Cognitive risk, coping-oriented substance use, and increased avoidance tendencies among depressed outpatients: A prospective investigation.

Objective: The present study was designed to assess the interplay between depressive cognition, coping-oriented substance use, and future behavioral disengagement tendencies. Cognitive risk subtypes examined include brooding rumination, attributional bias (internal/stable/global), and dysfunctional attitudes.

Method: Individuals were recruited from outpatient treatment settings and met criteria for a unipolar depressive disorder (N = 70; 66% female; 81% White; M  = 31; SD  = 13.2). Participants completed self-report measures of brooding rumination, attributional style, dysfunctional attitudes, coping-oriented substance use, and behavioral disengagement tendencies following a 3-week period.

Results: Brooding rumination, stable attributional style, and dysfunctional attitudes were positively associated with later behavioral disengagement tendencies. Coping-oriented substance use moderated associations between both internal attributional style, as well as dysfunctional attitudes onto later behavioral disengagement.

Conclusions: With regard to stress-related avoidance, subsyndromal substance use may play a detrimental role among cognitively vulnerable, depressed outpatients when said drug or alcohol use serves as a means of coping.