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Cognitive therapy, pioneered by Aaron T. Beck in the 1960s, is a structured approach to addressing psychological distress by focusing on the influence of thoughts on emotions and behaviors. All cognitive therapies involve the basic assumption that human beings have control over their feelings, and that how individuals feel about something depends on how they think about it. Unlike psychoanalytic methods that delve into unconscious processes or humanistic approaches emphasizing...
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Cognitive therapy is a psychological approach designed to address distortions in thinking, which can lead to negative emotions and unrealistic beliefs. These cognitive distortions often influence how individuals interpret and respond to situations, exacerbating emotional distress. Below are some prevalent cognitive distortions, their characteristics, and examples of how they manifest in thought processes.
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Rational Emotive Behavior Therapy01:24

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Cognitive-behavioral therapies (CBTs) are grounded in the belief that our thoughts profoundly influence our emotions and actions. Advocates of CBT emphasize three core assumptions: first, that cognitions are identifiable and measurable; second, that they are central to psychological functioning; and third, that irrational or maladaptive beliefs can be replaced with rational and adaptive ones. This transformative approach to therapy has paved the way for specific models such as Albert...
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MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
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Cognition in Treatment-Resistant Depression: Obstacles and Challenges?

Marina Sagud1,2, Nenad Jakšić1,2, Darko Marcinko1,2

  • 1Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.

Advances in Experimental Medicine and Biology
|April 26, 2026
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Summary
This summary is machine-generated.

Treatment-resistant depression (TRD) involves significant cognitive deficits. Understanding the biological basis of these cognitive issues is crucial for developing targeted therapies for TRD patients.

Keywords:
CognitionCognitive disturbancesDepressionTherapeutic strategyTreatmentTreatment-resistant depression

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Science

Background:

  • Treatment-resistant depression (TRD) is characterized by a lack of response to adequate treatments, including electroconvulsive therapy (ECT).
  • Cognitive disturbances are central to TRD, significantly impacting functional outcomes and treatment resistance.
  • Patients with TRD exhibit notable deficits in executive function, memory, attention, and processing speed compared to non-TRD individuals.

Purpose of the Study:

  • To elucidate the biological underpinnings of cognitive dysfunction in TRD.
  • To explore potential therapeutic strategies for cognitive impairment in TRD.
  • To emphasize the need for personalized treatments targeting cognitive deficits in TRD.

Main Methods:

  • Review of existing literature on TRD and cognitive disturbances.
  • Analysis of biological factors contributing to cognitive deterioration, including brain alterations and neurochemical changes.
  • Examination of current and potential therapeutic interventions for cognitive dysfunction.

Main Results:

  • Cognitive deficits in TRD span multiple domains, including executive function, memory, and attention.
  • Biological factors implicated in cognitive decline include brain region alterations, reduced N-acetyl aspartate, inflammatory processes, and specific neurotransmitter receptor involvement (e.g., serotonergic, adrenergic).
  • Pharmacotherapy, neuromodulation, psychotherapy, and cognitive remediation are identified therapeutic avenues.

Conclusions:

  • Cognitive disturbances are a key feature of TRD, presenting significant challenges.
  • Further research into the biological basis of cognitive impairment is essential for developing personalized TRD treatments.
  • Integrating cognitive assessments and targeted interventions is vital for effective TRD management.