Adolescent Depression and Negative Life Events, the Mediating Role of Cognitive Emotion Regulation.

Yvonne Stikkelbroek,Anneloes L Van Baar,Denise H M Bodden,Mirjam Reijnders,Marloes Kleinjan,Therese Van Amelsvoort

doi:10.1371/journal.pone.0161062

Yvonne Stikkelbroek, Anneloes L Van Baar + Show 4 more

Open Access

https://doi.org/10.1371/journal.pone.0161062

Copy DOI

Abstract

BackgroundDepression during adolescence is a serious mental health problem. Difficulties in regulating evoked emotions after stressful life events are considered to lead to depression. This study examined if depressive symptoms were mediated by various cognitive emotion regulation strategies after stressful life events, more specifically, the loss of a loved one, health threats or relational challenges.MethodsWe used a sample of 398 adolescents (Mage = 16.94, SD = 2.90), including 52 depressed outpatients, who all reported stressful life event(s). Path analyses in Mplus were used to test mediation, for the whole sample as well as separately for participants scoring high versus low on depression, using multigroup analyses.ResultsHealth threats and relational challenging stressful life events were associated with depressive symptoms, while loss was not. More frequent use of maladaptive strategies was related to more depressive symptoms. More frequent use of adaptive strategies was related to less depressive symptoms. Specific life events were associated with specific emotion regulation strategies. The relationship between challenging, stressful life events and depressive symptoms in the whole group was mediated by maladaptive strategies (self-blame, catastrophizing and rumination). No mediation effect was found for adaptive strategies.ConclusionThe association between relational challenging, stressful life events and depressive symptoms was mediated by maladaptive, cognitive emotion regulation strategies.

Highlights

Depression during adolescence is a serious problem because of its high prevalence [1,2,3], considerable burden of disease [4], suicide risk [5], other comorbid psychiatric disorders [6] and the high risk of recurrence [5,7]
This study examined if depressive symptoms were mediated by various cognitive emotion regulation strategies after stressful life events, the loss of a loved one, health threats or relational challenges
Health threats and relational challenging stressful life events were associated with depressive symptoms, while loss was not

Summary

Introduction

Depression during adolescence is a serious problem because of its high prevalence [1,2,3], considerable burden of disease [4], suicide risk [5], other comorbid psychiatric disorders [6] and the high risk of recurrence [5,7]. An intriguing question is what mechanisms are involved that may lead different types of stressful life events to contribute to the development of depressive symptoms and depression. Emotion regulation is seen as a potential mediator of depressive symptoms after stressful life events have occurred [13]. From a clinical viewpoint it is necessary to establish which factors mediate the occurrence of depressive symptoms after specific types of stressful life events, as such factors could be addressed effectively in prevention and treatment efforts. Difficulties in regulating evoked emotions after stressful life events are considered to lead to depression. This study examined if depressive symptoms were mediated by various cognitive emotion regulation strategies after stressful life events, the loss of a loved one, health threats or relational challenges

Objectives

Results

Conclusion