Week 8: Etiology and Maintenance of Depression (2) Flashcards
What do we already know about depressed youth
4 things
We already know depressed youth are:
Less prosocial
Less assertive
More avoidant and withdrawn
Some children with depression are also more hostile and aggressive
Interpersonal Theories of Depression
Children and adolescents may be responding to challenging interpersonal situations in problematic ways
We know, for example, that responding by aggressing or
withdrawing when someone aggresses against you may result in continued experience of aggression
We also know that being treated poorly by peers results in increased
depression
Are children and adolescents experiencing depression getting
trapped in a vicious cycle?
Stress Exposure vs. Stress Generation
Stress Exposure Models of Depression
- Depression results from exposure to stressful events (robust finding)
- Experience of stress precedes the experience of depression
- Peer rejection leads to an increase in depression
Stress Generation Models
- Depression may lead individuals to generate stressful life events
- Difficulties in interactions may cause interpersonal problems
Stress Generation Models of Depression
Study
88 children
Clinically referred (so already seeking help)
Using a clinical interview, placed participants into the following diagnostic groups:
(1) Depressed only
(2) Externalizing only
(3) Both (comorbid)
(4) Neither (clinic control)
Assessed experience of life stress
Objective/Subjective assessment of stress
Subjective - how a person experiences a problem
Objective - how an outsider might assess a problem
Depression is associated with subjective stress
Stress Generation Models of Depression
How was stress assessed
Stressful episodes rated by researchers along several dimensions:
Severity
- No stress/impact to severe stress/impact
- Rated by a team based on detailed information about what happened
Academic
- Failed a test at school, has otherwise done okay in that class, and has a decent overall GPA
- Failed a class at school, has to go to summer school to make it up, but will graduate high school on time
- Failed a class at school, this is the second class this year, and graduation will be delayed
Extent to which child contributed to the event
-Completely independent to completely dependent
Independent: Your dad got a new job and you had to move and start at a new school where you don’t
know anyone
Dependent: You did not study for your test because you wanted to hang out with your friend instead and
you got a really bad grade
Interpersonal or non interpersonal
- Fight with a friend
- Failing a test
Stress Generation Models of Depression
Results
Depression was associated with dependent, interpersonal stress
-This association was stronger than the relationship between
externalizing disorders and dependent interpersonal stress
Depression was not associated with dependent, non-interpersonal stress
-Externalizing disorders were associated with dependent, non-interpersonal stress
Depression was not associated with independent stressors
Neither were externalizing disorders
BUT these kids were clinically referred, they may be experiencing more of these than non-referred kids, we do not know that
DEFFO not associated with depression though as not different to externalizing disorders
Children with comorbidity experienced the highest levels of both interpersonal and non interpersonal dependent stress
Stress Generation Models of Depression
How do youth with depression generate problematic interpersonal circumstances
Youth with depression more likely to generate problematic interpersonal circumstances
These interpersonal circumstances, in turn, may exacerbate depression
See similar patterns for:
Life hassles
-Internalizing symptoms predicts life hassle, and life hassles predict subsequent internalizing symptoms
Victimization
-Internalizing symptoms predict victimization, and victimization
predict subsequent internalizing symptoms
Viscous circles
Friends are a critically important part of healthy development
Protect children from feelings of loneliness and depression
Children with friendships are less likely to be victimized by peers
Provides an opportunity to develop important social skills
For children with depression, may be difficult to maintain healthy,
meaningful relationships
Features of friendships may be contributing to their symptoms
What have studies shown when observing depressed kids interacting with their freinds?
Studies have observed children with depression interacting with their
friends
Have noticed the friends’ affect becoming more negative over the
course of the interaction
Co-rumination
Rumination is the tendency to dwell on problems and not solve them
Co rumination is when two friends do it together
Paradox
Sharing and intimacy are associated with better friendships
Rumination and dwelling on bad things are associated with negative mood
What does co-rumination look like study
Boys and girls in 3 rd , 5 th , 7 th , and 9 th grade
Completed measures about:
- Internalizing symptoms (anxiety and depression)
- Friendship nominations
- Identified best friend dyads
- Friendship quality and closeness
Co rumination
-“When we talk about a problem one of us has, we usually talk about that
problem every day even if nothing knew has happened”
-“When we talk about a problem one of us has, we try to figure out
everything about the problem, even if there are parts we may never
understand”
RESULTS
Co rumination predicts positive friendship quality
Co rumination also predicts internalizing symptoms
(does not tell us anything about temporal order)
What does co-rumination look like study
follow up for temporal order
Co rumination at one time point predicts later increases in friendship quality and internalizing symptoms
So co-rumination is causal
Co- rumination and depressive symptoms
Study
Are some components of co rumination more problematic than others?
Observational task
Two adolescent friends come to the lab
Each identifies a problem they are having
Talk about your problems, make sure you talk about each person’s problem, if you finish, you can talk about something else or do the
puzzle that’s on the table
Coded different types of behavior
Found that dwelling on negative affect was associated with
depressive and anxious symptoms, and was not associated with
friendship quality
LOOKS LIKE A GOOD TARGET FOR TREATMENT
In contrast, (a) discussing the problem repeatedly (rehashing), and
(b) speculating about what might happen were associated with
increased friendship quality and closeness, but not greater depressive or anxious symptoms
LEAVE ALONE
Reassurance Seeking
Children want others to demonstrate that they care about them, tell them that they are okay, etc.
Initially, people will do this
Person thinks they don’t mean it, and seeks more reassurance
As child ignores this, there is no positive reinforcement for the friend, so they stop
Overtime, this becomes irritating and/or invalidating
Eventually, the child will be rejected
Reassurance seeking is associated with unstable friendships
As one friend does reassurance seeking, the other experiences a decrease in friendship quality
