Tests of generalizability can diversify psychological science and improve theories and measurement. To this end, we conducted five studies testing the cognitive vulnerability to depression hypothesis featured in the hopelessness theory of depression: Study 1 was conducted with Honduran young adults (n = 50); Study 2 was conducted with Nepali adults (n = 34); Study 3 was conducted with Western hemisphere adults (n = 104); Study 4 was conducted with Black U.S. adults (n = 119); and Study 5 was conducted with U.S. undergraduates (n = 110). Results showed that cognitive vulnerability could be measured reliably in diverse populations and the distribution of vulnerability scores was similar for all samples. However, the tendency to generate negative inferences about stress had different implications for depression depending on sample; the association between cognitive vulnerability and depressive symptoms did not generalize to Honduran and Nepali participants. It is now necessary to understand why a negative cognitive style confers risk for depression in some contexts but not others (e.g., is it issues related to measurement, theory, or both). The results also suggest that understanding and reducing the global burden of depression will require more than simply “translating” existing cognitive measures and theories to other countries.

Background and Objective:In Kenya, youth needing mental health (MH) treatment vastly outnumber licensed mental health professionals. Task-sharing MH treatment to non-professionals has potential to reduce the treatment gap. For youth, non-professional peer counselors have the benefit of increasing engagement and reducing stigma. Problem-solving therapy (PST) is one treatment shown to alleviate MH symptoms even when delivered by non-professionals. Here we (1) evaluate the implementation of a PST training and (2) codify adaptations for PST implementation at a youth drop-in center at Family Health Options Kenya. Experimental Design or Project Methods:A 2-week training for peer mentors was conducted. Curriculum included core counseling skills, overview of MH, and PST introduction and application.Peer Outcomes: Mean scores from pre- and post-written exams were compared using paired t-tests. Standard role plays were evaluated using the Working with children – Assessment of Competencies Tool (WeACT). Consensus WeACT scores from pre- and post-role plays were compared using paired t-tests.Adaptations: Feedback on cultural acceptability, language comprehensibility, and intervention flow was collected. Proposed intervention changes were coded within the Ecological Validity Model framework. Results:Based on a written exam, mentors’ knowledge of MH conditions and core counseling skills improved after training (Pre: 10.88±4.36; Post: 15.38±2.88; p=.026). Competence in application of counseling skills evaluated with WeACT improved after training (Pre: 20.63±6.61; Post: 28±1.69). Examples of adaptations to PST include: changes to address stigma for MH treatment in Kenya and redistribution of content between sessions. Conclusion and Potential Impact:A 2-week PST training improved peers' counseling skills and ability to deliver a manualized PST treatment. Training allowed contextual, conceptual, and methodological adaptations to PST for use in a Kenyan context. Implementing and improving lay-counselor trainings for MH interventions in Kenya has the potential to increase access to preliminary MH treatment.