Cognitive trio: relationship with major depression and clinical predictors in Han Chinese women

Abstract

BackgroundPrevious studies support Beck's cognitive model of vulnerability to depression. However, the relationship between his cognitive triad and other clinical features and risk factors among those with major depression (MD) has rarely been systematically studied.MethodThe three key cognitive symptoms of worthlessness, hopelessness and helplessness were assessed during their lifetime worst episode in 1970 Han Chinese women with recurrent MD. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression.ResultsCompared to patients who did not endorse the cognitive trio, those who did had a greater number of DSM-IV A criteria, more individual depressive symptoms, an earlier age at onset, a greater number of episodes, and were more likely to meet diagnostic criteria for melancholia, postnatal depression, dysthymia and anxiety disorders. Hopelessness was highly related to all the suicidal symptomatology, with ORs ranging from 5.92 to 6.51. Neuroticism, stressful life events (SLEs) and a protective parental rearing style were associated with these cognitive symptoms.ConclusionsDuring the worst episode of MD in Han Chinese women, the endorsement of the cognitive trio was associated with a worse course of depression and an increased risk of suicide. Individuals with high levels of neuroticism, many SLEs and high parental protectiveness were at increased risk for these cognitive depressive symptoms. As in Western populations, symptoms of the cognitive trio appear to play a central role in the psychopathology of MD in Chinese women.

Depression and prospection

“…Beck postulated a negative view of the world, of the self, and of the future as the hallmark symptoms of depression, and suggested they were more than mere symptoms – that they caused depression. We agree with this perspective, particularly in the light of the empirical evidence supporting it (e.g., Abela & D'Alessandro, ; Alloy et al ., ; Hankin, Abramson, Miller, & Haeffel, ; Wang et al ., ) – and we further suggest that the negative view of the future is the first among equals in the triad. Much research and therapeutic work focuses on negative views of the self (e.g., Fennell, ; Metalsky, Joiner, Hardin, & Abramson, ; Orth, Robins, & Roberts, ), but negative views of the future may matter even more; we hypothesize that the entire cognitive triad may actually boil down to negative future‐thinking.…”

Subtypes of major depression: latent class analysis in depressed Han Chinese women

“…The analysis was performed on three sets of items: (i) the nine DSM-IV criteria for MD; (ii) 14 items representing the disaggregated DSM-IV criteria (i.e. increased and decreased appetite and weight, insomnia or hypersomnia, and psychomotor agitation or retardation); and (iii) 27 items consisting of detailed assessments of DSM-IV criteria and symptoms of melancholia, anxiety and Beck’s cognitive trio (Beck & Alford, 2008; Wang et al 2013). We then attempted to validate the identified classes by examining other depression-related clinical features, co-morbidities and environmental risk factors.…”

The Influence of Family-Related Factors on Suicide in Major Depression Patients

“…Alas, some studies have shown that a lack of parental warmth and care and parental control of children with negative psychology such as criticism and guilt induction are related to patients' depression and negative cognitive style (49). And parental overprotection in childhood may as well increase the risk of cognitive impairment, and neurocognitive impairment may be a risk factor for SRB (50,51). Therefore, to mitigate the risk of SRB, adjusting the appropriate rearing style and improving the communication between parents and children were suggested.…”