抑郁认知易感性应激模式的研究：起源、发展和整合

近年来,对抑郁易感性的研究,已经成为探寻抑郁心理病理的一个热点。文章介绍了抑郁易感性应激模型的相关定义、起源、及主要特点。介绍了在当代具有代表性的3个理论：（1）Abramson的抑郁无望理论;（2）Beck的认知易感理论;（3）双信息过程理论。尤其对抑郁认知易感性因素本身的起源、发展及影响因素进行了评述。最后,介绍了整合的抑郁认知易感性应激模型。在此基础上,提出了模型进一步完善和发展的方向     

早期应激对抑郁相关行为及神经内分泌反应的长期影响

临床研究发现,早期创伤性经历是导致成年抑郁症易感性增加的高风险因素之一。但早期应激通过何种途径对抑郁发病产生长期的影响,目前尚不清楚。本文综述了近年来有关的实验动物研究,从早期应激的动物模型建立、早期应激对成年动物抑郁相关行为及神经内分泌反应的长期影响等方面进行了系统论述和分析,进而提出了早期应激并不影响动物的本能行为,但早期应激影响与行为动机和应激应对等认知相关的行为的观点,进一步论证了早期应激是通过增加个体潜在的易患病素质对抑郁症发病产生影响     

完美主义人格特质与抑郁易感性的关系研究

积极完美主义者追求卓越并达到杰出的成就,而消极完美主义者追求绝对的完美,不能接受任何不完美的事物,进而容易使个体产生抑郁.首先对完美主义人格特质的特点进行了阐述,其次对完美主义与高成就的关系进行了评论,讨论了抑郁的易感性因素,确定了完美主义和抑郁的关系,最后提出了完美主义者可以用来降低抑郁易感性的方法和策略.     

抑郁的内隐认知与治疗

认知模型认为抑郁个体存在认知加工的偏向,但是,相对于外显认知,抑郁的内隐认知研究较少。现有研究表明：抑郁个体沉迷于特定的内隐认知偏向：抑郁个体倾向于注意环境中的负性刺激;在概念驱动内隐记忆测验中表现出偏向;更可能呈现出无望感的内隐态度。内隐认知可能是抑郁个体维持抑郁的重要因素,在治疗中,可采用知觉内隐认知、扩展功能失调思维记录、记忆日志和增进注意控制等认知技术改变抑郁患者的内隐认知偏向。     

抑郁个体的内隐心境一致性记忆

情绪和记忆的关系始终足认知心理学的重要研究领域,随着临床心理学和认知心理学的融合与发展,抑郁个体的心境一致性记忆的临床价值逐渐受到重视.就目前来看,抑郁个体的内隐心境一致件记忆的研究结论仍存在较大分歧,在被试群体、样本大小、任务难度、测验类型、抑郁程度等众多变量中,测验纯度和学习/测验的匹配程度足最重要的影响因素.     

无望抑郁认知易感操作化方法及其研究述评

合成分数、基于最弱联结假设提出的最大值以及基于解释方式差异性提出的个体内标准差是目前无望抑郁研究中应用较广的认知易感操作化方法.回顾无望抑郁研究所使用的认知易感操作化方法,梳理这些操作化方法对理解无望抑郁症状发展及其治疗的意义,可发现合成分数与最大值反映了无望抑郁认知易感因子之间关系的不同侧面,后续研究可继续对这两种操作化方法进行比较,以个体内标准差计算出的解释弹性可能是无望抑郁理论之外新的易感因素,可为治疗抑郁提供新的视角.     

应对方式与认知训练对青少年情绪障碍易感性的影响

以往研究指出青少年阶段是情绪障碍的高发时期, 各种情绪问题深刻影响青少年的身心健康。通过文献分析得出青春期压力所采取的应对方式(即个体对压力事件做出反应的稳定方式)可能是决定青少年情绪障碍易感程度的核心因素; 而认知训练可降低该易感性, 从而提高青少年的心理健康水平。为了验证上述观点, 综合采用行为调查与生理测量, EEG/ERP与fMRI手段, 拟开展如下4个方面的研究工作：1)青春期发育阶段影响个体负性情绪易感性的大脑机制; 2)认知应对方式与青春期发育阶段的交互作用对负性情绪易感性的影响及大脑机制; 3)认知训练(包括注意训练、解释训练与接受训练)对健康青少年负面情绪易感性的调节作用及大脑可塑性机制; 4)认知训练对青少年抑郁/焦虑症患者情绪应对方式与临床症状的影响及大脑可塑性机制。通过上述系列研究, 揭示青少年更高情绪障碍易感性的认知神经机制, 找出并培养有利于青少年身心健康的情绪应对方法, 从而为情绪障碍的临床治疗奠定理论与实践基础。     

消极偏差还是积极缺乏:抑郁的积极心理学解释

抑郁的认知理论被认为是当代最具影响的抑郁理论之一,其中贝克抑郁理论与无望抑郁理论是两大主要的认知理论。认知理论主张消极认知偏差是导致抑郁的易感因素。然而,"抑郁现实主义"及"积极错觉"等研究却证实抑郁个体并不存在消极认知偏差。以往研究的矛盾实际上反映了当代心理学过分关注消极的病理化倾向。新兴的积极心理学则试图从全新视角解释抑郁,导致抑郁的原因不是个体身上积极因素的缺位,而是积极力量未被充分发挥。     

抑郁认知易感性的新解释——双重加工模型

双重加工模型认为人类拥有两种信息加工模式,联想模式是快速、不需努力的加工,以良好学习联想(Well-learned associations)为基础:反思模式是慢速的、需要付出努力的加工,建立在基于规则的符号推理基础上,联想模式的发生是自动化的,当预期被违反时,执行反思模式,并需要足够的认知资源.当反思加工没有校正消极的有偏向的联想加工时,就会表现出抑郁的认知易感性.双重加工模型对抑郁认知易感性的评估、病原学和治疗提出了新的看法.     

抑郁的人格易感性：概念、理论与发展

抑郁人格易感性的研究主要围绕依赖-自我批评,社会性依赖-自主以及完美主义等概念展开。目前该方向的理论和研究不仅涉及抑郁易感人格的特点与结构,还探讨了人格与压力情境、抑郁的关系,易感人格与一般人格、特定抑郁症状的关系,人格易感性的不适应性本质等问题,文章对此进行了回顾。今后的研究除了应当在已有方向上深入探究之外,还应当考虑在不同文化背景下对人格易感性采用自下而上的方式重新考察,以及将人格与认知易感性研究相结合等新思路     

Cognitive vulnerability to depression during middle childhood: Stability and associations with maternal affective styles and parental depression

Theories of cognitive vulnerability to depression (CVD) imply that CVD is early-emerging and trait-like; however, little longitudinal work has tested this premise in middle childhood, or examined theoretically relevant predictors of child CVD. We examined test–retest correlations of self-referent encoding task performance and self-reported attributional styles and their associations with parental characteristics in 205 seven-year-olds. At baseline, child CVD was assessed, structured clinical interviews were conducted with parents, and ratings of observed maternal affective styles were made. Children’s CVD was re-assessed approximately one and two years later. Both measures of children’s CVD were prospectively and concurrently associated with children’s depressive symptoms and showed modest stability. Multilevel modeling indicated that maternal criticism and paternal depression were related to children’s CVD. Findings indicate that even early-emerging CVD is a valid marker of children’s depression risk.     

Negative life events and cognitive vulnerability to depression: Informant effects and sex differences in the prediction of depressive symptoms in middle childhood

While diathesis-stress models of cognitive vulnerability to depression (CVD) in childhood have been tested, few studies have included both parent- and child-reported negative life events, despite the fact that they provide unique information on events that may be relevant to depression risk in boys and girls. It was hypothesized that different types of stress may show moderation of CVD for boys and girls; specifically, we predicted that parent-reported stressors may moderate boys’ CVD, and that self-reported stress may play a more critical moderating role for girls. A community sample of 182 eight-year-olds completed measures of CVD at baseline, and child- and parent-reported measures of stress were collected at follow-up, one year later. Support for diathesis-stress models of CVD varied depending on child sex and the source of information on stress. Results highlight the importance of collecting multiple measures of stress in testing diathesis-stress models of CVD in middle childhood.     

Depressogenic cognitive styles: predictive validity, information processing and personality characteristics, and developmental origins.

Two of the major cognitive theories of depression, the theory of Beck [Beck, A. T. (1967). Depression: clinical, experimental and theoretical aspects. New York: Harper & Row. and Beck, A. T. (1987) Cognitive models of depression. Journal of Cognitive Psychotherapy: an International Quarterly, 1, 5-37] and the hopelessness theory [Abramson, Metalsky, & Alloy, (1989) Hopelessness depression: a theory-based subtype of depression. Psychological Review, 96, 358-372], include the hypothesis that particular negative cognitive styles increase individuals' likelihood of developing episodes of depression, in particular, a cognitively mediated subtype of depression, when they encounter negative life events. The Temple-Wisconsin Cognitive Vulnerability to Depression (CVD) project is a two-site, prospective longitudinal study designed to test this cognitive vulnerability hypothesis, as well as the other etiological hypotheses of Beck's and the hopelessness theories of depression. In this article, based on CVD project findings to date, we review evidence that the hypothesized depressogenic cognitive styles do indeed confer vulnerability for clinically significant depressive disorders and suicidality. In addition, we present evidence regarding moderators of these depressogenic cognitive styles, the information processing and personality correlates of these styles and the possible developmental antecedents of these styles. We end with a consideration of future research directions and the clinical implications of cognitive vulnerability to depression.     

Cognitive vulnerability to depression, rumination, hopelessness, and suicidal ideation: multiple pathways to self-injurious thinking

In order to advance the detection and prevention of suicide, recent research has focused on predictors of suicidal ideation and behavior such as negative cognitive styles, dysfunctional attitudes, hopelessness, and rumination. In this study the relationships among these risk factors in the context of the Attention Mediated Hopelessness (AMH) theory of depression are examined. One hundred and twenty-seven undergraduates in the Cognitive Vulnerability to Depression (CVD) project were followed for 2.5 years. The CVD project followed initially nondepressed freshmen, at either high or low cognitive risk for depression, in order to predict onsets and recurrences of depressive disorders. The presence and duration of suicidal ideation were predicted prospectively by rumination and hopelessness, and hopelessness partially mediated the relationship between rumination and ideation and fully mediated the association between rumination and duration of suicidality. Further, rumination mediated the relationship between cognitive vulnerability and suicidal ideation.     

Childhood abuse and vulnerability to depression: Cognitive scars in otherwise healthy young adults

Models of depression vulnerability posit that negative early experiences, such as exposure to childhood abuse (CA), increase vulnerability to depression later in life. Though most victims of CA do not go on to develop depression, the question remains as to whether these individuals retain cognitive ‘scars’ that may contribute to depression vulnerability. The present study examined the relationship between self-reported, retrospective CA and cognitive vulnerability to depression in a carefully selected sample of young adults without current or past psychopathology. We measured cognitive vulnerability with both a self-report questionnaire, the Dysfunctional Attitudes Scale (DAS), and a measure of information processing bias, the Scrambled Sentences Test (SST). Self-reported severity of CA was associated with increased cognitive vulnerability to depression on both the DAS and SST. Vulnerability to depression as measured by the SST, but not by the DAS, prospectively predicted increases in depressive symptoms over a 6-month period. Scores on the SST also interacted with CA to predict increases in depressive symptoms. These findings demonstrate the pernicious effects of CA even in those without current or past psychopathology.     

Depressive implicit associations and adults' reports of childhood abuse

Theory and research suggest that negative events in childhood (e.g., childhood abuse) may contribute to the development of a cognitive vulnerability to depression. A limitation of past research, however, is that the majority has focused on explicit cognitions (e.g., attributional style) and it remains unclear whether similar relations would be observed for more implicit measures of depressive cognitions. This study investigated the relation between young adults' reports of childhood abuse and their implicit depressive cognitions, as measured by the Implicit Association Test. As hypothesised, young adults reporting a history of childhood abuse exhibited stronger implicit associations for depression-relevant stimuli than did individuals with no abuse history. These results were maintained even after statistically controlling for the influence of current depressive symptom levels.     

学龄儿童失调态度在应激与抑郁间的作用：一项多波段追踪研究

通过对3年级和7年级学龄儿童的追踪研究,探讨儿童群体中Beck抑郁理论认知易感因素在应激事件与抑郁症状间的作用。对追踪数据的多层线性模型和多层结构方程模型分析发现,作为Beck抑郁理论中认知易感因素的失调态度在3年级儿童中既没有显著的中介作用也没有显著的调节作用,而在7年级儿童中虽然失调态度仍然没有显著的调节作用,但却有显著的中介作用。研究结果可能初步揭示了失调态度在应激事件与抑郁症状关系中的发展性特征,这一发现对在儿童群体中实施抑郁的有效干预将具有较为重要的启示意义。     

Depressive implicit associations and adults' reports of childhood abuse

Theory and research suggest that negative events in childhood (e.g., childhood abuse) may contribute to the development of a cognitive vulnerability to depression. A limitation of past research, however, is that the majority has focused on explicit cognitions (e.g., attributional style) and it remains unclear whether similar relations would be observed for more implicit measures of depressive cognitions. This study investigated the relation between young adults' reports of childhood abuse and their implicit depressive cognitions, as measured by the Implicit Association Test. As hypothesised, young adults reporting a history of childhood abuse exhibited stronger implicit associations for depression-relevant stimuli than did individuals with no abuse history. These results were maintained even after statistically controlling for the influence of current depressive symptom levels.     

Parental death,depression and beck's theory of cognitive vulnerability: A critical appraisal and suggestions for research

An adequate model of depression should be able to (i) specify the origins of the disorder; (ii) explain the maintenance of depressive behaviour and (iii) result in effective therapy. The adequacy of Beck's cognitive theory of depression has been increasingly questioned (e.g. Alagaratnam, 1984; Alladin, 1985; Bebbington, 1985; Power & Champion (1986); Beidel & Turner (1986); Power (1987) and fundamental questions remain unexplored. In this paper, we focus on the assumption that early parental death results in the development of depressive schemas which constitute a cognitive vulnerability to depression. Bereavement is the most severe psychological trauma most people will encounter in the course of their lives (cf. Parkes & Weiss, 1983). Thus a most stringent test of Beck's hypothesis that depressive schemas are formed in early childhood by loss experiences such as parental death may be conducted by assessing the relationship between adult depression and parental death in childhood. In this paper the evidence will be considered briefly, within the context of Beck's theory of cognitive vulnerability. The specificity of parental loss to depression is questioned. Then, the role of schemas in cognitive theory is explored critically. Problems with Beck's idiosyncratic conceptualisation of depressive schemas are highlighted. A more adequate conceptualisation of the concept of loss is suggested. Finally, suggestions for future research into the origins of depression are offered.     

The ABCs of depression: integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression

In adulthood, twice as many women as men are depressed, a pattern that holds in most nations. In childhood, girls are no more depressed than boys, but more girls than boys are depressed by ages 13 to 15. Although many influences on this emergent gender difference in depression have been proposed, a truly integrated, developmental model is lacking. The authors propose a model that integrates affective (emotional reactivity), biological (genetic vulnerability, pubertal hormones, pubertal timing and development) and cognitive (cognitive style, objectified body consciousness, rumination) factors as vulnerabilities to depression that, in interaction with negative life events, heighten girls' rates of depression beginning in adolescence and account for the gender difference in depression.