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09-03-2017 | Original Article

The Hopelessness Theory of Depression: Clinical Utility and Generalizability

Auteurs: Gerald J. Haeffel, Rachel Hershenberg, Jason T. Goodson, Sascha Hein, Amanda Square, Elena L. Grigorenko, John Chapman

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 4/2017

Abstract

To date, “basic” research has dominated the empirical literature on hopelessness theory. The next logical step in this area of research is to determine if the theory can be used to help people. We conducted three studies to determine if the cognitive vulnerability factor featured in hopelessness theory could be reliably measured in diverse samples in a treatment context and if it could predict depressive therapeutic outcomes. Study 1 used a sample of male juvenile detainees (n = 296; 70% from underrepresented groups) and found that cognitive vulnerability moderated the effectiveness of a social problem solving training intervention. Study 2 used a clinical sample of U.S. Veterans (n = 16; 56% from underrepresented groups) enrolled in a cognitive behavioral therapy group for depression and found that cognitive vulnerability predicted post-therapy depressive outcomes. In both Study 1 and Study 2, higher levels of cognitive vulnerability resulted in poorer treatment outcomes (i.e., greater post-treatment levels of depressive symptoms). Study 3 used a clinical sample of U.S. Veterans (n = 76; 67% from underrepresented groups) enrolled in a behavior activation group and found no effect of cognitive vulnerability on post-therapy depressive outcomes. The results of the three studies indicate that hopelessness theory’s cognitive vulnerability construct can be reliably measured in diverse samples in real world clinical contexts and that it has the potential to be a useful predictor of clinical outcomes in the context of cognitively focused treatments.

vorige artikel Emotional Intensity and Emotion Regulation in Response to Autobiographical Memories During Dysphoria

volgende artikel Decision Justification Theory in Depression: Regret and Self-Blame

It is necessary to distinguish between the hopelessness theory of depression (Abramson et al. 1989) and its theoretical predecessor, the reformulated learned helplessness theory of depression (Abramson, Seligman, & Teasdale, 1978). Similarly to the hopelessness theory, the reformulated learned helplessness theory underscored the importance of causal attributions as vulnerability for depression. However, it defined cognitive vulnerability as the tendency to attribute negative life events to stable, global, and internal causes. The vulnerability factor featured in the hopelessness theory does not view attributions of internality as being central in the development of depression itself, but as an element that may decrease self-esteem among already-depressed individuals. In addition, the reformulated learned helplessness theory did not include the other two vulnerability components currently featured in the hopelessness theory—negative consequences and negative self-worth implications. Prior studies have examined the vulnerability factor featured in the reformulated learned helplessness theory in an intervention context. Prior randomized controlled trials have measured the vulnerability factor featured in the reformulated learned helplessness theory as a possible mediator of intervention efficacy. However, this theory is now over 40 years old and the measure that was used in these studies (the Attribution Style Questionnaire) is now outdated. Indeed, according to Liu et al., (2015) “…the still-prevalent focus on attributional styles (particularly as measured with the Attributional Style Questionnaire; Peterson et al., 1982) according to the reformulated learned helplessness theory (Abramson et al., 1978), rather than inferential styles according to the hopelessness theory, may be among the most significant obstacles to the advancement of the field” (p. 15). To our knowledge, cognitive vulnerability, as conceptualized by the hopelessness theory has not yet been focused on in a real world treatment context.

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Titel: The Hopelessness Theory of Depression: Clinical Utility and Generalizability
Auteurs: Gerald J. Haeffel
Rachel Hershenberg
Jason T. Goodson
Sascha Hein
Amanda Square
Elena L. Grigorenko
John Chapman
Publicatiedatum: 09-03-2017
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 4/2017
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-017-9833-1

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