Cognitive vulnerability to depression: a comparison of the weakest link, keystone and additive models

Multiple theories of cognitive vulnerability to depression have been proposed, each focusing on different aspects of negative cognition and utilising different measures of risk. Various methods of integrating such multiple indices of risk have been examined in the literature, and each demonstrates some promise. Yet little is known about the interrelations among these methods, or their incremental validity in predicting changes in depression. The present study compared three integrative models of cognitive vulnerability: the additive, weakest link, and keystone models. Support was found for each model as predictive of depression over time, but only the weakest link model demonstrated incremental utility in predicting changes in depression over the other models. We also explore the correlation between these models and each model's unique contribution to predicting onset of depressive symptoms.     

Operationalizing the "vulnerability" and "stress" components of the hopelessness theory of depression: a multi-wave longitudinal study

The current study tested of the diathesis-stress component of the hopelessness theory (HT) using (1) a "weakest link" approach towards operationalizing vulnerability (e.g., an individual is as vulnerable to depression as his/her most depressogenic inferential style-DIS) and (2) an idiographic approach towards operationalizing high levels of stress. The procedure involved an initial assessment during which participants completed measures assessing DISs and depressive symptoms. The procedure also involved a series of eight follow-up assessments, occurring every 6 weeks, during which depressive symptoms and hassles were assessed. Hypotheses were tested in two samples of adults (i.e., adults diagnosed with a current MDE and adults diagnosed with a past MDE at Time 1). In line with hypotheses, in both samples, depressogenic weakest links were associated with greater elevations in depressive symptoms following elevations in hassles. At the same time, equally strong support was obtained for the HT when stress was operationalized from a nomothetic perspective and when vulnerability was operationalized as a DIS about causes (but not consequences or self).     

Cognitive vulnerability to depression during middle childhood: Stability and associations with maternal affective styles and parental depression

Theories of cognitive vulnerability to depression (CVD) imply that CVD is early-emerging and trait-like; however, little longitudinal work has tested this premise in middle childhood, or examined theoretically relevant predictors of child CVD. We examined test–retest correlations of self-referent encoding task performance and self-reported attributional styles and their associations with parental characteristics in 205 seven-year-olds. At baseline, child CVD was assessed, structured clinical interviews were conducted with parents, and ratings of observed maternal affective styles were made. Children’s CVD was re-assessed approximately one and two years later. Both measures of children’s CVD were prospectively and concurrently associated with children’s depressive symptoms and showed modest stability. Multilevel modeling indicated that maternal criticism and paternal depression were related to children’s CVD. Findings indicate that even early-emerging CVD is a valid marker of children’s depression risk.     

Dysfunctional attitudes, self-esteem, and hassles: cognitive vulnerability to depression in children of affectively ill parents

The current study tested the diathesis-stress component of Beck's [(1967). Depression: Clinical, experimental, and theoretical aspects. New York: Harper & Row, (1983). Cognitive therapy of depression: New perspectives. In P.J. Clayton, J.E. Barnett (Eds.), Treatment of depression: Old controversies and new approaches (pp. 265-290). New York: Raven Press] cognitive theory of depression in a sample of children between the ages of 6 and 14. We also examined whether high self-esteem buffers cognitively vulnerable youth against experiencing increases in depressive symptoms following increases in hassles. To provide a effective test of hypotheses, an at-risk sample (children of parents with a history of major depressive episodes) and a multi-wave longitudinal design were used. At Time 1, children (n=140) completed measures assessing dysfunctional attitudes, self-esteem, and depressive symptoms. Every 6 weeks for the next year, children completed measures assessing depressive symptoms and hassles. Hierarchical linear modeling analyses indicated that children possessing high levels of dysfunctional attitudes and low levels of self-esteem reported greater elevations in depressive symptoms following elevations in hassles than other children.     

Explicit and implicit cognition: a preliminary test of a dual-process theory of cognitive vulnerability to depression

Two studies were conducted to test a dual-process theory of cognitive vulnerability to depression. According to this theory, implicit and explicit cognitive processes have differential effects on depressive reactions to stressful life events. Implicit processes are hypothesized to be critical in determining an individual's immediate affective reaction to stress whereas explicit cognitions are thought to be more involved in long-term depressive reactions. Consistent with hypotheses, the results of study 1 (cross-sectional; N=237) showed that implicit, but not explicit, cognitions predicted immediate affective reactions to a lab stressor. Study 2 (longitudinal; N=251) also supported the dual-process model of cognitive vulnerability to depression. Results showed that both the implicit and explicit measures interacted with life stress to predict prospective changes in depressive symptoms, respectively. However, when both implicit and explicit predictors were entered into a regression equation simultaneously, only the explicit measure interacted with stress to remain a unique predictor of depressive symptoms over the five-week prospective interval.     

Attributional style and depressive symptoms in adolescents: an examination of the role of various indicators of cognitive vulnerability

This study focuses on the hopelessness theory to explain depressive symptoms in adolescents. The aim is to assess which dimensions of the attributional style (causal attribution, attribution of consequences, implications for the self, total score, and weakest link score) better moderate the impact of negative events on the increase of depressive symptoms. For this purpose, 856 Spanish adolescents (449 girls and 407 boys, ages between 14 and 17 years) were assessed at the beginning of the school year and at follow-up 6 months later. They completed measures of depressogenic cognitive style [Hankin, B. L., & Abramson, L. Y. (2002). Measuring cognitive vulnerability to depression in adolescents: Reliability, validity, and gender differences. Journal of Clinical Child and Adolescent Psychology, 31, 491-504], negative life events, and depressive symptoms. The results show that only the dimension of attribution of stable and global causes moderated the impact of the negative events on the increase of depression at follow-up. The results are discussed in terms of the meaning of the weakest link score and the construct of attributional style from a developmental perspective.     

Negative life events and cognitive vulnerability to depression: Informant effects and sex differences in the prediction of depressive symptoms in middle childhood

While diathesis-stress models of cognitive vulnerability to depression (CVD) in childhood have been tested, few studies have included both parent- and child-reported negative life events, despite the fact that they provide unique information on events that may be relevant to depression risk in boys and girls. It was hypothesized that different types of stress may show moderation of CVD for boys and girls; specifically, we predicted that parent-reported stressors may moderate boys’ CVD, and that self-reported stress may play a more critical moderating role for girls. A community sample of 182 eight-year-olds completed measures of CVD at baseline, and child- and parent-reported measures of stress were collected at follow-up, one year later. Support for diathesis-stress models of CVD varied depending on child sex and the source of information on stress. Results highlight the importance of collecting multiple measures of stress in testing diathesis-stress models of CVD in middle childhood.     

Cognitive reactivity mediates the relationship between neuroticism and depression

Although neuroticism has long been established as an important risk factor for depression, the mechanisms through which this temperamental predisposition translates into the occurrence of symptoms are still relatively unclear. This study investigated cognitive reactivity, i.e. the ease with which particular patterns of negative thinking are reactivated in response to mild low mood, as a potential mediator. Individuals with (N = 98) and without a previous history of depression (N = 83) who had provided neuroticism scores six years previously were assessed for cognitive reactivity and current symptoms of depression using self-report questionnaires. Tendencies to respond to mild low mood with ruminative thinking mediated the relation between neuroticism and current symptoms of depression in both groups. Reactivation of hopelessness and suicidal thinking occurred as an additional mediator only in those with a history of previous depression. The results suggest that neuroticism predisposes individuals to depression by generally increasing the likelihood of ruminative responses to low mood. In those with a history of depression in the past, neuroticism additionally increases risk of recurrence by facilitating reactivation of previously associated patterns such as suicidal thinking and hopelessness. These findings suggest potential targets for interventions to help preventing the occurrence, or recurrence of depression in those who due to their temperamental predisposition are at an increased risk.     

Childhood abuse and vulnerability to depression: Cognitive scars in otherwise healthy young adults

Models of depression vulnerability posit that negative early experiences, such as exposure to childhood abuse (CA), increase vulnerability to depression later in life. Though most victims of CA do not go on to develop depression, the question remains as to whether these individuals retain cognitive ‘scars’ that may contribute to depression vulnerability. The present study examined the relationship between self-reported, retrospective CA and cognitive vulnerability to depression in a carefully selected sample of young adults without current or past psychopathology. We measured cognitive vulnerability with both a self-report questionnaire, the Dysfunctional Attitudes Scale (DAS), and a measure of information processing bias, the Scrambled Sentences Test (SST). Self-reported severity of CA was associated with increased cognitive vulnerability to depression on both the DAS and SST. Vulnerability to depression as measured by the SST, but not by the DAS, prospectively predicted increases in depressive symptoms over a 6-month period. Scores on the SST also interacted with CA to predict increases in depressive symptoms. These findings demonstrate the pernicious effects of CA even in those without current or past psychopathology.     

Cognitive biases in three prediction tasks: A test of the cognitive model of depression

Cognitive therapy for depression is based on an assumption that depressed individuals have inaccurate, negative biases. Whether this assumption is accurate remains unresolved. Thus, this study sought to examine the relationship between depressive symptoms and bias in three sets of predictions (i.e., predictions of future life events, how one would be rated by a significant other, and performance on a vocabulary test). Following study announcements made to a subset of people pre-screened for depressive symptoms, 85 participants with widely varying depressive symptoms (17 of whom met diagnostic criteria for depression) made predictions on three judgment tasks and the outcomes for these tasks were assessed. Optimistic/pessimistic biases were related to depressive symptoms for each of the three tasks. Participants with high levels of depressive symptoms and depressed participants exhibited substantial pessimistic bias. Those high in depressive symptoms exhibited significant pessimistic bias on all three tasks. Participants meeting diagnostic criteria for depression exhibited pessimistic bias on two of three tasks. There was no evidence that depressive symptoms were associated with greater accuracy in judgments. Results are largely consistent with cognitive models of depression which postulate that depression is associated with pessimistic biases.     

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.     

An experimental investigation of the cognitive vulnerability to depression

The present study employed an experimental design, to examine the role of metacognitive processing in the prevention of relapse to depression. Eighty remitted depressed participants were randomly allocated to receive training in the metacognitive style of rumination, distraction, acceptance or no training control prior to a negative mood induction. Rumination prolonged the intensity of the negative mood consistent with no training, whereas both distraction and acceptance reduced the intensity of the negative mood. Changes in attitudes were only found in the acceptance condition, as participants in this condition reduced negative attitudes towards negative experiences. These results are consistent with information processing theory, and imply that acceptance-based preventative interventions may operate by both reducing the intensity of sad moods and altering one's attitudes towards temporary moments of sadness.     

Cognitive and serotonergic vulnerability to depression: convergent findings

Cognitive reactivity (CR) is a psychological vulnerability marker of depression, whereas response to acute tryptophan depletion (ATD; a serotonergic challenge procedure) is a biological vulnerability marker. The aim of this study was to investigate the relationship between these markers. Thirty-nine remitted depressed patients participated in 2 ATD sessions in a double-blind crossover design. CR, assessed prior to the ATD sessions, predicted depressive response to high-dose ATD. CR also diminished the effects of 2 known predictors of ATD response: gender and residual symptoms. Neuroticism and behavioral inhibition were unrelated to ATD response. CR is associated with an increased sensitivity to reductions of serotonin concentrations. These findings present a small step toward unifying cognitive and neurobiological theories of depression.     

Cognitive and Interpersonal Predictors of Stress Generation in Children of Affectively Ill Parents

Stress generation is a process in which individuals, through their depressive symptoms, personal characteristics, and/or behaviors, contribute to the occurrence of stressful life events. While this process has been well documented in adults, few studies have examined it in children. The present study examines whether cognitive and interpersonal vulnerability factors to depression contribute to stress generation in children, independent of their current depressive symptoms. Participants included 140 children (ages 6 to 14) and one of their parents. During an initial assessment, children completed self-report measures assessing cognitive and interpersonal vulnerability factors to depression. Children and their parents also completed measures assessing depressive symptoms. One year later, children and their parents participated in a semi-structured interview assessing the occurrence of stressful life events in the past year. Multi-level modeling results provided strong support for the stress generation process in children of affectively ill parents and highlight the importance of considering gender and age moderation effects.

Implicit depression and hopelessness in remitted depressed individuals

Cognitive theories of depression posit that automatically activated cognitive schemas, including negative thoughts about the self and the future, predispose individuals to develop depressive disorders. However, prior research has largely examined these constructs using explicit tests in currently depressed individuals. Using the Implicit Association Test (IAT), the present study examined automatic associations between the self and mood state ("depression IAT") and between the future and mood state ("hopelessness IAT") before and after a negative mood induction in 19 remitted depressed individuals and 23 healthy controls. In the depression IAT, remitted depressed participants exhibited an overall lower tendency to associate themselves with happiness relative to the healthy controls before the mood induction. Control, but not remitted depressed, participants' automatic associations between the self and happiness diminished following the mood induction. Contrary to our hypotheses, no significant findings emerged when considering the hopelessness IAT. Consistent with prior studies, no significant correlations emerged between implicit and explicit biases, suggesting that these measures probe different processes. Results extend prior IAT research by documenting the presence of a reduced tendency to associate the self with happiness in a sample at increased risk for depression.     

Relationships between cognitive coping,self-esteem,anxiety and depression: A cluster-analysis approach

It is important for prevention efforts and for designing appropriate interventions to identify people at risk of depression while considering cognitive coping and individual characteristics. This study with 334 French adults examined the ways in which people may combine the use of several cognitive coping strategies and investigated whether depression, self-esteem, and state- and trait-anxiety would differ across distinctive cognitive coping profiles. A two-phased cluster analytic plan was employed to derive clusters of cognitive coping profiles. We identified three profiles that differed according to the levels of depression, self-esteem, and state- and trait-anxiety. Research should therefore not focus on a single cognitive coping strategy, but on all cognitive coping strategies that are used simultaneously to investigate the relation between cognitive coping and emotional problems. Cognitive coping profiles provided a deeper understanding of how different individuals cope with negative and unpleasant events, and they allowed us to identify targeted groups that are most likely to benefit from specific mental health promotion and prevention campaigns.     

Implicit interpretation biases affect emotional vulnerability: A training study

Cognitive theories of emotion propose that the interpretation of emotion-eliciting situations crucially shapes affective responses. Implicit or automatic biases in these interpretations may hinder emotion regulation and thereby increase risk for the onset and maintenance of psychological disorders. In this study, participants were randomly assigned to a positive or negative interpretation bias training using ambiguous social scenarios. After the completion of the training, a stress task was administered and changes in positive and negative affect and self-esteem were assessed. The results demonstrate that the interpretation bias training was successful in that participants exhibited a tendency to interpret novel scenarios in accordance with their training condition. Importantly, the positive training condition also had a protective effect on self-esteem. Participants in this condition did not exhibit a decrease in self-esteem after the stress task, whereas participants in the negative condition did. These results demonstrate that implicit cognitive biases can be trained and that this training affects self-esteem. Implications of these findings for research on psychopathology and emotion regulation are discussed.     

Relation of depression to perceived social support: results from a randomized adolescent depression prevention trial

Theorists posit that certain behaviors exhibited by depressed individuals (e.g., negative self-statements, dependency, reassurance seeking, inappropriate or premature disclosures, passivity, social withdrawal) reduce social support, yet there have been few experimental tests of this hypothesis. Using data from a randomized depression prevention trial (N = 253) involving adolescents (M age = 15.5, SD = 1.2), we tested whether a cognitive behavioral group intervention that significantly reduced depressive symptoms relative to bibliotherapy and educational brochure control conditions through 2-year follow-up produced improvements in perceived parental and friend social support and whether change in depressive symptoms mediated the effect on change in social support. Cognitive behavioral group participants showed significantly greater increases in perceived friend social support through 1-year follow-up relative to bibliotherapy and brochure controls, but there were no significant effects for perceived parental support. Further, change in depressive symptoms appeared to mediate the effects of the intervention on change in perceived friend support. Results provide experimental support for the theory that depressive symptoms are inversely related to perceived social support, but imply that this effect may be specific to friend vs. parental support for adolescents.     

Motivation and goal orientation in vulnerability to depression

Depression may be related to motivational systems that govern approach and avoidance behaviour such as temperament and goal orientation. Using a remitted depression design we found that previously depressed and never-depressed individuals did not differ on number of approach goals generated, degree of goal commitment or extent of planning to reach goals. However, previously depressed individuals generated more avoidance goals indicating that the tendency to set avoidance goals may be a trait-like vulnerability to depression. Previously depressed individuals also reported higher activation of the behavioural approach system (BAS) raising the possibility that this system is energising approach behaviour in the service of avoiding aversive consequences.