The Schema Theory of Depression: A Cross-Cultural Validation in a Canadian and an Egyptian Sample

Abstract

Depression is prevalent in all regions of the world. Population-based studies show that the lifetime prevalence of depression varies in different countries. The cognitive model of depression, which is the conceptual foundation for Cognitive-Behavioural Therapy, postulates that the thoughts of depressed individuals differ systematically from those of their non-depressed counterparts. These proposed differences have been validated among individuals of Western descent. Unfortunately, and despite the universal connotations of the cognitive model, the hypotheses generated by this model have seldom been tested among depressed individuals living outside the Western world. The study presented examined a number of hypotheses (e.g., negativity, exclusivity, severity, schema activation, and selective attention) among a group of depressed (n = 29) and non-depressed (n = 29) Egyptians. To this end, a number of self-report measures as well as an experimental attentional measure (the visual dot-probe) were used to test these hypotheses. The results were compared to a cultural control group of depressed (n = 35) and non-depressed (n = 38) Canadians (total N = 73). The results indicated that, in comparison to non-depressed Egyptians, depressed Egyptians harbored significantly more dysfunctional attitudes and negative thoughts about self and future, and significantly less positive thoughts about self. Contrary to predictions, depressed Egyptians and Canadians did not exhibit an attentional bias toward negative stimuli in comparison to non-depressed participants of both nations. Finally, Egyptians exhibited significantly more positive thoughts, and depressed Egyptians showed significantly higher positive attentional bias scores than their Canadian counterparts. These results, their implications, and the theoretical considerations of this research are further discussed.