Cognitive style and depressive symptoms in elderly people - Extending the empirical evidence for the cognitive vulnerability-stress hypothesis

Introduction

Depression is common in older people and its identification and treatment has been highlighted as one of the major challenges in an ageing world. Poor physical and cognitive health, bereavement, and prior depression are important risk factors for depression in elderly people. Attributional or cognitive style has been identified as a risk factor for depression in children, adolescents and younger adults but its relevance for depression and mood in elderly people has not been investigated in the context of other risk factors.

Method

Sixty-four older adults from an ‘extra care’ living scheme (aged 59-97) were recruited for a 6-week prospective study to examine the relationships between cognitive style and depressive symptoms.

Results

Regression analyses revealed that, when other risk factors were controlled for, cognitive style and its interaction with stress predicted changes in depressive symptoms, therefore partially replicating prior research.

Conclusion

Cognitive-stress-vulnerability models also apply to elderly populations, but may be rather predictive of changes in depression when facing lower levels of stress.     

Intimate partner violence and depressive symptoms in women: cognitive schemas as moderators and mediators

In this study the role of cognitive schemas as moderators and mediators between intimate partner violence and depressive symptoms was examined. The sample consisted of 312 women who had suffered an abusive relationship. Participants completed measures of physical, psychological and sexual abuse, maladaptive cognitive schemas (disconnection and rejection, autonomy, and other-directedness), and depression. The evidence for a moderation effect was low and mainly restricted to schemas of the impaired autonomy domain. In contrast, the results supported mediational models in which violence was associated to the cognitive schemas, and these in turn were associated to depressive symptoms. Mediation was partial, with the schemas of the disconnection and rejection domain explaining most of the association between violence and depression. Finally, several explanations for these findings are examined, and their implications for the concept and measure of the cognitive schemas are discussed.     

Depressive symptoms and cognitive control in a mixed antisaccade task: Specific effects of depressive rumination

Growing empirical evidence suggests that cognitive and affective problems in depression may be a reflection of cognitive control impairments. However, to date, the nature of such impairments is still poorly understood and further investigation of this topic is required to advance current knowledge on the underlying vulnerability factors for depression. Using a mixed antisaccade paradigm, the present study examined if depressive symptoms in general, and more specifically rumination, are related to impairments in cognitive control functions such as inhibition and switching. The results on antisaccade latency and error rates indicated that depressive symptoms in general were not related to impairments in inhibition and switching. However, rumination was associated with impaired inhibition such that high, compared to low, ruminators had slower antisaccade latencies. No group differences were observed on antisaccade error rates. Implications for understanding the underlying vulnerability factors for the development of depressive symptoms are discussed.     

Route-based travel and shared routes in sympatric spider and woolly monkeys: cognitive and evolutionary implications

Many wild primates occupy large home ranges and travel long distances each day. Navigating these ranges to find sufficient food presents a substantial cognitive challenge, but we are still far from understanding either how primates represent spatial information mentally or how they use this information to navigate under natural conditions. In the course of a long-term socioecological study, we investigated and compared the travel paths of sympatric spider monkeys (Ateles belzebuth) and woolly monkeys (Lagothrix poeppigii) in Amazonian Ecuador. During several field seasons spanning an 8-year period, we followed focal individuals or groups of both species continuously for periods of multiple days and mapped their travel paths in detail. We found that both primates typically traveled through their home ranges following repeatedly used paths, or “routes”. Many of these routes were common to both species and were stable across study years. Several important routes appeared to be associated with distinct topographic features (e.g., ridgetops), which may constitute easily recognized landmarks useful for spatial navigation. The majority of all location records for both species fell along or near identified routes, as did most of the trees used for fruit feeding. Our results provide strong support for the idea that both woolly and spider monkey use route-based mental maps similar to those proposed by Poucet (Psychol Rev 100:163–182, 1993). We suggest that rather than remembering the specific locations of thousands of individual feeding trees and their phenological schedules, spider and woolly monkeys could nonetheless forage efficiently by committing to memory a series of route segments that, when followed, bring them into contact with many potential feeding sources for monitoring or visitation. Furthermore, because swallowed and defecated seeds are deposited in greater frequency along routes, the repeated use of particular travel paths over generations could profoundly influence the structure and composition of tropical forests, raising the intriguing possibility that these and other primate frugivores are active participants in constructing their own ecological niches. Building upon the insights of Byrne (Q J Exp Psychol 31:147–154, 1979, Normality and pathology in cognitive functions. Academic, London, pp 239–264, 1982) and Milton (The foraging strategy of howler monkeys: a study in primate economics. Columbia University Press, New York, 1980, On the move: how and why animals travel in groups. University of Chicago Press, Chicago, pp 375–417, 2000), our results highlight the likely general importance of route-based travel in the memory and foraging strategies of nonhuman primates.

---

This contribution is part of the Special Issue “A Socioecological Perspective on Primate Cognition” (Cunningham and Janson 2007).     

Interpretation bias and depressive symptoms: The role of self-relevance

Cognitive theories of depression emphasize negatively biased interpretations as an important target of therapy. Much of the research on interpretation bias in depression has focused on selection, or deciding which of several interpretations is likely. However, depressive biases may also exist in the generation of possible interpretations, or the ability to think of positive alternatives. If biases exist for generation as well as selection, therapeutic techniques to encourage the generation of more positive interpretations would be warranted. Asking therapy clients to consider someone else in a similar situation is a commonly used therapy strategy but has not been sufficiently examined empirically. In the current studies, we examine interpretation generation and selection in dysphoric and nondysphoric individuals, and contrast interpretations made for the self to interpretations made for two types of “other.” Our studies reveal depressive biases in both interpretation generation and selection, and indicate that interpretation valence is highly sensitive to the type of other considered. All participants generated and selected significantly more positive interpretations for friends than for themselves, but generated significantly more negative interpretations for hypothetical others than for themselves. Our results suggest that encouraging dysphoric individuals to imagine others can be beneficial, but the type of “other” used is critically important, with instructions to consider a close friend most likely to be effective in decreasing negativity in interpretation.     

When self-help is no help: Traditional cognitive skills training does not prevent depressive symptoms in people who ruminate

A randomized trial was conducted to test the efficacy of three self-directed prevention intervention workbooks for depression. Cognitively at-risk college freshmen were randomly assigned to one of three conditions: traditional cognitive, non-traditional cognitive, and academic skills. Consistent with hypotheses, participants who were high in rumination and experienced stress exhibited significantly greater levels of depressive symptoms after completing the traditional cognitive skills workbook than after completing the other two workbooks. This pattern of results held post-intervention and 4 months later. These findings indicate that rumination may hinder ones ability to identify and dispute negative thoughts (at least without the help of a trained professional). The results underscore the importance of identifying individual difference variables that moderate intervention efficacy. They also raise concerns about the potential benefits of self-help books, an industry that generates billions of dollars each year.     

Mood induced cognitive and emotional reactivity, life stress, and the prediction of depressive relapse

This study examined a group of participants who were fully remitted from a previous episode of major depressive disorder, and evaluated the role of cognitive and emotional reactivity to a mood challenge, and life stress in the prediction of relapse. Fifty-two participants were evaluated during remission, and their reactivity (i.e., change in dysfunctional attitudes and emotional state) to a depressed mood induction was evaluated. The cohort was followed up 12 months after the initial assessment. Thirty-five percent of the sample experienced a relapse during the follow-up period. Relapse was predicted by higher rates of life stress, and lower levels of emotional reactivity (specifically less reduction in happiness) to the mood induction during the initial assessment. Cognitive reactivity to the mood induction did not predict relapse, nor did the interaction between cognitive reactivity and life stress. These findings are discussed in terms of recent literature suggesting that depression is associated with insensitivity to emotion context, such that depressed individuals display blunted emotional responses to affective stimuli, including sadness-inducing stimuli. These findings suggest that insensitivity to emotional context may also be a characteristic of euthymic individuals at risk of relapse.     

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

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

The indirect effect of attention bias on memory via interpretation bias: Evidence for the combined cognitive bias hypothesis in subclinical depression

Little research has investigated functional relations among attention, interpretation, and memory biases in depressed samples. The present study tested the indirect effect of attention bias on memory through interpretation bias as an intervening variable in a mixed sample of non-depressed and subclinically depressed individuals. Subclinically depressed and non-depressed individuals completed a spatial cueing task (to measure attention bias), followed by a scrambled sentences test (to measure interpretation bias), and an incidental free recall task (to measure memory bias). Bias-corrected bootstrapping yielded evidence for the hypothesised indirect effect model, in that an emotional bias in attention is related to a congruent bias in interpretative choices which are in turn reflected in memory. These findings extend previous research and provide further support for the combined cognitive bias hypothesis in depression. Theoretical and clinical implications of our findings are discussed.     

Unpacking the cognitive map: the parallel map theory of hippocampal function

In the parallel map theory, the hippocampus encodes space with 2 mapping systems. The bearing map is constructed primarily in the dentate gyrus from directional cues such as stimulus gradients. The sketch map is constructed within the hippocampus proper from positional cues. The integrated map emerges when data from the bearing and sketch maps are combined. Because the component maps work in parallel, the impairment of one can reveal residual learning by the other. Such parallel function may explain paradoxes of spatial learning, such as learning after partial hippocampal lesions, taxonomic and sex differences in spatial learning, and the function of hippocampal neurogenesis. By integrating evidence from physiology to phylogeny, the parallel map theory offers a unified explanation for hippocampal function.     

Emotion regulation in depression: Examining the role of cognitive processes

Sustained negative affect is a hallmark feature of depressive episodes. The ability to regulate emotional responses to negative events may therefore play a critical role in our understanding of this debilitating disorder. Individual differences in cognitive processes such as attention, memory, and interpretation may underlie difficulties in emotion regulation and numerous studies have identified cognitive biases and deficits that characterise depressed people. Few studies, however, have explicitly linked these biases to the difficulties in emotion regulation that are associated with depression. In this paper we discuss relations among cognitive processes and emotion regulation and review the depression literature to identify cognitive biases and deficits that may underlie maladaptive responses to negative events and mood states. Our review suggests that difficulties in the disengagement from negative material, memory biases, and deficits in cognitive control are frequently observed in depressive disorders and may be associated with the use of maladaptive emotion regulation strategies, such as rumination. These biases may also be related to difficulties implementing strategies that are effective for non-depressed people, such as recall of mood-incongruent material and reappraisal. Our review also suggests, however, that empirical studies linking cognitive biases and emotion regulation in depression are still largely missing and would present an important goal for future research in this area.     

An investigation of extreme responding as a mediator of cognitive therapy for depression

Although the efficacy of Cognitive Therapy (CT) for depression is well documented, questions remain about the conditions under which CT is maximally effective, and the mechanisms by which CT is efficacious. This study examined the role of extreme responding (ER) as a mediator and predictor of relapse, as well as a predictor of acute treatment outcome. To test mediation, ER of participants in CT was compared to ER of participants receiving Behavioral Activation (BA). Results indicated that ER was not a mediator of relapse in either condition. Both CT and BA showed reductions in depression severity, however neither group showed significant changes in ER over the course of treatment. Finally, ER did not predict or moderate acute treatment outcome. The implications of these results, strengths and limitations of the current study, and future research directions are discussed.     

Dispositional mindfulness moderates the relation between neuroticism and depressive symptoms

Negative emotional reactivity as measured by neuroticism has been shown to be an important risk factor for the development of depressive symptoms. This study investigated whether the ability to be mindful can protect against the negative effects of this temperamental vulnerability. An English community sample of N = 144 individuals who had completed a neuroticism questionnaire six years previously were assessed for current depressive symptoms and dispositional levels of mindfulness at points of assessment approximately one year apart. Dispositional mindfulness moderated the relation between neuroticism and current depressive symptoms: Neuroticism was significantly related to depression in those with low to medium levels of dispositional mindfulness but not in those with relatively high levels of mindfulness. Further analyzes focusing on particular mindfulness skills indicated that this effect was carried mostly by the ability to describe inner experience. The results suggest that dispositional mindfulness and particularly the ability to describe inner experience are helpful in dealing with negative emotional reactivity in a way that reduces the likelihood of depressive symptoms to develop.     

Pathways linking temperament and depressive symptoms: A short-term prospective diary study among adolescents

The current study examined mechanisms through which trait negative affectivity (NA) and effortful control (EC) prospectively predict increases in depressive symptoms in a community sample of 110 adolescents (mean age=16.40 years) in a 9-week, multi-wave diary study. We hypothesised youth with high NA and low EC would experience greater increases in depressive symptoms because they generate more maladaptive cognitive responses to stress. NA predicted greater event-specific rumination and negative cognitive style across the study period. After controlling for trait cognitive vulnerabilities, only event-specific rumination mediated the effect of NA on subsequent depressive symptoms, suggesting that high-NA youth are more likely to ruminate about stressful events, which then predicts increases in depressive symptoms. EC did not moderate the effects of NA on either depressive symptoms or cognitive responses to stress. Results are discussed in terms of vulnerability-stress models linking temperament and depressive symptoms in adolescence.     

Individual differences in cognitive control over emotional material modulate cognitive biases linked to depressive symptoms

Deficient cognitive control over emotional material and cognitive biases are important mechanisms underlying depression, but the interplay between these emotionally distorted cognitive processes in relation to depressive symptoms is not well understood. This study investigated the relations among deficient cognitive control of emotional information (i.e. inhibition, shifting, and updating difficulties), cognitive biases (i.e. negative attention and interpretation biases), and depressive symptoms. Theory-driven indirect effect models were constructed, hypothesising that deficient cognitive control over emotional material predicts depressive symptoms through negative attention and interpretation biases. Bootstrapping analyses demonstrated that deficient inhibitory control over negative material was related to negative attention bias which in turn predicted a congruent bias in interpretation and subsequently depressive symptoms. Both shifting and updating impairments in response to negative material had an indirect effect on depression severity through negative interpretation bias. No evidence was found for direct effects of deficient cognitive control over emotional material on depressive symptoms. These findings may help to formulate an integrated understanding of the cognitive foundations of depressive symptoms.     

Effects of cognitive therapy for depression on daily stress-related variables

This study used a daily diary design to evaluate depressed patients' changes on daily stress-related variables during cognitive therapy (CT). Patients completed daily diaries on two week-long occasions: after the intake interview and again after the sixth session of CT. Patients also completed a measure of depressive symptoms before every treatment session. After six sessions of CT, patients reported a significant reduction in: (a) depressive symptoms; (b) daily sad affect (SA); (c) daily negative thoughts associated with the day's most stressful event; and (d) SA reactivity to daily stressors. In addition, patients reported a significant increase in: (e) daily positive affect (PA); and (f) SA reactivity to daily negative thoughts. The results suggest that CT has its intended effects on the daily lives of depressed adults, and highlight the value of a daily diary methodology for research on CT.     

The creative suffering of the triune God: An evolutionary panentheistic paradigm

Abstract

One way the alleged conflict between science and religion is often presented is the claim that Western religions represent human beings as the pinnacle of creation. Science, however, has progressively shown this perspective to be false, specifically through the discoveries that we are not at the universe's center, that the universe is much larger than we once thought, and that we evolved from “lower” life forms. While these discoveries are valid, the interpretation that they mortify vain human pretensions to significance is not. In this essay we assess this claim of mortification and argue that it is a myth.     

Mood congruent memory in dysphoria: the roles of state affect and cognitive style

Biases in incidental memory for self-referent adjectives and intentional memory were compared across nondysphoric (ND; n=48), experimentally induced dysphoric (EXP; n=49), and naturally dysphoric (NAT; n=48) individuals. Negative biases, "evenhandedness", and positive biases were demonstrated among NAT, EXP and ND participants, respectively, in terms of incidental memory. Correlation analyses suggested that the effects of cognitive style (self-esteem, dysfunctional attitudes, and attributional style) are limited to negative stimuli. Memory for incidental positive stimuli was only predicted by state affect. Groups did not differ in performance on an intentional memory task. Implications for network and schema models of depression are explored.     

The reinterpretation of dreams: an evolutionary hypothesis of the function of dreaming

Several theories claim that dreaming is a random by-product of REM sleep physiology and that it does not serve any natural function. Phenomenal dream content, however, is not as disorganized as such views imply. The form and content of dreams is not random but organized and selective: during dreaming, the brain constructs a complex model of the world in which certain types of elements, when compared to waking life, are underrepresented whereas others are over represented. Furthermore, dream content is consistently and powerfully modulated by certain types of waking experiences. On the basis of this evidence, I put forward the hypothesis that the biological function of dreaming is to simulate threatening events, and to rehearse threat perception and threat avoidance. To evaluate this hypothesis, we need to consider the original evolutionary context of dreaming and the possible traces it has left in the dream content of the present human population. In the ancestral environment human life was short and full of threats. Any behavioral advantage in dealing with highly dangerous events would have increased the probability of reproductive success. A dream-production mechanism that tends to select threatening waking events and simulate them over and over again in various combinations would have been valuable for the development and maintenance of threat-avoidance skills. Empirical evidence from normative dream content, children's dreams, recurrent dreams, nightmares, post traumatic dreams, and the dreams of hunter-gatherers indicates that our dream-production mechanisms are in fact specialized in the simulation of threatening events, and thus provides support to the threat simulation hypothesis of the function of dreaming.