Toward a Comprehensive Functional Analysis of Depressive Behavior: Five Environmental Factors and a Possible Sixth and Seventh (Report‪)‬

In the 1990's, a resurgence of interest in behavioral theories of depression occurred. This resurgence derived from the establishment of clinical behavior analysis as a vibrant adjunct to applied behavior analysis (Dougher, 1993; 1994; 2000) with active theoretical and empirical investigations and treatment developments relevant to outpatient psychotherapeutic treatment of depression. In addition, a component analysis of cognitive-behavior therapy for depression showed that the behavioral component (behavioral activity scheduling was referred to as behavioral activation) was sufficient to explain recovery from initial depression (Jacobson et al., 1996) and at follow up (Gortner, Gollan, Dobson, & Jacobson, 1998). The cognitive component of treatment appeared to add little to the overall outcome. These findings renewed interest in behavioral approaches to depression treatment (Hollon, 2001; Jacobson & Gortner, 2000) and sparked development of a complete Behavioral Activation approach (Martell, Addis, & Jacobson, 2001; also see Kanter, Callaghan, Landes, Busch, & Brown, 2004). Other clinical behavior analytic approaches to depression have also been evaluated, including Acceptance and Commitment Therapy (Zettle & Hayes, 1986; Zettle & Rains, 1989) and Functional Analytic Psychotherapy (Kanter, Schildcrout, & Kohlenberg, in press; Kohlenberg, Kanter, Bolling, Parker, & Tsai, 2002). The above sets the stage for a re-analysis of behavioral theories of depressive behavior (e.g., Bolling, Kohlenberg, & Parker, 2000; Dougher & Hackbert, 1994; 2000; Ferster, 1973; Hoberman & Clarke, 1993; Kanter et al., 2004; Lewinsohn, 1974). In review of current behavioral models of depression, we found that several factors were highlighted. First, early models incorporated Skinner's (1953; 1974) stance that feelings such as depression are respondent bi-products of behavior-environment interactions. For example, failure to achieve sleep as a reinforcer for insomniacs might produce depressive symptoms. Subsequent models focused on direct functional aspects of depression.