Cognative Approaches To explaining and treating Depression Flashcards
Lewinsohn (2001)
Aimed to test whether negative attitudes (negative schema) are associated with greater vulnerability to depression after a triggering life event.
- carried out a longitudinal study measuring negative attitudes in adolescents.
- none were depressed at the start, then he followed them up a year on and assessed whether they had depression, and if they’d had and unpleasant life events (e.g. Relationship breakup, parents splitting up etc.)
Results: those who had experienced negative life events AND who held negative attitudes at the start, were most likely to suffer from depressions
Appelby (1997)
Aimed to test the effectiveness of CBT compared to medication and a placebo.
-87 women with post natal depression in Manchester were randomly selected In to one of three conditions: antidepressants, cognitive behaviour therapy, and drug placebo. (Each given over 12 weeks).
Results: CBT was just as effective in reducing symptoms as medication, placebo was worst.
Hollon et al (2005)
Aim to investigate the long term effectiveness of CBT compared to medication.
- 104 patients who had responded well to CBT or antidepressants were followed up a year on.
Results: relapse rates (regain of symptoms) were much higher for antidepressants 12 months after end of treatment than after CBT.
Clarke and Teasdale (1985)
Aimed to test whether depressed mood is associated with biased memories.
- In patients who were more depressed in the morning than the evening found that their memories were more negative in the morning. The opposite pattern was found for those who’s depression was worse in the evening.
Conclusion: depression is linked to our biased memories.
Ellis’ cognitive model of depression
Depression isn’t just down to unpleasant events, but your thoughts and beliefs about them
Ellis’ ABC model
A=adverse event- failing an exam
B=beliefs- “I’m stupid, I won’t ever get a job”
C=consequences- depressed feelings
Beck’s cognitive approach to depression
Negative schema
Cognitive errors
Biased memories
Nasty smelly
Cats eat
Bad meat
Becky negative triad
Self- I am worthless
World- no one can be trusted
Future- it’s hopeless
What cognitive errors are there
Catastrophising- assuming the worst will happen all the time
Applying a negative filter- someone will only see the negative in things
- misinterpreting positive events in a negative way.
Evidence for biased memories
Clarke and Teasdale
Evidence for negative schema
Lewinsohn (2001)
Two important steps of CBT
1) identifying the distorted thinking
2) challenging the distorted thinking
What does identifying distorted thinking include?
- using a thought diary where the patient writes down when they feel depressed, how they’re feeling, what had happened prior
- assessment in sessions, where the therapist will ask questions to find out how the patient is feeling during sessions when they’re depressed.
What is included in challenging irrational thinking
Socrative questioning- the therapist asks questions helping the patient see new ways of thinking for their self.
Collaborative empiricism- they think of the irrational thinking as being hypothesis, and the patient and therapist will gather evidence to challenge the irrational thinking. E.g. Woman thinks husband doesn’t love her because he watches tv alone after work. Another explanation may be because he’s tired and stressed from work rather than not loving her.
- they also carry out mini experiments (giving a teacher a bad essay to see if she reacts as badly as the patient thinks)
Is CBT an appropriate treatment?
YES
- the approach is relatively straight forward and makes sense to do so it.
- it’s time limited 5-20 sessions which appeals to patients
-it is more long lasting than anti depressants
NO
- it’s not as cost effective as anti depressants
- altering patients thinking may be impossible and inappropriate depending on the persons life
- not suitable for people with limited verbal skills
- may not be suitable for people with severe depression
