Social context, coping strategies, and depressive symptoms: an expanded model with cardiac patients

This research broadened and refined a resources model of coping to encompass negative as well as positive aspects of social relationships and examined this expanded conceptualization in a 4-year prospective model with 183 cardiac patients (140 men and 43 women). Social support and social stressors in the family and extrafamily domains contributed significantly to a common social context latent construct. In addition, this conceptualization of social context was significantly related to depressive symptoms 4 years later. Especially important conceptually, coping strategies functioned as a mechanism through which both social support and social stressors related to subsequent depressive symptoms. Moreover, positive and negative aspects of social relationships made essentially unique contributions in predicting subsequent coping efforts.     

Adolescent Girls' Interpersonal Vulnerability to Depressive Symptoms: A Longitudinal Examination of Reassurance-Seeking and Peer Relationships.

A transactional, interpersonal framework involving adolescents' reassurance-seeking and peer experiences may be useful for understanding the emergence of gender differences in depression prevalence during the adolescent transition. Sociometric nominations of peer acceptance/rejection and ratings of friendship quality provided by adolescents and their friends were used to measure peer experiences among 6th-8th-grade adolescents (N = 520) over 3 annual time points. After controlling for age and pubertal development, significant but small prospective effects offered mixed support for hypotheses: (a) depressive symptoms and negative peer relations predicted increasing levels of girls' reassurance-seeking; (b) initial levels of reassurance-seeking and depressive symptoms predicted deteriorating friendship quality among girls and low friendship stability, respectively; and (c) reassurance-seeking combined with poor peer experiences predicted increases in girls' depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Role of Social Stressors and Interpersonal Orientation in Explaining the Longitudinal Relation Between Externalizing and Depressive Symptoms.

The authors examined the longitudinal association between externalizing and depressive symptoms using a sample of 185 young adolescents whose mothers had histories of depression. The relation between externalizing behaviors in 6th grade and depressive symptoms a year later was partially mediated by dependent social stressors. Moreover, consistent with the personality-event congruence hypothesis, this mediation model was particularly true for children with high levels of interpersonal orientation (Neediness and Connectedness). In contrast, social stressors that were judged to be independent of the children's behavior, as well as both dependent and independent nonsocial stressors, did not mediate the longitudinal relation between externalizing and depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship functioning moderates the association between depressive symptoms and life stressors.

Data from 172 newlywed couples were collected over the first 4 years of marriage to test how behaviors demonstrated during marital interactions moderate associations between depressive symptoms and subsequent life stressors. Depressive symptoms and behaviors coded from problem-solving and social support interactions were analyzed as predictors of nonmarital stressors that were interpersonal and dependent on the participant's actions. Behavioral codes were found to moderate 3 of 16 symptom-to-life event associations for husbands. Husbands' reports of more depressive symptoms predicted greater levels of stress when husbands' positive affect and hard negative affect during problem-solving were relatively infrequent and when wives made frequent displays of positive behaviors during husbands' support topics. These effects remained after controlling for marital satisfaction. For wives, behavioral moderators did not interact with depressive symptoms to predict changes in stress, but marital satisfaction consistently interacted with depressive symptoms to predict future stressors beyond interpersonal behaviors. Specifically, for wives, stress generation was more evident when relationship satisfaction was low than when it was high. Our results, though different for men and women, suggest that relationship functioning can alter associations between depressive symptoms and life stress in the early years of marriage. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Predictors of the first onset of a major depressive episode and changes in depressive symptoms across adolescence: Stress and negative cognitions.

This 6-year longitudinal study examined stressors (e.g., interpersonal, achievement), negative cognitions (self-worth, attributions), and their interactions in the prediction of (a) the first onset of a major depressive episode (MDE), and (b) changes in depressive symptoms in adolescents who varied in risk for depression. The sample included 240 adolescents who were first evaluated in Grade 6 (M = 11.86 years old; SD = 0.57; 54.2% female) and then again annually through Grade 12. Stressful life events and depressive diagnoses were assessed with interviews; negative cognitions and depressive symptoms were assessed with self-report questionnaires. Discrete time hazard modeling revealed a significant interaction between interpersonal stressors and negative cognitions, indicating that first onset of an MDE was predicted by high negative cognitions in the context of low interpersonal stress, and by high levels of interpersonal stressors at both high and low levels of negative cognitions. Analyses of achievement stressors indicated significant main effects of stress, negative cognitions, and risk in the prediction of an MDE, but no interactions. With regard to the prediction of depressive symptoms, multilevel modeling revealed a significant interaction between interpersonal stressors and negative cognitions such that among adolescents with more negative cognitions, higher levels of interpersonal stress predicted higher levels of depressive symptoms, whereas at low levels of negative cognitions, the relation between interpersonal stressors and depression was not significant. Risk (i.e., maternal depression history) and sex did not further moderate these interactions. Implications for intervention are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Stress Generation, Avoidance Coping, and Depressive Symptoms: A 10-Year Model.

This study examined (a) the role of avoidance coping in prospectively generating both chronic and acute life stressors and (b) the stress-generating role of avoidance coping as a prospective link to future depressive symptoms. Participants were 1,211 late-middle-aged individuals (500 women and 711 men) assessed 3 times over a 10-year period. As predicted, baseline avoidance coping was prospectively associated with both more chronic and more acute life stressors 4 years later. Furthermore, as predicted, these intervening life stressors linked baseline avoidance coping and depressive symptoms 10 years later, controlling for the influence of initial depressive symptoms. These findings broaden knowledge about the stress-generation process and elucidate a key mechanism through which avoidance coping is linked to depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathways to childhood depressive symptoms: The role of social, cognitive, and genetic risk factors.

Childhood depressive conditions have been explored from multiple theoretical approaches but with few empirical attempts to address the interrelationships among these different domains and their combined effects. In the present study, the authors examined different pathways through which social, cognitive, and genetic risk factors may be expressed to influence depressive symptoms in 300 pairs of child twins from a longitudinal study. Path analysis supported several indirect routes. First, risks associated with living in a step- or single-parent family and punitive parenting did not directly influence depressive outcome but were instead mediated through maternal depressive symptoms and child negative attributional style. Second, the effects of negative attributional style on depressive outcome were greatly exacerbated in the presence of precipitating negative life events. Third, independent of these social and cognitive risk mechanisms, modest genetic effects were also implicated in symptoms, with some indication that these risks are expressed through exposure to negative stressors. Together, these routes accounted for approximately 13% of total phenotypic variance in depressive symptoms. Theoretical and analytical implications of these results are discussed in the context of several design-related caveats. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support, social stressors at work, and depressive symptoms: Testing for main and moderating effects with structural equations in a three-wave longitudinal study.

This study investigated the moderating effects of social support by supervisors and colleagues relative to social stressors at work and depressive symptoms using a structural equations approach in a 3-wave longitudinal study over 1 year. The analyses were based on a randomly drawn sample of 543 citizens (aged 16–63 yrs) in the area around Dresden in the former East Germany. LISREL analysis with latent moderating effects revealed a moderating effect for supervisor support. This applied only if the time lag was 8 months, but not for longer or shorter lags. Under low-support conditions depressive symptoms were increased by social stressors, whereas, contrary to expectations, social stressors reduced subsequent depressive symptoms under high-support conditions. No moderating effect for colleague support was found. Several mechanisms are discussed that may explain the results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The unique effect of paternal depressive symptoms on adolescent functioning: Associations with gender and father–adolescent relationship closeness.

Prospective, longitudinal data from a community sample of 451 families were used to assess the unique contribution of paternal depressive symptoms to adolescent functioning. Results indicated that paternal depressive symptoms were significantly related to subsequent depressive symptoms in adolescent offspring; this association remained significant after controlling for previous adolescent depressive symptoms, maternal depressive symptoms, gender, and family demographic variables. Adolescent gender and perception of father–adolescent relationship closeness moderated this association such that paternal depressive symptoms were positively associated with adolescent depressive symptoms for girls whose relations with fathers lacked closeness. These findings add to a growing literature on the interpersonal mechanisms through which depression runs in families, highlighting the need for future investigation of paternal mental health, adolescent gender, and intrafamily relationship quality in relation to adolescent development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Excessive reassurance-seeking predicts depressive but not anxious reactions to acute stress.

The authors hypothesized that excessive reassurance-seeking would prospectively predict changes in depressive symptoms, even controlling for changes in anxious symptoms, and would not predict changes in anxious symptoms controlling for changes in depressive symptoms. This prediction was supported in a study of 1,005 air force cadets. Participants completed measures of excessive reassurance-seeking and depressive and anxious symptoms before basic training, and completed symptom measures again following basic training. This study, together with others, demonstrates that excessive reassurance-seeking is an important depression-related variable that deserves serious attention as a potential vulnerability factor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Poor interpersonal problem solving as a mechanism of stress generation in depression among adolescent women.

The authors examined C. Hammen's (1991) model of stress generation in depression and the role of interpersonal problem-solving strategies (IPS) in the stress generation process in a longitudinal sample of 140 young women who entered the study at ages 17–28. Structural equation modeling was used to test a model in which IPS and subsequent interpersonal stress mediated the relationship between initial and later depressive symptoms. Results supported the main prediction of the stress generation model: Interpersonal stress mediated the relationship between initial and later depressive symptoms. In addition, IPS predicted interpersonal stress. However, no association was found between depressive symptoms and IPS. An alternative model in which IPS moderated the relationship between stress and depressive symptoms was tested; it was not supported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Axis II symptomatology, depression, and life stress during the transition from adolescence to adulthood.

This study examined 2 models of the relationship between personality disorder symptomatology and depression, incorporating life stress as an intervening variable. In a community sample of late adolescent women, symptoms of Cluster B disorders predicted interpersonal chronic stress and self-generated episodic stress over 2 years, controlling for initial depression. Cluster A symptoms also predicted subsequent chronic interpersonal stress, over initial depression. Cluster C pathology did not predict subsequent stress. Personality disorder symptomatology was also associated with partner reported relationship dissatisfaction. Support was found for a mediation model whereby women with higher levels of initial personality disturbance in Clusters A and B generated excessive amounts of episodic stress and interpersonal chronic stress in the next 2 years, which, in turn, increased vulnerability for depressive symptoms. A moderation model, whereby the presence of greater personality disorder symptoms would increase the likelihood of depression in response to stress, was not supported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender-specific pathways between maternal depressive symptoms, family discord, and adolescent adjustment.

Relations among maternal depressive symptoms, family discord, and adolescent psychological adjustment were examined in a sample of 443 middle adolescents and their mothers. Histories of maternal depressive symptoms, gathered at 3 occasions with 6-month intervals, were related to subsequent adolescent reports of depressive symptoms, conduct problems, and academic difficulties for girls but not for boys. Mediational tests indicated that girls' greater vulnerability to family discord (e.g., marital discord, low family intimacy, parenting impairments) accounted for the impact of maternal depressive symptoms on their social and emotional adjustment. Analyses suggest that family discord is a strong mediator in the development of girls' conduct disturbances and a modest mediator of girls' depressive symptoms. Results are discussed within a framework that integrates interpersonal models of parental depressive symptoms with the gender intensification hypothesis. (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)     

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)     

Impaired neuroendocrine response mediates refractoriness to cardiopulmonary resuscitation in spinal anesthesia

The authors hypothesized that excessive reassurance-seeking would prospectively predict changes in depressive symptoms, even controlling for changes in anxious symptoms, and would not predict changes in anxious symptoms controlling for changes in depressive symptoms. This prediction was supported in a study of 1,005 air force cadets. Participants completed measures of excessive reassurance-seeking and depressive and anxious symptoms before basic training, and completed symptom measures again following basic training. This study, together with others, demonstrates that excessive reassurance-seeking is an important depression-related variable that deserves serious attention as a potential vulnerability factor.     

Social problem solving and depressive symptoms over time: A randomized clinical trial of cognitive-behavioral analysis system of psychotherapy, brief supportive psychotherapy, and pharmacotherapy.

Objective: Depression is associated with poor social problem solving, and psychotherapies that focus on problem-solving skills are efficacious in treating depression. We examined the associations between treatment, social problem solving, and depression in a randomized clinical trial testing the efficacy of psychotherapy augmentation for chronically depressed patients who failed to fully respond to an initial trial of pharmacotherapy (Kocsis et al., 2009). Method: Participants with chronic depression (n = 491) received cognitive-behavioral analysis system of psychotherapy (CBASP; McCullough, 2000), which emphasizes interpersonal problem solving, plus medication; brief supportive psychotherapy (BSP) plus medication; or medication alone for 12 weeks. Results: CBASP plus pharmacotherapy was associated with significantly greater improvement in social problem solving than BSP plus pharmacotherapy, and a trend for greater improvement in problem solving than pharmacotherapy alone. In addition, change in social problem solving predicted subsequent change in depressive symptoms over time. However, the magnitude of the associations between changes in social problem solving and subsequent depressive symptoms did not differ across treatment conditions. Conclusions: It does not appear that improved social problem solving is a mechanism that uniquely distinguishes CBASP from other treatment approaches. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Developmental trajectories of adolescents' depressive symptoms: Predictors of change.

in a sample of 240 adolescents assessed annually in Grades 6 through 11, the developmental trajectories of their depressive symptoms were examined using latent factor growth modeling. Growth in mother-reported adolest.ent depressive symptoms was quadratic; growth in adolescent-reported symptoms was linear. In the model with gender and maternal depression, girls reported a greater increase in depressive symptoms over time than boys, and adolescents of mothers with histories of mood disorders had higher initial levels of depressive symptoms than offspring of never-depressed mothers. After gender and maternal depression were controlled, initial levels of negative attributions and stressors significantly predicted initial levels of adolescent- and mother-reported depressive symptoms. Attributional styles that were increasingly negative across time were associated with significantly higher initial levels (mother reported) and increasing growth (adolescent reported) of depressive symptoms. Reciprocal models in which development of depressive symptoms predicted the development of attributions and stress also were examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism, negative social feedback, and interpersonal rumination in depression and social anxiety.

The current study investigated the associations among trait perfectionism, perfectionistic self-presentation, negative social feedback, interpersonal rumination, depressive symptoms, and social anxiety. New measures of negative social feedback and interpersonal rumination were used to evaluate their relevance to the social aspects of perfectionism and their roles in distress. A sample of 155 undergraduate students completed the Multidimensional Perfectionism Scale, the Perfectionistic Self-Presentation Scale, the Social Feedback Questionnaire, Rumination About an Interpersonal Offense, and measures of depressive symptoms and social anxiety. The results confirmed that socially prescribed perfectionism and perfectionistic self-presentation were associated significantly with negative social feedback and rumination following interpersonal events (i.e., being hurt, humiliated, mistreated). Also, depressive symptoms and social anxiety were associated significantly with negative social feedback, interpersonal rumination, trait perfectionism, and perfectionistic self-presentation. Additional analyses indicated that negative social feedback and interpersonal rumination mediated the links between components of the perfectionism construct and distress. Overall, our findings suggest that self-reported receipt of frequent negative feedback from others and engaging in rumination about an interpersonal event play important roles in the distress experienced by certain individuals with high levels of perfectionism. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A test of the cognitive diathesis-stress model of depression in children: Academic stressors, attributional style, perceived competence, and control.

The cognitive diathesis–stress model of depression was tested in a sample of 439 children in grades 5 and 6. Attributional style and cognitions about academic competence and control over achievement were assessed before the occurrence of a potentially stressful event—receiving unacceptable grades on a report card. Depressive symptoms were assessed 1 week before the event, the morning after, and 5 days later. Replicating G. I. Metalsky, L. J. Halberstadt, and L. Y. Abramson (1987), stressor level and negative cognitions predicted depressive symptoms the morning after the event, controlling for initial symptom levels. Depressive symptoms 5 days later were predicted by the interactions of negative cognitions with stressors, supporting a cognitive diathesis–stress model. Students who reported a negative explanatory style or lack of academic control and competence expressed more distress after receiving unacceptable grades than did students without such cognitions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)