abnormal Flashcards
negative schema in Beck’s Theory
argued to develop because of family problems, poor school experiences, depression within close people. Types:
- ineptness schema
- self-blame schema
- negative self-evaluation schema
6 Irrational thinking/errors in logic (Beck)
- selective abstraction
- magnification
- minimization
- overgeneralization
- personalization
- arbitrary inference
selective abstraction
e.g. fixation on one awkward exchange in a day
magnification
e.g. bad mark really weighing someone down
minimization
e.g. not recognizing the good marks you’ve gotten in past tests as an indicator of your academic ability
overgeneralization
e.g. i failed this test therefore im going to fail the course and become homeless
personalization
e.g. blaming yourself for your sisters death even though its not ur fault
abstract inferences
e.g. ‘everyone hates me’ or ‘im going to fail the exam’ before taking the exam
Behaviourism
stresses the importance of the environment in shaping a person, and its role in depression development
- classical conditioning
associating specific stimuli with negative emotions - operant conditioning
removal of positive reinforcement contributes to depression - social learning theory
states behaviour can be learned indirectly through the actions and responses of other people
doesn’t take into account influence of thoughts on ones mood
alloy et al
in this longitudinal study, people were tested and placed in a “positive” or “negative” thinking group. After 6 years, the negative thinking group had higher rates of depression, indicating a correlation between cognition and depression development.
seligman
learned helplessness
dogs electrocuted in a place unable to escape learned to not even try to escape anymore, even if it became possible. also lethargy, passiveness, appetite loss, and other depression symptoms were exhibited.
Humanist approach
human needs are unique, and anything that ultimately blocks self-actualization contributes to depression development
common antidepressants
tricyclics: antidepressants, often used to treat MDD
Selective serotonin reuptake inhibitors: Commonly prescribed antidepressants used to treat MDD, psychological conditions, and anxiety.
Monoamine oxidase inhibitors: Effective antidepressants that biologically target one or both monoamine oxidase enzymes, namely monoamine oxidase A and B. Prescribed especially for atypical depression and treatment-resistant depression.
advantages of biological treatments
- patients with severe depression can get relief from symptoms, allowing for psychological treatments to provide long-term solutions
- drug treatments have allowed for out-patient care and decreases in institutionalization
- not dependent on language abilities, language can be a barrier for psychotherapy
disadvantages of biological treatments
- not all patients respond to the medications
- possibility of harmful, unintended side effects
- medication treats symptoms but often will not get to the root of the problem. The relief ignores important psychological or social factors necessary to holistically overcome the disorder
- may lead to discontinuation syndrome, aka withdrawal symptoms from prescribed drugs
- high relapse rates for patients that receive drug treatments without psychotherapy
advantages of psychological treatments
- CBT clients reported lower relapse rates than biological treatments, shown in Rush et al.
- Individualized therapy can focus more personally and specifically on the client, unlike the generic treatment that is drug therapy
- Supportive system and human relationship built that is often absent in drug therapy
Disadvantages of psychological treatments
- Elkin et al found no difference in the effectiveness of CBT and drug treatment
- CBT does not address past experiences of client or potential biological natures of the disorder. Only focuses on the present, per se.
- Take a lot of time, practicality problems
- ethical concerns, like with therapists rationalizing/judging patients’ suffering
- cross-cultural application of therapy is not yet determined
CBT = cognitive behavioural therapy
what is cbt
therapists aim to change negative thought patterns, blending cognitive and behavioural therapy. treats depression. Using Beck’s argument, a pioneer in cognitive therapy, he argues that it is not the specific event that are the problem but rather one’s reaction/interpretation of the situation that leads to neuroses.
- identify and change bad thinking patterns and behaviours
- develop effective coping strategies and a problem-solving mindset and toolkit
general approach involved guiding patients through structured learning experiences
through
- journaling
- monitoring their associating with their thoughts, feelings, physiology
elkin et al
sample: patients with MDD from 3 different treatment centers in the US, and exluded if they had any disorder in addition to their MDD
procedure: after informed consent, participants were randomly allocated to treatment conditions: IPT, CBT, biological treatment (imipramine) or a placebo pill. With the use of therapists conducting weekly session, over the course of 16 weeks. Those under the biological condition were also provided with clinical management, ie minimal psychological therapy due to ethical concerns regarding their health and the need for therapy to them. A large variety of close assessments, boiling down to symptoms, life functioning, functioning related to their treatment. Assessments were conducted with the therapist, client, and often close family members to increase validity.
results: no significant differences in the reduction of MDD or improvement of functioning between CBT, IPT, or imipramine, i.e. all succeeded in equal degrees, and often superior to the placebo group.
biological treatment was faster in reducing depressive symptoms, however patients in IPT or CBT reported greater psychological/behavioural benefits from the treatment, like understanding sources of depression. by the end they had all evened out to the same outcome. the outcomes were influenced by the initial severity.
After the 18 month follow up session, 20-30 percent were completely asymptomatic, regardless of the treatment they got. CBT/IPT treated people reported better interpersonal skills and mental adaptations to recognize unhealthy depression sources that helped them to overcome their illnesses
riggs et al
aim: study the effectiveness of CBT in combination with placebos or SSRIs
sample: adolescents with depression
procedure: double blind study that found those allocated with CBT + placebo / CBT + ssri had often “very much / much improved.” after 4 months of treatment. Concluded that both are effective, but the use of placebo is almost as effective as with an actual antidepressant. self-reports also highlighted depression/other behavioural problems had decreased. also concluded that treatments start psychologically (CBT), and if needed biological intervention can be added.
IPT
Helps patients become aware of their interpersonal behaviour that could prevent them from attaining pleasure from their relationships. Focuses on effective social skills and their current life situation. eg a patient could work on their communication to increase social satisfaction. IPT can take the form of discussions regarding patients interpersonal concerns, improvement of verbal/nonverbal communication, encouragement/exploration of negative emotion expression.
elkin et al eval
33% of imipramine patients had dropped out before the study ended, This high attrition rate was not seen in the other treatments.
The 3 sites had different results. For example, CBT did as well as imipramine, and at another site IPT would do as well as imipramine, not necessarily for all sites.
By excluding those with other conditions, such as alcoholism, the demographic they conducted the study on may not be representative of the MDD community, who often to tackle more than one issue at a time. Potentially lacks generalizability
Comparison of the treatments is not always fair, some treatments stress the process rather than the outcome.
data triangulation from receiving information from patient therapist and close member.
