Toward Understanding the Causal Status of Prominent Psychological Risk Factors for Depression Symptoms: A Causal Network Analysis

Understanding causal influences on depression symptoms is essential for improving depression treatment. We therefore examined the causal status of promising candidate risk factors (repetitive negative thinking, cognitive reactivity, experiential avoidance, low self-esteem, low meaning in life [MiL]). We analyzed cross-sectional data of 674 adults from the general population using causal network analysis. Results provided evidence for depression symptoms as a cause rather than effect. None of the candidate risk factors causally influenced depression symptoms, and depression indirectly connected to MiL through its causal effect on well-being. Our findings point to the idiosyncrasy of pathways leading to depression and the importance of distinguishing factors relevant for symptom development versus persistence. This distinction may also partly explain the (short-term) effectiveness of existing depression treatments. As a next step, it seems important to examine the causal role of promising risk factors (e.g., low MiL) in depression-symptom persistence next to symptom development.