DEPRESSIONothers as the sources of reinforcement (e.g., spous-
es, friends).
Cognitive Theories of Depression. Although
it is probably indisputable that the final common
pathways to clinical depression and even dysphoric
mood involve biological changes in the brain, the
most influential theories of depression today focus
on the thoughts of the depressed individual. This
cognitive perspective also recognizes that behav-
ior and biochemistry are important components
of depression, but it is more concerned with the
quality, nature, and patterns of thought processes.
Cognitive therapists believe that when depressive
cognitions are changed, behavior and underlying
biological responses change as well. Cognitive theo-
ries of depression differ from behavioral theories
in two major ways (see Gotlieb and Hammen 1992
for a more detailed description). First, whereas
behavioral theories focus on observable behaviors,
cognitive theories emphasize the importance of
intangible factors such as attitudes, self-statements,
images, memories, and beliefs. Second, cognitive
approaches to depression consider maladaptive,
irrational, and in some cases, distorted thoughts to
be the cause of the disorder and of its exacerbation
and maintenance. Depressive behaviors, negative
moods, lack of motivation, and physical symptoms
that are seen to accompany depression are all seen
as stemming from faulty thought patterns. There
are three main cognitive theories of depression:
Beck’s cognitive-distortion model, Seligman’s learned
helplessness model, and the hopelessness theory of
depression.
Beck’s cognitive-distortion model. The most influ-
ential of these theories is Aaron Beck’s cognitive-
distortion model of depression (1967). Beck be-
lieves that depression is composed of three fac-
tors: negative thoughts about oneself, the situa-
tion, and the future. A depressed person misinterprets
facts in a negative way, focuses on negative aspects
of a situation, and has no hope for the future. Thus
any problem or misfortune experienced, like the
loss of a job, is completely assumed to be one’s
own fault. The depressed individual blames these
events on his or her own personal defects. Aware-
ness of these presumed defects becomes so in-
tense that it overwhelms any positive aspects of the
self and even ambiguous information is inter-
preted as evidence of the defect in lieu of positive
explanations. A depressed person might focus on
a minor negative exchange within an entire con-
versation and interpret this as a sign of complete
rejection. These types of thought patterns, also
referred to as ‘‘automatic thoughts’’ when responses
based on insufficient information are made, are
persistent and act as negative filters for all of life’s
experiences. Excellent descriptions of the way these
thoughts operate can be found in books by the
psychologist Norman Endler (Holiday of Darkness,
1990) and the writer William Styron (Darkness
Visible: A Memoir of Madness, 1982).Together with the idea that depressed indi-
viduals mentally distort reality and engage in faulty
processing of information, the most important
part of Beck’s cognitive model of depression is the
notion of a ‘‘negative self-schema.’’ A schema is a
stored body of knowledge that affects how infor-
mation is collected, processed, and used, and serves
the function of efficiency and speed. In the con-
text of depression, schemas are mental processes
that represent a stable characteristic of the person,
influencing him or her to evaluate and select
information from the environment in a negative
and pessimistic direction. Similar to psychoana-
lytical theories, negative self-schemas are theo-
rized to develop from negative experiences in
childhood. These schemas remain with the indi-
vidual throughout life, functioning as a vulnera-
bility factor for depression. Cognitive treatments
of depression necessarily work to change these
negative schemas and associated negative-auto-
matic thought patterns.Seligman’s learned helplessness model. Based on
work on animals (later replicated in humans),
Martin Seligman’s (1975) theory of learned help-
lessness and his model of depression holds that
when individuals are exposed to uncontrollable
stress they fail to respond to stimulation and show
marked decrements in the ability to learn new
behaviors. Because this theory did not sufficiently
account for the self-esteem problems faced by
depressed individuals, it was reformulated by
Abramson who hypothesized that together with
uncontrollable stress, people must also expect that
future outcomes are uncontrollable. When they
believe that these negative uncontrollable out-
comes are their own doing (internal versus exter-
nal), will be stable across time and will apply to
everything they do (global), they feel helpless and
depressed.