Cognitive risk factors for the recurrence of depression

This dissertation focuses on three factors, possibly contributing to the recurrrent nature of major depressive disorder; negative self-associations, cognitive reactivity and attentional bias. Negative self-associations (measured on implicit as well as on explicit level) showed a positive relation between the number of depressive episodes and the duration of depressive symptoms. These results are consistent with the hypothesis that negative self-associations are strengthened by longer activation of negative self-associations during depressive episodes. Remitted participants with more depressive episodes in their history reported significant higher cognitive reactivity (CR) than participants with a single or none depressive episode in their history. These findings are consistent with the hypothesis that higher CR makes participants more vulnerable for recurrence into a next depressive episode and seems less relevant for the development of a single depressive episode. Findings from a first study do not support the idea that attentional bias (AB) towards negative or away from positive stimuli is of critical importance for depressive participants. Possibly the relative high AB for negative information in the group remitted participants can be involved as a risk factor for recurrence. A higher chance on recurrence turned out neither to be associated with AB towards negative stimuli nor for positive stimuli. Thus, these findings do not support the hypothesis that AB towards negative or away from positive stimuli plays a role of importance in the process of recurrence into a next depressive episode.

Dissertation: http://hdl.handle.net/11370/67e9e2a5-baee-4174-a356-d192c8c42160