An experimental test of the maintenance and vulnerability hypothesis of depression in consideration of the cognitive hierarchy.

According to Beck's cognitive model of depression the activation of dysfunctional beliefs triggers negative automatic thoughts, which can be interpreted as the proximal "cause" for emotional, somatic, and motivational symptoms of depression. This top-down processes of beliefs causing thoughts and furthermore of thoughts causing symptoms can be called "cognitive hierarchy." Besides these processes there are bottom-up influences as well with dysfunctional beliefs being activated by external and internal events. A differentiation between top-down processes and bottom-up influences can be drawn with the first being seen as causing thoughts and emotions while the latter only activate existing beliefs. To test Beck's maintenance and the vulnerability hypothesis considering the cognitive hierarchy we suggest an experimental paradigm to experimentally manipulate beliefs, thoughts, and emotions separately and independent from each other. To test both hypotheses in an experimental paradigm depressed and nondepressed subjects are asked to concentrate on new beliefs, thoughts, or emotions during the imagination of personally stressful life events in two studies. Based on the top-down processes it was posited that concentration on new beliefs should lead to changes on all three levels of experience. Adding a new thought should cause changes on the levels of thoughts and emotions while new emotions should only change the level of emotions. The results confirm our hypotheses concerning beliefs and thoughts, but adding emotions changes the levels of thoughts as well as emotions. The results support the central role of beliefs in the development and maintenance of depressive symptoms.