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抑郁:认知视角。

Depression: A cognitive perspective.

机构信息

University of British Columbia, Canada.

Stanford University, United States.

出版信息

Clin Psychol Rev. 2019 Apr;69:51-66. doi: 10.1016/j.cpr.2018.06.008. Epub 2018 Jun 18.

Abstract

Cognitive science has been instrumental in advancing our understanding of the onset, maintenance, and treatment of depression. Research conducted over the last 50 years supports the proposition that depression and risk for depression are characterized by the operation of negative biases, and often by a lack of positive biases, in self-referential processing, interpretation, attention, and memory, as well as the use of maladaptive cognitive emotion regulation strategies. There is also evidence to suggest that deficits in cognitive control over mood-congruent material underlie these cognitive processes. Specifically, research indicates that difficulty inhibiting and disengaging from negative material in working memory: (1) increases the use of maladaptive emotion regulation strategies (e.g., rumination), decreases the use of adaptive emotion regulation strategies (e.g., reappraisal), and potentially impedes flexible selection and implementation of emotion regulation strategies; (2) is associated with negative biases in attention; and (3) contributes to negative biases in long-term memory. Moreover, studies suggest that these cognitive processes exacerbate and sustain the negative mood that typifies depressive episodes. In this review, we present evidence in support of this conceptualization of depression and discuss implications of research findings for theory and practice. Finally, we advance directions for future research.

摘要

认知科学在推进我们对抑郁症的发病机制、维持和治疗的理解方面发挥了重要作用。过去 50 年的研究支持了这样一种观点,即抑郁症和抑郁症风险的特征是自我参照加工、解释、注意和记忆中的负性偏差的运作,通常缺乏正性偏差,以及使用适应不良的认知情绪调节策略。也有证据表明,认知控制对情绪一致材料的缺陷是这些认知过程的基础。具体来说,研究表明,在工作记忆中抑制和脱离负性材料的困难:(1)增加了使用适应不良的情绪调节策略(例如,沉思),减少了使用适应性情绪调节策略(例如,再评价),并可能阻碍情绪调节策略的灵活选择和实施;(2)与注意力的负性偏差有关;(3)导致长期记忆中的负性偏差。此外,研究表明,这些认知过程加剧和维持了典型的抑郁发作的负面情绪。在这篇综述中,我们提出了支持这种抑郁症概念的证据,并讨论了研究结果对理论和实践的意义。最后,我们提出了未来研究的方向。

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