The roles of two levels of cognitions in the development, maintenance, and treatment of depression

We attempt to clarify the roles of maladaptive cognitions in depression by making distinctions between two different types of cognition and among three dijferent phases of depression. A stable and deep level of cognition and an unstable and surface level of cognition are distinguished. These two types of cognitions are assumed to play different roles in the development, maintenance, and recovering or treatment phases of depression. Based on these distinctions, Beck's cognitive theory of depression is clarified and elaborated. In addition, on the basis of the existing theoretical and empirical literature, alternative or competing models are outlined and evaluated. Finally, some methodological considerations are suggested for future investigations.