Introduction to the Featured Article—A Unified Model of Depression

Depression has received enormous attention in both research and clinical practice, and deservedly so. By 2030, depression is projected to be the number one cause of disability in the world, ahead of cardiovascular disease, traffic accidents, chronic pulmonary disease, and HIV/AIDS (World Health Organization, 2008). The national and global impacts are easily conveyed by all sorts of indices (e.g., cost, lost days of work, years lived with a disability, premature mortality, and others). Of course, none of these captures the personal and familial experiences, often tragic to the extreme, which play out daily as individuals try to cope with the pervasive impact depression can have.

Our knowledge base at multiple levels of understanding (molecule to culture) has advanced considerably. Among those who have contributed directly by his own work and impact on generations of researchers, Aaron Beck is without peer. His work pioneered and then continued to advance conceptualization, treatment, and measurement development and began programs of work on cognition, suicide, and more. For example, long before the formalization of empirically supported treatments in the 1990s, cognitive therapy for depression already began controlled clinical trials and had established its effects (e.g., Rush, Beck, Kovacs, & Hollon, 1977) and with a treatment manual before manuals became de rigueur (e.g., Beck, Rush, Shaw, & Emery, 1979). In relation to measurement, any social or medical scientist hearing the term beady eye immediately thinks of the Beck Depression Inventory (Beck, Ward, & Mendelson, 1961), rather than a small-eyed, suspicious-looking character or the short-lived British rock band. These were all just a part of the work that began decades ago, continues today, and guides many research programs and clinical applications.

From these remarkable beginnings, theory, research, and practice on cognition and psychopathology have evolved. We are very fortunate to have in this issue of the journal a seminal product of that evolution. In the featured article, Aaron Beck and his colleague Keith Bredemeier have provided an integrative conceptualization of depression. The conceptualization draws on multiple levels of analyses (e.g., personality, environment, biological factors), human and nonhuman animal research, and key concepts (e.g., resilience, adaptation) to explain how depression emerges, is maintained, and can be ameliorated. All of this is within the framework of an evolutionary perspective. The comprehensive statement of this article has the benefit of years of development of theory, research, and clinical experience. Integrating these three perspectives serves as a model for advancing our understanding and, no less important, having an impact in ways that genuinely reduce the burdens that depression imposes. The article also provides a rich buffet of hypotheses for future empirical investigations that will further elaborate the theory and extend our views of clinical dysfunction more generally.