Cognitive vulnerability to depression in never depressed subjects

The purpose of this study was to investigate whether dysfunctional cognitions could be measured in never-depressed individuals after a sad mood prime, and if these dysfunctional cognitions would predict future depression. Subjects were first screened for current or past depression. Never-depressed subjects were randomly assigned to a prime or no-prime condition and completed the Dysfunctional Attitudes Scale. After one month, subjects completed the Beck Depression Inventory. The mood induction was successful in producing a sad mood, but had no effect on accessibility of dysfunctional cognition. Dysfunctional cognitions did predict depressive symptoms one month later, for the women in the sample, but not the men. These results were actually stronger for the unprimed subjects. The results provide some support for the cognitive diathesis-stress model, and suggest that cognitive vulnerability to depression may exist prior to a clinically significant depressive episode. However, mood priming does not appear to be a useful strategy with never-depressed subjects.     

Autobiographical memory characteristics in depression vulnerability: Formerly depressed individuals recall less vivid positive memories

The differential activation hypothesis (DAH; Teasdale, 1988) proposes that individuals who are vulnerable to depression can be distinguished from non-vulnerable individuals by the degree to which negative thoughts and maladaptive cognitive processes are activated during sad mood. While retrieval of negative autobiographical memories is noted as one such process, the model does not articulate a role for deficits in recalling positive memories. Two studies were conducted to compare the autobiographical memory characteristics of never-depressed and formerly depressed individuals following a sad mood induction. In Study 1, features of negative memories of never-depressed and formerly depressed individuals did not differ, either in neutral or sad mood. For positive memories, groups did not differ in neutral mood, but following a sad mood induction, formerly depressed individuals rated their positive memories as less vivid than their never-depressed counterparts. Study 2 examined positive autobiographical memory features more comprehensively and replicated the finding that in a sad mood formerly depressed individuals recalled less vivid positive memories than never-depressed controls. These findings suggest that the phenomenological features of positive memories could represent an important factor in depressive vulnerability, and, more broadly, that depression may be associated with a deficit in the processing of positive material.     

Autobiographical memory characteristics in depression vulnerability: formerly depressed individuals recall less vivid positive memories

The differential activation hypothesis (DAH; Teasdale, 1988) proposes that individuals who are vulnerable to depression can be distinguished from non-vulnerable individuals by the degree to which negative thoughts and maladaptive cognitive processes are activated during sad mood. While retrieval of negative autobiographical memories is noted as one such process, the model does not articulate a role for deficits in recalling positive memories. Two studies were conducted to compare the autobiographical memory characteristics of never-depressed and formerly depressed individuals following a sad mood induction. In Study 1, features of negative memories of never-depressed and formerly depressed individuals did not differ, either in neutral or sad mood. For positive memories, groups did not differ in neutral mood, but following a sad mood induction, formerly depressed individuals rated their positive memories as less vivid than their never-depressed counterparts. Study 2 examined positive autobiographical memory features more comprehensively and replicated the finding that in a sad mood formerly depressed individuals recalled less vivid positive memories than never-depressed controls. These findings suggest that the phenomenological features of positive memories could represent an important factor in depressive vulnerability, and, more broadly, that depression may be associated with a deficit in the processing of positive material.     

Intraindividual relations between the intensity and disclosure of daily emotional events: The moderating role of depressive symptoms

Individuals with high levels of depressive symptoms tend to engage in lower levels of emotional disclosure than individuals who are lower in depressive symptoms. However, little is known about how depressive symptoms relate to the intraindividual relation between daily disclosure and the intensity of the daily events. The authors addressed these relations using a daily diary methodology. College students (N = 239) completed a measure of depression symptoms. They then completed measures of the intensity of the day's most unpleasant event and their disclosure of that event each day for 7 days. Results indicated that depression moderated the intensity-disclosure relation such that depression symptoms were associated with diminished emotional disclosure for high-intensity events but not for low-intensity events. Individuals with relatively higher levels of depressive symptoms also experienced unpleasant daily events at a higher intensity level than did individuals with relatively fewer symptoms. Sex differences emerged such that men were less likely than women to disclose high-intensity negative events. These findings extend the use of the diary methodology to the study of emotional disclosure and also suggest possible interventions for counseling psychology practitioners.     

Depression history and coping with chronic pain: a daily process analysis.

This study examined how a previous episode of depression is related to daily pain and reactions to pain among individuals with fibromyalgia, a chronic pain syndrome. Seventy-one women with fibromyalgia (including 30 who were previously depressed) rated their pain and mood 3 times daily for 30 days. Each night, participants rated the extent to which they responded to pain by catastrophizing, how much control they had over that day's pain, their ways of coping with pain that day, and the effectiveness of their coping efforts. Multivariate multilevel regression models revealed that after controlling for neuroticism and current depressive symptoms, formerly depressed and never-depressed individuals differed in how they coped with increased pain and in how they appraised the efficacy of their coping efforts. Formerly depressed participants who also reported more current depressive symptoms showed a greater decline in pleasant mood on more painful days than did formerly depressed participants who were experiencing fewer current depressive symptoms. These findings illustrate how a history of depression can be captured in the dynamics of daily life.     

Self-esteem reconsidered: unstable self-esteem outperforms level of self-esteem as vulnerability marker for depression

Previous studies have built up evidence that an unstable self-esteem is associated with vulnerability to depression and that it outperforms level of self-esteem as a predictor for symptoms of depression. However, most of these studies have used student samples exclusively to investigate the role of self-esteem instability in depression vulnerability. Our present study used samples of currently depressed inpatients, formerly depressed individuals, and never-depressed controls to investigate the relationship between self-esteem instability and depression. In addition, we examined the predictive validity of self-esteem instability in predicting future depressive symptoms. The results indicate that self-esteem instability is associated with depression and vulnerability to depression. Furthermore, self-esteem instability interacted with perceived stress variability and depressed mood variability in predicting future depressive symptomatology at six months follow-up. These results are in line with the diathesis-stress model and support the hypothesis that self-esteem instability might be more important than level of self-esteem in predicting vulnerability to depression.     

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.     

Proximal Predictors of Depressive Symptomatology: Perceived Losses in Self-Worth and Interpersonal Domains and Introjective and Anaclitic Mood States

Although much research has demonstrated a relationship between negative life events and depressive symptoms, relatively little research has examined the mechanisms that may mediate this relationship. The theories of Blatt (1974), Bowlby (1980), and Gilbert (1992) each propose proximal predictors of depression. In accordance with these theories, this study examined the relationships among perceived losses in self-worth and interpersonal relationships, anaclitic (dependent) and introjective (self-critical) mood states, and depressive symptoms following a significant negative life event. A sample of 172 undergraduate students completed measures of depressive symptoms and depressive vulnerability factors and retrospectively described the worst period of their lives. They also rated the extent to which the events surrounding this worst period affected their self-worth and their relationships with close others. Structural equation modeling demonstrated that the effect of a perceived loss of self-worth on depressive symptoms was fully mediated by both introjective and anaclitic mood states, whereas the effect of a perceived loss of interpersonal relationships on depressive symptoms was fully mediated by an anaclitic mood state. Additionally, perceived losses of self-worth showed a stronger effect on introjective mood in highly self-critical individuals. Findings highlight the importance of perceived losses in both self-worth and interpersonal domains in response to adverse life events and suggest pathways through which perceived losses may affect depressive symptoms.     

Proximal predictors of depressive symptomatology: perceived losses in self-worth and interpersonal domains and introjective and anaclitic mood states

Although much research has demonstrated a relationship between negative life events and depressive symptoms, relatively little research has examined the mechanisms that may mediate this relationship. The theories of Blatt (1974), Bowlby (1980), and Gilbert (1992) each propose proximal predictors of depression. In accordance with these theories, this study examined the relationships among perceived losses in self-worth and interpersonal relationships, anaclitic (dependent) and introjective (self-critical) mood states, and depressive symptoms following a significant negative life event. A sample of 172 undergraduate students completed measures of depressive symptoms and depressive vulnerability factors and retrospectively described the worst period of their lives. They also rated the extent to which the events surrounding this worst period affected their self-worth and their relationships with close others. Structural equation modeling demonstrated that the effect of a perceived loss of self-worth on depressive symptoms was fully mediated by both introjective and anaclitic mood states, whereas the effect of a perceived loss of interpersonal relationships on depressive symptoms was fully mediated by an anaclitic mood state. Additionally, perceived losses of self-worth showed a stronger effect on introjective mood in highly self-critical individuals. Findings highlight the importance of perceived losses in both self-worth and interpersonal domains in response to adverse life events and suggest pathways through which perceived losses may affect depressive symptoms.     

Disentangling the effects of depression symptoms and adult attachment on emotional disclosure

Individuals with high levels of depression symptoms and individuals with insecure attachment orientations have been shown to limit their use of emotional disclosure as a means of emotion regulation. However, little is known about how depression symptoms and insecure attachment orientations might jointly predict whether individuals engage in emotional disclosure. The authors addressed this question using both inter- and intraindividual approaches. College students (N = 121) completed measures of depression symptoms, adult attachment orientation, and generalized disclosure tendencies. To obtain an intraindividual measure of emotional disclosure, participants also completed an online daily diary in which they rated the intensity of the day's most unpleasant event and their disclosure of that event for 7 days. Results indicated that depression symptoms were negatively related to generalized disclosure tendencies and to intraindividual daily intensity-disclosure slopes. Attachment avoidance was negatively related to both generalized disclosure tendencies and to daily disclosure, and attachment anxiety moderated the relation between daily event intensity and disclosure. The authors discuss the implications for theory and counseling psychology practice.     

An investigation of the relationship between cognitive reactivity and rumination

Teasdale’s (Teasdale, J.D. (1988). Cognitive vulnerability to persistent depression. Cognition and Emotion, 2, 247–274) differential activation hypothesis refers to the ease with which maladaptive cognitive processes are triggered by mild dysphoria as cognitive reactivity. Supporting this model is evidence of a differential association between sad mood and dysfunctional cognitions in formerly depressed and never-depressed individuals and the finding that cognitive reactivity predicts depression recurrence in remitted depressives. The Leiden Index of Depression Sensitivity–Revised (LEIDS-R; Van der Does, A.J.W., Williams, J.M.G. (2003). Leiden Index of Depression Sensitivity–Revised (LEIDS-R). Retrieved September 4, 2007, from http://www.dousa.nl/publications_depression.htm#LEIDS) is a recently developed self-report measure that provides clinicians and researchers with a time-efficient means by which to assess cognitive reactivity. This study investigated the relationship between cognitive reactivity (indexed by the LEIDS-R) and depressive rumination in a nonclinical sample (N = 324). As predicted, partial correlations between the LEIDS-R (subscale and Total scores) and the Ruminative Response Scale (RRS; Nolen-Hoeksema, S., and Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115–121) were significant after controlling for current depressive symptoms. A subsample of participants (n= 130) was administered a structured interview to determine current and past depression diagnostic status. Recovered depressed individuals scored more highly on the LEIDS-R Total and LEIDS-R Rumination subscale; however, the groups did not differ on the remaining subscales. Regression analyses indicated that (across all participants) LEIDS-R Total made a unique contribution to the prediction of depression over and above trait level of depressive rumination. Overall, the LEIDS-R is a time-efficient self-report index of cognitive reactivity that demonstrates promise in distinguishing recovered and never-depressed individuals.     

Emotional reactivity to daily events in major and minor depression

Although emotional dysfunction is an important aspect of major depressive disorder (MDD), it has rarely been studied in daily life. Peeters, Nicolson, Berkhof, Delespaul, and deVries (2003) observed a surprising mood-brightening effect when individuals with MDD reported greater reactivity to positive events. To better understand this phenomenon, we conducted a multimethod assessment of emotional reactivity to daily life events, obtaining detailed reports of appraisals and event characteristics using the experience-sampling method and the Day Reconstruction Method (Kahneman, Krueger, Schkade, Schwarz, & Stone, 2004) in 35 individuals currently experiencing a major depressive episode, 26 in a minor depressive (mD) episode, and 38 never-depressed healthy controls. Relative to healthy controls, both mood-disordered groups reported greater daily negative affect and lower positive affect and reported events as less pleasant, more unpleasant, and more stressful. Importantly, MDD and mD individuals reported greater reductions in negative affect following positive events, an effect that converged across assessment methods and was not explained by differences in prevailing affect, event appraisals, or medications. Implications of this curious mood-brightening effect are discussed.     

Are people changed by the experience of having an episode of depression? A further test of the scar hypothesis

The purpose of this study was to identify characteristics of individuals before and after their first depressive episode. Subjects were 49 older persons assessed before and after their first depressive episode on depression-related psychosocial variables. The control group consisted of 351 never-depressed individuals. Consistent with previous findings, patients were more likely to be younger, female, and mildly depressed both before and after the episode. In addition, they were more likely to be employed. Following an episode of depression, the recovered patients described their social skills and health as poorer and their interpersonal dependency as greater than the controls. However, on an experiment-wise basis, the number of significant differences were no greater than expected by chance. The stress activation model was examined but did not appreciably enhance the results. Results suggest that most of the psychosocial variables associated with depression are state dependent.     

Recalling positive self-defining memories in depression: The impact of processing mode

Recalling positive memories is a powerful and effective way to improve mood. However, unlike never-depressed individuals, those with current or past depression do not benefit emotionally from positive memory recall. To examine whether rumination is involved in this difficulty, 80 participants (26 currently depressed, 29 recovered depressed, and 25 never depressed) were instructed to recall a positive self-defining memory while in a sad mood. They were then instructed to think about their memory, adopting either an abstract or concrete processing mode. Never-depressed and recovered depressed participants experienced improved mood after memory recall, regardless of processing mode. However, for depressed individuals neither an abstract nor a concrete processing mode produced emotional benefit. These findings suggest that a complex relationship exists among processing mode, memory type, and depressive status, and indicate that the way in which individuals process positive emotional material may have important consequences for treatment.     

Rumination as a vulnerability factor to depression during the transition from early to middle adolescence: a multiwave longitudinal study

The current study examined vulnerability to depression during the transition from early to middle adolescence from the perspective of the response styles theory. During an initial assessment, 382 adolescents (ages 11-15 years) completed self-report measures assessing rumination and depressive symptoms as well as a semistructured clinical interview assessing current and past major depressive episodes. Every 3 months for the subsequent 2 years, adolescents completed self-report measures assessing depressive symptoms and negative events. Every 6 months, adolescents completed a semistructured clinical interview assessing the onset of new major depressive episodes. Higher levels of rumination were associated with a greater likelihood of exhibiting a past history of major depressive episodes, a greater likelihood of experiencing the onset of a future major depressive episode, and greater duration of future depressive episodes. Consistent with a vulnerability-stress perspective, rumination moderated the association between the occurrence of negative events and the development of future depressive symptoms and major depressive episodes.     

Dysfunctional attitudes and episodes of major depression: Predictive validity and temporal stability in never-depressed, depressed, and recovered women

In a large, community-based sample of women (N = 750), the authors examined the nature of associations between dysfunctional attitudes and depression. Dysfunctional attitudes were evaluated both as a vulnerability factor for depression and as a consequence of depression. A link was found between past depression and baseline elevations in dysfunctional attitudes that was independent of current subsyndromal symptoms, but intensification of dysfunctional attitudes following prospectively evaluated episodes of depression (depressive "scarring") was not observed. Although baseline dysfunctional attitudes predicted an episode of major depression over 3 years of prospective study, this prediction, considered alone or in interaction with negative life events, was redundant with that offered by history of past depression. Further, no significant prediction was evident for the Dysfunctional Attitude Scale (A. N. Weissman & A. T. Beck, 1978) when the formerly depressed and never-depressed cohorts were considered separately. Implications for cognitive theories are discussed.     

Recalling happy memories in remitted depression: A neuroimaging investigation of the repair of sad mood

Major depressive disorder (MDD) is a recurrent mood disorder. The high rate of recurrence of MDD suggests the presence of stable vulnerability factors that place individuals with a history of major depression at an increased risk for the onset of another episode. Previous research has linked the remitted state, and therefore increased vulnerability for depressive relapse, with difficulties in the use of pleasant autobiographical memories to repair sad mood. In the present study, we examined the neural correlates of these difficulties. Groups of 16 currently euthymic, remitted depressed individuals and 16 healthy (control) women underwent functional magnetic resonance imaging (fMRI) during sad mood induction and during recovery from a sad mood state through recall of mood-incongruent positive autobiographical memories. Sad mood was induced in participants by using film clips; participants then recalled positive autobiographical memories, a procedure previously shown to repair negative affect. During both the sad mood induction and automatic mood regulation, control participants exhibited activation in the left ventrolateral prefrontal cortex (vlPFC) and cuneus; in contrast, remitted participants exhibited a decrease in activation in these regions. Furthermore, exploratory analyses revealed that reduced activation levels during mood regulation predicted a worsening of depressive symptoms at a 20-month follow-up assessment. These findings highlight a dynamic role of the vlPFC and cuneus in the experience and modulation of emotional states and suggest that functional anomalies of these brain regions are associated with a history of, and vulnerability to, depression.     

Daily depression and cognitions about stress: evidence for a traitlike depressogenic cognitive style and the prediction of depressive symptoms in a prospective daily diary study

The authors examined the stability and dynamic structure of negative cognitions made to naturalistic stressors and the prediction of depressive symptoms in a daily diary study. Young adults reported on dispositional depression vulnerabilities at baseline, including a depressogenic cognitive style, dysfunctional attitudes, rumination, neuroticism, and initial depression, and then completed short diaries recording the inferences they made to the most negative event of the day along with their experience of depressive symptoms every day for 35 consecutive days. Daily cognitions about stressors exhibited moderate stability across time. A traitlike model, rather than a contextual one, explained this pattern of stability best. Hierarchical linear modeling analyses showed that individuals' dispositional depressogenic cognitive style, neuroticism, and their daily negative cognitions about stressors predicted fluctuations in daily depressive symptoms. Dispositional neuroticism and negative cognitive style interacted with daily negative cognitions in different ways to predict daily depressive symptoms.     

Cognitive vulnerability to depression: The role of thought suppression and attitude certainty

Previous research indicates that dysfunctional attitudes wax and wane with shifts in mood, suggesting that they are more likely the result than the cause of depression. The present research examined the possibility that attitudinal precursors to depression exist but are difficult to detect because at-risk individuals are trying to suppress dysfunctional thinking. However, the lingering maladaptive beliefs should be reflected in attitude uncertainty. To test this idea, participants completed a measure of chronic thought suppression and the Dysfunctional Attitude Scale that was amended to include certainty ratings. Participants also reported current and past experiences with depression. The results indicated that although formerly depressed individuals—who are at high risk for relapse—reported relatively adaptive attitudes, they were more uncertain about those beliefs than were their never-depressed counterparts. Moreover, this greater uncertainty was associated with high levels of thought suppression that, in turn, were related to previous depression.     

Perfectionism,life events,and depressive symptoms: A test of a diathesis-stress model

The present research tested the hypothesis that perfectionists who experience stress are vulnerable to depression, in part because negative life events represent a failure to maintain control over negative outcomes. In Study 1, 215 subjects completed the Multidimensional Perfectionism Scale (MPS) and control measures. The MPS assesses self-oriented, other-oriented, and socially prescribed perfectionism. It was confirmed that self-oriented and other-oriented perfectionism were associated with both higher desire for control and greater perceived personal control. Study 2 examined whether trait levels of perfectionism moderate the link between life stress and symptoms of depression. In addition, prospective analyses investigated whether perfectionism accounts for changes in levels of depressive symptomatology over time. Two samples comprised of 374 students (Sample 1) and 173 students (Sample 2) completed the MPS and measures of major life stress and depression symptoms. Subjects in Sample 2 completed these measures at two timepoints separated by a three-month interval. Regression analyses indicated that self-oriented perfectionism and life stress interact significantly to produce higher levels of depressive symptomatology. Moreover, in Sample 2, self-oriented perfectionism at Time 1 was associated with increases in depression symptoms three months later for those individuals who had experienced a major life event. The results provide support for diathesis-stress models, which maintain that perfectionists exposed to life stress are vulnerable to symptoms of depression. The results are discussed in terms of their implications for the study of personality, stress, and vulnerability to symptoms of depression. This research was supported by grants #410-89-0335, #410-91-8056, and #410-93-1256 from the Social Sciences and Humanities Research Council of Canada awarded to the authors.