Shannon E. Daley

Toward an interpersonal life-stress model of depression: The developmental context of stress generation

The validity of a developmentally based life-stress model of depression was evaluated in 88 clinic-referred youngsters. The model focused on (a) the role of child-environment transactions, (b) the specificity of stress-psychopathology relations, and (c) the consideration of both episodic and chronic stress. Semistructured diagnostic and life-stress interviews were administered to youngsters and their parents. As predicted, in the total sample child depression was associated with interpersonal episodic and chronic stress, whereas externalizing disorder was associated with noninterpersonal episodic and chronic stress. However, the pattern of results differed somewhat in boys and girls. Youngsters with comorbid depression and externalizing disorder tended to experience the highest stress levels. Support was obtained for a stress-generation model of depression, wherein children precipitate stressful events and circumstances. In fact, stress that was in part dependent on childrens contribution distinguished best among diagnostic groups, whereas independent stress had little discriminative power. Results suggest that life-stress research may benefit from the application of transactional models of developmental psychopathology, which consider how children participate in the construction of stressful environments.

Poor interpersonal problem solving as a mechanism of stress generation in depression among adolescent women.

The authors examined C. Hammens (1991) model of stress generation in depression and the role of interpersonal problem-solving strategies (IPS) in the stress generation process in a longitudinal sample of 140 young women who entered the study at ages 17-18. Structural equation modeling was used to test a model in which IPS and subsequent interpersonal stress mediated the relationship between initial and later depressive symptoms. Results supported the main prediction of the stress generation model: Interpersonal stress mediated the relationship between initial and later depressive symptoms. In addition, IPS predicted interpersonal stress. However, no association was found between depressive symptoms and IPS. An alternative model in which IPS moderated the relationship between stress and depressive symptoms was tested; it was not supported.

Interpersonal attachment cognitions and prediction of symptomatic responses to interpersonal stress.

The authors tested a cognitive-interpersonal hypothesis of depression by examining the role of interpersonal cognitions in the prediction of depression associated with interpersonal stressors. A measure of adult attachment assessed interpersonal cognitions about ability to be close to others and to depend on others and anxiety about rejection and abandonment. Participants were women who had recently graduated from high school; they were followed for 1 year with extensive interview evaluation of life events, depression, and other symptomatology. Generally, cognitions, interpersonal events, and their interactions contributed to the prediction of interview-assessed depressive symptoms, but the effects were not specific to depression and predicted general symptomatology measured by diagnostic interviews as well, and results also varied by attachment subscale. Results were discussed in terms of a developmental psychopathology approach to disorders in young women.

Continuity of Depression During the Transition to Adulthood: A 5-Year Longitudinal Study of Young Women

OBJECTIVEnTo characterize the clinical course and psychosocial correlates of unipolar depression in late adolescent women and to examine the continuity in affective disturbance from adolescence to early adulthood during the post-high school transition.nnnMETHODnOne hundred fifty-five women aged 17 or 18 years were recruited from 3 local public high schools and were followed at yearly intervals for 5 years for clinical and psychosocial outcomes.nnnRESULTSnThe 5-year incidence of first major depressive episode was 36.9%, and overall, 47% of the women had one or more episodes of major depression. Risk for recurrence was substantial, and those with onsets prior to the study were more likely to have depressive episodes during the post-high school period. The presence of nonaffective disorder also increased the risk for depression. Young women with major depression during the post-high school transition had more negative functional outcomes in school and intimate romantic relationships.nnnCONCLUSIONSnThese results suggest that there is substantial continuity in affective disturbance from adolescence to adulthood. The risk for both new onset of depression and recurrence is remarkably high during late adolescence, and the risk continues throughout early adult years, accompanied by notable interpersonal dysfunction.

Relationship Between Depression and Substance Use Disorders in Adolescent Women During the Transition to Adulthood

OBJECTIVESnTo examine the continuity of substance use disorder (SUD) in adolescent women during the transition to adulthood and to assess psychosocial functioning associated with SUD. Furthermore, to examine concurrent and longitudinal relationships between major depressive disorder (MDD) and SUD during this developmental transition.nnnMETHODnOne hundred fifty-five women, aged 17 to 19 years, were recruited from 3 high schools and were followed annually for 5 years. Comprehensive diagnostic and psychosocial assessments were performed with standardized instruments. The primary outcome measures included MDD and SUD during follow-up in those with and without a prior history of MDD or SUD, and psychosocial functioning associated with SUD.nnnRESULTSnThe 5-year incidence of SUD was 9.6% and, by the end of follow-up, 18.7% had a lifetime episode. Prior SUD significantly increased the risk for SUD diagnosis during the study. Co-occurrence of MDD and SUD was high during adolescent and early adult years, with episodes of both disorders occurring in close temporal proximity. SUD also predicted MDD over time, but the reverse was not true. After controlling for the effects of MDD on social adjustment, SUD was associated with significant impairment in school functioning.nnnCONCLUSIONSnThese results suggest that the risk for new onset and recurrence of SUD is high during the developmental transition to adulthood. SUD during this developmental period is associated with significant school-related problems. The findings also suggest that SUD and MDD frequently co-occur during the post-high school transition in women. Given the significant psychosocial dysfunction associated with these illnesses, early detection of these problems and effective intervention are crucial.

Borderline Personality Disorder Symptoms as Predictors of 4-Year Romantic Relationship Dysfunction in Young Women Addressing Issues of Specificity

The relationships between romantic relationship dysfunction and symptoms of borderline personality disorder (BPD), other personality disorders, and depression were examined prospectively in a community sample of 142 late adolescent women. Although BPD symptoms predicted 4-year romantic dysfunction (romantic chronic stress, conflicts, partner satisfaction, abuse, and unwanted pregnancy), the associations were not unique to BPD. Instead, relationship dysfunction was better predicted by a cumulative index of non-BPD Axis II pathology. Depression did not predict outcomes uniquely when Axis II symptoms were included, except in the case of unplanned pregnancy. The results suggest that although BPD is associated with relationship dysfunction, the effect is a more general phenomenon applying rather broadly to Axis II pathology. The results also highlight the importance of subclinical psychopathology in the construction of early intimate relationships.

The relationship between attachment cognitions and psychological adjustment in late adolescent women

This longitudinal study of 137 female high school seniors investigated the relationship of attachment cognitions, current psychological functioning, and psychological functioning 12 months later. Attachment cognitions, assessed with the Revised Adult Attachment Scale and the Inventory of Parent and Peer Attachment, were significantly associated with current symptomatology. The Revised Adult Attachment Scale, in interaction with initial symptomatology, predicted depression, substance abuse, eating disorders, and personality disorders 12 months later. The Inventory of Parent and Peer Attachment parent subscales predicted eating disorder and personality disorder symptomatology, whereas the peer subscales predicted substance abuse, eating disorder, and personality disorder symptomatology.

Axis II symptomatology, depression, and life stress during the transition from adolescence to adulthood

This study examined 2 models of the relationship between personality disorder symptomatology and depression, incorporating life stress as an intervening variable. In a community sample of late adolescent women, symptoms of Cluster B disorders predicted interpersonal chronic stress and self-generated episodic stress over 2 years, controlling for initial depression. Cluster A symptoms also predicted subsequent chronic interpersonal stress, over initial depression. Cluster C pathology did not predict subsequent stress. Personality disorder symptomatology was also associated with partner-reported relationship dissatisfaction. Support was found for a mediation model whereby women with higher levels of initial personality disturbance in Clusters A and B generated excessive amounts of episodic stress and interpersonal chronic stress in the next 2 years, which, in turn, increased vulnerability for depressive symptoms. A moderation model, whereby the presence of greater personality disorder symptoms would increase the likelihood of depression in response to stress, was not supported.

Sociotropic and Autonomous Personality Styles: Contributions to Chronic Life Stress

Sociotropy and autonomy are personality styles that are believed to moderate the effects of stressors on depression. This study tested the hypothesis that these styles may actually contribute to the occurrence of chronic stress. Specifically, we tested whether the personality styles are associated with increased chronic stress in the domain of vulnerability or in the cross domain. In a longitudinal study of 115 young women followed over 18 months, results indicated that one facet of autonomy, need for control, is a risk factor for increases in chronic interpersonal stress. Sociotropy was a risk factor for increases in future chronic achievement stress when coupled with either poor problem solving or low levels of perceived interpersonal competence. These results are consistent with Hammens stress generation model, which emphasizes how individuals play a role in the creation of their own stress. Results also suggest that those with highly sociotropic or autonomous personality styles are more likely to create stress in the domain that they value less.

Attachment Cognitions Predict Perceived and Enacted Social Support during Late Adolescence.

This study examined the relationship between attachment cognitions and social support in a community sample of late-adolescent women. Participants were 129 women recruited as seniors from three Los Angeles high schools to take part in a 5-year longitudinal study of adolescent development. As predicted, attachment cognitions representing greater security in close relationships were found to be associated with higher levels of perceived and enacted social support. The study also found that differences between subjects reporting secure and insecure attachment cognitions were primarily in the domain of enacted emotional support, as opposed to two other types of enacted support, information and material aid. These findings are consistent with a basic principle of attachment theory: that internalized representations of attachment relationships continue to influence interpersonal functioning during adolescent and adult development.