Aaron Beck is considered the father of cognitive therapy.  He proposed a theory of depression that focused on the patterns of thinking that he saw in his own patients.  He argued that maladaptive schema were responsible for depression.  These schema are the result of negative childhood experiences – both at home and at school.  The pattern of negative schemas he called the negative triad.  He also argued that irrational thinking plays a role in depression.  The therapy he developed – CBT – has been highly successful; however, there are limitations to his theory of depression.

Beck based his theory on his clinical notes on patients suffering from depression.  He found that there are certain patterns of thinking that were used by his patients.  He argued that the schema that they used in response to environmental stimuli lead to an emotional response that is negative in nature.   These “automatic thoughts” include feelings of worthlessness and ineptness.  Overall, the thoughts can be classified into negative views of one’s self, the world and the future.  He also found patterns of illogical thinking. For example, depressive patients tend to use selective abstraction – that is, they make judgments of their own value based on a single incident while ignoring the bigger picture – for example, in spite of having many people praise your art exhibition, one person is critical and that leaves you feeling that the exhibition was terrible and you are a failure as an artist.

Ruiz-Caballero & Gonzalez carried out a study that showed that there is a memory bias in people with depression.  His participants were students who had depression or not. The researchers gave the participants a word-stem completion task to see if students would recall words with a positive or negative connotation. The results were that depressed participants showed a memory bias for negative words. Although this appears to support Beck’s theory, it is problematic in that the task is highly artificial and lacks ecological validity. It is also the case that the people in the study had already been diagnosed with depression, so it is not clear that this form of thinking led to their depression.  It could be that the memory bias is a result of their depression.  In general, this is a limitation of Beck’s theory in that it is not clear whether the thinking pattern is a cause or an effect of depression.  This is why prospective research has been done.

Alloy et al carried out a study in which they measured the mental health of a randomly selected sample of young Americans for six years. After measuring their “thinking style” with several different tests, participants were either put into the “positive” or the “negative” thinking group. After six years, researchers found that only 1% of those in the positive thinking group had developed depression compared to 17% in the negative thinking group. Although this is support for the theory that negative thinking precedes depression, it does not show a clear cause and effect relationship as the data is correlational.  There is no control over the daily lives of the individuals.  It could be that the level of stress is different in the sample.  It also does not take genetics into consideration.  However, there is a strong trend so the role of one’s thinking style may play an important role in the development of depression.

The use of CBT has been highly successful in the treatment of people living with depression. By helping patients to restructure their thinking patterns and challenge illogical thinking, therapists have helped to alleviate depression.  However, the theory does not explain the biological aspects of the disorder.  Research has shown that CBT in combination with drug treatment may be the best form of treatment and that this leads to lower relapse rates. It may be that the theory only addresses one aspect of the disorder and cannot explain all forms of depression.

The cognitive approach has offered an explanation of depression that has gives us an alternative to simply a biological model.  The way we think may be a “mediating factor” in stress that either helps us to cope or leads to depression.  A more optimistic thinking strategy appears to lower stress and thus may the reason why depression is less likely in people with such thinking strategies.  However, not all pessimists develop depression.  This shows that the cognitive approach is limited in its ability to completely explain the disorder and must work together with biological and sociocultural explanations in order to get a more complete understanding.  This type of theory triangulation is the basis of modern psychology.

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