Proximity, Relationship Closeness, and Cognitive Vulnerability: Predicting Enduring Depressive Reactions to a College Campus Tragedy Benjamin J. Pfeifer and Gerald J. Haeffel University of Notre Dame

Objective:

To test the hypothesis that enduring depressive reactions to tragedy are due to a unique combination of three factors—close physical proximity to the event, close relationship with the victim(s), and high levels of cognitive vulnerability. Method: Participants were 70 undergraduates (66% female; mean age = 18) from a midsized private university. Cognitive vulnerability and depressive symptoms were assessed 2 years before a college campus tragedy; physical proximity, relationship with the victim, and depressive symptoms were assessed 2 months after the tragedy. Results: Individuals with a combination of high levels of cognitive vulnerability and close physical proximity to the event were at greater risk for enduring depression, but only if they did not have a very close relationship with the victim. Conclusion: This article puts forth a testable theory that helps to explain why some individuals are at risk for enduring depressive reactions to tragedy. Implications for research and C 2014 Wiley Periodicals, Inc. J. Clin. Psychol. 70:1196–1210, 2014. practice are discussed.  Keywords: tragedy; cognitive vulnerability; depression; proximity

Tragedies that occur on college campuses are often the subject of significant focus and interest worldwide. The bulk of media attention tends to be on large-scale events like the 2007 shootings at Virginia Tech or the 1999 bonfire disaster at Texas A&M. However, many campus communities struggle each year with far less publicized tragedies. For example, accidental deaths and suicide are all too common on college campuses. Indeed, suicide alone is the second leading cause of death among college students, accounting for an average of 1,100 deaths per year (Wilcox et al., 2010). Although these tragedies do not receive widespread public attention, they can still have a profound effect on a college community, affecting thousands of young adults at a time of considerable emotional and social transition (Larose & Boivin, 1998; Meilman & Hall, 2006; Ryan & Hawdon, 2008). The majority of empirical studies investigating the emotional effect of college tragedies have focused on anxiety reactions (e.g., posttraumatic stress disorder [PTSD]) to violent and lifethreatening events such as shootings and natural disasters. In contrast, less work has focused on depressive reactions to college tragedies (Bernat, Ronfeldt, Calhoun, & Arias, 1998; Frazier et al., 2009; Galatzer-Levy, Burton, & Bonanno, 2012; Vrana & Lauterback, 1994). It is important to consider depressive reactions to college tragedies for a number of reasons. First, most tragedies that occur on college campuses are not characterized by a threat of mass violence or death, unlike the events focused on by prior research. Indeed, the most common types of tragedies among college students tend to be isolated events like accidental deaths (e.g., motor vehicle accidents; accidents due to alcohol use) and suicide (Kisch, Leino, & Silverman, 2005). For most members of a college community, these smaller scale tragedies are not likely to engender the intense fear response thought to be necessary for PTSD vulnerability (e.g., Diagnostic and Statistical Manual of Mental Disorders Fourth Edition [APA, 1994] diagnostic This research was supported, in part, by a grant from the University of Notre Dame’s Undergraduate Research Opportunity Program. Please address correspondence to: Gerald J. Haeffel, Haggar Hall, University of Notre Dame, Notre Dame, IN 46656. E-mail: [email protected] JOURNAL OF CLINICAL PSYCHOLOGY, Vol. 70(12), 1196–1210 (2014) Published online in Wiley Online Library (wileyonlinelibrary.com/journal/jclp).

 C 2014 Wiley Periodicals, Inc. DOI: 10.1002/jclp.22078

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criteria; Jovanovic et al., 2010; Shalev et al., 1998; Kilic & Ulusoy, 2003). Instead of feelings of fear and danger, individuals affected by these tragedies are more likely to experience feelings of loss, which confer greater risk for depression than for anxiety (Ehring, Ehlers, & Glucksman, 2006; Livanou, Basoglu, & Salcioglu, 2002; Kilic & Ulusoy, 2003). It is imperative that researchers begin to study these more common tragedies and their potential depressive reactions. Second, epidemiological studies indicate that college students are within the age range of those at greatest risk for developing depression (Hankin et al., 1998; Kessler et al., 2005; Weissman et al., 1996; Klein et al., 2013). Within this peak period of risk, a recent study found that participants were most likely to develop a first episode of depression before 25 years of age (Klein et al., 2013). Thus, college students represent a particularly vulnerable population in terms of having a first lifetime episode of depression and are an important group to focus on in the aftermath of a community tragedy. Such events could potentially trigger episodes of depression in this vulnerable population. Finally, regardless of the type of event, most people involved in a tragedy will experience at least some increase in depressive symptoms in the immediate aftermath (Galea et al., 2002; MacGeorge, Samter, Feng, Gillihan, & Graves, 2004; Vicary & Fraley, 2010). The comorbidity of depression and PTSD is empirically well-established (Fullerton, Ursano, & Wang, 2004; La Greca, 2007; Meewisse, Olff, Kleber, Kitchiner, & Gersons, 2011), indicating that even life threatening events may increase risk for depressive symptoms (in addition to PTSD). Taken together, prior research indicates that it is vital to study depressive reactions to college campus tragedies; however, few studies to date have addressed this topic. Prior research suggests that depressive reactions to tragedy are typically temporary and tend to remit within several weeks of the event, much like anxiety reactions to tragedy (Blom, 1986; Shaw, Applegate, Tanner, & Perez, 1995; Vicary & Fraley, 2010). However, not all individuals are equally resilient to tragedy. A small minority of individuals will continue to experience depression in the months after a tragedy (Chen, Chung, Chen, Fang, & Chen, 2003; Clayton & Darvish, 1979; Hensley, 2006; Vicary & Fraley, 2010). It is critical to understand why these individuals are not able to recover from tragedy as quickly or efficiently as their peers. The answer to this question has important implications for both theory and practice. Identifying the factors that increase risk for prolonged depressive responses to tragedy can inform theories about coping as well as theories of depressive processes. Further, the ability to identify those at risk for enduring depression can help to create more effective interventions, facilitate efficient allocation of resources, and avoid the dangers in treating individuals who do not actually need an intervention. For example, there is research showing that grief counseling can actually lead to worse mental health outcomes than no treatment at all for upwards of 40% of individuals (Neimeyer, 2000; for other examples of harmful treatments, see Ehlers & Clark, 2003; Mayou, Ehlers, & Hobbs, 2000; Lilienfeld et al., 2007; McNally, Bryant, & Ehlers, 2003). Identifying factors that put people at risk for enduring depressive reactions after a tragedy has proven difficult. One reason for this slow progress is that it is extremely challenging to conduct pre-post longitudinal studies of tragic events. Tragic events tend to be unpredictable, and it is therefore difficult, if not impossible, to measure the factors of interest before the occurrence of the tragic event. As a result, most research on tragedy has had to focus on postevent risk factors. In these studies, the recruitment of participants and measurement of study variables are conducted after the occurrence of the tragedy. Although it is clearly useful to identify postevent risk factors that could predict depression, this design does not enable scientists to identify preexisting personality factors that put people at risk for depression. It also does not allow scientists to control for pretragedy levels of the outcome variable (e.g., pretragedy levels of depression). Therefore, it is necessary to identify preexisting vulnerability factors that may have implications for both theory and practice (e.g., the creation of targeted prevention interventions). The purpose of this study is to test a novel hypothesis that can distinguish a priori students who will experience transient depressive symptoms in the aftermath of an accidental college campus tragedy from those who will experience more enduring depressive symptoms, defined here as heightened symptoms two months after the tragedy. Specifically, we hypothesized that a unique combination of three factors is needed to create risk for enduring depressive symptoms after a tragedy: close physical proximity to the site of the event when it occurred, a close relationship

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with the victim, and a high level of cognitive vulnerability to depression. In the sections to follow, we briefly provide empirical support for each of the factors that compose our theory.

Physical Proximity to the Event The majority of research on the effect of physical proximity to tragedy has focused on posttraumatic anxiety reactions. This work provides strong evidence that those who are physically close to the site of a tragedy are at greater risk for PTSD than those who are not physically close to that site (Fullerton et al., 2004). Far less research has focused on the effect of physical proximity to tragedy on depressive reactions (La Greca, 2007; Meewisse et al., 2011). However, preliminary research in this area suggests that the closer that one is in physical proximity to a tragic event, the greater one’s risk is for developing depression (Blanchard, Rowell, Kuhn, Rogers, & Wittrock, 2005; Fullerton, Ursano, Kao, & Bharitya, 1999; Schiff et al., 2006). Close physical proximity appears to have a negative effect by creating feelings of survivor guilt, insignificance, and grief (Sprang, 1999).

Relationship with Victim(s) Both intuition and research findings support the idea that the closer one is with the victim of a tragedy, the more likely he or she is to experience symptoms of psychopathology, including depression (Brent, Moritz, Bridge, Perper, & Canobbio, 1996; Chen et al., 2003; Galea et al., 2002; Schiff et al., 2006; Vicary & Fraley, 2010). Indeed, research shows that the loss of a close relationship is a risk factor for increased depression in the immediate aftermath of the event (Chen et al., 2003), as well as for enduring depression up to 18 months after the event (Brent et al., 1996). In light of this work, those individuals who endorse a close relationship with a victim of a community tragedy are likely to be at elevated risk for enduring depressive symptoms.

Cognitive Vulnerability Not everyone who is in close proximity to a tragedy and who is personally close to the victim(s) will develop greater levels of depression (Blanchard et al., 2005; Brent et al, 1993; Chen et al., 2003). This begs the question: Why is it that one person with these two risk factors will develop depressive symptoms whereas another person will not? We contend that this theoretical gap can be addressed by integrating work from the cognitive theories of depression. According to these theories (e.g., Abramson, Metalsky, & Alloy, 1989; Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008), some individuals have a cognitive vulnerability that increases their risk for the occurrence of depression. Specifically, people are vulnerable to depression because they have a tendency to generate interpretations of stressful life events (and dysphoric moods) that have negative implications for their future and for their self-worth. Individuals with these types of negative thinking patterns are at greater risk for depression than individuals who do not have these patterns. Research has provided direct and compelling support for the cognitive vulnerability hypothesis (Haeffel et al., 2008; Nolen-Hoeksema et al., 2008). Prospective studies have consistently found that cognitive vulnerability interacts with negative events to predict the development of depressive symptoms and depressive disorders (Abramson et al., 1999; Haeffel et al., 2008; Nolen-Hoeksema, 2000; Nolen-Hoeksema et al., 2008). Impressively, these studies have shown that it is possible to take a group of never depressed individuals and predict which of them are most likely to develop a first episode of clinically significant depression based solely on individual differences in their cognitive style for interpreting life events (i.e., their level of cognitive vulnerability). It is likely that a variety of factors (e.g., genetic, biological, and environmental) contribute to developing negative thinking patterns (i.e., cognitive vulnerability); however, many researchers have converged on the idea that early exposure to negative interpersonal contexts is a particularly influential antecedent. For example, both negative parenting practices (e.g., emotional abuse) and direct inferential feedback from significant others (e.g., teachers, peers, and parents) predict

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the development of cognitive vulnerability (e.g., Alloy et al., 2001; Cole, Jacquez, & Maschman, 2001; Dweck, Davidson, Nelson, & Enna, 1978; Garber & Flynn, 2001; Lau, Belli, Gregory, Napolitano, & Eley, 2012; Murray, Woolgar, Cooper, & Hipwell, 2001). Importantly, it appears that these early contexts do not take long to exert their influences on the development of cognitive vulnerability. By early adolescence, it is possible to detect meaningful and stable individual differences in how individuals cognitively interpret stressful life events. Longitudinal and cross-sectional studies indicate that cognitive vulnerability can predict depression in children as young as 12 years of age (Cole et al., 2008; Nolen-Hoeksema, Girgus, & Seligman, 1992). Once cognitive vulnerability forms and stabilizes in early adolescence, it confers risk for depression throughout the life span (see Romens, Abramson, & Alloy, 2009, for review). Research shows that cognitive vulnerability exhibits moderate to high stability during high school (Hankin & Abramson, 2002), college (Alloy et al., 2000), and the rest of adulthood (Burns & Seligman, 1989; Haeffel et al., 2005). These findings suggest that by early adulthood one’s level of cognitive risk is relatively impervious to changes in environmental conditions (Hankin, 2008). Within the context of cognitive theory, it is possible to determine when physical proximity to a tragedy and a close relationship with a victim should lead to an increase in depression. According to cognitive theory, the individual must infer that their experience with the tragedy will have negative implications for his or her future or self-worth; if this is the case, then he or she should develop depression. In other words, being in close proximity to the event when it occurs and having a close relationship with the victim in the tragedy should be most likely to trigger an increase in depressive symptoms for those with high levels of cognitive vulnerability.

Hypothesis and Study Overview The goal of the current study was to test a novel hypothesis that could explain why some people will experience enduring depressive reactions to tragedy whereas most will recover quite quickly. We hypothesized that enduring depressive reactions to tragedy are due to a unique interaction of three factors—close physical proximity to the event, close relationship with the victim(s), and high levels of cognitive vulnerability. We tested our hypothesis in a sample of undergraduates who experienced a highly publicized campus tragedy at the University of Notre Dame. In October 2010, a Notre Dame student was killed when the tower from which he was recording a football practice collapsed. Using baseline measures of depressive symptoms and cognitive vulnerability from 2 years before the tragedy, we examined whether our hypothesized three-way interaction could predict which students were still experiencing heightened levels of depression approximately 2 months after the tragedy. The 2-month time frame was chosen because prior research suggests that initial depressive reactions to tragedy tend to remit by this time (Gray, Weller, Fristad, & Weller, 2011; Vicary & Fraley, 2010). We measured cognitive vulnerability as defined by two prominent cognitive theories of depression—the response styles theory (Nolen-Hoeksema, 1991) and the hopelessness theory (Abramson et al., 1989). We chose to focus on these two cognitive vulnerability factors for a number of reasons. First, both of these vulnerability factors have strong empirical support. Prospective longitudinal studies demonstrate that vulnerability factors of both the response styles theory and the hopelessness theory precede and predict future depressive symptoms and disorders, respectively, even when controlling for prior depression (Abramson et al., 1999; Haeffel et al., 2008; Nolen-Hoeksema, 2000; Nolen-Hoeksema et al., 2008). Second, there is a highly reliable and validated measurement tool to assess each vulnerability factor (Haeffel et al., 2008; Nolen-Hoeksema et al., 2008). Third, the two vulnerability factors are distinct conceptually and empirically (e.g., the hopelessness theory vulnerability factor focuses on cognitive content, whereas response styles theory focuses on the process by which people respond to negative moods, i.e., brooding vs. distraction). By using two distinct operationalizations of cognitive vulnerability, it is possible to provide a more rigorous test of our hypotheses and confirm the importance of cognitive factors in predicting depressive reactions to tragedy.

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Method Participants Participants were 70 undergraduates (46 females, 24 males; mean [M] age at baseline = 18.00) from the University of Notre Dame. The self-reported ethnicity of the sample was 80% Caucasian, 9% Hispanic, 6% Asian, 3% African American, and 2% endorsed an “other” category. Participants, as part of a different unpublished study, completed baseline measures 2 years before the tragic death of the Notre Dame student. Approximately 2 months (6–8 weeks) after the tragedy on the University of Notre Dame campus, the 171 participants from this prior study were e-mailed to ask for their participation in the current study. Of those contacted, 70 participants agreed to participate and completed all of the follow-up measures. Note that students who did not volunteer to participate in the follow-up study were not different from students who participated in the follow-up study on their baseline measures of cognitive vulnerability or depressive symptoms (all ps > .54; all partial eta squared effect sizes .90; Haeffel et al., 2008), strong test-retest reliability over months and even years (e.g., 1-year testretest is .80; Alloy et al., 2000), and predictive validity (Haeffel et al., 2008). Prospective studies have consistently found that the CSQ interacts with measures of negative events to predict the development of depressive symptoms (e.g., Haeffel et al., 2007; Metalsky & Joiner, 1992) and depressive disorders (e.g., Alloy et al., 2006; Hankin et al., 2004). Internal consistency in the current sample was good with alpha = .89.

Perceived closeness. Participants rated how well they knew the student involved in the tragedy on a Likert scale ranging from 1 (I did not know the student at all) to 5 (the student was a close friend). Physical proximity. Participants rated their physical proximity to the tragedy on a Likert scale ranging from 1 (I was not on campus) to 5 (I was at the practice field). Procedure Participants completed two assessments separated by approximately 2 years. At the baseline assessment (fall 2008), participants completed self-report measures of cognitive vulnerability (CSQ, RRS), and depressive symptoms (BDI). Two years later (fall 2010), and approximately 6 to 8 weeks after the Notre Dame campus tragedy, participants completed a follow-up assessment. The follow-up assessment was comprised of self-report measures of depressive symptoms (BDI), relationship closeness to the victim, and proximity to the tragedy.

Results We used hierarchical multiple regression (Cohen, Cohen, West, & Aiken, 2003) to test the hypothesis that the interaction of physical proximity to the event, closeness to the victim(s), and cognitive vulnerability would predict enduring depressive reactions to a campus tragedy. The baseline depression measure was entered in the first step of the regression equation to control for initial levels of depression 2 years before the tragedy. In the second step, the main effects of cognitive vulnerability (CSQ or RRS Brooding subscale, respectively), proximity, and perceived closeness were entered. Descriptive statistics and correlations for the measures are listed in Table 1. Next, the two-way interaction terms were entered (Cognitive Vulnerability × Proximity, Cognitive Vulnerability × Perceived Closeness, and Proximity × Perceived Closeness). In the final step, the hypothesized three-way interaction (Cognitive Vulnerability × Proximity × Perceived Closeness) was entered. Two regression analyses were run: once with the CSQ as the measure for cognitive vulnerability, and once with the RRS Brooding subscale as the measure of cognitive vulnerability (Tables 2 and 3, respectively). Consistent with the recommendations of Cohen et al. (2003), all continuous independent variables were centered and individual variables within a given set were not interpreted unless the set as a whole was significant, thereby reducing Type I errors. As predicted, the three-way interaction of physical proximity, perceived closeness, and cognitive vulnerability was significant (see Tables 2 and 3). Importantly, the three-way interaction was significant when using either the CSQ or the RSS as the cognitive vulnerability measure (using RSS: t = −2.02, p = .048, pr = −.25; using CSQ: t = −2.33, p = .006, pr = −.34). The only other significant predictor was baseline level of depression (t = 3.13, p = .003, pr = .36). The other main effects or two-way interactions were not significant predictors of

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Table 1 Means, Standard Deviations, and Correlations Variable 1. BDI Base 2. CSQ Base 3. Brood Base 4. Proximity 5. Closeness 6. BDI Post M SD

1

2

3

4

5

— .38 −.15 −.09 .17 3.84 .90

— −.17 .16 .27 9.05 3.47

— .12 .04 2.51 .99

6

— .28 .61 −.16 .10 .36 5.30 5.70

— .04 1.61 .97

— 5.07 4.93

Note. BDI_Base = Beck Depression Inventory administered at baseline (∼2 years prior to tragedy); CSQ_Base = Cognitive Style Questionnaire administered at baseline (∼2 years prior to tragedy); Brood_Base = Ruminative Response Scale Brooding subscale administered at baseline (∼2 years prior to tragedy); Proximity = Physical Proximity to location of tragedy; Closeness = Self-reported closeness of relationship with the victim; BDI_Post = Beck Depression Inventory post tragedy (administered approximately 2 months after the tragic event); M = mean; SD = standard deviation. For all measures, scores indicate greater levels of the construct being measured. Correlations in bold are significant at the .05 level.

Table 2

RSS Brooding × Proximity × Perceived Closeness Predictor Step 1 BDI Base Step 2 Brood Base Proximity Closeness Step 3 Brood Base × Proximity Brood Base × Closeness Proximity × Closeness Step 4 Brood Base × Proximity × Closeness

b

pr

t

Step R2 Change .13**

3.13**

.38

.36

.22 .56 −.15

.14 .12 −.03

1.10 .96 −.25

.08 −.11 −.71

.05 −.08 −.13

.42 −.63 −1.00

−.43

−.25

−2.02*

.03

.02

.05*

Note. BDI_Base = Beck Depression Inventory administered at baseline (∼2 years prior to tragedy); Brood_Base = Ruminative Response Scale Brooding subscale administered at baseline (∼2 years prior to tragedy); Proximity = Physical Proximity to location of tragedy; Closeness = Self-reported closeness of relationship with the victim. *p < .05. **p < .01.

enduring depressive symptoms. To determine the pattern of the three-way interaction, we followed the recommendations of Cohen et al. (2003) and computed posttragedy depressive symptoms scores by inserting specific values for predictor variables (i.e., 1 standard deviation [SD] above and below the mean) into the regression equation. The pattern provided partial support for our hypothesis. As can be seen in Figures 1 and 2, participants who had high levels of cognitive vulnerability, close physical proximity, and unexpectedly low perceived closeness exhibited the greatest levels of depressive symptoms. It is important to note that this pattern was replicated with both cognitive vulnerability measures, and that there were not any outliers that affected the study results.

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Table 3

CSQ × Proximity × Perceived Closeness Predictor Step 1 BDI Base Step 2 CSQ Base Proximity Closeness Step 3 CSQ Base × Proximity CSQ Base × Closeness Proximity × Closeness Step 4 CSQ Base × Proximity × Closeness

b

pr

t

.38

.36

3.13**

.71 .55 .01

.13 .12 .00

1.09 .94 .01

.81 −.70 −.72

.15 −.12 −.14

1.20 −.95 −1.10

−2.33

−.34

−2.85**

Step R2 Change .13** .02

.04

.10**

Note. BDI_Base = Beck Depression Inventory administered at baseline (∼2 years prior to tragedy); CSQ_Base = Cognitive Style Questionnaire administered at baseline (∼2 years prior to tragedy); Proximity = Physical Proximity to location of tragedy; Closeness = Self-reported closeness of relationship with the victim. *p < .05. **p < .01.

Figure 1. Posttragedy BDI score as a function of cognitive vulnerability (high Brooding score vs. low Brooding score), proximity to the tragedy (close vs. far), and closeness with the victim (high vs. low).

Discussion Depressive reactions to tragedy, although common, are usually temporary and tend to remit several weeks after the event (Blom, 1986; Salloum & Overstreet, 2008; Shaw et al., 1995; Vicary & Fraley, 2010). However, a small minority of individuals will continue to experience depression in the months after a tragedy. The goal of this study was to identify factors that could predict which individuals are at greatest risk for enduring depressive symptoms after a tragedy. Specifically, we hypothesized that enduring depressive reactions to tragedy are due to an interaction of three factors—close physical proximity to the event, a close relationship with the victim(s), and high levels of cognitive vulnerability. The results of our study provided partial support for our hypothesis. As predicted, the three-way interaction of proximity, closeness, and

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Figure 2. Posttragedy BDI score as a function of cognitive vulnerability (high CSQ score vs. low CSQ score), proximity to the tragedy (close vs. far), and closeness with the victim (high vs. low).

cognitive vulnerability was a significant predictor of enduring depressive reactions to a college campus tragedy, even after controlling for baseline levels of depression. However, the pattern of the interaction did not fully conform to our hypothesis. Individuals with a combination of high levels of cognitive vulnerability and close physical proximity to the event were at greater risk for enduring depression, but only if they did not have a very close relationship with the victim. It is surprising that a lack of closeness with the victim was a moderating factor for enduring depressive symptoms. It is well established that the loss of a close friend or family member is a risk factor for increases in depressive symptoms (Brent et al., 1996; Chen et al., 2003; Galea et al., 2002). One possible explanation for our unexpected finding is that the individuals who reported being the closest to the victim may have also been the most likely to receive increased social support after the tragedy. Increased social support has been identified in multiple studies as a protective factor for depression in the aftermath of a tragedy (Fullerton et al., 1999; Galea et al., 2002). Similarly, multiple studies have found that low social support interacts with cognitive vulnerability and stress to predict prospective increases in depression (Haeffel & Mathew, 2010; Panzarella, Alloy, & Whitehouse, 2006). Thus, it is possible that in our study, individuals without a close relationship to the victim may not have been perceived as particularly affected by the tragedy, and therefore “ignored” by the campus community. In some cases, such individuals may have even experienced the invalidation of their negative mood as a result of being ignored by the community or questioned by peers about their response in light of their lack of connection to the victim. Such invalidation may be damaging to individuals with these risk factors. A second possible explanation for the unexpected result in this case is that we did not account for participants’ relationship with their academic institution. In the days and weeks after the tragedy, local media and some members of the community argued that the University of Notre Dame bore responsibility or even guilt for the student’s death (Hiserman, 2010). Prior research indicates that assigning blame for a tragedy can promote recovery (Solomon, Regier, & Burke, 1989). Thus, it is possible that students who were close to the victim in this study might have been more motivated to search for a cause of identifiable transgressor, which would have helped in their recovery. In contrast, those who were not close to the victim might have been less willing to blame their university (as it tends to be part of their self-identity). Indeed, having no identifiable cause for a tragedy has been shown to have negative consequences for one’s mood in some cases (Abramson, Seligman, & Teasdale, 1978). Clearly, future research is needed to test these alternative explanations for the unexpected finding in this study.

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Our findings have important implications for both theory and practice. We have put forth a testable theory that delineates a specific combination of factors (proximity, closeness, and cognitive vulnerability) that can help explain why some individuals are at elevated risk for enduring depressive reactions to a tragedy. Our introduction of cognitive vulnerability into the literature on college tragedies is unique, and we look forward to future work examining this critical construct. Our findings could also be of use to mental health professionals. Given limited resources, it is not feasible to provide mental health services to everyone involved in common campus tragedies. Our theory helps to narrow down the potential pool of those needing services. It is only those individuals who possessed all three risk factors that were at risk for enduring depression; none of the three factors exerted a main effect, nor were there any twoway interactions that were predictive of depression. Thus, interventions would only need to target one of the three factors to reduce an individual’s risk for enduring depression. Clearly, it is not possible to change one’s proximity to the event or their relationship with the victim. This means that cognitive vulnerability would need to be reduced to help individuals after an accidental campus tragedy. Fortunately, there are very effective interventions for reducing cognitive vulnerability. Research shows that cognitive-based therapies (e.g., cognitive-behavioral therapy) are very effective in reducing individuals’ cognitive vulnerability (DeRubeis & Hollon, 1995; Seligman, Schulman, DeRubeis, & Hollon, 1999). Thus, cognitive interventions might be the first line of defense for individuals who have all three risk factors for enduring depression. It is important to note strengths and limitations of the current study. A strength of this study is the use of two distinct operationalizations of cognitive vulnerability—the CSQ from hopelessness theory and the RRS from the response styles theory. Although overlapping, the two vulnerabilities focus on different cognitive attributes. The hopelessness theory vulnerability factor focuses on cognitive content (i.e., the particular types of interpretations that people generate about stress), whereas response styles theory focuses on the process by which people respond to negative moods (i.e., brooding vs. distraction). These conceptual differences are supported by factor analytic studies (Hankin, Lakdawalla, Carter, Abela, & Adams, 2007), which show the two vulnerabilities (as measured by the CSQ and RRS) load on different factors. By using these two distinct operationalizations of cognitive vulnerability, it allowed us to “replicate” our findings and confirm the importance of cognitive factors in predicting depressive reactions to tragedy. A second strength of the study was that cognitive vulnerability and baseline depressive symptoms were assessed before the tragedy occurred. Because of the random nature of tragic events, it is extremely difficult to conduct studies on this topic in which the factors of interest are measured before the occurrence of the event. Thus, having a preexisting baseline is noteworthy. Along these same lines, it is impressive that cognitive vulnerability contributed to changes in depression after a 2-year follow-up period. These results provide further support for the stability of cognitive vulnerability as well as its predictive power. Our results might also help to reconcile a recent finding by Felton, Cole, and Martin (2013), who did not find a direct effect of pretragedy levels of cognitive vulnerability (rumination) on depressive reactions to the 2010 Nashville flood. Their results are actually consistent with our finding that cognitive vulnerability does not exert a main effect on depressive reactions, but rather requires additional risk factors. Moreover, their study examined depressive reactions only 10 days after the event. Research shows that cognitive vulnerability does not tend to predict immediate reactions to stress, but rather is a better predictor of long-term reactions (e.g., Haeffel 2011; Haeffel et al., 2007). This makes sense because there tends to be little variation in depressive reactions immediately after a stressful event to predict; most people exhibit at least some increase in depression immediately afterward. However, as time goes by, individual differences begin to emerge with some people recovering and some people staying symptomatic (or getting worse). There are also limitations to this study. First, we examined depressive symptoms but not clinical diagnoses. Thus, we cannot make conclusions about clinically significant forms of depression. However, given research suggesting that depressive symptoms and depressive syndromes lie on a continuum (Flett, Vredenburg, & Krames, 1997; Halberstadt et al., 2008), we expect that future research will provide evidence that our pattern of results also extends to depressive disorders. A second limitation of the current study is that it focused exclusively on depressive symptoms. Prior

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research indicates that posttraumatic stress reactions often include both depressive and anxious symptoms (Campbell et al., 2007; Shalev et al., 1998; Breslau, Davis, Peterson, & Schultz, 2000; O’Donnell, Creamer, & Pattison, 2004). We did not assess PTSD reactions in this study because we did not have a pretragedy measure of these symptoms; thus, we could not have examined changes in symptoms from pre- to posttragedy. Further, we did not expect the Notre Dame tragedy to confer risk for PTSD. The tragedy in this study did not involve a violent event that elicited a fear response, but rather was an accidental death, which is more likely to confer risk for depression (Galea et al., 2002; Goenjian et al., 1995; Kilpatrick et al., 1989; Kilic & Urusoy, 2003; Resnick, Kilpatrick, Dansky, Saunders, & Best, 1993). However, without measuring both types of symptoms, we cannot conclude that participants also did not experience co-occurring symptoms of anxiety. Similarly, we cannot conclude that our theory will generalize to anxiety reactions. Finally, the current study used a college sample, so it is possible that the results may not generalize to community samples that experience tragedies. However, it is important to note that the “college sophomore problem” is often overstated. The results of studies using college samples often do generalize to community and clinical samples, particularly when basic processes (e.g., cognition) are being studied (e.g., Anderson, Lindsay, & Bushman, 1999). In conclusion, most people will show incredible resilience when faced with tragedy. However, a small group of individuals will not. The purpose of this study was to test a unique theory that could discriminate between those who will and will not experience enduring depressive reactions to tragedy. In partial support of our hypothesis, we found that close proximity to the event, high levels of cognitive vulnerability, and a lack of closeness with the victim increased risk for elevated depressive symptoms 2 months after the tragedy. We hope that these results spur both additional basic research in this area as well as intervention studies in this area.

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