Cognitive Reactivity, Implicit Associations, and the Incidence of Depression: A Two-Year Prospective Study

Abstract

BackgroundCognitive reactivity to sad mood is a vulnerability marker of depression. Implicit self-depressed associations are related to depression status and reduced remission probability. It is unknown whether these cognitive vulnerabilities precede the first onset of depression.AimTo test the predictive value of cognitive reactivity and implicit self-depressed associations for the incidence of depressive disorders.MethodsProspective cohort study of 834 never-depressed individuals, followed over a two-year period. The predictive value of cognitive reactivity and implicit self-depressed associations for the onset of depressive disorders was assessed using binomial logistic regression. The multivariate model corrected for baseline levels of subclinical depressive symptoms, neuroticism, for the presence of a history of anxiety disorders, for family history of depressive or anxiety disorders, and for the incidence of negative life events.ResultsAs single predictors, both cognitive reactivity and implicit self-depressed associations were significantly associated with depression incidence. In the multivariate model, cognitive reactivity was significantly associated with depression incidence, together with baseline depressive symptoms and the number of negative life events, whereas implicit self-depressed associations were not.ConclusionCognitive reactivity to sad mood is associated with the incidence of depressive disorders, also when various other depression-related variables are controlled for. Implicit self-depressed associations predicted depression incidence in a bivariate test, but not when controlling for other predictors.

Associations between chronotypes and psychological vulnerability factors of depression

“…Cognitive reactivity has been established as a vulnerability factor of depression in prior studies. In a prospective analysis of the NESDA sample, we found that higher cognitive reactivity predicted the onset of depression in a healthy group (Kruijt et al, 2013). Furthermore, higher cognitive reactivity measured with the LEIDS-R was also found to be a predictor of relapse in a longitudinal study, with the rumination subscale being the best predictor (Figueroa et al, 2015).…”

“…This is not contrary to expectation, since the questionnaire (the LEIDS-R) is addressed to participants who are not in the middle of a depressive episode, since they have to imagine themselves to be "somewhat sad" and how they would react cognitively to this mild sad mood. We have previously shown that the scale is able to capture vulnerability to depression in healthy participants and to predict prospectively the onset of depression (Kruijt et al, 2013).…”

“…Cognitive reactivity is the extent to which negative thoughts become activated when mood is low, and has been studied mainly in relation to depression. Cognitive reactivity predicts first onset of depression in healthy individuals (Kruijt et al, 2013) and relapse in remitted individuals (Segal et al, 1999;Scher et al, 2005;Elgersma et al, 2015). Cognitive reactivity is higher in remitted depressed than in never depressed individuals (Moulds et al, 2008;Van Der Does, 2002).…”

Cognitive reactivity, self-depressed associations, and the recurrence of depression

“…Supporting its validity as a measure of CR, the LEIDS had strong predictive value for CR, as measured with a mood induction procedure (van der Does, 2002). CR as indexed by the LEIDS-R was found to be associated with an increase in depressive symptoms over a one year period (Struijs et al, 2013) and emphasizing its relevance as a premorbid risk factor it was also found to be predictive for the first onset of depression (Kruijt et al, 2013).…”

“…CR (as indexed by the LEIDS-R) has been shown to predict first onsets of depression, whereas self-depressed associations (IAT scores) did not predict first onsets after statistically partialling out the level of depressive symptoms and negative life events (Kruijt et al, 2013). High CR may also increase the risk of recurrence of depression and two studies using mood induction procedures have shown CR to be a significant predictor of recurrence over periods of 15 and 18 months after remission (Segal et al, 2006;Kuyken et al, 2010).…”