Conceptualizing depression: an integration of 27 theories

A multidimensional scaling study is presented which aims to integrate 20 depression researchers' understanding of psychological theories of depression. Ninety-nine concepts were derived from 27 psychological accounts of the aetiology of depression and formed the basis of a card sort task. The analysis uses three-way multidimensional scaling techniques and additional proximity analysis to create a meaningful two-dimensional framework. This framework organizes concepts of depression into four distinct conceptual areas occurring at the dimension poles. One area is concerned with the cognitive processing bias towards negative information, the opposing area describes self-reinforcement in relation to the social environment. A third area emphasizes the individual's lack of positive social support and is opposed by a fourth area that focuses on the pursuit of and prolonged commitment to unrealistic goals. Each area contains factors from a wide range of theories and thus provides a unique representation of concepts of depression. The solution provides a useful model of multiple understandings of depression theories. The four areas in the solution emphasize the need for consideration of individual concepts within an integrated framework. In addition, each area identifies an important focus for future primary research. Copyright © 1999 John Wiley & Sons, Ltd.