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Dysfunctional Attitudes and Early Maladaptive Schemas as Predictors of Depression: A 9-Year Follow-Up Study

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Abstract

The Dysfunctional Attitude Scale (DAS) and the Young Schema Questionnaire (YSQ) have been suggested as vulnerability markers for depression and entrenched psychological disorders, respectively. One-hundred-and-fifteen clinically depressed (CDs), previously depressed (PDs), and never depressed individuals completed the DAS, the YSQ, and the Beck Depression Inventory in the index study, and were followed up 9 years later in relation to diagnostic status, depression severity and course of depression. From multiple regression analyses YSQ domain scales emerged as significant predictors of concurrent depression severity in the index study, and depression severity and episodes of Major Depression, 9 years later. A majority of CDs and PDs experienced a recurrent depression over 9 years. The findings indicate that YSQ scales are promising as vulnerability markers for depression and underscore a conceptualisation of depression as a serious disorder due to its highly recurrent course, and highlight the necessity to identify and tackle long-term vulnerability factors.

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References

  • Alloy, L. B., Abramson, L. Y., Whitehouse, W. G., Hogan, M. E., Panzarella, C., & Rose, D. T. (2006). Prospective incidence of first onsets and recurrence of depression in individuals at high and low cognitive risk for depression. Journal of Abnormal Psychology, 115, 145–156.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). DC: Washington.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). DC: Washington.

    Google Scholar 

  • Andrade, L., Caraveo-Anduaga, J. J., Berglund, P., Bijl, R. V., De Graaf, R., Vollebergh, W., et al. (2003). The epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. International Journal of Methods in Psychiatric Research, 12, 3–21.

    Article  PubMed  Google Scholar 

  • Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. New York: Harper & Row.

    Google Scholar 

  • Beck, A. T. (1987). Cognitive models of depression. Journal of Cognitive Psychotherapy: An International Quarterly, 1, 5–37.

    Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.

    Google Scholar 

  • Beck, A. T., & Steer, R. A. (1987). Beck depression inventory manual. New York: The Psychological Corporation Harcourt Brace Jovanovich, Inc.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II: Beck Depression Inventory (2nd ed.). San Antonio, Texas: The Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the beck depression inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.

    Article  Google Scholar 

  • Beevers, C. G., & Miller, I. W. (2004). Depression-related negative cognition: Mood-state and trait dependent properties. Cognitive Therapy and Research, 28, 293–307.

    Article  Google Scholar 

  • Bowlby, J. (1973). Attachment and loss: Vol 2. Separation. New York: Basic Books.

    Google Scholar 

  • Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss, sadness, and depression. New York: Basic Books.

    Google Scholar 

  • Cane, D. B., Olinger, L. J., Gotlib, I. H., & Kuiper, N. A. (1986). Factor structure of the Dysfunctional Attitude Scale in a student population. Journal of Clinical Psychology, 42, 307–309.

    Article  Google Scholar 

  • Chioqueta, A. P., & Stiles, T. C. (2004). Psychometric properties of the Norwegian version of the Dysfunctional Attitude Scale (Form A). Cognitive Behaviour Therapy, 33, 83–86.

    Article  PubMed  Google Scholar 

  • Costa, P. T., Bagby, R. M., Herbst, J. H., & McCrae, R. R. (2005). Personality self-reports are concurrently reliable and valid during acute depressive episodes. Journal of Affective Disorders, 89, 45–55.

    Article  PubMed  Google Scholar 

  • Dent, J., & Teasdale, J. D. (1988). Negative cognition and the persistence of depression. Journal of Abnormal Psychology, 97, 29–34.

    Article  PubMed  CAS  Google Scholar 

  • Dobson, K. S., & Breiter, H. J. (1983). Cognitive assessment of depression: Reliability and validity of three measures. Journal of Abnormal Psychology, 92, 107–109.

    Article  PubMed  CAS  Google Scholar 

  • Dykman, B. M., & Johll, M. (1998). Dysfunctional attitudes and vulnerability to depressive symptoms: A 14-week longitudinal study. Cognitive Therapy and Research, 22, 337–352.

    Article  Google Scholar 

  • Farmer, A., Harris, T., Redman, K., Mahmood, A., Sadler, S., & McGuffin, P. (2001). The Cardiff depression study: A sib-pair study of dysfunctional attitudes in depressed probands and healthy control subjects. Psychological Medicine, 31, 627–633.

    Article  PubMed  CAS  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997). The structured clinical interview for DSM-IV, Axis I disorders–clinician version (SCID-CV). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Haaga, D. A. F., Dyck, M. J., & Ernst, D. (1991). Empirical status of cognitive theory of depression. Psychological Bulletin, 110, 215–236.

    Article  PubMed  CAS  Google Scholar 

  • Halvorsen, M., Wang, C. E., Richter, J., Myrland, I., Pedersen, S. K., Eisemann, M., & Waterloo, K. (2009). Early maladaptive schemas, temperament and character traits in clinically depressed and previously depressed subjects. Clinical Psychology & Psychotherapy. [Epub ahead of print].

  • Hankin, B. L., Abramson, L. Y., Miller, N., & Haeffel, G. J. (2004). Cognitive vulnerability-stress theories of depression: Examining affective specificity in the prediction of depression versus anxiety in three prospective studies. Cognitive Therapy and Research, 28, 309–345.

    Article  Google Scholar 

  • Harris, A. E., & Curtin, L. (2002). Parental perceptions, early maladaptive schemas, and depressive symptoms in young adults. Cognitive Therapy and Research, 26, 405–416.

    Article  Google Scholar 

  • Hoffart, A., Sexton, H., Hedley, L. M., Wang, C. E., Holthe, H., Haugum, J. A., et al. (2005). The structure of maladaptive schemas: A confirmatory factor analysis and a psychometric evaluation of factor-derived scales. Cognitive Therapy and Research, 29, 627–644.

    Article  Google Scholar 

  • Iacoviello, B. M., Alloy, L. B., Abramson, L. Y., Whitehouse, W. G., & Hogan, M. E. (2006). The course of depression in individuals at high and low cognitive risk for depression: A prospective study. Journal of Affective Disorders, 93, 61–69.

    Article  PubMed  Google Scholar 

  • Judd, L. L. (1997). The clinical course of unipolar major depressive disorders. Archives of General Psychiatry, 54, 989–991.

    PubMed  CAS  Google Scholar 

  • Kendler, K. S., Thornton, L. M., & Gardner, C. O. (2000). Stressful life events and previous episodes in the etiology of major depression in women: An evaluation of the “kindling” hypothesis. American Journal of Psychiatry, 157, 1243–1251.

    Article  PubMed  CAS  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., et al. (2003). The epidemiology of major depressive disorder: Results from the national Comorbidity Survey Replication (NCS-R). Journal of American Medical Association, 289, 3095–3105.

    Article  Google Scholar 

  • Kovacs, M., & Beck, A. T. (1978). Maladaptive cognitive structures in depression. American Journal of Psychiatry, 135, 525–533.

    PubMed  CAS  Google Scholar 

  • Lam, D. H., Green, B., Power, M. J., & Checkley, S. (1996). Dependency, matching adversities, length of survival and relapse in major depression. Journal of Affective Disorders, 37, 81–90.

    Article  PubMed  CAS  Google Scholar 

  • Lee, C. W., Taylor, G., & Dunn, J. (1999). Factor structure of the schema questionnaire in a large clinical sample. Cognitive Therapy and Research, 23, 441–451.

    Article  Google Scholar 

  • Miranda, J., & Persons, J. B. (1988). Dysfunctional thoughts are mood-state dependent. Journal of Abnormal Psychology, 97, 76–79.

    Article  PubMed  CAS  Google Scholar 

  • Norman, W. H., Miller, I. W., & Dow, M. G. (1988). Characteristics of depressed patients with elevated levels of dysfunctional cognitions. Cognitive Therapy and Research, 12, 39–52.

    Article  Google Scholar 

  • Olinger, L. J., Kuiper, N. A., & Shaw, B. F. (1987). Dysfunctional attitudes and stressful life events: An interactive model of depression. Cognitive Therapy and Research, 11, 25–40.

    Article  Google Scholar 

  • Oliver, J. M., & Baumgart, E. P. (1985). The Dysfunctional Attitude Scale: Psychometric properties and relation to depression in an unselected adult population. Cognitive Therapy and Research, 9, 161–167.

    Article  Google Scholar 

  • Otto, M. W., Teachman, B. A., Cohen, L. S., Soares, C. N., Vitonis, A. F., & Harlow, B. L. (2007). Dysfunctional attitudes and episodes of major depression: Predictive validity and temporal stability in never-depressed, depressed, and recovered women. Journal of Abnormal Psychology, 116, 475–483.

    Article  PubMed  Google Scholar 

  • Peselow, E. D., Robins, C., Block, P., Barouche, F., & Fieve, R. R. (1990). Dysfunctional attitudes in depressed patients before and after clinical treatment and in normal control subjects. American Journal of Psychiatry, 147, 439–444.

    PubMed  CAS  Google Scholar 

  • Power, M. J., Duggan, C. F., Lee, A. S., & Murray, R. M. (1995). Dysfunctional attitudes in depressed and recovered depressed patients and their first-degree relatives. Psychological Medicine, 25, 87–93.

    Article  PubMed  CAS  Google Scholar 

  • Power, M. J., Katz, R., McGuffin, P., Duggan, C. F., Lam, D. H., & Beck, A. T. (1994). Dysfunctinal Attitude Scale (DAS). A comparison of forms A and B and proposals for a new subscale version. Journal of Research in Personality, 28, 263–276.

    Article  Google Scholar 

  • Reda, M. A., Carpiniello, B., Secchiaroli, L., & Blanco, S. (1985). Thinking, depression, and antidepressants: Modified and unmodified beliefs during treatment with amitryptiline. Cognitive Therapy and Research, 9, 135–143.

    Article  Google Scholar 

  • Riso, L. P., Froman, S. E., Raouf, M., Gable, P., Maddux, R. E., Turini-Santorelli, N., et al. (2006). The long-term stability of early maladaptive schemas. Cognitive Therapy and Research, 30, 515–529.

    Article  Google Scholar 

  • Scher, C. D., Ingram, R. E., & Segal, Z. V. (2005). Cognitive reactivity and vulnerability: Empirical evaluation of construct activation and cognitive diatheses in unipolar depression. Clinical Psychology Review, 25, 487–510.

    Article  PubMed  Google Scholar 

  • Schmidt, N. B., Joiner, T. E., Young, J. E., & Telch, M. J. (1995). The schema questionnaire: Investigation of psychometric properties and the hierarchical structure of a measure of maladaptive schemas. Cognitive Therapy and Research, 19, 295–301.

    Article  Google Scholar 

  • Segal, Z. V., Gemar, M., & Williams, S. (1999). Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression. Journal of Abnormal Psychology, 108, 3–10.

    Article  PubMed  CAS  Google Scholar 

  • Segal, Z. V., Kennedy, S., Gemar, M., Hood, K., Pedersen, R., & Buis, T. (2006). Cognitive reactivity to sad mood provocation and the prediction of depressive relapse. Archives of General Psychiatry, 63, 749–755.

    Article  PubMed  Google Scholar 

  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.

    Google Scholar 

  • Solomon, D. A., Keller, M. B., Leon, A. C., Mueller, T. I., Lavori, P. W., Shea, M. T., et al. (2000). Multiple recurrences of major depressive disorder. American Journal of Psychiatry, 157, 229–233.

    Article  PubMed  CAS  Google Scholar 

  • Steer, R. A., Ball, R., Ranieri, W. F., & Beck, A. T. (1999). Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients. Journal of Clinical Psychology, 55, 117–128.

    Article  PubMed  CAS  Google Scholar 

  • Wang, C. E., Brennen, T., & Holte, A. (2005). Mechanisms of recurrent depression: A cognitive battle model and some preliminary results. Clinical Psychology & Psychotherapy, 12, 427–442.

    Article  Google Scholar 

  • Wang, C. E., Brennen, T., & Holte, A. (2006). Automatic and effortful processing of self-statements in depression. Cognitive Behaviour Therapy, 35, 117–124.

    Article  PubMed  CAS  Google Scholar 

  • Weissman, A. (1979). Dysfunctional attitudes scale: A validation study. Unpublished doctoral dissertation, University of Pennsylvania, Philadelphia.

  • Weissman, A. N., & Beck, A. T. (1978). Development and validation of the dysfunctional attitudes scale: A preliminary investigation. Toronto, Canada: Paper presented at the annual meeting of the Education Research Association.

    Google Scholar 

  • Young, J. E. (1990). Cognitive therapy for personality disorders. Sarasota, FL: Professional Resource Press.

    Google Scholar 

  • Young, J. E. (1999). Cognitive therapy for personality disorders: A schema-focused approach (rev. ed.). Sarasota, FL: Professional Resource Press.

    Google Scholar 

  • Young, J. E., & Brown, G. (1990). Young schema questionnaire. New York: Cognitive Therapy Centre of New York.

    Google Scholar 

  • Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. New York: The Guilford Press.

    Google Scholar 

  • Zuroff, D. C., Blatt, S. J., Sanislow, C. A., Bondi, C. M., & Pilkonis, P. A. (1999). Vulnerability to depression: Reexamining state dependence and relative stability. Journal of Abnormal Psychology, 108, 76–89.

    Article  PubMed  CAS  Google Scholar 

  • Zuroff, D. C., Igreja, I., & Mongrain, M. (1990). Dysfunctional attitudes, dependency, and self-criticism as predictors of depressive mood states: A 12-month longitudinal study. Cognitive Therapy and Research, 14, 315–326.

    Article  Google Scholar 

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Acknowledgments

The project has been supported by the Norwegian Research Council, the Norwegian Foundation for Health and Rehabilitation, the Norwegian Council for Mental Health, and the Psychiatric Research Centre of Northern Norway. The authors would like to thank Professor Mick Power for his valuable comments on the statistical analyses and on an early draft of the paper. We would also like to thank the anonymous reviewers for helpful suggestions that improved this paper. Last but not least, we would like to thank the participants and the research assistants who contributed to the data collection.

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Correspondence to Marianne Halvorsen.

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Halvorsen, M., Wang, C.E., Eisemann, M. et al. Dysfunctional Attitudes and Early Maladaptive Schemas as Predictors of Depression: A 9-Year Follow-Up Study. Cogn Ther Res 34, 368–379 (2010). https://doi.org/10.1007/s10608-009-9259-5

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