A test of cognitive vulnerability in individuals prone to depression

The assessment of dysfunctional attitudes and their role in the onset, persistence and recurrence of clinical depression

Dysfunctional attitudes have been proposed as an important vulnerability factor in the cognitive model of depression. Yet it has often proved difficult to demonstrate their existence in non‐symptomatic populations. We examine the ways in which dysfunctional attitudes have been conceptualized and assessed, from self‐report methods to information‐processing tasks. A s dysfunctional attitudes are typically viewed as latent in non‐symptomatic groups, the importance of priming or activating such variables is emphasized, together with recommendations as to how this may best be achieved. Comparative studies of depressed, control, and at‐risk groups are then considered, together with longitudinal studies that have directly testedpredictions of the cognitive model. Prospective studies of non‐depressed, non‐clinical samples have so far had mixed results in demonstrating that dysfunctional attitudes precede depression or that specific attitudes interact with congruent events in the way the model predicts, although more consistent results emerge from clinical samples with a past history of depression. Possible reasons for the variability in findings are presented, together with suggestions for further research and a revised cognitive model of depression.

Self-Referent Versus Other-Referent Information Processing in Dysphoric, Clinically Depressed, and Remitted Depressed Subjects

Two studies examined the processing of responses directed toward the self versus others by dysphoric, clinically depressed, and remitted depressed subjects. Study 1 showed that dysphoric subjects found positive and negative responses toward the self equally informative. Nondysphoric subjects found positive responses toward the self more informative than negative responses. When responses were directed toward others, dysphoric subjects found positive responses more informative than negative responses. In contrast, nondysphoric subjects found positive and negative responses directed toward others equally informative. Study 2 replicated these results with clinically depressed versus nondysphoric subjects. Study 2 also showed that remitted depressed subjects found positive responses more informative than negative responses, regardless of whether they were directed toward the self or toward others. Results suggest that positive and negative constructs are differentially accessible for dysphoric, clinically depressed, remitted depressed, and nondysphoric subjects when processing information directed toward the self versus others.

Teasdale's differential activation hypothesis: implications for mechanisms of depressive relapse and suicidal behaviour

Teasdale's differential activation hypothesis (DAH) has been proposed as one account of cognitive vulnerability to depression. This view holds that important factors determining whether one's initial depression becomes more severe or persistent are the degree of activation, and content, of negative thinking patterns that become accessible in the depressed state. This phenomenon has been referred to as cognitive reactivity. Empirical support for the predictions of this model derives from a combination of cross-sectional and prospective studies. In this article, we evaluate this evidence with the goal of determining whether mood-induced cognitive reactivity can be considered a risk factor for depressive relapse/recurrence. Our review demonstrates sufficient evidence to consider cognitive reactivity as a potential causal risk factor for depressive relapse/recurrence. Furthermore, we extend the application of this model to the problem of suicidal relapse/recurrence including a review of preliminary support for this approach.

Remitted depression studies as tests of the cognitive vulnerability hypotheses of depression onset: a critique and conceptual analysis

Investigations of cognitive patterns among individuals who have recovered from a depressive episode (i.e., remitted depressives) have figured importantly in evaluations of the validity of the vulnerability hypotheses of the cognitive theories of depression. However, we suggest that remitted depression studies as typically conducted and interpreted are inadequate tests of the cognitive vulnerability hypotheses of depression onset for four reasons: (1) remitted depression studies are based on the erroneous assumption that cognitive vulnerability should be an immutable trait; (2) remitted depression studies use a logically "backward" participant selection strategy in which participants are selected on the basis of the "dependent" variable (depression) and then compared on the "independent" variable (cognitive vulnerability), which is likely to result in heterogeneity of cognitive vulnerability among both the remitted depressed as well as the nondepressed groups given the causal relations specified in the cognitive theories of depression; (3) many remitted depression studies have ignored the possible activating role of stress in the cognitive vulnerability-stress theories, particularly Beck's theory, and thus, may attempt to assess cognitive vulnerability at a time when it is not operative (i.e., priming hypothesis); and (4) remitted depression studies inappropriately use postmorbid participants to test causal hypotheses, and therefore, are ambiguous about whether negative cognitive styles observed in remitted depressed persons are vulnerabilities as opposed to consequences of depression (i.e., scar hypothesis). As a remedy, we advocate the use of a theory-guided behavioral high-risk strategy to more adequately test the cognitive vulnerability hypotheses of depression onset.