ABSTRACT: Cognitive theory holds that inaccurate beliefs and maladaptive information processing play a role in the cause and maintenance of depression, and a cognitive theory of change posits that correcting those errors in thinking will ameliorate existing distress and reduce subsequent risk. Cognitive therapy has been shown to be efficacious in the treatment of depression and prevention of subsequent relapse, but evidence for mediation has been difficult to detect. The authors review efforts to test for mediation in cognitive therapy and describe the epistemological issues that complicate the process. Cognitive mediation of acute response likely will be hard to detect, whereas there already is good evidence that cognitive processes play a role in the mediation of enduring effects.
Cognitive behaviour therapy 09/2009; 38 Suppl 1:43-7.