Cognitive triad: Relationship to depressive symptoms, parents' cognitive triad, and perceived parental messages

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Evaluating the relationship between children's depressogenic thinking, children's depressive symptoms, parents' depressogenic thinking, and perceived parental messages about the self, world, and future was the primary objective of this
  Journal of Abnormal Child Psychology, Vol. 24, No. 5, 1996 Cognitive Triad: Relationship to Depressive Symptoms, Parents' Cognitive Triad, and Perceived Parental Messages Kevin D. Stark, 1,3 Kristen L. Schmidt, 1 and Thomas E. Joiner, Jr. 2 Evaluating the relationship between children s depressogenic thinking, children s depressive symptoms, parents depressogenic thinking, and perceived parental messages about the self world, and future was the primary objective of this investigation. Children (n = 133) from grades 4 to 7 completed measures of depression and anxiety, including a semistructured clinical interview, a measure of their cognitive triad, and a measure of perceived parental messages about the self, world, and future. Mothers (n = 112) and fathers (n = 95) completed a measure of their own cognitive triad. Results of a series of regression analyses revealed that (1) children s views of self world, and future (cognitive triad) are related to severity of depression; (2) mothers but not fathers cognitive triads are related to their children s cognitive triads; (3) perceived parental messages to the children about the self world, and future are predictive of the children s cognitive triads and ratings of depression; and (4) the relationship between perceived parental messages and depression is completely mediated by children s cognitive triads. Analyses of covariance indicated that the obtained mediational relationship between children s views of self, world, and future, perceived parental messages, and children s depressive symptoms was specific to depressive versus anxious symptomatology. Implications for existing theory and research are discussed. Research has progressed from documenting the existence and expression of depressive disorders during childhood (e.g., Poznanski, 1982), to identi- Manuscript received in final form August 9, 1995 1Department of Educational Psychology, University of Texas, Austin, Texas 78712. 2Division of Child and Adolescent Psychiatry, University of Texas Medical Branch, Galveston, Texas 77555. 3Address all correspondence, including reprint requests, to Kevin D. Stark, Ph.D., Department of Educational Psychology, University of Texas, Education Building 504, Austin, Texas 78712-1296. 615 0091-0627/96/1000-0615509.50/0 © 1996 Plenum Publishing Corporation  616 Stark, Schmidt, and Joiner fying significant factors in its development (e.g., Miller, Birnbaum, & Dur- bin, 1990), and to building empirically based models (e.g., Stark, Hum- phrey, Laurent, Livingston, & Christopher, 1993). Stark, Rouse, and Livingston (1991) have proposed a multidimensional model of childhood depression that emphasizes the reciprocal relationship of cognitive, behav- ioral, family, and biochemical variables. Initial research designed to evalu- ate this model indicates that disturbances are evident in the cognitive, behavioral, and family domains, although cognitive disturbances, especially the child's view of the self, world, and future (the depressive cognitive triad, Beck, 1967) appear to be of central importance (Stark et al., 1993). Research indicates that disturbances in cognition are associated with depressive disorders during childhood. Depressed youths are reported to possess a negative self-schema (Zupan, Hammen, & Jaenicke, 1987), a negative view of the world (Kaslow, Stark, Printz, Livingston, and Tsai, 1992), and negative expectations for the future (e.g., Kazdin, Rodgers, & Colbus, 1986). These disturbances are associated with negatively biased in- formation processing (e.g., Haley, Fine, Marriage, Moretti, & Freeman, 1985) and appear to produce a distortion in information processing (Ken- dall, Stark, & Adam, 1990). Furthermore, in line with the content specificity hypothesis (Beck, 1967), the cognitive disturbance associated with depres- sion in children may be different from the disturbance associated with anxi- ety disorders (Laurent & Stark, 1993). This distinction is particularly important because of the overlap between anxiety and depression (Watson & Kendall, 1989). While evidence has accumulated which suggests that a disturbance in cognition is associated with depressive disorders, the mecha- nisms underlying the development of the cognitive disturbances have not been delineated. Garber and Kashani (1991) hypothesized that children's attributional styles, expectations, schematic processing, and values are learned during interactions with significant others through processes such as direct com- munication, modeling, and reinforcement. Beck (Beck, Rush, Shaw, & Em- ery, 1979) as well as others (e.g., Freeman, 1986) believe that depressive schemata, which drive information processing, are formed through early learning experiences, especially those within the family. Young (1991) hy- pothesized that maladaptive schemata could be the result of inadequate parenting or ongoing aversive experiences within the family milieu such as repeated criticism or rejection. Thus, a number of authors have hypothe- sized that significant others, especially family members, play an important role in the development of adaptive and maladaptive cognitive processes. Early research that explored the possible link between the family and children's cognitive processes examined the relationship between children's and parents' attributional styles. Results of these studies were equivocal.  Perceived Parental Messages 617 A pair of investigations found a significant relationship between mothers' attributional style for negative events and those of their 8 to 13-year-old children (Seligman & Peterson, 1986; Seligman et al., 1984) while this re- lationship was not evident in another study (Kaslow, Rehm, Pollock, & Siegel, 1988). Additional research has evaluated the relationship between distur- bances in child-parent interactions and depressogenic cognitive processes. Consistent with theoretical predictions (Beck, 1967; Freeman, 1986; Stark et al., 1993), maladaptive communications between parent and child have been implicated in the development of depressogenic cognitive processes. Jaenicke et al. (1987) found mothers' self-critical statements were unrelated to their children's self-criticism; however, a significant relationship was found between mothers' verbal criticism of their children and their chil- dren's tendency to make self-blaming attributions for negative events. Radke-Yarrow, Belmont, Nottelmann, and Bottomly (1990) reported that mothers' negatively toned comments contribute to children's development of a negative self-schema. Together, these findings suggest that negative verbal communications or messages from parents to children are related to the development of children's maladaptive information processing. The present study was designed to evaluate the relationship between a negative view of the self, the world, and the future (depressive cognitive triad) and depression in children, and to evaluate the relationships between the children's view of the self, the world, and the future, and perceived parental messages, and the parents' views of self, world, and future. We hypothesized the following: (1) Parents' views of self, world, and future would predict (a) the children's perceptions of the messages that they re- ceive from their parents about the child him or herself, the world, and the future; and (b) children's views of self, world, and future. (2) Children's perceptions of their parents' verbal messages to them would predict their own view of self, world, and future. (3) Children's views of self, world, and future would predict children's depression. (4) Children's view of self, world, and future would mediate the relationship between perceived pa- rental messages and children's depression. METHOD Subjects Subjects were 133 children from Grades 4(n = 34), 5(n = 32), 6(n = 38), and 7(n = 29) including 35 boys and 98 girls. Children ranged in age from 9.5 to 14.75 years old (X = 11.66). Children were predominantly An-  618 Stark, Schmidt, and Joiner glo (82 ) with 10 Hispanic, 6 African American, and 2 of mixed racial heritage. The majority of children (95 ) were enrolled in regular education courses, 4 were classified as learning disabled, and 1 as se- riously emotionally disturbed. All of these youngsters were mainstreamed into regular education classrooms. Children lived in the following family structures: both biological parents (n = 56); mother and ~tepfather (n = 41); mother (n = 22); father (n = 4); father and stepmother (n = 6); other (n = 4). Children exhibited a broad range of depressive and anxious sympto- matology as assessed with the Schedule for Affective Disorders and Schizo- phrenia for School-Age Children (K-SADS; Puig-Antich & Ryan, 1986) Depression (M = 90.69, S = 31.04), and Anxiety scales (M = 78.74, S = 20.81). A number of children received iagnostic Statistical Manual of Mental isorders (3rd ed., rev.) (DSM-III-R; American Psychiatric Asso- ciation, 1987) diagnoses based on their responses to the K-SADS (see Table I). Table II contains the means and standard deviations for all of the meas- ures completed by the children and their parents. Table I. Diagnoses of Children with a Depressive, Anxious, or Comorbid Depressive Anxiety Disorder Diagnosis n Depression (14) Major depression 2 Dysthymic disorder 5 Depressive disorder not otherwise specified 7 Anxiety (11) Overanxious disorder 1 Anxiety disorder not otherwise specified 10 Depressed and anxious (18) Major depression, overanxious disorder 3 Major depression, overanxious disorder, separation anxiety 2 Dysthymic disorder, overanxious disorder, separation anxiety 1 Dysthymic disorder, generalized anxiety 1 Dysthymic disorder, generalized anxiety, separation anxiety 1 Dysthymic disorder, overanxious disorder 1 Dysthymic disorder, separation anxiety 1 Overanxious disorder, separation anxiety, depressive disorder not otherwise specified 3 Depressive disorder not otherwise specified, anxiety disorder not otherwise secified 2 Depressive disorder not otherwise specified, separation anxiety 2 Overanxious disorder, depressive disorder not otherwise specified 1  Perceived Parental Messages Table II. Means and Standard Deviations of Measures Completed by Children and Their Mothers and Fathers 619 Rater/measure a n m SD Children 133 K-SADS Depression 77.79 25.76 CTI-C Self 16.82 5.09 CTI-C World 16.09 4.07 CTI-C Future 17.37 5.00 CTI-C Total 50.28 12.85 SRMFF-C Relationship D'n 27.71 6.14 SRMFF-C Value D'n 15.01 4.41 SRMFF-C Systems Maintenance D'n 16.58 4.03 Family Messages--Mother 58.87 10.02 Family Messages--Father 58.26 11.01 Mothers 112 CTI Self 67.10 10.00 CTI World 62.30 9.76 CTI Future 64.48 9.36 CTI Total 197.88 26.49 Fathers 95 CTI Self 68.29 7.61 CTI World 62.17 9.31 TCTI Future 69.18 8.32 CTI Total 199.64 22.26 aK-SADS = Schedule for Affective Disorders and Schizophrenia for School-Age Children; CTI-C -- Cognitive Triad Inventory for Children. Instrumentation Measures Completed by Children. The Children's Depression Inventory (CDI; Kovacs, 1981) is the most commonly used self-report measure of depression for children 7 to 17 years old. The CDI consists of 27 items which assess the presence and severity of overt symptoms of depression over the previous 2 weeks. High internal consistency and test-retest reli- ability and acceptable convergent validity are reported. However, it has not demonstrated adequate discriminant validity (e.g., Saylor, Finch, Spirito, & Bennett, 1984). The Revised Children's Manifest Anxiety Scale (RCMAS; Reynolds & Richmond, 1985) is a 37-item self-report measure which assesses the presence and severity of anxiety in youngsters from 6 to 19 years old. The RCMAS is reported to have high internal consistency and adequate test- retest reliability (Reynolds & Richmond, 1985).
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