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Chapter: Essentials of Psychiatry: Cognitive Psychology: Basic Theory and Clinical Implications

Major Depressive Disorder (MDD)

It has been consistently observed that individuals suffering from major depression are prone to a negativistic bias in cognitive pro-cessing.

Major Depressive Disorder (MDD)

 

It has been consistently observed that individuals suffering from major depression are prone to a negativistic bias in cognitive pro-cessing. Within Beck’s influential cognitive model of depression (Figure 16.2) (Beck, 1976; Beck et al., 1979), these depressotypic negative thoughts are held to be centrally involved in the onset and maintenance of the depressive episode (Figure 16.2). In addi-tion, Beck’s model proposes that many depressive thoughts occur automatically, in the absence of attentional awareness. In a man-ner similar to that observed with anxiety disorders, it appears that the attention of depressed patients is selectively focused on environmental cues congruent with the depressed state (Engel

 


 

and DeRubeis, 1993), such as cues related to themes of failure or rejection.

 

Rehm (1974) has identified another prominent dysregula-tion of the attentional system in MDD in the self-control model of depression, in which it is noted that depressed patients often devote excessive attentional focus to ruminative appraisal of self. By extension, self-management therapy for depression (Rehm, 1984) assists patients in shifting attentional focus away from self, thereby freeing up mental processing resources for the formula-tion of more effective behavioral responses.

 

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