UCL Institute of Cognitive Neuroscience, London, UK.
Neuropsychopharmacology. 2012 Jan;37(1):117-36. doi: 10.1038/npp.2011.183. Epub 2011 Oct 5.
Cognitive abnormalities are a core feature of depression, and biases toward negatively toned emotional information are common, but are they a cause or a consequence of depressive symptoms? Here, we propose a 'cognitive neuropsychological' model of depression, suggesting that negative information processing biases have a central causal role in the development of symptoms of depression, and that treatments exert their beneficial effects by abolishing these biases. We review the evidence pertaining to this model: briefly with respect to currently depressed patients, and in more detail with respect to individuals at risk for depression and the effects of antidepressant treatments. As well as being present in currently depressed individuals, negative biases are detectable in those vulnerable for depression due to neuroticism, genetic risk, or previous depressive illness. Recent evidence provides strong support for the notion that both antidepressant drugs and psychological therapies modify negative biases, providing a common mechanism for understanding treatments for depression. Intriguingly, it may even be possible to predict which patients will benefit most from which treatments on the basis of neural responses to negative stimuli. However, further research is required to ascertain whether negative processing biases will be useful in predicting, detecting, and treating depression, and hence in preventing a chronic, relapsing course of illness.
认知异常是抑郁症的核心特征，对带有负面情绪的信息存在偏见很常见，但这些偏见是抑郁症状的原因还是结果呢？在这里，我们提出了一个“认知神经心理学”的抑郁症模型，该模型表明，对负面信息的处理偏见在抑郁症症状的发展中起着核心的因果作用，而治疗方法则通过消除这些偏见来发挥其有益的效果。我们回顾了与该模型相关的证据：简要介绍了目前患有抑郁症的患者，以及更详细地介绍了处于抑郁风险中的个体以及抗抑郁治疗的效果。除了目前患有抑郁症的个体存在负性偏见外，具有神经质、遗传风险或以前患有抑郁症的个体也存在易患抑郁症的负性偏见。最近的证据有力地支持了这样一种观点，即抗抑郁药物和心理疗法都可以改变负性偏见，为理解抑郁症的治疗方法提供了一个共同的机制。有趣的是，甚至有可能根据对负面刺激的神经反应来预测哪些患者将从哪种治疗中获益最大。然而，需要进一步的研究来确定负面处理偏见是否有助于预测、检测和治疗抑郁症，从而预防慢性、反复发作的疾病过程。
