Avoid Depressed and Cognitively Vulnerable People? They Could Be Contagious, Yikes!!

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“Using a natural experimental design with three time points, we found that:

  • when people change from a home context to a college context they are susceptible to the influence of the cognitive styles of those around them, even when the others are initially strangers
  • This effect was shown at both 3 and 6 months
  • and the results cannot be explained by a depression contagion effect or by increased stress.

Moreover, the contagion effect has depressive consequences.  Those who experienced an increase in cognitive vulnerability had increased risk for future depressive symptoms.”

Cognitive Vulnerability to Depression Can Be Contagious — April 16, 2013
Gerald J. Haeffel, Haggar Hall, University of Notre Dame, Notre Dame

Abstract
Cognitive vulnerability is a potent risk factor for depression. Individual differences in cognitive vulnerability solidify in early adolescence and remain stable throughout the life span. However, stability does not mean immutability. We hypothesized that cognitive vulnerability would be susceptible to change during major life transitions when social milieus undergo significant changes (e.g., moving to college). Specifically, we tested the hypothesis that cognitive vulnerability could change via a contagion effect. … Results supported the hypotheses. Participants who were randomly assigned to a roommate with high levels of cognitive vulnerability were likely to “catch” their roommate’s cognitive style and develop higher levels of cognitive vulnerability. Moreover, those who experienced an increase in cognitive vulnerability had significantly greater levels of depressive symptoms over the prospective interval than those who did not.

The cognitive theories of depression are among the most clearly articulated and well-supported models of depression. According to these theories, some individuals have a cognitive vulnerability that interacts with stress to produce depression. Specifically, people are vulnerable to depression because they have a tendency to generate interpretations of stressful life events (and dysphoric moods) that have negative implications for their future and for their self-worth.

Recent research has provided direct and compelling support for the cognitive vulnerability hypothesis. Prospective studies have consistently found that cognitive vulnerability interacts with stressful events to predict the development of depressive symptoms and depressive disordersThese studies have shown that it is possible to take a group of never depressed individuals and predict which of them are most likely to develop a first episode of clinically significant depression based solely on individual differences in their cognitive style for interpreting life events (i.e., their level of cognitive vulnerability). The cognitive model of depression is also supported by prevention and treatment studies. Interventions designed to modify cognitive vulnerabilities are among the most effective interventions available for depression. For example, cognitive therapy is as effective as medication and may even have a prophylactic effect.

Taken together, prior studies indicate that cognitive vulnerability is a potent risk factor for depression. Thus, it is critical to understand how one “acquires” a cognitive vulnerability. It is likely that a variety of factors (e.g., genetic, biological, and environmental) contribute to developing a cognitive vulnerability; however, many researchers have converged on the idea that early exposure to negative interpersonal contexts is a particularly influential antecedent. For example, both negative parenting practices (e.g., emotional abuse) and direct inferential feedback from significant others (e.g., teachers, peers, and parents) predict the development of cognitive vulnerability. Of importance, it appears that:

  • these early contexts do not take long to exert their influences on the development of cognitive vulnerability
  • By early adolescence it is possible to detect meaningful and stable individual differences in how individuals cognitively interpret stressful life events
  • Indeed, longitudinal and cross-sectional studies indicate that cognitive vulnerability can predict depression in children as young as 12 years of age
  • Once cognitive vulnerability forms and stabilizes in early adolescence, it confers risk for depression throughout the life span. Research shows that cognitive vulnerability exhibits moderate to high stability during high school, college, and the rest of adulthood.

These findings suggest that by early adulthood one is saddled (or blessed) with a level of cognitive risk that is relatively impervious to changes in environmental conditions.

Although highly stable, there may be unique environmental situations during which cognitive vulnerability can be altered. One situation is when it is directly targeted by a prevention or treatment intervention. Results of studies testing cognitive interventions for depression (e.g., cognitive therapy) demonstrate that cognitive vulnerability can indeed be changed….Results from these studies suggest that cognitive vulnerability is not completely resistant to change. However, targeted interventions such as cognitive therapy are the exception rather than the rule for most people. Thus, the question remains as to whether there are naturally occurring environmental conditions that can alter (either increase or decrease) this potent risk factor.

The purpose of this study was to test the hypothesis that cognitive vulnerability can change via a contagion effect….Specifically, we predicted that individuals would be influenced directly by the cognitive vulnerability levels of those around them (e.g., through direct inferential feedback or modeling). In other words, the level of cognitive vulnerability of those around a person might “rub off” and be contagious. Moreover, we hypothesized that contagion-induced changes in cognitive vulnerability would have implications for risk for future depressive symptoms.

We tested two primary hypotheses:

  1. First, we predicted that cognitive vulnerability to depression would be contagious between roommates
  2. Second, we predicted that changes in cognitive vulnerability would lead to changes in risk for future depressive symptoms.

As expected due to random assignment, there was no association between roommates’ levels of cognitive vulnerability at baseline

Results — Cognitive vulnerability to depression is contagious

….the results supported our main hypothesis that cognitive vulnerability would be contagious between college roommates…a person’s future level of cognitive vulnerability was significantly affected by his or her roommate’s baseline level of cognitive vulnerability (and vice versa)….

Specifically, individuals who were randomly assigned to a roommate with high initial levels of cognitive vulnerability experienced increases in their own level of cognitive vulnerability over time, whereas those who were assigned to a roommate with low initial levels of cognitive vulnerability experienced decreases in their levels of cognitive vulnerability.

Discussion

The results of the study support the hypothesis that cognitive vulnerability to depression can be contagious. We found that participants’ level of cognitive vulnerability was significantly influenced by their roommates’ level of cognitive vulnerability and vice versa.

Participants who were randomly assigned to a roommate with high levels of cognitive vulnerability (specifically a ruminative response style) were likely to “catch” their roommate’s cognitive style and develop higher levels of cognitive vulnerability over the prospective interval. This contagion effect was detectable after only 3 months of cohabitation. It is important to emphasize that these results cannot be explained by participants’ and roommates’ levels of depressive symptoms or by the occurrence of stressful life events (neither roommates’ level of depressive symptoms nor their level of stress was a significant predictor of changes in cognitive vulnerability). Not only was cognitive vulnerability contagious, but changes in vulnerability affected risk for future depressive symptoms. Participants who experienced an increase in cognitive vulnerability levels during the first 3 months of college had nearly twice the level of depressive symptoms at 6 months than did participants who did not experience an increase in cognitive vulnerability, particularly under conditions of high stress.

To date, there has been little reason to view cognitive vulnerability as anything other than highly stable, akin to a genetic diathesis. However, the results of this study indicate that it may be time to rethink how cognitive vulnerability is conceptualized. Our study demonstrates that cognitive vulnerability has the potential to wax and wane over time depending on the social context. This means that cognitive vulnerability should be thought of as plastic rather than immutable.

Our findings are consistent with a growing number of studies that have found that many psychological and biological factors previously thought to be “set in stone” by adulthood continue to be malleable. For example, it was assumed for nearly a century that the central nervous system became structurally stable in early childhood and that the brain was not capable of generating new neurons in adulthood. …

This naturalistic experimental enabled us to make definitive conclusions about the presence of a contagion effect and rule out alternative explanations such as a self-selection bias, in which participants choose their own social context.

….We suspect that as a person’s social media network changes over time, so will his or her levels of cognitive vulnerability. Preliminary research has already demonstrated the potential power of social networks in creating contagion effects. For example, scientists have found social media networks to exhibit contagion-like effects for mood, smoking habits, and even obesity.  A recent study of reciprocal-reply networks on Twitter found that happiness appears to be contagious up to three degrees away from the user. These results add to a growing number of studies that suggest that psychological constructs can be contagious within social media networks and that the effects are not merely due to homophily (Christakis & Fowler, 2013).

…It is important to note that the rumination vulnerability factor was less stable over time (and more likely to be contagious) than the hopelessness theory vulnerability factor….These results are consistent with a study by Hankin (2008), which showed that the hopelessness theory cognitive vulnerability factor was highly stable over time, whereas the rumination vulnerability factor exhibited more moderate stability.

One explanation for why the two vulnerabilities exhibit different temporal stabilities is that they focus on different cognitive attributes. The hopelessness theory vulnerability factor focuses on cognitive content (i.e., the particular types of interpretations that people generate about stress), whereas response styles theory focuses on the process by which people respond to negative moods (i.e., brooding vs. distraction). We suspect that cognitive processes might be more amenable to change than cognitive content. For example, learning a new process such as distraction (e.g., playing a sport rather than brooding) in response to a negative mood seems more readily attainable for someone to learn than altering his or her cognitive content, which is likely part of a well-organized latent schematic structure…

In conclusion, the goal of this study was to establish the presence of the contagion phenomenon for cognitive vulnerability to depression. Although it is difficult to fathom the idea of people suddenly “catching” a different style of interpreting their world, the current study demonstrates that people’s cognitive vulnerability can affect the cognitive vulnerability of those around them, at least when people are going through relatively large-scale changes in their interpersonal environment. Using a natural experimental design with three time points, we found that when people change from a home context to a college context they are susceptible to the influence of the cognitive styles of those around them, even when the others are initially strangers. This effect was shown at both 3 and 6 months…and the results cannot be explained by a depression contagion effect or by increased stress. Moreover, the contagion effect has depressive consequences. Those who experienced an increase in cognitive vulnerability had increased risk for future depressive symptoms.

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