Cognitive appraisals, cognitive avoidance and rumination as shared vulnerabilities for PTSD and depression in trauma-exposed adolescents

Background: Depression and Post Traumatic Stress Disorder (PTSD) are highly comorbid disorders following trauma exposure; when comorbid they are associated with more deleterious and long-term impact. However, the nature of this relationship lacks consensus and is understudied in adolescence, despite...

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Main Authors: Jade Claxton, Alice Alberici, Richard Meiser-Stedman, Henry Tak Shing Chiu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:European Journal of Psychotraumatology
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Online Access:https://www.tandfonline.com/doi/10.1080/20008066.2025.2527550
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author Jade Claxton
Alice Alberici
Richard Meiser-Stedman
Henry Tak Shing Chiu
author_facet Jade Claxton
Alice Alberici
Richard Meiser-Stedman
Henry Tak Shing Chiu
author_sort Jade Claxton
collection DOAJ
description Background: Depression and Post Traumatic Stress Disorder (PTSD) are highly comorbid disorders following trauma exposure; when comorbid they are associated with more deleterious and long-term impact. However, the nature of this relationship lacks consensus and is understudied in adolescence, despite this being highlighted as a critical period for trauma exposure. Cognitive processes such as appraisals, avoidance and rumination have been implicated in both disorders separately and could be potential shared mechanisms underlying this comorbidity.Method: In a cross-sectional design, 280 secondary school pupils (12–15 years), reporting trauma exposure, completed self-report measures of Post Traumatic Stress Symptoms (PTSS), depression and maladaptive cognitive processes (trauma-related and depressogenic appraisals, cognitive avoidance and rumination).Results: PTSS and depression symptoms were highly correlated (r = 0.79) and 60–65% of all probable diagnostic cases of PTSD or depression were comorbid. Strong positive correlations were found for negative trauma appraisals, depressogenic appraisals, cognitive avoidance and rumination, with statistically comparable strengths found for both PTSS and depression symptoms. Comparisons of probable diagnostic groups showed all groups endorsed all maladaptive processes although the comorbid group showed the greatest endorsement (and symptomology). Stepwise hierarchical regression models of the maladaptive processes explained 75-77% of the variance. Trauma-related appraisals were found most prominent in predicting both PTSS and depression symptoms although a commonality analysis suggested the interplay between all cognitive variables explained the vast amount of variance.Conclusions: Cognitive appraisals, cognitive avoidance and rumination appear to be shared cognitive vulnerabilities in PTSD and depression, which may underlie PTSD-depression comorbidity and provide targets for intervention.
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spelling doaj-art-1a5e6254fbb14356860ff815c4e09d952025-08-20T02:47:58ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662025-12-0116110.1080/20008066.2025.2527550Cognitive appraisals, cognitive avoidance and rumination as shared vulnerabilities for PTSD and depression in trauma-exposed adolescentsJade Claxton0Alice Alberici1Richard Meiser-Stedman2Henry Tak Shing Chiu3Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UKDepartment of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UKDepartment of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UKDepartment of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UKBackground: Depression and Post Traumatic Stress Disorder (PTSD) are highly comorbid disorders following trauma exposure; when comorbid they are associated with more deleterious and long-term impact. However, the nature of this relationship lacks consensus and is understudied in adolescence, despite this being highlighted as a critical period for trauma exposure. Cognitive processes such as appraisals, avoidance and rumination have been implicated in both disorders separately and could be potential shared mechanisms underlying this comorbidity.Method: In a cross-sectional design, 280 secondary school pupils (12–15 years), reporting trauma exposure, completed self-report measures of Post Traumatic Stress Symptoms (PTSS), depression and maladaptive cognitive processes (trauma-related and depressogenic appraisals, cognitive avoidance and rumination).Results: PTSS and depression symptoms were highly correlated (r = 0.79) and 60–65% of all probable diagnostic cases of PTSD or depression were comorbid. Strong positive correlations were found for negative trauma appraisals, depressogenic appraisals, cognitive avoidance and rumination, with statistically comparable strengths found for both PTSS and depression symptoms. Comparisons of probable diagnostic groups showed all groups endorsed all maladaptive processes although the comorbid group showed the greatest endorsement (and symptomology). Stepwise hierarchical regression models of the maladaptive processes explained 75-77% of the variance. Trauma-related appraisals were found most prominent in predicting both PTSS and depression symptoms although a commonality analysis suggested the interplay between all cognitive variables explained the vast amount of variance.Conclusions: Cognitive appraisals, cognitive avoidance and rumination appear to be shared cognitive vulnerabilities in PTSD and depression, which may underlie PTSD-depression comorbidity and provide targets for intervention.https://www.tandfonline.com/doi/10.1080/20008066.2025.2527550DepressionPTSDcomorbidityadolescentscognitive mechanismsDepresión
spellingShingle Jade Claxton
Alice Alberici
Richard Meiser-Stedman
Henry Tak Shing Chiu
Cognitive appraisals, cognitive avoidance and rumination as shared vulnerabilities for PTSD and depression in trauma-exposed adolescents
European Journal of Psychotraumatology
Depression
PTSD
comorbidity
adolescents
cognitive mechanisms
Depresión
title Cognitive appraisals, cognitive avoidance and rumination as shared vulnerabilities for PTSD and depression in trauma-exposed adolescents
title_full Cognitive appraisals, cognitive avoidance and rumination as shared vulnerabilities for PTSD and depression in trauma-exposed adolescents
title_fullStr Cognitive appraisals, cognitive avoidance and rumination as shared vulnerabilities for PTSD and depression in trauma-exposed adolescents
title_full_unstemmed Cognitive appraisals, cognitive avoidance and rumination as shared vulnerabilities for PTSD and depression in trauma-exposed adolescents
title_short Cognitive appraisals, cognitive avoidance and rumination as shared vulnerabilities for PTSD and depression in trauma-exposed adolescents
title_sort cognitive appraisals cognitive avoidance and rumination as shared vulnerabilities for ptsd and depression in trauma exposed adolescents
topic Depression
PTSD
comorbidity
adolescents
cognitive mechanisms
Depresión
url https://www.tandfonline.com/doi/10.1080/20008066.2025.2527550
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