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

Joseph S. Silverman, MD
Arch Gen Psychiatry. 1984;41(11):1112-1112. doi:10.1001/archpsyc.1983.01790220102019
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In Reply.—  Until recently, data were lacking as to whether attitudes that are characteristic of actively depressed persons—perfectionistic, absolutistic, external-control oriented, etc—persist after recovery. Such data are now available. In all studies, including those cited by Riskind and Steer, these data have showed a considerable decline in dysfunctional beliefs as recovery ensues. Our depressive patients, when fully asymptomatic, did not differ significantly from a control group in their performance on the DAS. In close agreement with our findings, Simons et al1 simultaneously but independently reported that the DAS scores of their depressed patients dropped with recovery from 154.3 to 97.5; the latter score is well within the normal range. Lewinsohn et al2 summarized additional evidence in support of our position. Although the reports of Eaves and Rush3 and of Reda4 revealed a "maladaptive attitudes gap" between treated depressives and control subjects, we deduced that symptoms in neither group

REFERENCES

Simons AD, Garfield SL, Murphy GE:  The process of change in cognitive therapy and pharmacotherapy for depression . Arch Gen Psychiatry 1984;;41:45-51.
Lewinsohn PM, Hoberman H, Teri L, et al:  An integrative theory of depression , in Reiss S, Bootzin R (eds): Theoretical Issues in Behavior Therapy . New York, Academic Press Inc, in press.
Eaves G, Rush AJ:  Cognitive patterns in symptomatic and remitted unipolar major depression . J Abnorm Psychol 1984;;93:31-40.
Reda MA:  Cognitive organization and antidepressants: Attitude modification during amitriptyline treatment in severely depressed individuals , in Reda MA, Mahoney MJ (eds): Cognitive Psychotherapies: Recent Developments in Theory, Research, and Practice . Cambridge, Mass, Ballinger Publishing Co, 1984;, pp 119-140.
Lewinsohn PM, Steinmetz JL, Larson DW, Franklin J:  Depression-related cognitions: Antecedent or consequence? J Abnorm Psychol 1981;;90:213-219.

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Simons AD, Garfield SL, Murphy GE:  The process of change in cognitive therapy and pharmacotherapy for depression . Arch Gen Psychiatry 1984;;41:45-51.
Lewinsohn PM, Hoberman H, Teri L, et al:  An integrative theory of depression , in Reiss S, Bootzin R (eds): Theoretical Issues in Behavior Therapy . New York, Academic Press Inc, in press.
Eaves G, Rush AJ:  Cognitive patterns in symptomatic and remitted unipolar major depression . J Abnorm Psychol 1984;;93:31-40.
Reda MA:  Cognitive organization and antidepressants: Attitude modification during amitriptyline treatment in severely depressed individuals , in Reda MA, Mahoney MJ (eds): Cognitive Psychotherapies: Recent Developments in Theory, Research, and Practice . Cambridge, Mass, Ballinger Publishing Co, 1984;, pp 119-140.
Lewinsohn PM, Steinmetz JL, Larson DW, Franklin J:  Depression-related cognitions: Antecedent or consequence? J Abnorm Psychol 1981;;90:213-219.

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