Depression: A clinical-research approach.

Abstract

The following case is presented to illustrate the treatment of a depressed individual within a social-learning theory framework. Some of the assumptions underlying the approach are as follows: (a) a reduced rate of positive reinforcement is a critical antecedent condition for the occurrence of depressed behaviors; (b) social interactions provide contingencies which strengthen and maintain depressive behaviors. The latter are seen as part of a vicious circle in which the depressive behaviors serve to maintain the individual's impoverished social relations and the latter serve to prolong his depression. Hence, the approach attempts to reduce the occurrence of depressive behaviors and to help the individual to engage in behaviors which are likely to restore an adequate schedule of positive reinforcement for him.Mrs. G. is a 38-year-old German warbride. She and her husband, an unskilled laborer, were married in 1953. Shortly after the death of her mother in 1961 Mrs. G. became intensely depressed. Since that time she has been seen by several psychiatrists and psychologists. In October of 1967 she was referred to the University of Oregon Psychology Clinic.Mrs. G. assumed that her treatment would be similar to her previous experiences and immediately launched into a detailed description of her many symptoms and complaints. She also complained about the absence of close friends, blaming this situation on her husband, who professes no need for people. She said that she no longer had any feelings for her husband and that she had neither the capacity nor the desire to love him. She indicated an interest in discussing past experiences about which she felt a great deal of guilt. Mrs. G. displayed a wide range of symptoms including severe anxiety attacks, feelings of illness and fatigue, and imagining her children to be in mortal danger. Mr. G.'s usual reaction to her depression, in the past as well as in the present, was to withdraw, thus even further reducing the interaction between them. Mrs. G. also described herself as being very lonely.

Behavioral activation treatment for major depressive disorder: A pilot investigation.

“…Early treatment studies provided support for behavioral activation for depression (Brown & Lewinsohn, 1984;Lewinsohn & Atwood, 1969;Zeiss, Lewinsohn, & Munoz, 1979), but as discussed by Hopko and colleagues (Hopko, Lejuez, LePage, Hopko, & McNeil, 2003), a paradigm shift toward more cognitive explanations of psychological phenomena led to criticisms that behavioral approaches to depression were inadequate by failing to directly address depressive schemas and cognitive structures. The cognitive theory of depression, developed by Beck and colleagues (Beck et al, 1979), is based on the premise that dysfunctional cognitions and core beliefs are at the root of depression, causing both negative moods and avoidance behavior (Beck, 1970).…”

Terapia analítico-comportamental da depressão: uma antiga ou uma nova ciência aplicada?

“…Nele, o autor propõe uma análise funcional dos comportamentos depressivos a partir do conhecimento cumulativo crescente alcança-do pelos estudos de base (Ferster, 1967;Ferster et al, 1979;Ferster e Skinner, 1997). Embora outros autores já tivessem publicado seus trabalhos alguns anos antes (Lazarus, 1968;Lewinsohn e Libet, 1972;Lewinsohn et al, 1969;Seligman e Maier, 1967;Seligman et al, 1968), relega-se ao trabalho de Ferster a matriz conceitual que orientou a maioria dos estudos relativos à avaliação funcional e à intervenção na depressão.…”

Desamparo aprendido e incontrolabilidade: relevância para uma abordagem analítico-comportamental da depressão

“…A depressão é frequentemente considerada um déficit generalizado no repertório comportamental do indivíduo (Cavalcante, 1997;Dougher & Hackbert, 1994;Fester, 1973;Lewinsohn & Atwood, 1969). A instalação e manutenção do padrão comportamental identificado como depressivo dá-se sob diferentes contingências.…”