OVERVIEW

This study investigates whether it is the number of life stresses or the way in which a person perceives stress and perceives life (cognition), that induces depression.

BACKGROUND

Most attempts to understand depression in adolescents have centered on the effects of stress in their lives and their response to it. Depression was believed to be a response to overwhelming stress. Studies of depression have found a relationship between life stress, cognitive distortion, and depression (Michael and Funabiki, 1985). Cognition is the perception and understanding of reality. Cognitive distortion then is misperception or filtering of reality. These studies, however, focused on college-age subjects—not on high school age, where, according to the authors, stressors are quantitatively different. In addition, previous studies have not conclusively measured whether stress causes cognitive distortions or whether the cognitive distortions preexist, causing stress to be perceived as more severe than it actually is. Nor have studies found whether faulty cognition enables stress to engender depression. This study was thus created to measure three hypotheses:

• Cognitive distortions are more closely related to depressive tendencies than the amount of stress a subject has experienced.
• Cognitive distortions are related more to how stressful a subject perceives a situation than the number of stressful events the person has experienced.
• There is a relationship between different types of distorted thinking, but that tests measuring the frequency of negative thinking are more closely associated with depressive tendencies than those measuring irrational beliefs and dysfunctional attitudes.

DESIGN

This study was conducted by administering tests to 103 ninth through twelfth grade students during one class period. Each test measured either stress or a different way in which reality is distorted. The tests were as follows:

• The Youth Adaption Rating Scale (YARS), which measured three aspects of life stress: the number of stressful events experienced (YARS-C), the amount of life stress experienced (YARS-P), and how stressful the subject perceives common experiences (YARS-R). The YARS was created by having adolescents list events that they considered to be stressful and by having a second group of adolescents rate the severity of stress caused by each event.
• The Automatic Thoughts Questionnaire (ATQ), which measured the frequency of negative self-talk (also called negative self-relevant thoughts). Questions on this test asked such things as, "No one understands me," "I do not think I can go on," and "There must be something wrong with me," and asks subjects to rate how often they had these thoughts in the past week.
• The Barnes-Vulcano Rationality Test (BVRT), which measured irrational beliefs. A sample question, which students rated on a five-point scale from "agree strongly" to "disagree strongly," included "people have little or no ability to control the things that make them sad or to get rid of bad feelings."
• The Dysfunctional Attitude Scale (DAS), which used a five-point scale similar to the BVRT, and asked subjects to rate 35 attitude statements such as, "I must be a useful, productive, creative person or life has no purpose." This test, as the name infers, measured the prevalence of dysfunctional thinking.
• The Beck Depression Inventory (BDI), which is the most widely used and accepted test for identifying depression.

FINDINGS

• Personally experienced stress (YARS-P) correlated significantly with the number of stressful life events a person had experienced.
• The weighted measures of personal stress—that is, personally experienced stress (YARS-P)—correlated significantly with how stressful a subject perceived an event.
• The number of stressful events experienced (YARS-C) was not significantly correlated with how stressful subjects perceived life events. The perception of stress then is not directly related to experience with stress.
• The three measurements of cognitive distortion were significantly correlated, meaning that negative self-talk, irrational beliefs, and dysfunctional attitudes are all affected by a similar component.
• Negative thoughts (ATQ) correlated most significantly with each measure of stress, though irrational beliefs (BVRT) did correlate with personal experience of stress (YARS-P).
• The measure of personal stress (YARS-P) emerged as the stress measure that correlated most with the three measures of cognitive distortion and depressive tendencies and measured by BDI scores.
• All three measures of cognitive distortion correlated highly with depressive tendencies (BDI). Negative self-talk as measured by the ATQ showed the most correlation and emerged as the best predictor of depression.

CONCLUSIONS

The findings of this study are consistent with the hypothesis. Cognitive distortions may mediate between stress and depression and that these distortions are better predictors of depressive tendencies than the experience of stress. Negative self-relevant thoughts, as measured by the ATQ, are the best indicators of depressive tendencies in a person. Irrational beliefs and dysfunctional thinking are progressively less predictive. A statistical analysis showed that once cognitive distortions are considered in predicting depressive tendencies, measurements of stress contribute little.

The second hypothesis is also supported by the study. Cognitive distortion is more closely associated with the perceived stress of an event than is the number of stressful events personally experienced. This suggests that cognitive patterns are more related to the perception of stress than is the actual experience of stress. It also suggests that the experience of stress does not lead a person to view all events as stressful. Rather, faulty cognitive patterns and the tendency to distort cognitively does.

Regarding the third hypothesis, it was found that all three measures of cognitive distortion are significantly related, suggesting that they all tap into a single dimension. The measure of irrational beliefs correlates most strongly with the measure of negative self-talk and the measure of dysfunctional attitudes correlates most strongly with irrational beliefs. After negative thinking is considered, the measure of irrational thoughts makes an additional contribution to predicting depressive tendencies. This suggests to the authors that more stable constructs, such as beliefs, contribute to the understanding of depression.

Overall, the ATQ emerged as the strongest predictor of depressive tendencies. This suggests to the authors that immediate cognitions, such as negative self-talk, are more related to the degree of depression than an individual’s beliefs and attitudes.

IMPLICATIONS

• A depressed adolescent will not see the world as we do, because their cognition is skewed. This calls for compassion on our part. Trite answers implying that their view is wrong and needs correction will have little effect.
• The outcome of depression is not so bleak, but as caring professionals we must understand that for the depressed individual, the world really is as bleak and as hopeless as it appears. We can come alongside the depressed teen and offer an alternative view, but this will take time and we cannot expect instant results. Their very way of perceiving the world is biased and will take time and counseling to change. But we can be patiently caring and compassionate.
• An adolescent with a faulty cognitive pattern (often from a dysfunctional home, i.e., addictive, ACOA, or divorced, or a person with a patchwork self) will view common events as much more stressful than a person whose cognition is intact. For those who lead small group discussions, this means that a challenge that may not seem very stressful to us or most teens may cause incredible stress in the depressive person. Again, this calls for compassion and understanding. Help the depressive person view these events in a new light, and understand that the situation appears far more stressful to them.
• Because depression is related more to cognitive patterns and how stress is handled than to the actual experience or quantity of stressors, people have different "depression thresholds." An event or series of events (stressors) which have no effect on one person may be beyond the depression threshold of another and initiate depression in him or her. The old ideal that "I could handle it, so can you" does not work in these situations.
• As caring professionals, understand that each person is unique: what one person may be able to handle, another may not because their cognition is biased, and they have fewer resources to deal with the stressor. We can, however, work with them, or refer them to someone who can help them to view the world in a more balanced way.