Discrimination, cognitive styles, and their associations with adolescents' mental and physical health.

This study is based on the hopelessness theory of depression and previous research on perceived everyday discrimination (PED) and both depressive symptoms and Interleukin-6 (an inflammatory cytokine; IL-6) in adolescents. The purpose of this study is to examine the negative attribution, self, and consequence cognitive styles (CSs) proposed in the hopelessness theory as a possible mechanism underlying the association between PED and inflammation in adolescents and expand our understanding of the comorbidities between depressive symptoms and systemic inflammation (IL-6). This cross-sectional study featured a sample of 102 adolescents aged 13-16 (M = 14.10, SD = 0.52) who identified as White (47.5%), Black (41.4%), Mixed Race (7.1%), Latino (2%), and other (2%). Data analysis was conducted using PROCESS to compute regressions and effects between PED, negative CSs, depressive symptoms, and Interleukin-6. Results showed that negative attribution CS is the only negative CS associated with PED, depressive symptoms, and IL-6. Negative attribution CS is also the only negative CS of the three negative CSs that mediates both the association between PED and depressive symptoms and PED and IL-6 in our adolescent sample. Overall, these results indicate that individual negative CSs proposed in the hopelessness theory impact adolescents' physical and mental outcomes differently, which can inform targeted treatments. Nurses should provide cognitive-based interventions and promote societal-level change to reduce the experience and impact of PED on the mental and physical health of their adolescent patients.

Cognitive Triad and Depressive Symptoms in Adolescence: Specificity and Overlap.

Adolescence is a critical period for the development of depressive symptoms and the understanding of vulnerability factors that facilitate their onset is pivotal. In this study, we focused on Beck's cognitive triad, namely its three-fold structure, comprising views of the self, world, and future. Despite its crucial role in the cognitive theory of depression, the relationship between the cognitive triad and depressive symptoms in adolescence is still unclear. In our study, we adopted a meta-analytic commonality analysis approach, in order to clarify whether the three components of the triad overlap in accounting for depressive symptoms, or they show distinct profiles of association. By relying on six independent samples of early adolescents (age range = 13-14: n = 174, 66% female, n = 347, 41% female), mid adolescents (age range = 15-17: n = 304, 61% female; n = 92, 34% female), and late adolescents (age range = 18-21: n = 217, 84% female, n = 101, 56% female), we showed that the views of the self, world, and future substantially overlap in accounting for depressive symptoms, although specific areas of distinctiveness could be detected. Moreover, the association between the cognitive triad and depressive symptoms appeared to be a function of both the developmental phase and gender. Furthermore, the cognitive triad emerged as specifically related to symptoms related to negative mood, absence of positive mood, and negative appraisal of the past. These findings advance our understanding of cognitive vulnerability for depressive symptoms in adolescence.

Relation Between the Negative Cognitive Triad, Perceived Everyday Discrimination, Depressive Symptoms, and TNF-⍺ in Adolescents.

Our study is guided by Beck's cognitive stress-vulnerability model of depression. We examined the associations between perceived everyday discrimination (PED) and TNF-⍺, an inflammatory biomarker associated with risk for severe illness, through the negative cognitive triad (NCT; negative thoughts about the self, world, and future) and depressive symptoms in adolescents. We utilized a sample of 99 adolescents (36.4% female; ages 13-16, M = 14.10, SD = 0.52) in our cross-sectional study. We used PROCESS and AMOS to compute regressions and direct, indirect, and total effects of PED, NCT aspects and depressive symptoms on TNF-⍺. Negative views of the self and world mediated between PED and depressive symptoms and that negative views of the self and future mediated between PED and TNF-⍺. In conclusion, Beck's theory can be expanded to physical health providing directions for addressing mental and physical health simultaneously by restructuring adolescents' negative view of the self.

Perceived discrimination and depressive symptoms: What role does the cognitive triad play?

OBJECTIVE: The present study was designed to integrate perceived everyday discrimination (PED) as stressor in Beck's cognitive theory of depression. We focused on the relationships between PED, the individual components of the cognitive triad, and depressive symptoms and the role of gender and race in these relationships. METHOD: Participants included 243 technical and community college students (women: 59%; men: 41%; Black: 30%; White: 51%). They completed measures examined PED, the cognitive triad, and depressive symptoms. RESULTS: Conducting mediation analyses using PROCESS 4.1.1, we found significant indirect effects from PED on depressive symptoms through negative views of the self and world. The indirect effect through negative views of the future was not significant. The indirect effects of negative views of the world and future were significantly stronger in women participants than men participants and the indirect effect of negative views of the world was significantly stronger in White students than Black students. CONCLUSIONS: Our findings generally support the integration of PED as stressor into Beck's cognitive theory independent of gender and race. This highlights the responsibility of therapists to assist clients in coping with PED and to advocate for equality within organizations, communities, and society in general.

Temporal Directionality Between Teaching Behavior and Affect in High School Students.

The associations between teaching behaviors and students' affect are examined in cross-sectional studies in younger samples, but the temporal direction of these associations in high school students is unknown. In this longitudinal study, adolescents (N = 188; 88.8% White; 69.7% female) completed instruments to measure teaching behaviors and adolescents' negative (e.g., cheerful) and positive affect (e.g., ashamed) twice, four months apart. Adolescents' negative affect predicted future negative teaching behavior and negative teaching behavior marginally predicted adolescents' future negative affect. Positive affect predicted future socio-emotional teaching behavior and vice versa. The findings provide insight into which teaching behaviors impact students' affect and the impact that students' mental health has on teaching behavior, an area of study that has received limited attention.

Association of cancer caregiver stress and negative attribution style with depressive symptoms and cortisol: a cross-sectional study.

PURPOSE: We examined the effect of informal cancer caregiver stress and negative attribution style (NAS) on depressive symptoms and salivary cortisol. METHOD: The sample came from a hospital bone marrow unit and caregiver support organizations and included 60 informal cancer caregivers (51.7% partners) of individuals with cancer (provided care for a median of 27.5 h per week for 12 months) and 46 non-caregiver participants. In this cross-sectional study, participants completed questionnaires assessing NAS and depressive symptoms and provided saliva samples to measure cortisol. RESULTS: Linear regressions demonstrated that cancer caregiver stress (p = 0.001) and the cancer caregiver stress by NAS interaction (p = 0.017), but not NAS alone (p = 0.152), predicted depressive symptoms. Caregivers independent of their NAS and non-caregivers high in NAS reported high depression while non-caregivers low in NAS reported low depression. Neither cancer caregiver stress (p = 0.920) nor NAS alone (p = 0.114), but their interaction, predicted cortisol (p = 0.036). Higher NAS was associated with a higher cortisol in both groups while non-caregivers had higher cortisol than caregivers. CONCLUSIONS: If the findings can be replicated, consideration of NAS in existing interventions to support informal cancer caregivers in managing chronic stress appears warranted.

A Primer on Meta-Analytic Structural Equation Modeling: the Case of Depression.

In this paper, we show how the methods of systematic reviewing and meta-analysis can be used in conjunction with structural equation modeling to summarize the results of studies in a way that will facilitate the theory development and testing needed to advance prevention science. We begin with a high-level overview of the considerations that researchers need to address when using meta-analytic structural equation modeling (MASEM) and then discuss a research project that brings together theoretically important cognitive constructs related to depression to (a) show how these constructs are related, (b) test the direct and indirect effects of dysfunctional attitudes on depression, and (c) test the effects of study-level moderating variables. Our results suggest that the indirect effect of dysfunctional attitudes (via negative automatic thinking) on depression is two and a half times larger than the direct effect of dysfunctional attitudes on depression. Of the three study-level moderators tested, only sample recruitment method (clinical vs general vs mixed) yielded different patterns of results. The primary difference observed was that the dysfunctional attitudes → automatic thoughts path was less strong for clinical samples than it was for general and mixed samples. These results illustrate how MASEM can be used to compare theoretically derived models and predictions resulting in a richer understanding of both the empirical results and the theories underlying them.

Depressive Symptoms Among Adolescents: Testing Vulnerability-Stress and Protective Models in the Context of COVID-19.

Adolescents who experience negative life events may be at risk for depression, particularly those with psychosocial vulnerabilities. We investigate longitudinally the impact of vulnerability/protective factors on the relation between a large-scale negative life event, the COVID-19 pandemic, and depressive symptoms. Adolescents (N = 228, Mage = 14.5 years, 53% female, 73% white) self-reported depressive symptoms 2-4 months before the pandemic (Time 1), and again 2 months following stay-at-home orders (Time 2). At T2, adolescents also completed measures of vulnerability, protective factors, and COVID-19-related distress. Depressive symptoms increased at T2, and COVID-19 distress interacted with resilience and negative cognitive style in predicting increases in T2 depression. Focusing on vulnerability and protective factors in adolescents distressed by large scale negative life events appears crucial.

Are negative views of the self, world and future, mediators of the relationship between subjective social status and depressive symptoms?

BACKGROUND: Elevated depressive symptoms are associated with impairments, reduced quality of life, and societal economic burden. A well-established stress-vulnerability model explaining depressive symptoms is Beck's cognitive theory (Beck, 1976). An independent line of research demonstrated that a person's perception of their status in comparison with others' (subjective social status, SSS) is a stressor associated with depressive symptoms. AIMS: Theory-driven research investigating the interplay of different factors associated with depressive symptoms opens the door to improve the lives of the affected individuals and to reduce the overall societal burden. This study's aim was to examine if SSS can be integrated as a stressor into Beck's theory, looking specifically at whether it impacts depressive symptoms through the individual components (self, world and future) of the cognitive triad. METHOD: In this cross-sectional study, 243 community college students (58.6% female; mean age 23.95 years) in the southern United States completed self-reports measuring SSS, negative views of the self, world and future, and depressive symptoms. RESULTS: SSS is negatively associated with each view of the cognitive triad. SSS and views of the self and world are negatively associated with depressive symptoms. Mediation analyses displayed a significant direct effect between SSS and depressive symptoms, as well as two indirect effects via negative view of self and world. CONCLUSIONS: While further research is needed, therapists might benefit from our findings when tailoring their treatment to a client by considering their SSS and which negative view is particularly detrimental for this specific client.

The Conceptualization of the Positive Cognitive Triad and Associations with Depressive Symptoms in Adolescents.

The positive cognitive triad (positive cognitions about the self, world, and future) has been considered a protective factor against depressive symptoms. This study examines three conceptualizations of the positive cognitive triad and their relation to depressive symptoms. Analyses were replicated in two samples in order to provide evidence for the validity of findings. Two samples (n1 = 2982, Mage = 13.04, Rangeage = 11-15 years; n2 = 2540, Mage = 13.11, Rangeage = 11-16 years) of Australian adolescents completed the Positive Cognitive Triad Inventory and Center for Epidemiological Studies Depression Scale. Findings supported the notion that the overall positive cognitive triad is a protective factor for depressive symptoms, and specifically, the role of positive cognitions about the self in this protection. After future studies examine the directionality of the relation between positive cognitions and depressive symptoms, mental health providers using cognitive behavioral approaches may consider examining positive cognitions with patients.

Does frontal brain activity mediate the effect of depression prevention in adolescents? A pilot study.

We investigated whether (a) depression prevention was associated with depressive symptoms and medial-frontal alpha asymmetry in adolescents; (b) alpha asymmetry mediated the association between participation in a prevention program and depressive symptoms; and (c) gender affects these associations. In our randomised control group study, we compared a universal prevention program (n = 40 adolescents, 14 females) with a non-intervention control condition (n = 39 adolescents, 20 females) in German secondary school students (mean age: 13.53 years, SD = 0.53). We collected data at baseline, post-intervention, 6-month, and 12-month follow-up using the Self-Rating Questionnaire for Depressive Disorders (SBB-DES) and resting medial-frontal alpha activity on F3 and F4. We found that girls benefitted from participating in the prevention program in regards to their depressive symptoms at 12-month follow-up but not alpha asymmetry. In boys, participation in the prevention program was associated with their alpha asymmetry at 6-month follow-up but not their depressive symptoms. Alpha asymmetry did not mediate the effects of the prevention program on depressive symptoms in either gender. Although participation in the prevention program was associated with both depressive symptoms and alpha asymmetry, those associations seem independent from each other. Possible explanations for this result pattern are discussed.

Relations of Subjective Social Status and Brooding with Blood Pressure.

BACKGROUND: Brooding, a type of rumination, and subjective social status (SSS) may be two interacting factors for cardiovascular disease (CVD). Our goal was to examine the relations of brooding and SSS with systolic blood pressure (SBP) and diastolic blood pressure (DBP), two measures of CVD. We predicted that [1] brooding and SSS are each related to SBP and DBP and [2] the interaction of brooding and SSS is linked to SBP and DBP. METHOD: In this cross-sectional study, college student participants (n = 240; 58.6% female, age: M = 23.95 years, SD = 8.62) completed demographics questionnaires, the Ruminative Response Scale, and MacArthur Subjective Social Status scale, and gave blood pressure samples. RESULTS: Linear models suggested that, for participants low in SSS, high brooding and DBP were positively related. For participants high in SSS, high brooding and low DBP were negatively related. There were no relations between SSS, brooding, and SBP. CONCLUSIONS: As predicted, for individuals with low SSS, more brooding was associated with higher DBP. Yet, in individuals with high SSS, more brooding was associated with lower DBP. There was no relation between SSS, brooding, and SBP. Our results suggest that brooding may serve as diathesis for some symptoms of CVD (i.e., high DBP but not high SBP) in individuals with low SSS. We discuss how other factors, like burnout or defensive pessimism, may contribute to the relation between high SSS, high brooding, and low DBP.

Associations between Social Support from Family, Friends, and Teachers and depressive Symptoms in Adolescents.

Approximately 20% of adolescents develop depressive symptoms. Family, friends, and teachers are crucial sources of social support for adolescents, but it is unclear whether social support impacts adolescents directly (principle-effect model) or by moderating the effect of stress (stress-buffer model) and whether each source of social support remains meaningful when their influence is studied simultaneously. To help fill this gap, we followed 1452 Australian students (average age at enrollment = 13.1, SD = 0.5; range: 11-16 years; 51.9% female) for 5 years. Based on our findings, each source of support is negatively related to depressive symptoms one year later when studied independently but when combined, only family and teacher support predicted depressive symptoms. Family support in all grades and teacher support in grade 8 to 10 but not in grade 11 directly impacted adolescent depressive symptoms 1 year later. Family support in grades 8 and 11 also buffered against the negative impact of stress on depressive symptoms one year later. Based on the unexpected findings, the most important limitations seem to be that the used instruments do not allow for a separation of different groups of friends (e.g., classmates, same-gender peers, romantic partners), types of social support, and stress. In addition, the high, nonrandom attrition rate with adolescents reporting less social support, more stressful events, a higher frequency of depressive symptoms, and/or being of Torres Strait Islander or Aboriginal background limits the generalizability of our findings. Summarized, our findings demonstrate that adolescents facing stress might benefit more from family support compared to their peers without stressful life events and that friends may have a weaker presence in adolescent lives than expected.

Associations of depression status and hopelessness with blood pressure: a 24-year follow-up study.

Hypertension is estimated to cause 12.8% of all deaths worldwide. Both literature and well-supported cognitive models indicate that hopelessness predicts depressive symptoms. This study aimed to test whether high levels of hopelessness are associated with increased blood pressure, as well as whether depression acts as a mediator between hopelessness and blood pressure. Data from the original 24-year longitudinal Baltimore Epidemiologic Catchment Area Study (ECA) were analyzed via linear regression (N = 917; 60.3% female; 62.9% European American; mean age = 42.96 years, SD = 16.94). Hopelessness was found to have a significant direct relationship with systolic blood pressure (SBP, p < .05), but not with diastolic blood pressure (DBP, p > .05); while depression had no significant direct relationship with SBP or with DBP. Overall, findings indicated that hopelessness has a significant relationship with SBP. Limitations and implications are discussed.

Comparing Different Sequential Mediational Interpretations of Beck's Cognitive Model of Depression in Adolescents.

Depression is a developmental phenomenon with significantly increasing rates during adolescence. As Beck's cognitive model of depression has been commonly accepted to explain the development and maintenance of depression, it is crucial to understand how and when cognitive vulnerabilities predicted in this model begin to interact. Three sequential interpretations of this model were compared. The causal mediational interpretation identifies dysfunctional attitudes as most distal to depressive symptoms, followed by cognitive errors, cognitive triad, and negative automatic thoughts, with each construct successively more proximal to depressive symptoms. In the symptom model the causal chain is reversed, with depressive symptoms as the most distal construct, followed by negative automatic thoughts, the cognitive triad, cognitive errors, and then dysfunctional attitudes. The bidirectional model merges both interpretations in which the activation of cognitive constructs causes the development of depressive symptoms which in turn trigger and reinforce already existing dysfunctional attitudes. Further, while Beck's model of depression proposes full mediation, empirical studies identified repeatedly partial mediations. Thus, the causal meditational, the symptoms, and the bidirectional model were each tested as full and partial mediation models. Finally, sex differences in the associations between variables were studied. In the 3-wave longitudinal study, 518 high school students (62.7 % female, average age: 15.09 years) completed questionnaires measuring all mentioned elements of Beck's model. The bidirectional model with partial mediation fits the data best. Cognitive errors emerged as the main mediator in the bidirectional model with partial mediation and significant sex differences in the strengths of associations were identified. The findings demonstrate the relevance of adolescence as developmental period during which the examined associations develop into the network they form in adulthood. Further, psychological interventions focusing on cognitive errors promise to be most effective.

Understanding Student Drinking Patterns: Does Shame Proneness Matter?

This study ( N = 202; mean age = 19.52 years, SD = 1.36 years; 66.5% female) analyzed three structural equation models to determine whether ruminative brooding and negative affect, moderated by shame proneness, explained college student drinking behaviors more than a model without shame proneness. Results indicated a model including shame proneness fit the data best; however, the moderated variables were not significantly associated with other variables in the retained model. Results are discussed alongside clinical recommendations within a university counseling center framework.

Do depressive symptoms mediate the relationship between hopelessness and diurnal cortisol rhythm?

BACKGROUND: Research has revealed a well-established relationship of depressive symptoms and hopelessness with a variety of physical illnesses that are associated with a dysfunction of the hypothalamic-pituitary-adrenal-axis. PURPOSE: The purpose of this study was to test if depressive symptoms mediate the relationship between hopelessness and cortisol, a measure of the hypothalamic-pituitary-adrenal-axis. METHODS: Hopelessness, depressive symptoms, and diurnal cortisol rhythm were measured in 257 adults (128 women and 129 men; age range, 20-74 years) in this cross-sectional study. To test the hypothesis, two linear regression analyses and asymmetrical confidence intervals around the regression weights were conducted. A second set of analyses was calculated to be able to exclude the possibility of hopelessness as a mediator between depressive symptoms and cortisol. RESULTS: As predicted, after adjusting for age, gender, awakening time, and medication use, more hopelessness predicted more depressive symptoms and more depressive symptoms predicted a flatter diurnal cortisol rhythm. The 95% confidence intervals revealed that the indirect relationship between hopelessness and diurnal cortisol rhythm was significant. The analyses with hopelessness as a potential mediator revealed that hopelessness does not mediate the association between depressive symptoms and cortisol. CONCLUSIONS: While the relationship between hopelessness and cortisol was mediated by depressive symptoms in this cross-sectional study, many other risk factors of depression have not been examined. Thus, future longitudinal studies should examine the relationships between those risk factors of depression and the hypothalamic-pituitary-adrenal-axis.

Integrating Beck's cognitive model and the response style theory in an adolescent sample.

Depression becomes more prevalent as individuals progress from childhood to adulthood. Thus, empirically supported and popular cognitive vulnerability theories to explain depression in adulthood have begun to be tested in younger age groups, particularly adolescence, a time of significant cognitive development. Beck's cognitive theory and the response style theory are well known, empirically supported theories of depression. The current, two-wave longitudinal study (N = 462; mean age = 16.01 years; SD = 0.69; 63.9% female) tested various proposed integrative models of Beck's cognitive theory and the response style theory, as well as the original theories themselves, to determine if and how these cognitive vulnerabilities begin to intertwine in adolescence. Of the integrative models tested-all with structural equation modeling in AMOS 21-the best-fitting integrative model was a moderation model wherein schemata influenced rumination, and rumination then influenced other cognitive variables in Beck's model. Findings revealed that this integrated model fit the data better than the response style theory and explained 1.2% more variance in depressive symptoms. Additionally, multigroup analyses comparing the fit of the best-fitting integrated model across adolescents with clinical and subclinical depressive symptoms revealed that the model was not stable between these two subsamples. However, of the hypotheses relevant to the integrative model, only 1 of the 18 associations was significantly different between the clinical and subclinical samples. Regardless, the integrated model was not superior to the more parsimonious model from Beck's cognitive theory. Implications and limitations are discussed.

Disclosure during private prayer as a mediator between prayer type and mental health in an adult christian sample.

According to Poloma and Pendleton's (J Psychol Theol 19:71-83, 1991) prayer model, there are four prayer types (colloquial, meditative, petitionary, and ritual), all of which have varying associations with mental health. However, few studies have examined what mechanisms explain these associations. The literature demonstrates that disclosing distressing information can improve mental health. Thus, the current study examined self-disclosure as a mediating variable between Poloma and Pendleton's (J Psychol Theol 19:71-83, 1991) prayer types and mental health. It was hypothesized that self-disclosure would mediate the association between prayer types involving meaningful communication with God (colloquial and meditative prayer types) and mental health and would not mediate associations between petitionary and ritual prayer types and mental health. This cross-sectional, online study analyzed data from praying Christian adults (N = 296) to test the hypotheses. As predicted, self-disclosure mediated the positive associations between colloquial and meditative prayer types and mental health. Self-disclosure was not associated with petitionary or ritual prayer and therefore did not mediate the relationships of these prayer types with mental health, as expected. Petitionary prayer had a negative relationship to mental health, while ritual prayer had a positive relationship to mental health. The results indicate that self-disclosure is an important mediator to consider when investigating the associations between private prayer and mental health.

Testing three different sequential mediational interpretations of Beck's cognitive model of the development of depression.

OBJECTIVES: This study tested and compared three sequential interpretations of Beck's cognitive model of the development of depression (1996). The causal mediational interpretation identifies dysfunctional attitudes as most distal to depressive symptoms, followed by cognitive distortions, the cognitive triad, and negative automatic thoughts, with each construct successively more proximal to depressive symptoms. By contrast, the symptom model reverses the causal chain with negative automatic thoughts as the most proximal consequence and dysfunctional attitudes as the most distal consequence of depression. The bidirectional model merges both interpretations into one model. Previous studies on sequential interpretations of Beck's model have not included cognitive distortions or the cognitive triad and did not test the bidirectional model finding contradictory empirical evidence for the sequential order. METHOD: In the 3-wave longitudinal study, 308 German university students without clinically significant depressive symptoms (245 female, average age: 23.69 years) completed self-report questionnaires measuring their dysfunctional attitudes, cognitive distortions, cognitive triad, negative automatic thoughts, and depressive symptoms. RESULTS: The bidirectional model with partial mediation fit the data best and cognitive distortions mediated the relationship between dysfunctional attitudes and negative automatic thoughts and vice versa. CONCLUSIONS: The findings have important consequences for the prevention of depression. Prevention programs may want to focus on cognitive distortions, the only construct in Beck's model that influences every other construct in the model.