Examples of these include beliefs such as, “If I fail at something it means I’m a complete failure” or “If I don’t have someone to love and accept me it means I’m unlovable.” This results in an increasingly negative view of the self (“I am a failure I am unlovable”), the world (“the world is unrewarding others will reject me”), and the future (“I will never achieve my goals”) during the course of a depressive episode. Underlying this bias are cognitive structures or schemas, often expressed as dysfunctional attitudes which, when activated by an event or accumulation of events, skew the interpretations and evaluations the person makes about the world. In depression, he hypothesized, there was a shift in information processing such that stimuli which might usually be perceived as neutral or positive are seen as negative: a systematic cognitive bias. Beck noted that the dreams and self-reports of depressed patients were pervasively negative: They experienced a stream of negative automatic thoughts in response to events. In contrast to behavioral approach that saw “internal” self-talk as a covert behavior, Beck suggested that cognition was central to depression. ![]() Beck first identified the importance of thoughts in depression in the early 1960s (Beck, 1963, 1964). ![]() However, this did not lead to significant developments in treatment or in outcome research, partly due to the surge in interest in Beck’s cognitive approach to depression that resulted from publication of the first randomized controlled trial to show that a psychological treatment could be as effective as antidepressants in depression (Rush, Beck, Kovacs, & Hollon, 1977). Lewinsohn ( 1974) developed this model further, as did Staats and Helby ( 1985) (see Dimidjian, Barrera, Martell, Muñoz, & Lewinsohn, 2011). Factors such as decreased environmental reward (e.g., resulting from a significant loss), avoidance or escape from aversive stimuli, schedules of reinforcement, and suppressed anger contribute to a reduction in the depressed person’s behavioral repertoire which in turn leads to less rewarding experiences. ![]() Ferster ( 1973) proposed a model that saw depression as characterized by a decrease in the frequency of positively reinforced activities. Origins and Development of Behavioral and Cognitive Models of Depressionīehavioral models of depression have been largely based on Skinnerian or operant conditioning theory. Its efficacy-established CBT now faces the challenge of cost-effective dissemination to depressed people in the community. Promising results are emerging from therapies such as Mindfulness Based Cognitive Therapy (MBCT) and rumination-focused therapy that focus on the process of managing thoughts rather than their content. Behavioral approaches, such as Behavioral Activation, which emphasize behavioral rather than cognitive change, also has a growing evidence base. Beck’s Cognitive Therapy sees negative distorted thinking as central to depression and is the most established form of CBT for depression. They also share a commitment to empirical testing of the theory and clinical practice. All models of CBT share in common an assumption that emotional states are created and maintained through learned patterns of thoughts and behaviors and that new and more helpful patterns can be learned through psychological interventions. It has been shown to be effective in reducing symptoms of depression and preventing relapse. Cognitive behavioral therapy (CBT) has the strongest evidence base of all the psychological treatments for depression.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |