Depression · Causes and Treatment by Beck, Aaron T. -- Read -- Imperial Library of Trantor

Index

Half title Title Copyright Contents Preface to the Second Edition Part I. Clinical Aspects of Depression

1. The Definition of Depression

Paradoxes of Depression Prevalence of Depression

Prevalence and Severity by Types and Age at Onset

Descriptive Concepts of Depression Semantics of Depression Depression and Normal Moods

2. Symptomatology of Depression

Previous Systematic Studies Chief Complaint Symptoms

Emotional Manifestations

Dejected Mood Negative Feelings Toward Self Reduction in Gratification Loss of Emotional Attachments Crying Spells Loss of Mirth Response

Cognitive Manifestations

Low Self-Evaluation Negative Expectations Self-Blame and Self-Criticism Indecisiveness Distortion of Body Image

Motivational Manifestations

Paralysis of the Will Avoidance, Escapist, and Withdrawal Wishes Suicidal Wishes Increased Dependency

Vegetative and Physical Manifestations

Loss of Appetite Sleep Disturbance Loss of Libido Fatigability

Delusions

Worthlessness Crime and Punishment Nihilistic Delusions Somatic Delusions Poverty

Hallucinations

Clinical Examination

Appearance Retardation Agitation

Variations in Symptoms

Children and Adolescents Cultural Variations

3. Course and Prognosis

Depression as a Clinical Entity Importance of Course and Outcome Systematic Studies

Onset of Episodes Remission and Chronicity

Remission from Dysthymic Disorder Remission from Functional Impairments

Duration

Brief Attacks of Manic-Depressive Psychosis (Bipolar Disorder)

Recurrence Intervals between Attacks Outcome for “Endogenous” Versus “Neurotic” Depression Schizophrenic Outcome Suicide

Suicide Risk in Bipolar Disorder

Predictors of Chronic Depression

Developmental Factors Personality Disorders Psychological Stressors Comorbid Disorders Biological Factors Cognitive Factors

Conclusions

4. Classifying Mood Disorders

The Official Nomenclature Derivation of System of Classification Reliability and Validity of Classification Dichotomies and Dualisms: Past and Present

Endogenus Versus Exogenous Autonomous Versus Reactive Agitated Versus Retarded Psychotic Versus Neurotic

Endogenous and Exogenous Depressions

Origin of Endogenous-Exogenous Model “The Great Debates” Distinction between Endogenous and Reactive Depressions Systematic Studies

Methodological Problems Studies of Symptomatology Physiological Responses and Tests Body Build Response to Treatment

Depressive Equivalents Depressions Secondary to Somatic Disorders

5. Psychotic Versus Nonpsychotic Depression

“Psychoneurotic” Depressive Reaction

Definition Evolution of the Concept

Severe Depression with Psychotic Features (Psychotic Depressive Reaction)

Case 1 Case 2 Case 3

Contemporary Diagnosis

6. Bipolar Disorders

History and Definition Current Criteria for Bipolar Disorder Relationship of Manic to Depressive Episodes Symptomatology of Manic Phase

Emotional Manifestations

Elation Increased Gratification Self-Love Increased Attachment to People and Activities Increased Mirth Response

Cognitive Manifestations

Positive Self-Image Positive Expectations Assignment of Blame Denial Arbitrariness Delusions

Motivational Manifestations

Impulse-Driven Action-Oriented Drive for Independence Drive for Self-Enhancement

Physical and Vegetative Manifestations

Hyperactivity High Tolerance for Fatigue Appetite Increased Libido Insomnia

Behavioral Observations of Manic Phase Periodicity of Manic-Depressive Behavior Premorbid Personality of Manic-Depressive Patients Issues for Further Study

Classification Problems Goal Achievement and Manic Symptoms

7. Involutional Depression

History of the Concept Etiology Age Symptomatology Premorbid Personality Conclusion

8. Schizoaffective Disorder

Definition Evolution of the Concept

Catatonia and Manic-Depressive Psychosis Benign Stupor

Inactivity Negativism Affect Catalepsy Intellectual Processes Ideational Content Follow-up Studies

Acute Schizoaffective Psychosis Acute Remitting Schizophrenia Studies of Revised Diagnoses

Differentiation of Depression and Schizophrenia Prognosis

Affective Factors and Prognosis in Schizophrenia

Manifest Affect Content of Delusions Hallucinations Manic-Depressive Heredity and Outcome in Schizophrenia Presence of Depression Patterns of Aggression in Overt Behavior

Present Classification of Schizoaffective Disorder Unresolved Issues for Continuing Research

Course of Illness Symptom and Cognitive Profiles Family and Genetic Studies Bertelsen and Gottesman’s Review

Conclusion

Part II. Experimental Aspects of Depression

9. Biological Studies of Depression

Early studies Manic-Depressive Disorder and Constitution Heredity in Manic-Depressive Disorder

Identical Twin Studies Identical Twins Reared Separately Pedigree Studies Summary

Bipolar Disorder Unipolar Depression

Biochemical Studies of Depression

Early Studies

Blood Glucose Glucose Tolerance Acidity and Alkaline Reserve Serum Calcium and Phosphorus Nitrogenous Substances Lipoidal Substances Chlorides Critique of Studies

More Recent Studies

Differences Between Manic and Depressive Phases Studies of Continued Cycles Studies During Depressive Episodes An Experimental Test of Biological Markers Responses of Normal Subjects to Stress

Endocrine Studies

Steroid Metabolism Thyroid Function

Autonomic Function

Blood Pressure Responses to Mecholyl Salivation Studies

Critique of Salivation Studies

Neurophysiological Studies

Sedation Threshold

Anatomical Studies

Frodl’s Study

Neurotropic and Neurogenesis Theories

Electromyograph (EMG) Studies Electroencephalogram (EEG) Sleep Studies EEG Arousal Response

Recent Studies of Children and Adolescents Neuropsychological Studies Conclusions

10. Psychological Studies: Tests of Psychoanalytic Theory

Early Tests of Psychological Functioning

Psychomotor Performance Conceptual Performance Perceptual Threshold Distortion of Time Judgment Distortion of Spatial Judgment

Early Experimental Studies Family Background and Personality Self-Concept Beck’s Systematic Investigation of Depression

Psychodynamic Factors History of the Investigation Testing the Hypothesis

Definition of Negative Dream Study Early Memories Focused Fantasy Test Negative Inventory Self-Concept Test Experimental Studies

Collateral Studies

Cognitive Patterns in Verbal Material Longitudinal Studies Patterns in Dreams of Depressed Patients

Preliminary Study Principal Study

Childhood Bereavement and Adult Depression

Childhood Bereavement Study

Cognitive Distortions in Depression

Thematic Content of Cognitions Typology of Cognitive Distortions Formal Characteristics of Depressive Cognitions Relationship of Depressive Thoughts to Affect Discussion

Afterword

Part III. Theoretical Aspects of Depression

11. Theories of Depression

Behavioral Theories Cognitive and Evolutionary Theories Psychoanalytic Theories

Aggression in Depression Orality in Depression

Psychodynamic and Psychological Theories Existential Theories Neurological Theory Neuropsychological Theories Biochemical Theory Animal Models Expressed Emotion

12. Cognition and Psychopathology

The Primary Triad in Depression

Negative Interpretation of Experience

Thwarting or Defeat Deprivation Deprecation

Negative View of Self Negative Expectations

The Affective Response Cognitive Primacy Changes in Motivation Physical Symptoms Cognition in Mania and Other Disorders A Cognitive Classification of Psychiatric Disorders

Neuroses

Depressive Hypomanic Anxious Phobic Somatization Paranoid Obsessive and Compulsive

Psychoses

Conclusions

13. Development of Depression

Predisposition to Depression

Formation of Permanent Concepts Value Judgments and Affect Specific Vulnerability

Precipitation of Depression

Specific Stress Genetic Moderation of the Stress-Depression Link Nonspecific Stress Other Contributing Factors

Developmental Studies on Effects of Chronic Stress

Genetic Risk, Previous Episodes, and Chronic Stress

Personality Organization in Depression

Literature on Cognitive Organizations Definition of Schemas Identification of Schemas Schemas in Depression

Modes and Psychopathology

Distortion and Misinterpretation Perseveration (Rumination) Loss of Objectivity

Affects and Cognition A Feedback Model

Part IV: Treatment of Depression

14. Somatic Therapies

Pharmacotherapy

The Tricyclic Drugs

Early Studies

MAO Inhibitors Selective Serotonin-Reuptake Inhibitors (SSRIS) Antidepressant Prescribing Patterns Side Effects Stimulants Lithium Current Use of Tricyclics and Maois Treatment Resistance

Augmenting Versus Switching Antidepressants Placebo-Controlled Studies of Drug Combinations Medication, Psychotherapy, and Prescriptive Indices Clinical Considerations

Treatment after Age 60 Research Problems and Controversies

Rater Bias Placebo Response Nonrandom Distribution of Variables Variability of Measures Other Problems

Issues of Risk Versus Benefit Controversy about Placebo Effect Adverse Effects of Antidepressant Drugs

SSRIs Tricyclic Drugs MAO Inhibitors

Electroconvulsive Therapy

Physiological Effects Biochemical Effects Psychological Effects Complications Mechanism of Action Efficacy

Future Directions

Transcranial Magnetic Stimulation Pharmacogenomics

15. Psychotherapy

Early Approaches Supportive Psychotherapy

Reassurance Ventilation and Catharsis Guidance and Environmental Change

Psychoanalysis and Psychoanalytic Psychotherapy Depression-Focused Psychotherapies Interpersonal Therapy (IPT)

IPT for Chronic Depression IPT for Elderly Populations

Cognitive Therapy

Formulation and Conceptualization Structure and Strategy

Basic Elements Structure of Sessions Behavioral Aspects

Interpersonal Aspects of Change

Maintaining a Therapeutic Relationship A Collaborative Context Teaching Independent Problem-solving Modification of Interpersonal Dysfunctions Behavioral Activation

Cognitive Techniques

Delineating the Major Maladaptive Patterns Neutralizing Automatic Thoughts Pinpointing Depressive Cognitions Identifying Idiosyncratic Content Recognizing Formal Characteristics of Cognitions Distinguishing “Ideas” from “Facts” Checking Observations Responding to Depressive Cognitions Weighing Alternative Explanations Validating Basic Premises Modifying Mood by Induced Fantasies Case Illustration Case Illustration: Relapse Prevention

Treating Bipolar Disorder: Drugs and Psychotherapy Prevention of Suicide Prevention of Relapse Psychotherapy Change Processes

16. Evaluating Depression Treatments: Randomized Controlled Trials

Outcome and Follow-Up Data

Randomized Clinical Trials Ecological Validity and Randomized Clinical Trials Relapse Prevention

Overall Conclusions Issues for Further Study Afterword The New Developmental Cognitive Model

Cognitive Vulnerability Genetic Links to Cognitive Vulnerability Physiological Hyperreactivity Cognitive Neurobiology

Appendix: Scoring Instructions for Negative Dreams Definition Scoring

Negative Representation of the Self Physical Discomfort and Injury Thwarting Deprivation Physical Attack Nonphysical Attack Excluded, Superseded, or Abandoned Lost Punishment Failure

Exclusions

Threat Dreams

References Name Index Subject Index

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