Three types of university students with subthreshold depression characterized by distinctive cognitive behavioral skills

ABSTRACT

Subthreshold depression impairs young people’s quality of life and places them at greater risk of developing major depression. Cognitive behavioral therapy (CBT) is an evidence-based approach for addressing such depressive states. This study identified subtypes of university students with subthreshold depression and revealed discrete profiles of five CBT skills: self-monitoring, cognitive restructuring, behavioral activation, assertive communication, and problem solving. Using data from the Healthy Campus Trial (registration number: UMINCTR-000031307), a hierarchical clustering analysis categorized 1,080 students into three clusters: Reflective Low-skilled, Non-reflective High-skilled, and Non-reflective Low-skilled students. Non-reflective Low-skilled students were significantly more depressed than other students (p < .001). The severity of depression seemed to be related to the combination of self-monitoring skills and other CBT skills. Considering the high prevalence of poor self-monitoring skills in persons with autism, the most severe depression was observed in the significant association between Non-reflective Low-skilled students and autistic traits (p = .008). These findings suggest that subthreshold depression can be categorized into three subtypes based on CBT skill profiles. The assessment of autistic traits is also suggested when we provide CBT interventions for Non-reflective Low-skilled students.

KEYWORDS:

• Alexithymia
• general anxiety
• higher education
• subclinical depression
• pervasive developmental disorders

Disclosure statement

NS received lecture fees from Mochida Pharma and Sumitomo Pharma for work not associated with this article. MS reports personal fees from SONY. TAF reports grants and personal fees from Mitsubishi-Tanabe, personal fees from SONY, and personal fees from Shionogi outside the submitted work. TAF has a patent (2020-548587) concerning a smartphone CBT app pending and intellectual properties for a Kokoro-app licensed to Mitsubishi-Tanabe. The other authors have no competing interests to declare.

Data availability statement

The datasets analyzed in this study are available from the corresponding author upon reasonable request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/16506073.2023.2288557

Additional information

Funding

The work was supported by the Grant-in-Aid for Scientific Research from the Japanese Ministry of Education, Science, and Technology [21K03049]; World Health Organization Centre for Health Development (WHO Kobe Centre – WKC: K22001).