Although various psychological theories offer different explanations for depression, most acknowledge the role of cognition, or thoughts, in depressive symptoms. In 1967, Aaron Beck's cognitive model of depression emerged as the first of these theories to posit a central link between cognitive traits and depression via cognitive distortions--systematic irrational biases in thinking. These traits remain important components in the conceptualization and treatment of depression.
History
Cognitive therapy developed in the early 1960s against the backdrop of Sigmund Freud's psychoanalytic theory. Having studied psychoanalysis, Aaron Beck set out to validate Freud's psychoanalytic model of depression, which viewed depression as a result of mismanaged anger. Rather than finding support for Freud's anger hypothesis, Beck observed a pattern of biases and distortions in his patients' thoughts that he felt could not be accounted for by psychoanalytic theory. As a result, Beck formulated cognitive therapy as an alternative approach to understanding depression. According to Beck, the work of many other theorists, such as Albert Ellis and Michael J. Mahoney, also influenced the refinement of his model.
Significance
Cognition plays a vital and central role in depression. Based on the narratives of depressed individuals, which included irrational beliefs and sweeping pessimism, he proposed a cognitive triad of negative thoughts--a negative view of self, environment and future--as a defining attribute of depression. The cognitive model views beliefs and expectations as the determinants of affective states. That is, your perception of life events, rather than the events themselves, determines how you feel about them.
Features
Cognitive distortions characterize depressed thinking. Examples of cognitive distortions include dichotomous thinking--viewing life experiences as either full successes or full failures--and overgeneralization--creating general, global rules from particular events. These biases often arise as automatic thoughts and as negative self-talk. Schemas, mental categories we create to organize information, also represent an important feature. According to the cognitive model of depression, maladaptive schemas, such as beliefs about the inevitability of failure, developed early in life can lead to cognitive distortions.
Treatments
Health professionals such as psychiatrists, psychologists and mental health counselors treat depression with antidepressant medication in conjunction with talk therapy. While medication aims to treat the biochemical causes of depression, the goals of talk therapy may differ depending on the theoretical orientation of the clinician. Those who espouse Beck's cognitive model of depression likely focus directly on the client's thoughts by identifying and exploring dysfunctional beliefs. Cognitive therapy, rational-emotive behavior therapy and cognitive-behavioral therapy all champion an approach consistent with Beck's model.
Evidence
Many researchers have studied the validity of Beck's cognitive model of depression and the efficacy of cognitive therapies. According to the "Clinical Handbook of Psychological Disorders, fourth edition", much research supports the role of cognitive traits in the maintenance depression. Cognitive therapies are effective in treating depression, according to an article published in the September 2001 issue of "Behavior Therapy", although there is scientific debate as to whether cognitive therapies are superior to interventions that focus on other, non-cognitive traits of depression.
References
- "Current Psychotherapies"; Raymond Corsini, Ph.D. & Danny Wedding, Ph.D., MPH; 8th edition; 2008
- "Depression: Causes and Treatment"; Aaron T. Beck, Ph.D.; 1967
- "Clinical Handbook of Psychological Disorders"; David Barlow, Ph.D.; 4th edition, 2008
- "Behavior Therapy": Treatment Guidelines; Steven Hollon, Ph.D. & Richard Shelton, M.D.; 2001
- "The Great Psychotherapy Debate"; Bruce Wampold, Ph.D.; 2001
