In the 40 years since Aaron Beck first proposed his cognitive model of depression, the elements of this model--biased attention, biased processing, biased thoughts and rumination, biased memory, and dysfunctional attitudes and schemas--have been consistently linked with the onset and maintenance of depression. Although numerous studies have examined the neural mechanisms that underlie the cognitive aspects of depression, their findings have not been integrated with Beck's cognitive model. In this Review, we identify the functional and structural neurobiological architecture of Beck's cognitive model of depression. Although the mechanisms underlying each element of the model differ, in general the negative cognitive biases in depression are facilitated by increased influence from subcortical emotion processing regions combined with attenuated top-down cognitive control.
For over 50 years, Beck's cognitive model has provided an evidence-based way to conceptualize and treat psychological disorders. The generic cognitive model represents a set of common principles that can be applied across the spectrum of psychological disorders. The updated theoretical model provides a framework for addressing significant questions regarding the phenomenology of disorders not explained in previous iterations of the original model. New additions to the theory include continuity of adaptive and maladaptive function, dual information processing, energizing of schemas, and attentional focus. The model includes a theory of modes, an organization of schemas relevant to expectancies, self-evaluations, rules, and memories. A description of the new theoretical model is followed by a presentation of the corresponding applied model, which provides a template for conceptualizing a specific disorder and formulating a case. The focus on beliefs differentiates disorders and provides a target for treatment. A variety of interventions are described.
This study examined the relation between insecure attachment and depression in a sample of 140 children (69 boys and 71 girls; ages 6 to 14) whose parents have a history of major depressive episodes. In addition, we examined whether this relation was moderated by excessive reassurance seeking. Children completed measures assessing insecure attachment to parents, excessive reassurance seeking, and current depressive symptoms. In addition, children and their parents participated in a semistructured clinical interview assessing children's current and past history of depressive symptoms and episodes. In line with hypotheses, children who exhibited high levels of both insecure attachment and excessive reassurance seeking experienced higher levels of current depressive symptoms than children who possessed only one or neither of these interpersonal risk factors. Furthermore, the interaction of insecure attachment with excessive reassurance was associated with a past history and greater severity of depressive episodes even after controlling for current depressive symptoms.
Langer's theory of mindfulness proposes that a mindful person seeks out and produces novelty, is attentive to context, and is flexible in thought and behavior. In three independent studies, the factor structure of the Langer Mindfulness/Mindlessness Scale was examined. Confirmatory factor analysis failed to replicate the four-factor model and a subsequent exploratory factor analysis revealed the presence of a two-factor (mindfulness and mindlessness) solution. Study 2 demonstrated that the two factors assessed discrete constructs and were not merely products of acquiescence. Support was also found for a nine-item, one-factor model comprised solely of mindfulness items. On comparing models, Study 3 suggested the superiority of the one-factor mindfulness model. Finally, a preliminary investigation of the concurrent validity of the revised nine-item Langer Mindfulness/Mindlessness Scale is presented. The current article offers researchers a revised version of a mindfulness measure derived from a cognitive perspective.
Despite decades of research on the etiology and treatment of depression, a significant proportion of the population is affected by the disorder, fails to respond to treatment and is plagued by relapse. Six prominent scientists, Aaron Beck, Richard Davidson, Fritz Henn, Steven Maier, Helen Mayberg, and Martin Seligman, gathered to discuss the current state of scientific knowledge on depression, and in particular on the basic neurobiological and psychopathological processes at play in the disorder. These general themes were addressed: 1) the relevance of learned helplessness as a basic process involved in the development of depression; 2) the limitations of our current taxonomy of psychological disorders; 3) the need to work towards a psychobiological process-based taxonomy; and 4) the clinical implications of implementing such a process-based taxonomy.
The objective of this study is to summarize staff perceptions of the acceptability and utility of the safety planning and structured post-discharge follow-up contact intervention (SPI-SFU), a suicide prevention intervention that was implemented and tested in five Veterans Affairs Medical Center emergency departments (EDs). A purposive sampling approach was used to identify 50 staff member key informants. Interviews were transcribed and coded using thematic analysis. Almost all staff perceived the intervention as helpful in connecting SPI-SFU participants to follow-up services. A slight majority of staff believed SPI-SFU increased Veteran safety. Staff members also benefited from the implementation of SPI-SFU. Their comfort discharging Veterans at some suicide risk increased. SPI-SFU provides an appealing option for improving suicide prevention services in acute care settings.
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