Cross-Cultural Examination of the Cognitive Theory of Depression Among Individuals of Chinese and Canadian Descent

Abstract

Major Depressive Disorder (MDD) or major depression is a debilitating condition affecting members of all cultures around the world. The cognitive theory of depression is one of the most researched theories of the disorder worldwide; however, the theory’s cross-cultural applicability has not been extensively studied, especially among Chinese participants. According to the cognitive theory of depression, symptoms of major depression are hypothesized to strongly associate with negatively distorted cognitions about the self, world, and future. The present investigation examined five descriptive hypotheses (e.g., negativity hypothesis, exclusivity hypothesis, severity/persistence hypothesis, schema activation hypothesis, and selective processing hypothesis) derived from the cognitive theory of depression in a Canadian and a Chinese sample of dysphoric and non-dysphoria individuals to evaluate the theory’s cross-national validity. Dysphoria is conceptualized as a complex emotional state characterized by intense unhappiness and irritability. Data from 259 participants (129 dysphoric and 32 non-dysphoric Canadians; 18 dysphoric and 18 non-dysphoric Chinese) were analyzed to examine the five descriptive hypotheses. Participants completed a battery of self-report measures (i.e., Patient Health Questionnaire [PHQ-9], The Center for Epidemiologic Studies– Depression Scale [CES-D], Automatic Thoughts Questionnaire–Negative [ATQ-N], Automatic Thoughts Questionnaire–Positive [ATQ-P], and Dysfunctional Attitudes Scale [DAS-24]) and a facial expression recognition task. Dysphoric participants in both countries exhibited significantly more negative self-referent cognitions and dysfunctional attitudes, but significantly less positive self-referent cognitions than their non-dysphoric counterparts. Further, negative and positive self-referent cognitions, and dysfunctional attitudes were correlated with depressive symptoms among the Canadian sample. With the exception of the correlation between dysfunctional attitudes and depressive symptoms, negative and positive self-referent cognitions were significantly and meaningfully correlated with depressive symptoms among Chinese participants. Additionally, there was a trend showing that dysphoric participants in both countries demonstrated higher recall for sad faces in comparison to their non-dysphoric counterparts. Taken together, the current results support the cross-national validity of five descriptive hypotheses of the cognitive theory of depression among individuals of Canadian and Chinese descent and the findings may have clinical implications in the treatment of major depression among non-Western populations.