Relaciones transaccionales longitudinales entre vulnerabilidades cognitivas, estrés y depresión en adolescentescomparación entre muestra clínica y comunitaria

Résumé

Depressive disorders are increasingly more widespread among adolescents, and some studies suggest that, by age 14, at least 9% of young people will have suffered a severe episode of depression. Therefore, this stage of evolution is a key point for its study (Abela & Hankin, 2008; Lewinsohn, Hops, Roberts, Seely, & Andrews, 1993; Padilla & Calvete, 2014). In addition, significant differences have been observed between men and women, which are accentuated with age, with women being more affected by depression over time. Numerous studies have pointed out that stress and cognitive vulnerabilities are key factors that predict the development of depression as of adolescence (for a review, see Abela & Hankin, 2011). Two such cognitive vulnerabilities are the ruminative response style (Nolen-Hoeksema, 1991) and dysfunctional cognitive schemas (Beck, Rush, Shaw, & Emery, 1979; Young, Klosko, & Weishaar, 2003) More recent models suggest that the relationships between cognitive vulnerabilities, stress, and depression are dynamic and bidirectional. For example, the transactional model of cognitive vulnerability to stress (Hankin & Abramson, 2001) and the cascade model (Masten et al., 2005) suggest that stress and negative cognitive styles increase the likelihood of experiencing depressive symptoms, and that once the levels of depression increase, these, in turn, increase the likelihood of new stressors and worsen the cognitive vulnerabilities. Thus, in recent years, phenomena like stress generation, or the prediction of new stressors from depression and cognitive styles (Hammen, 1991), or cognitive impairment from stress and depression (Calvete, Orue, & Hankin, 2013) are studied. The research of these models applied to the ruminative style and dysfunctional schemas is almost non-existent, so few studies have examined these mechanisms in a clinical sample of adolescents, a key aspect for understanding the development and maintenance of depression. This thesis is divided into four chapters. Chapter 1 defines the basic concepts addressed in this research: depression, stress, rumination (brooding and reflection), and early maladaptive schemas. A theoretical and current vision of the state of the issue and how it has been reached is provided. Chapter 1 also includes the objectives and hypotheses of each particular empirical study. Chapters 2-4 contain the three empirical studies of the thesis, in accordance with the objectives and hypotheses of the project. These studies have been published or accepted in various scientific journals, so that many of the concepts and theories are repeated several times throughout the thesis. Finally, the last chapter presents a general discussion and the main conclusions of the project as well as the clinical implications. To comply with the requirement of the international doctorate mention, several sections, such as two of the empirical studies, the summary, and general discussion are in English. The rest is in Spanish.