Encyclopedia of Opinion
Question
What is the etiology of depression (Major Depressive Disorder)?
Position2 of 3
Depression has a cognitive etiology
Argument1 of 2

A cluster of negative thoughts and beliefs cause depression

Beck argues that people with depression have a triad of negative thoughts about themselves, the world, and the future. These negative thoughts give life events distorted meanings, which cause emotional disturbances. Negative schemas and cognitive errors also lead to depression.

The argument

Beck proposed that cognitive factors (thoughts and beliefs) are the cause of depressive behavior. Beck’s theory of depression has three components: cognitive triad, negative schema, and cognitive errors. The cognitive triad relates to the fact that people with depression have a triad of negative thoughts about themselves, the world, and the future. Beck suggested that these automatic thought processes may give life events distorted meanings. These then lead to the emotional disturbances associated with depression. Secondly, Beck argued that depression is rooted in a patient’s automatic thoughts such as negative self-schemas organized around themes of failure, inadequacy, and worthlessness. Thirdly, Beck proposed that people tend to selectively attend to the negative aspects of a situation and ignore the positive aspects. Beck’s theory has vast empirical support from laboratory experiments. For example, Alloy et al. (1999) has shown that having a negative cognitive style is a vulnerability to depression, whereas a positive cognitive style can reduce the risk of depression. Only 1% of the participants who had positive styles developed depression after six years, versus 17% of the participants with negative styles. Similarly, Caseras et al. (2007) concluded that negative attention bias (focusing on negative stimuli rather than positive stimuli) is one of the mechanisms of depression. Additionally, the success of Cognitive Behavioral Therapy (CBT) in treating depression supports Beck’s theory. CBT assumes that depression stems from maladaptive automatic thoughts that lead to irrational behavior. It targets the negative automatic thoughts to replace them with more reality-congruent information processing. Many empirical studies, such as Goldapple et al. (2004), have established CBT as an effective treatment method for depression. Overall, Beck’s theory explains depression from a cognitive perspective. It has high empirical support as well as a successful application (CBT).

Premises

[P1]Beck's cognitive theory holds that negative thought patterns — the cognitive triad, negative self-schemas, and selective attention to negative information — cause depression. [P2] Longitudinal and experimental studies (e.g., Alloy et al., Caseras et al.) show that negative cognitive styles and attention biases predict and mechanistically underlie depression. [P3] Cognitive Behavioral Therapy, which works by targeting these maladaptive thoughts, is empirically effective in treating depression. [C] Therefore, depression has a cognitive etiology rooted in negative thoughts and beliefs.

Counter-arguments

Beck’s theory is central to negative thoughts only. It fails to consider other factors, such as biological (hormones and genetics) and environmental factors. For example, psychologist Josiah P. Allen wrote that females are more likely than males to be depressed due to biological and gender-role/identity differences. Additionally, Beck and the supporting empirical studies mainly used white, educated, industrialized, rich, democratic (WEIRD) participants. Therefore, the theory is culturally biased. Naeem et al. found cross-cultural perception in psychological symptoms of depressed patients in Pakistan, which may lead to different manifestations of depression. There are significant weaknesses associated with the empirical evidence. The study of Alloy et al. fails to establish causation. It only demonstrates a correlation between cognitive styles and the occurrence of depression. It is not clear whether negative thinking causes depression or whether negative thinking is a symptom of depression. It is also difficult to predict the likelihood of someone developing depression based on their negative thinking. Only 17% (not the majority) of participants became depressed. As for the laboratory study of Caseras, it lacks ecological validity. Real-life visual information is a lot more complex and active than the lab stimuli. It also establishes correlation rather than causality.

Rejecting the premises

[Rejecting P1] The cognitive triad, negative self-schemas and attentional bias are features that reliably accompany depression. Describing a symptom cluster with precision does not establish that the cluster is the cause rather than part of what depression consists in. [Rejecting P2] The longitudinal evidence is correlational: in the study the argument leans on, only a minority of the high-risk group became depressed, so negative cognitive style is neither necessary nor sufficient. The samples are also drawn overwhelmingly from Western, educated populations, and cross-cultural work finds depression presenting differently elsewhere. [Rejecting P3] Treatment response does not identify aetiology. Pharmacological treatments targeting neurotransmitter systems are also effective, and an intervention that works at one point in a causal chain tells you nothing about where the chain begins. [Rejecting C] What the premises support is that cognition is one contributing factor. Genetic, hormonal and environmental contributions are omitted rather than ruled out, so a single-factor aetiology overstates the case.