Cognitive Model Of Depression

The cognitive model posits that in nonendogenous, unipolar depression, life events activate highly charged negative schemas which override more adaptive schemas and set negatively biased cognitive processing in motion. The activation of schemas is the mechanism by which depression occurs, not its cause. Depression may be caused by any combination of genetic, biological, stress, or personality factors. Regardless of its cause, the same cognitive changes occur in depression. Cognitive distortions bias perceptions and interpretations, judgments and problem-solving skills become limited, and thinking reflects the cognitive triad: a negative view of the self as a failure, a negative view of one's personal world as harsh and unyielding, and a negative view of the future as hopeless. As a consequence of pessimism, hopelessness, or apathy, the depressed person becomes less active, avoids social contact, and takes fewer risks. Reduced performance is then taken as a sign of failure or worthlessness, reinforcing the negative view of the self.

Although the cognitive model is not explicitly causal, it does propose that schemas containing negative beliefs about the self and the world are a cognitive vulnerability to depression. Examples of depres-sogenic schemas are, "I am unlovable" and "I can

Cognitive Therapy never get what I want.'' Schemas are believed to be established by early learning experiences which are reinforced over time. As they are used to explain further events, schemas become anchored and are both self-perpetuating and difficult to change.

Cognitive therapy also considers the interaction of personality and stressful life events in the onset of depression. Two broad personality types have been identified among depressed patients: autonomous and so-ciotropic. Autonomous individuals are most likely to become depressed when thwarted from achieving their goals or when confronted with failure. Sociotropic types are most sensitive to personal rejection or to loss of a relationship. Although these are pure types at opposite ends of a continuum of personality styles, they allow investigation of the relationship between life events and various cognitive vulnerabilities. Current research supports the association between sociotropy and depressive symptoms.

Beck's original formulation of depression describes nonendogenous, unipolar depression. He later refined his theory to include six separable but overlapping models: cross-sectional, structural, stressor-vulnerability, reciprocal interaction, psychobiological, and evolutionary. This reformulation was made to describe comprehensively the onset and maintenance of various types of depression. It was articulated in response to such developments in psychology as the growing interest in Bowlby's attachment theory, the emergence of evolutionary psychology, and findings on marital interaction and depression. For example, the original cognitive model exemplifies the stressor-vulnerability model. The maintenance of depression seen in marital discord demonstrates the reciprocal interaction model.

A further clarification of the cognitive theory of depression addressed the misconception that cognitive therapy states that only the thinking of depressed persons is inaccurate or distorted. Research from the field of social cognition demonstrates that the thinking of nondepressed persons tends to be distorted or biased in an optimistic way, rather than being entirely realistic or rational. It also appears that the thinking of mildly depressed persons is more accurate in some specific ways than is the thinking of euthymic individuals. Beck conceives of bias as operating in either a positive or negative direction. According to his formulation, the nondepressed cognitive organization has a positive bias, as it shifts toward depression, the posi tive cognitive bias is neutralized, and as depression develops, a negative bias occurs. In bipolar cases, there is a pronounced swing into an exaggerated bias as the manic phase develops.

A negative bias in thinking is most likely to occur when data are not immediately present, are not concrete, are ambiguous, and are relevant to self-evaluation. An important feature of the cognitive bias in depression seems to be a perception that current negative circumstances cannot improve. Thus, a depressed person may perceive a situation accurately, but lack the persistence and creativity necessary to solve the problem.

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