<p><strong>Short answer:</strong></p>

<p>Negative thoughts in Cognitive Behavioral Therapy are both a cause and a consequence in depression. In fact if these thoughts are produced by <strong>schemes</strong> this theory considers as a specific factor of vulnerability that predisposes to depression in certain events.</p>

<p><strong>Long answer:</strong></p>

<p>First of all we should consider the considerations in terms of <strong>schemes</strong> in depression, there are different theories in depression that address schemes: </p>

<ul>
<li><p>Behavioral Cognitive Therapy. </p></li>
<li><p>Emotion-Focused Therapy.</p></li>
<li><p>Emotional Schema Therapy. </p></li>
<li><p>Mindfulness to avoid recurrence in depression.</p></li>
</ul>

<p>All these therapies consider schemas in a central way and there are important <strong>subtleties</strong> in the consideration of such schemes.</p>

<p>The fundamental thing in Behavioral Cognitive Therapy is that the processing from these schemes is a key factor in the maintenance of depression. Also the Focused Therapy in Emotions considers dysfunctional schemes in the maintenance of the depression however, although it considers them necessary, it does not consider them sufficient.</p>

<p>Document with some contents about schemes in Emotion-Focused Therapy:
<a href="https://www.researchgate.net/publication/307869346_Affective_Change_in_Psychodynamic_Psychotherapy_Theoretical_Models_and_Clinical_Approaches_to_Changing_Emotions" rel="nofollow noreferrer">https://www.researchgate.net/publication/307869346_Affective_Change_in_Psychodynamic_Psychotherapy_Theoretical_Models_and_Clinical_Approaches_to_Changing_Emotions</a></p>

<p>Document with some information about schemes in Emotional Schema Therapy:
<a href="http://www.thrivetraining.info/wp-content/uploads/CPI-18-A-Model-of-Emotional-Schemas.pdf" rel="nofollow noreferrer">http://www.thrivetraining.info/wp-content/uploads/CPI-18-A-Model-of-Emotional-Schemas.pdf</a></p>

<p>Document that you cite, prepared in <strong>1981</strong>:
<a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.380.5119&amp;rep=rep1&amp;type=pdf" rel="nofollow noreferrer">http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.380.5119&amp;rep=rep1&amp;type=pdf</a></p>

<p><strong>Later</strong>, Peter Lewinsohn formulated his theory of depression (Lewinsohn, Hoberman, Teri and Hautzinger, <strong>1985</strong>).
Lewisohn postulates that <strong>environmental factors</strong> are primarily responsible for depression, although there would be <strong>cognitive mediating factors</strong>. The main mediating variable is the increase of self-consciousness, transient and situational state of self-focusing or amount of attention that a person directs towards himself instead of towards the environment.</p>

CC BY-SA 4.0
2018-08-26T19:57:04.507Z
You seem to be addressing theories of therapy, whereas OP asks what the causative factor is for depression. Environmental factors, as you state, do certainly apply, as are genetics (it runs in families). My answer, which you find incorrect, explains a causative factor on another level, namely a neurophysiological one. Hence, I don't really understand what would make your answer so different from my approach?  Nonetheless, +1 for the well-cited answer and great to see other user compiling a neat second answer.
AliceD
CC BY-SA 4.0
2018-08-26T21:11:07.757Z
The OP basically asks in relation to negative thoughts and if they are interpreted as cause or consequence in CBT. Your answer with the serotoninergic hypothesis does not refer to the cause, it does not refer to cognitive therapy, all content about emotional (processes) are eluded and the claim that the cause of depression is neurochemical is ruthlessly false.
hexadecimal
CC BY-SA 4.0
2018-08-26T21:27:04.930Z
Then why are SSRIs effective?
AliceD
CC BY-SA 4.0
2018-08-26T21:28:57.203Z
One of the main problems in depression is relapse or recurrence, that problem would not occur if only it were a matter of chemistry. Why does relapse occur?
hexadecimal
CC BY-SA 4.0
2018-08-26T21:31:26.067Z
Effective to what extent? Those considered most effective escitalopram and sertraline would not exceed 65%.
hexadecimal
CC BY-SA 4.0
2018-08-26T21:58:47.493Z
I'm not saying it's an all inclusive, water tight explanation. It's a model. You're shooting at it, but you can also appreciate it, if that 65% figure is accurate, it's a pretty good starting point.
AliceD
CC BY-SA 4.0
2018-08-26T22:12:28.547Z
I have never criticized the serotonergic hypotesis, I appreciate it in a certain sense. This hypothesis is taken very much into account in psychology, of course.
hexadecimal
CC BY-SA 4.0
2018-08-26T14:52:09.520Z
2018-08-26T14:52:09.520Z
hexadecimal
<p><strong>Short answer</strong><br>
The cause of depression is thought to be one of neurochemistry, resulting in depressive thoughts.  </p>

<p><strong>Background</strong><br>
I think the general consensus is that depression is a psychological disorder with neurochemical causes. In particular, the <strong><a href="https://en.wikipedia.org/wiki/Biology_of_depression" rel="nofollow noreferrer">serotonin hypothesis</a></strong> of depression has received much attention, basically due to the success of the serotonin-specific reuptake inhibitors (SSRIs) that <strong>increase overall serotonin levels in the brain</strong>. The serotonin hypothesis basically states that depression is the <strong>result of a lack of serotonin and its metabolites in the brain</strong> (<em>e.g.</em>, <a href="http://clinchem.aaccjnls.org/content/40/2/288.short" rel="nofollow noreferrer">Nemeroff (1994)</a>). However, the story is of course more complicated that that. For example, other monoamine systems in the nervous system may also be affected. </p>

<p>The general idea is that the consequences of that monoamine imbalance in the brain include depressive thoughts, among other (more physical) effects, such as a loss of weight. The <strong><a href="https://www.ncbi.nlm.nih.gov/books/NBK64063/" rel="nofollow noreferrer">DSM-V criteria</a></strong> for depression include: </p>

<blockquote>
  <ol>
  <li><strong>Depressed mood</strong> most of the day.</li>
  <li><strong>Diminished interest or pleasure</strong> in all or most activities.</li>
  <li><strong>Feelings of worthlessness</strong> or excessive <strong>guilt</strong>.</li>
  <li>Recurrent <strong>thoughts of death</strong> (APA, 2000, p. 356).</li>
  </ol>
</blockquote>

<p><sub><strong>Reference</strong><br>
<strong>-</strong> <a href="http://clinchem.aaccjnls.org/content/40/2/288.short" rel="nofollow noreferrer">Nemeroff, <em>Clin Chemistry</em> (1994); <strong>40</strong>(2): 288-95</a></sub></p>

CC BY-SA 4.0
2018-08-26T15:08:17.143Z
I think both answers are not right. In the short answer you reduced depression to a medical problem without emotional symptoms, without cognitive processing. In the long answer negative thoughts or schemes are not treated at all. The theory of serotonin is mentioned as if it were its cause and it is about maintenance the same thing happens with the document that you cite. You write the criteria of the APA and do not develop them in any sense.
hexadecimal
CC BY-SA 4.0
2018-08-26T15:32:18.067Z
@hexadecimal, OP asks for the cause of depression. I think the question premise is incorrect and I'm providing a theory of the cause of depression unrelated to the ideas of OP. I think OP is incorrect. My answer is *an* answer, not *the* answer.
AliceD
CC BY-SA 4.0
2017-12-05T09:40:10.207Z
2019-04-13T18:29:34.110Z
2019-04-13T18:29:34.110Z
AliceD
<p>Simplypsychology.org <a href="https://www.simplypsychology.org/cognitive-therapy.html" rel="noreferrer">page on Cognitive Behavioral Therapy</a> mentions that</p>
<blockquote>
<p>Lewinsohn (1981) studied a group of participants before any of them became depressed, and found that those who later became depressed were no more likely to have negative thoughts than those who did not develop depression. This suggests that hopeless and negative thinking may be the result of depression, rather than the cause of it.  [...]</p>
<ul>
<li>Lewinsohn, P. M., Steinmetz, J. L., Larson, D. W., &amp; Franklin, J. (1981). Depression-related cognitions: antecedent or consequence?. Journal of abnormal psychology, 90(3), 213.</li>
</ul>
</blockquote>
<p>Has there been more research into the cause/effect relationship of negative thoughts and depression since then? If so, is there some kind of consensus on this cause-effect relationship? Or has the inquiry been judged not terribly interesting or (non-)productive?</p>

CC BY-SA 3.0
2017-12-05T15:56:50.340Z
Note that modern emotion theories view thoughts as a downstream process for all emotions in general - ie, this is not particular to depression (more detail in my answers to different questions here: https://cogsci.stackexchange.com/a/9017/7001, https://cogsci.stackexchange.com/a/8916/7001).  @AliceD gave a very good answer specific to this case.
Arnon Weinberg
CC BY-SA 3.0
2017-12-06T13:47:49.063Z
Depression, as I understand it, is orthogonal to “negative thoughts” (whatever those are). It’s more a set of moods, feelings, lack of motivation, etc. - both a nondepressed person and a regular person can have “negative thoughts.”
theMayer
<cognitive-psychology><depression><therapy>
Negative thoughts as cause or consequence of depression
got trolled too much this week
# Negative thoughts as cause or consequence of depression

(Asked by: username_0 on 2017-12-05)

Simplypsychology.org [page on Cognitive Behavioral Therapy](https://www.simplypsychology.org/cognitive-therapy.html) mentions that

> Lewinsohn (1981) studied a group of participants before any of them became depressed, and found that those who later became depressed were no more likely to have negative thoughts than those who did not develop depression. This suggests that hopeless and negative thinking may be the result of depression, rather than the cause of it. [...]
>
> * Lewinsohn, P. M., Steinmetz, J. L., Larson, D. W., & Franklin, J. (1981). Depression-related cognitions: antecedent or consequence?. Journal of abnormal psychology, 90(3), 213.

Has there been more research into the cause/effect relationship of negative thoughts and depression since then? If so, is there some kind of consensus on this cause-effect relationship? Or has the inquiry been judged not terribly interesting or (non-)productive?

**Tags:** cognitive-psychology, depression, therapy

> **Comments:**
> **username_1**: Note that modern emotion theories view thoughts as a downstream process for all emotions in general - ie, this is not particular to depression (more detail in my answers to different questions here: https://cogsci.stackexchange.com/a/9017/7001, https://cogsci.stackexchange.com/a/8916/7001).  @username_4 gave a very good answer specific to this case.  
> **username_2**: Depression, as I understand it, is orthogonal to “negative thoughts” (whatever those are). It’s more a set of moods, feelings, lack of motivation, etc. - both a nondepressed person and a regular person can have “negative thoughts.”  

---

## 2 answers

### Answer by username_4 on 2017-12-05. Score: 4 | Accepted answer

**Short answer**  
The cause of depression is thought to be one of neurochemistry, resulting in depressive thoughts.

**Background**  
I think the general consensus is that depression is a psychological disorder with neurochemical causes. In particular, the **[serotonin hypothesis](https://en.wikipedia.org/wiki/Biology_of_depression)** of depression has received much attention, basically due to the success of the serotonin-specific reuptake inhibitors (SSRIs) that **increase overall serotonin levels in the brain**. The serotonin hypothesis basically states that depression is the **result of a lack of serotonin and its metabolites in the brain** (*e.g.*, [Nemeroff (1994)](http://clinchem.aaccjnls.org/content/40/2/288.short)). However, the story is of course more complicated that that. For example, other monoamine systems in the nervous system may also be affected.

The general idea is that the consequences of that monoamine imbalance in the brain include depressive thoughts, among other (more physical) effects, such as a loss of weight. The **[DSM-V criteria](https://www.ncbi.nlm.nih.gov/books/NBK64063/)** for depression include:

> 1. **Depressed mood** most of the day.
> 2. **Diminished interest or pleasure** in all or most activities.
> 3. **Feelings of worthlessness** or excessive **guilt**.
> 4. Recurrent **thoughts of death** (APA, 2000, p. 356).

**Reference**  
**-** [Nemeroff, *Clin Chemistry* (1994); **40**(2): 288-95](http://clinchem.aaccjnls.org/content/40/2/288.short)

> **Comments:**
> **username_3**: I think both answers are not right. In the short answer you reduced depression to a medical problem without emotional symptoms, without cognitive processing. In the long answer negative thoughts or schemes are not treated at all. The theory of serotonin is mentioned as if it were its cause and it is about maintenance the same thing happens with the document that you cite. You write the criteria of the APA and do not develop them in any sense.  
> **username_4**: @username_3, OP asks for the cause of depression. I think the question premise is incorrect and I'm providing a theory of the cause of depression unrelated to the ideas of OP. I think OP is incorrect. My answer is *an* answer, not *the* answer.  

---

### Answer by username_3 on 2018-08-26. Score: 2

**Short answer:**

Negative thoughts in Cognitive Behavioral Therapy are both a cause and a consequence in depression. In fact if these thoughts are produced by **schemes** this theory considers as a specific factor of vulnerability that predisposes to depression in certain events.

**Long answer:**

First of all we should consider the considerations in terms of **schemes** in depression, there are different theories in depression that address schemes:

* Behavioral Cognitive Therapy.
* Emotion-Focused Therapy.
* Emotional Schema Therapy.
* Mindfulness to avoid recurrence in depression.

All these therapies consider schemas in a central way and there are important **subtleties** in the consideration of such schemes.

The fundamental thing in Behavioral Cognitive Therapy is that the processing from these schemes is a key factor in the maintenance of depression. Also the Focused Therapy in Emotions considers dysfunctional schemes in the maintenance of the depression however, although it considers them necessary, it does not consider them sufficient.

Document with some contents about schemes in Emotion-Focused Therapy:
<https://www.researchgate.net/publication/307869346_Affective_Change_in_Psychodynamic_Psychotherapy_Theoretical_Models_and_Clinical_Approaches_to_Changing_Emotions>

Document with some information about schemes in Emotional Schema Therapy:
<http://www.thrivetraining.info/wp-content/uploads/CPI-18-A-Model-of-Emotional-Schemas.pdf>

Document that you cite, prepared in **1981**:
<http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.380.5119&rep=rep1&type=pdf>

**Later**, Peter Lewinsohn formulated his theory of depression (Lewinsohn, Hoberman, Teri and Hautzinger, **1985**).
Lewisohn postulates that **environmental factors** are primarily responsible for depression, although there would be **cognitive mediating factors**. The main mediating variable is the increase of self-consciousness, transient and situational state of self-focusing or amount of attention that a person directs towards himself instead of towards the environment.

> **Comments:**
> **username_4**: You seem to be addressing theories of therapy, whereas OP asks what the causative factor is for depression. Environmental factors, as you state, do certainly apply, as are genetics (it runs in families). My answer, which you find incorrect, explains a causative factor on another level, namely a neurophysiological one. Hence, I don't really understand what would make your answer so different from my approach?  Nonetheless, +1 for the well-cited answer and great to see other user compiling a neat second answer.  
> **username_3**: The OP basically asks in relation to negative thoughts and if they are interpreted as cause or consequence in CBT. Your answer with the serotoninergic hypothesis does not refer to the cause, it does not refer to cognitive therapy, all content about emotional (processes) are eluded and the claim that the cause of depression is neurochemical is ruthlessly false.  
> **username_4**: Then why are SSRIs effective?  
> **username_3**: One of the main problems in depression is relapse or recurrence, that problem would not occur if only it were a matter of chemistry. Why does relapse occur?  
> **username_3**: Effective to what extent? Those considered most effective escitalopram and sertraline would not exceed 65%.  
> **username_4**: I'm not saying it's an all inclusive, water tight explanation. It's a model. You're shooting at it, but you can also appreciate it, if that 65% figure is accurate, it's a pretty good starting point.  
> **username_3**: I have never criticized the serotonergic hypotesis, I appreciate it in a certain sense. This hypothesis is taken very much into account in psychology, of course.  

---

