Gerald I. Metalsky

Hopelessness depression: A theory-based subtype of depression

Summary and Future Directions On the basis of the aforementioned studies, the hopelessnesstheory appears promising. However, further research is needed.For example, although powerful tests of the attributional diath-esis-stress component have been conducted, no one has exam-ined the cognitive diatheses of inferring negative consequencesor characteristics about the self or whether the cognitive stylediathesis-stress interaction predicts clinically significant de-pression. Moreover, it is crucial to determine if this interactionpredicts the development of the hypothesized symptoms ofhopelessness depression. More generally, an important short-coming of the prior work is that it has not focused on the symp-toms of hopelessness depression in particular and, instead, sim-ply has examined the symptoms of depression in general. Fu-ture investigators need to test more fine-grained predictionsabout the hypothesized symptoms of hopelessness depression.The issue of the stability of the cognitive diatheses has not beenresolved satisfactorily. We have only begun, in a preliminaryway, to investigate the issues of specific vulnerability and media-tional processes. Finally, further tests of the predictions aboutcourse, cure, and prevention are needed. We eagerly await thisresearch.Difficult methodological issues may arise in the search forhopelessness depression, however. For example, the hopeless-ness theory is silent about the time lag between formation ofhopelessness and onset of the symptoms of hopelessness depres-sion. If it is very short, then a major challenge will be to developmethods with sufficient temporal resolving power to determineif hopelessness indeed precedes the occurrence of the hypothe-sized symptoms of hopelessness depression (see Alloy, Hartlage,et al., 1988, for proposed methods for testing the hopelessnesstheory). The results of work to test the hopelessness theory willdetermine if the concept of hopelessness depression needs tobe revised. For example, perhaps the statement of the causalpathway is correc t bu culminate n a differen se f symp-toms than those currently hypothesized to compose hopeless-ness depression. In this case, the symptom—but not thecause—component of the hopelessness theory would need to bemodified.In discussing how to search for hopelessness depression, wenote the possibility that future work may not corroborate theexistence of hopelessness depression as a bona fide subtype withcharacteristic cause, symptoms, course, treatment, and preven-tion. Instead, the etiological chain featured in the hopelessnesstheory may be one of many pathways to a final common out-come of depression. In this case, it would be more compellingto speak of a hopelessness cause, as opposed to a hopelessnesssubtype, of depression.

The attributional Style Questionnaire

Of current interest are the causal attributions offered by depressives for the good and bad events in their lives. One important attributional account of depression is the reformulated learned helplessness model, which proposes that depressive symptoms are associated with an attributional style in which uncontrollable bad events are attributed to internal (versus external), stable (versus unstable), and global (versus specific) causes. We describe the Attributional Style Questionnaire, which measures individual differences in the use of these attributional dimensions. We report means, reliabilities, intercorrelations, and test-retest stabilities for a sample of 130 undergraduates. Evidence for the questionnaires validity is discussed. The Attributional Style Questionnaire promises to be a reliable and valid instrument.

Vulnerability to depressive symptomatology: a prospective test of the diathesis-stress and causal mediation components of the hopelessness theory of depression.

The diathesis-stress and causal mediation components of the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989) were tested using a prospective methodology. Measures of the 3 vulnerability factors posited by the theory (cognitive diatheses about cause, consequences, and self) were completed by 152 Ss at Time (T) 1. Ss completed measures of depressive symptoms, anxious symptoms, and hopelessness at Tl and again at T2, 5 weeks later. Naturally occurring stressors were assessed at T2 (covering the T1-T2 interval). Consistent with the diathesis-stress component, each Cognitive Diathesis X Stress (CD X S) interaction predicted onset of depressive symptoms from Tl to T2. In contrast, the CD X S interactions predicted neither state nor trait anxiety. In addition, 2 of the 3 CD X S interactions (those involving cause and self, but not consequences) were partially mediated by hopelessness. Implications for future work on the hopelessness theory of depression are discussed. Abramson, Metalsky, and Alloy (1989) recently proposed a revision of the reformulated helplessness theory of depression (Abramson, Seligman, & Teasdale, 1978). They referred to the revision as the hopelessness theory of depression because (a) hopelessness is viewed as a proximal sufficient cause of the symptoms of the depressive subtype proposed in the theory (hopelessness depression), and (b) hopelessness is viewed as a final common pathway for all of the remaining causes in the theory; thus, attributional styles and other proposed etiological factors are posited to contribute to depressive symptoms through the operation of hopelessness. Hopelessness is defined as an expectation that highly desired outcomes will not occur or that highly aversive outcomes will occur and that nothing is going to change this situation for the better. One purpose of the present study was to test the diathesisstress component of the hopelessness theory. This component specifies three vulnerability factors (cognitive diatheses), each of which is posited to interact with negative life events in contributing to the onset of depressive symptoms. The first vulnerability factor includes a style to attribute negative life events to stable and global causes (see Metalsky, Abramson, Seligman, Semmel, & Peterson, 1982, for an early conceptualization of attributional style in a diathesis-stress framework). We refer to this factor as the attributional diathesis (Metalsky, Halberstadt, & Abramson, 1987; Metalsky, Joiner, Hardin, & Abramson, in

The Hopelessness Depression Symptom Questionnaire

Evaluated the Hopelessness Depression Symptom Questionnaire (HDSQ; Metalsky & Joiner, 1991). The HDSQ is a 32-item self-report measure of eight symptoms posited by L. Abramson, G. Metalsky, and L. Alloy (1989) to comprise a specific subtype of depression—hopelessness depression. Factor analytic results from 435 subjects suggested that: (a) Each of the eight subscales of the HDSQ reflects a distinct symptom of hopelessness depression; and (b) The eight subscales, taken together, reflect one higher-order construct—Hopelessness Depression Symptoms. Diathesis-stress results from a subset of 174 subjects indicated that the attributional diathesis × stress interaction predicted onset of hopelessness depression symptoms on the HDSQ but not nonhopelessness depression symptoms. The HDSQ should allow for enhanced precision in tests of the hopelessness theory of depression.

Excessive Reassurance Seeking: Delineating a Risk Factor Involved in the Development of Depressive Symptoms

Six studies investigated (a) the construct validity of reassurance seeking and (b) reassurance seeking as a specific vulnerability factor for depressive symptoms. Studies 1 and 2 demonstrated that reassurance seeking is a reasonably cohesive, replicable, and valid construct, discernible from related interpersonal variables. Study 3 demonstrated that reassurance seeking displayed diagnostic specificity to depression, whereas other interpersonal variables did not, in a sample of clinically diagnosed participants. Study 4 prospectively assessed a group of initially symptom-free participants, and showed that those who developed future depressive symptoms (as compared with those who remained symptom-free) obtained elevated reassurance-seeking scores at baseline, when all participants were symptom-free, but did not obtain elevated scores on other interpersonal variables. Studies 5 and 6 indicate that reassurance seeking predicts future depressive reactions to stress. Taken together, the six studies support the construct validity of reassurance seeking, as well as its potential role as a specific vulnerability factor for depression.

Measuring cognitive vulnerability to depression: Development and validation of the cognitive style questionnaire

The Cognitive Style Questionnaire (CSQ) measures the cognitive vulnerability factor featured in the hopelessness theory of depression. The CSQ has been used in over 30 published studies since its inception, yet detailed information about the psychometric and validity properties of this instrument has yet to be published. In this article, we describe the development of the CSQ and review reliability and validity evidence. Findings to date using college samples, indicate that the CSQ is a reliable measure of cognitive vulnerability with a high degree of construct validity.

The Children's Attributional Style Interview: developmental tests of cognitive diathesis-stress theories of depression.

This paper presents an initial assessment of the Childrens Attributional Style Interview (CASI), a newly designed measure for assessing attributional style in young children (age 5 and up). The CASI was used to conduct prospective tests of the reformulated helplessness (L. Y. Abramson, M. Seligman, & J. Teasdale, 1978) and the integrated hopelessness/self-esteem (G. I. Metalsky, T. E. Joiner, Jr., T. S. Hardin, & L. Y. Abramson, 1993) theories of depression in a sample of 147 5–10-year-old children. For comparison, the same tests were also conducted with the Childrens Attributional Style Questionnaire-Revised (CASQ-R; N. J. Kaslow & S. Nolen-Hoeksema, 1991), a commonly used measure for assessing attributional style in older children (age 8 and up). The CASI evidenced support of the reformulated helplessness theory and partial support of the integrated hopelessness/self-esteem theory. The CASI also demonstrated good internal consistency. Thus, our findings provide initial support for the CASI as a methodologically sound measure of attributional style for children as young as 5 years old. Although preliminary, our findings also suggest possible developmental differences in how attributional style interacts with self-esteem and negative life stress. The CASI should prove to be a useful tool in furthering the understanding of the origins and development of attributional style in childhood, as well as its contribution to the understanding of the development and prevention of depressive symptomatology in children.

A test of the tripartite model's prediction of anhedonia's specificity to depression: patients with major depression versus patients with schizophrenia.

The tripartite model of depression and anxiety suggests that anhedonia represents a relatively specific marker of depression. A strong version of this view is that anhedonic symptoms would particularly characterize depressed patients, even when compared to another diagnostic group-schizophrenic patients-for whom anhedonic symptoms represent a well-studied feature. This prediction was tested among 102 VA psychiatric inpatients (95 men), ages 21-72 (M=43.56; S.D.=8.47), all of whom received diagnoses of either major depression (n=50) or schizophrenia (n=52) based on structured diagnostic interviews. As predicted, patients with major depression scored significantly higher on the anhedonic symptoms scale of the Beck Depression Inventory (BDI) than did patients with schizophrenia. However, there was no difference between the two groups on the BDI total score or the BDI non-anhedonic symptoms score. Consistent with the tripartite model, anhedonic symptoms were more related to depressive vs. schizophrenic diagnostic status, whereas non-anhedonic depressive symptoms were not. Within the studys limitations, results were interpreted as relatively strong support for the validity and extension of the tripartite model.

Testing the Causal Mediation Component of Beck's Theory of Depression: Evidence for Specific Mediation

Psychopathology researchers are increasinglyconcerned with the diagnostic and symptom specificity oftheir findings, yet the specificity of the mechanismsthrough which hypothesized vulnerability factors culminate in symptoms has received littleattention. The present study examines this issue withregard to Becks theory of depression. Using a midtermmethodology, 119 undergraduates completed questionnaires on dysfunctional attitudes, depressive andanxious cognitions, and depressive symptoms before andafter their midterm examinations. Consistent withprediction, students who were high in dysfunctionalattitudes experienced increases in depressive symptoms,but only if they also received a low midterm exam grade.Students high in dysfunctional attitudes who receivedhigh grades did not experience symptom increases, similar to students low in dysfunctionalattitudes. Quite importantly, the DysfunctionalAttitudes X Midterm Outcome interaction contributed todepressive symptoms through the operation of depressivecognitions, but not through the operation of anxiouscognitions.

Cognitive Vulnerability to Depression and Lifetime History of Axis I Psychopathology: A Comparison of Negative Cognitive Styles (CSQ) and Dysfunctional Attitudes (DAS)

The goal of this study was to “unpack” the “generic” cognitive vulnerability employed in the retrospective behavioral high-risk design of Alloy and colleagues (2000), one of the major publications emanating from the Cognitive Vulnerability to Depression (CAD) Project to date. To this end, we used a retrospective behavioral high-risk design with a new sample of unselected undergraduates and examined the unique association between lifetime history of clinically significant depression as well as other Axis I disorders (e.g., anxiety disorders, substance abuse disorders) and both dysfunctional attitudes (DAS, featured in Beck’s theory) and negative cognitive styles (CSQ, featured in hopelessness theory). We present results supporting the cognitive vulnerability factor featured in the hopelessness theory and the construct validity of the CSQ. Negative cognitive styles were more strongly and consistently associated with lifetime history of Research Diagnostic Criteria (RDC) major depression and hopelessness depression than were dysfunctional attitudes. These results suggest that negative cognitive styles, as assessed by the CSQ, were a potent component of the “generic” cognitive vulnerability effect in Alloy and associates’ (2000) retrospective behavioral high-risk design. Interestingly, negative cognitive styles also were significantly associated with a participant having had a past RDC anxiety diagnosis. Thus, consistent with past research, our results suggest that negative cognitive styles and dysfunctional attitudes are distinct constructs as measured by the CSQ and DAS, respectively. Of further interest, gender differences in depression were obtained with college women in our study exhibiting significantly greater lifetime history of RDC major depression than college men.