Relapse was defined in this study as a return,
within six months of symptom improvement, of
depressive symptoms required for a diagnosis of a MDD.
In addition, relapse was operationally defined as an
individual experiencing one or both of the following
criteria within six months of discharge after
hospitalization for a MDD: a depressive symptom score
of seven or more on the Nine-Question Assessment
for Depressive Disorders(9Q)35 and/or readmission
to a hospital due to the severity of depressive
symptoms. To explain factors contributing to relapse
among individuals with a MDD, four potential
psychosocial factors (cognitive vulnerability, selfefficacy
for coping with depression, stressful life
events, and expressed emotion of family members)
were proposed as being uniquely related to relapse of a
MDD. Thus, based upon review of literature and prior
research, the research question for this study was: How
much of the variability of relapse in persons with a
MDD could be explained by the psychosocial factors
of cognitive vulnerability, stressful life events, selfefficacy
for coping with depression, and expressed
emotion of family members?