Introduction
In psychology, the issues with emotional regulation and mental health disruptions have been addressed from the point of view of a multitude of theoretical frameworks and models. Among the many mental health problems, depression is recognized as “one of the leading causes of disability in the world and is associated with great social and economic costs” (Nieto et al., 2020, p. 2). Indeed, over 200 million people suffer from depression on a global scale and with a high likelihood of the condition’s relapse over time (Nieto et al., 2020).
When investigating the problem of depression, scholars and psychologists have proposed different opinions as per the causes of the issue and the relevant means of its treatment. The cognitive approach incorporates a set of cognitive schemas and predispositions to self-perception and reaction to the environment, which unfold under negative circumstances and provoke depressive symptoms (Davoodi et al., 2018). Beck’s cognitive model has been one of the most influential theoretical approaches to depression that has dominated therapeutic circles and shaped scholarly and clinical views on major depression as a mental disorder.
Beck’s cognitive model is a multifaceted theoretical framework that holds that the cause of depressive conditions is inherent to individuals with an emotional predisposition. Maladaptive schemas prevail over the emotional responses of such individuals and shape negative reactions and perception of self under the influence of adverse circumstances (Davoodi et al., 2018). The theory was proposed in 1967 and has significantly evolved since then (Wills, 2021). The theory is now used in multiple studies as a framework for investigating depressive symptoms and behavioral patterns in therapy and diagnostics. Overall, Beck’s cognitive model has dominated the field of psychology as a reliable and highly evidence-based framework. However, it is relevant to overview its concepts, structure, and application characteristics to conduct a critical evaluation for the validation of its applicability to therapy and research.
Overview of Beck’s Cognitive Model
Within the framework of the cognitive theory, Beck’s approach to explaining depression is based on the cognitive processes in response to stressors. In particular, as stated by Beck (1967), the patterns in thinking of individuals with depression are different from the patterns in individuals without them; and these patterns become the reasons for experiencing depressive symptoms. People with emotional disturbances develop them on the basis of maladaptive schemas, or patterns of behavior, which occur automatically in response to negative situations in life (Warren, 2020).
In the early stages of the lifespan, people “develop negative cognitive structures or ‘schemata’,” which are activated when a person encounters negative situations or experiences (Weeland et al., 2017, p. 39). In such a manner, the dysfunctional interaction between one’s “individual vulnerabilities and stressors in the environment” provokes the emergence of persistent negative beliefs about oneself, which ultimately cause depressive symptoms (Weeland et al., 2017, p. 39). Thus, dysfunctional cognitive schemas predetermine the likelihood of an individual to suffer from anxiety and depression (Ruiz & Odriozola-González, 2016). Beck’s theory entails essential dysfunctions in cognition that lead to the symptoms of depression.
There are five cognitive dysfunctions that deal with specific cognitive processes. Namely, arbitrary inference implies “drawing a specific negative conclusion from no or insufficient evidence, or evidence that opposes the conclusion” (Weeland et al., 2017, p. 40). Another error is a selective abstraction, implying the focus on only negative aspects; overgeneralization holds that a person makes general conclusions based on one event (Weeland et al., 2017). In addition, minimizing and maximizing are the dysfunctions of “exaggerating or minimizing the significance of an event,”; and personalizing means that one applies external experiences and situations to oneself (Weeland et al., 2017, p. 40). Thus, these standardized dysfunctions help in recognizing the causes and mechanisms of the emergence of depressive symptoms.
Another important element of Beck’s cognitive model is the cognitive triad. It includes three essential elements that constitute the core of human perception, predetermining either negative or positive attitudes. In particular, they include the perception of self, the perception of the world, and the perception of the future (Keser et al., 2020; Pittard et al., 2021). According to Pierce and Hoelterhoff (2017), “Beck’s cognitive triad (1976) describes how depression impacts the three elements of an individual’s belief system to produce pessimistic and illogical thoughts about the self, the world and the future, exemplified as “I have no worth,” “I am ignored by everyone,” and “My life is going to get worse” respectively” (p. 8). Thus, the consideration of these three elements in the context of the five cognitive dysfunctions enables applying the model to clinical practice and effectively diagnosing and treating depression.
History of the Model’s Development and Evolution
Beck’s cognitive model of depression was introduced to the psychological field more than half a century ago. Since that time, the theoretical claims made by the author of the approach have been tested and validated by the representatives of multiple fields. The theory evolved into a model for self-reported cognitive biases for detecting depressive symptoms in patients (Nieto et al., 2020). Indeed, the Beck Depression Inventory has been used as a reliable assessment tool, the questionnaire for which “was developed from clinical observations of attitudes and symptoms occurring frequently in depressed psychiatric patients and infrequently in non-depressed psychiatric patients” (Jackson-Koku, 2016, p. 174). Later, the premises of the theory were supported by evidence from a variety of other fields of science, such as neurology, neuropsychology, and genetics (Jere et al., 2021). Thus, the evolution and an effective application of the model demonstrate its scientific validity and accuracy.
Indeed, the model was first applied as a theory for interpreting depression. With more studies emerging in the field of psychiatry and later in neurology and neuropsychology, the use of the model began to evolve rapidly. It has become a clinical tool validated among some of the most reliable screening means for detecting depression. Given the scope of the model’s application and the vast volume of evidence presented by contemporary studies, the popularity and validity of the approach are difficult to overestimate.
Critical Evaluation of Beck’s Model as a Theory of Depression in Light of Modern Evidence
When conducting a critical evaluation of a theory, one should appeal to evidence and its illustration of the reliability and applicability of the theory to practice. Multiple studies have been conducted using Beck’s cognitive model and testing it. In particular, some important systematic review demonstrates the scope of research studies aimed at evaluating the use of the Beck Depression Inventory as a tool for screening for depression. Von Glischinski et al. (2019) have presented an analysis of “27 studies that tried to identify optimal cut points for the BDI-II” (p. 1111). The review of the studies showed the reliability of the screening tool and its flexibility for different settings, including psychiatric, somatic, and healthy (von Glischinski et al., 2019). Thus, the model and its application to the inventory are still being improved, tested, and adapted to the needs of clinicians and therapists.
Another systematic review was conducted in with a similar purpose using Beck’s model. Nieto et al. (2020) used 23 studies to test the prevalence of cognitive dysfunctions in depressive patients. In particular, the Beck Depression Inventory was used to measure and screen for depression alongside such criteria as DSM, which demonstrates the reliability of the model. There exists a revised version of the inventory, which is represented by the abbreviation BDI-II. It “consists of 21 items with a range from 0 to 3 (total score range: 0-63)” where “higher scores reflect high levels of depressive symptom severity” (Davoodi et al., 2018, p. 92). The scholars indicate that the BDI has documented psychometric characteristics and is reliable for clinical settings (Davoodi et al., 2018). Moreover, several versions of the BDI, including the Iranian version, which are deemed viable and valid. Similarly, the study by Nieto et al. (2020) also demonstrated that the cognitive model proposed by Beck had become an essential element in working with depression. Its flexibility allows for combining it with other tools and models for more accuracy and better patient results.
Moreover, the model has been applied in studies investigating the neurological processes associated with depression. In particular, the study by Leahy (2021) was aimed at testing the conceptualization of the emotional processes of envy as informed by Beck’s cognitive model. The researcher used Beck’s claims about cognitive schemas and their role in emotional responses as the basis for the research (Leahy, 2021). In such a manner, the multifaceted application of Beck’s cognitive model demonstrates that the theory continues to evolve and is being applied to multiple areas of science about human behavior, namely neuroscience.
Moreover, scholars and clinicians continue working on the application and adapting of the model developed by Beck by integrating it with other cognitive approaches. For example, Kube et al. (2018) conducted a study in which Beck’s theory of depression was complemented by the concept of expectations. The scholars used Beck’s cognitive model and its claims concerning the dysfunctions on a cognitive level that predetermine human depressive symptoms in response to negative events to test the applicability of expectations to the approach. The researchers assumed that intermediate beliefs, situation-specific dysfunctional expectations, and dispositional optimism would have their effect on depressive symptoms (Kube et al., 2018). The results of the study showed that intermediate beliefs were fully mediated by situation-specific dysfunctional expectations, and dispositional optimism was partially mediated by situation-specific dysfunctional expectations (Kube et al., 2018). Thus, the research re-affirmed the validity of Beck’s claims on the essential role of cognitive dysfunctions in the development of major depression in patients.
Conclusion
In summary, the overview of Beck’s cognitive model demonstrated that this theoretical approach to depression had become an invaluable framework for understanding, investigating, diagnosing, and treating depressive syndromes. The long-term process of the model’s evolution and its vast application in different settings for screening patients for depression validate its reliability. The overview of contemporary studies based on Beck’s cognitive model demonstrates that the scientific basis of the theory is solid, and the model should be used in the future.
References
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