Symptoms of Depression and Anxiety in Children: Specificity of the Hopelessness Theory

The common etiology hypothesis proposes that depression and anxiety commonly co-occur because they share etiological factors. This study examined the specificity of the hopelessness theory in the development of depressive and anxious symptoms in children. Students in Grades 3 through 6 (N = 418, 47% boys) completed measures assessing inferential styles about causes, consequences, and the self, depressive symptoms, and anxious symptoms. Six weeks later, children completed measures of depressive symptoms, anxious symptoms, and hassles. All 3 inferential styles interacted with hassles to predict increases in depressive symptoms, although this relation only held for children with low levels of initial symptoms. Inferential styles about consequences and the self also predicted increases in anxious symptoms. Consistent with the common etiology hypothesis, after controlling for the association between depressive and anxious symptoms, the effects of inferential styles about consequences and the self persisted.     

The timing of parent and child depression: a hopelessness theory perspective.

This study examined whether children's inferential styles moderate the association between the onset of depressive symptoms in children and their parents. To provide a powerful test of our hypotheses, we utilized a high-risk sample (parents with a history of major depressive episodes and their children) and a multiwave longitudinal design. During the initial assessment, 140 children (ages 6 to 14) completed measures assessing depressogenic inferential styles. Parents and children also completed measures assessing current level of depressive symptoms. Following the initial assessment, children and parents were contacted every 6 weeks for the next year to complete measures assessing depressive symptoms. The results of hierarchical linear modeling analyses indicated that children who exhibited depressogenic inferential styles reported greater elevations in depressive symptoms following elevations in their parent's level of depressive symptoms than did children who did not exhibit such styles. The strength of this association was greater in girls.     

A longitudinal study of the hopelessness theory of depression: testing the diathesis-stress model within a differential reactivity and exposure framework

A ten-week prospective longitudinal study was conducted to test the diathesis-stress component of the hopelessness theory and to test whether negative attributional style leads to an increased exposure to stressors. Participants completed initial measures of attributional style and depressive symptoms followed by weekly assessments of depressive symptoms and daily hassles. Consistent with the diathesis-stress hypothesis, Hierarchical Linear Modeling revealed that attributional style moderated the impact of daily hassles on depressive symptoms. Negative attributional style predicted greater depressive symptom reactivity in response to stress. The results also indicated that attributional style was not predictive of the number of subsequent daily hassles. Thus, the data were supportive of a differential reactivity to stress model, but not supportive of a differential exposure to stress model. Implications for understanding the mechanisms involved in the hopelessness theory are discussed.     

An examination of congruency hypothesis in hopelessness theory of depression

A longitudinal study was conducted to test two hypotheses, congruency and hopelessness-mediation, in hopelessness theory of depression. Three cognitive diatheses (attributional style, and inferential styles for consequences as well as the self), symptoms of depression, and hopelessness were measured in a survey of 279 men and women. About three months later, symptoms and hopelessness were measured again, along with negative life events in the interim. Some support was obtained for congruency hypothesis. Women with depressogenic attributional style in interpersonal domain became depressed when they experienced negative events in the domain, while men with depressogenic attributional style in achievement domain similarly became depressed. However, no comparable effect was found for the other diatheses: inferential styles. Hopelessness-mediation hypothesis was partly supported in interpersonal domain.     

Anxiety- and depression-related thoughts in children: development and evaluation of a cognition measure.

This study examined anxiety- and depression-related cognitive content in children. We developed the Children's Thought Questionnaire (CTQ) to include anxious thoughts characterized by threat and uncertainty; depressive thoughts by loss, self-deprecation, and certainty/hopelessness; and positive thoughts by interest, pleasure, and positive self-reference. The CTQ and measures of anxious and depressive symptoms were completed by 193 5th- and 6th-grade children. Exploratory factor analysis of the CTQ revealed that items loaded on 2 factors according to negative and positive valence. However, use of conceptually derived subscales demonstrated specificity, with higher levels of anxious thoughts uniquely predicting greater anxious symptoms and higher depressive thoughts uniquely predicting greater depressive symptoms. Furthermore, positive thoughts were negatively related to depressive symptoms but either unrelated or positively related to anxious symptoms, thus providing support for cognitive specificity.     

Anxiety- and Depression-Related Thoughts in Children: Development and Evaluation of a Cognition Measure

This study examined anxiety- and depression-related cognitive content in children. We developed the Children's Thought Questionnaire (CTQ) to include anxious thoughts characterized by threat and uncertainty; depressive thoughts by loss, self-deprecation, and certainty/hopelessness; and positive thoughts by interest, pleasure, and positive self-reference. The CTQ and measures of anxious and depressive symptoms were completed by 193 5th- and 6th-grade children. Exploratory factor analysis of the CTQ revealed that items loaded on 2 factors according to negative and positive valence. However, use of conceptually derived subscales demonstrated specificity, with higher levels of anxious thoughts uniquely predicting greater anxious symptoms and higher depressive thoughts uniquely predicting greater depressive symptoms. Furthermore, positive thoughts were negatively related to depressive symptoms but either unrelated or positively related to anxious symptoms, thus providing support for cognitive specificity.     

Daily hassles and social support as predictors of adjustment in children with pediatric rheumatic disease

OBJECTIVE: To test hypotheses that social support moderates the effects of microstressors on the psychosocial adjustment of children with pediatric rheumatic diseases (PRDs) and that among multiple sources of support, classmate and parent support are significant predictors of adjustment, after controlling for demographic and disease severity variables. METHODS: Children with PRDs (N = 160 children; 8-17 years) were recruited from three pediatric rheumatology centers and completed measures of daily hassles, social support, depressive symptoms, and state and trait anxiety; their parents completed measures of internalizing and externalizing behaviors. RESULTS: Fewer daily hassles and higher social support predicted fewer adjustment problems. Among the sources of support, classmate and parent support were significant predictors. Tests for moderation were significant only for a Hassles x Classmate Support interaction in the prediction of depression. A plot of the interaction between hassles and classmate support showed that children with high classmate support had lower levels of depression than children with low classmate support under high or low levels of daily hassles. Furthermore, children with high classmate support had lower levels of depression under conditions of low versus high daily hassles. DISCUSSION: Results are consistent with a main effect rather than buffering model for social support. CONCLUSIONS: Interventions should focus on management of daily hassles and increasing social support for children with PRDs.     

Preliminary Examination of Sex Differences in Depressive Symptoms Among Adolescent Psychiatric Inpatients: The Role of Anxious Symptoms and Generalized Negative Affect

Assessed the emerging view that generalized negative affect and anxious symptoms are important in understanding sex differences in depressive symptoms. Sixty-three adolescent psychiatric inpatients (32 boys, 31 girls), ages 12 to 16 (M = 13.87, SD = 1.36), completed measures of positive and negative affect and anxious and depressive symptoms. Results demonstrated, as predicted, that depressive and anxious symptoms were more highly associated in adolescent girls than boys. Furthermore, girls with depressive symptoms were more likely to have comorbid anxious symptoms than boys with depressive symptoms. Sex differences were not found for adolescents with specific depressive symptoms and specific anxious symptoms (i.e., the absence of comorbidity). Our findings supported the possibility that sex differences in pure forms of depression are overestimated and that comorbid internalizing conditions may be more prevalent in adolescent girls than boys.     

A prospective test of the hopelessness theory of depression in children.

Providing a developmental extension of the cognitive theories of depression, researchers and theorists have suggested that during early to middle childhood, attributional styles may mediate rather than moderate the association between negative life events and the development of depression. Within the context of the hopelessness theory of depression, we tested this hypothesis in a 6-month longitudinal study of 4th- and 5th-grade children. Using path analysis, we found support for the mediating role of attributional styles among both 4th and 5th graders. Supporting recent refinements in the hopelessness theory, the best fitting mediation model was one in which depressive symptoms exhibited reciprocal relations with the other variables. Specifically, attributional styles partially mediated the link between verbal victimization and residual change in depressive symptoms. In addition, initial depressive symptoms predicted negative changes in children's attributional styles and increases in verbal victimization across the follow-up. Contrary to our hypothesis, we also found support for the moderating role of attributional styles, although this was significant only among 5th graders.     

述情障碍特征对青少年应激与抑郁症状的调节作用

目的:了解青少年述情障碍特征与应激水平对抑郁症状的预测作用。方法:采用多伦多20条目述情障碍量表、流调中心用抑郁量表和青少年生活事件量表对618名在校高中生进行了首次测查,随后每隔3个月对被试的抑郁症状和生活事件进行追踪测查,追踪时间为期一年。结果:与低述情障碍青少年相比,随着日常应激水平的升高,高述情障碍青少年的抑郁躯体症状上升速度更快,而其抑郁心理症状则在日常应激水平升高时,较之低述情障碍青少年没有显著差异。结论:述情障碍在青少年日常应激和抑郁躯体症状的关系中起调节作用。     

A Prospective Test of the Hopelessness Theory of Depression in Children

Providing a developmental extension of the cognitive theories of depression, researchers and theorists (e.g., Cole & Turner, 1993; Rose & Abramson, 1992) have suggested that during early to middle childhood, attributional styles may mediate rather than moderate the association between negative life events and the development of depression. Within the context of the hopelessness theory of depression (e.g., Abramson, Metalsky, & Alloy, 1989), we tested this hypothesis in a 6-month longitudinal study of 4th- and 5th-grade children. Using path analysis, we found support for the mediating role of attributional styles among both 4th and 5th graders. Supporting recent refinements in the hopelessness theory, the best fitting mediation model was one in which depressive symptoms exhibited reciprocal relations with the other variables. Specifically, attributional styles partially mediated the link between verbal victimization and residual change in depressive symptoms. In addition, initial depressive symptoms predicted negative changes in children's attributional styles and increases in verbal victimization across the follow-up. Contrary to our hypothesis, we also found support for the moderating role of attributional styles, although this was significant only among 5th graders.     

Positive and Negative Affectivity in Children: A Multitrait-Multimethod Investigation

Examined the validity of the tripartite model of anxiety and depression and its internal structure in children. Measures of positive affect/surgency (PA/S) and negative affect/neuroticism (NA/N) and self-report and peer nominations of symptoms of depression and anxiety were completed by 104 children (mean age = 14.9 years, SD = 1.9). Parents completed measures of temperament and anxious and depressive symptoms. Multitrait-multimethod and confirmatory factor analyses (CFA) supported a 3-factor model that included separate Child and Parent NA/N factors and a joint PA/S factor. Child and Parent NA/N were related to symptoms of both depression and anxiety, but neither parent nor peer symptom ratings related to Child NA/N. PA/S was primarily related to symptoms of depression. These results support aspects of the tripartite model in children and suggest caution in the use of multimethod assessment of children's temperament and internalizing symptoms.     

Social and cognitive impairment in first-grade children with anxious and depressive symptoms

Examined the degree of social and cognitive impairment in an epidemiologically defined sample of first-grade children with anxious symptoms alone, depressive symptoms alone, and comorbid anxious and depressive symptoms. For boys, both anxious and depressive symptoms alone were associated with statistically significant impairment in multiple domains of social and cognitive functioning. In girls, little evidence of associated impairment was found for either anxious or depressive symptoms alone. For boys, depressive symptoms alone was associated marginally with impairment in a greater number of domains of adaptive functioning than anxious symptoms alone. No such differences were found for girls. Finally, there was limited evidence that comorbid anxious and depressive symptoms were associated with greater social and cognitive impairment.     

The relationship of sociotropy and autonomy to posttraumatic cognitions and PTSD symptomatology in trauma survivors

The current study examined relationships between sociotropic and autonomous personality styles and posttraumatic stress disorder (PTSD) symptomatology following trauma as well as specific posttraumatic cognitions that have been shown to characterize individuals with PTSD. Self-report data were collected in a sample of 156 college students indicating a history of traumatic experience. Significant relationships were found between symptoms of PTSD and depression and measures of sociotropy, autonomy, and negative posttraumatic beliefs about self and world. Additionally, measures of autonomy and negative posttraumatic thoughts improved prediction of PTSD symptom level after controlling for depressive symptoms.     

Prospective evaluation of a cognitive vulnerability‐stress model for depression: the interaction of schema self‐structures and negative life events

This study tested the diathesis‐stress component of Beck's (1967) cognitive theory of depression. Initially, participants completed measures assessing cognitive organization of the self‐schema and depressive symptoms. One year later, participants completed measures assessing cognitive organization of the self‐schema, depressive symptoms, and negative life events. Hierarchical multiple regression analyses, controlling for initial depression, indicated that more tightly interconnected negative content was associated with greater elevations in depressive symptoms following the occurrence of life events. More diffusely interconnected positive content for interpersonal self‐referent information also interacted with life events to predict depressive symptoms. Cognitive organization dimensions showed moderate to high stability across the follow‐up, suggesting that they may be trait‐like vulnerability factors. Implications for the cognitive vulnerability‐stress model of depression are discussed. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66:1–17, 2010.     

2型糖尿病患者焦虑抑郁情绪与社会心理因素的关系

目的：探讨2型糖尿病患者焦虑、抑郁情绪与心理压力、应对方式和社会支持的关系。方法：采用自填式问卷，对172名2型糖尿病患者进行调查，了解患者的一般情况、心理压力来源、病人应对措施、社会支持等社会心理因素，同时用医院焦虑抑郁量表（HAD）测量其焦虑与抑郁情况。结果：焦虑得分≥9分者35人，占20．3％；抑郁得分≥9分者33人，占19．2％。控制性别、年龄、婚姻状况、学历、经济收入等潜在的混杂因素后的多因素logistic回归分析表明，感受“担心疾病可能造成的伤害”（OR=1．76，95％CI=1．12-2．77）、“疾病造成的社会／家庭危机感”（OR=1．85，95％CI=1．18-2．92）、“担心身体／生理功能下降”（OR=2．16，95％CI=1．28～3．67）和“担心经济条件降低”（OR=2．03，95％CI=1．27～3．26）的压力越大，对疾病越多采取“消极应对”的措施（OR=1．94，95％CI=1．26-2．97），越容易出现焦虑情绪：感受“疾病造成的社会／家庭危机感”（OR=1．79，95％CI=1．09～2．96）、“担心身体／生理功能下降”（OR=2．89，95％CI=1．59-5．24）的压力越大，对疾病越多采取“消极应对”的措施（OR=1．95，95％CI=1．23～3．11），越容易出现抑郁情绪，较多采取“逃避”的应对措施者较少出现抑郁情绪（OR=0．52，95％CI=0．30-0．90）。结论：2型糖尿病人的焦虑、抑郁情绪与疾病引起的心理紧张和病人采取的应对方式有关。     

Concurrent levels of maternal salivary cortisol are unrelated to self-reported psychological measures in low-risk pregnant women

Associations between salivary cortisol and maternal psychological distress and well-being were examined prospectively on 112 women with normally progressing, singleton pregnancies between 24 and 38 weeks gestation. At each of 5 visits, conducted in 3-week intervals, women provided a saliva sample and completed questionnaires measuring trait anxiety, depressive symptoms, pregnancy-specific hassles and uplifts, and psychological well-being. Maternal salivary cortisol was unrelated to psychological measures with the exception of minor associations detected with measures of anxiety and depressive symptoms between 30 and 32 weeks only. Findings indicate that self-reported maternal psychological distress and well-being are not associated with significant variation in maternal salivary cortisol levels during the second half of gestation. This suggests that studies that measure psychological factors in pregnancy but do not measure maternal cortisol should exercise caution in assuming activation of the maternal hypothalamic–pituitary–adrenal axis is the mechanism through which maternal psychological factors are transduced to the fetus.     

Perceived family characteristic differences between depressed and anxious children and adolescents.

BACKGROUND: The present study compared anxious vs. depressed children's and adolescents' perceptions about their family environment. METHODS: One hundred inpatient youngsters were interviewed for the study. Of these participants, 21 who met criteria for a depressive disorder without an anxiety disorder and 18 who met criteria for an anxiety disorder without a depressive disorder were compared on several self-report family measures. These measures included the Family Adaptability and Cohesion Evaluation Scales-II (FACES-II), Family Strengths, and Social Support Questionnaire-Revised (SSQS-R). RESULTS: Youngsters with depressive disorders reported having less pride in their families and perceived their families as being less adaptable to problems than did anxious children. Also, depressed children expressed lower levels of satisfaction with their social network than did anxious children. LIMITATIONS: The fact that our study only included reports from inpatient youngsters, families of anxious and depressed children may differ in the way family members relate to one another and in the way they deal with everyday problems. CONCLUSIONS: Based on the evidence obtained in this study, anxiety and depression may be two distinct internalizing disorders with specific family characteristics.     

The relationship between anger and depression in a clinical sample of young men: the role of insecure attachment

BACKGROUND: Even though the relevance of insecure attachment in the etiology of dysfunctional anger is indicated by a number of findings, few studies have examined the relationship between anger and depression from the perspective of attachment theory. METHODS: Self-reported measures of trait anger, depression, and adult attachment style were simultaneously administered to 87 young men with clinically significant depressive symptoms. RESULTS: Higher levels of trait anger were associated with an insecure style of attachment. Such an association remained significant after controlling for the severity of depressive symptoms. In a multiple regression model, both a measure of anxious attachment and a measure of avoidant attachment emerged as independent predictors of trait anger.LIMITATIONS: The study was cross-sectional and the sample did not include women. CONCLUSIONS: Insecure attachment is a useful predictor of anger experience among patients with depressive symptoms.     

The prevention of depressive symptoms in rural school children: a randomized controlled trial

A controlled trial was conducted to evaluate a prevention program aimed at reducing depressive and anxious symptoms in rural school children. Seventh-grade children with elevated depression were selected. Nine primary schools (n = 90) were randomly assigned to receive the program, and 9 control schools (n = 99) received their usual health education classes. Children completed questionnaires on depression, anxiety, explanatory style, and social skills. Parents completed the Child Behavior Checklist (T. M. Achenbach, 1991). No intervention effects were found for depression. Intervention group children reported less anxiety than the control group after the program and at 6-month follow-up and more optimistic explanations at postintervention. Intervention group parents reported fewer child internalizing and externalizing symptoms at postintervention only.