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

Abstract

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.

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

“…Although some validity evidence was provided for the constraint of both the paths for the World and Future group across each samples, the inconsistency with the Self group, along with the relatively lower percentage of variance explained using the strongest link conceptualization (Table 9) As expected, both the single factor and higher-order factor additive models were statistically significantly negatively related to depressive symptoms, explaining from 27% to 30% of variance across models and samples in depressive symptoms. This is consistent with previous studies that have used an additive conceptualization of the positive cognitive triad (Patton et al, 2011;Sawyer et al, 2009) as well as previous findings regarding using an additive conceptualization of the negative cognitive triad's positive relation with depressive symptoms (Greening et al, 2005;Kaslow et al, 1992;Pössel, 2016). Thus, the positive cognitive triad can be conceptualized as a single protective factor, as evidenced by its negative relation with depressive symptoms.…”

“…However, findings regarding the conceptualization of the negative cognitive triad may lend some support to the prediction of outcomes of the hypothesized conceptualizations of the positive cognitive triad. Several studies with youth have used the additive approach when conceptualizing the negative cognitive triad (Greening et al, 2005;Kaslow, Stark, Printz, Livingston, & Tsai, 1992;Pössel, 2016) finding positive associations between the overall negative cognitive triad and adolescents' depressive symptoms. Other studies have used the independent factor approach, finding that all three subfactors of the cognitive triad (Braet et al, 2015;Kaslow et al, 1992) (Jacobs & Joseph, 1997).…”

“…The additive approach to the negative cognitive triad is positively associated with depressive symptoms (Greening et al, 2005;Kaslow et al, 1992;Pössel, 2016).…”

Do Dysfunctional Attitudes Mediate or Moderate the Association Between Everyday Discrimination and Symptoms of Depression in Adolescents?

“…According to cognitive models of depression, depressive symptoms result from maladaptive, faulty, or irrational cognitions [5,[31][32][33] and have explained the development and maintenance of depressive symptoms in adolescents well [34]. In his theory, one of the most widely-accepted cognitive vulnerabilitystress models of depression [32,33,35,36], Beck [5] emphasizes the role negative environmental in uences (stressors) play in activating cognitive factors (vulnerability), which then lead to depressive symptoms in adolescents [37].…”