Remitted depression studies as tests of the cognitive vulnerability hypotheses of depression onset: A critique and conceptual analysis

Investigations of cognitive patterns among individuals who have recovered f rom a depressive episode (i.e., remitted depressives) have figured importan tly in evaluations of the validity of the vulnerability hypotheses of the c ognitive theories of depression. However, we suggest that remitted depressi on studies as typically conducted and interpreted are inadequate tests of t he cognitive vulnerability hypotheses of depression onset for four reasons: (1) remitted depression studies are based on the erroneous assumption that cognitive vulnerability should be an immutable trait; (2) remitted depress ion studies use a logically "backward" participant selection strategy in wh ich participants are selected on the basis of the "dependent" variable (dep ression) and then compared on the "independent" variable (cognitive vulnera bility), which is likely to result in heterogeneity of cognitive vulnerabil ity among both the remitted depressed as well as the nondepressed groups gi ven the causal relations specified in the cognitive theories of depression; (3) many remitted depression studies have ignored the possible activating role of stress in the cognitive vulnerability-stress theories, particularly Beck's theory, and thus, may attempt to assess cognitive vulnerability at a time when it is not operative (i.e., priming hypothesis); and (4) remitte d depression studies inappropriately use postmorbid participants to test ca usal hypotheses, and therefore, are ambiguous about whether negative cognit ive styles observed in remitted depressed persons are vulnerabilities as op posed to consequences of depression (i.e., scar hypothesis). As a remedy, w e advocate the use of a theory-guided behavioral high-risk strategy to more adequately test the cognitive vulnerability hypotheses of depression onset . (C) 2000 Elsevier Science Ltd.