Core beliefs and self-schematic structure in depression
Introduction
Beck proposed a hierarchical classification of cognition, ranging from deeper structures to more surface-level thoughts [1, 2•, 3]. Schemas represent the deepest level of thinking and are purported to play a critical role in the development of depression. Self-schemas — well-organized, internal representations of self — consist of both propositional (content) elements, such as core beliefs, and structural (organization) properties. Through experience and interpretation of past and ongoing events, such content becomes increasingly consolidated in the belief system of individuals vulnerable to depression, and influences the subsequent appraisal and organization of new experiences. Once activated by life-stress, self-schemas also impact the emergence of more proximal cognitions (e.g., negative automatic thoughts). Insecure attachment experiences and maltreatment encompass some of the early predictors of the development of a negative belief system [4•, 5••, 6].
A number of variables have been studied in the context of cognitive vulnerability to depression [7••]; however, we focus on the content and structure of self-schemas. Recent research on early maladaptive schemas (i.e., deeper core beliefs) and the structure of self-referent content is reviewed. After defining the specific construct of interest, we discuss the current empirical status, highlight predictors and outline the potential modifiability of each vulnerability factor. We conclude with suggestions for further research.
Section snippets
Early maladaptive schemas
Early maladaptive schemas (EMS; [8]) represent an extension of Beck's cognitive theory of depression and account for the developmental origins of core beliefs. EMS are rigid and pervasive absolutist beliefs about self that originate in childhood in response to ongoing aversive relational patterns, and are elaborated on throughout life. EMS, which serve as templates for processing later experiences, are organized into five domains (see Table 1). These self-defeating cognitive patterns vary in
Cognitive structure
A critical assumption of Beck's theory is that negative content in depression exists within a cognitive structure, such that various self-descriptive traits, beliefs and memories (e.g., ‘I’m unlovable, unattractive, undesirable’) are represented in a highly organized and clustered manner. The activation of this structure purportedly impacts more surface-level cognitions (see [3]) which exacerbates depressed mood and may contribute to thoughts, behaviors and experiences (e.g., stress generation,
Future directions for research and practice
Future research is needed to elucidate the mechanisms of change in treatments like CBT and whether a shift in deeper cognitive structures and core beliefs may be a final common pathway regardless of treatment modality. Additional research is also needed to ensure that these findings are robust and to determine which strategies (and doses of psychotherapeutic interventions) produce the most stable cognitive change. Furthermore, it would be interesting to explore whether change in EMS and
References and recommended reading
Papers of particular interest, published within the period of review, have been highlighted as:
• of special interest
•• of outstanding interest
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