The Theory and Treatment of Depression: Towards a Dynamic Interactionism Model

Recent research indicates that depression, once believed to be relatively benign, is highly recurrent and does not respond well to treatment. The goal of this book is to facilitate the development of more encompassing theories and more effective treatments for this disabling disorder by fostering dialogue and enhancing the integration of work across the boundaries of separate fields. Each chapter offers an overview of the state of the art of research in a particular area - cognitive-behavioral therapy, psychodynamic therapy, epidemiology, developmental psychopathology, neurobiology - and explores both the implications of the latest hypotheses and findings for work in other areas and the barriers to constructive collaboration. In an integrative Epilogue, the editors identify and discuss the points of primary convergence. They note dissatisfaction with the DSM approach to depression because it is insufficiently informed by basic research, and with existing guidelines for intervention because they underestimate the need for more extended treatments for many patients, the importance of patient and therapist factors, and the central role of the therapeutic alliance. As an alternative to the DSM approach, the editors propose an etiologically-based, dynamic interactionism model of depression that emphasizes recursive interactions among genetic and neurobiological factors, personality, and life stress in etiology. Finally, they reflect on the potential of this dynamic interactionism model to guide future research on mood disorders and the formulation of treatment guidelines that are better informed by science and more congruent with complex clinical reality.