A longitudinal twin and sibling study of the hopelessness theory of depression in adolescence and young adulthood.

M A Waszczuk,A M Gregory,T C Eley,A E Coulson

doi:10.1017/s0033291716000489

Abstract

Maladaptive cognitive biases such as negative attributional style and hopelessness have been implicated in the development and maintenance of depression. According to the hopelessness theory of depression, hopelessness mediates the association between attributional style and depression. The aetiological processes underpinning this influential theory remain unknown. The current study investigated genetic and environmental influences on hopelessness and its concurrent and longitudinal associations with attributional style and depression across adolescence and emerging adulthood. Furthermore, given high co-morbidity between depression and anxiety, the study investigated whether these maladaptive cognitions constitute transdiagnostic cognitive content common to both internalizing symptoms. A total of 2619 twins/siblings reported attributional style (mean age 15 and 17 years), hopelessness (mean age 17 years), and depression and anxiety symptoms (mean age 17 and 20 years). Partial correlations revealed that attributional style and hopelessness were uniquely associated with depression but not anxiety symptoms. Hopelessness partially mediated the relationship between attributional style and depression. Hopelessness was moderately heritable (A = 0.37, 95% confidence interval 0.28-0.47), with remaining variance accounted for by non-shared environmental influences. Independent pathway models indicated that a set of common genetic influences largely accounted for the association between attributional style, hopelessness and depression symptoms, both concurrently and across development. The results provide novel evidence that associations between attributional style, hopelessness and depression symptoms are largely due to shared genetic liability, suggesting developmentally stable biological pathways underpinning the hopelessness theory of depression. Both attributional style and hopelessness constituted unique cognitive content in depression. The results inform molecular genetics research and cognitive treatment approaches.

Highlights

Depression is very common, chronic, and increases markedly in adolescence (Costello et al 2003; Ford et al 2003; Hankin et al 1998)
Partial correlations indicated that when controlling for depression symptoms, neither attributional style nor hopelessness remained significantly associated with anxiety symptoms
Prospective longitudinal results indicated that about a third of the association between early attributional style and later depression was mediated via hopelessness, both attributional style and hopelessness were uniquely associated with depression symptoms, indicating that they may be independent cognitive risk factors for developing depression in adolescence

Summary

Introduction

Depression is very common, chronic, and increases markedly in adolescence (Costello et al 2003; Ford et al 2003; Hankin et al 1998). Adolescent depression reliably predicts long-term mental health difficulties (Harrington et al 1990; Dunn & Goodyer, 2006; Gregory et al 2007) and carries burden of social and educational impairment (Puig-Antich et al 1993; Katon et al 2010; Riglin et al 2014). Maladaptive cognitions, such as biases in how individuals attend to, interpret and remember emotional information, have been implicated in the development and maintenance of depression (Jacobs et al 2008), and are targeted by recommended first-line treatments such as cognitive behavioural therapy (CBT) (AACAP, 2007). Given high co-morbidity between depression and anxiety, the study investigated whether these maladaptive cognitions constitute transdiagnostic cognitive content common to both internalizing symptoms

Methods

Results

Discussion

Conclusion