Cognitive Explanations of Major Depressive Disorder (MDD) (SL IB Psychology)

• The cognitive approach to explaining behaviour focuses on processes such as thinking and decision-making, memory, information processing and perception
• The cognitive approach to explaining MDD assumes that depression is a result of faulty or irrational thought processes which may lead to the depressed person over-using cognitive biases in their thinking
• Beck (1963) developed an explanation of MDD known as the cognitive triad which was based on conclusions he had drawn from working with depressed patients over a number of years
• The cognitive triad is divided into the following: 
• Negative thoughts about the self
• Negative thoughts about the world
• Negative thoughts about the future

Beck’s cognitive triad.

• Depressed people tend to irrationally personalise the world and events that happen to them e.g. ‘The world hates me’; ‘Even the bus hates me, it didn’t stop for me this morning’
• Depressed people will always seek out the negative in any situation e.g. ‘I may have got a promotion but it will mean more work for me to have to take on’ (an example of negative automatic thoughts)
• Depressed people also engage in catastrophising (e.g. ‘I got a low mark for this essay which means I’m going to fail the IB and end up homeless and broke’); overgeneralisations (e.g. ‘I had a date last night but it didn’t go well so what’s the point of dating at all?)
• Beck suggested that irrational and faulty thought processes as seen in the cognitive triad could be a result of adverse childhood experience (see early maladaptive schemas below)
• Beck proposed a diathesis-stress component of his theory which states that some people are naturally predisposed to developing MDD which makes them vulnerable to environmental stressors (e.g. one person may fall into a deep depression if they lose their job whereas a different person may feel no such low mood and may even frame the event positively)

Evaluation of Beck’s cognitive triad explanation of MDD

Strengths

• There is good research evidence to support Beck’s theory e.g. Bothwell and Scott (1997) found that cognitive biases were linked to symptoms of depression
• The theory has good application for treating depression e.g. CBT (Cognitive Behavioural Therapy) is used to identify, challenge and change irrational thoughts so that MDD symptoms recede

Weaknesses

• Beck’s theory is useful for highlighting what characterises irrational thinking but not why such thoughts occur or where they come from so in this respect the theory lacks some explanatory power
• Beck’s theory may not be generalisable to collectivist cultures with its emphasis on individual experience and one-to-one therapy

• This theory takes some core ideas and concepts from Beck’s theory of depression (e.g.irrational thoughts about the self which Beck termed negative self-schemas) but it focuses its attention squarely on the influence of childhood experience as an explanation of MDD
• An Early Maladaptive Schema (EMS), proposed by Young (2006), is a type of self-schema in which a person’s early, childhood experience forms the basis for their self-image, self-esteem and general well-being
• An EMS may develop if a child is abused, neglected or placed into situations which are distressing and/or unpredictable
• An EMS is stable – which means it is resistant to change – and consists of long-term beliefs about the self which are very difficult to eradicate, even if the person undergoes years of therapy or counselling
• An EMS may well lead to the development of a mental disorder such as Major Depressive Disorder (MDD) or anxiety disorders
• Types of EMS include:
  • Abandonment (which develops if someone feels that their caregivers are unreliable and/or cold and unloving) 
  • Defectiveness (which develops if someone has been told that they are not worthy of love, that they are bad, that people will reject them) 
  • Failure to Achieve (which develops if someone believes that they are doomed to always fail and that others are better than them)

• An EMS is likely to prevent an individual from realising their true potential (self-actualisation) as it erects obstacles to their success, happiness and fulfilment

Evaluation of the Early Maladaptive Schema explanation of MDD

Strengths

• The concept of negative self-schemas formed the basis for early cognitive behavioural therapy so it has some useful application to mental health settings
• Research by Sojta & Strzelecki (2023) highlights the importance of understanding how EMS impact parenting, the findings of which could be used as a preventative measure against generational MDD

Weaknesses

• It is difficult to operationalise and measure schemas which means that research on EMS can lack reliability
• A therapist would have to take great care when discussing a patient’s EMS as such a discussion may result in some traumatic memories being revisited which means that only suitably qualified professionals should attempt this type of assessment

Which research studies investigate cognitive explanations of MDD?

• Beck et al. (1974): Beck’s Cognitive Triad - investigated cognitive distortions in patients with MDD

• Riso et al. (2006): Early Maladaptive Schemas - found that EMS are stable and long-lasting and should be treated using suitable therapy

Beck et al. (1974) and Riso et al. (2006) are available as Two Key Studies of Cognitive Explanations of MDD – just navigate the Explanations for Disorders section of this site.