Depression is a common disorder primarily characterized by either a low or depressed mood or a loss of interest or pleasure in nearly all activities. Many additional symptoms are often present in the disorder, such as changes in weight, appetite or sleep patterns, fatigue, difficulty with concentration or decision making, moving more slowly than usual or agitation, feelings of worthlessness or guilt, and suicidal thinking. To receive a diagnosis of major depression, an individual must have at least five of these symptoms, causing significant impairment in functioning, nearly every day for at least 2 weeks. Biological, cognitive, and interpersonal factors have all been shown to play a significant role in the development and treatment of the disorder.
In addition to being extremely common, depression also has serious consequences. Up to 25% of individuals may experience depression at some point in their lives, and the disorder leads to significant problems in social and occupational functioning and heightened risk for suicide. It is also recurrent, with individuals who have experienced one episode of depression having a very high risk for future episodes. No one approach to the study of depression can provide a complete picture of the disorder, and different areas of research provide a variety of insights. Common perceptions of depression often emphasize the role of biological factors and medical treatments, and neurotransmitters, such as serotonin, have been found to be different in individuals who are experiencing or are at risk for depression. Genetic factors may also play a role, as those with relatives who have the disorder are also at somewhat higher risk. In addition to these biological factors, however, psychological factors have been found to be very important in understanding the development and treatment of depression, and this entry will focus on current research on the cognitive and interpersonal factors involved in the disorder.
Studies conducted on college students have been an important part of the development of all of the major psychological theories of depression. Many social psychologists and other depression researchers are interested in examining the possible origins of depression; to this end, they examine mild levels of depression experienced by college students and its association with their cognitions or interpersonal relationships. While these mild levels of depression are very different from the full syndrome of clinical depression, small, theoretical studies often provide the first information supporting a new theory of depression, which is later tested on larger and more diverse samples. Understanding how mild symptoms of depression increase over time and in response to a variety of factors provides a good starting point for more intensive clinical research on depression.
One of the most common features of depression is its impact on an individual’s thoughts, and a persistent pattern of negative thoughts plays a prominent role in the disorder. The cognitive theories of depression describe how an individual’s pattern of thoughts or interpretations may increase risk for depression as well as being a part of, and helping to maintain, an episode of depression after it has started.
Attributions, Hopelessness, and Depression. One of the earliest cognitive developments in the study of depression was based on Martin Seligman’s work on learned helplessness. This research proposes that an individual’s interpretations, or attributions, about the causes of events can lead to a feeling of helplessness, which can lead to depression. Individuals who tend to make internal (i.e., the event was caused by something about the self), stable (the causes of the event are unlikely to change over time), and global (the causes of the event also have a negative impact on other areas of the individual’s life) are said to have a negative attributional style, which is associated with depression. The more recent hopelessness theory of depression proposes a process by which an individual’s attributional style may lead to the development of depression in some individuals. A negative attributional style places an individual at risk for depression, and in these people, the occurrence of negative life events can lead to attributions causing hopelessness, which then leads to depression.
Beck’s Cognitive Theory of Depression. Another cognitive theory of depression was developed by Aaron Beck. Beck’s cognitive theory of depression focuses on the persistent negative thoughts of depressed individuals. In this theory, individuals who have, or are at risk for, depression have negative mental schemas, or automatic patterns of viewing themselves and the world. Their experiences are filtered through these schemas, leading to certain automatic negative thoughts. These distorted thoughts about the self, world, and future are automatic in a variety of situations, and the depressed person has difficulty coming up with more positive, adaptive thoughts which might help reduce the symptoms of depression.
Cognitive Therapy for Depression. Cognitive theories of depression have led to the development of cognitive therapy, one of the most successful and common forms of treatment for depression. Cognitive therapy works to identify and challenge the automatic negative thoughts of the depressed individual. Over time, the negative cognitive style of the individual becomes less biased, and depression is reduced. Cognitive therapy is highly effective, and clinical trials have shown it to be at least as effective as medication in treating depression and preventing its recurrence.
Depression has a significant negative impact on interpersonal processes and relationships. Patterns of negative interpersonal behaviors, leading to increased stress or even rejection, have been observed in depressed individuals and may be a part of the process that maintains a depressive episode.
Feedback-Seeking Behaviors and Depression. Research has shown that depressed individuals are highly interested in different kinds of feedback from others. One such interpersonal process that has been linked to depression is excessive reassurance-seeking, which was initially described as part of James Coyne’s interpersonal theory of depression. Some individuals who are experiencing, or are at risk for, depression may continually seek reassurance from others as to their own worth. This process has been shown to lead to rejection by others and increased depression. Another, opposite behavior has also been associated with depression and is based on William Swann’s selfverification theory. This theory states that individuals desire feedback from others that will maintain their consistent views about themselves. As this theory predicts, research has shown that depressed individuals desire, and may even seek, negative feedback from others that confirms their negative self-views. Even though desired, negative feedback may lead to increased feelings of depression. Additionally, the process of feedback-seeking may be aversive to others and has been associated with increased rejection.
Stress Generation and Contagious Depression. Depression has a strong impact on the relationships and experiences of the depressed individual. Negative life events generally have been found to place an individual at risk for depression, but one unusual effect that has been observed in depression is stress generation, which refers to the tendency for depression to lead to increases in negative life events. The processes involved in stress generation are unclear, but the interpersonal stress and rejection that can be caused by depressive behaviors may play an important role. Depression has also been found to be “contagious,” in that the significant others of depressed individuals are likely to experience symptoms of depression. All these negative interpersonal processes put strain on an individual and his or her relationships and may operate in a cyclical way in the development and maintenance of depression.
Interpersonal Therapy for Depression. Many different interpersonal processes are involved in depression, and although no therapy has been developed to specifically address the individual processes, interpersonal therapy for depression is a type of psychotherapy that naturally addresses some of these issues. Interpersonal therapy examines the interpersonal patterns of a depressed individual’s life and then focuses on specific interpersonal problem areas. Interpersonal therapy has been studied in clinical trials and has been shown to be effective in treating depression.
Diverse psychological and biological processes play a role in depression. Negative cognitive and interpersonal processes have been shown to be prominent aspects of the disorder and may also act as risk factors for the disorder. Depressive thoughts and interpersonal behaviors may work together in contributing a negative cycle, maintaining depression and adversely affecting many areas of an individual’s life. Despite this, psychotherapies have been developed that can alleviate many of these problems and are highly effective in the treatment of the disorder.
Learned Helplessness; Schemas; Self-Verification Theory; Stress and Coping
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