[Cognitive approach to anticipation in depression]
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B Rivière1, P Légeron, J P Marboutin
1Psychiatre des Hôpitaux, Hôpital Esquirol, Saint-Maurice.
Abstract:
There is an extensive philosophical and humanistic literature concerning anticipation. Behavioural and cognitive theories have approached the concept of anticipation and have led to therapeutic solutions. The Lewinsohn model enables prediction and restoration of the activities of mastery and pleasure. The social psychology model (Bandura) forms the basis of training in assertiveness, using role-playing in order to be able to produce the relational situations which the patient will encounter. Learned helplessness for action (Seligman), teaches the reattribution of failures or successes, which leads the depressed patient to once again become involved in the action concerned. Exposure to feared situations (Marks) modifies catastrophic anticipations. The social reinforcement model (Liberman) enables prediction by functional analysis of factors involved in the persistence of problems and their modification. The mechanisms of anticipation have been reviewed since Bartlett and Ellis and up to the work of Beck. Structured patterns during existence determine thought processes in face of the circumstances which provoke them. Thus, in the opinion of the authors, our past affects our future in terms of the manner in which these patterns deal with information and determine our thoughts (cognitive events) and our vision of the future. The experimental basis of the cognitive model and the validation of these therapeutic approaches are described. The depressed patient makes negative predictions. Negative cognitions vary in conjunction with mood. Modification of these cognitions changes mood. Numerous studies are presented. They establish the effectiveness of this model, comparable to the action of antidepressant drugs and appearing to have a prolonged effect. The evaluation and cognitive treatment of anticipation are described: cognitive rating scales and analysis are proposed.(ABSTRACT TRUNCATED AT 250 WORDS)