Investigation of the relationship between disease severity and automatic thought and dysfunctional schemes in patients w

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Investigation of the relationship between disease severity and automatic thought and dysfunctional schemes in patients with depression and non-clinical group: a structural equation modeling study Yığman Fatih 1

&

Özdel Kadir 1 & Efe Canan 2

# Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract According to the cognitive model, the cognitive structure has three layers. It consists of core beliefs, intermediate beliefs and automatic thoughts. In this study, it was aimed to investigate the relationship between depression clinical severity, automatic thoughts, intermediate beliefs and core beliefs. Core beliefs and intermediate beliefs are defined as schemas according to Beck and form a source for automatic thoughts. We aimed to discuss our findings in terms of schema activation model. A total of 101 outpatients and 82 healthy controls were evaluated using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCIDI), sociodemographic data form, Automatic Thoughts Questionnaire (ATQ), Dysfunctional Attitudes Scale-short form (DASSF), and Social Comparison Scale (SCI). For the clinical sample, higher depression scores were associated with more automatic thoughts (r = .75) and intermediate beliefs (r = .55). When the structural equation model was examined, it was found that automatic thoughts significantly predicted the severity of depressive symptoms in both the clinical group (β = .64) and the non-clinical group (β = .57). For the clinical sample, automatic thoughts directly predict the severity of depression. Intermediate beliefs predict the severity of depression indirectly through automatic thoughts; core beliefs predict both directly and indirectly through automatic thoughts as weaker than automatic thoughts. For the non-clinical sample, the relationship between automatic thoughts and severity of depressive symptoms are significant, but other ways are not. This may indicate that the disease does not occur clinically without scheme activation. Keywords Depression . Cognitive theory . Automatic thought . Dysfunctional schemes

Introduction Depression, which manifests itself as symptoms of sleep and appetite disorders and sexual aversion in psychophysiological functions, unwillingness, inability to enjoy, fatigue in the psychomotor area, slowdown in behavior, themes of guilt, pessimism, worthlessness and depressive disorder is an important public health problem (Sadock et al. 2016). Depression is considered as a serious economic burden in terms of cost of treatment because of its onset at a young age, its recurrent * Yığman Fatih [email protected] 1

Department of Psychiatry, Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Science, Sehit Omer Halisdemir Street, Ankara, Türkiye

2

Ankara Gölbaşı Şehit Ahmet Özsoy State Hospital, Ankara, Turkey

course by nature, its tendency to be continuous and the difficulties in providing adequate treatment. Major depressive disorder (MDD) is relatively common in the general population and is a major public health