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

Previous studies have linked life events with depression in chronic schizophrenia, but those studies had methodological limitations. Using a prospective research design and examining events that were clearly independent of the patients' illnesses, the authors sought to determine whether stressful life events could trigger depressive symptoms in the early course of schizophrenia. Schizophrenia patients (n?=?99) were followed for 1 year from a point of outpatient stabilization. Life event interviews were conducted every 4 weeks and symptom assessments every 2 weeks. Survival analyses showed a significantly increased risk for an exacerbation of significant depressive symptoms following an independent life event. Of interest is that an analysis of competing risk showed that the odds of psychotic exacerbation following a major independent life event were not significantly greater than the odds of depressive exacerbation. The risk of depression and of psychosis after experiencing a stressful life event is significantly increased for the first month, but the risk period can extend to 3 months. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-complexity as a cognitive buffer against stress-related illness and depression.

This prospective study tested the self-complexity buffering hypothesis that greater self-complexity moderates the adverse impact of stress on depression and illness. This hypothesis follows from a model that assumes self-knowledge is represented in terms of multiple self-aspects. As defined in this model, greater self-complexity involves representing the self in terms of a greater number of cognitive self-aspects and maintaining greater distinctions among self-aspects. Subjects completed measures of stressful events, self-complexity, depression, and illness in two sessions separated by 2 weeks. A multiple regression analysis used depression and illness at Time 2 as outcomes, stressful life events and self-complexity at Time 1 as predictors, and drepression and illness at Time 1 as control variables. The Stress?×?Self-Complexity interaction provided strong support for the buffering hypothesis. Subjects higher in self-complexity were less prone to depression, perceived stress, physical symptoms, and occurrence of the flu and other illnesses following high levels of stressful events. These results suggest that vulnerability to stress-related depression and illness is due, in part, to differences in cognitive representations of the self. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Applicability of Cognitive Mediational and Moderational Models to Explain Children's Depression Inventory Factor Scores in Urban Youth.

This investigation examined whether cognition serves as a direct factor, mediates, or moderates the relationship between stressful life events and Children's Depression Inventory (CDI; Kovacs, 1992) factor scores in urban, ethnic minority youth. Ninety-eight middle school students completed measures of stressful life events, cognition (cognitive triad and locus of control), and depressive symptoms. Results provided support for both mediating and moderating models of depression. Specifically, the cognitive triad mediated the relationship between stressful life events and depressive symptom categories of negative mood, ineffectiveness, and anhedonia, while it interacted with stressful life events to predict negative self-esteem. In addition, locus of control was found to interact with stressful life events to predict anhedonia. Finally, the diathesis-stress model was not supported when predicting the CDI Interpersonal Problems factor score, which taps externalizing behaviors. Implications for school psychology research and practice include the importance of including measures of stressful life events and cognitive styles in assessment of children's social-emotional functioning. In addition, results highlight the need to target children's perceptions for intervention since they appear to play a significant role in psychological reactions to stressors. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Temporal variability in global self-esteem and specific self-evaluation as prospective predictors of emotional distress: Specificity in predictors and outcome.

Recent studies have found that temporal variability and reactivity in self-esteem (SE) are associated with risk for depressive symptoms subsequent to life stress. It is unclear, however, whether it is variability uniquely in SE that is critical, or whether variability in other domains, such as specific self-evaluation (SSE) and affect, would show similar effects. Further, the specificity of these effects to depression is unknown. In the present study, initially nondepressed women completed 7 daily ratings of SE, SSE, and affect. Over a 6-week prospective interval, the interactions of stressful life events and variability in both SE and SSE predicted changes in depression, particularly in individuals with more severe worst lifetime episodes of depressive symptoms. These effects were independent of average level of SE and SSE, as well as neuroticism and self-concept uncertainty. In contrast, variability in affect failed to predict changes in depression in interaction with life stress. Finally, none of the predictor variables interacted with stressful life events in predicting changes in anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective study of stress autonomy versus stress sensitization in adolescents at varied risk for depression.

This longitudinal study investigated the stress autonomy, stress sensitization, and depression vulnerability hypotheses in adolescents across 6 years (i.e., Grades 6 through 12). Participants were 240 children (Time 1 mean age = 11.86, SD = 0.57) who varied in risk for depression on the basis of their mother's history of mood disorders. All analyses were conducted as multilevel models to account for nesting in the data. Results were consistent with the stress sensitization hypothesis. The within-subject relation of stress levels to depressive symptoms strengthened with increasing numbers of prior depressive episodes. In addition, evidence consistent with the vulnerability hypothesis was found. The relation of stress levels to depressive symptoms was stronger for adolescents who were at risk for depression on the basis of maternal depression history and for those who had experienced more depressive episodes through Grade 12. These findings suggest that onsets of depression in adolescents may be predicted by both relatively stable and dynamic transactions between stressful life events and vulnerabilities such as maternal depression and youths' own history of depressive episodes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal study of stress buffering for adolescent problem behaviors.

A 2-wave longitudinal design, with a 6-mo interval between occasions of measurement, was used to study the interrelations between stressful life events, perceived social support from family and friends, and the internalizing (e.g., depressive symptoms) and externalizing (e.g., alcohol use and delinquent activity) of problems of a sample of 277 middle adolescents (mean age?=?15.7 yrs). Although little support was found for the stress-buffering effects of either family or friend social support, the main effects of stressful life events and low family support were significant prospective predictors of problem behaviors for adolescent girls but not adolescent boys. Results are discussed with regard to mechanisms of differential gender socialization, such as the adolescent gender intensification hypothesis (J. P. Hill and M. W. Lynch, 1983). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms.

This study examined the role of both pubertal and social transitions in the emergence of gender differences in depressive symptoms during adolescence. This study generated the following findings: (a) Gender differences in depressive symptoms emerged during 8th grade and remained significant through 12th grade. (b) Pubertal status in 7th grade was related to adolescent depressive symptoms over time. (c) Early-maturing girls represented the group with the highest rate of depressive symptoms. (d) Depressive symptoms measured in 7th grade predicted subsequent symptom levels throughout the secondary school years. (e) Recent stressful life events were associated with increased depressive symptoms. (f) Early-maturing girls with higher levels of initial symptoms and more recent stressful life events were most likely to be depressed subsequently. The findings demonstrate the importance of the interaction between the pubertal transition and psychosocial factors in increasing adolescent vulnerability to depressive experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress reactivity following brief treatment for depression: Differential effects of psychotherapy and medication.

Psychotherapy and medication treatments are both effective in reducing depressive symptoms. However, only psychotherapy provides an enduring effect by reducing depressive vulnerability following treatment termination. This differential efficacy may reflect mode-specific effects on the longitudinal relationship between depression and stress. The current study examined posttreatment data from 153 outpatients enrolled in the Treatment of Depression Collaborative Research Program. Longitudinal analyses using the latent difference score (LDS) framework (a structural modeling technique that combines features of latent growth curve and cross-lagged regression models) evaluated the temporal relationship between severity of depression and frequency of stressful life events, assessed by interviewers at treatment termination and at 6, 12, and 18 months following treatment. Results supported a stress reactivity model in that stressful events led to elevations in the rate of depression change. Furthermore, multigroup LDS analysis indicated that this longitudinal stress reactivity occurred only for outpatients in the medication conditions. Results demonstrate that the enduring impact of psychotherapy involves the development of enhanced resiliency to stressful life events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of stressful life events and depressive symptoms during adolescence.

This 4-yr longitudinal study of 191 girls and 185 boys living in intact families in the rural Midwest examines the trajectories of life events and depressive symptoms in adolescence. The trajectories of depressive symptoms differ between boys and girls. Compared with boys, girls experienced a greater number of depressive symptoms after age 13. Changes in uncontrollable events are associated with the increases in girls' but not boys' depressive symptoms. Latent growth curve analyses show that, over 4 yrs, (1) depressive symptoms for girls changed according to a curvilinear pattern that is associated with changes in stressful events; (2) the level of depressive symptoms is related to the level of life events for both boys and girls; and (3) change in depressive symptoms is significantly related to change in stressful events only for girls. Girls living with less supportive mothers are more vulnerable to negative life changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal study of the effects of pessimism, trait anxiety, and life stress on depressive symptoms in middle-aged women.

The relative contributions of life stress, menopausal status, and pessimism and trait anxiety during the presence and absence of stress on increases in depressive symptoms across 3 years were examined in a sample of 460 premenopausal women, aged 42-50, who had few depressive symptoms at study entry. Multivariate analyses showed that after statistical adjustments for initial depressive symptoms and education, depressive symptoms at follow-up were higher among women (a) who reported stressful events, especially of a chronic nature, (b) who scored highly on trait anxiety, and (c) who were pessimistic and subsequently experienced a stressful ongoing problem. Change in menopausal status was not related to symptoms. The study confirms that midlife stress and both optimism and trait anxiety are important predictors of depressive symptoms during midlife. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric history and stress: Predictors of severity of unipolar depression.

Unipolar depression is frequently a recurrent or chronic disorder. In studies on predicting its course, outcomes are typically linked to either psychiatric features or stressful life events. In order to integrate the 2 approaches, 51 unipolar patients were assessed periodically over at least 1 yr for symptoms, stressful events, and chronic stressors. It was hypothesized that adverse family history and early age of onset impair role functioning and coping capabilities, thereby contributing to stressful circumstances that predict severity of depressive reactions. Results of causal modeling analyses supported a model in which background factors were associated with severity of depressive outcomes as mediated by their effects on stress variables. Such a model implicates the self-perpetuating nature of clinical depression, both for the individual and across generations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences and adolescent depression.

This study investigates the role of certain psychosocial variables—sex, age, body image/self-esteem, self-consciousness, stressful life events, and the degree to which an individual identifies with the cultural stereotype of masculinity—as correlates and antecedents to depression in adolescents and explores possible intraindividual mediators of the stress–depression relationship in adolescents. A battery of self-report measures was administered to public high school students in Grades 9–12 in their classrooms at two different times 1 month apart. Female adolescents reported more depressive symptoms, self-consciousness, stressful recent events, feminine attributes, and negative body image and self-esteem; no age effects were obtained. Results suggest a model of adolescent depression in which body image/self-esteem and stressful recent events are significant contributors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life events, symptom course, and treatment outcome in unipolar depressed women.

Although a large number of studies have addressed issues of etiology associated with stressful life events and diverse forms of disorder, little attention has been focused on the importance of such psychosocial parameters for the course and remission of symptoms once the disorder has begun. The authors review research on this latter topic, with special reference to the depressive disorders. A longitudinal study of 130 22–60 yr old unipolar depressive females receiving treatment was conducted. Results indicate that life events preceding entry into treatment significantly predicted certain forms of depressive symptomatology and of clinical outcome over a 6-mo follow-up period. In contrast, events occurring during the treatment and/or posttreatment period were not related to any of the depressive symptom outcome measures. Different subclassifications of events particularly may have relevance for the course and remission of symptoms in unipolar depressives under treatment. (51 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disentangling the effects of low self-esteem and stressful events on depression: Findings from three longitudinal studies.

Diathesis-stress models of depression suggest that low self-esteem and stressful events jointly influence the development of depressive affect. More specifically, the self-esteem buffering hypothesis states that, in the face of challenging life circumstances, individuals with low self-esteem are prone to depression because they lack sufficient coping resources, whereas those with high self-esteem are able to cope effectively and consequently avoid spiraling downward into depression. The authors used data from 3 longitudinal studies of adolescents and young adults, who were assessed 4 times over a 3-year period (Study 1; N = 359), 3 times over a 6-week period (Study 2; N = 249), and 4 times over a 6-year period (Study 3; N = 2,403). In all 3 studies, low self-esteem and stressful events independently predicted subsequent depression but did not interact in the prediction. Thus, the results did not support the self-esteem buffering hypothesis but suggest that low self-esteem and stressful events operate as independent risk factors for depression. In addition, the authors found evidence in all 3 studies that depression, but not low self-esteem, is reciprocally related to stressful events, suggesting that individuals high in depression are more inclined to subsequently experience stressful events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-perceived competence and the relation between life events and depressive symptoms in adolescence: Mediator or moderator?

In a 2-wave longitudinal study, 9th-grade students (N ?=?468) completed self-report measures of stressful life events, depressive symptoms, and 5 domains of self-perceived competence (i.e., academic competence, social acceptance, physical appearance, behavioral conduct, and athletic competence). Teachers and peers also reported about the participants' depressive symptoms. In longitudinal analyses, negative (but not positive) events related to depressive symptoms. Results suggested that self-perceived competence served as a mediator (but not a moderator) of this relation. Negative events predicted changes in self-perceived competence. Self-perceived competence predicted changes in depressive symptoms. Also, the direct effect of negative events on depressive symptoms diminished after controlling for self-perceived competence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal vulnerability, life events, and depressive symptoms: A test of a specific interactional model.

We tested Beck's (1983) hypothesis that depressive symptoms occur when an individual experiences a negative life event that specifically matches the individual's personal motivational vulnerability. Ninety-eight undergraduates completed measures of depression level, recent life events, and sociotropic and autonomous achievement motivations. Consistent with the theory, sociotropy was associated with depression level and also served as a moderator of the relations between depression and frequency of recent negative social events. However, sociotropy also demonstrated nonpredicted interactive effects with negative events categorized a priori as autonomy related. Autonomy was unrelated to depression and showed no evidence of being a vulnerability to any type of life event. The findings generally support the value of examining the role in depression of interactions between personality characteristics and life events, although they do not support the specific matching predictions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognition and life stress in depression: Cognitive factors and the definition, rating, and generation of negative life events.

The relationship between cognitive factors and different conceptualizations and measures of life stress poses important questions for contemporary theories of depression. The authors examined whether cognitive factors (dysfunctional attitudes and attributional style) are related to the definition, rating, and generation of negative life events. Life events were assessed with both subjective self-report and more objective interview-based methods in endogenously depressed outpatients. The results partially support the hypothesis that cognitive factors are related to definition and severity ratings of self-report measures of particular types of life events. These relationships held primarily for achievement, as compared with interpersonal, events. The results also support the hypothesis that elevated scores on measures of cognition are associated with the number of objectively defined events occurring prior to the onset of depression, suggesting that some patients may generate the life events that in turn may initiate a depressive episode. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Cross-Cultural Investigation of Cognitions and Depressive Symptoms in Adolescents.

Adolescents (N=2,272) from Hong Kong and the United States provided information regarding their depressive symptoms, cognitions (self-efficacy, negative cognitive errors, and hopelessness), and stressful events between 2 surveys 6 months apart. Depressive symptoms and hopelessness were higher, and self-efficacy and negative cognitive errors were lower in Hong Kong than in the United Stales. Cognitions were associated with concurrent depressive symptoms and predicted depressive symptoms 6 months later in both cultures. The "reverse" model was also supported with more variance predicted by depressive symptoms to later cognitions than from cognitions to depressive symptoms. There was some support for the hypothesis that self-efficacy is less salient in collective compared with individualistic cultures. These findings extend cognitive theories of depression to a non-Western culture. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal relationships between depressive symptoms and health in normal older and middle-aged adults.

Comorbidity between health and depression is salient in late life, when risk for physical illness rises. Other community studies have not distinguished between the effects of brief and long-standing depressive symptoms on excess morbidity and mortality. S. Cohen and M. S. Rodriguez's (1995) differential hypothesis of pathways between depression and health was used to examine the relationships between health and depression in a prospective probability sample of 1,479 community-resident middle-aged and older adults. Findings suggest that different durations of depressive symptoms have different relationships to health. Health had an impact on short-term increases in depressive symptoms, but depressive symptoms had a weaker impact on health. The reciprocal impact was indistinguishable from the health influence on depression. In contrast, longer term depressive symptoms had a clear impact on health. The results imply that physical illness can affect depressive states; depressive traits but not states can affect illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)