Childhood Adversity, Attributional Style, and Cognitive Schemas As Predictors of the Spanish Version of the State-Trait Depression Questionnaire Score

Background and purpose: Major depressive disorder (MDD) is one of the leading causes of disability and one of the most prevalent mental disorders worldwide (WHO, 2017). Multidimensional models have been proposed to explain the development of the disorder, including aspects such as environmental factors, biological determinants, and cognitive processes. Beck and Bredemeier (2016) argue that beliefs, embedded in schemas, influence information processing leading to the onset of severe depression. As well, childhood abuse or maltreatment has consistently demonstrated the increased risk of developing depression. Considering that childhood maltreatment may influence the perception and appraisal of events increasing vulnerability to the development of MDD, this study aims to examine the effects of childhood adversity, attributional style, and schemas over the resulting score of the Spanish version of the State Trait Depression Questionnaire (IDER). IDER is designed to evaluate the affective components of depression, in terms of both the occurrence or frequency (trait) and intensity at the moment of the evaluation (state) (Spielberger ,Carretero, De los Santos-Roig, & Buela-Casal, 2001).

Methods: The study sample comprised 342 adults, 171 cases were recruited through a screening procedure from two psychiatric hospitals in Bogotá (Colombia), and 171 healthy controls recruited through a screening procedure from the general population. A 3-stage hierarchical linear regression analysis was performed. Variables that may explain a high score in the IDER were entered in 3 steps including sex and age as covariables. In step 1, childhood adversity was included. In step 2, attributional style was added, and in step 3 schemas where incorporated.

Results: The results of step 1 indicated that the variance accounted for childhood adversity was equal to 15% F_(3,341)=29,89, p<0,01. In step 2, when attributional style was added, the variance increased to 44% F_(6,341)=46,10, p<0,01 and the change in variance (ΔR²) equal to 0,29, which was significantly different from zero (p<0,01). Finally, in step 3, when schemas are included to the model, the variance increased to 73% F_(11,341)=75,49, p<0,00 and the delta of variance equal to 0,28 which was also statistically significant (p<0,01). Finally, a power analysis was calculated a posteriori using GPower3 (Faul, Erdfelder, Buchner, & Lang, 2009), the results yield a more than adequate observed power (β=1.00) for the third model.

Conclusions and implications: The results from this study support the theoretical model that highlights the role of childhood adversity and cognitive processes in the development of depression in a Colombian sample. Limitations from this trial concern the difficulty to obtain unbiased evidence of schemas and beliefs given that they are considered to remain latent until activated. Further studies may evaluate separately the trait and state scales of the IDER to assess the relationship of the predictor variable to each resulting score and design studies to determine their predictive power of cognitions, evaluating the cognitive process through priming procedures. However, our study adds to the literature on MDD by supporting the theory of multidimensional factors interacting to increase the chances of developing depression.