Reassurance seeking and depression in adults with mild intellectual disability

Abstract

Background: Adults with intellectual disability (ID) experience a high prevalence of depression. Yet, little research has investigated interpersonal processes related to depression in this population. In the general population, depressed persons behave in ways that elicit negative and rejecting reactions from others. In particular, excessive reassurance seeking, defined as excessively and persistently seeking assurance from others that one is lovable and worthy, indirectly contributes to depressive symptoms through evoking negative and rejecting social interactions. We examined the relation between excessive reassurance seeking, negative and rejecting social interactions and depression in adults with mild ID.

Method: Eighty-seven adults with mild ID and staff completed the Glasgow Depression Scale for people with a Learning Disorder and the Reassurance-Seeking Scale. In addition, adults with mild ID reported on their experience of negative social interactions, and staff rated their relative preference to interact with the adult with mild ID. A meditational model of the indirect effect of excessive reassurance seeking on depressive symptoms via negative and rejecting social interactions was tested.

Results: Excessive reassurance seeking was positively related to depressive symptoms. Negative and rejecting interactions partially mediated the relation between excessive reassurance seeking and depressive symptoms.

Conclusions: Findings identify an important interpersonal process in depression. Efforts to educate staff and adults with mild ID about excessive reassurance seeking and ways to alter it may be useful in treating depression.

Figure 1

Mediation model of the Reassurance-Seeking Scale (RSS), Inventory of Negative Social Interactions (INSI) and the Glasgow Depression Scale for People with a Learning Disorder (GDS) by using self-report measures. The two βs at the bottom represent the β before (above line) and after (below line) the introduction of the mediator into the regression model. *P ≤ 0.05, **P≤0.01.

Figure 2

Mediation model of the Reassurance-Seeking Scale (RSS), interpersonal rejection and the Glasgow Depression Scale for People with a Learning Disorder (GDS) by using staff-reported measures. The two βs at the bottom of each figure represent the β before (above line) and after (below line) the introduction of the mediator into the regression model. **P ≤ 0.01.