Cognitive vulnerabilities and Depression: A Culture-Moderated Meta-Analysis

One of the several competing hypotheses that attempt to explain cross-cultural variations in major depressive disorder prevalence states that some of the core characteristics of collectivistic cultural structures may prevent the development of mood disorders. We investigated whether cognitive vulnerabilities derived from the cognitive-behavioral model discriminate similarly between clinically depressed and healthy samples in individualistic and collectivistic cultures. We searched PubMed, PsychINFO, web of Science, and Scopus until June 2019 for studies comparing levels of cognitive vulnerabilities between depressed and healthy samples. By employing a three-level meta-analytic procedure, we tested whether individualism-collectivism could predict the difference in levels of cognitive vulnerabilities between the two populations. For control purposes, we used two different country-level individualism indexes. We included 63 studies, conducted in 13 countries. Depressed samples displayed significantly higher levels of cognitive vulnerabilities compared to healthy ones ( g = 1.69, 95%CI [1.48; 1.87]). The two individualism indexes significantly predicted the effect size for automatic thoughts ( β = 0.501, p = .007). Only one individualism index predicted the effect sizes for dysfunctional attitudes ( β = 0.357, p = .011), and schemas ( β = 0.380, p = .049). Our findings indicate that cognitive vulnerabilities discriminate more poorly between depressed and healthy individuals in collectivistic countries.