Clinical Psychology -- Depression Research

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Clinical psychology depression research of Undergraduate Honors Students in the Psychological Sciences at Vanderbilt University.

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Relations among Measures of Theory of Mind in Depressed Adolescents Receiving Cognitive Behavior Therapy
(Vanderbilt University, 2025-04-23) Isabella Dietrich; Dr. Judy Garber
Adolescent depression is associated with cognitive and social impairments, including deficits in Theory of Mind (ToM) — the ability to infer others' thoughts and emotions. Cognitive Behavior Therapy (CBT) is a generally effective treatment although further improvements can be made. This study examined the associations among measures of ToM in depressed adolescents and tested whether integrating social cognitive training (CBT+SCT) into CBT enhanced treatment outcomes compared to CBT alone. Forty-five depressed adolescents (ages 12-17) were randomly assigned to CBT+SCT or CBT-only. ToM was assessed using four measures: Faux Pas Recognition Test, Strange Stories, Flexibility and Automaticity of Social Cognition (FASC), and Reading the Mind in the Eyes (RME) tests. Results showed that at baseline, the RME task correlated significantly with FASC Mental State Response Time. Results of the regression analyses showed that CBT+SCT produced significantly greater improvements in ToM particularly in recognizing social faux pas. These effects were strongest in adolescents with lower baseline ToM scores, suggesting that social cognitive training may enhance CBT effectiveness for those with significant ToM deficits. Findings highlight the need for individualized treatment approaches that account for individuals’ levels of social cognitive development. Future research should explore the long-term effects of ToM training on depression and interpersonal functioning.
Associations among Depression, Rumination, and Mindfulness in Adolescents
(Vanderbilt University, 2024-03-27)
We examined the associations among mindfulness, rumination, and depression, and between trait and state mindfulness in an at-risk adolescent sample. In addition, we tested the effect of an internet-based mindfulness intervention on depressive symptoms and rumination. Participants were 110 adolescents between 12- to 17-years-old (Mean = 14.73, S.D. = 1.65). The sample was 68% female and 55% White. At both pre- and post-intervention, we measured rumination, trait mindfulness, and depressive symptoms using self-report questionnaires and state mindfulness using Ecological Momentary Assessment (EMA). Using Pearson correlations, we found significant correlations among mindfulness, rumination, and depression, and between state and trait mindfulness. Multiple regression analyses revealed no significant main effects of Condition (intervention vs. control) on rumination, depression, or state mindfulness. Furthermore, baseline trait mindfulness did not moderate the effect of Condition on rumination, depression, or state mindfulness. Midpoint trait mindfulness did not mediate the effect of Condition on rumination or depression. Future research concerning mindfulness interventions for at-risk adolescents should use a larger sample. In addition, there is a need to further examine the components of a mindfulness intervention that may produce benefits for adolescents.
Investigating the Relationship Between Childhood Depressive Symptoms and Prosocial Behavior with Guilt and Anhedonia as Moderating Factors
(Vanderbilt University, 2024-04-12) Ashar, Devisi
Prosocial behavior is defined as any voluntary social behavior performed to benefit others. While many studies have found that prosocial behavior protects against depressive symptoms and negative emotions, few have examined what variables may moderate the relationship between depressive symptoms and prosocial behavior. Guilt and anhedonia, two symptoms common in depressive disorders, may be especially relevant to prosocial behaviors, with guilt possibly leading to greater prosocial behaviors and anhedonia leading to less prosocial behaviors. However, the moderating effects of guilt and anhedonia have not yet been tested. The purpose of the current study is to investigate the relationship between childhood depressive symptoms and prosocial behavior, while examining guilt and anhedonia as moderating factors. We hypothesize that that greater levels of anhedonia will be associated with less prosocial behavior and greater symptoms of guilt will predict greater prosocial behavior in the relationship between depression and prosocial behavior. Using the Adolescent Brain Cognitive Development (ABCD) Study dataset of over 11,000 children, we analyzed these factors and found that anhedonia moderates the relationship between depression and prosocial behavior while guilt does not. Specifically, lower levels of anhedonia showed a more pronounced decline in prosociality as depression increased. These results have major implications for recognizing and treating childhood depressive symptomatology and disorders. PI: Dr. Antonia Kaczkurkin, PSY 4999
Neurophysiological Responses To Pleasant Emotional Images: An Examination Of The Effects of Personal Preference And A Brief Positive Emotion-Focused Intervention
(Vanderbilt University, 2023-03-22)
The positive valence system (PVS) is a domain associated with attention to, and engagement with, rewarding activities. Individual differences in neurological responses associated with the PVS, such as the amplitude of the late positive potential (LPP), may indicate potential risks for the development or presence of internalizing symptomatology. Recent research has found that positive affect interventions can help individuals attend more to positive events; however, these interventions effects on neurological responses has yet to be studied. The present study examined differences in neural activation in relation to positive stimuli following a brief promoting positive emotions (BPPE) intervention to test its efficacy in modulating PVS functioning. EEG data was collected from a sample of 27 undergraduate students to examine associations between the LPP and categories of positively valanced emotional images, rankings of image categories by personal preferences, and intervention effects. Participants completed a battery of questionnaires, and then were randomly assigned to either the BPPE intervention or a study skills group for comparison. The BPPE group was taught to recount, savor, visualize, and plan for positive experiences while the control group learned study skills tools. EEG data was recorded while participants passively viewed positive images. Responses based on participant preferences for each category of stimuli were analyzed. We found that there was a significant difference between positively valanced images and neutral images. Significant differences were also found between participant preference rankings and neutral images, however, not in the expected direction. No significant intervention effects were found. Future studies should examine within-person effects of the intervention, as well as the efficacy of a longer positive affect intervention over multiple sessions to determine if the LPP can be modulated over time.
The Effects of a Brief Promoting Positive Emotions Intervention and Depression Symptoms on Reward Responsiveness in Young Adults
(Vanderbilt University, 2023-03) Boldwyn, Emma
Relations Among Parental Depression, Parents' and Chrildrens' Reports about Parenting, and Observed Parenting Behavior
(Vanderbilt University, 2022) Wallace, Breeann
Parental depression is associated with a range of difficulties in parenting behaviors such as low levels of warmth and low positive involvement and high levels of criticism and control. The literature has shown, however, that reports of parenting behaviors vary by informant. The current study examined congruence on parent and child reports of parental warmth and psychological control, the association between parents’ and children’s reports of parenting and observational ratings of parent-child interactions, the extent to which parents’ depression moderated these associations. The sample consisted of 243 parent-child dyads. All parents had a history of a depressive disorder during their child’s life. Children were ages 9 to 15 (Meanage = 11.12; SD = 2.38; 53% female) (parents’ Meanage = 42.78, SD = 6.41; 90% female). Parents and children’s depressive symptoms were assessed with self-report measures (Patient Health Questionnaire, and the Center for Epidemiological Studies of Depression, respectively). Parents and children completed a measure of parenting behaviors using the Child Report of Parent Behavior Inventory (CRPBI), which measured parental warmth and psychological control. Parents and youth also participated in a ten-minute laboratory interaction task during which they discussed an emotion arousing situation. Findings indicated that higher levels of parental depression were significantly associated with fewer positive behaviors but not more negative behaviors during a brief laboratory interaction with their child. Parents’ and children’s reports of parental warmth and psychological control were significantly correlated with each other. The association between parent-reported psychological control and observed parent angry coercion was strongest at higher levels of depressive symptoms in parents. Children’s reports about parenting were significantly associated with observers’ ratings of parenting, thus providing further evidence of the validity of each method of assessing parenting behaviors
Parental Conflict and Neural Response to Social Reward as Predictors of Response to Cognitive Behavioral Therapy for Depressed Adolescents
(Vanderbilt University, 2022-03-28) Herman, Nicole
Depression is a prevalent disorder among adolescents, with evidence that rates have been increasing over the past 10 years. Cognitive behavioral therapy (CBT) is a leading evidence- based treatment option, but it is not effective for all depressed adolescents, raising questions about who benefits the most. Past research has separately identified low social support and an enhanced reward positivity (RewP) event-related potential (ERP) component to be predictive of decreased responsivity to treatment; however, these factors have not been examined within the same study. This study followed 70 adolescents with depression (14-18 years old) across 16 sessions of group CBT. Baseline parental conflict and RewP in an EEG social reward task were examined as predictors of clinician-rated improvement across treatment. Results showed that while both maternal and paternal conflict were predictive of lower clinician-rated improvement within treatment, only paternal-child conflict was significant when accounting for baseline depression and anxiety symptoms. Additionally, the association between RewP and parental conflict was not significant. Future research is needed to identify various interventions that would increase the efficacy of CBT for individuals who are less likely to succeed in treatment. The results indicate that it may be helpful for clinicians to assess parental-child conflict at the beginning of treatment to determine whether the patient is likely to respond to CBT and to administer individualized interventions accordingly. This thesis was created in conjunction with the Honors Program for Psychological Sciences (PSY-PC 4998, Honors Thesis) and the Mood, Emotion, and Development Lab led by Dr. Autumn Kujawa.
Associations of Parental Emotions and Behaviors with Changes in Child Emotions During Face-to-Face Interactions
(Vanderbilt University, 2021-03-29) Redic, Margaret
Objectives. Parenting is a significant factor in the development of depression during adolescence. However, little research has specifically studied the association of expressed parental emotion during parent-child interactions on later expressed child emotion. The current study investigated the relationship between parent and child observed emotion—more specifically, how parents’ expressed emotion in one task may be associated with children’s expressed emotion in a subsequent task. Methods. Parents with a history of depression (N = 242, M age = 41.72) and their children (M age = 11.53) participated in two interaction tasks—one conversation about a recent pleasant activity and one about a recent stressful experience for the family. Observed emotions including sadness, hostility, and positive mood in parents and children in these video-recorded interactions were measured using a macro-level coding system. Parent observed emotion scores in the stressful task were used to predict changes in child observed emotion scores in the stressful task, controlling for child observed emotion scores in the prior, pleasant task. Results. Parent sadness was positively correlated with child sadness and negatively correlated with child hostility in the second task. Parent sadness accounted for changes in child sadness and hostility in task 2, parent hostility accounted for changes in child hostility in task 2, and parent positive mood accounted for changes in child positive mood in task 2, even after accounting for levels of child respective emotions in the prior task and the parent BDI-II score. Conclusions. Parent and child emotions are significantly related and parents’ emotions may contribute to changes in children’s emotions. Analyzing changes in child emotions from moment-to-moment, interaction-to-interaction may provide insight into healthy parenting strategies, and, more specifically, the significant influence of parental emotions and behaviors on their children.
Does Trait Mindfulness Moderate the Effect of Stress on Executive Control?
(Vanderbilt University, 2020-04-20) Beard, Cameron
Stress can impair one’s ability to effectively problem solve and think critically. This study tested the extent to which trait mindfulness moderated the relation between stress and executive control (EC). Participants were 112 college students (Meanage = 19; SD = 1.1) participating in research for credit. At the first session (Time 1), we assessed trait level mindfulness, current depressive symptoms, and EC using an emotional n-back task. At the second session, a week later, we assessed EC again following a stress induction task. Participants were randomized to either a high or low stress condition. Finally, participants again completed the measure of depressive symptoms at the follow-up assessment conducted during the week of finals. We hypothesized that higher levels of mindfulness would predict better performance on the post-stress EC task and lower levels of depressive symptoms at follow-up. Results indicated, however, that trait mindfulness did not predict performance on the EC task or follow-up depression scores. Limitations of the study, particularly the small sample size, are discussed.
Examining Rumination and Neurophysiological Measures of Emotional Reactivity and Regulation in Depressed Adolescents
(Vanderbilt University, 2020-03-25) Kekes-Szabo, Sophia
The goal of the current study is to investigate the neural mechanisms and time course of emotion and associations with individual differences in rumination in a sample of depressed adolescents. Rumination is the repetitive and focused attention on one’s distress and involves the inability to produce effective solutions to one’s problems, and this negative thought process may prolong or worsen depressive symptoms. The effects of rumination on neural processing of emotionally salient stimuli can be examined using electrophysiological measures. In this study, 55 depressed adolescents completed an emotion regulation task during which they were asked to observe 25 sad and 25 neutral images. Participants were instructed to either react as they normally would or reduce their emotional response to the pictures while electroencephalogram (EEG) data was recorded. The late positive potential (LPP), which reflects sustained attention to stimuli, was measured in order to understand how and when individuals allocate their attention to negative stimuli. Results showed that higher levels of depressive rumination correlated with reduced LPPs during reappraisal for both middle (1000-3500ms) and late (3500-6000ms) time windows. Reactivity indexed by the LPP was higher in both reappraise and look conditions compared to the neutral condition. Additionally, the difference for the reappraise condition compared to the look condition was trending significant in the expected direction, where LPP magnitude was relatively decreased during reappraisal compared to passive viewing of the images. Such insight into these stages of emotion processing may help target interventions in reducing ruminative thought processes in certain subgroups of depressed populations.
Theory of Mind, Depressive Symptoms, and Social Competence in Youth
(Vanderbilt University, 2018) Green, Haley; Garber, Judy
The goal of the current study was to investigate the relations among depressive symptoms, theory of mind, and social functioning in children. Participants were 98 children ages 8- through 15-years-old (mean age = 10.89 years, SD = 1.91). Children completed the Center for Epidemiological Studies Scale for Children (CES-DC), interview measures of theory of mind including the Strange Stories and the Faux Pas Stories task and the Flexibility and Automaticity of Social Cognition task (FASC). Parents (65 mothers and 3 fathers) completed the CES-DC about their child’s depressive symptoms, the Children’s Social Understanding Scale (CSUS), which measures their child’s theory of mind (ToM), and the Social Skills Subscale of the Social Skills Improvement System (SSIS) regarding their child’s social competence. Significant associations were found between children’s depressive symptoms (CES-DC) and their use of FASC mental state terms (-0.256, p = .012), parents’ report of children’s depressive symptoms (P-CES-DC) and social competence (SSIS), r(69) = -.504, p = .000, and parent reports of children’s ToM (CSUS) and social competence, r(69) = .529, p = .000. Although correlations among the relevant variables were significant, mediation analyses did not show a significant indirect effect of parents report of child ToM (CSUS) on the relation between parent reports of children’s depressive symptoms (P-CES-DC) and social competence (SSIS) (bootstrap 95% confidence interval for indirect effect of ToM = [-.0583, .0552]). Limitations of the current study and suggestions for future research, as well as implications for treatment of depression in children, are discussed.
The Family Group Depression Prevention Program: Assessment of Fidelity
(Vanderbilt University, 2017-05-11) Freilich, Colin; Garber, Judy; Compas, Bruce
Fidelity to the intervention manual for a family-based, group cognitive-behavioral depression prevention program for children of depressed parents was examined. Fidelity was measured with regard to adherence and competence. The Family Depression Program was delivered as designed across sites, cohorts, and group leaders regarding both adherence and competence. Parental depression symptoms at baseline and the presence of a second group leader were significant predictors of adherence. A second group leader also predicted higher competence. Higher levels of fidelity did not predict greater reductions in depressive symptoms, controlling for baseline symptoms.
Respiratory Sinus Arrhythmia Levels and Fluctuation in Children of Depressed versus Nondepressed Mothers
(Vanderbilt University, 2015-04) Curhan, Alexa; Garber, Judy
Previous research has demonstrated that offspring of depressed mothers are at increased risk for developing dysfunctional affect regulation, which is a risk factor for the onset of depression and other psychopathology. One way in which depression may be transmitted from mothers to their children is through dysfunctional neuroregulatory mechanisms, especially those related to affect regulation. Respiratory Sinus Arrhythmia (RSA) has been shown to be related to affect regulation, and RSA level and fluctuation index an individual’s autonomic flexibility. The present study investigated whether there were differences in RSA level and fluctuation in offspring of depressed and nondepressed mothers, as well as how RSA levels related to affect. The study consisted of 92 mother-child dyads (37 mothers with a history of depression and 55 nondepressed mothers). Mothers and children completed questionnaires, and RSA data were obtained from children while they watched brief video clips (neutral, negative, and positive). RSA levels or fluctuation did not differ significantly between children of depressed and nondepressed mothers, and RSA levels did not significantly predict children’s affect during the mood induction videos. Exploratory analyses revealed a nonsignificant, trend for child sex and mother’s level of depression symptoms to predict RSA during the mood induction videos. Limitations of the current study and directions for future research are discussed.
Positive and Negative Affect in Children of Depressed vs. Nondepressed Mothers
(Vanderbilt University, 2015-04-16) Yu, Qiongru; Garber, Judy
Children of depressed mothers are at a higher risk of developing depression in their lifetime compared to children of nondepressed mothers. Based on the tripartite model of depression and anxiety, low positive affect is the core symptom of depression. The current study examined the affect pattern of children of depressed and nondepressed mothers in general and in response to stimuli. Participants were 92 children (ages 8 to 10, mean=9.39, SD=.83; 55.4% female) and their mothers. Thirty-seven children were offspring of mothers with a history of depression during the child’s lifetime (high risk), and 55 were offspring of mothers without a depression history (low risk). The Positive Affect and Negative Affect Schedule was used to measure trait and state positive and negative affect; the Smiley Face Mood Rating was used to measure children’s affect after exposure to audio and visual stimuli that were neutral, negative, and positive. Results indicated that maternal depression history predicts low positive affect trait, and high positive parenting predicts high positive affect. Sex difference was found in the reactivity to mood induction stimuli, in a way that girls respond more positive to positive stimulus and more negative to negative stimulus than boys.
Peer Victimization and Its Adverse Effects on Self-Schema in Children and Adolescents
(Vanderbilt University, 2013-04-19) McMillan, Jessica; Cole, David A.
Our current study builds on Beck’s cognitive model of depression by testing whether peer victimization gives rise to depressive schemas in children and adolescents. Specifically, we created a model stating that chronic peer victimization affects the construction of self-cognitions and adds negative information to the content of self-schema, in turn predisposing for depression. Stemming from a larger 2-year, 3-wave longitudinal study, our experimental study yielded a sample of elementary and middle children who were either chronically peer victimized (n = 110) or those who were not (n = 105). Using self-reports and a self-referent encoding task, this study yielded four major findings: (1) all forms of chronic peer victimization were positively associated with students’ self-reported negative self-cognitions, (2) all forms of peer victimization were negatively related to students’ self-reported positive self-cognitions, (3) relational and verbal peer victimization were related to a decrease in or eradication of the positive memorial bias, and (4) the association between peer victimization and some indicators of depressive self-schemas was stronger for relational and verbal peer victimization than for physical peer victimization. Clinical implications and future research are also elaborated upon in this study.
The Role of Childhood Trauma in Bipolar Disorder
(Vanderbilt University, 2012-04-10) Clinton, Sarah; Saylor, Megan
The relationship between childhood trauma and Bipolar Disorder was investigated by analyzing Childhood Trauma Questionnaires of participants with Type I or Type II BD. Due to the small sample size, data were not found to support hypotheses that higher levels of childhood trauma are correlated with a higher incidence of BD Type I or psychotic features, or that there were sex differences within childhood trauma exposure that correlated with sex differences in the presentation of BD Type I versus Type II. Results show a strong statistically significant relationship between minimalization/denial subscores and total CTQ scores, which indicates the possibility that some BD patients who denied experiencing childhood trauma may minimalize the effect possible trauma played in their development of BD.
Relation between parent and child depression: Sex, age, pubertal status, and parent-child conflict as moderators
(Vanderbilt University, 2010-04-06) Borgschulte, Claire E; Frankel, Sarah Anne; Garber, Judy
Children of depressed parents are at increased risk for developing depression themselves. Children’s sex, age, pubertal development, and parent-child conflict all have been shown to be related to depressive symptoms in children. The current study examined the relation between parental depression and children’s depressive symptoms, and explored possible moderators including children’s sex, age, pubertal development, and parent-child conflict. Participants were 227 parent-child dyads; of these, 129 parents were in treatment for depression (high risk); the remaining 98 parents were lifetime free of depression (low risk). Linear regression analyses revealed that high-risk children reported significantly higher levels of depressive symptoms than low-risk children. Sex significantly moderated the relation between risk and children’s depressive symptoms, such that high-risk girls reported higher levels of depressive symptoms than low-risk girls. Pubertal development also was a significant moderator, whereas age was not. More advanced pubertal development was associated with higher depressive symptoms in the high-risk group, but not in the low risk group. Finally, the relation between risk and children’s depressive symptoms also was moderated by parent-child conflict; the relation between parent and child depression was stronger in high as compared to low conflict dyads. Thus, children of depressed parents who were female, more advanced pubertally, or had greater parent-child conflict may be at increased risk for depression and therefore should be targeted for intervention
Caretaking Behaviors and Stress Reactivity in Adolescents of Depressed Parents
(Vanderbilt University, 2011-05-02) Hudson, Kelsey; Smith, Craig (Craig Alexander)
The mechanisms of stress responses “fight or flight” and “tend and befriend” were used to define the stress response to parental depression. In a sample of 180 families of parents with a history of major depressive disorder, observed and reported caretaking behaviors and levels of stress-reactivity were examined. The association of children’s emotional and instrumental caretaking behaviors with levels of physiological and emotional stress response will be identified.
Correlates and Predictors of Recurrent Depression
(Vanderbilt University, 2011-04-18) Fox, Kathryn R; Smith, Craig (Craig Alexander)
Depression is a recurrent and debilitating disorder affecting nearly 340 million people worldwide. The present study examined what differentiates individuals with a history of one or more major depressive episodes (MDEs) from individuals who have never been depressed as well as examine which of these differentiating factors predict subsequent depressive symptoms during a six-month follow-up. Participants were 108 young adults, ages 18-30 years old. No participant was in a current MDE at time one; 56 individuals had a history of one or more MDE and 46 had no history of psychiatric diagnoses. Those with a history of depression had higher rates of physical abuse in childhood, maladaptive coping styles, and stressors than the never-depressed controls. At the follow-up, number of stressors, dysfunctional attitudes, maladaptive coping, and some forms of early childhood maltreatment interacting with stress predicted depressive symptoms.
Effects of Victimization on Depression: How Children Respond to Being Bullied
(Vanderbilt University, 2011-02-06) Cordel, Stephanie, L.; Cole, David A.
Many victimized children suffer negative psychological outcomes as a result of being bullied. One prominent consequence is that of depression. In a cross-sectional study about childhood victimization and depression among elementary school students (N=421), children completed a free response survey regarding how he or she would respond to relational, physical and verbal victimization respectively as well as a depression inventory and self report of victimization history. Two categorization systems (RSQ and CRTB) classified the responses to see whether certain responses moderated the effect of depression for a particular set of children. Results suggest that certain responses to victimization scenarios moderate the relation between victimization history and depression.

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