EARLY MALADAPTIVE SCHEMAS FROM CHILD MALTREATMENT IN DEPRESSION AND PSYCHOTHERAPEUTIC REMEDIATION: A PREDICTIVE CODING FRAMEWORK

Gita Ramamurthy ^1* Alan Chen ²

• ¹ Upstate Medical University, Syracuse, United States
• ² Keck School of Medicine, University of Southern California, Los Angeles, California, United States

Figure 1: The self-sustaining feedback loops underlying depression. CM exacerbates all the elements driving the loops. In one loop, psychological sequalae of CM, including shame, maladaptive shame-coping, mentalization difficulties, social withdrawal and amotivation, all impair socio-occupational function (1-6). In turn, repeated socio-occupational disappointments can confirm EMS of Defectiveness/Shame and Social Isolation/Alienation, reinforcing their certainty and resistance to schema-incongruent information (7, 8). In another interlocked recursive loop, CM sequalae diminish exposure to and learning from reward prediction errors, which could have revised depressogenic EMS: For example, avoidant coping decreases social/occupational engagement, thus reducing opportunities for reward prediction errors. When rewarding experiences do arise, their impact is decreased by biological sequalae of CM: Amygdala hyperactivity, HPA axis dysfunction and inflammation promote preferential learning of negative information (9-13), through attenuated reward prediction error, negative overgeneralized memory and negative memory/attention biases Socio-occupational stress further exacerbates the biological sequalae (14-16), completing the loop.