Transactional Relationships among Cognitive Vulnerabilities, Stressors, and Depressive Symptoms in Adolescence

The transactional cognitive vulnerability to stress model Hankin & Abramson (Psychological Bulletin, 127:773–796, 2001) extends the traditional diathesis-stress model by proposing that the relationships among cognitions, depressive symptoms, and stressors are dynamic and bidirectional. In this study three different pathways among these variables were assessed simultaneously: (1) cognitive vulnerabilities and stressors as predictors of depressive symptoms (vulnerability model), (2) depressive symptoms and cognitive vulnerabilities as predictors of stressors (stress generation model), and (3) depressive symptoms and stressors as predictors of cognitive vulnerabilities (consequence model). A fully cross-lagged design panel was employed with 1,187 adolescents (545 girls and 642 boys, Mean Age?=?13.42 years) who were assessed at two time points separated by 6 months. They completed measures of cognitive vulnerabilities (maladaptive schema domains and negative inferential style), stressors, and depressive symptoms. Inferential style and schemas of the disconnection and rejection domain predicted prospective increases in depressive symptoms. Initial levels of depressive symptoms and most cognitive vulnerabilities predicted greater stress generation. Initial levels of stressors and depressive symptoms predicted an increase in negative inferential style and maladaptive schema domains over time. These bidirectional relationships were mostly similar for boys and girls, although there were a few gender differences. The findings support a transactional model with reciprocal relationships among stress, depressive symptoms, and cognitive vulnerabilities. Transactional implications for depression interventions among adolescents are discussed.     

Cognitive Vulnerability–Stress Model of Depression During Adolescence: Investigating Depressive Symptom Specificity in a Multi-Wave Prospective Study

Depression commonly co-occurs with anxiety and externalizing problems. Etiological factors from a central cognitive theory of depression, the Hopelessness Theory (Abramson et al. Psychological Review, 96, 358-372, 1989), were examined to evaluate whether a negative inferential style about cause, consequence, and self interacted with stressors over time to predict prospective elevations in depressive symptoms specifically compared with typically co-occurring symptoms. Negative inferential style was assessed at baseline in a sample of early and middle adolescents (N = 350, sixth to tenth graders). Measures of general depressive, anhedonic depressive, anxious arousal, general internalizing, and externalizing symptoms and occurrence of stressors were assessed at four time points over a 5-month period. Results using hierarchical linear modeling show that a negative inferential style interacted with negative events to predict prospective symptoms of general and anhedonic depression specifically but not anxious arousal, general internalizing or externalizing symptoms. Negative events predicted prospective elevations of symptoms of anxious arousal, internalizing, and externalizing problems.     

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.     

The relationship between automatic thoughts and negative emotions in children and adolescents: a test of the cognitive content-specificity hypothesis

The aim of this study was to test the cognitive content-specificity hypothesis in children and adolescents aged 7-16 years. Participants consisted of a community sample of 200 youth and a clinical sample of 160 youth with anxiety, depressive, or disruptive behavior disorders. Participants completed several self-report measures assessing a wide range of negative beliefs and symptoms of internalizing and externalizing problems. Multivariate analyses examining the interrelationships between beliefs and noncognitive symptoms revealed that thoughts on loss or personal failure were the strongest predictors of depressive symptoms, thoughts on social threat were the strongest predictors of anxiety symptoms, and thoughts on hostility or revenge were the strongest predictors of aggression. Results showed clear evidence of cognitive-affective specificity across both internalizing and externalizing problems in youth.     

Neuroticism,Life Events and Negative Thoughts in the Development of Depression in Adolescent Girls

Theories of depression suggest that cognitive and environmental factors may explain the relationship between personality and depression. This study tested such a model in early adolescence, incorporating neuroticism, stress-generation and negative automatic thoughts in the development of depressive symptoms. Participants (896 girls, mean age 12.3 years) completed measures of personality and depressive symptoms, and 12 months later completed measures of depressive symptoms, recent stressors and negative automatic thoughts. Path analysis supported a model in which neuroticism serves as a distal vulnerability for depression, conferring a risk of experiencing dependent negative events and negative automatic thoughts, which fully mediate the effect of neuroticism on later depression. A second path supported a maintenance model for depression in adolescence, with initial levels of depression predicting dependent negative events, negative automatic thoughts and subsequent depressive symptoms. Unexpectedly, initial depression was also associated with later independent life events. This study establishes potential mechanisms through which personality contributes to the development of depression in adolescent girls.     

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.     

A Comparison of Stress Measures in Children and Adolescents: A Self-Report Checklist Versus an Objectively Rated Interview

A self-report checklist assessing the occurrence of stressful life events in children and adolescents' lives was compared to an objectively rated interview to determine whether the checklist would introduce over-reporting of events or over-rating of event severity as a function of child/parent depressive symptoms, cognitive vulnerability, or anxiety. Participants completed the Children's Life Events Scale (CLES), the Life Events Interview (LEI), and questionnaires assessing cognitive vulnerability and symptoms of depression and anxiety. Findings yielded a positive association between the checklist and the interview. Contrary to hypotheses, depressive symptoms, cognitive vulnerability, and anxiety were not associated with over-reporting of events. Anxiety was associated with over-rating of event severity in parents but not children. Findings suggest that the checklist and interview may be equally viable approaches to assessing the occurrence of life events. Findings have mixed implications with regard to assessing event severity, as subjective reports may be systematically influenced by anxiety.

The Role of Repetitive Negative Thoughts in the Vulnerability for Emotional Problems in Non-Clinical Children

The current study examined the role of repetitive negative thoughts in the vulnerability for emotional problems in non-clinical children aged 8–13 years (N = 158). Children completed self-report questionnaires for assessing (1) neuroticism and behavioral inhibition as indicators of general vulnerability (2) worry and rumination which are two important manifestations of repetitive negative thoughts, and (3) emotional problems (i.e., anxiety, depression, and sleep difficulties). Results demonstrated that there were positive correlations between measures of general vulnerability, repetitive negative thoughts, and emotional problems. Further, support was found for a model in which worry and rumination acted as partial mediators in the relation between neuroticism and symptoms of anxiety and depression. In the case of sleep difficulties, no evidence was obtained for such a mediation model. In fact, data suggested that sleeping difficulties are better conceived as an epiphenomenon of high symptom levels of anxiety and depression or as a risk factor for the development of other types of psychopathology. Finally, besides neuroticism, the temperamental trait of behavioral inhibition appeared to play a unique direct role in the model predicting anxiety symptoms but not in the models predicting depressive symptoms or sleep difficulties. To conclude, the current findings seem to indicate that worry and rumination contribute to children’s vulnerability for anxiety and depression.     

Vulnerability to depressive symptomatology: a prospective test of the diathesis-stress and causal mediation components of the hopelessness theory of depression.

The diathesis-stress and causal mediation components of the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989) were tested using a prospective methodology. Measures of the 3 vulnerability factors posited by the theory (cognitive diatheses about cause, consequences, and self) were completed by 152 Ss at Time (T) 1. Ss completed measures of depressive symptoms, anxious symptoms, and hopelessness at T1 and again at T2, 5 weeks later. Naturally occurring stressors were assessed at T2 (covering the T1-T2 interval). Consistent with the diathesis-stress component, each Cognitive Diathesis x Stress (CD x S) interaction predicted onset of depressive symptoms from T1 to T2. In contrast, the CD x S interactions predicted neither state nor trait anxiety. In addition, 2 of the 3 CD x S interactions (those involving cause and self, but not consequences) were partially mediated by hopelessness. Implications for future work on the hopelessness theory of depression are discussed.     

Rumination in Response to Stress as a Common Vulnerability Factor to Depression and Substance Misuse in Adolescence

The current study examined rumination in response to stress as a common vulnerability factor to both depression and substance use problems in adolescence. Specifically, we used a multi-wave longitudinal design to examine whether adolescents who tend to ruminate in response to stress exhibit increases in depressive symptoms and substance misuse following the occurrence of negative events. At time 1, adolescents (n = 161) completed measures assessing depressive symptoms, substance misuse, and the tendency to ruminate in response to stress. Every 6 weeks for the next 18 weeks participants completed measures assessing the occurrence of negative events, depressive symptoms, and substance misuse. Hierarchical linear modeling analyses indicated that adolescents who tend to ruminate in response to stress report greater elevations in depressive symptoms and substance misuse following elevations in negative events than other adolescents. The relationship between rumination, negative events, and substance misuse was moderated by age. Support was not obtained for fluctuations in depressive symptoms as a mediator of the relationship between negative events and substance misuse. Fluctuations in negative affect, however, were found to mediate this relationship.

Identifying Cognitive and Interpersonal Predictors of Adolescent Depression

Emerging research has begun to examine cognitive and interpersonal predictors of stress and subsequent depression in adolescents. This research is critical as cognitive and interpersonal vulnerability factors likely shape expectations, perspectives, and interpretations of a given situation prior to the onset of a stressor. In the current study, adolescents (n?=?157; boys=64, girls=93), ages 12 to 18, participated in a 6-month, multi-wave longitudinal study examining the impact of negative cognitive style, self-criticism, and dependency on stress and depression. Results of time-lagged, idiographic multilevel analyses indicate that depressogenic attributional styles (i.e., composite score and weakest link approach) and self-criticism predict dependent interpersonal, but not noninterpersonal stress. Moreover, the occurrence of stress mediates the relationship between cognitive vulnerability and depressive symptoms over time. At the same time, self-criticism predicts above and beyond depressogenic attributional styles (i.e., composite and weakest link approach). In contrast to our hypotheses, dependency does not contribute to the occurrence of stress, and additionally, no gender differences emerge. Taken together, the findings suggest that self-criticism may be a particularly damaging vulnerability factor in adolescence, and moreover, it may warrant greater attention in the context of psychotherapeutic interventions.     

Cognitive Vulnerabilities as Predictors of Stress Generation in Early Adolescence: Pathway to Depressive Symptoms

Although individuals with depression have been found to experience a higher rate of stress in their lives, it remains unclear to what extent other personal characteristics may contribute to stress generation. The current study extended past research by examining the effects of two theoretically and empirically supported cognitive vulnerabilities to depression (negative cognitive style and rumination) as predictors of dependent interpersonal and achievement events, independent events, and relational peer victimization. In a diverse sample of 301 early adolescents (56 % female; M_age?=?12.82 years), we found that negative cognitive style prospectively predicted the experience of dependent interpersonal stress and relational victimization, and that rumination did not predict stress in any of the domains. Furthermore, the occurrence of intervening stress mediated the associations between negative cognitive style and subsequent depressive symptoms. Additionally, whereas negative cognitive style predicted relational victimization among both boys and girls, girls were particularly vulnerable to developing depressive symptoms following the occurrence of relational victimization. Thus, a negative cognitive style may contribute to the occurrence of stressful events, which in turn increases depressive symptoms. Girls may be particularly reactive to relational victimization, representing one pathway through which sex differences in depression may emerge.     

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.

The impact of parental borderline personality disorder on vulnerability to depression in children of affectively ill parents

Children of parents with major depressive disorder (MDD) are four to six times more likely than other children to develop MDD. Little research has examined whether comorbid parental diagnoses further increase children's risk. This study examines whether children of parents with comorbid MDD and Borderline Personality Disorder (BPD) (1) are at greater risk for experiencing depressive symptoms and/or episodes and (2) whether such increased risk may be due, in part, to their exhibiting higher levels of cognitive/interpersonal vulnerability factors. Children (n = 140; ages 6-14) of parents with MDD completed measures assessing cognitive/interpersonal vulnerability factors. Parents completed semi-structured clinical interviews assessing severity of current depressive symptoms and BPD. Both children and parents completed a semi-structured clinical interview assessing the child's current and past history of MDD. Children of parents with comorbid MDD and BPD exhibited higher levels of current depressive symptoms and higher levels of cognitive/interpersonal vulnerability factors than children of parents with MDD but no BPD, even after controlling for parents' current levels of depressive symptoms. The relationship between parental BPD and chil-dren's current levels of depressive symptoms was partially mediated by children's cognitive/interpersonal vulnerability factors. Last, children of parents with comorbid BPD and MDD were 6.84 times more likely to exhibit a current or past diagnosis of MDD.     

Multi-wave Prospective Examination of the Stress-Reactivity Extension of Response Styles Theory of Depression in High-Risk Children and Early Adolescents

The current study tested the stress-reactivity extension of response styles theory of depression (Nolen-Hoeksema Journal of Abnormal Psychology 100:569–582, 1991) in a sample of high-risk children and early adolescents from a vulnerability-stress perspective using a multi-wave longitudinal design. In addition, we examined whether obtained results varied as a function of either age or sex. During an initial assessment, 56 high-risk children (offspring of depressed parents; ages 7–14) completed measures assessing rumination and depressive symptoms. Children were subsequently given a handheld personal computer which signalled them to complete measures assessing depressive symptoms and negative events at six randomly selected times over an 8-week follow-up interval. In line with hypotheses, higher levels of rumination were associated with prospective elevations in depressive symptoms following the occurrence of negative events. Sex, but not age, moderated this association. Rumination was more strongly associated with elevations in depressive symptoms following the occurrence of negative events in girls than in boys.     

Do extraversion and neuroticism moderate the association between bullying victimization and internalizing symptoms? A three-wave longitudinal study

The current study examined the moderating roles of neuroticism and extraversion in victims of bullying. According to a stress-diathesis model, we hypothesized that adolescents with high levels of neuroticism and low levels of extraversion would react to victimization with increased symptoms of depression and social anxiety. A sample of 1440 adolescents (648 girls and 792 boys; ages between 13- and 17-years-old) completed measures of extraversion and neuroticism at time 1, as well as measures of bullying victimization, depressive symptoms and social anxiety symptoms at time 1, time 2, and time 3 (in intervals of six months). The results of multilevel analyses for longitudinal data indicated that there was a weak association between bullying victimization and social anxiety symptoms for the adolescents who scored high on extraversion. In addition, the adolescents with high levels of extraversion presented a greater reduction in depressive symptoms over time than adolescents with low levels. Although neuroticism predicted both depression and social anxiety, no significant interactions were evident between neuroticism and bullying victimization. Regarding gender differences, the association between bullying victimization and social anxiety was stronger for boys than for girls, whereas the association between neuroticism and depression was stronger for girls.     

A Cognitive-Interpersonal Approach to Depressive Symptoms in Preadolescent Children

Cognitive and interpersonal aspects of depressive symptoms were investigated in a community sample of children. Eighty-one 8- to 12-year-olds completed scales assessing cognitive representations of social relationships and symptoms of depression and anxiety. Teachers provided ratings of peer rejection. Children with elevated levels of depressive symptoms displayed increased negativity in their beliefs about self, family, and peers, as well as distinct patterns of interpersonal information processing. Anxiety symptoms did not make a unique contribution beyond depression to negative representations of family and peers; in contrast, symptom-specific profiles of self-representations were found. Structural equation analysis supported a model linking negative interpersonal representations, peer rejection, and depressive symptoms. The findings suggest that future studies may benefit from approaches that incorporate both cognitive and interpersonal variables as predictors of child depression.     

高中生沉思与应激性生活事件对抑郁症状的影响:1年追踪研究

探讨沉思及沉思亚型与应激性生活事件的交互作用对抑郁症状的影响。采用流调中心用抑郁量表、青少年生活事件问卷和沉思反应量表等自评量表对527名高中生的抑郁症状、应激性生活事件和沉思进行评估,随后每3个月测评一次抑郁症状和应激性生活事件的发生情况,追踪调查1年,用多层线性模型分析数据。结果表明:沉思和强迫性冥思对抑郁症状的主效应显著,而反思不显著;沉思、强迫性冥思和反思与生活事件对抑郁症状的交互作用均不显著。结论:应激性生活事件和强迫性冥思会加重抑郁症状,而反思没有加重抑郁症状;沉思及亚型均不会改变应激性生活事件对抑郁症状的影响程度。     

Depressogenic cognitive styles: predictive validity, information processing and personality characteristics, and developmental origins.

Two of the major cognitive theories of depression, the theory of Beck [Beck, A. T. (1967). Depression: clinical, experimental and theoretical aspects. New York: Harper & Row. and Beck, A. T. (1987) Cognitive models of depression. Journal of Cognitive Psychotherapy: an International Quarterly, 1, 5-37] and the hopelessness theory [Abramson, Metalsky, & Alloy, (1989) Hopelessness depression: a theory-based subtype of depression. Psychological Review, 96, 358-372], include the hypothesis that particular negative cognitive styles increase individuals' likelihood of developing episodes of depression, in particular, a cognitively mediated subtype of depression, when they encounter negative life events. The Temple-Wisconsin Cognitive Vulnerability to Depression (CVD) project is a two-site, prospective longitudinal study designed to test this cognitive vulnerability hypothesis, as well as the other etiological hypotheses of Beck's and the hopelessness theories of depression. In this article, based on CVD project findings to date, we review evidence that the hypothesized depressogenic cognitive styles do indeed confer vulnerability for clinically significant depressive disorders and suicidality. In addition, we present evidence regarding moderators of these depressogenic cognitive styles, the information processing and personality correlates of these styles and the possible developmental antecedents of these styles. We end with a consideration of future research directions and the clinical implications of cognitive vulnerability to depression.     

Cognitive Vulnerability to Depression in Canadian and Chinese Adolescents

The goal of the current study was to compare diathesis-stress and transactional models of cognitive vulnerability to depression in samples of Canadian (n = 118) and Chinese (n = 405) adolescents. We utilized a six-month multi-wave, longitudinal design in order to examine whether (a) perceived control moderated the association between the occurrence of dependent interpersonal stressors and subsequent increases in depressive symptoms (i.e., a diathesis-stress perspective) and (b) dependent interpersonal stressors mediated the association between perceived control and subsequent increases in depressive symptoms (i.e., a transactional perspective). Results from idiographic, time-lagged, hierarchical linear modeling analyses indicated that for Canadian adolescents both diathesis-stress and transactional models were significant predictors of depressive symptomology. When examining the diathesis-stress model, boys, but not girls, who reported lower perceived control, reported higher levels of depressive symptoms following the occurrence of dependent interpersonal stress. Gender differences, however, were not present in the transactional model. In contrast, transactional, but not diathesis-stress, models were significant in Chinese adolescents, and gender differences did not emerge. Overall, these results may reflect culturally-relevant differences in the etiology of depression in Canadian and Chinese adolescents.