Cognitive vulnerability-stress theories of depression: Examining affective specificity in the prediction of depression versus anxiety in three prospective studies

Abstract

Anxiety and depression overlap extensively at the level of symptoms and disorder. We tested the etiological factors from two cognitive vulnerability-stress models of depression (Hopelessness theory and Beck's theory) for specificity in predicting depression compared with anxiety. Multiple symptom measures of anxiety and depression with good discriminant validity, diagnoses of anxiety and depression, cognitive vulnerability (negative cognitive style and dysfunctional attitudes), and negative events were assessed in three prospective studies: one with a short-term (5-weeks) follow-up, the second with a long-term (2-years) follow-up, and the third with an academic midterm design. Results show that negative events were a general risk factor for anxiety and depression. Cognitive vulnerability for depression interacted with negative events to predict future depression specifically but not anxiety. Comparison of the two theories suggests that their cognitive vulnerability-stress components overlap largely in the prediction of depression. Implications for the co-occurrence of anxiety and depression as well as for the cognitive vulnerability-stress theories of depression are discussed.