Low self-esteem is a risk factor for depressive symptoms from young adulthood to old age.

Data from two large longitudinal studies were used to analyze reciprocal relations between self-esteem and depressive symptoms across the adult life span. Study 1 included 1,685 participants aged 18 to 96 years assessed 4 times over a 9-year period. Study 2 included 2,479 participants aged 18 to 88 years assessed 3 times over a 4-year period. In both studies, cross-lagged regression analyses indicated that low self-esteem predicted subsequent depressive symptoms, but depressive symptoms did not predict subsequent levels of self-esteem. This pattern of results replicated across all age groups, for both affective–cognitive and somatic symptoms of depression, and after controlling for content overlap between the self-esteem and depression scales. The results suggest that low self-esteem operates as a risk factor for depressive symptoms at all phases of the adult life span. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dysfunctional attitudes and episodes of major depression: Predictive validity and temporal stability in never-depressed, depressed, and recovered women.

In a large, community-based sample of women (N = 750), the authors examined the nature of associations between dysfunctional attitudes and depression. Dysfunctional attitudes were evaluated both as a vulnerability factor for depression and as a consequence of depression. A link was found between past depression and baseline elevations in dysfunctional attitudes that was independent of current subsyndromal symptoms, but intensification of dysfunctional attitudes following prospectively evaluated episodes of depression (depressive "scarring") was not observed. Although baseline dysfunctional attitudes predicted an episode of major depression over 3 years of prospective study, this prediction, considered alone or in interaction with negative life events, was redundant with that offered by history of past depression. Further, no significant prediction was evident for the Dysfunctional Attitude Scale (A. N. Weissman & A. T. Beck, 1978) when the formerly depressed and never-depressed cohorts were considered separately. Implications for cognitive theories are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of cognitive diathesis-stress models in predicting major depressive disorder in adolescents.

Diathesis-stress predictions regarding the onset of adolescent major depression and nonmood disorders were tested. Adolescents ((N?=?1,507) were assessed for dysfunctional attitudes and negative attributional style, as well as current depressive symptoms, current depressive and nondepressive diagnoses, and past and family histories of psychopathology. Approximately 1 year later, participants were reassessed on all measures. Analyses supported A. T. Beck's (1976) theory of depression (at the level of a trend) but not the hopelessness theory of depression. Findings were suggestive of a threshold view of vulnerability to depression; for those who experienced negative life events, depressive onset was related to dysfunctional attitudes but only when dysfunctional attitudes exceeded a certain level (low = intermediate     

Cognitions, depressive symptoms, and development in adolescents.

Examined the generalizability of cognitive models of depression to adolescents and explored developmental differences with regard to depressotypic cognitions. Self-reported depressive symptoms and various hypothesized cognitive correlates (e.g., automatic thoughts, attributions, dysfunctional attitudes) were investigated in a sample of 688 adolescents in Grades 7–12. Measures of normative adolescent cognitions (e.g., egocentrism, self-consciousness) also were included. There was a strong association between negative thinking and depression in adolescents. There was no association between depressogenic thinking and age, nor did the strength of the association between negative cognitions and depression vary from early to middle adolescence. Finally, negative cognitions were associated with self-report measures of both depressive and anxious symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive thinking and depression: Relations with personality and social resources.

We studied depression, depressive cognitions, social supports, and self-esteem in a sample of 68 spouse-caregivers of patients with Alzheimer's Disease in an attempt to identify possible buffering mechanisms of the latter 2 variables. Specifically, we hypothesized that the well-known relation of depressive cognitions to depression would vary as a function of satisfaction with social supports and with level of self-esteem. Hierarchical multiple regression analyses conducted to predict depression revealed significant and independent main effects for depressive cognitions, social supports, and self-esteem, with depressive cognitions associated with higher depression and the other 2 variables associated with reduced depression. In addition, the relation of depressive cognitions with depression varied substantially depending on the level of social supports; caregivers with high levels of depressive cognitions had high levels of depression only if social supports were low. Self-esteem and depressive cognitions showed a similar interaction, but it failed to reach significance. Analyses to determine whether self-esteem and social supports were directly associated with lower depressive cognitive activity yielded a main effect for self-esteem only. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An innovative approach to short-term group cognitive therapy in the combined treatment of anxiety and depression.

Twenty-six adult outpatients completed a 12-session group cognitive therapy program specifically designed to conjointly treat individuals with comorbid depressive and anxiety symptoms. The program takes a content specificity approach, differentially treating depression and anxiety from a cognitive therapy perspective. Participants showed significant improvement on measures of depression, anxiety, and dysfunctional attitudes from pre- to posttest. Findings suggest clinical and practical utility for this intervention and support the use of combination therapeutics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive predictors of symptom return following depression treatment.

This study tested whether poor cognitive change during depression treatment predicted time to return of depressive symptoms. Depressed participants (N=121) completed assessments of dysfunctional attitudes and extreme thinking (i.e., number of totally agree and totally disagree responses) during hospitalization and again after 6 months of outpatient treatment. Participants then completed monthly depression assessments for 1 year. Survival analyses for time to symptom recurrence during follow-up were conducted among participants who reported 50% improvement in their depressive symptoms and were at least partially asymptomatic at the end of treatment (n=53). Poor change in dysfunctional attitudes and poor change in extreme thinking both predicted shorter time to return of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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

Stability of cognitive vulnerabilities to depression: A short-term prospective multiwave study.

The stability of 3 cognitive vulnerabilities--a negative cognitive style, dysfunctional attitudes, and rumination--as well as depressive symptoms as a benchmark were examined to investigate whether cognitive vulnerabilities are stable, enduring risks for depression. A sample of adolescents (6th-10th graders) completed measures of these 3 cognitive vulnerabilities and depressive symptoms every 5 weeks for 4 waves of data across 5 months. Mean-level and differential stability were examined for the sample overall and by age subgroups. A negative cognitive style exhibited mean-level stability, whereas rumination and dysfunctional attitudes showed some mean-level change. Absolute magnitudes of test-retest reliabilities were strong for depressive symptoms (mean r = .70), moderately high for a negative cognitive style (mean r = .52), and more modest for rumination (mean r = .28) and dysfunctional attitudes (mean r = .26). Structural equation modeling showed that primarily enduring processes, but not contextual forces, contributed to the patterning of these test-retest reliabilities over time for a negative cognitive style and dysfunctional attitudes, whereas both enduring and contextual dynamics appeared to underlie the stability for rumination. Theoretical and clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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

Antecedents of stressful experiences: Depressive symptoms, self-esteem, gender, and coping.

Numerous studies have identified depressive symptoms as antecedent to stressful experiences. However, the interrelations of depressive symptoms, personal resources, and coping as antecedents of stressful experiences are largely unknown. For this investigation, a prospective design was used to test a model estimating two categories of daily hassles at Time 2 in relation to depressive symptoms, self-esteem, gender, coping, and daily hassles at Time 1. Utilizing simultaneous equations, direct effects were observed for depressive symptoms, Time 1 hassles, gender, and avoidance coping in relation to category of hassles at Time 2. Depressive symptoms and avoidance coping were observed to be mediators for gender and self-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily Depression and Cognitions About Stress: Evidence for a Traitlike Depressogenic Cognitive Style and the Prediction of Depressive Symptoms in a Prospective Daily Diary Study.

The authors examined the stability and dynamic structure of negative cognitions made to naturalistic stressors and the prediction of depressive symptoms in a daily diary study. Young adults reported on dispositional depression vulnerabilities at baseline, including a depressogenic cognitive style, dysfunctional attitudes, rumination, neuroticism, and initial depression, and then completed short diaries recording the inferences they made to the most negative event of the day along with their experience of depressive symptoms every day for 35 consecutive days. Daily cognitions about stressors exhibited moderate stability across time. A traitlike model, rather than a contextual one, explained this pattern of stability best. Hierarchical linear modeling analyses showed that individuals' dispositional depressogenic cognitive style, neuroticism, and their daily negative cognitions about stressors predicted fluctuations in daily depressive symptoms. Dispositional neuroticism and negative cognitive style interacted with daily negative cognitions in different ways to predict daily depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adult Attachment, Depressive Symptoms, and Validation From Self Versus Others.

Attachment working models of self and others may govern adults' preferences for internal vs. external sources of reassurance, which, if unavailable, lead to depressive symptoms. This study examined a model in which the link between depressive symptoms and attachment anxiety is mediated by (a) capacity for self-reinforcement and (b) need for reassurance from others, whereas the link between depressive symptoms and attachment avoidance is mediated only by the capacity for self-reinforcement. Analysis of survey data from 425 undergraduates indicated that both capacity for self-reinforcement and need for reassurance from others partially mediated the link between attachment anxiety and depression. Capacity for self-reinforcement fully mediated the link between attachment avoidance and depression. Moreover, 54% of the variance in depressive symptoms was explained by attachment anxiety, self-reinforcement, and need for reassurance from others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comorbidity between depressive disorders and nicotine dependence in a cohort of 16-year-olds

BACKGROUND: There has been growing interest in the associations between cigarette smoking and symptoms of depression. This study documents the comorbidity between depression and nicotine dependence in a birth cohort of 16-year-olds and examines the extent to which comorbidity between depression and nicotine dependence could be explained by risk factors associated with both outcomes. METHODS: Data were gathered during the course of a 16-year longitudinal study of a birth cohort of 947 New Zealand children for (1) depressive disorders and nicotine dependence at age 16 years; and (2) prospectively measured risk factors including family social position, family history of criminality, parental smoking, life events, parental attachment, conduct problems, self-esteem, and affiliations with delinquent peers. RESULTS: There was evidence of moderate to strong comorbidity between depression and nicotine dependence at age 16 years; teenagers with a depressive disorder had odds of nicotine dependence that were 4.6 times those of teenagers without depressive disorder. Analyses using logistic regression and log-linear modeling methods revealed that a substantial component of the comorbidity between depression and nicotine dependence was explained by common or correlated risk factors associated with both outcomes. After adjustment for common or correlated risk factors, the adjusted odds ratio between depression and nicotine dependence was 2.3. CONCLUSIONS: Comorbidities between depression and nicotine dependence seem to be well established by the age of 16 years. Much of this comorbidity can be explained by common or correlated risk factors associated with depression or nicotine dependence.     

Latent class analysis of lifetime depressive symptoms in the national comorbidity survey

OBJECTIVE: Although clinical trials have documented the importance of identifying individuals with major depression with atypical features, there are fewer epidemiological data. In a prior report, the authors used latent class analysis (LCA) to identify a distinctive atypical depressive subtype; they sought to replicate that finding in the current study. METHOD: Using the National Comorbidity Survey data, the authors applied LCA to 14 DSM-III-R major depressive symptoms in the participants' lifetime worst episodes (N=2,836). Validators of class membership included depressive disorder characteristics, syndrome consequences, demography, comorbidity, personality/attitudes, and parental psychiatric history. RESULTS: The best-fitting LCA solution had six classes. Four were combinations of atypicality and severity: severe atypical, mild atypical, severe typical, and mild typical. Syndrome severity (severe atypical and typical versus mild atypical and typical classes) was associated with a pronounced pattern of more and longer episodes, worse syndrome consequences, increased psychiatric comorbidity, more deviant personality and attitudes, and parental alcohol/drug use disorder. Syndrome atypicality (severe and mild atypical versus severe and mild typical classes) was associated with decreased syndrome consequences, comorbid conduct disorder and social phobia, higher interpersonal dependency and lower self-esteem, and parental alcohol/drug use disorder. CONCLUSIONS: As in prior reports, the atypical subtype of depression can be identified in epidemiological samples and, like typical depression, exists in mild and severe variants. Atypical depressive subtypes were characterized by several distinctive features. However, the correspondence between epidemiologically derived typologies of atypical depression and DSM-IV major depression with atypical features is not yet known.     

An investigation of the object relations theory of depression.

The current study investigated a particular aspect shared by a number of theories of depression under the common heading of object relations theory (ORT), namely that depression is associated with a continuing pattern of poor attachment that is laid out in childhood and continues into adulthood. The study examined the relationship between attachment (both parental and peer) and depressive symptoms in young adults (N = 85) of Northern Ireland. Results provided support for the continuity of perceptions of attachment styles across the life span and revealed that perceptions of early attachment experiences, as well as continuing peer attachment styles, appeared to be predictive of current depressive symptoms. More specifically, the analyses revealed a statistically significant positive correlation between perceived quality of current peer attachment and symptoms of depression, as well as a statistically significant negative correlation between self-reported childhood maternal care and symptoms of depression. However, other self-reported measures of childhood attachment were not found to be significant predictors of depressive symptoms (i.e., paternal care, maternal overprotection, paternal overprotection). Taken together, the findings lend some support for this important element of a number of object relations theories, as they pertain to depression. Further empirical research is indicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression, self-esteem, and anger in emerging adulthood: Seven-year trajectories.

This study used a school-based community sample (N = 920) to examine trajectories of depressive symptoms, self-esteem, and expressed anger in the critical years of emerging adulthood (ages 18-25). Using data from 5 waves, the authors discovered that multilevel models indicated that, on average, depressive symptoms and expressed anger declined, whereas self-esteem increased. Between-persons predictors of variability in trajectories included gender (gender gaps in depressive symptoms and self-esteem narrowed), parents' education, and conflict with parents (depressive symptoms and expressed anger improved fastest in participants with highly educated parents and in those with higher conflict). Across time, increases in social support and marriage were associated with increased psychological well-being, whereas longer periods of unemployment were connected with higher depression and lower self-esteem. Emerging adulthood is a time of improving psychological well-being, but individual trajectories depend on specific individual and family characteristics as well as role changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptoms among physically abused and psychiatrically disturbed children.

Examined the relation of physical abuse and depressive symptoms among 79 6–13 yr old child psychiatric inpatients. Childhood depression, hopelessness, and self-esteem were assessed through questionnaire or interview measures administered to the children. 79 25–52 yr old mothers or maternal guardians also completed measures to evaluate their children's dysfunction. As predicted, the 33 physically abused children, compared with the 46 nonphysically abused patient controls, evinced significantly lower self-esteem and greater depression and negative expectations toward their futures. Among abused children, those with both past and current abuse showed more severe symptoms of depression that did those with either past or current abuse only. The differences in depressive symptoms between abused and nonabused children could not be accounted for by differences in child psychiatric diagnosis, age, race, gender, IQ, or severity of psychopathology or parent psychiatric diagnoses, marital, or SES. Results suggest that physical abuse, at least for a psychiatric patient sample, is related to symptoms of depression. The possible basis for this relation and the treatment implications are discussed. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships between symptoms of depression and anxiety and dysfunctional beliefs about achievement and attachment.

293 psychiatric outpatients provided data to test the symptom specificity and final common pathway hypotheses about symptoms of depression and anxiety. The symptom specificity hypothesis predicts that the symptoms reported by a depressed or anxious patient depend on the dysfunctional beliefs he or she endorses. In contrast, the final common pathway hypothesis predicts that symptoms are unrelated to the types of beliefs the patient endorses. These hypotheses were tested in the context of theories that emphasize the importance of dysfunctional beliefs about achievement and attachment. Only limited support for the symptom specificity hypothesis was obtained; support was strongest for the link between attachment beliefs and anxiety symptoms. Relationships between symptoms and dysfunctional beliefs did not depend on psychiatric diagnosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bidirectional relations of religious orientation and depressive symptoms in adolescents: A short-term longitudinal study.

Religious orientation can be divided into intrinsic and extrinsic: intrinsically oriented individuals “live their religion,” whereas extrinsically oriented individuals practice religion mainly to gain external benefits. In adults, depression has been found to correlate negatively with intrinsic religious orientation and positively with extrinsic orientation. Studies of the relation between religiosity and depression typically have not been longitudinal, conducted with adolescents, controlled for the influence of other factors associated with depression (i.e., negative cognitions), or examined the reverse relation of depression predicting religious orientation. Our 4-month longitudinal study of 273 ninth-grade students addressed these issues. Results showed that higher intrinsic religious orientation measured at baseline significantly predicted lower self-reported depressive symptoms 4 months later, controlling for initial level of depressive symptoms and cognitive style; in contrast, extrinsic orientation and the interaction between religious orientation and life events did not significantly predict later depressive symptoms. Self-reported depressive symptoms, however, did not predict either intrinsic or extrinsic religious orientation 4 months later. Factors contributing to different findings for adolescents versus adults in the relation between extrinsic religious orientation and depression are suggested. (PsycINFO Database Record (c) 2011 APA, all rights reserved)