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

Claxton, Jade, Alberici, Alice, Meiser-Stedman, Richard and Chiu, Henry Tak Shing (2025) Cognitive appraisals, cognitive avoidance and rumination as shared vulnerabilities for PTSD and depression in trauma-exposed adolescents. European Journal of Psychotraumatology, 16 (1). ISSN 2000-8066

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Abstract

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.

Item Type:	Article
Additional Information:	Data availability statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health) Faculty of Medicine and Health Sciences > Research Groups > Mental Health
Depositing User:	LivePure Connector
Date Deposited:	24 Jun 2025 16:30
Last Modified:	06 Aug 2025 15:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/99709
DOI:	10.1080/20008066.2025.2527550

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