Day-to-day changes in negative attributions of stress: A daily diary study of cognitive vulnerability and negative affect in adults with elevated risk of suicidal thoughts and behaviors

Abstract

BackgroundThe hopelessness theory is one of the most studied cognitive vulnerability theories of depression. It proposes that risk for depression is conferred by attributing the causes of negative events to global, internal, stable causes and inferring future negative consequences and negative characteristics about oneself from these events. Nearly all research has operationalized cognitive style using individuals’ responses to hypothetical events at single timepoints. Far less research has explored attributions of specific events as they occur, none of which has involved clinical samples. MethodsThis study aimed to examine if measuring event-specific attributions clarifies the relationship between negative cognitive style and clinical symptoms. Adults (n = 51), who had attempted suicide at least once in the year prior, were recruited from the community via online forums related to suicide risk. Participants provided nightly ratings of hopelessness and attributions of the most stressful event that day for four weeks. ResultsThe daily diary composite measure of cognitive style was more strongly associated with hopelessness and depressive symptoms than the trait measure. Daily attributions fully mediated the relationship between trait cognitive style and hopelessness. LimitationsThe measurement period could not capture the occurrence of a next depressive episode for all participants. Relatedly, we could not account for the precise nature of individual stressors. ConclusionsAt a population level, trait measures alone may be a useful risk factor. But, with the goal to move towards more personalized prediction and intervention, more dynamic, ecologically valid, and real time measures may help gain more traction.