Between vulnerability and resilience: A network analysis of fluctuations in cognitive risk and protective factors following remission from depression

• Published in: Behaviour research and therapy Vol. 116; pp. 1 - 9
• Main Authors: Hoorelbeke, Kristof, Van den Bergh, Nathan, Wichers, Marieke, Koster, Ernst H.W.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2019; Elsevier Science Ltd
• Subjects: Activities of daily living; Adaptation, Psychological; Adult; Affect; Aged; Appraisal; Between-subjects design; Cognition; Cognitive ability; Cognitive vulnerability; Deployment; Depression; Depression - psychology; Ecological momentary assessment; Emotion regulation; Female; Humans; Internalization; Internalizing disorders; Male; Mental depression; Middle Aged; Models, Psychological; Network; Network analysis; Positive emotions; Protective Factors; Remission; Remission (Medicine); Remission Induction; Residual symptoms; Resilience; Resilience, Psychological; Risk Factors; Rumination; Vulnerability; Young Adult; Remission; Depression; Cognitive vulnerability; Emotion regulation; Network; Resilience
• ISSN: 0005-7967; 1873-622X; 1873-622X
• DOI: 10.1016/j.brat.2019.01.007

Research exploring how cognitive risk- and protective factors relate following remission from internalizing disorders suggests a central role for resilience. However, it remains unclear what constitutes resilience in this context. Furthermore, previous studies have typically relied on cross-sectional data which do not allow to map the temporal dynamics of such relations. Using a seven-day experience sampling period in 85 remitted depressed patients, we examined the interplay between five transdiagnostic vulnerability- and protective factors in daily life. We present a temporal, contemporaneous, and a between-subjects network, providing an in-depth analysis of how these factors relate to daily life fluctuations in residual symptomatology. Furthermore, we test the role of positive affect as a main resilience factor. Resilience uniquely predicted all other factors over time (temporal network). Higher levels of resilience were related to less momentary use of rumination, more deployment of positive appraisal, and lower occurrence of residual symptoms (contemporaneous network). Participants scoring high on resilience mostly engaged in positive appraisal (between-subjects network). Similar structures were obtained when substituting self-reported resilience by positive affect. This highlights the importance of resilience, and in particular, positive affectivity, to cope with stressors following remission. This may be fostered by facilitating the use of positive appraisal. •Resilience held a central position in the temporal and contemporaneous network models.•Resilience uniquely predicted transdiagnostic risk- and protective factors over time.•Resilient individuals are characterized by higher use of positive appraisal.•Positive affectivity forms a key resilience factor.•This may be fostered via deployment of positive appraisal.