Depression is an information processing problem

Depression theories

Depression theories1)Biological models: The biological models include genetic factors, changes in neurotransmitter systems and in the neuroendocrinological area. Twin, Adoption, and Family Studies indicate an increased risk of illness for relatives of people with an affective disorder. The concordance rates for unipolar depression in monozygotic twins are 50%, in dizygoti between 15-20%. Higher rates are found with bipolar courses. The originally formulated Deficiency Hypothesis believed that depression was due to a decrease in neurotransmitters in the synaptic cleft. Since the concentration of biogenic amines can be increased directly by antidepressants, but the clinical effect usually only occurs after a few weeks, this model was expanded and a change in the sensitivity of the receptors was postulated. Another approach is related to a Imbalance in the cholinergic adrenergic (aminergic) System in favor of the cholinergic system during depression. Furthermore, the Excitation conduction within the cell subject of research activities (second messenger systems). During a depressive episode there are also characteristic changes in REM sleep with a small proportion of deep sleep, a lower REM latency and a longer first REM phase. In the neuroendocrinological area, depression is a hyperactivity of the Hypothalamic-pituitary-adrenal axis (HHN), associated with an increased Cortisol levels returned. Effects on other endocrine systems (thyroid axis, growth hormone system) are assumed (Berger, 1999). 2)Psychological models: Be in the psychological field psychodynamic, interpersonal and cognitive-behavioral Approaches differentiated as main groups. The last-mentioned approach will be discussed below. Today's behavioral treatment approach is based on one heuristic framework. On the basis of a biological and / or psychological Vulnerability (Diathesis) three main factors are held responsible for the maintenance and possibly also the development of a depression: a) one low rate of behavioral positive reinforcement, e.g. through the loss of important areas of life, people. The person comes under "cancellation conditions", i.e. inactivity and depression are the result. A lack of social skills and adverse environmental conditions can contribute to insufficient reinforcement. b) Cognitions as "automatic thoughts" that have a behavioral and experience-controlling function and point to activated depressogenic schemes. c) Reactions from the social partnersthat can exacerbate depressive symptoms.
According to Beck et al. (1996) have negative thoughts and schemes an important function in triggering and maintaining depressive disorders. Negative thoughts, which appear "automatically" in situations, represent a superficial level of the cognitive structure. The patient often only becomes aware of them when they direct their attention to them. Within this model, they are important for explaining behavior and emotions. They include issues like worthlessness, guilt, incompetence, loneliness, and hopelessness. Beck sums this up in the concept of cognitive triad together, i.e. the negative view of oneself, the environment and the future. These automatic thoughts point to dysfunctional schemes which, in the form of superordinate structures and attitudes, are to be regarded as a surrogate of life experiences. Schemas in general represent internal models of the self and the world that are necessary to perceive, process and remember information. They are used to make information processing effective, i.e., schema-consistent information is processed with preference. Stressful life events or emotional states can now activate specific schemes. In the case of depression, this means that errors such as e.g. Over-generalization, selective generalization of negative experiences, dichotomous thinking occur with negative effects on mood and activity. This typical depressive information processing has been demonstrated in a number of experimental studies. Seligman has because of animal experiments Research results coined the concept of learned helplessness and transferred it to depression (ethics and animal experiments). In a further development of this approach, a depressive attribution style Postulated: Depressives make themselves responsible for a negative event (internal attribution), expect that it will always persist (stable attribution) and generalize the experience to other life situations (global attribution) (attribution).
3) Interaction of biological and psychological models: Today's models of depression emphasize the Interactions of dispositional, triggering and sustaining factors. The integration of biological and psychological concepts is only just beginning. Genetic dispositions and / or an increased vulnerability to depression due to life events and experiences that have prevented the development of stable self-esteem, for example, form the background for the development of depression. Triggering factors such as stressful life events that are not managed can lead to an imbalance of the cholinergic-aminergic system against the background of an over-sensitivity of cholinergic receptors or activated depressogenic schemes. Environmental factors such as a trusting relationship can influence these processes. Depression itself could in turn represent a stressor, combined with hypercortisolism and altered transmitter activity (Berger, 1999).

U.L.-K.

literature
Beck, A. T., Rush, A. J., Shaw, B. F., Emery, G. (1996). Cognitive therapy for depression (5th ed.). Munich: Psychologie Verlags Union.
Berger, M. (1999). Psychiatry and psychotherapy. Munich: Urban & Schwarzenberg.