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When Do Negative Thoughts Become Depression?

When Do Negative Thoughts Become Depression? New research suggests early suppression of negative thoughts can keep millions of people from developing full-blown depression.

The key is identification of the thought processes before they become established. To assist in this effort, researchers have developed a brief survey to help health care providers identify depressive thinking patterns that may lead to serious depression if not identified and addressed early.

Jaclene Zauszniewski, Ph.D., of Case Western Reserve University, developed an 8-item Depression Cognition Scale (DCS). The questionnaire asks individuals to respond to questions about helplessness, hopelessness, purposelessness, worthlessness, powerlessness, loneliness, emptiness and meaninglessness using a scale that ranges from “strongly agree” to “strongly disagree.”

“Clinicians need guidelines and measures to know when negative thinking has reached a tipping point and has begun to spiral into clinical depression,” she said.

The DCS has been used effectively to screen for more serious depressive symptoms in persons in the U.S. and around the world, but the researchers wanted to take it further and determine the point at which negative thinking establishes a pattern for the onset of clinical depression — even without other emotional expressions or body symptoms associated with depression.

Investigators studied use of the tool on 629 healthy adults from 42 states who responded to questions through the Internet survey. Participants ranged in age from 21 to 84 years, and 70 percent were women. The majority of the participants were college educated and had incomes greater than $40,000.

Researchers then compared DCS scores to the Center for Epidemiologic Studies Depression Scale (CES-D), which is recognized as a “gold standard” measure for identifying clinically significant depressive symptoms.

Their goal was to determine a cut score on the DCS that would represent the point at which individuals may benefit from learning ways to change negative thinking in order to prevent serious depression.

They found that a score of 7 on the DCS would be that point at which individuals should begin initiating strategies to change negative thoughts into positive ones.

The findings also showed that at this cut score, the DCS accurately differentiated between persons with and without clinical depressive symptoms as determined by the CES-D.

Researchers have reported their findings in the Western Journal of Nursing Research.

Source: Case Western Reserve University

When Do Negative Thoughts Become Depression?

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). When Do Negative Thoughts Become Depression?. Psych Central. Retrieved on October 26, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 4 Apr 2012)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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