Dr Beck has provided a useful commentary on some of the theoretical issues raised by our study of cognitive and affective changes in depressed outpatients who were treated with cognitive therapy and pharmacotherapy. While Dr Beck's views are fundamentally in agreement with ours, his letter may lead to some confusion regarding the compatibility of our views. Therefore, we will briefly reiterate our position on these issues before turning to particular points that may require further clarification.Dr Beck offered an "alternative" conceptualization of depression, and described it as a "unitary phenomenon that may be studied at various levels, using a variety of techniques." We fail to see how the essential features of our view differ from his. As stated in our report, we view depression as a complex of interrelated emotions, cognitions, behaviors, and physiological processes, a view most elegantly presented by Akiskal and McKinney1 almost one decade ago.
Simons AD. Cognition and Therapy-Reply. Arch Gen Psychiatry. 1984;41(11):1114-1115. doi:10.1001/archpsyc.1983.01790220104021