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)     

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)     

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)     

Cognitive change and the therapeutic alliance: The role of technical and nontechnical factors in cognitive therapy.

Tests whether there are reciprocal interactions between the technical and nontechnical aspects of cognitive therapy (CT). 47 outpatients (mean age 36.8 yrs) with a depressive and/or anxiety disorder were treated with a 20-week, manualized CT intervention. Measures included the Beck Depression Inventory, the Dysfunctional Attitude Scale, and the Working Alliance Inventory. Results indicate that pretreatment depressogenic cognitions impact on the ability to form an early therapeutic alliance, whereas pretreatment depression severity is unrelated to alliance formation. Second, the degree to which patients were in agreement with the goals and tasks of therapy was predictive of subsequent change in depressogenic cognitions. Third, the 2-way interaction between the therapeutic bond and cognitive-change scores was found to predict depression outcomes: patients who reported a better therapeutic bond and who experienced greater reduction in their depressogenic cognitions, experienced the most favorable clinical outcomes. Certain aspects of the therapeutic alliance (i.e., goals and tasks) may facilitate the implementation of the technical factors of CT, while other aspects of the alliance (i.e., bond) act in concert with technical factors to produce direct effects on depressed symptoms. (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)     

Cognitive vulnerability to depressive symptoms in adolescents in urban and rural Hunan, China: A multiwave longitudinal study.

The current multiwave longitudinal study examined the applicability of two cognitive vulnerability-stress models of depression—Beck's (1967, 1983) cognitive theory and the hopelessness theory (Abramson, Metalsky, & Alloy, 1989)—in two independent samples of adolescents from Hunan Province, China (one rural and one urban). During an initial assessment, participants completed measures assessing dysfunctional attitudes (Beck, 1967, 1983), negative cognitive style (Abramson et al., 1989), neuroticism (Costa & McCrae, 1992), depressive symptoms, and anxiety symptoms. Once a month for the subsequent 6 months, participants completed measures assessing the occurrence of different types of negative events, depressive symptoms, and anxiety symptoms. Results provided support for cognitive vulnerability factors as predictors of increases in depressive symptoms following the occurrence of higher than average levels of negative events in Chinese adolescents. The results also supported the specificity of these two cognitive vulnerability factors as predictors of depressive versus anxiety symptoms following the occurrence of higher than average levels of negative events (i.e., symptom specificity), and the ability of cognitive vulnerability factors to predict prospective change in depressive symptoms above and beyond the effects of trait neuroticism (i.e., etiological specificity). (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Cognitive triad: relationship to depressive symptoms, parents' cognitive triad, and perceived parental messages

Evaluating the relationship between children's depressogenic thinking, children's depressive symptoms, parents' depressogenic thinking, and perceived parental messages about the self, world, and future was the primary objective of this investigation. Children (n = 133) from grades 4 to 7 completed measures of depression and anxiety, including a semistructured clinical interview, a measure of their cognitive triad, and a measure of perceived parental messages about the self, world, and future. Mothers (n = 112) and fathers (n = 95) completed a measure of their own cognitive triad. Results of a series of regression analyses revealed that (1) children's views of self, world, and future (cognitive triad) are related to severity of depression; (2) mothers' but not fathers' cognitive triads are related to their children's cognitive triads; (3) perceived parental messages to the children about the self, world, and future are predictive of the children's cognitive triads and ratings of depression; and (4) the relationship between perceived parental messages and depression is completely mediated by children's cognitive triads. Analyses of covariance indicated that the obtained mediational relationship between children's views of self, world, and future, perceived parental messages, and children's depressive symptoms was specific to depressive versus anxious symptomatology. Implications for existing theory and research are discussed.     

Integration of positive and negative affectivity and cognitive content-specificity: Improved discrimination of anxious and depressive symptoms.

In a sample of 159 psychiatric outpatient adults, negative affectivity (NA) was significantly correlated with a broad range of anxiety and depressive symptoms and was not useful for the differentiation of anxiety from depression. Low positive affectivity (PA) was significantly related only to depressive symptoms. Whereas depressive cognitions demonstrated discriminant capability, anxiety cognitions (in isolation) demonstrated nonspecificity. A combination of NA and anxious cognitions significantly predicted anxiety symptoms, better than did cognitions or affect alone. NA, depressive cognitions, and low PA significantly predicted depressive symptoms. Results support the integration of affective and cognitive models for the discrimination of anxious from depressive symptoms and have implications for measure development. Modifications in the cognitive content-specificity theory of anxiety states are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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

The hopelessness theory of depression proposes that individuals with a depressogenic cognitive style are more likely to become hopeless and experience depression following negative life events. Although the neurophysiological underpinnings of cognitive style remain speculative, research indicates that decreased relative left frontal brain electrical activity holds promise as a traitlike marker of depression. This begs the question: Do measures of depressogenic cognitive style and resting frontal brain asymmetry index a common vulnerability? The present study provides preliminary support for this hypothesis. At baseline assessment, increased cognitive vulnerability to depression was associated with decreased relative left frontal brain activity at rest in individuals with no prior history of, or current, depression. Following baseline assessment, participants were followed prospectively an average of 3 years with structured diagnostic interviews at 4-month intervals. Both cognitive vulnerability and asymmetric frontal cortical activity prospectively predicted onset of first depressive episode in separate univariate analyses. Furthermore, multivariate analyses indicated that cognitive vulnerability and frontal asymmetry represented shared, rather than independent, predictors of first depression onset. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychosocial antecedents of depressive symptoms: An evaluation using daily experiences methodology.

College students provided ratings regarding the intensity of depressive symptoms every day for 45 consecutive days. Participants also made daily ratings of the degree to which they experienced 3 psychosocial processes that have been theoretically linked to depression: dependency, negative cognitions, and interpersonal stress. Concomitant time-series analyses revealed significant temporal covariation of each psychosocial variable, with depressive symptoms for virtually all participants. Across-time analyses also revealed that elevations in interpersonal stress and feelings of dependency preceded, by 1 day, the onset of periods of intense depression, and that elevations in all 3 psychosocial variables were apparent 1 to 2 days after such episodes had ended. The findings suggest that a "daily experiences methodology" may be useful in identifying short-term antecedents and residuals of symptomatic states. (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)     

Interpersonal attachment cognitions and prediction of symptomatic responses to interpersonal stress.

The authors tested a cognitive-interpersonal hypothesis of depression by examining the role of interpersonal cognitions in the prediction of depression associated with interpersonal stressors. A measure of adult attachment assessed interpersonal cognitions about ability to be close to others and to depend on others and anxiety about rejection and abandonment. Participants were women who had recently graduated from high school; they were followed for 1 year with extensive interview evaluation of life events, depression, and other symptomatology. Generally, cognitions, interpersonal events, and their interactions contributed to the prediction of interview-assessed depressive symptoms, but the effects were not specific to depression and predicted general symptomatology measured by diagnostic interviews as well, and results also varied by attachment subscale. Results were discussed in terms of a developmental psychopathology approach to disorders in young women. (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)     

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)     

Intraindividual relations between the intensity and disclosure of daily emotional events: The moderating role of depressive symptoms.

Individuals with high levels of depressive symptoms tend to engage in lower levels of emotional disclosure than individuals who are lower in depressive symptoms. However, little is known about how depressive symptoms relate to the intraindividual relation between daily disclosure and the intensity of the daily events. The authors addressed these relations using a daily diary methodology. College students (N = 239) completed a measure of depression symptoms. They then completed measures of the intensity of the day’s most unpleasant event and their disclosure of that event each day for 7 days. Results indicated that depression moderated the intensity–disclosure relation such that depression symptoms were associated with diminished emotional disclosure for high-intensity events but not for low-intensity events. Individuals with relatively higher levels of depressive symptoms also experienced unpleasant daily events at a higher intensity level than did individuals with relatively fewer symptoms. Sex differences emerged such that men were less likely than women to disclose high-intensity negative events. These findings extend the use of the diary methodology to the study of emotional disclosure and also suggest possible interventions for counseling psychology practitioners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing mediators of intervention effects in randomized controlled trials: An evaluation of three depression prevention programs.

Objective: Evaluate a new 5-step method for testing mediators hypothesized to account for the effects of depression prevention programs. Method: In this indicated prevention trial, at-risk teens with elevated depressive symptoms were randomized to a group cognitive–behavioral (CB) intervention, group supportive expressive intervention, CB bibliotherapy, or assessment-only control condition. Results: The group CB intervention reduced depressive symptoms and negative cognitions and increased pleasant activities. Change in these mediators predicted change in depression, and intervention effects became weaker controlling for change in the mediators; yet, change in depression appeared typically to occur before change in the mediators. The supportive expressive intervention reduced depressive symptoms but affected only 1 of 2 mediators (emotional expression but not loneliness). Change in emotional expression did not correlate with change in depression, and change in depression usually occurred before change in the mediators. Bibliotherapy did not significantly affect depressive symptoms or the ostensive mediators (negative cognitions and pleasant activities), and change in depression usually occurred before change in the mediators. Conclusion: Results imply that this procedure provides a sensitive test of mediation but yielded limited support for the hypothesized mediators, suggesting that nonspecific factors may play an important mediational role. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression history and coping with chronic pain: A daily process analysis.

This study examined how a previous episode of depression is related to daily pain and reactions to pain among individuals with fibromyalgia, a chronic pain syndrome. Seventy-one women with fibromyalgia (including 30 who were previously depressed) rated their pain and mood 3 times daily for 30 days. Each night, participants rated the extent to which they responded to pain by catastrophizing, how much control they had over that day's pain, their ways of coping with pain that day, and the effectiveness of their coping efforts. Multivariate multilevel regression models revealed that after controlling for neuroticism and current depressive symptoms, formerly depressed and never-depressed individuals differed in how they coped with increased pain and in how they appraised the efficacy of their coping efforts. Formerly depressed participants who also reported more current depressive symptoms showed a greater decline in pleasant mood on more painful days than did formerly depressed participants who were experiencing fewer current depressive symptoms. These findings illustrate how a history of depression can be captured in the dynamics of daily life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitions and stress: Direct and moderating effects on depressive versus externalizing symptoms during the junior high school transition.

This study examined direct and stress-moderating effects of attributional style and global self-worth on depressive and externalizing symptoms in adolescents. Attributional style, perceived self-worth, depressive symptoms, and externalizing behaviors were assessed in 371 students in the spring of 6th grade. After the transition to 7th grade, they again completed measures of depression and externalizing symptoms as well as measures of negative life events and school hassles. Stressors around the transition predicted both depressive and externalizing behaviors. Perceived self-worth predicted depressive symptoms, but not externalizing behaviors. Attributional style directly and in interaction with stressors predicted depressive symptoms and did not predict externalizing behavior. A 3-way interaction between stress, attributional style, and self-worth suggested that level of perceived self-worth may moderate the effects of attributional style in times of stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental changes in depressive cognitions: A longitudinal evaluation of the Cognitive Triad Inventory for Children.

As part of a longitudinal study, the Cognitive Triad Inventory for Children (CTI-C; N. J. Kaslow, K. D. Stark, B. Printz, R. Livingston, & S. L. Tsai, 1992) as well as other measures of cognitive style and depressive symptoms were administered annually to 3 cohorts of children starting in Grades 2, 4, and 6. Developmentally based analyses revealed 4 things: (a) The factor structure of the CTI-C changed over the course of middle childhood and then stabilized in early adolescence; (b) the CTI-C correlated significantly with measures of depression, self-perceived competence, self-worth, perceived controllability, and perceived contingency, but not with measures of attributional style; (c) 1-year stability correlations increased substantially from Grade 2 to Grade 8; and (d) the CTI-C did not generally predict self-reported depressive symptoms 1 year later. Implications emerge regarding developmental changes in the structure of children's depressive cognitions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes toward depression among rehabilitation participants with acute stroke: Evidence of an age cohort effect.

Purpose/Objective: Depression is commonplace after acute stroke and is associated with increased morbidity and mortality. No data exist regarding attitudes about depression among older persons with acute stroke and their potential impact on self-report of depressive symptoms. The objective of this study was to determine if attitudes toward depression affect depression symptom reporting. Research Method/Design: Cross-sectional using data from an inpatient rehabilitation unit. Seventy-two people with acute stroke were surveyed regarding their attitudes toward depression as part of a larger battery assessing their cognitive and emotional functioning. Results: Both age and cognitive status were significant predictors of attitudes toward depression. Older participants expressed significantly more negative attitudes about depression and seeking professional help compared with younger participants. Those with higher cognitive scores held more positive attitudes. However, attitudes about depression were unrelated to participants' responses on self-report measures of depression. Conclusions/Implications: Participants with stroke who were older were more likely to report negative attitudes about depressive symptoms than were younger participants. However, these attitudes do not appear to represent a barrier to their ability to accurately report the presence and severity of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)