The Cognitive Vulnerabilitystress Models Of Unipolar Depression

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Given that people vary in their responses to stressful life events, the cognitive theories of unipolar depression have sought to explain why some individuals are vulnerable to depression when confronted with stressful events, whereas others do not become depressed at all or suffer only mild, short-lived dysphoria. From the cognitive perspective, the meaning or interpretation people give to their life experiences influences their vulnerability to depression. According to the hopelessness theory of depression (Abramson et al., 1989; Alloy, Abramson, Metalsky, & Hartlage, 1988), individuals who tend to attribute negative life events to stable (enduring) and global (general) causes infer that further negative consequences will follow from a current negative event, and infer that the occurrence of a negative event in their lives means that they are deficient or unworthy are hypothesized to be more likely to experience an onset of depression or a worsening of current depression when confronted with stressors than are individuals who do not exhibit these negative inferential styles. Individuals who exhibit any of these three negative inferential styles should be more likely to make negative attributions and inferences about actual negative events they encounter, thereby incrementing the likelihood of becoming hopeless, the proximal cause of the symptoms of depression. However, in the absence of negative events, individuals who exhibit the hypothesized depressogenic inferential styles should be no more likely to develop depression than persons without these styles.

In Beck's (1967) model of depression, negative self-schemata organized around themes of failure, inadequacy, loss, and worthlessness serve as vulnerabilities for the onset and exacerbation of depression that are activated by the occurrence of stressful events relevant to the content of the self-schemata. Such negative self-schemata are often represented as a set of dysfunctional attitudes in which the individuals believe that their happiness and self-worth depend on being perfect or on others' approval. Consistent with cognitive science operationalizations of the schema construct (e.g., Alba & Hasher, 1983; Taylor & Crocker, 1981), Beck (1967) hypothesized that depressive self-schemata influence the perception, interpretation, and recall of personally relevant experiences, thereby leading to a negatively biased construal of one's personal world. When activated by the occurrence of negative events, depressive self-schemata lead to the onset or exacerbation of depressive symptoms through their effect on preferential encoding and retrieval of negative self-referent information. In Beck's (1987) model, individual differences in the value people place on various life experiences serve as additional vulnerabilities for depression. People who are high in sociotropy place great importance on intimacy, social relationships, and acceptance from others and are vulnerable to de pression when they experience interpersonal disappointments or losses, whereas those high in autonomy value achievement, freedom, and independence and are at risk for depression when they encounter failures or events that impinge on their personal choice.

The vulnerability hypotheses of the cognitive theories of unipolar depression have received considerable empirical support (see Abramson et al., 1999,2002; Alloy, Abramson, Whitehouse, et al., 1999; Alloy, Abramson, Safford, & Gibb, chap. 2, this vol. for reviews). The logic of these models may be extended to bipolar spectrum disorders. The same cognitive processes that contribute vulnerability to unipolar depressive episodes in response to negative life events may also confer risk to the depressive episodes experienced by bipolar individuals following negative events.

Based on the logic behind cognitive theories of unipolar depression, two predictions can be made concerning vulnerability to manic and hypomanic episodes. On the one hand, based on the hopelessness theory, individuals who characteristically exhibit positive inferential styles for positive life events (stable, global attributions for positive events, positive consequences and positive self-implications of positive events) should react to the occurrence of positive events by becoming hopeful and, in turn, developing euphoria and hypomanic/manic symptoms. Similarly, Beck (1976) suggested that manic individuals are characterized by a set of positive self-schemata, consisting of unrealistically positive attitudes about the self, world, and future. Beck hypothesized that when these individuals experience positive events, their positive schemata are activated and promote the development of manic symptoms. Alternatively, given that negative life events have been found to trigger manic episodes as well as depressive episodes in bipolar individuals (Johnson & Roberts, 1995; see later section, "Life Events and Bipolar Spectrum Disorders"), it may be that bipolar individuals' cognitive styles for interpreting negative events, rather than their styles for construing positive events, are more important in influencing their vulnerability to manic and hypomanic episodes. A review of the role of cognitive styles as vulnerability factors for bipolar disorders shows that there is evidence for both of these alternatives. There is also discussion of the conditions under which cognitive styles for interpreting negative events may promote vulnerability to manic/ hypomanic episodes versus depressive episodes at different times in the same individual.

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