The cognitive model of depression has significantly influenced the understanding of distorted cognitive processes in major depression; however, this model's conception of cognition has recently been criticized as possibly too broad and unspecific. In this review, we connect insights from cognitive neuroscience and psychiatry to suggest that the traditional cognitive model may benefit from a reformulation that takes current Bayesian models of the brain into account. Appealing to a predictive processing account, we explain that healthy human learning is normally based on making predictions and experiencing discrepancies between predicted and actual events or experiences. We present evidence suggesting that this learning mechanism is distorted in depression: current research indicates that people with depression tend to negatively reappraise or disregard positive information that disconfirms negative expectations, thus resulting in sustained negative predictions and biased learning. We also review the neurophysiological correlates of such deficits in processing prediction errors in people with depression. Synthesizing these findings, we propose a novel mechanistic model of depression suggesting that people with depression have the tendency to predominantly expect negative events or experiences, which they subjectively feel confirmed due to reappraisal of disconfirming evidence, thus creating a self-reinforcing negative feedback loop. Computationally, we consider too much precision afforded to negative prior beliefs as the main candidate of pathology, accompanied by an attenuation of positive prediction errors. We conclude by outlining some directions for future research into the understanding of the behavioral and neurophysiological underpinnings of this model and point to clinical implications of it.

中文翻译：

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重度抑郁症中扭曲的认知过程——预测性处理的观点

抑郁症的认知模型显着影响了对重性抑郁症扭曲认知过程的理解；然而，这个模型的认知概念最近被批评为可能过于宽泛和不具体。在这篇综述中，我们将认知神经科学和精神病学的见解联系起来，表明传统的认知模型可能会受益于将当前贝叶斯大脑模型考虑在内的重新表述。诉诸预测处理帐户，我们解释说，健康的人类学习通常基于做出预测并体验预测与实际事件或经验之间的差异。我们提供的证据表明这种学习机制在抑郁症中被扭曲了：目前的研究表明，抑郁症患者倾向于消极地重新评价或忽视否定消极期望的积极信息，从而导致持续的消极预测和有偏见的学习。我们还回顾了抑郁症患者在处理预测错误方面的这种缺陷的神经生理学相关性。综合这些发现，我们提出了一种新的抑郁机制模型，表明抑郁症患者倾向于主要预期负面事件或经历，由于重新评估否定证据，他们主观上感觉得到了证实，从而创造了一个自我强化的负面反馈循环。在计算上，我们认为消极的先验信念提供了太多的精确度作为病理学的主要候选者，伴随着正预测误差的衰减。最后，我们概述了未来研究的一些方向，以了解该模型的行为和神经生理学基础，并指出其临床意义。