Examination of the Cognitive Diathesis-Stress Conceptualization of the Hopelessness Theory of Depression in Children With Chronic Illness: The Moderating Influence of Illness Uncertainty

This study utilized a cognitive diathesis-stress conceptualization to examine the relationship of attributional style and illness uncertainty to depression in children with type 1 diabetes, asthma, or cystic fibrosis. Children ages 8 to 12 completed measures of illness uncertainty, attributions for illness-unrelated negative events, and depressive symptoms. Results indicated that general attributions for negative events predicted higher levels of depressive symptoms under conditions of both high and low illness uncertainty. Subsequent plotting of the regressions revealed that depressive symptoms were greater at higher levels of uncertainty when attributions were stable and global. Findings support a diathesis-stress conceptualization in pediatric chronic illness and highlight the importance of interventions targeting management of illness uncertainty and maladaptive cognitions.