Pössel Patrick, Knopf Kerstin
Department of Clinical and Developmental Psychology, University of Tüebingen, Tüebingen, Germany.
Depress Anxiety. 2008;25(9):E47-55. doi: 10.1002/da.20313.
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.
根据贝克的抑郁认知模型，功能失调信念的激活会引发消极自动思维，而消极自动思维可被视为抑郁的情绪、躯体和动机症状的直接“原因”。信念引发思维进而思维引发症状的这种自上而下的过程可被称为“认知层级”。除了这些过程，也存在自下而上的影响，即功能失调信念会被外部和内部事件激活。可以区分自上而下的过程和自下而上的影响，前者被视为引发思维和情绪，而后者只是激活现有的信念。为了检验贝克的维持和易感性假说并考虑认知层级，我们提出一种实验范式，以便分别且相互独立地对信念、思维和情绪进行实验操控。为了在实验范式中检验这两个假说，在两项研究中，要求抑郁和非抑郁的受试者在想象个人压力大的生活事件时专注于新的信念、思维或情绪。基于自上而下的过程，假定专注于新信念应会导致在所有三个体验层面上发生变化。添加新的思维应会导致思维和情绪层面发生变化，而新的情绪应只会改变情绪层面。结果证实了我们关于信念和思维的假说，但添加情绪也会改变思维和情绪层面。这些结果支持了信念在抑郁症状的发展和维持中的核心作用。
