Hopelessness depression: A theory-based subtype of depression.

Abstract

Summary and Future Directions On the basis of the aforementioned studies, the hopelessnesstheory appears promising. However, further research is needed.For example, although powerful tests of the attributional diath-esis-stress component have been conducted, no one has exam-ined the cognitive diatheses of inferring negative consequencesor characteristics about the self or whether the cognitive stylediathesis-stress interaction predicts clinically significant de-pression. Moreover, it is crucial to determine if this interactionpredicts the development of the hypothesized symptoms ofhopelessness depression. More generally, an important short-coming of the prior work is that it has not focused on the symp-toms of hopelessness depression in particular and, instead, sim-ply has examined the symptoms of depression in general. Fu-ture investigators need to test more fine-grained predictionsabout the hypothesized symptoms of hopelessness depression.The issue of the stability of the cognitive diatheses has not beenresolved satisfactorily. We have only begun, in a preliminaryway, to investigate the issues of specific vulnerability and media-tional processes. Finally, further tests of the predictions aboutcourse, cure, and prevention are needed. We eagerly await thisresearch.Difficult methodological issues may arise in the search forhopelessness depression, however. For example, the hopeless-ness theory is silent about the time lag between formation ofhopelessness and onset of the symptoms of hopelessness depres-sion. If it is very short, then a major challenge will be to developmethods with sufficient temporal resolving power to determineif hopelessness indeed precedes the occurrence of the hypothe-sized symptoms of hopelessness depression (see Alloy, Hartlage,et al., 1988, for proposed methods for testing the hopelessnesstheory). The results of work to test the hopelessness theory willdetermine if the concept of hopelessness depression needs tobe revised. For example, perhaps the statement of the causalpathway is correc t bu culminate n a differen se f symp-toms than those currently hypothesized to compose hopeless-ness depression. In this case, the symptom—but not thecause—component of the hopelessness theory would need to bemodified.In discussing how to search for hopelessness depression, wenote the possibility that future work may not corroborate theexistence of hopelessness depression as a bona fide subtype withcharacteristic cause, symptoms, course, treatment, and preven-tion. Instead, the etiological chain featured in the hopelessnesstheory may be one of many pathways to a final common out-come of depression. In this case, it would be more compellingto speak of a hopelessness cause, as opposed to a hopelessnesssubtype, of depression.