The direct and interactive effects of neuroticism and life stress on the severity and longitudinal course of depressive symptoms

The direct and interactive effects of neuroticism and stressful life events (chronic and episodic stressors) on the severity and temporal course of depression symptoms were examined in 826 outpatients with mood and anxiety disorders, assessed on 3 occasions over a 1-year period (intake and 6- and 12-month follow-ups). Neuroticism, chronic stress, and episodic stress were uniquely associated with intake depression symptom severity. A significant interaction effect indicated that the strength of the effect of neuroticism on initial depression severity increased as chronic stress increased. Although neuroticism did not have a significant direct effect on the temporal course of depression symptoms, chronic stress significantly moderated this relationship such that neuroticism had an increasingly deleterious effect on depression symptom improvement as the level of chronic stress over follow-up increased. In addition, chronic stress (but not episodic stress) over follow-up was uniquely predictive of less depression symptom improvement. Consistent with a stress generation framework, however, initial depression symptom severity was positively associated with chronic stress during follow-up. The results are discussed in regard to diathesis-stress conceptual models of emotional disorders and the various roles of stressful life events in the onset, severity, and maintenance of depressive psychopathology.     

The contribution of negative reproductive experiences and chronic medical conditions to depression and pain among Israeli women

This study of 302 Israeli women sought to investigate the associations among stressful reproductive experiences (e.g. fertility problems, abortions, and traumatic births), chronic medical conditions, pain, and depression. The specific aims of the study were to examine (1) the effect of stressful reproductive experiences, chronic medical conditions, and pain on depressive symptoms and (2) the effect of stressful reproductive experiences, chronic medical conditions, and depressive symptoms on pain. Our findings corroborate with previous studies demonstrating that depression and pain are two interrelated, but different phenomena, which have both common and distinct risk factors. The findings are discussed in the light of stress and adaptation theories that point to the long-term effects of stressful life events on emotional and physiological aspects such as depression and pain.     

Dysfunctional attitudes and psychosocial stress: The differential prediction of future psychological symptomatology

The interactive effects of dysfunctional attitudes, stressful life events, and social support on symptoms of depression and general psychological distress were investigated in the present study. Self-report measures of these five constructs were administered to 57 female undergraduates twice, with 3 months between testing sessions. Whereas the interactions of dysfunctional attitudes with stressful life events and with social support were expected to predict the subsequent severity of symptoms of depression, it was hypothesized that these two-way interactions would not predict symptoms of general psychological distress. These predictions were confirmed, with the exception that the interaction between dysfunctional attitudes and stressful life events was not a significant predictor of depressive symptoms. Specifically, it was found that the combination of a high number of dysfunctional attitudes measured at Time 1 with a low level of social support measured at Time 2 was positively related to the level of depressive symptoms assessed at Time 2. These results suggest that dysfunctional attitudes moderate the relationship between stress and mild depressive symptomatology. The implications of these findings for an interactional model of depression, as well as for directions for future research, are discussed.Preparation of this article was facilitated by a Medical Research Council of Canada Studentship to the first author, and by Grant MA-8574 from the Medical Research Council of Canada to the second author.     

Are Reports of Life Event Stress among Suicidal Youth Subject to Cognitive Bias?

Severity of depressive symptoms, hopelessness, and suicidal ideation were examined to determine whether they were significantly associated with the accuracy of suicidal adolescents' ratings of stressful life events. The sample included 130 inpatient adolescents who endorsed suicide‐related behaviors. Stress interviews were administered, and the severity of stressful events was rated separately by adolescents and an independent team. A residualized cognitive bias score was created by regressing adolescents' severity ratings to the independent team's severity ratings of the same events. Depressive symptoms, but not hopelessness or suicidal ideation, were significantly associated with cognitive bias scores. A negative cognitive bias in adolescents' reports of life stress may be present at higher levels of depression relative to minimal levels of depression. Further research on the relations between stress and suicide‐related behaviors is encouraged to include independent ratings of stress severity.     

Generation of stress in the course of unipolar depression.

The effect of stressful events on depression has been amply demonstrated, but the opposite relation is also important. I examined event occurrence over 1 year in 14 women with unipolar depression who were compared with demographically matched groups of women with bipolar disorder (n = 11), chronic medical illness (n = 13), or no illness or disorder (n = 22). Interview assessments of life events, severity, and independence of occurrence confirmed the hypothesis that unipolar women were exposed to more stress than the normal women, had significantly more interpersonal event stress than all others, and tended to have more dependent events than the others. The implication is that unipolar women by their symptoms, behaviors, characteristics, and social context generate stressful conditions, primarily interpersonal, that have the potential for contributing to the cycle of symptoms and stress that create chronic or intermittent depression.     

Life events can trigger depressive exacerbation in the early course of schizophrenia

Previous studies have linked life events with depression in chronic schizophrenia, but those studies had methodological limitations. Using a prospective research design and examining events that were clearly independent of the patients' illnesses, the authors sought to determine whether stressful life events could trigger depressive symptoms in the early course of schizophrenia. Schizophrenia patients (n = 99) were followed for 1 year from a point of outpatient stabilization. Life event interviews were conducted every 4 weeks and symptom assessments every 2 weeks. Survival analyses showed a significantly increased risk for an exacerbation of significant depressive symptoms following an independent life event. Of interest is that an analysis of competing risk showed that the odds of psychotic exacerbation following a major independent life event were not significantly greater than the odds of depressive exacerbation. The risk of depression and of psychosis after experiencing a stressful life event is significantly increased for the first month, but the risk period can extend to 3 months.     

Behavioral manifestations of social support: a microanalytic investigation

This study was designed to examine the specific interpersonal behaviors that convey support from one person to another. Subjects were 41 undergraduate students who completed a general measure of perceived social support and, subsequently, kept daily records of their social interactions and stressful experiences for 14 days. In addition, they completed a brief depressive mood measure (DACL; Lubin, 1981) each day. Results showed that behaviors reflecting emotional support and informational support occurred as a specific response to stressful life events. Although esteem support was expressed with equal frequency in the presence and absence of stress, it was especially effective in preventing depressive reactions to stressful events. Subjects who perceived themselves as having high levels of perceived social support were more frequently the recipients of helping behaviors following stressful events than those low in perceived support. Perceived social support was only predictive of helping behaviors on days on which at least one stressful event occurred. The total number of helping behaviors received following stressful events was a significant negative predictor of level of depressive mood, although one helping behavior was associated with higher levels of depression. Results are interpreted within the framework of the buffering model of social support.     

The indirect effects of emotion regulation on the association between attachment style,depression, and meaning made among undergraduates who experienced stressful events

Undergraduates frequently report exposure to stressful life events which may negatively impact mental health. The current study examined associations among attachment style, depression, and meaning made, and tested both direct effects and indirect effects through emotion regulation difficulties. Undergraduates (N?=?336) who reported having experienced stressful and/or potentially traumatic events completed measures through an online survey. More than half of participants (64%) were female, with a mean age of 19.26 years. In both models, higher attachment anxiety and higher attachment avoidance were significantly associated with greater difficulties with accessing emotion regulation strategies, which in turn were related to higher depression symptom severity and lower meaning made. Lack of emotional awareness also partially explained the associations between attachment avoidance and outcomes in both models. Difficulties in engaging in goal-directed behavior partially explained the associations between attachment anxiety and meaning made, but not depression symptom severity. Our results suggest certain emotion regulation strategies may be key mechanisms through which individuals with high attachment anxiety or avoidance may reduce the potential negative mental health impact that stressful life events may have.     

Mediators of the Relationship Between Life Events and Memory Functioning in a Community Sample of Adults

The present study examines the association of frequency and severity of life events with memory functioning in a community sample of adults. We tested the hypothesis that stress‐related cognitive interference mediated the effects of recent life events on cognition, in addition to examining the potential roles of fatigue, sleep disturbances, and depression. The sample consisted of 310 adults (age range 19–83 years) who received a battery of cognitive tests assessing their primary memory, episodic memory, and working memory. Individuals rated how stressful previous life events were when they occurred, as well as how stressful the events were for them currently. Ratings of current but not past severity were negatively associated with working memory performance. Both stress‐related cognitive interference and depressive symptoms independently mediated this association. These findings highlight the importance of intrusive and avoidant thinking as a potential focus of psychosocial treatment for remediating stress‐related memory dysfunction. Copyright © 2014 John Wiley & Sons, Ltd.     

Understanding the impact of prior depression on stress generation: Examining the roles of current depressive symptoms and interpersonal behaviours

Stress generation is a process in which individuals contribute to stressful life events. While research has supported an association between current depression and stress generation, it has been noted that individuals with prior depression tend to contribute to stressors even when they are no longer experiencing a depressive episode. The aim of the study is to elucidate the pathways through which prior major depression predicts interpersonal stress generation in women. Specifically, we examined current subsyndromal depressive symptoms and problematic interpersonal behaviours as potential mediators. Fifty‐one college women were followed prospectively for 6 weeks. Participants were interviewed to assess current and past depression as well as stressful life events they experienced over the 6‐week period. The findings suggest that prior major depression continues to have an impact even after the episode has ended, as the disorder continues to contribute to stress generation through residual depressive symptoms.     

The relation between low self-esteem and depressive mood in a non-clinical sample: The role of gender and negative life events

The suggestion that self-esteem is both a protective and a risk factor for depression is well documented. However, this association is not consistently observed by empirical research. The current study investigated the main and interactive effects of low self-esteem and stressful life events on depressive mood in a sample of university students (N = 862; female = 72%; black = 67%; mean age = 21.70, SD = 13.51). The students completed the Hopkins Symptom Checklist, the Rosenberg Self-Esteem Scale, and the Perceived Stress Scale. Data were analysed using structural equation modelling (SEM); with stressful life events scores as a mediator, and gender as a moderator, of the relation between low self-esteem and depression. Results indicate that low self-esteem significantly predicted depression, and that stressful life events partially mediated that relationship. Support emerged for the vulnerability effects of low self-esteem on depression and they held across gender groups. Low self-esteem may be a significant indicator of individuals who are at risk for developing depressive mood.     

Early Pubertal Timing as a Vulnerability to Depression Symptoms: Differential Effects of Race and Sex

Robust evidence supports that girls and boys who experience early pubertal timing, maturing earlier than one’s peers, are vulnerable to developing symptoms of depression. However, it has yet to be clarified whether early pubertal timing confers vulnerability to African American as well as to Caucasian adolescents and whether this vulnerability is specific to depressive symptoms or can be generalized to symptoms of social anxiety. In previous studies, one race or one sex was examined in isolation or sample sizes were too small to examine racial differences. Our longitudinal study consisted of a sample of 223 adolescents (M_age?=?12.42, 54.3 % female, 50.2 % African American, and 49.8 % Caucasian). At baseline, depressive symptoms, social anxiety symptoms, and pubertal timing were assessed by self-report. Nine months later, we assessed depressive symptoms, social anxiety symptoms, body esteem, and stressful life events that occurred between baseline and follow-up. Analyses indicated that early pubertal timing interacted with stressful life events to predict increased symptoms of depression, but only for Caucasian girls and African American boys. Results were found to be specific to depressive symptoms and did not generalize to symptoms of social anxiety. Additionally, there was a significant positive indirect effect of pubertal timing on symptoms of depression through body esteem for Caucasian females.     

Depressive Symptoms Among Delinquent Youth: Testing Models of Association with Stress and Support

The high prevalence of depression among incarcerated youth indicates a need to better understand factors that contribute to depression within this vulnerable subgroup. Previous research in general community samples has suggested that high levels of stress and low levels of parental support are associated with depression in young people, but it is unclear whether or how they might be associated with depression among incarcerated youth who are already vulnerable. Using a sample of 228 adolescents (aged 13–18 years) who were detained in the juvenile justice system, stress and support were modeled as independent main effects and as interactive risk factors in relation to depressive symptoms. More stressful life events and less caregiver support were each independently associated with depressive symptoms, but no evidence was found for the buffering hypothesis in this sample. Stressful life events were more strongly associated with depressive symptoms among boys compared to girls.     

Sleep Quality and the Stress‐Buffering Role of Religious Involvement: A Mediated Moderation Analysis

Although several studies have documented an inverse association between stressful events and sleep quality, much less is known about the factors that might moderate or buffer against the adverse effects of psychosocial stress on sleep. Building on previous research, we employ national cross‐sectional survey data from the 2017 Baylor Religion Survey (n= 1,410) to test whether the association between recent stressful events and sleep quality varies according to several dimensions of religious involvement. We also formally assess whether any attenuation of the association between stressful events and sleep quality is at least partially mediated or explained by lower levels of depressive symptoms (mediated moderation). Our moderation analyses indicate that the inverse association between stressful events and sleep quality is in fact attenuated by religious cognitions (secure attachment to God and assurance of salvation), but not religious attendance or private religiousness. We also observe direct evidence of mediated moderation through depressive symptoms for both religious cognitions. Taken together, our results demonstrate that religious cognitions may buffer against stress‐related sleep disturbance by helping people avoid symptoms of depression.     

Measuring abuse stress and negative cognitive appraisals in child sexual abuse: Validity data on two new scales

The validity of two measures assessing degree of stress associated with child sexual abuse was examined in a sample of 48 girls who had been sexually abused. The Checklist of Sexual Abuse and Related Stressors (C-SARS) assessed negative life events that were part of or were related to the abuse, and the Negative Appraisals of Sexual Abuse Scale (NASAS) assessed negative cognitive appraisals of threat, harm, or loss associated with the abuse. Total scores for victim reports of both stressful events and negative appraisals were positively and significantly related to two other measures of abuse severity: therapist ratings of abuse stress and the number of types of sexual abuse reported. Stressful event scores were also related to aggressive behavior problems, sexual concerns, and total symptom scores on the Child Behavior Checklist. Negative cognitive appraisal scores were related to victims' self-reports of depression, anxiety, and posttraumatic stress symptoms, and to parent reports of child depression and total symptoms. Regression analyses indicated that there were significant effects of negative appraisals on internalizing symptoms when controlling for the level of stressful events experienced. The results suggest that negative life events and negative appraisals associated with sexual abuse are valid constructs that help account for variability in mental health outcomes among child victims. The implications of these results and future research directions in examining variable outcomes among sexual abuse victims are discussed.     

Sex differences and adolescent depression

This study investigates the role of certain psychosocial variables--sex, age, body image/self-esteem, self-consciousness, stressful life events, and the degree to which an individual identifies with the cultural stereotype of masculinity--as correlates and antecedents to depression in adolescents and explores possible intraindividual mediators of the stress-depression relationship in adolescents. A battery of self-report measures was administered to public high school students in Grades 9-12 in their classrooms at two different times 1 month apart. Female adolescents reported more depressive symptoms, self-consciousness, stressful recent events, feminine attributes, and negative body image and self-esteem; no age effects were obtained. Results suggest a model of adolescent depression in which body/self-esteem and stressful recent events are significant contributors.     

Early Maladaptive Schemas as Moderators of the Impact of Stressful Events on Anxiety and Depression in University Students

The aim of this study was to test the effects of early maladaptive schemas (EMS) derived from the Schema Therapy model (Young 1999) according to the diathesis-stress paradigm. We expected that EMS would make students more vulnerable to symptoms of depression and anxiety in the presence of stressful events and that the effects of these schemas would be different for each symptom. In particular, it was hypothesised that abandonment, emotional deprivation, defectiveness, and failure schemas would interact with stressful events to predict depressive symptoms, whereas abandonment, vulnerability to harm, and dependence schemas were expected to moderate anxiety symptoms. Due to gender differences in EMS and depressive and anxiety symptoms, we also expected that sex would act as a moderator of the relationships between EMS and symptoms. A two-wave prospective study showed that the presence of EMS constitutes a vulnerability factor for both, depressive and anxiety symptoms, and this effect was also moderated by sex. Moreover, the EMS’s content specificity revealed which schemas were more relevant to each symptom, providing valuable information for prevention and intervention programmes.     

Social support, stress, and depressive symptoms among the elderly: test of a process model.

Effects of social support, negative life events, and daily hassles on depressive symptoms were assessed in 301 adults aged 65 or older, in person 3 times at 6-month intervals and by mail questionnaires every month over a 12-month period. Initial social support predicted severity of depressive symptoms 12 months later. Social support and initial levels of depressive symptomatology predicted number of daily hassles but not number of major life events. Effects of social support, depression, and major life events on the incidence of daily hassles remained significant without the inclusion of hassles reflecting depressive symptomatology or problems in relationships or whose content overlapped with major life events. Daily hassles mediated the effects of major life events on subsequent depression. Results did not differ for men and women. Implications for models of the relations among social support, stress, and depression are discussed.     

Application of a stress and coping model to antenatal depressive symptomatology

This study examined the utility of a stress/coping model of antenatal depressive symptomatology. The direct and moderating effects of appraisal, coping resources and coping strategies on depression were explored. A total of 242 primiparous women completed questionnaires during the third trimester of pregnancy. Predictors included life events, coping resources (social support, quality of women's earlier relationships with parents), appraisal (threat, self-efficacy) and coping strategies (wishful thinking, positive reappraisal, problem solving, emotional approach). Results of regression analyses indicated that higher depression was related to higher stressful life events, threat appraisal and wishful thinking coping, and lower positive reappraisal coping. The expected stress exacerbation effects of wishful thinking on depression were supported. There was no support for the expected stress buffering effects of coping resources and coping strategies on depression. Findings provide preliminary support for the use of a stress/coping model to guide future research into psychosocial predictors of antenatal depression.     

Depressive symptoms are associated with unrealistic negative predictions of future life events

This study examined the relationship between depressive symptoms and bias in the prediction of future life events. Responding to internet announcements, 153 participants varying widely in self-reported depression symptom severity estimated the probability of 40 events occurring over the succeeding 30 days. After the 30-day period, participants reported which events occurred. Optimistic/pessimistic biases were related to level of depressive symptoms. A non-significant optimistic bias characterized participants with low depressive symptoms whereas a significant pessimistic bias characterized participants with high depressive symptoms. Those reporting mild symptoms did not exhibit a systematic pessimistic or optimistic bias. General imprecision in predictions for undesirable events was associated with depressive symptoms. These findings suggest that depression is associated with pessimistic bias rather than accuracy in judgment.