Cognitive vulnerability to depression, rumination, hopelessness, and suicidal ideation: multiple pathways to self-injurious thinking

In order to advance the detection and prevention of suicide, recent research has focused on predictors of suicidal ideation and behavior such as negative cognitive styles, dysfunctional attitudes, hopelessness, and rumination. In this study the relationships among these risk factors in the context of the Attention Mediated Hopelessness (AMH) theory of depression are examined. One hundred and twenty-seven undergraduates in the Cognitive Vulnerability to Depression (CVD) project were followed for 2.5 years. The CVD project followed initially nondepressed freshmen, at either high or low cognitive risk for depression, in order to predict onsets and recurrences of depressive disorders. The presence and duration of suicidal ideation were predicted prospectively by rumination and hopelessness, and hopelessness partially mediated the relationship between rumination and ideation and fully mediated the association between rumination and duration of suicidality. Further, rumination mediated the relationship between cognitive vulnerability and suicidal ideation.     

The developmental origins of cognitive vulnerability to depression: temperament, parenting, and negative life events in childhood as contributors to negative cognitive style

Cognitive models of depression have been well supported with adults, but the developmental origins of cognitive vulnerability are not well understood. The authors hypothesized that temperament, parenting, and negative life events in childhood would contribute to the development of cognitive style, with withdrawal negativity and negative parental feedback moderating the effects of negative life events to predict more depressogenic cognitive styles. These constructs were assessed in 289 children and their parents followed longitudinally from infancy to 5th grade; a subsample (n = 120) also participated in a behavioral task in which maternal feedback to child failure was observed. Results indicated that greater withdrawal negativity in interaction with negative life events was associated with more negative cognitive styles. Self-reported maternal anger expression and observed negative maternal feedback to child's failure significantly interacted with child's negative events to predict greater cognitive vulnerability. There was little evidence of paternal parenting predicting child negative cognitive style.     

The Hopelessness Theory of Depression: A Test of the Diathesis–Stress and Causal Mediation Components in Third and Seventh Grade Children

The goal of the current study was to test the diathesis–stress and causal mediation components of the hopelessness theory of depression in third- and seventh-grade children. The procedure involved an initial assessment of depressive symptoms, hopelessness, and the 3 cognitive styles posited as vulnerability factors by hopelessness theory. The procedure also involved a series of 6 weekly follow-up assessments in which depressive symptoms, hopelessness, and the occurrence of negative events were assessed. A depressogenic attributional style interacted with negative events to predict increases in depressive symptoms in seventh-grade children but not in third-grade children. A depressogenic inferential style about consequences interacted with negative events to predict increases in depressive symptoms in both third- and seventh-grade children. Last, a depressogenic inferential style about the self interacted with negative events to predict increases in depressive symptoms in third- and seventh-grade girls but not boys. None of these interactions were mediated by hopelessness.     

Cognitive vulnerability and frontal brain asymmetry: common predictors of first prospective depressive episode

The hopelessness theory of depression proposes that individuals with a depressogenic cognitive style are more likely to become hopeless and experience depression following negative life events. Although the neurophysiological underpinnings of cognitive style remain speculative, research indicates that decreased relative left frontal brain electrical activity holds promise as a traitlike marker of depression. This begs the question: Do measures of depressogenic cognitive style and resting frontal brain asymmetry index a common vulnerability? The present study provides preliminary support for this hypothesis. At baseline assessment, increased cognitive vulnerability to depression was associated with decreased relative left frontal brain activity at rest in individuals with no prior history of, or current, depression. Following baseline assessment, participants were followed prospectively an average of 3 years with structured diagnostic interviews at 4-month intervals. Both cognitive vulnerability and asymmetric frontal cortical activity prospectively predicted onset of first depressive episode in separate univariate analyses. Furthermore, multivariate analyses indicated that cognitive vulnerability and frontal asymmetry represented shared, rather than independent, predictors of first depression onset.     

Negative cognitive styles, dysfunctional attitudes, and the remitted depression paradigm: a search for the elusive cognitive vulnerability to depression factor among remitted depressives

Results from studies using a behavioral high-risk design and approximations to it generally have corroborated the cognitive vulnerability hypothesis of depression, whereas results from remitted depression studies typically have not. Suspecting that design features of previously conducted remitted designs likely precluded them from detecting maladaptive cognitive patterns, the authors conducted a study featuring the remitted design that has been successful in studies of a biological vulnerability for depression. Participants' current depressive symptoms, negative cognitive styles (hopelessness theory), dysfunctional attitudes (Beck's theory), and lifetime prevalence of clinically significant depression were assessed. Participants who had remitted from an episode of clinically significant depression had more negative cognitive styles, but not greater levels of dysfunctional attitudes, than did never depressed individuals.     

Depressogenic inferential styles, negative events, and depressive symptoms in youth: an attempt to reconcile past inconsistent findings

Research examining the diathesis-stress component of the hopelessness theory (HT) in youth has provided mixed support for the theory. One explanation for inconsistent findings is the failure to consider relationships among the three inferential styles posited to serve as vulnerability factors by the theory. The weakest link hypothesis posits that an individual is as vulnerable to depression as his/her most depressogenic inferential style (DIS) makes him/her. A second explanation is that researchers have operationalized "high stress" from a nomothetic, as opposed to an idiographic, perspective. The current study tested the diathesis-stress component of the HT in 230 third-grade and 152 seventh-grade schoolchildren using both a weakest link and an idiographic approach towards analysis. Children completed measures assessing depressive symptoms and DISs. Children subsequently completed measures assessing depressive symptoms and negative events once a week for 6 weeks. Hierarchical linear modeling and time-lagged analyses indicated that a depressogenic weakest link was associated with greater elevations in depressive symptoms following elevations in stress.     

Do Negative Cognitive Styles Confer Vulnerability to Depression?

According to the cognitive-vulnerability hypothesis of depression, negative cognitive styles confer vulnerability to depression when people confront negative life events. In this article, we present evidence that negative cognitive styles do indeed confer vulnerability to clinically significant depressive disorders and suicidality and discuss possible developmental antecedents of cognitive vulnerability to depression. We consider the issue of stability versus change in cognitive vulnerability to depression and discuss the broader implications of the cognitive-vulnerability findings for mental and physical health.     

儿童抑郁认知易感性的发展特点

相对稳定的负性认知特征会使个体容易发生抑郁,被称为抑郁认知易感性.文章总结并对比当前关于抑郁认知易感性的稳定性与可变性的观点,提出从儿童发展早期开始研究认知易感性因素的必要性.接着回顾消极归因方式、功能失调态度和冗思这三种认知易感性因素在儿童期的表现及其前期心理特征,试图找到抑郁认知易感性在个体发展中的连续性.建议今后探讨认知易感性因素在不同年龄的发展特点,关注发展早期认知易感性因素的测量.     

Depressive realism and attributional style: implications for individuals at risk for depression

Prior research has found that depressed individuals are more realistic in their interpretations of certain events than nondepressed individuals. However, the implications of this finding for the etiology of depressive disorders have never been clarified. The current investigation sought to remedy this situation by exploring realism in the context of a well-validated, cognitive diathesis-stress theory of the etiology of a subtype of depression: hopelessness theory (Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96, 358-372). A sample of 239 college students, including groups of participants with depressogenic versus nondepressogenic attributional styles, recorded the causes they assigned to events; the extent to which their attributions were objectively realistic was evaluated. A comparison of the degree of objectivity was also made between dysphoric and nondysphoric individuals. Contrary to expectations derived from the depressive realism hypothesis, dysphoric individuals exhibited less realistic attributions as compared to nondysphoric individuals. Further, individuals at risk for depression evidenced a pessimistic bias, while individuals not at risk evidenced an optimistic bias.     

A review of cognitive biases in youth depression: attention,interpretation and memory

Depression is one of the most common mental health problems in childhood and adolescence. Although data consistently show it is associated with self-reported negative cognitive styles, less is known about the mechanisms underlying this relationship. Cognitive biases in attention, interpretation and memory represent plausible mechanisms and are known to characterise adult depression. We provide the first structured review of studies investigating the nature and causal role of cognitive biases in youth depression. Key questions are (i) do cognitive biases characterise youth depression? (ii) are cognitive biases a vulnerability factor for youth depression? and (iii) do cognitive biases play a causal role in youth depression? We find consistent evidence for positive associations between attention and interpretation biases and youth depression. Stronger biases in youth with an elevated risk of depression support cognitive-vulnerability models. Preliminary evidence from cognitive bias modification paradigms supports a causal role of attention and interpretation biases in youth depression but these paradigms require testing in clinical samples before they can be considered treatment tools. Studies of memory biases in youth samples have produced mixed findings and none have investigated the causal role of memory bias. We identify numerous areas for future research in this emerging field.     

Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression

Do negative cognitive styles provide similar vulnerability to first onsets versus recurrences of depressive disorders, and are these associations specific to depression? The authors followed for 2.5 years prospectively college freshmen (N = 347) with no initial psychiatric disorders at high-risk (HR) versus low-risk (LR) for depression on the basis of their cognitive styles. HR participants had odds of major, minor, and hopelessness depression that were 3.5-6.8 times greater than the odds for LR individuals. Negative cognitive styles were similarly predictive of first onsets and recurrences of major depression and hopelessness depression but predicted first onsets of minor depression more strongly than recurrences. The risk groups did not differ in incidence of anxiety disorders not comorbid with depression or other disorders, but HR participants were more likely to have an onset of anxiety comorbid with depression.     

Depression as a mediator of negative cognitive style and hopelessness in stress generation

Over the past 20 years, there has been considerable interest in the role of cognitive factors in the stress generation process. Generally, these studies find that depressed individuals, or individuals at cognitive risk for depression, are more likely to experience stressful life events that are in part influenced by their own characteristics and behaviours (i.e., negative dependent events). However, there is still much to be learnt about the mediators of these effects. For example, does the development of depression symptoms explain why individuals at cognitive risk for depression experience increased negative dependent events? Or, is it that increases in cognitive risk explain why depressed individuals experience increased negative dependent events? To explore these questions, a short‐term prospective study was conducted with 209 college students who were given measures of depression, depressogenic risk factors (i.e., negative cognitive style and hopelessness), and negative dependent events at two time points 6 weeks apart. Support was found for three models: (1) depression symptoms mediated the relationship between negative cognitive style and negative dependent events; (2) depression symptoms mediated the relationship between hopelessness and negative dependent events; and (3) first hopelessness and then depression symptoms mediated the relationship between negative cognitive style and negative dependent events in a multiple‐step model. In contrast, the reverse models were not confirmed, suggesting specificity in the direction of the mediational sequence.     

Cognitive Schemas as Mediating Variables of the Relationship Between the Self-Defeating Personality and Depression

The current investigation was designed to examine particular maladaptive cognitive schemas as mediating variables of the relationship between the self-defeating personality and depression. A total of 82 mildly to severely depressed adult outpatients, referred for counseling and psychotherapy services, were assessed in terms of self-defeating personality and maladaptive cognitive schema characteristics. Results indicated that 57% of the variance within depression, measured by the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), was accounted for by the self-defeating personality and five maladaptive cognitive schemas: abandonment/instability; defectiveness/shame; failure; subjugation; and vulnerability to harm. Further, mediation analyses indicated that abandonment/instability and defectiveness/shame statistically mediated the relationship between the self-defeating personality and depression. Results are discussed in light of contemporary theories of depression.     

Attributions and expectations: a confluence of vulnerabilities in mild depression in a college student population

The reformulated model of learned helplessness assumes that attributional style has its impact on depression in part through the intermediary effect of pessimistic or negative expectations about the occurrence of future outcomes. A possible logical next step in testing the model is to measure jointly attributions and expectations and to examine their combined (interactive) contributions. We used a short-term longitudinal design to examine whether attributional style works in combination with other factors, such as expectations, to predispose individuals to depression. Consistent with the initial theoretical analysis, the interaction of attributional style and expectations predicted depression on the Beck Depression Inventory 6 weeks later. We also found that attributional style predicted depression 6 weeks later in interaction with initial level of depression. These findings support our confluence hypothesis, which assumes that vulnerability factors can combine interactively and qualify the effects of attributional style. These interaction-effect findings have implications for currently popular cognitive theories of depression and for previous research on vulnerability to depression that has examined only the effects of single cognitive variables (such as attributional style) considered alone. Further study is also necessary to determine the nature of the overlap of the effects of expectation and initial level of depression.     

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.     

The Cognitive, Learned-Helplessness and Hopelessness Theories of Depression: A Review with Implications for Counsellors

Four theories of depression and the Attributional Style Questionnaire (ASQ) are described and their implications for counselling discussed. Recent research has focused upon the testing of the diathesis-stress component of the reformulated learned-helplessness theory of depression, and in particular upon the role which a hypothesised depressogenic causal attributional style towards events in general, and/or 'depressive attributions' towards specific events, play in the development of depression. It is suggested that the recently revised version of this theory — the hopelessness theory of depression — is both a more fruitful area of future research and of more interest to the counsellor, since it emphasises the role which attributions and other cognitive factors play in the maintenance and prevention of depression, rather than concentrating on a continued search for a cause.     

Cognitive vulnerability to depression: a taxometric analysis

Although there is increasing support for the hypothesis that negative cognitive styles contribute vulnerability to depression, it remains unclear how best to conceptualize the heterogeneity in cognitive vulnerability to depression. Specifically, does this heterogeneity reflect quantitative or qualitative differences among individuals? The goal of this study was to address this question by examining whether the underlying structure of cognitive vulnerability to depression is best conceptualized as dimensional or categorical. Taxometric analyses provided consistent support for the dimensional nature of negative cognitive styles. It appears, therefore, that cognitive vulnerability to depression is best conceptualized as a dimensional construct, present to a greater or lesser extent in all individuals. Despite this, the strength of the relationship between negative cognitive styles and depressive symptoms does appear to vary as a function of where along the cognitive style continuum one falls.     

Negative attributional style, hopelessness depression and endogenous depression

The hopelessness theory of depression [Abramson, L. Y., Metalsky, G. I. & Alloy, L. B. (1989). Hopelessness depression: a theory-based subtype of depression. Psychological Review, 96, 358-372.] postulates that a negative attributional style represents a risk factor for a particular constellation of depressive symptoms, termed 'hopelessness depression'. Four studies tested the relation of negative attributional style to hopelessness depression symptoms versus endogenous depression symptoms. Despite the considerable overlap of hopelessness and endogenous depression symptoms, negative attributional style was more related to the former than the latter, consistent with hopelessness theory.     

Adult attachment styles and cognitive vulnerability to depression in a sample of undergraduate students: the mediational roles of sociotropy and autonomy

We analysed the mediational role of the personality dimensions of sociotropy and autonomy in the relationship between certain styles of attachment and depressive symptoms. In order for us to do so, a group of university students filled out the Beck Depression Inventory (BDI), the Revised Personal Style Inventory (PSI-II) and the Relationship Questionnaire (RQ). Individuals having attachment styles with a negative model of self (preoccupied and fearful) obtained significantly higher scores in the BDI than those having attachment styles with a positive model of self (secure and dismissing), which coincides with previous research. We followed the standard procedure of Baron and Kenny of linear regression in order to perform the mediational analyses. The preoccupied attachment style-depressive symptoms relationship was mediated by sociotropy. It was also found that autonomy exerted a significant mediational effect on the relationship between the fearful attachment style and depressive symptoms. These results are consistent with the notion that insecure attachment predisposes individuals to the development of depressogenic personality styles. Thus, the findings of the present study contribute to improving the understanding of the factors involved in the development of vulnerability to depression. Furthermore, the results point out the importance of evaluating both attachment style and sociotropy/autonomy personality dimensions for the treatment of depressive patients.     

Depression in child psychiatric inpatients: Cognitive and attributional patterns

Cognitive and learned helplessness models of depression view maladaptive cognitive and attributional patterns as core features of depressive disorders. This study examined cognitive and attributional patterns in depressed children, nondepressed children, and a subgroup of remitting depressives who had histories of depression but were not reporting depressive symptoms when evaluated during the first 2 weeks of hospitalization. When compared with nondepressed controls, depressed children reported significantly more hopelessness, more negative self-perceptions, and negative self-perceptions across a wider variety of domains, and they displayed more dysfunctional attributional styles. While 55% of depressed children displayed pervasive maladaptive cognitive patterns, the other 45% of depressed children scored more similarly to nondepressed children, suggesting that childhood depressive disorders may be heterogeneous with respect to cognitive patterns. Contrary to the notion of traitlike depressive cognitive and attributional patterns that persist after the remission of depressive episodes, children with remitting depressions scored similarly to nondepressed children.Partial support for this project was provided by a grant from the John D. and Catherine T. MacArthur Foundation as part of their Network on Risk and Protective Factors in the Major Mental Disorders. I wish to thank Donald Guthrie for providing statistical consultation, Gwen Gordon for her computer assistance, and Niels Mueller and Jean Keller for their help with data collection.