# The impact of adolescent clinical depression and depressive symptoms on moral thinking: based on process dissociation approach

## TL;DR

Depression in adolescents reduces their ability to make moral judgments, with negative rumination worsening the effects by increasing hostility and paranoia.

## Contribution

This study identifies a sequential mediation pathway linking rumination, depression, and reduced deontological moral reasoning in adolescents.

## Key findings

- Depressed adolescents show reduced utilitarian and deontological moral reasoning compared to healthy controls.
- Subclinical depressive symptoms predict lower deontological tendencies in moral judgments.
- Negative rumination increases depressive symptoms, which in turn raise paranoid ideation and hostility, lowering deontological judgments.

## Abstract

Adolescence is a critical period for moral development, and depression significantly impacts this process by altering cognitive and emotional processing, affecting the resolution of moral dilemmas. Rumination, closely linked to depression, also influences emotional and cognitive processing during moral judgments.

Study 1 examined 34 depressed adolescents and 36 healthy controls who completed the Beck Depression Inventory-Short Form and Beck Anxiety Inventory, followed by 20 moral dilemmas from the Process Dissociation (PD) procedure. Study 2 (n = 568) explored subclinical depressive symptoms and their antecedent role of rumination on moral judgments. The SCL-90 scale measured depression, paranoid ideation, and hostility, while the Positive and Negative Rumination scales assessed rumination levels.

Clinically depressed adolescents showed significantly reduced reliance on both utilitarian [t(65) = −3.90, p < 0.001, Cohen’s d = 0.95, 95%CI(−0.18, −0.06)] and deontological tendencies [t(65) = −3.03, p = 0.004, Cohen’s d = 0.74, 95%CI (−0.25, −0.05)], compared to control group. Subclinical depressive symptoms predicted lower deontological tendencies [β = −0.13, t(566) = −3.09, p = 0.02, 95%CI (−0.05, −0.01)]. Sequential mediation analyses revealed: (a) Negative rumination → depression → paranoid ideation → deontological decline [Indirect effect: b = −0.003, 95%CI (−0.005, −0.001)]; (b) Negative rumination → depression → hostility → deontological decline [Indirect effect: b = −0.003, 95%CI (−0.005, −0.0004)]. Negative rumination exacerbated depressive symptoms, which sequentially increased paranoid ideation and hostility, ultimately lowering deontological judgments.

Clinical depression decreases deontological and utilitarian moral reasoning, while negative rumination exacerbated depressive symptoms, which sequentially increased paranoid ideation and hostility, ultimately lowering deontological judgments. These findings highlight depression’s nuanced impact on adolescent moral development and underscore transdiagnostic mechanisms requiring targeted intervention.