repression as a coping mechanism, and are overly self-reliant (see Mikulincer et al., 2000). Sloman et al. (2003) also note that secure attachments make it easier to deal with defeats and regulate affect and cognition in the context of defeat.

A related concept has been that of rejection sensitivity. Rejection-sensitive children and adults expect rejection when asking for help and respond with more NA (anger and anxiety) to rejection (Downey et al., 1998a,b). In an ongoing study of depressed people in our department, we have found that rejection sensitivity is significantly correlated with depression, seeing the self as inferior to others, and submissive behaviour. Based on Bowlby's (1969, 1973) idea of attachment as a safe base, Gilbert (1989, 1993) noted that securely attached children feel relatively safe in interpersonal contexts, feel lovable (as well as loved), and thus have confidence to build helpful and PA-boosting relationships, whereas the insecurely attached do not. Sloman (2000b) has outlined how rejection sensitivity can develop from attachment difficulties and be manifested in inferiority sensitivities. In a series of studies, Allan (2000) found that insecure attachment was highly correlated with rank perceptions (for example, seeing the self as inferior and thinking that others look down on the self), with some evidence that social rank and perceptions of defeat may mediate the link between attachment insecurity and depression.

If low or threatened social rank conveys vulnerability to depression, one would expect that social anxiety would be a vulnerability factor. Although not all socially anxious people are depressed, of course, social anxiety is comorbid with other disorders, including depression, schizophrenia, eating disorders, and substance misuse and often precedes these disorders (Schneier et al., 1992). Again, one reason for such comorbidity, and why social anxiety may often precede a mood disorder (Alpert et al., 1997), is that social anxiety can reduce the ability to develop supportive/affiliative relationships (Gilbert, 1992). Spence et al. (1999) found that socially phobic children have more negative cognitions, expect more negative outcomes from interactions, express anxiety, are more submissive, and thus have less positive interactions with peers and are more likely to be rejected. Socially anxious adults see their anxious behaviours and symptoms as unattractive to others (Creed & Funder, 1998); indeed, social phobics, in first encounters, are liked less and seen as less sympathetic or desirable as friends than low socially anxious people (Alden & Wallace, 1995). They are then disadvantaged in eliciting PA in, and positive responses from, others (Gilbert, 2001b).

Other researchers have focused on generalised raised anxieties in social relationships, often referred to as 'interpersonal sensitivity'. Davidson et al. (1989) explored a measure of interpersonal sensitivity in depression and suggested that:

Interpersonal sensitivity (IPS) is a construct that refers to an individual's hypersensitivity to perceived self-deficiencies in relation to others. It embraces sensitivity to rejection and criticism on the part of others; it also embodies a sense of personal inadequacy, inferiority, and poor morale. Such individuals are quick to take offense, are unduly sensitive to ridicule, feel uncomfortable in the presence of others, and show a negative set of expectations in their dealings with others. A close relationship with social phobia is suggested. (p. 357)

Their study showed that high scorers, compared to low(er) scorers had an earlier age of onset, more chronicity, and more severe depression; were more retarded; had higher guilt and suicidality; and were more paranoid. Again the themes of low rank are strongly implicated.

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