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A cognitive science perspective on kindling and episode sensitization in recurrent affective disorder

Published online by Cambridge University Press:  09 July 2009

Z. V. Segal ,
J. M. Williams ,
J. D. Teasdale  and
M. Gemar
Z. V. Segal*
Affiliation:
Clarke Institute of Psychiatry, University of Toronto, Ontario, Canada; Department of Psychology, University College of North Wales, Bangor; and MRC Applied Psychology Unit, Cambridge
J. M. Williams
Affiliation:
Clarke Institute of Psychiatry, University of Toronto, Ontario, Canada; Department of Psychology, University College of North Wales, Bangor; and MRC Applied Psychology Unit, Cambridge
J. D. Teasdale
Affiliation:
Clarke Institute of Psychiatry, University of Toronto, Ontario, Canada; Department of Psychology, University College of North Wales, Bangor; and MRC Applied Psychology Unit, Cambridge
M. Gemar
Affiliation:
Clarke Institute of Psychiatry, University of Toronto, Ontario, Canada; Department of Psychology, University College of North Wales, Bangor; and MRC Applied Psychology Unit, Cambridge
*
*Address for correspondence: Dr Zindel V. Segal, Clarke Institute of Psychiatry. 250 College Street, Toronto, Ontario, Canada M5T 1R8.
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Synopsis

A cognitive science analysis of the interaction between psychosocial stress and the neurobiology of affective illness highlights a number of mechanisms relevant to the study of recurrence in major depressive disorder. It builds on observations previously offered by Post (1992) regarding the importance of kindling and sensitization effects in determining activation of neural structures, and proposes a model of knowledge structure activation that follows similar parameters. Vulnerability to depressive relapse/recurrence is determined by the increased risk of particular negative patterns of information processing being activated in depressed states. As is found in studies of kindling and behavioural sensitization, the likelihood of cognitive patterns being activated is dependent on the frequency of past usage, and increased reliance on these patterns of processing makes it easier for their future activation to be achieved on the basis of increasingly minimal cues. This model suggests that the processes related to relapse/recurrence and episode onset may not be isomorphic and, as such, treatments that emphasize relapse prevention strategies should take this distinction into account.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 2 , March 1996 , pp. 371 - 380
Copyright
Copyright © Cambridge University Press 1996

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References

REFERENCES

Anderson, J. R. (1983). The Architecture of Cognition. Harvard University Press: Cambridge, MA.Google Scholar
Baastrup, P. C. (1964). The use of lithium in manic-depressive psychosis. Comprehensive Psychiatry 5, 396–400.CrossRefGoogle ScholarPubMed
Bandura, A., Taylor, C. B., Williams, S. L. & Barchas, J. D. (1985). Catecholamine secretion as a function of perceived coping self-efficacy. Journal of Consulting and Clinical Psychology 53, 406–414.CrossRefGoogle ScholarPubMed
Baxter, L. R., Schwartz, J. M., Bergman, K. S., Szuba, M. P., Guze, B. H., Mazziota, J. C., Alazraki, A., Selin, C. E., Huan-Kwang, F., Munford, P. & Phelps, M. E. (1992). Caudate glucose metabolic rate changes with both drug behaviour therapy for obsessive-compulsive disorder. Archives of General Psychiatry 49, 681–689.CrossRefGoogle ScholarPubMed
Beck, A. T. (1967). Depression: Clinical, Experimental, and Theoretical Aspects. Harper & Row: New York.Google Scholar
Berti Ceroni, G., Neri, C. & Pezzoli, A. (1984). Chronicity in major depression: a naturalistic prospective study. Journal of Affective Disorders 10, 121–144.Google Scholar
Beutler, L. E., Scogin, F., Kirkish, P., Scretlen, D., Corbishleay, A., Hamblin, D., Meredith, K., Potter, R., Banford, C. R. & Leverson, A. I. (1987). Group cognitive therapy and alprazolam in the treatment of depression in older adults. Journal of Consulting and Clinical Psychology, 55, 550–556.CrossRefGoogle ScholarPubMed
Bifulco, A., Brown, G. W. & Adler, Z. (1991). Sexual abuse and clinical depression in later life. British Journal of Psychiatry 159, 115–122.CrossRefGoogle Scholar
Blackburn, I. M., Whalley, L. J., Christie, J. E., Shering, A., Foggo, M., Bennie, J., Farrer, D., Watts, G., Wilson, H. & Fink, G. (1987). Mood, cognition and cortisol: their temporal relationships during recovery from depressive illness. Journal of Affective Disorders 13, 31–43.CrossRefGoogle ScholarPubMed
Blaney, P. H. (1986). Affect and memory: a review. Psychological Bulletin 99, 229–246.CrossRefGoogle ScholarPubMed
Bower, G. H. (1981). Mood and memory. American Psychologist 36, 129–148.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. O. (1978). Social Origins of Depression. Free Press: New York.Google ScholarPubMed
Clark, D. M. & Teasdale, J. D. (1982). Diurnal variations in clinical depression and accessibility of memories of positive and negative experiences. Journal of Abnormal Psychology 91, 87–95.CrossRefGoogle ScholarPubMed
Collins, A. M. & Loftus, E. F. (1975). A spreading-activation theory of semantic processing. Psychological Review 82, 407–428.CrossRefGoogle Scholar
DeRubeis, R. J., Evans, M. D., Hollon, S. D., Garvey, M. J., Grove, W. M. & Tuason, V. B. (1990). How does cognitive therapy work? Cognitive change and symptom change in cognitive therapy and pharmacotherapy for depression. Journal of Consulting and Clinical Psychology 6, 862–869.CrossRefGoogle Scholar
Edelman, G. M. (1987). Neural Darwinism: The Theory of Neuronal Group Selection. Basic Books: New York.Google Scholar
Ellis, A. (1962). Reason and Emotion in Psychotherapy. Stuart: New York.Google Scholar
Evans, M. D., Hollon, S. D., DeRubeis, R. J., Piasecki, J. M., Grove, M. W., Garvey, M. J. & Tuason, V. B. (1992). Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry 49, 802–808.CrossRefGoogle ScholarPubMed
Erdelyi, M. H. (1992). Psychodynamics and the unconscious. American Psychologist 47, 784–787.CrossRefGoogle ScholarPubMed
Frank, E., Kupfer, D. J., Perel, J. M., Cornes, C., Jarret, D. B., Mallinger, A. G., These, M. E., McEachron, A. B. & Grocholinski, V. J. (1990). Three-year outcomes for maintenance therapies in recurrent depression. Archives of General Psychiatry 47, 1093–1099.CrossRefGoogle ScholarPubMed
Free, M. L. & Oei, T. P. (1989). Biological and psychological processes in the treatment and maintenance of depression. Clinical Psychology Review 9, 653–688.CrossRefGoogle Scholar
Gabbard, G. O. (1992). Psychodynamic psychiatry in the ‘decade of the brain’. American Journal of Psychiatry 149, 991–998.Google ScholarPubMed
Gold, P. W., Goodwin, F. K. & Chrousos, G. P. (1988). Clinical and biochemical manifestations of depression: relation to the neurobiology of stress, part II. New England Journal of Medicine 319, 413–420.CrossRefGoogle Scholar
Greenwald, A. G. (1992). Unconscious cognition reclaimed. American Psychologist 47, 766–695.CrossRefGoogle ScholarPubMed
Hartlage, S., Alloy, L. B., Vazquez, C. & Dykman, B. (1993). Automatic and effortful processing in depression. Psychological Bulletin 113. 247–278.CrossRefGoogle ScholarPubMed
Higgins, E. T. & Bargh, J. (1987). Social cognition and social perception. Annual Review of Psychology 38, 369–425.CrossRefGoogle ScholarPubMed
Higgins, E. T. & King, G. A. (1981). Accessibility of social constructs: Information processing consequences of individual and contextual variability. In Personality, Cognition, and Social Interaction (ed Cantor, N. and Kihlstrom, J. F.), pp. 69–121. Erlbaum: Hillsdale, NJ.Google Scholar
Ingram, R. E. (1984). Toward an information-processing analysis of depression. Cognitive Therapy and Research 8. 443–478.CrossRefGoogle Scholar
Joffe, R., Segal, Z. V. & Singer, W. (1995). Changes in thyroid hormone levels following response to cognitive therapy for depression. (In preparation.)Google Scholar
Izard, C. E. (1993). Four systems for emotion activation: cognitive and noncognitive processes. Psychological Review 100, 68–90.CrossRefGoogle ScholarPubMed
Kabat-Zinn, J. (1990). Full Catastrophe Living. Delacorte: New York.Google Scholar
Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L., Lenderking, W. R. & Santorelli, S. F. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. American Journal of Psychiatry 149, 936–943.Google ScholarPubMed
Kandel, E. R. (1983). From metapsychology to molecular biology: explorations into the nature of anxiety. American Journal of Psychiatry 140, 1277–1293.Google ScholarPubMed
Kovacs, M. & Beck, A. T. (1978). Maladaptive cognitive structures in depression. American Journal of Psychiatry 135, 525–533.Google ScholarPubMed
Kraepelin, E. (1921). Manic Depressive Illness. E&S Livingstone: Edinburgh.Google Scholar
Leonhard, K., Korff, I. & Schultz, H. (1962). Die temperamente in den familien der monopolaren und bipolaren phasischen psychosen. Psychiatry and Neurology 143, 416.CrossRefGoogle Scholar
Loftus, E. F. & Klinger, M. R. (1992). Is the unconscious smart or dumb? American Psychologist 47, 761–765.CrossRefGoogle ScholarPubMed
McKnight, D. L., Nelson-Gray, R. O. & Barnhill, J. (1992). Dexamethasone suppression test and response to cognitive therapy and antidepressant medication. Behaviour Therapy 23, 99–111.CrossRefGoogle Scholar
Matt, G. E., Vazquez, C. & Campbell, W. K. (1992). Mood-congruent recall of affectively toned stimuli: a meta-analytic review. Clinical Psychology Review 12. 227–255.CrossRefGoogle Scholar
Merikle, P. M. (1992). Perception without awareness. American Psychologist 47, 792–795.CrossRefGoogle ScholarPubMed
Miranda, J. & Persons, J. B. (1988). Dysfunctional attitudes are mood-state dependent. Journal of Abnormal Psychology 97, 76–79.CrossRefGoogle ScholarPubMed
Miranda, J., Persons, J. B. & Byers, C. (1990). Endorsement of dysfunctional beliefs depends on current mood state. Journal of Abnormal Psychology 99, 237–241.CrossRefGoogle ScholarPubMed
Monroe, S. M. & Simons, A. D. (1991). Life stress in the context of diathesis stress theories: implications for the depressive disorders. Psychological Bulletin 110, 406–425.CrossRefGoogle ScholarPubMed
Pardo, J. V., Pardo, P. J. & Raichle, M. E. (1993). Neural correlates of self-induced dysphoria. American Journal of Psychiatry 150. 713–719.Google ScholarPubMed
Posner, M. I. & Warren, R. E. (1972). Traces, concepts and conscious constructions. In Coding Processes in Human Memory (ed. Melton, A. W. and Martin, E.), pp. 23–43. Winston & Sons: Washington. DC.Google Scholar
Post, R. M. (1992). Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. American Journal of Psychiatry 149, 999–1010.Google ScholarPubMed
Post, R. M. & Weiss, S. R. (1992). Endogenous biochemical abnormalities in affective illness: therapeutic versus pathogenic. Biological Psychiatry 32, 469–484.CrossRefGoogle ScholarPubMed
Post, R. M., Rubinow, D. R. & Ballenger, J. C. (1984). Conditioning, sensitization, and kindling: Implications for the course of affective illness. In Neurobiology of Mood Disorders (ed. Post, R. M. and Ballenger, J. C.). Baltimore: Williams & Wilkins.Google Scholar
Power, M. J. & Champion, L. A. (1986). Cognitive depression: a theoretical critique. British Journal of Clinical Psychology 25, 201–212.CrossRefGoogle ScholarPubMed
Salzman, C. (1984). Clinical Geriatric Psychopharmacology. McGraw Hill: New York.Google Scholar
Segal, Z. V. & Blatt, S. J. (1993). The Self in Emotional Distress: Cognitive and Psychodynamic Perspectives. Guilford Press: New York.Google Scholar
Segal, Z. V. & Ingram, R. E. (1994). Priming and construct activation in tests of cognitive vulnerability to unipolar depression. Clinical Psychology Review 14, 663–695.CrossRefGoogle Scholar
Segal, Z. V., Gemar, M., Truchon, C., Guirguis, M. & Horowiz, L. (1995). A priming methodology for studying self-representation in major depressive disorder. Journal of Abnormal Psychology 104. 205–213.CrossRefGoogle ScholarPubMed
Simons, A., Garfield, S. & Murphy, G. (1984). The process of change in cognitive therapy and pharmacotherapy: changes in mood and cognition. Archives of General Psychiatry 41. 45–51.CrossRefGoogle ScholarPubMed
Singer, J. A. & Salovey, P. (1988). Mood and memory: evaluating the network theory of affect. Clinical Psychology Review 8, 211–251.CrossRefGoogle Scholar
Skelton, J. A. & Croyle, R. T. (1991). Mental Representation in Health and Illness. Springer-Verlag: New York.CrossRefGoogle Scholar
Sotsky, S. M., Glass, D. R., Shea, M. T., Pilkonis, P., Collins, J., Elkin, I., Watkins, J., Imber, S., Leber, W., Moyer, J. & Oliveri, M. (1991). Patient predictors of response to psychotherapy and pharmacotherapy: findings in the NIMH treatment of depression collaborative research program. American Journal of Psychiatry 148, 997–1008.Google ScholarPubMed
Sturt, E., Kumarkura, N. & Der, G. (1984). How depressing life is: lifelong morbidity risk for depression in the general population. Journal of Affective Disorders 6, 104–122.Google Scholar
Teasdale, J. D. (1983). Negative thinking in depression: cause, effect, or reciprocal relationship? Advances in Behaviour Research and Therapy 5, 3–25.CrossRefGoogle Scholar
Teasdale, J. D. (1988). Cognitive vulnerability to persistent depression. Cognitive and Emotion 2, 247–274.CrossRefGoogle Scholar
Teasdale, J. D. & Barnard, P. J. (1993). Affect, Cognition, and Change. Erlbaum: Hillsdale, NJ.Google Scholar
Teasdale, J. D. & Dent, J. (1987). Cognitive vulnerability to depression: an investigation of two hypothesis. British Journal of Clinical Psychology 26, 113–126.CrossRefGoogle Scholar
Teasdale, J. D., Segal, Z. V. & Williams, J. M. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? An information processing analysis. Behaviour Research and Therapy 33, 25–39.CrossRefGoogle Scholar
Thase, M. E., Simons, A. D., Cahalane, J. F. & McGeary, J. (1991). Cognitive behaviour therapy of endogenous depression: part 1: an outpatient clinical replication series. Behaviour Therapy, 22, 457–467.CrossRefGoogle Scholar
Tulving, E. & Schacter, D. L. (1990). Priming in human memory systems. Science 247, 301–306.CrossRefGoogle ScholarPubMed
Weissman, A. (1979). The Dysfunctional Attitudes Scale: A validation study. Dissertations Abstracts International 40, 1389–1390B (University Microfilm No. 79–19, 533).Google Scholar
Williams, J. M. G.(1992). The Psychological Treatment of Depression. Routledge: London.Google Scholar
Williams, J. M. G., Watts, F. N., MacLeod, C. & Mathews, A. (1988). Cognitive Psychology and Emotional Disorders. Wiley: Chichester.Google Scholar
Williams, R. M. (1988). Individual differences in the effects of mood on cognition. Ph.D. thesis, University of Oxford.Google Scholar