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。     

无望与希望：从认知方式看无望抑郁的风险和恢复

由于视角和侧重点的差异, 无望抑郁认知研究基本上可以分为两大取向。一是以认知易感-压力模型为核心, 围绕“无望”展开的病因学研究, 关注认知危险因素、消极生活事件与无望以及抑郁风险之间的关系。二是以恢复模型为核心, 围绕重获“希望”展开的无望抑郁恢复研究, 关注认知保护因素、积极生活事件与重获希望以及抑郁缓解之间的关系。厘清一些相关问题、整合两个研究取向有利于准确评估个体无望抑郁的风险和弹性恢复。     

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     

青少年无望感与生活事件、控制信念和社会支持的关系

以607名初高中阶段青少年为被试,采用量表法收集收据,探讨了青少年未来无望感的基本状况以及所受压力生活事件、控制信念和社会支持的影响.结果表明,半数青少年无望感在正常范围内,然而余者存在不同程度的无望感,特别是有13.7%的人至少存在中等及以上程度的无望感而需特别帮助.从影响因素角度看,控制信念对无望感的解释率最高(12.6%),其中二级控制中的认知控制有保护作用,而情感控制则是危险因素,初级控制的预测作用不显著;其次是社会支持,解释率为6.2%,其中家庭支持显著有利于减少未来无望感,朋友或一般他人的支持无显著预测作用;最后是压力生活事件(主要是事件影响程度),解释率为2.7%.     

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。     

社会认知复杂性的量化指标及其关系

在Kelly个人构念理论的基础上,Bieri提出用构念的分化程度衡量个体社会认知复杂性的思路,并具体用从不同构念上评价每个角色时评分的匹配个数作为复杂性的最化指标。此后,研究者从不同分析思路提出了一系列新的复杂性指标,如根据对构念的相关分析所得组内相关、RMS、SMC等,基于因素分析所得第一因素解释率、主要因素个数及其解释率等,冲突分析所得整体冲突百分比,此外还有MPP、LPP、ASO等各种Fiedler分数。本研究以402名初中一二年级青少年为被试。采用库格测验收集数据,以Gridstat4．0、Excel、SPSSl0．0等软件统计数据,分析了上述各种复杂性指标的内在关联,为同类研究选择使用这些指标提供了依据。     

心智化社会认知观的演变及发展——来自潜心智化的思考

社会认知的机制一直存在心智化与具身认知观点的争论。前者认为社会认知是对心理状态的推测,而后者则认为社会认知是具身实践活动。虽然,心智化研究者认为具身认知有关灵长类动物和婴儿的社会认知的解释可以兼容于内隐心智化,但内隐心智化在解释社会互动时仍然存在间接性的问题。近期,潜心智化理论旨在挑战上述立场中有关社会认知先天论的预设,该理论将个体的潜心智化视为内隐心智化的替代,通过检验与分析相关研究的构想效度,强调社会认知是从非社会性的一般认知功能中衍生而来的,这种立场在社会认知的领域特殊性与非社会认知的领域一般性之间建立起了纽带,从而挑战了心智化与具身认知的争论。未来研究应设计更为严谨的心智化研究方法并对其进行方法学验证,借助先进的技术手段,尝试在神经科学层面探索一般认知功能与社会认知的关系。     

内隐操作绩效的加工分离:四分模型及其研究

一般认为,社会认知过程的内隐测量反映了不受个体控制的自动化加工.本文简要介绍了新近由Sherman等人提出的内隐操作绩效的四分模型及其相关研究.该模型认为,社会认知过程的内隐测量效应并非单纯自动加工的结果,而是多种加工成分的综合表达,这些成分包括联想的自动激活,确定正确反应的能力,对被自动激活联想的成功克服以及反应偏向的影响.该模型为重新认识内隐加工效应的机制提供了新的概念框架和分析技术,被广泛应用于基于内隐测量的社会认知研究领域,并引起该领域研究者的广泛关注.     

抑郁症网络化自助干预的效果及作用机制——以汉化MoodGYM为例

抑郁症是全球性的重要公共健康问题,抑郁症的网络化认知行为治疗近年来备受关注。本研究采用随机对照组试验考察抑郁症网络化干预程序Mood GYM中文版对中国大学生抑郁患者的在线干预效果,并且使用多重中介模型同时探索了基于临床实践提出的认知歪曲(ATQ和DAS)与认知领域研究发现的解释偏差(SST)在抑郁症网络化认知行为治疗中的作用机制。结果发现:(1)相较之对照组,Mood GYM对中国大学生抑郁的网络化自助干预具有中到大的效果量(CES-D,d=0.93;PHQ-9,d=0.79);(2)Mood GYM也显著降低抑郁患者的负性自动思维(ATQ)、消极解释偏差(SST)和功能失调性态度(DAS);(3)自动思维(ATQ)和消极解释偏差(SST)二者的改变在抑郁症网络化认知行为治疗效果中起中介作用,功能失调性态度改变的中介效应不显著。抑郁症的网络化干预还存在着诸如脱落率较高等多种局限,推荐作为传统心理治疗的额外补充手段,也可作为梯度治疗模型的自助式初级干预。     

Cognitive therapy outcome: the effects of hopelessness in a naturalistic outcome study

This study prospectively examined the effect of hopelessness on outcome in cognitive therapy. Hopelessness has a central role in cognitive theories of depression, and consistently predicts suicide attempts and suicide completion. Furthermore, there is indirect evidence that hopelessness predicts cognitive therapy outcome, in terms of early termination of therapy, perhaps in part because theories of therapy change suggest that "remoralization" is a critical first phase of change. It was hypothesized that hopelessness non-responsiveness early in therapy would be predictive of eventual outcome, over and above hopelessness severity at intake. In a naturalistic study of 122 patients diagnosed with unipolar depression, it was found that non-responsive hopelessness predicted outcome in cognitive therapy, and this effect is over and above any effect of initial severity of hopelessness or depression. These findings suggest that patients whose level of hope is responsive to early interventions make more rapid and pronounced improvements during "real world" cognitive therapy.     

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.     

Toward an integrative model of suicide attempt: a cognitive psychological approach.

Applying a cognitive approach, the purpose of the present study was to expand previous research on stress-vulnerability models of depression and problem-solving deficits, as it relates to suicide attempt. Structural equation modelling, involving latent variables, was used to evaluate (a) whether low self-esteem, a low sense of self-efficacy, loneliness, and divorce constituted vulnerability factors for the development of depression; (b) whether hopelessness and suicidal ideation mediated the relationship between depression and suicide attempt; and (c) whether problem-solving deficits mediated the relationship between the vulnerability factors and suicide attempt, separate from depression/hopelessness. A total of 123 individuals, aged 18-75 years, participated in the study (72 suicide attempters and 51 psychiatric outpatients with no history of suicidal behavior). The results indicated a two path model of suicide attempt. The first path began with low self-esteem, loneliness, and separation or divorce, which advanced to depression, and was further mediated by hopelessness and suicidal ideation which led to suicide attempt. The second path developed from low self-esteem and a low sense of self-efficacy and advanced to suicide attempt, mediated by a negative appraisal of one's own problem-solving capacity, and poor interpersonal problem-solving skills. The importance of addressing both depression/hopelessness, and problem-solving deficits when working with suicide attempters is noted.     

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.     

Cognitive vulnerability and frontal brain asymmetry: common predictors of first prospective depressive episode

The hopelessness theory of depression proposes that individuals with a depressogenic cognitive style are more likely to become hopeless and experience depression following negative life events. Although the neurophysiological underpinnings of cognitive style remain speculative, research indicates that decreased relative left frontal brain electrical activity holds promise as a traitlike marker of depression. This begs the question: Do measures of depressogenic cognitive style and resting frontal brain asymmetry index a common vulnerability? The present study provides preliminary support for this hypothesis. At baseline assessment, increased cognitive vulnerability to depression was associated with decreased relative left frontal brain activity at rest in individuals with no prior history of, or current, depression. Following baseline assessment, participants were followed prospectively an average of 3 years with structured diagnostic interviews at 4-month intervals. Both cognitive vulnerability and asymmetric frontal cortical activity prospectively predicted onset of first depressive episode in separate univariate analyses. Furthermore, multivariate analyses indicated that cognitive vulnerability and frontal asymmetry represented shared, rather than independent, predictors of first depression onset.     

Negative cognitive styles, dysfunctional attitudes, and the remitted depression paradigm: a search for the elusive cognitive vulnerability to depression factor among remitted depressives

Results from studies using a behavioral high-risk design and approximations to it generally have corroborated the cognitive vulnerability hypothesis of depression, whereas results from remitted depression studies typically have not. Suspecting that design features of previously conducted remitted designs likely precluded them from detecting maladaptive cognitive patterns, the authors conducted a study featuring the remitted design that has been successful in studies of a biological vulnerability for depression. Participants' current depressive symptoms, negative cognitive styles (hopelessness theory), dysfunctional attitudes (Beck's theory), and lifetime prevalence of clinically significant depression were assessed. Participants who had remitted from an episode of clinically significant depression had more negative cognitive styles, but not greater levels of dysfunctional attitudes, than did never depressed individuals.     

Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression

Do negative cognitive styles provide similar vulnerability to first onsets versus recurrences of depressive disorders, and are these associations specific to depression? The authors followed for 2.5 years prospectively college freshmen (N = 347) with no initial psychiatric disorders at high-risk (HR) versus low-risk (LR) for depression on the basis of their cognitive styles. HR participants had odds of major, minor, and hopelessness depression that were 3.5-6.8 times greater than the odds for LR individuals. Negative cognitive styles were similarly predictive of first onsets and recurrences of major depression and hopelessness depression but predicted first onsets of minor depression more strongly than recurrences. The risk groups did not differ in incidence of anxiety disorders not comorbid with depression or other disorders, but HR participants were more likely to have an onset of anxiety comorbid with depression.     

Attributional style and depressive symptoms in adolescents: an examination of the role of various indicators of cognitive vulnerability

This study focuses on the hopelessness theory to explain depressive symptoms in adolescents. The aim is to assess which dimensions of the attributional style (causal attribution, attribution of consequences, implications for the self, total score, and weakest link score) better moderate the impact of negative events on the increase of depressive symptoms. For this purpose, 856 Spanish adolescents (449 girls and 407 boys, ages between 14 and 17 years) were assessed at the beginning of the school year and at follow-up 6 months later. They completed measures of depressogenic cognitive style [Hankin, B. L., & Abramson, L. Y. (2002). Measuring cognitive vulnerability to depression in adolescents: Reliability, validity, and gender differences. Journal of Clinical Child and Adolescent Psychology, 31, 491-504], negative life events, and depressive symptoms. The results show that only the dimension of attribution of stable and global causes moderated the impact of the negative events on the increase of depression at follow-up. The results are discussed in terms of the meaning of the weakest link score and the construct of attributional style from a developmental perspective.     

Vulnerability to depressive symptomatology: a prospective test of the diathesis-stress and causal mediation components of the hopelessness theory of depression.

The diathesis-stress and causal mediation components of the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989) were tested using a prospective methodology. Measures of the 3 vulnerability factors posited by the theory (cognitive diatheses about cause, consequences, and self) were completed by 152 Ss at Time (T) 1. Ss completed measures of depressive symptoms, anxious symptoms, and hopelessness at T1 and again at T2, 5 weeks later. Naturally occurring stressors were assessed at T2 (covering the T1-T2 interval). Consistent with the diathesis-stress component, each Cognitive Diathesis x Stress (CD x S) interaction predicted onset of depressive symptoms from T1 to T2. In contrast, the CD x S interactions predicted neither state nor trait anxiety. In addition, 2 of the 3 CD x S interactions (those involving cause and self, but not consequences) were partially mediated by hopelessness. Implications for future work on the hopelessness theory of depression are discussed.