Resilience to depressive symptoms: The buffering effects of enhancing cognitive style and positive life events

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Abstract

Background and Objectives

There are two lines of research examining the role of cognition in depression. One line of research focuses on risk for depression, and shows that a negative cognitive style interacts with stressful life events to create depression. The second line of research focuses on recovery, and shows that an enhancing cognitive style interacts with positive life events to reduce depression. The goal of this study was to integrate these two areas and provide a more comprehensive test of the cognitive model of depression.

Methods

A 4-week prospective longitudinal design was used to test the interaction between cognitive style (both negative and enhancing) and life events (both negative and positive) in a sample of undergraduates (n = 128).

Results

Cognitively vulnerable individuals were buffered from the depressive effects of stress if they also possessed an enhancing cognitive style or experienced high numbers of positive life events. Individuals with low levels of negative cognitive style and life stress, but high levels of enhancing cognitive style or positive life events were the most resilient to depressive symptoms.

Limitations

Future research is needed to determine if the results of this study generalize to a more diverse sample as well as to clinically significant forms of depression.

Conclusions

The results provide some of the first evidence for the protective role of enhancing cognitive style and positive live events among vulnerable individuals. These findings underscore the importance of examining a broader environmental context when investigating risk and resiliency to depression.

Research highlights

► Cognitive vulnerability is a potent risk factor for depression. ► It is important to identify naturally occurring factors that can increase resiliency. ► Vulnerable individuals were buffered from depressive symptoms if they possessed an enhancing cognitive style. ► Vulnerable individuals were buffered from depressive symptoms if they experienced high numbers of positive life events.

Introduction

According to the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989), some individuals have a negative cognitive style (i.e., a cognitive vulnerability) that interacts with stressful life events to produce depression. Hopelessness theory defines a negative cognitive style as the tendency of an individual to make particular kinds of inferences about the cause, consequences, and self-worth implications of stressful life events. Specifically, when faced with a stressful life event, an individual who has a negative cognitive style is likely to: (a) attribute the event to stable and global causes; (b) view the event as likely to lead to other negative consequences; and (c) construe the event as implying that he or she is unworthy or deficient. Individuals who generate these three types of negative inferences are hypothesized to be at high risk for depression.

Recent research has provided strong support for hopelessness theory’s cognitive vulnerability hypothesis (see Abramson et al., 2002 for review). Prospective studies (Gibb et al., 2006, Haeffel et al., 2007, Hankin et al., 2004, Metalsky and Joiner, 1992) have consistently found that a negative cognitive style interacts with stressful events to predict the development of depressive symptoms (even after statistically controlling for participants’ baseline level of depressive symptoms). Moreover, research has demonstrated that a negative cognitive style is associated with the onset of clinically significant depression as measured by structured diagnostic interview. For example, results from the Temple-Wisconsin Cognitive Vulnerability to Depression (CVD) Project (Abramson et al., 1999, Alloy et al., 2006) found that participants with a negative cognitive style were approximately 7 times more likely than participants without a negative cognitive style to experience an episode of major depressive disorder during the 2.5-year prospective follow-up.

Taken together, research indicates that a negative cognitive style is a potent risk factor for depression. Thus, it is important to begin to understand the factors that can buffer or protect a cognitively vulnerable individual from becoming depressed. Clearly, one strategy for protecting cognitively vulnerable individuals is to try to change their cognitive style with an intervention such as cognitive-behavioral therapy. However, it is also important to identify naturally occurring factors that might increase resiliency (e.g., Shahar & Priel, 2002). Understanding how a negative cognitive style operates in the “real world” has the potential to reveal new resiliency factors that can be used to create novel interventions. To date, studies testing the hopelessness theory have focused almost exclusively on the role of stressful life events (and their interpretation) on risk for depression. This makes sense in light of hopelessness theory’s cognitive vulnerability hypothesis. However, it is important to recognize that an individual’s natural environment does not consist solely of stressful life events. Indeed, an individual who is experiencing stressful events may also be experiencing positive events at the same time. The omission of positive life events in previous research is a problem because their occurrence, and subsequent interpretation, may have important implications for individuals who have a negative cognitive style.

Despite the lack of empirical studies, there is a strong theoretical rationale for including positive life events (and their interpretation) in the cognitive vulnerability framework. In 1990, Needles and Abramson proposed a recovery model of depression based on the hopelessness theory. They hypothesized that the occurrence of positive life events would interact with an “enhancing cognitive style” to create hopefulness, and in turn, decrease depression. In their recovery model, enhancing cognitive style is defined as the tendency to: (a) attribute positive events to stable and global causes; (b) view the events as likely to lead to other positive consequences; and (c) construe the events as implying that he or she is special in someway. Individuals who generate these three types of enhancing inferences are hypothesized to experience a restoration of hope, and in turn, fewer depressive symptoms.

Preliminary studies have generally supported the Needles and Abramson (1990) recovery model. Research has shown that individuals with an enhancing cognitive style (alone or in combination with positive life events) were more likely to experience decreases in depressive symptoms than individuals without an enhancing cognitive style (Edelman et al., 1994, Johnson et al., 1996, Johnson et al., 1998, Needles and Abramson, 1990, Voelz et al., 2003). Moreover, the results appear to hold in both adult and adolescent samples (e.g., Voelz et al., 2003).

In summary, there are two lines of research examining the role of cognition in depression. One line of work focuses on risk for depression, and shows that a negative cognitive style interacts with stressful life events to predict depression (Abramson et al., 1989). The second line of work focuses on recovery from depression, and shows that an enhancing cognitive style interacts with positive life events to predict reductions in depression (Needles & Abramson, 1990). Surprisingly, these two lines of research have developed in relative isolation. Research testing the effect of negative cognitive style on depression has typically ignored the role of enhancing cognitive style (and positive life events). Similarly, research testing the effect of enhancing cognitive style has typically ignored the role of negative cognitive style (and stressful life events). Furthermore, in the few studies that actually measured all of these factors, the analyses were conducted in a manner that still separated the effects of negative and positive events (e.g., Fresco, Alloy, & Reilly-Harrington, 2006). Thus, researchers have created an artificial separation between the different cognitive styles (and life events) that does not appear to hold in nature. Both theory and data support the idea that negative and enhancing cognitive styles can coexist within an individual. Similarly, an individual can experience both negative and positive life events. All of these factors can occur simultaneously to influence depressive outcomes. For example, Needles and Abramson (1990) stated, “…even among those at risk for hopelessness depression, there may be a subset who have the hypothesized enhancing style for positive events and who thereby may be better able to recover.” Indeed, studies reveal that negative and enhancing cognitive styles are either statistically unrelated (e.g., Voelz et al., 2003) or weakly positively correlated (correlations ranging from 0.01 to 0.40 in prior studies) and exhibit different patterns of associations with depressive symptoms (e.g., Sweeney et al., 1986, Voelz et al., 2003, Zautra et al., 1985).

To understand risk for depression, it is necessary for researchers to investigate a wider range of cognitive and environmental factors. Specifically, prior research indicates that there are at least four factors to consider: negative cognitive style, enhancing cognitive style, stressful life events, and positive life events. To date, no study has simultaneously tested the interaction of all four factors. However, a study by Voelz et al. (2003) provides some insight about how these factors might behave. Using a longitudinal design with a sample of child psychiatric inpatients, they examined the interaction of negative and enhancing cognitive styles. They found that children with a negative cognitive style and no enhancing cognitive style exhibited the greatest levels of depressive symptoms. However, children with both a negative cognitive style and an enhancing cognitive style exhibited decreased levels of depressive symptoms. Interestingly, the children with the lowest level of depressive symptoms were those who had neither a negative nor enhancing cognitive style.

Unfortunately, the conclusions that can be drawn from the Voelz et al. (2003) study are limited because they did not include measures of positive and stressful life events. Rather, the researchers assumed that the participants’ admission to a hospital would act as a positive life event. Thus, it was not possible for Voelz and colleagues to test the vulnerability by stress interaction hypothesis. Moreover, the study did not address risk for depression, but rather focused on recovery in an already symptomatic clinical sample. It is important to examine cognitive style and life events in a non-clinical sample using a prospective design in order to gain a more comprehensive understanding of what factors precede and predict depressive symptoms.

The goal of the current study was to provide a more rigorous and comprehensive test of the cognitive model of depression. To this end, the study used a 4-week longitudinal prospective design to investigate risk and resilience to depression in a non-clinical adult sample. The study is the first to simultaneously examine the interaction of negative cognitive style, enhancing cognitive style, and natural occurring negative and positive life events. By including all four of these factors, this study should provide important insights into the etiology of depression. It should also reveal protective factors that can be used to inform treatment and prevention interventions.

Based on the results of the Voelz et al. (2003) study, we tested three hypotheses: (a) individuals with a negative cognitive style and high levels of stressful life events would exhibit the greatest increases in depressive symptoms over the prospective interval; (b) individuals with a negative cognitive style and high levels of stress would be buffered from depressive symptoms if they also possessed an enhancing cognitive style and experienced high levels of positive events; and, (c) individuals with neither a negative cognitive style nor an enhancing cognitive style would exhibit the lowest levels of depressive symptoms when faced with either negative or positive life events.

Section snippets

Participants

Participants were 131 unselected undergraduates from the volunteer psychology participant pool at the University of Notre Dame. Specific data regarding ethnicity was not collected; however, the sample was likely largely Caucasian given the ethnic diversity of the university more generally (76% Caucasian, 11% Hispanic, 8% Asian, 5% African American). Participants were recruited through an on-line sign-up procedure and were given extra credit points for their participation. A total of 128 (88

Results

We used hierarchical multiple regression (Cohen, Cohen, West, & Aiken, 2003) to test the hypotheses. The Time 1 depression score (T1 BDI) was entered in the first step of the regression equation to create a residual change score for the same measure at Time 2 (T2 BDI). In the second step, the main effects of negative cognitive style (T1 CSQ), enhancing cognitive style (T1 CSQ), stressful life events (T1 ALEQ) and positive life events (T1 ALEQ) were entered. Next, all two-way interaction terms

Discussion

This study was the first to simultaneously test the interaction of negative cognitive style, enhancing cognitive style, and naturally occurring negative and positive life events. There were a number of important findings. First, the results corroborated prior work showing that a negative cognitive style is a potent risk factor for depression. Individuals with a negative cognitive style reported the highest level of depressive symptoms, particularly when faced with high levels of stress. The

Acknowledgements

This research was supported, in part, by a University of Notre Dame Undergraduate Research Opportunity Program (UROP) grant to Ivan Vargas.

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