Department of Psychology, Stanford University, Stanford, California 94305-2130, USA.
Annu Rev Clin Psychol. 2010;6:285-312. doi: 10.1146/annurev.clinpsy.121208.131305.
Cognitive theories of depression posit that people's thoughts, inferences, attitudes, and interpretations, and the way in which they attend to and recall information, can increase their risk for depression. Three mechanisms have been implicated in the relation between biased cognitive processing and the dysregulation of emotion in depression: inhibitory processes and deficits in working memory, ruminative responses to negative mood states and negative life events, and the inability to use positive and rewarding stimuli to regulate negative mood. In this review, we present a contemporary characterization of depressive cognition and discuss how different cognitive processes are related not only to each other, but also to emotion dysregulation, the hallmark feature of depression. We conclude that depression is characterized by increased elaboration of negative information, by difficulties disengaging from negative material, and by deficits in cognitive control when processing negative information. We discuss treatment implications of these conclusions and argue that the study of cognitive aspects of depression must be broadened by investigating neural and genetic factors that are related to cognitive dysfunction in this disorder. Such integrative investigations should help us gain a more comprehensive understanding of how cognitive and biological factors interact to affect the onset, maintenance, and course of depression.
抑郁的认知理论假设,人们的思维、推理、态度和解释,以及他们关注和回忆信息的方式,会增加他们患抑郁症的风险。有三种机制与认知加工偏差和抑郁中情绪失调有关:抑制过程和工作记忆缺陷、对负面情绪状态和负面生活事件的沉思反应,以及无法使用积极和有益的刺激来调节负面情绪。在这篇综述中,我们呈现了抑郁认知的当代特征,并讨论了不同的认知过程不仅彼此相关,而且与情绪失调(抑郁症的标志性特征)相关。我们得出的结论是,抑郁症的特征是对负面信息的过度阐述,难以从负面材料中解脱出来,以及在处理负面信息时认知控制能力不足。我们讨论了这些结论的治疗意义,并认为,必须通过研究与该障碍认知功能障碍相关的神经和遗传因素,来拓宽对抑郁认知方面的研究。这种综合性的研究应该有助于我们更全面地理解认知和生物因素如何相互作用,影响抑郁症的发作、维持和病程。