Eur Arch Psychiatry Clin Neurosci (2002) 252 : 240 – 249 DOI 10.1007/s00406-002-0389-y ■ Abstract Helplessness and hopelessness are central aspects of cognitive-behavioural explanations for the development and persistence of depression. In this arti- cle a general overview concerning the evolution of those approaches to depression is provided. Included is a critical examination of the theories. The review of the literature suggests that those cognitive models describing helplessness/hopelessness as trait factors mediating depression do not really have a strong empirical base. The majority of those studies had been conducted in healthy or only mildly depressed subjects. Thus, there seems to be little justification for broad gen- eralisations beyond the populations studied. It seems that some of the reported studies have not tested the un- derlying theories adequately (e. g. correlation had some- times been interpreted as causation; adequate prospec- tive longitudinal study designs had seldom been applied). Moreover, the theoretical models are not gen- erally prepared to explain all depressive features (e. g. the possibility of a spontaneous shift in a manic episode). Despite those limitations, there is a relevant impact of the learned helplessness paradigm on preclinical re- search in neurobiological correlates of depressive states. Last but not least, the models are of high interest with re- spect to the theoretical background of important mod- ules of cognitive-behavioural therapy and its acute and prophylactic effects. ■ Key words depressive disorder · helplessness · hopelessness · cognitive models · neurobiological correlates ORIGINAL PAPER V. Henkel · P. Bussfeld · H.-J. Möller · U. Hegerl Cognitive-behavioural theories of helplessness/hopelessness: Valid models of depression? Received: 1 October 2002 / Accepted: 2 October 2002 EAPCN 389 Introduction For psychiatric researchers and clinicians of a biological orientation helplessness and hopelessness are typical symptoms of depressive disorders among others such as anhedonia, feelings of guilt, loss of energy or sleep dis- turbances. These symptoms are described within the scope of a symptom-oriented approach to depression in the classification systems of DSM-IV (APA 1994) and ICD–10 (WHO 1992). According to cognitive-behav- ioural theories, helplessness and hopelessness are rather considered to be potential aetiological factors as ante- cendent causes for the onset or maintenance of depres- sion. In this context, helplessness and hopelessness are considered as trait factors which enhance the vulnera- bility of a person to react to certain environmental stim- uli with depression. In these concepts helplessness and hopelessness exist independently from depressive episodes as individual attitudes representing vulnera- bility and risk factors. This review briefly describes and refers to the major theoretical positions most studies in this area are based on: those of Beck (1967), Beck et al. (1985), Overmier and Seligman (1967), Seligman (1974) as well as Abram- son et al. (1989). Limitations concerning the empirical foundation of the concepts will be discussed. Studies evaluating the relevance of hopelessness and helpless- ness as trait characteristics, predictors and risk factors for the development of depression will be described. Preclinical and clinical research concerning neurobio- logical correlates will be presented. Finally, in a critical appraisal the relevance of the concepts for the treatment of depressive disorders and the prevention of relapse will be discussed. Verena Henkel, MD () · P. Bussfeld · H.-J. Möller · U. Hegerl Department of Psychiatry Ludwig-Maximilians-University Munich Nußbaumstr. 7 80336 Munich, Germany Tel.: +49-89/51 60-55 58 Fax: +49-89/51 60-55 42 E-Mail: verena.henkel@psy.med.uni-muenchen.de