Do Maladaptive Attitudes 'Cause' Depression: Misconception of Cognitive Theory

To the Editor.—  Recently, Silverman et al¹ published an article entitled "Do Maladaptive Attitudes Cause Depression?" in which they concluded that "dysfunctional attitudes are the symptoms or effects of depression" and not the cause. The Dysfunctional Attitude Scale (DAS) total scores of 35 patients who were diagnosed as having major depression disorders were compared when the patients were both depressed and nondepressed, and the mean DAS scores were found to be higher during the depressive phase than during remission. However, the presence of such a finding is not sufficient evidence to conclude that dysfunctional attitudes are simply symptoms of depression.Silverman et al wrongly based their "cognitive" hypothesis that the DAS measures beliefs that are "firmly held" before, through, and after depression on a misinterpretation of Beck's (1967) theory.² Several quotations from Beck demonstrate that Silverman et al have set up a "straw man," and that their findings