Effortful control, repetitive negative thinking and depression in adolescence
Baker, Erika Claire
Date: 11 May 2018
University of Exeter
Doctor of Clinical Psychology
LITERATURE REVIEW: A systematic review of the associations between effortful control, repetitive negative thinking and depression in adolescence. ABSTRACT: Background: Repetitive negative thinking (RNT) and the self-regulatory temperament, effortful control (EC), have been found to be important risk factors for the development of ...
LITERATURE REVIEW: A systematic review of the associations between effortful control, repetitive negative thinking and depression in adolescence. ABSTRACT: Background: Repetitive negative thinking (RNT) and the self-regulatory temperament, effortful control (EC), have been found to be important risk factors for the development of depressive symptoms. Furthermore, adolescence has been found to be a period of increased risk for developing depressive symptoms. The relationships between these risk pathways are not well understood during this period of development. Objective: This systematic review aimed to evaluate the literature exploring the relationships RNT and EC have in accounting for depressive symptoms in adolescents. In particular, whether RNT and EC are associated with depressive symptoms, and whether EC moderates the effects of RNT on depressive symptoms. Methods: Three databases and key journals were searched for studies measuring EC, RNT and depressive symptoms in 10-20 year olds. Study selection was undertaken by applying inclusion and exclusion criteria. The methodological quality of the included studies was assessed using a validated checklist. Inter-rater reliability was calculated for a random subsample of the search. Results: Thirteen studies were selected for inclusion. There was evidence indicating that RNT was correlated with depressive symptoms both concurrently and prospectively. The evidence for a relationship between lower EC and higher levels of depressive symptoms was mixed. High quality studies concluded that EC and depressive symptoms are associated concurrently, but not over time. There is evidence that lower EC predicts RNT over time, and even spanning over childhood. Some evidence was found for EC as a moderator between RNT and depressive symptoms and this was also found when the relationship was prospective. Conclusions: Whilst the reviewed literature had many strengths, there were large differences in how EC in particular, was measured. This resulted in a challenge synthesising the results and making clear conclusions. Future research would benefit from considering self-report and behavioural measures, and recognising the potential impact of stressful life events. EMPIRICAL PAPER: Investigating associations between repetitive negative thinking, stress, and effortful control, and the development and maintenance of depression in adolescence: A follow-up study. ABSTRACT: Background: Adolescence is a period of increased vulnerability for depressive symptoms (Twenge & Nolen-Hoeksema, 2002). Given the impact of emotional disorders on an individual, it is important to understand risk factors, and conversely, protective factors to inform effective interventions. Repetitive negative thinking (RNT) and the self-regulatory temperament, effortful control (EC), have been found to be important risk factors for the development of depressive symptoms and require further exploration in adolescence. Objective: This study investigated whether RNT predicted changes in later depressive symptoms, and if so, whether this change was moderated by EC. The study examined these associations during emotional reactivity to a stressor (exams), and emotional recovery following the stressor. Methods: Two samples with similar designs and measures were combined in this study. Two-hundred-and-fifty-five females completed Baseline questionnaires measuring life events, RNT, EC, and depressive symptoms. One-hundred-and-ninety-nine participants were followed up prior to their exams (Pre-exam), and 115 participants were followed up after their exams (Post-exam). Results: The study first examined emotional reactivity to stress, finding that contrary to the literature, RNT did not predict depressive symptoms in response to stress, when controlling for Baseline depressive symptoms. EC did not significantly interact with RNT in predicting depressive symptoms. However, RNT was associated with emotional recovery from stress: RNT predicted levels of depressive symptoms following exams, when controlling for Pre-exam depressive symptoms. Furthermore, EC moderated this relationship, however contrary to the literature and predictions, this was not in the expected direction, with high levels of EC associated with high levels of depressive symptoms. Conclusions: These findings suggest that despite the strengths of the study design, including a large sample at Baseline and follow up over a period of stress, hypothesized associations were not found during emotional reactivity to stress, but hypothesized associations were found during emotional recovery from stress. Recommendations are made for future studies, including recruiting sufficient number of males to the study.
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