ORIGINAL ARTICLE

Catastrophizing As a Predictor of Depressive and AnxiousSymptoms in Children

Valerie A. Noel • Sarah E. Francis •

Kristen Williams-Outerbridge • Stephanie L. Fung

Published online: 21 May 2011

� Springer Science+Business Media, LLC 2011

Abstract This study assessed the predictive relationship

between catastrophizing and depressive symptoms, when

controlling for anxiety, amongst 231 third-, fifth-, and sev-

enth-grade children. Hopelessness theory of depression

posits that the diathesis of consistently generating cata-

strophic inferences to the consequences of a negative event

can lead to hopelessness depression. Catastrophizing is often

observed in anxiety, yet no prior study has controlled for

anxiety when studying this cognitive risk factor for depres-

sion in the context of hopelessness theory. Results replicated

previous findings amongst youth aged 7–13, such that a

significant relationship was observed between depressive

symptoms and catastrophizing; this relationship remained

significant in the full sample after controlling for anxiety.

However, the relationship between catastrophizing and

depression differed by grade such that, after controlling for

anxiety, catastrophizing was predictive of depressive

symptoms amongst third-grade but not fifth- or seventh-

grade children. The inclusion of the anxiety construct in

hopelessness theory may enhance current conceptualizations

of the changing nature of depression across development.

Keywords Hopelessness theory � Depression �Catastrophizing � Anxiety � Children

The hopelessness theory of depression (Abramson et al.

1989) proposes that there exists a subtype of depression

referred to as hopelessness depression. Hopelessness

depression is defined by a subset of motivation- and

emotion-related symptoms of major depressive disorder

(i.e., retarded voluntary responses, sad affect, suicidal

ideation, lack of energy, apathy, psychomotor retardation,

sleep disturbance, difficulty in concentration, and mood

exacerbated negative cognitions; Abramson et al. 1989)

and is conceptualized as a subtype of the current subclas-

sifications of depression as defined by the Diagnostic and

Statistical Manual, Fourth Edition (DSM-IV; American

Psychiatric Association 2000). Three pessimistic inferen-

tial styles represent diatheses or risks for hopelessness

depression: (1) a negative attributional style (comprised of

internal, stable, and global attributions), (2) a consistent

catastrophizing of consequences of negative events (i.e.,

inferring pessimistic and catastrophic consequences), and

(3) a negative self-appraisal (e.g., about one’s self-worth,

self-efficacy), which, in sum, are referred to as a depress-

ogenic inferential style (Abramson et al. 1989). These

diatheses, coupled with stressful negative life events, can

result in the experience of hopelessness depression. As

such, the presence of any of these three diatheses presents a

cognitive risk factor for the development of depression.

Previous research has suggested that prior to adoles-

cence, children do not posses a stable attributional style (a

consistent style of inferences about the cause of an event)

but rather that their attributions are context dependent (e.g.,

Cole and Turner 1993; Turner and Cole 1994). It has been

suggested that the development of a consistent attributional

style requires a certain level of cognitive ability that may

only emerge in adolescence or adulthood (e.g., abstract

reasoning) (Abela 2001). According to hopelessness the-

ory, inferences about the cause of a negative event are only

V. A. Noel � S. E. Francis (&) � S. L. Fung

Department of Psychology, Memorial University

of Newfoundland, St. John’s, NL A1B 3X9, Canada

e-mail: sfrancis@mun.ca; sf9103@hotmail.com

K. Williams-Outerbridge

Department of Psychology, University of Windsor,

Chrysler Hall South, Room 173, 401 Sunset Avenue,

Windsor, ON N9B 3P4, Canada

123

Cogn Ther Res (2012) 36:311–320

DOI 10.1007/s10608-011-9370-2

one of the three types of inferences that can be made in

response to a negative event, the other two being inferences

about the consequences of a negative event and inferences

about oneself. Given that children might not possess the

requisite cognitive skills to adopt a consistent negative

attributional style, there may be better predictors of hope-

lessness depression in children. Having a consistent style of

inferences regarding the causes of an event may require

more abstract reasoning that may not be present in younger

children. Indeed, the style of inferences made about the

consequences of an event, rather than the causes, might be

more salient to hopelessness depression among children.

One specific type of inference about the consequences of

events, catastrophizing (consistently inferring catastrophic

consequences resulting from a negative event), has been

posited as a specific risk factor for depression (Abramson

et al. 1989). However, a limited number of empirical

investigations of this cognitive risk factor for depression

have been conducted with children (e.g., Abela 2001; Abela

and Payne 2003; Adams et al. 2007; Garnefski et al. 2002;

Hankin and Abramson 2002). Moreover, although studies

with children have demonstrated a relationship between

catastrophizing and anxiety (Epkins 1996; Legerstee et al.

2010; Leitenberg et al. 1986; Watts and Weems 2006;

Weems et al. 2001), and depression and anxiety (e.g., Chorpita

et al. 1998; Seligman and Ollendick 1998 Verduin and

Kendall 2003; Zahn-Waxler et al. 2000), no study to date has

controlled for anxiety in the examination of the relationship

between catastrophizing and depression, within the frame-

work of hopelessness theory. Given that anxiety is associated

with catastrophizing and depression, it might represent a

third variable that is responsible for the potentially spurious

relationship between catastrophizing and depression that has

been observed in previous studies. The purpose of this

investigation is to further the current understanding of the

factors that may contribute to the development of depression

in children by investigating the nature of the relationship

between catastrophizing and concurrent depressive and

anxious symptoms in children. Specifically, this investiga-

tion sought to ascertain whether a specific diathesis proposed

by the hopelessness theory of depression (catastrophizing) is

indeed a predictor of depression symptoms amongst youth.

As such, this study examined the style of generating infer-

ences related to the consequences of negative events (spe-

cifically, catastrophizing consequences), rather than the

causes, and controlled for anxiety when testing for a rela-

tionship between catastrophizing and depression.

Catastrophizing, Depression, and Anxiety in Children

Drawing from theories of cognitive development, making

inferences of the consequences of events may require less

abstract reasoning than making inferences of the causes of

events, and would thus emerge before the ability to form

causal attributions (Abela 2001). Consistent with this

notion, children have been found to be able to form

inferences about the consequences of events (e.g., catas-

trophizing) before they are able to make causal inferences

(Abela 2001). In children ages 8–13 years, the interaction

between a life stressor and catastrophizing cognitions in

response to that stressor has been shown to be predictive of

depression (Abela 2001). Furthermore, adolescents who

catastrophize have been shown to exhibit elevated levels of

depression (Abela and Sarin 2002; Hankin and Abramson

2002). Catastrophizing has also been shown to be predic-

tive of depression in this age group (Hankin and Abramson

2002). However, the studies reporting a relationship

between catastrophizing and depressive symptoms have not

assessed or controlled for concurrent symptoms of anxiety,

a particularly salient limitation given that anxiety has been

shown to be related to both of these constructs and thus

might explain the previously observed association between

depression and catastrophizing.

Just as is observed in adults, in children, anxiety and

catastrophizing are significantly correlated, such that chil-

dren with a greater number of anxious symptoms catastro-

phize more than those with fewer symptoms (Watts and

Weems 2006). Weems and colleagues (2001) evaluated the

relationship between cognitive errors and anxiety in a

clinical sample of children between the ages of 6 and

17 years who met diagnostic criteria for an anxiety disorder.

Consistent with previous findings, the cognitive errors of

catastrophizing and personalizing (i.e., taking personal

responsibility of negative outcomes) were the strongest

predictors of anxious symptoms in the child sample. Over-

generalizing (i.e., assuming that the outcome of one expe-

rience will be repeated later in other similar experiences)

and selective abstraction (i.e., the tendency to focus only on

negative experiences) were found to be the strongest for

depressive symptoms. Although the authors did not state the

variance in depression scores accounted for by catastro-

phizing, they did note that when controlling for anxiety, a

small yet significant correlation was observed between

catastrophizing and depression, suggesting that a relationship

may exist between catastrophizing and depression beyond

that which is accounted for by anxiety. This study provides

evidence to suggest that catastrophizing and depression are

related independent of anxiety. However, independent rep-

lication of these findings, when examined within the context

of hopelessness depression amongst a sample of non-anxiety

disordered youth, is needed to gain a more comprehensive

understanding of the relationship between depression and

the cognitive risk factor of catastrophizing.

Previous studies have noted a trend across age groups

such that older participants catastrophize less frequently

312 Cogn Ther Res (2012) 36:311–320

123

than younger participants (e.g., Abela 2001; Watts and

Weems 2006); more specifically, younger children (less

than 12 years of age) engage in the catastrophizing thought

process in response to negative events more often than

older children (12 years of age and older). However, not all

studies have examined the catastrophizing-depression

relationship across different age groups, instead testing this

relationship among their child samples as a whole (Abela

and Payne 2003; Brozina and Abela 2006). Yet the dif-

ferences in catastrophizing frequency across different age

groups in childhood demonstrated by some previous stud-

ies provide reason to suggest the relationship between

catastrophizing and depression might be different at dif-

ferent ages as well. That is, the relationship between

catastrophizing and depression, independent of anxiety, may

be exhibited differently in younger children (ages 8–11),

who are predicted to catastrophize more often, as compared

to older children (ages 12–13). However, given that anxiety

has not been controlled for in previous studies, our pre-

dictions instead follow from what has previously been

found in terms of the catastrophizing-depression relation-

ship. Specifically, in the present study it is predicted that,

after controlling for anxiety, catastrophizing will be a

significant predictor of depressive symptoms in both

younger (ages 8–11) and older participants (ages 12–13);

however, significant between groups differences are pre-

dicted with respect to catastrophizing frequency such that

younger children (ages 8–11 years) are predicted to

catastrophize more than older children (ages 12–13 years).

This study’s examination of catastrophizing and

depression differs from earlier studies in that the relation-

ship between catastrophizing and depression was examined

at three independent intervals during childhood in order to

assess potential changes in the relationship between

catastrophizing and depression across age groups. Addi-

tionally, as several studies demonstrating a relationship

between catastrophizing and depression have not con-

trolled for anxiety (e.g., Abela 2001; Ghahramanlou-Hol-

loway et al. 2007; Hankin and Abramson 2002), this study

assessed and controlled for anxiety in an effort to distin-

guish the contribution of catastrophizing to anxiety from

that to depression. Although a relationship between catas-

trophizing and depression independent of anxiety has been

observed across a sample of children and adolescents

diagnosed with anxiety (Weems et al. 2001), the present

study will examine this relationship in a sample of youth

without clinical levels of anxiety in order to ascertain the

specific contribution of catastrophizing to depressive

symptoms outside of the context of elevated anxiety.

Moreover, to examine the extent to which the relationship

between depression and catastrophizing might differ across

age, the present study evaluated this relationship amongst

three different age groups to determine (a) whether the

contribution of catastrophizing to depressive symptoms

changes as a function of age, and (b) whether previously

observed differences in the frequency of catastrophizing

across age are also present in a sample of non-referred

youth.

Method

Participants

The present sample consisted of 77 third-grade participants

(44 girls and 33 boys), 64 fifth-grade participants (49 girls

and 15 boys), and 90 seventh-grade participants (55 girls

and 35 boys) yielding a total sample of 231 participants

(148 girls and 83 boys). Grade three participants ranged in

age from 8 years, 3 months to 9 years, 8 months (M =

8.86 years; SD = 3.69 months). Grade five participants

ranged in age from 10 years, 3 months to 11 years, 10

months (M = 10.84 years; SD = 4.18 months). Grade

seven participants ranged in age from 11 years, 11 months to

13 years, 4 months (M = 12.67 years; SD = 4.32 months).

The sample was 95.2% (n = 220) White, 2.6% (n = 6)

mixed, .4% (n = 1) Black, .4% (n = 1) East Asian, .4%

(n = 1) South Asian, and .4% (n = 1) Native. One partici-

pant did not indicate their ethnic group. All participants’

parents provided informed consent consistent with proce-

dures approved by the university’s institutional review board

prior to the child’s participation in the study.

Measures

The study concurrently measured catastrophizing, depres-

sion, and anxiety among the sample of school-aged chil-

dren. Three questionnaires were used to measure these

constructs.

Demographic Information Sheet

The demographic information sheet consisted of a series of

questions regarding the participant’s age, gender, living

situation, number of brothers and sisters, ethnicity, and

mother’s and father’s line of work (an assessment of

socioeconomic status). This form appeared at the front of

every package following the assent form.

Children’s Cognitive Style Questionnaire (CCSQ;

Abela 2001)

The CCSQ is a questionnaire designed to measure catas-

trophizing (Part I) and the tendency to make negative

inferences about the self (Part II) following a negative

event. The CCSQ has been administered and validated in

Cogn Ther Res (2012) 36:311–320 313

123

children between the ages of 8 and 13 years. As the current

study measured catastrophizing and not self-appraisal, only

Part I of the CCSQ, which measures catastrophizing

(CCSQ-CAT), was administered. Catastrophizing, as

operationalized by the CCSQ-CAT, was measured by 12

items. Each of the 12 items describe a negative event to

which the child is given four response options: (1) This

won’t cause other bad things to happen to me; (2) This

might cause other bad things to happen to me; (3) This will

cause other bad things to happen to me; and (4) This will

cause many terrible things to happen to me. Response

scores range from 0 to 3 leading to total scores for the

catastrophizing cognitive error to range from 0 to 36.

Higher scores indicate a greater inclination to catastrophize

the consequences of a negative event. Moderate coefficient

alphas have been obtained for the catastrophizing scale in

third- and seventh- grade children (ranging from .66 to .81;

Abela 2001; Abela and Payne 2003; Brozina and Abela

2006). Significant correlations have been reported between

CCSQ-CAT scores over a seven week-interval (r = .41–

.46, P \ .01; Abela 2001).

Center for Epidemiological Studies Depression Scale

for Children (CES-DC; Weissman et al. 1980)

The CES-DC is a 20-item self-report questionnaire

designed to measure depressive symptoms in children aged

8–17 years old. The items measure the frequency of

depressive symptoms over the previous week on a 4-point

scale ranging from 0 (not at all) to 4 (a lot). Total scores

range from 0 to 60 with higher scores indicating higher

levels of depression. Faulstich (1986) reported good

internal consistency in a sample of children ranging in age

from 8 to 17 years with a coefficient alpha of .83, as well as

acceptable test–retest reliability over a 2 week-interval

(r = .51). The CES-DC has shown moderate correlation

(r = .44; Faulstich 1986) with the Children’s Depression

Inventory (Kovacs 1980).

Although the Children’s Depression Inventory (CDI;

Kovacs 1980) is a commonly used measure of depression

in children, many studies have included the CES-DC to

assess depressive symptoms as opposed to the Children’s

Depression Inventory (CDI; Kovacs 1980). The CES-DC

has demonstrated higher estimates of test–retest reliability

than the CDI amongst a non-referred sample (Cohen 1988),

suggesting that it not only assesses symptoms specific to

depression but also that it is less influenced by day-to-day

fluctuations in mood than the CDI. Moreover, recent

reports have suggested that the CDI assesses general neg-

ative affectivity (common to both anxiety and depression)

rather than specific depressive symptomatology (e.g.,

Chorpita et al. 1998; Stark and Laurent 2001). To maxi-

mize the likelihood that any relationship observed between

the constructs of catastrophizing and depression was indeed

reflective of an association between catastrophizing and

depression (and not negative affectivity), we chose to

employ the CES-DC.

Revised Child Anxiety and Depression Scale (RCADS;

Chorpita et al. 2000)

The RCADS is a 47-item self-report questionnaire that

measures symptoms of anxiety and depression in children.

The scale contains six subscales that correspond to six

DSM-IV disorders: Separation Anxiety Disorder (SAD),

Social Phobia (SP), Generalized Anxiety Disorder (GAD),

Panic Disorder (PD), Obsessive Compulsive Disorder

(OCD), and Major Depressive Disorder (MDD). Children

are instructed to rate how often each item applies to them

on a scale from 0 to 3 (0—Never, 1—Sometimes, 2—

Often, 3—Always). Total scores range from 0 to 141 with

higher scores indicating higher levels of anxious and

depressive symptoms. The reliability coefficients on each

subscale obtained from a normative school sample are

moderate and range from .71 to .85, and test–retest coef-

ficients range from .69 to .80 (Chorpita et al. 2000).

Internal consistencies for subscales measured using clinical

samples range from .78 to .88 (Chorpita et al. 2005). The

correlations between the RCADS anxiety subscales and the

Revised Children’s Manifest Anxiety Scale (RCMAS) total

score are moderate and range from .49 to .68 (Chorpita

et al. 2000). The present study used a composite score of

the anxiety scales (i.e., the summed score from the gen-

eralized anxiety disorder scale, obsessive compulsive scale,

panic disorder scale, separation anxiety scale, and social

anxiety scale) to measure symptoms of anxiety.

Procedure

A letter describing the study was sent to each principal of

36 schools. Thirteen schools (8 elementary and 5 junior

high) agreed to take part in the study. A letter and consent

form addressed to parents describing the purpose of the

study, data collection, and risks and benefits to participat-

ing were sent home with all third-, fifth-, and seventh-

grade children at each school. Only children whose parents

provided consent participated in the study. Consent rates at

each school ranged from 2 to 25%.

At the time of data collection, a brief 2–3 min presenta-

tion (introducing the investigator, describing the premise of

the study, and giving instructions for completion of the

questionnaires) was given prior to the distribution of the

assent form and questionnaires. As part of a larger study,

questionnaire packages included an assent form, a demo-

graphic information sheet, and five questionnaires including

the CCSQ-CAT, the CES-DC, and the RCADS which were

314 Cogn Ther Res (2012) 36:311–320

123

the three inventories used in this study. The questionnaire

packages were numbered to ensure the anonymity of the

participants and the questionnaires within each package

were counterbalanced according to Latin squares design

(Williams 1949). The fifth- and seventh-grade participants

read their questionnaires to themselves and completed the

three questionnaires and the demographic information form

in one sitting. Because the questionnaires were administered

orally to each group (ranging in size from 6 to 17 children) of

third grade participants, questionnaires in each package were

randomized across third-grade participant groups but not

within participant groups. Administration of the question-

naires to third-grade participants took place over two ses-

sions, each approximately 30 min in duration.

Results

Descriptive Statistics and Internal Consistencies

Descriptive statistics of the CES-DC, RCADS-anxiety

composite, and the CCSQ-CAT total scores across the full

sample and within each grade are reported in Table 1.

Examination of the three total scores indicated that each

deviated significantly from the normal distribution. To

normalize the skewed distributions, a square-root function

was used to transform each of the total scores. The trans-

formed variables were used in all subsequent analyses.

Preliminary analyses were conducted to determine

whether gender and the child’s living situation were related

to catastrophizing, depression, or anxiety in the full sample.

There were no significant differences between boys and

girls in mean scores on the CCSQ-CAT or the CES-DC.

However, girls had higher RCADS anxiety composite

scores compared to boys (t (226) = 3.86, P \ .01). As a

result of the observed gender difference in the RCADS

anxiety composite score, gender was used as a covariate in

all planned analyses. Because gender was not found to be a

significant covariate in any of the analyses, the results

reported are the planned analyses without gender entered as

a covariate. There was no significant difference across the

child’s living situation on the catastrophizing scale,

depression scale, or the anxiety composite. Group com-

parisons and analyses were collapsed across gender and

living situation for all subsequent analyses.

Tests of internal consistency were conducted for the

catastrophizing scale, the depression scale, and the RCADS

anxiety composite scale, in the full sample and within each

grade level. Across the full sample a high internal consis-

tency was found for the RCADS anxiety composite scale

and moderate internal consistencies were found for the

CES-DC, and the CCSQ-CAT (see Table 1). Within each

grade, moderate to high internal consistencies were found

for the CES-DC, the RCADS anxiety composite scale, and

the CCSQ-CAT (see Table 1).

Catastrophizing and Depression

The purpose of this study was to determine whether ca-

tastrophizing the consequences of a negative event signif-

icantly predicts concurrent depressive symptoms in

children and whether this relationship remains significant

after anxious symptoms have been controlled for. Corre-

lations between the CCSQ-CAT, CES-DC, and the

RCADS anxiety composite score across the full sample and

within each grade are reported in Table 2. In the full

sample and in each grade, catastrophizing and depression

were significantly correlated; this finding was consistent

with previous studies (e.g., Abela 2001; Abela and Sarin

2002; Weems et al. 2001). Anxiety and catastrophizing

were also significantly correlated in the fifth- and seventh-

grade samples, but not in the third-grade sample. This

finding suggested that the relationship between catastro-

phizing and anxiety in younger children was different from

that in older children; whereas catastrophizing and anxiety

were more strongly correlated than catastrophizing and

depression in older children, the reverse of this trend was

observed in younger children.

Regression analyses were conducted to determine whe-

ther catastrophizing would remain a significant predictor of

Table 1 Internal consistencies and descriptive statistics for the

CCSQ-CAT, CES-DC, and RCADS-ANX

Grade CCSQ-CAT CES-DC RCADS-ANX

Full sample .81 .87 .92

Mean (SD) 10.85 (5.73) 13.40 (9.41) 27.29 (14.98)

Range 1.00–36.00 .00–53.00 .00–83.00

Skew (SE) 1.02 (.16) 1.10 (.16) .77 (.16)

Grade 3 .84 .80 .90

Mean (SD) 11.18 (6.51) 13.91 (7.92) 29.90 (14.60)

Range 1.00–36.00 .00–37.00 .00–67.00

Skew (SE) 1.29 (.27) .70 (.27) .39 (.27)

Grade 5 .78 .84 .92

Mean (SD) 11.70 (5.29) 12.38 (9.17) 25.75 (14.90)

Range 2.00–30.00 .00–39.00 2.00–72.00

Skew (SE) .98 (.30) 1.11 (.31) .84 (.31)

Grade 7 .81 .92 .93

Mean (SD) 9.96 (5.24) 13.64 (10.71) 26.11 (15.22)

Range 2.00–26.00 .00–53.00 .00–83.00

Skew (SE) .59 (.25) 1.29 (.25) 1.10 (.25)

CCSQ_CAT children’s cognitive style questionnaire catastrophizing

subscale, CES-DC centre for epidemiological studies depression scale

for children, RCADS-ANX revised child anxiety and depression

scale—anxiety composite score

Cogn Ther Res (2012) 36:311–320 315

123

depression in younger and older children after controlling

for anxiety. Consistent with previous research, anxiety and

depression were highly correlated across the three age

groups (Table 2); in order to determine whether anxiety

accounted for the relationship between depression and

catastrophizing, anxiety was controlled for in subsequent

regression analyses (see Table 3). First, total anxiety scores

from the RCADS were regressed on the CES-DC. This

regression analysis was conducted across the full sample,

to be consistent with Weems and colleagues (2001), and

within each grade level. Next, the CCSQ-CAT was

regressed on CES-DC scores. The addition of the CCSQ-

CAT to the regression equation resulted in a significant

increase in variance accounted for in the full sample,

suggesting that there was a unique relationship between

catastrophizing and depression. However, after conducting

identical analyses within each grade, controlling for anxi-

ety, catastrophizing was a significant predictor of depres-

sive symptoms in the third-grade sample (DR2 = .07, F (1,

74) = 6.94, P = .01), which reinforced the correlational

finding, but not the fifth-grade (DR2 \ .01, F (1, 57) = .19,

P = .66) or seventh-grade (DR2 \ .01, F (1, 87) = .40,

P = .53) samples.

As inconsistent findings have been demonstrated with

respect to differences in catastrophizing between older

children (greater than age 12) and younger children (less

than age 12), grade was examined as a between groups

variable, testing the difference in catastrophizing at

different age groups. Specifically, the CCSQ-CAT

scores were compared between the third- and fifth-grade

participants, the fifth- and seventh- grade participants, and

the third- and seventh-grade participants through planned

comparisons using contrast coefficients (see Table 1 for

means and standard deviations).

Inconsistent with previous findings, there were no sig-

nificant differences in CCSQ-CAT scores between the

grades suggesting that in the present sample, age, as

measured by grade level, was not related to differences in

self-reports of catastrophizing cognitions (F (2, 228) =

2.12, P = .12). In addition, a small effect size was found in

testing differences in the CCSQ-CAT scores between the

fifth- and seventh-grade participants (d = .28). The effect

size for the difference in CCSQ-CAT scores between the

third- and fifth-grade participants (d = .12) and the third-

and seventh-grade participants (d = .16) was smaller than

the minimum value for a small effect size (d = .20; Cohen

1988) indicating no difference in catastrophizing between

these two groups.

Discussion

The purpose of this study was to assess the predictive

relationship between catastrophizing and depressive

symptoms in children when controlling for symptoms of

anxiety. Significant correlations were observed between the

CCSQ catastrophizing scale and the CES-DC across third-,

fifth-, and seventh-grade participants, suggesting, as pre-

vious studies have demonstrated, that catastrophizing is a

significant predictor of concurrent depressive symptoms in

youth. Additionally, analyses demonstrated that a unique

relationship exists between catastrophizing and depressive

symptoms, after controlling for anxiety, in children ages

8–13 years. Yet, when examined by age group, a rela-

tionship between catastrophizing and depression, while

controlling for anxiety, was observed in the younger chil-

dren between the ages of 8 and 9 years, but not amongst

Table 2 Correlational analyses across the full sample, and third-,

fifth-, and seventh- grade children

Measure CES-DC CCSQ_CAT

Full sample

CCSQ_CAT .32*

ANX .62* .33*

Grade 3

CCSQ_CAT .34*

ANX .46* .19

Grade 5

CCSQ_CAT .30*

ANX .62* .42*

Grade 7

CCSQ_CAT .35*

ANX .71* .43*

Pearson correlations conducted with normalized variables; CCSQ_CAT children’s cognitive style questionnaire catastrophizing subscale,

CES-DC centre for epidemiological studies depression scale for

children, ANX revised child anxiety and depression scale—anxiety

composite score

* P \ .01

Table 3 Regression analyses using normalized anxiety scores in step

1 and catastrophizing as measured by the normalized CCSQ_CAT

scores in step 2 predicting normalized CES-DC scores in each grade

Measure R2 DR2 df DF Dp B S.E. b

CES-DC

Full sample .39 .02 1, 224 5.46 .02* .19 .08 .13

Grade 3 .28 .07 1, 74 6.94 .01* .31 .12 .27

Grade 5 .38 \.01 1, 57 .19 .66 .09 .20 .05

Grade 7 .52 \.01 1, 87 .40 .53 .09 .14 .05

CCSQ_CAT children’s cognitive style questionnaire catastrophizing

subscale, CES-DC centre for epidemiological studies depression scale

for children, RCADS-ANX revised child anxiety and depression

scale—anxiety composite score

* P \ .05

316 Cogn Ther Res (2012) 36:311–320

123

the older children (aged 10–13 years). These findings

suggest that the relationship between catastrophizing and

depressive symptoms in youth does change as a function of

age when the important third variable of anxiety is con-

trolled for.

Findings from the present study, examining the full

sample of participants, are consistent with the findings of

several previously published reports. Specifically, Weems

and colleagues (2001), in their sample of children ages

6–17 years diagnosed with an anxiety disorder, reported a

significant correlation between depression and catastro-

phizing while controlling for anxiety. Similarly, Hankin

and Abramson (2002), utilizing a subscale of the Adoles-

cent Cognitive Style Questionnaire to measure catastro-

phizing in their grade 9–12 sample, reported that

catastrophizing was predictive of concurrent depressive

symptoms. However, because Weems and colleagues

(2001) did not examine the relationship between depres-

sion and catastrophizing by age and Hankin and Abramson

(2002) did not control for anxiety in their study, two

important questions remained unaddressed. Results of the

present study differed from previous findings by suggesting

that (1) the nature of the relationship between depression

and catastrophizing changes across age, such that (2)

amongst younger children (aged 8–9) a unique relationship

(not accounted for by anxiety) does exist between depres-

sion and catastrophizing, whereas amongst older children

anxiety does account for the previously observed rela-

tionship between depression and catastrophizing amongst

youth.

The present findings also diverge from previous findings

with respect to age-related differences in the frequency of

catastrophizing. Specifically, in testing the diathesis-stress

model between catastrophizing and negative life events in

predicting depressive symptoms, Abela and Payne (2003)

observed that their third-grade participants were more

likely to catastrophize than their seventh-grade partici-

pants; however, although there appeared to be a trend

suggesting that the seventh-grade sample in the present

study did have lower CCSQ scores compared to the third-

grade sample, this difference was not significant. Instead,

findings from this study suggested that third-, fifth-, and

seventh-grade children catastrophize negative events at a

similar frequency. These results differ from both Abela

(2001) and Abela and Payne (2003). An examination of the

CCSQ in the present study revealed good psychometric

properties across grade level. Although, Abela and Payne

(2003) did not report the reliability of the CCSQ within

their third- and seventh-grade samples, fairly low reliability

was reported for the CCSQ in Abela’s (2001) seventh-

grade sample. Additionally, the difference in CCSQ scores

reported by Abela and Payne (2003) only approached

significance, and their seventh-grade sample was nearly

twice as large as the sample employed in the present study.

Had the sample sizes between Abela and Payne (2003) and

the present study been more comparable, the results would

most likely have been more consistent, indicating that

younger children generate catastrophic inferences to the

consequences of negative events more often than older

children. This difference in the frequency of catastrophiz-

ing between younger and older children observed in

previous studies might also explain the differential rela-

tionship between catastrophizing and depression across the

different age groups examined here.

Alternatively, the lack of a unique relationship between

catastrophizing and depressive symptoms in the fifth- and

seventh-grade samples observed in this study may be

attributed to a change in the relationship between anxiety

and depression with age. The correlation analysis between

the RCADS anxiety composite and the CES-DC suggests a

linear trend in the increase of the correlation between

anxious and depressive symptoms across the three grade

levels. The magnitude of the relationship between these

two constructs changes from medium in the third-grade

sample (r = .46) to large in the fifth-grade (r = .62) and

seventh-grade samples (r = .72), indicating a potential

increase in the comorbidity of anxious and depressive

symptoms with increasing age. Accordingly, these results

suggest that as the variance shared by depressive and

anxious symptoms increases, catastrophizing might be

more closely related to the common negative affectivity

underlying both anxiety and depression rather than to the

attributes of depression that distinguish it from anxiety.

These findings would then tentatively suggest that the

cognitive processes associated with catastrophizing in early

childhood are more reflective of a depressive style of

thinking rather than an anxious one, whereas the reverse

might be true in later childhood. One such associated

cognitive process might be rumination. Rumination is

defined as a repetitive thought process which focuses

attention on one’s symptoms associated with distress and

the causes and consequences of these symptoms (Nolen-

Hoeksema 1998). Engaging in rumination has been shown

to lead individuals to generate more depressogenic infer-

ences of the causes and consequences of the events in their

life (Nolen-Hoeksema 1998). One could suggest a medi-

tational role of rumination between catastrophizing and

depressive symptoms. Specifically, since rumination may

augment an individual’s experience of negative emotions

(Nolen-Hoeksema 2001), a bidirectional relationship could

exist between catastrophizing and depression, which

would be accounted for by rumination. Children experi-

encing negative emotions might fixate on these symptoms

and evaluate the consequences of these negative emo-

tions through catastrophizing, which would further increase

depressive symptoms.

Cogn Ther Res (2012) 36:311–320 317

123

It could be suggested that once an inference as to the

consequences of an event is made, older children may

reflect upon that specific inference to a greater degree than

younger children, which would be a form of worrying,

which has been postulated to be a feature specific to anx-

iety rather than depression (e.g., Muris et al. 2004).

Accordingly, catastrophizing may be a feature more asso-

ciated with anxiety than depression in older children as it

may share with anxiety the underlying component of

worrying. As anxiety has been shown to be comorbid with

depression in older children, the presence of anxiety may

indicate an increased risk for the presence of depression

(Axelson and Birmaher 2001).

It is also quite possible that younger children, who in

previous research have been shown to have higher scores

on the CCSQ, may generate more unique catastrophic

consequences than older children but may not reflect on

them (i.e., worry) to the same extent as older children. The

CCSQ catastrophizing scale was not designed to capture

the worrying aspect of catastrophizing but rather the fre-

quency with which a child generates unique catastrophic

thoughts. Thus, the potential lack of worrying in the ca-

tastrophizing thought process displayed by young children

(which cannot be tapped by the CCSQ) may explain why a

lack of a correlation between anxiety and catastrophizing

was observed in the present study in the third-grade

children.

With respect to hopelessness theory, the findings from

the present study support the relationship stipulated under

this theory between catastrophizing and depression in

young children (ages 8–9). These results do not contradict

hopelessness theory for depression in older children but

rather suggest that in children over the age of 10 years, that

the relationship between catastrophizing and depressive

symptoms is not direct, and may be accounted for by

anxiety, a factor which is associated with both catastro-

phizing and depression.

Limitations and Future Directions

One key limitation of the present study was the absence of

a measure of hopelessness depression. Despite the value

that such a measure would lend to this area of study, an

empirically validated measure of hopelessness depression

does not currently exist. Because hopelessness depression

was not measured in the present study, one may only

speculate as to whether the present findings explain the

development of hopelessness depression specifically, as

opposed to depressive symptoms more generally. As such,

although the present study offers insight with respect to the

relationship between catastrophizing and depressive

symptomatology amongst three different age groups of

youth, further research is needed to ascertain the extent to

which this relationship is unique to symptoms of hope-

lessness depression. Accordingly, an important area of

future research will be developing a psychometri-

cally sound measure of hopelessness depression for use

amongst youth to facilitate the examination of the rela-

tionships between catastrophizing, anxiety, and hopeless-

ness depression specifically.

An additional limitation of the present study was the low

consent rate which ranged from 2 to 25%. As a result, the

generalizability of the current findings may be limited.

Therefore, replication of the study’s findings is necessary

to provide further support for the existence of age differ-

ences in the relationship between catastrophizing, anxiety,

and depression. The findings from the third-grade sample

fall within the framework of hopelessness theory; however,

the findings in the fifth- and seventh-grade sample are

novel. Therefore, a particularly salient goal of future

research would be to examine the relationships between

catastrophizing, anxiety, and depression amongst an addi-

tional sample at multiple intervals during childhood in

order to increase generalizability of the present findings.

An important addition to this study would have been the

inclusion of a measure of hopelessness, such as the

Hopelessness Scale for Children (Kazdin et al. 1983).

Hopelessness theory proposes that it is the state of being

hopeless that causes hopelessness depression. A measure of

hopelessness would have further validated the CES-DC by

providing additional evidence that the CES-DC measures

the construct of hopelessness as it is observed in depressed

individuals. Using a scale developed for the purpose of

measuring hopelessness may have provided more vari-

ability than a scale developed to measure depression.

Specifically, it may have detected a unique relationship

between catastrophizing and hopelessness across the full

sample, due to a probable higher prevalence of hopeless-

ness than of specific symptoms of depression, which would

provide results consistent with hopelessness theory. Mea-

suring hopelessness in future studies could contribute to

delineating the relationship between catastrophizing, anx-

iety, and depression and further explain the components

that contribute to the relationship between catastrophizing

and depression. Despite not including a measure of hope-

lessness in this study, however, these findings provide an

important first step in distinguishing the contributions of

catastrophizing to depression from those of catastro-

phizing to anxiety, thus yielding information critical to

better understanding the hopelessness theory of depression

amongst children.

Future studies might also consider examining the factor

structure of catastrophizing as it relates to anxiety and

depression to provide a more comprehensive understand-

ing of the catastrophizing construct. For example, if

318 Cogn Ther Res (2012) 36:311–320

123

catastrophizing is found to be comprised of a set of second

order factors, this area of research might benefit from

studies examining whether certain second order factors

correspond differentially to specific anxious symptoms and

specific depressive symptoms and how these relationships

may change with age.

It is also suggested that future investigations evaluate

the predictive relationship between catastrophizing and

depression in older children and adolescents. The results

from this study suggest that there is a weak to nonexistent

relationship between catastrophizing and depression when

controlling for anxiety in fifth- and seventh-grade partici-

pants. However, this finding should be replicated and fur-

ther evaluated using other measures of catastrophizing.

More specifically, future studies might consider employing

an inventory developed for adolescents such as the Ado-

lescent Cognitive Style Questionnaire (Hankin and

Abramson 2002). Additionally future studies might aim to

differentiate between the frequency with which a child

generates unique catastrophic thoughts and the degree to

which a child reflects or worries about these thoughts. Such

findings would help clarify whether the lack of a unique

relationship between catastrophizing and depression

observed in the fifth- and seventh-grade samples is to be

attributed to a factor shared by anxiety and catastrophizing

or whether this finding is a result of current definitions of

the catastrophizing construct and the methods presently

available to measure it.

Future studies might also benefit from examining

rumination [e.g., using the Children’s Response Style

Questionnaire (Abela et al. 2004)] as an emotion coping

strategy which might underlie the relationship between

catastrophizing and depression in young children. If

rumination is an underlying factor in the relationship

between catastrophizing and depression, teaching adaptive

emotion coping strategies, such as problem solving strat-

egies, in place of rumination might reduce catastrophizing

thought processes in response to negative events, in turn

reducing depressive symptoms and the risk of developing

depression.

Conclusion

The aim of this study was to examine the predictive rela-

tionship between catastrophizing and depressive symptoms

in children when controlling for anxiety. The results from

the full sample replicate what has previously been found in

samples between the ages of 7 and 13 years, such that a

significant relationship was observed between depressive

symptoms and catastrophizing; however, closer examina-

tion revealed differences that previous studies had not

found given that their analyses failed to control for anxiety

and were not performed separately for each age group.

Consistent with previous findings, the present study dem-

onstrated that a significant relationship between catastro-

phizing and depression was observed in the full sample

even after controlling for anxiety. However, results from

analyses conducted within each grade demonstrated that

the relationship between catastrophizing and depression

differed: after controlling for anxiety, catastrophizing was

predictive of depressive symptoms in the third-grade

sample but not in the fifth- or seventh-grade samples. The

results suggest that anxiety may account for the relation-

ship between catastrophizing and depression in older

children, as in older children, catastrophizing and anxiety

may share an underlying component of worrying. The

inclusion of the anxiety construct in hopelessness theory

may enhance current understanding of the changes in the

development of depression with increasing age, and could

have implications for the treatment and prevention of

depression and anxiety in children and adolescents.

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