Rosenblatt, Atara. Coping responses in anxious and depressed youth: the mediating role of rumination and cognitive reappraisal in CBT treatment effects. Retrieved from https://doi.org/doi:10.7282/t3-tjpv-hc23
DescriptionIneffective coping responses are strongly related to the development of anxiety and depression in youth (Betis, et al 2016). A more nuanced understanding of the differences in cognitive coping between anxious and depressed youth is important in order to improve efficacy of existing treatments and improve future treatment development. The literature points to a specific link between rumination and depression in youth, and a specific link between the use of cognitive reappraisal and anxious youth. This study aims to confirm these differences in cognitive coping styles. Furthermore, a small amount of research thus far has established treatment mediators and mechanisms of change in CBT for anxious and depressed youth (Prins and Ollendick, 2003). However, several studies have found cognitive change to mediate CBT treatment success in anxious and depressed youth. This study will look to 1) Confirm differences in cognitive coping between anxious and depressed youth; specifically, the unique relationship between rumination and depression and cognitive reappraisal and anxiety 2) Establish rumination as a mediator of CBT treatment success in depressed youth and changes in cognitive reappraisal as a mediator of CBT treatment success in anxious youth. Participants include 239 youth between the ages of 6-17 who received cognitive behavioral therapy to treat a primary DSM-IV diagnosis of Depression or Anxiety. A series of Analyses of Covariance (ANCOVA) was conducted to assess between group differences (anxiety/depression) in rumination and cognitive reappraisal while covarying for sex and age of youth at pre-treatment. Additionally, a series of moderated mediation analyses were used to assess for the roles of rumination and cognitive reappraisal in the respective change processes. Differences in rumination and cognitive reappraisal between anxious and depressed youth, were mostly non-significant. Rumination was found to significantly mediate treatment results in anxious and depressed youth. This mediation was not significantly moderated by a diagnosis of anxiety versus depression. Implications for future research are discussed, including continuing to look at various forms of cognitive coping as potential treatment mediators. Continuing to establish such treatment mediators can help maximize treatment focus and efficacy.