Assessing cognitive mediation of relapse prevention in recurrent mood disorders

Cognitive-behavioural therapy (CBT) reduces risk of relapse in mood disorders. Further improvements in preventative interventions will benefit from identification and assessment of the cognitive processes mediating relapse prevention. Possible mediating mechanisms are considered and their implications for assessment are discussed. It is recommended that assessment focus on the ‘cognitive sets’ (schematic mental models) and patterns of cognitive-affective processing that become activated in situations of potential relapse (dysphoric mood, loss-related events). Assessments should use contextually-situated ‘challenge’ paradigms (e.g. mood induction procedures) aimed at identifying, dynamically, potential to respond, rather than procedures aimed at assessing static, enduring, ‘cognitive structures’. Illustrative examples are provided. © 1997 John Wiley & Sons, Ltd.