Objective: Cognitive Reactivity (CR) is the (re-)activation of negative cognitions by dysphoric mood. We examined whether CR predicts depressive episodes across 2 and 9 years, beyond subclinical depressive symptoms, neuroticism, and previous depressive episodes.
Methods: Participants (N = 1,734) from the Netherlands Study of Depression and Anxiety (NESDA) were never-depressed or remitted-depressed for ≥1 month prior to baseline. We examined 2-year and 9-year predictions using Cox's survival analysis and logistic regression, respectively. Two-year coefficient-based weight-points were calculated and evaluated using ROC analysis.
Results: CR was a statistically-significant predictor of two-year depressive episodes, with an odds ratio of 1.04, 95% CI (1.02-1.06), and over nine years, with an adjusted hazard ratio of 1.01, 95% CI (1.01-1.02). The influence of CR and subclinical depressive symptoms decreased as the number of episodes increased, especially in ≥ 3 past episodes. Calculated weight-points correctly predicted 33.5% of participants who developed 2-year depression, compared to a 17.8% base rate (sensitivity = .81, specificity = .66).
Conclusions: CR is a moderately strong predictor of depressive episodes across 2 and 9 years. In participants with ≥ 3 prior episodes, depression history is such a strong predictor that a ceiling effect occurs, removing any added value of other predictors.
Keywords: cognitive vulnerability; depression onset; longitudinal study; recurrent depression; risk factors.
CR is a moderately strong, independent predictor of first (onset) and second (relapse) depressive episodes across 2- and 9-years;After three past depressive episodes, personal history of depression is stronger than CR as a predictor of future depressive episodes, although the effect is so strong that no other factor added value, suggesting a ceiling effect;The 2-year risk for depression relapse is higher than 70%, with higher risks for women than men;Our findings confirm the importance of early treatment and relapse prevention in clinical treatment for patients with a depression history.