Kube Tobias
Department of Clinical Psychology and Psychotherapy, RPTU Kaiserslautern-Landau, Germany.
Clin Psychol Rev. 2023 Jul;103:102298. doi: 10.1016/j.cpr.2023.102298. Epub 2023 Jun 1.
Cognitive approaches to depression have benefitted from recent research on belief updating, examining how new information is used to alter beliefs. This review presents recent advances in understanding various sources of bias in belief updating in depression. Specifically, research has demonstrated that people with depression have difficulty revising negative beliefs in response to novel positive information, whereas belief updating in depression is not related to an enhanced integration of negative information. In terms of mechanisms underlying the deficient processing of positive information, research has shown that people with depression use defensive cognitive strategies to devalue novel positive information. Furthermore, the disregard of novel positive information can be amplified by the presence of state negative affect, and the resulting persistence of negative beliefs in turn perpetuates chronically low mood, contributing to a self-reinforcing negative feedback loop of beliefs and affect. Synthesising previous research, this review proposes a coherent framework of when belief change is likely to occur, and argues that future research also needs to elucidate why people with depression hesitate to abandon negative beliefs. Recent insights from belief updating have not only improved the understanding of the psychopathology of depression, but also have the potential to improve its cognitive-behavioural treatment.
抑郁症的认知疗法受益于近期关于信念更新的研究，该研究探讨了新信息如何用于改变信念。这篇综述展示了在理解抑郁症信念更新中各种偏差来源方面的最新进展。具体而言，研究表明抑郁症患者在面对新的积极信息时难以修正消极信念，而抑郁症中的信念更新与消极信息的强化整合无关。在积极信息处理不足的潜在机制方面，研究表明抑郁症患者会使用防御性认知策略来贬低新的积极信息。此外，状态性消极情绪的存在会放大对新的积极信息的忽视，而由此产生的消极信念的持续存在反过来又会使长期低落的情绪持续下去，导致信念和情绪的自我强化负反馈循环。综合以往研究，本综述提出了一个关于信念改变可能发生时间的连贯框架，并认为未来的研究还需要阐明为什么抑郁症患者会犹豫是否放弃消极信念。信念更新方面的最新见解不仅增进了对抑郁症精神病理学的理解，也有可能改善其认知行为治疗。
