Seeing the silver lining: cognitive reappraisal ability moderates the relationship between stress and depressive symptoms

Individuals differ in their adjustment to stressful life events, with some exhibiting impaired functioning, including depression, while others exhibit impressive resilience. The present study examined the hypothesis that the ability to deploy a particularly adaptive type of emotion regulation-cognitive reappraisal-may be a protective factor. It expands upon existing research in three ways. First, participants' ability to use reappraisal (cognitive reappraisal ability: CRA) was measured by using a behavioral challenge that assessed changes in experiential and physiological domains, rather than questionnaires. Second, all participants had been exposed to one or more recent stressful life events, a context in which emotion regulation may be particularly important. Third, a community sample of 78 women aged 20 to 60 was recruited, as opposed to undergraduates. Results indicate that, at low levels of stress, participants' CRA was not associated with depressive symptoms. However, at high levels of stress, women with high CRA exhibited less depressive symptoms than those with low CRA, suggesting that CRA may be an important moderator of the link between stress and depressive symptoms.     

Emotional intensity of idiographic sad memories in depression predicts symptom levels 1 year later

When cued with generic happy and sad words, depressed individuals have been found to articulate contextually impoverished memories of autobiographical events. Although this pattern predicts a worse symptomatic course of disorder in some depressed samples, longitudinal findings with the cue-word paradigm are inconsistent. To address the etiological significance of autobiographical memories outside the cue-word paradigm, the authors used an idiographic interview in which depressed participants generated memories of their happiest and saddest lifetime events. Each memory was coded for detail and emotional intensity. At a 1-year follow-up, participants' levels of depressive symptoms were reassessed. Lower emotional intensity of saddest memories predicted higher levels of depressive symptoms at follow-up. Several implications for understanding sadness and emotional disclosure in depression are discussed.     

Cognitive styles and life events interact to predict bipolar and unipolar symptomatology

This study examined the interaction of cognitive style (as assessed self-report and information-processing battery) and stressful life events in predicting the clinician-rated depressive and manic symptomatology of participants with Research Diagnostic Criteria lifetime diagnoses of bipolar disorder (n = 49), unipolar depression (n = 97), or no lifetime diagnosis (n = 23). Bipolar and unipolar participants' attributional styles, dysfunctional attitudes, and negative self-referent information processing as assessed at Time 1 interacted significantly with the number of negative life events that occurred between Times 1 and 2 to predict increases in depressive symptoms from Time 1 to Time 2. Within the bipolar group, participants' Time 1 attributional styles and dysfunctional attitudes interacted significantly, and their self-referent information processing interacted marginally, with intervening life events to predict increases in manic symptoms from Time 1 to Time 2. These findings provide support for the applicability of cognitive vulnerability-stress theories of depression to bipolar spectrum disorders.     

Task feedback effects on conflict monitoring and executive control: relationship to subclinical measures of depression

Emerging evidence suggests that depression is associated with executive dysfunction, particularly after committing errors or receiving negative performance feedback. To test this hypothesis, 57 participants performed two executive tasks known to elicit errors (the Simon and Stroop Tasks) during positive or negative performance feedback. Participants with elevated depressive symptoms (Beck Depression Inventory scores >or= 13) were characterized by impaired posterror and postconflict performance adjustments, especially during emotionally negative task-related feedback. Additionally, for both tasks, depressive symptoms were inversely related to postconflict reaction time adjustments following negative, but not positive, feedback. These findings suggest that subclinical depression is associated with impairments in behavioral adjustments after internal (perceived failure) and external feedback about deficient task performance.     

Overgeneral autobiographical memory as a predictor of the course of depression: A meta-analysis

Overgeneral autobiographical memory (OGM) is a robust phenomenon in depression, but the extent to which OGM predicts the course of depression is not well-established. This meta-analysis synthesized data from 15 studies to examine the degree to which OGM 1) correlates with depressive symptoms at follow-up, and 2) predicts depressive symptoms at follow-up over and above initial depressive symptoms. Although the effects are small, specific and categoric/overgeneral memories generated during the Autobiographical Memory Test significantly predicted the course of depression. Fewer specific memories and more categoric/overgeneral memories were associated with higher follow-up depressive symptoms, and predicted higher follow-up symptoms over and above initial symptoms. Potential moderators were also examined. The age and clinical depression status of participants, as well as the length of follow-up between the two depressive symptom assessments, significantly moderated the predictive relationship between OGM and the course of depression. The predictive relationship between specific memories and follow-up depressive symptoms became greater with increasing age and a shorter length of follow-up, and the predictive relationship was stronger for participants with clinical depression diagnoses than for nonclinical participants. These findings highlight OGM as a predictor of the course of depression, and future studies should investigate the mechanisms underlying this relationship.     

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.     

Treating Young Adult Depression With Text-Delivered Cognitive Behavioral Therapy: A Pilot Randomized Clinical Trial

Young adults (ages 18 to 25) in the U.S. suffer from the highest rates of past-year major depressive episode and are the least likely to receive treatment compared to other age groups. As such, we examined the feasibility, acceptability, and efficacy of a text-message delivered cognitive behavioral therapy: CBT-txt with young adults. The study was a 2-month pilot RCT to test a 4-week intervention for depression that contained 197 text messages (average 12 texts every other day). The sample, recruited via Facebook and Instagram, was 102 U.S. young adults who presented with at least moderate depressive symptomatology. Assessments occurred at baseline prior to randomization and at 1 and 2 months post enrollment. The primary outcome, severity of depressive symptoms, was assessed using the Beck Depression Inventory II. Feasibility benchmarks were met and participants reported high levels of engagement with and acceptability of the intervention. Logistic regression indicated that treatment participants were three times as likely to have minimal or mild depression symptoms at 2 months compared to waitlist control participants. Latent change score modeling found that the strongest significant treatment effect appeared at the 1-month follow-up period, particularly for participants who began with severe depressive symptoms. Mediation analysis revealed significant indirect treatment effects of increases in behavioral activation on reducing depressive symptoms, suggesting a mechanism of change. Limitations were that the sample was relatively small and consisted of primarily women. These results provide initial evidence for the feasibility, acceptability, and efficacy of a text-delivered treatment for young adult depression.     

Structure and measurement of depression in youths: applying item response theory to clinical data

Our goals in this article were to use item response theory (IRT) to assess the relation of depressive symptoms to the underlying dimension of depression and to demonstrate how IRT-based measurement strategies can yield more reliable data about depression severity than conventional symptom counts. Participants were 3,403 children and adolescents from 12 contributing clinical and nonclinical samples; all participants had received the Kiddie Schedule of Affective Disorders and Schizophrenia for School-Aged Children. Results revealed that some symptoms reflected higher levels of depression and were more discriminating than others. Furthermore, use of IRT-based information about symptom severity and discriminability in the measurement of depression severity was shown to reduce measurement error and increase measurement fidelity.     

Maladaptive coping, adaptive coping, and depressive symptoms: Variations across age and depressive state

Rumination has consistently been found to be associated with the onset and duration of major depressive episodes. Little research, however, has examined factors that may weaken the association between maladaptive coping, such as rumination, and depressive symptoms. In three samples of participants, including 149 never-depressed adolescent girls, 41 never-depressed women, and 39 depressed women, we examined whether generally adaptive forms of coping interacted with generally maladaptive forms of coping to predict depressive symptoms. Age-appropriate measures of coping and depression were administered to participants in each sample. In never-depressed females, maladaptive coping/rumination were more strongly related to depressive symptoms in the presence of lower levels of adaptive coping. The relation between depression and maladaptive coping/rumination was weaker in the context of higher levels of adaptive coping. In contrast, for the depressed females, we found main effects for rumination and adaptive coping, with higher levels of rumination and lower levels of adaptive coping being associated with higher levels of depressive symptoms. The present findings highlight how adaptive coping and maladaptive coping, including rumination, differentially relate to each other and depressive symptoms depending on individuals' current depressive state.     

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.     

Diurnal Patterns of Unpleasant Mood: Associations with Neuroticism, Depression, and Anxiety

The literature on symptoms of depression has included diurnal changes in mood. The morning-worse pattern is commonly mentioned. This pattern is often associated with endogenous or vegetative symptoms (e.g., weight and appetite loss, loss of pleasure, psychomotor retardation). However, depression researchers have also identified an evening-worse pattern of mood. This pattern is sometimes thought to be associated with milder depressive symptoms, and may characterize chronic dysthymia rather than clinical depression. The present study examines a nonclinical sample to test the hypothesis that an evening-worse diurnal pattern of mood would be associated with trait neuroticism, anxiety, and subclinical depressive symptoms. An experience sampling methodology was employed to assess mood three times a day for 60 consecutive days. This allowed us to calculate a reliable aggregate score for diurnal mood patterns. The evening-worse pattern was associated with many neurotic features, with scores on depression and anxiety measures, and with a cognitive style indicative of hopelessness. Discussion focuses on how an evening-worse diurnal pattern of mood may be indicative of mild subclinical depression, chronic dysthymia, or personality traits associated with negative affectivity.     

Symptoms of depression in Swedish fathers in the postnatal period and development of a screening tool

Methods for detecting depression in fathers after the birth of their child are scarce. The Edinburgh Postnatal Depression Scale (EPDS), used to screen mothers for postpartum depression (PPD), lacks somatization and externalizing items. This potentially decreases its sensitivity in detecting depression in fathers, as many men actually express depression with somatization or externalizing symptoms. The present study assessed depressive symptoms in fathers of children 0–18 months old, and evaluated whether addressing both typical depression and externalizing, so‐called “depressive equivalent” symptoms, might be more suitable for such assessment. The Beck Depression Inventory‐II (BDI‐II), EPDS, and Gotland Male Depression Scale (GMDS) were responded to by 447 Swedish fathers online. Among participants, 27% reported depressive symptoms above the BDI‐II cut‐off suggestive of depression. Most fathers reported both traditional and depressive equivalent symptoms and a subgroup expressed exclusively depressive equivalent symptoms. Consistently, a scale combining items from the EPDS and GMDS showed higher sensitivity than the EPDS alone in identifying fathers with elevated depressive symptoms, at equal levels of specificity. Our findings suggest that a combination of EPDS and depressive equivalent symptom items results in a more suitable instrument for screening for depression in fathers during the postnatal period.     

The Role of Perfectionism in Relation to an Intervention to Reduce Anxious and Depressive Symptoms in Children

Research has demonstrated an association between perfectionism and depressive and anxious symptoms in children. We examined whether a school-based program targeting anxious and depressive symptoms would reduce perfectionism, and whether perfectionism would interfere with intervention outcomes. The participants were 78 school-age children identified as at-risk for anxiety and/or depression. At-risk children took part in a randomized controlled trial of a school-based intervention program. Levels of perfectionism, depression, and anxiety were assessed at pre-treatment (Time 1) and again at post-treatment (Time 2) after participating in either a cognitive behavioral group or a structured activity group. Participation in either group was associated with significant reductions in overall levels of self-oriented perfectionism, anxious symptoms, and depressive symptoms. Supplementary analyses indicated that pre-treatment self-oriented perfectionism influenced post-treatment depression scores, suggesting that perfectionism interferes with treatment outcome. Perfectionism in children appeared amenable to group-based intervention, and identifying perfectionism may be important for treating children with depressive symptoms.     

Reduced substance use as a secondary benefit of an indicated cognitive-behavioral adolescent depression prevention program

Our first aim was to test whether a group cognitive-behavioral (CB) depression prevention program reduces substance use escalation over 2-year follow-up relative to two active comparison interventions and a brochure assessment control. Our second aim examined whether reductions in depressive symptoms mediate intervention effects, as posited by the affect-regulation model of substance use. In this indicated prevention trial, 341 high school adolescents at risk for depression because of the presence of elevated depressive symptoms were randomized to a Group CB intervention, group supportive-expressive group intervention, CB bibliotherapy, or educational brochure control condition. Participants in Group CB had significantly lower rates of substance use compared with brochure control participants at both 1- and 2-year follow-up and lower substance use at 2-year follow-up relative to bibliotherapy participants; no other condition differences were significant. Mediational analyses suggested that reductions in depressive symptoms from baseline to posttest accounted for changes in substance use over 2 years for participants in Group CB relative to brochure control participants but did not mediate effects relative to those receiving bibliotherapy. Results suggest that a secondary benefit of this CB group indicated depression prevention program is lower rates of long-term substance use. Findings supported the hypothesis that, relative to a nonactive comparison condition, reductions in depressive symptoms mediated the effects of Group CB prevention on substance use escalation. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

A longitudinal analysis of anxiety and depressive symptoms

The authors modeled depressive and anxiety symptom data from 1,391 participants in a longitudinal study of middle-aged and older Swedish twins (M age = 60.9 years, SD = 13.3). Although anxiety and depression were highly correlated, a model with distinct Anxiety and Depression factors fit the data better than models with Positive and Negative Affect factors or a single Mental Health factor. Lack of well-being was associated with anxiety rather than depression. Over two 3-year intervals, anxiety symptoms led to depressive symptoms, but the relationship was not reciprocal. Anxiety symptoms were more stable than depression. These findings provide additional support for the idea that anxiety symptoms may reflect a personality trait such as neuroticism more than do depressive symptoms and suggest that low positive affect may not be as specific to depression among older adults as in younger people.     

Directed forgetting of complex pictures in an item method paradigm

An item-cued directed forgetting paradigm was used to investigate the ability to control episodic memory and selectively encode complex coloured pictures. A series of photographs was presented to 21 participants who were instructed to either remember or forget each picture after it was presented. Memory performance was later tested with a recognition task where all presented items had to be retrieved, regardless of the initial instructions. A directed forgetting effect--that is, better recognition of "to-be-remembered" than of "to-be-forgotten" pictures--was observed, although its size was smaller than previously reported for words or line drawings. The magnitude of the directed forgetting effect correlated negatively with participants' depression and dissociation scores. The results indicate that, at least in an item method, directed forgetting occurs for complex pictures as well as words and simple line drawings. Furthermore, people with higher levels of dissociative or depressive symptoms exhibit altered memory encoding patterns.     

Cognitive schemas as longitudinal predictors of self-reported adolescent depressive symptoms and resilience

Given that depression risk intensifies in adolescence, examining associates of depressive symptoms during the shift from childhood to adolescence is important for expanding knowledge about the etiology of depression symptoms and disorder. A longitudinal youth report was employed to examine the trajectory of both the content and structure of positive and negative schemas in adolescence and also whether these schemas could prospectively predict depressive symptoms and youth-reported resilience. One hundred and ninety-eight participants (aged 9 to 14) were recruited from four schools to complete measures of youth depressive symptoms, resilience, and schema content and structure. Those who consented to a follow-up study completed the same measures online (50 participants completed). Negative and positive schema content and structure were related over time. After controlling depressive symptoms/resilience at Time 1, negative schema content was the only significant predictor (trend level) of depressive symptoms and resilience at Time 2. Implications for cognitive theories and clinical practice are discussed.     

The relation between depression and appreciation: The role of perceptions of emotional utility in an experimental test of causality

The present research examined the potential role of perceived utility of appreciation in depressive symptoms. In a between-subjects design, participants were induced to increase their experience of appreciation or their perceived usefulness of appreciation. Self-reported perceptions of emotional utility, actual experience of emotion, as well as depression scores gathered from semi-structured interviews, were obtained at baseline and post-induction. As predicted, although participants in both groups evidenced lower levels of depressive symptoms at post-induction than at baseline, there was a greater decrease among participants in the appreciation-utility condition than among those in the appreciation-experience condition. Further, perceived utility of appreciation was an important mediator in moderated mediation models.     

Stress, depressive symptoms, and smoking cessation among pregnant women.

Perceived stress and depressive symptoms were examined as correlates and predictors of smoking cessation during pregnancy in a sample of 819 pregnant smokers (454 baseline smokers and 365 baseline quitters). Women who quit early in pregnancy had lower levels of stress and depressive symptoms than baseline smokers. Adjusting for level of addiction and other demographic factors related to stress and depressive symptoms eliminated the significant association between depressive symptoms and smoking cessation. Lower levels of stress and depressive symptoms were not predictive of cessation in later pregnancy. Prenatal healthcare providers should continue to assess level of addiction and provide targeted intensive cessation interventions. Interventions that reduce stress and depression may also be of benefit to women who are continuing smokers in early pregnancy.