Aktuelle Forschungsarbeiten legen nahe, dass dysfunktionale Erwartungen die Entstehung und Aufrechterhaltung der Störung stärker als andere Kognitionen aus dem traditionellen kognitiven Modell beeinflussen. Dabei sind sowohl störungsimmanente Erwartungen (z.B. Erwartungen bzgl. sozialer Zurückweisung) als auch Erwartungen an eine psychotherapeutische Behandlung von Bedeutung. Angesichts der klinischen Relevanz von Erwartungen stellen wir in diesem Artikel einen erwartungsfokussierten Behandlungs-ansatz für depressive Störungen vor. Im Vergleich zur traditionellen kognitiven Therapie zielt dieser Behandlungsansatz selektiv auf die Modifikation von dysfunktionalen Erwartungen ab, während andere Kognitionen weniger bearbeitet werden. Die Veränderung von dysfunktionalen Erwartungen erfolgt im Vergleich zur traditionellen kognitiven Therapie rein erfahrungsbasiert durch die Durchführung von Verhaltensexperimenten, in denen die Validität der spezifischen Vorhersagen der Patientinnen und Patienten überprüft wird. Besonderes Augenmerk wird auf das Phä-nomen gelegt, dass Personen mit depressiver Symptomatik oft trotz korrigierender Erfahrungen weiter an ungünstigen Erwartungen festhalten, indem unerwartet positive Erfahrungen nachträglich devaluiert werden. Hierzu wird im Rahmen von Psychoedukation das Konzept der kognitiven Immunisierung (= nachträgliche Umbewertung von erwartungsverletzenden Erfahrungen) eingeführt und es werden spezifische therapeutische Strategien eingesetzt, um kognitiver Immunisierung entgegenzuwirken. Da eine empirische Überprüfung der Wirksamkeit dieses Ansatzes noch aussteht, kann der vorliegende Artikel die Grundlage für die Durchführung einer randomisierten-kontrollierten Studie darstellen.

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