Cognitive errors and coping patterns in Major Depressive Disorder and how they change over the course of cognitive therapy

Major Depressive Disorder (MDD), affects up to 16.2% of adults (Kessler et al., 2003), and is associated with immense personal suffering, and decreases in functioning and well-being (Scott & Sensky, 2003). The most well researched psychological treatment for depression is cognitive therapy (CT), developed by Beck and colleagues (Beck et al., 1979). Integral to CT is that negative early life experiences may create latent cognitive vulnerabilities in the form of core beliefs. Once activated by stressful events, these core beliefs may give rise to other forms of distorted cognitions such as dysfunctional attitudes, automatic thoughts, and cognitive errors, which reinforce depressive thinking and maintain symptoms of depression (Sacco & Beck, 1995). Similarly, coping patterns may also amplify or reduce the impacts of stress (Skinner et al., 2003). As such, CT aims to treat depression by reducing cognitive distortions and increasing the use of adaptive coping patterns (Oei & Free, 1995). Although the efficacy of CT has been well established (e.g., Dobson, 1989; Driessen & Hollon, 2010; Lynch, Laws, & McKenna, 2010), little is known about the mechanisms through which its successful results are achieved (Kazdin, 2007). Few studies have examined the frequency and type of cognitive errors and coping patterns in depression, nor how these variables change over the course of CT. In a series of three studies, this dissertation examined: 1. An early therapy profile of cognitive errors in depression, 2. Changes in cognitive errors from early to late cognitive therapy, 3. An early therapy profile of coping patterns in depression, and 4. Changes in coping patterns over the course of CT. Implications for research and practice are discussed.