
Aaron T. Beck (1921-2021) was a forerunner in the cognitive revolution of psychological sciences. He is regarded as the father of cognitive behavior therapy. Beck is a key contributor to cognitive treatment of depression. A foundational element to his cognitive theory of depression is the negative cognitive triad.
Beck theorized that “depressed persons have distorted negative perceptions of themselves, their world, and their future.” Researchers Beckham, Leber, and colleagues explain that “negative cognitions in these areas, known as the cognitive triad, lead to feelings of depression” (1986. p. 566).
The cognitive triad of depressed people typically centers on negative thoughts and beliefs. These core beliefs are “made up of distorted, unrealistic thinking styles, which contribute to the development and maintenance of depressive symptoms” (Pittard, et al., 2021, p. 904).
“Measures of the three dimensions of Beck’s negative cognitive triad have been linked to chronic low self-esteem, powerlessness, and hopelessness (Zauszniewski, 1999, p. 103). The cognitive triad deliver a powerful wallop to our mental wellness, knocking us into spiraling states of hopeless and helpless existence.
Empirical findings support the negative cognitive triad and depression connection. “Negative views of the self, the world, and the future impact the severity of depression and are precursors for other motivational, emotional, and somatic symptoms that are associated with depression” (p. 102).
Examples of Negative Thoughts About Self, World, and Future
Self
- I am a failure
- I can’t do anything right
- Nobody loves me
- I don’t deserve to be happy
World
- The world is dangerous
- You can’t trust anybody
- Others just want to take advantage of you
- As soon as things start going well, something will come and destroy it
Future
- Tomorrow is going to be as bad as today
- I’ll never find anyone to love
- I’ll never get promoted
- We all suffer then die
Why Do We Adopt the Negative Thinking
Patterns of the Cognitive Triad?
There are many reasons for adopting the negative thinking patterns contained in the cognitive triad. Usually, there is a combination of biological sensitivities and environmental factors.
According to the General Adaptation Syndrome (G-A-S), anything that threatens life creates stress, motivating an adaptive response. Because of our significant cognitive abilities, we associate many interactions as threatening, especially within the realm of relationships.
The heightened stress leads to adaptive (or maladaptive) responses. We scan the world seeking causes to give meaning to the threat. When our young lives are unpredictable, and infused with danger, it is easy to adopt a view of a dangerous world and hopeless future.
Daniel Siegel discusses some of the causes of adopting the cognitive triad, He writes “children exposed to ongoing stress and trauma, such as that associated with exposure to community violence, may develop schemas of the world as a hostile place and experience changed attitudes about people, life, and the future.” Siegel continues, “significant figures such as children’s caregivers may come to be viewed as incapable of keeping children safe from the dangers present in their environment. Likewise, children may feel that they are not worthy of being kept safe” (2020, Kindle location 2,070).
Children are especially sensitive to messages received from caregivers. In a Freudian superego style, the children adopt and integrate critical judgments from caregivers. Consequently, the voice of the parent continues to live in the mind—why are you so stupid, you can’t do anything right.
Why Are Thinking Patterns so Stubborn?
These core beliefs about our self, the world and the future are not just musings of an overactive mind, but integrated schemas operating beneath consciousness, serving as a working model to give meaning to all of lives complexing events.
Ronnie Janoff-Bulman explains the process of schemas are self-supporting. She wrote that “schema-relevant information is more likely to be noticed and attended to; it is also processed more rapidly and easily” (2010, p. 30). We absorb any message that can fit our models. If we believe the world to be dangerous, we give notice to everything in the world that supports that notion. The same holds true for our perceptions of self and our futures.
Life provides the supporting data for all our core beliefs (primal world beliefs). Jonathan Haidt describes this propensity this way, “the pathology of depression is that, while ruminating, the depressed person reworks her life narrative by using the tools of Beck’s negative triad: I’m bad, the world is bad, and my future is dark” (2006, Kindle location 2,777).
Overcoming the Cognitive Triad
Some research has found that medically treating depression, leads to natural decline in the use of negative triad thinking. Once depression is medically mediated, often thoughts improve on their own. However, there remains strong arguments for combining medical treatments with traditional therapies.
Improved thinking may assist with preventing or delaying a relapse.
The Positive Cognitive Triad
A recent study found that utilizing an overall positive cognitive triad ( I am proud of myself, the world is good, and I have a bright future) is a protective factor against depressive symptoms in adolescents (2021, Berghuis, Pössel, & Pittard, p. 904).
Existing research strongly supports the protective impact of a positive explanation style. A positive cognitive triad follows the same principle.
Cognitive Behavior Therapy
Beck suggested cognitive behavior therapy as treatment for changing a negative cognitive triad into something more positive, and by changing the thoughts, he proposed, the symptoms would subside. T. Franklin Murphy wrote that “cognitive behavior therapy focuses on the connections between thoughts, emotions and behaviors. The therapeutic approach is to help clients recognize negative or unhelpful thought and behavior patterns, exploring ways that emotions and thoughts impact actions. Once clients recognize unhelpful patterns, they can reframe thoughts in more positive and helpful ways through a process called cognitive reappraisal” (2021).
Beck’s Depression Inventory (BDI)
As part of Beck’s cognitive theory of depression, he introduced Beck’s Depression Index. Within his index there are several question related to the cognitive triad.
Cognitive Triad Inventory
As Beck’s cognitive theory of depression became widely accepted a better instrument for measuring the cognitive triad was needed. Researchers created The Cognitive Triad Inventory (CTI) to fill this need.
The CTI contains 36 items rated on a 7-point Likert scale from totally agree to totally disagree. Ten questions are given to each of the subcategories of the cognitive triad (self, world, future). The additional six questions are disregarded and do not impact overall score (Zauszniewski, 1999, p. 103).
A sampling of some of the questions:
- Most people are friendly and helpful.
- I am a failure
- I like to think about the good things that lie ahead for me
- The people I know help me when I need it
- I expect that things will be going very well for me a few years from now.
- I have messed up almost all the important relationships I have ever had
- The future holds a lot of excitement for me
- My daily activities are fun and rewarding (Pössel, 2009).
A Few Final Comments on the Cognitive Triad
Beck’s cognitive triad is associated with depression. Does it cause depression, well, that is another matter. We know that treatment to change themes of thought can be an effective treatment, so there is some inclination that negative thoughts may impact moods. Yet, the opposite is also true, medicated treatments that reduces depression also improves thought.
It’s important for those inflicted with depression to seek help from their physician and together try variety modes of treatment to find the combination that works best for them.
References:
Beckham, E., Leber, W., Watkins, J., Boyer, J., & Cook, J. (1986). Development of an Instrument to Measure Beck’s Cognitive Triad: The Cognitive Triad Inventory. Journal of Consulting and Clinical Psychology, 54(4), 566-567.
Berghuis, K., Pössel, P., & Pittard, C. (2020). Perceived Discrimination and Depressive Symptoms: Is the Cognitive Triad a Moderator or Mediator?. Child and Youth Care Forum, 49(4), 647-660.
Haidt, Johnathan (2006). The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom. Basic Books; 1st edition
Janoff-Bulman, Ronnie (2010). Shattered Assumptions: Towards a New Psychology of Trauma. Free Press; Completely Updated edition.
Murphy, T. Franklin (2021). Cognitive Behavior Therapy. Psychology Fanatic. Published 10-2-2021. Accessed 8-19-2022.
Pittard, C., Pössel, P., Adelson, J., Spence, S., Sheffield, J., & Sawyer, M. (2021). The Conceptualization of the Positive Cognitive Triad and Associations with Depressive Symptoms in Adolescents. Child Psychiatry and Human Development, 52(5), 903-915.
Pössel P. (2009). Cognitive Triad Inventory (CTI): psychometric properties and factor structure of the German translation. Journal of Behavior Therapy and Experimental Psychiatry. 2009 Jun;40(2)
Siegel, Daniel J. (2020). The Developing Mind, Third Edition: How Relationships and the Brain Interact to Shape Who We Are. The Guilford Press; 3rd edition .
Stark, K., Schmidt, K., & Joiner, T. (2005). Cognitive triad: Relationship to depressive symptoms, parents’ cognitive triad, and perceived parental messages. Journal of Abnormal Child Psychology, 24(5), 615-631.
Zauszniewski, J., Panitrat, R., & Youngblut, J. (1999). The Children’s Cognitive Triad Inventory: Reliability, Validity, and Congruence With Beck’s Cognitive Triad Theory of Depression. Journal of Nursing Measurement, 7(2), 101-115.
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