//Depression

Question 1

What is depression

Answer 1

an affective mood disorder characterised by feelings of respondency and hopelessness

• about 20% of people will suffer from some form of depression, women are twice as vulnerable as men
• women are vulnerable in mid to late adolescence
• depression can occur in cycles, with an episode lasting 2 and 6 months
• average age being late twenties

Question 2

How is depression diagnosed

Answer 2

• at least 5 symtoms needs to be apparent every day for two weeks for depression to be diagnosed by a doctor
• to be diagnosed with major depression, one of the 5 symptoms must be constant depressed mood or lessened interest in daily activities

Question 3

What is unipolar (major) depression

Answer 3

• a form of depression occurring without mania
• sufferers only experience depression and not the manic episodes
• 1/5 symptoms need to be apparent
• up to 25% of women will suffer from unipolar, and 12% of men
• it is characterised by clinical symptons, occurring in cycles
• a more servere version is when sufferers experience delusions
• sufferers don’t respond well to anti-depressants

Question 4

What is biopolar (maniac) depression

Answer 4

• this is divided into endogneous depression (related to hormonal factors) and exogenous depression (related to stressful life experiences)
• is less common that unipolar depression-2% of people suffer from it
• biopolar appears in a person’s twenties
• mixed episodes of mania and depression are common

Question 5

What is mania

Answer 5

An emotional state characterised by intense elation, resulting in hyperactivity, distractibility, excessive talking and disrupted thought processes

Question 6

Name some symptoms of unipolar depression

Answer 6

• BEHAVIOURAL-loss of energy, sleep pattern disturbance, poor personal hygiene
• EMOTIONAL-loss of enthusiasm, worthlessness, constant depressed mood
• COGNITIVE-delusions, thoughts of death, reduced concentration

Question 7

Name some symptoms of biopolar depression

Answer 7

• BEHAVIOURAL-high energy levels, talkative, reckless behaviour
• EMOTIONAL-irritability, elevated mood states, lack of guilt
• COGNITIVE-delusions, irrational thought processes,

Question 8

How does the cognitive approach explain depression

Answer 8

Faulty and irrational thought processes and perceptions. This approach focuses on maladaptive cognitions that underpin maladaptive behaviour

Question 9

Beck (1976) Cognitive triad

Answer 9

Negative views about oneself-Negative views about the world-Negative views about the future

Question 10

Explain Beck’s cognitive triad

Answer 10

• Beck perceived that negative schemas that develop in childhood and adolescence, are when authority figures place unrealistic demands on the individual and are highly critical of them
• these continue into adulthood, providing a negative framework to view life
• negative schemes dominate thinking

Question 11

Neagtive schemes are fuelled by cognitive biases that cause them to misperceive reality. What are they

Answer 11

• ineptness schema-make depressives expect to fail
• self-blame schema-make depressives feel responsible for all misfortunes
• negative self evaluation schemas-constantly reminded depressives of their worthlessness

Question 12

How is the negative triad maintained

Answer 12

Through negative schemas and cognitive biases/distortions

Question 13

What is the ABC model proposed by Ellis

Answer 13

• The model claims that disorders begin with an activating event (A), leading to a belief (B) about why this happened. This may be rational or irrational
• The belief leads to a consequence (C). Rational beliefs produce adaptive consequences. Irrational beliefs produce maladaptive consequences

Question 14

Strengths of the cognitive explanation

Answer 14

• offers a useful approach to depression because it considers the role of thoughts and beliefs, which are generally involved in problems like depression
• cogntive therapies have often successful treated depression
• lots of research evidence supporting the idea of cognitive vulnerability being linked to the onset of depression
• theory acknowledges other aspects such as early experiences

Question 15

Weaknesses of the cogntive explanation

Answer 15

• faulty cognitions may simply be the consequence of depression rather than its cause-depression may be caused by a chemical imbalance in the brain, which causes people to think negatively
• the person could begin to feel like he or she is to blame for their problems
• cognitive approach takes no account of biological factors

Question 16

How does the biological approach explain depression

Answer 16

• focuses on the idea that vulnerability to depression is to do with faults in the structure or function of the brain/body
• twin/adoption studies have been used that compare genetic material from those with high and low incidences of the disorder

Question 17

What are rational thoughts in depression

Answer 17

• these are based on reality
• they allow the individual to achieve their goals
• the individual experiences emotions they can handle
• allows the individual to behave in ways which promote life goals

Question 18

What are irrational thoughts in depression

Answer 18

• distorts your idea of reality
• stops the individual from achieving goals
• creates extreme emotions which persist and cause distress
• can lead to behaviours that cause harm to the individual

Question 19

What is cogntivie behavioural therapy

Answer 19

This is the main psychological treatment used to help treat depression and is based on the cognitive model

• it aims to identify and change the patient’s faulty conditions
• the idea is that patients learn how to notice negative thoughts when they have them, and test how accurate they are
• alter the irrational and maladaptive thoughts

Question 20

What happens during CBT

Answer 20

• the therapist and client identify the client’s faulty cognitions
• the therpist tries to help the client see that these cognitions aren’t true
• they then set goals to think in more positive or adaptive ways
• although the client may occassionally need to look back to past experiences, the treatment mainly focuses on the present situation
• therapists sometimes encourage their clients to keep a diary to record things

Question 21

Beck’s CBT-TNAT (Treatment of Negative Automatic Thoughts)

Answer 21

• active, directive therapy that focuses on now
• the therapy aims to identify and alter negative beliefs and expectations, to alter dysfunctional behaviours that contribute to or are maintaing the depression
• the therapist employs a range of suitable strategies-behavioural activation, graded homework assignments, thought catching, cognitive restructing, problem solving

Question 22

Ellis’s CBT-REBT (Rational Emotive Behaviour Therapy)

Answer 22

• reframing-challenge negative thoughts
• educational phrase-relationship between thoughts, emotions and behaviour
• behavioural activation and pleasant event scheduling-increasing physiological activity

Question 23

DeReubeis et al (2005)

Answer 23

• compared CBT and drug therapy as depression treatments in a placebo-controlled trial
• both treatments were more effective than the placebo after 8 weeks
• generally the two therapies were similarly effective, but CBT may have been less effective than drug therapy in cases where therapists lacked experience-CBT may only be effective if the therapist is experienced

Question 24

Hollon et al (2005)

Answer 24

• compared pps from DeReubeis study after they were withdrawn from CBT and drug treatment, with pps who continued drug treatment
• pps withdrawn from CBT were significantly less likely than patients withdrawn from drug treatment to have relapsed after one year, and no more likely to have relapsed than patient who continued drug treatment

Question 25

Brandsma et al (1978)

Answer 25

-found that CBT is particularly effective for people who put a lot of pressure on themselves and feel guilty about being inadequate

Question 26

Strengths of CBT

Answer 26

• most effective for moderate and severe depression
• the application of CBT occurs over relatively short time periods compared with other treatments and is more cost effective
• has long term benefits
• teaches patients own self help strategies-few ethical issues

Question 27

Weaknesses of CBT

Answer 27

• cognitive therapies may take a long time and be costly. They may be more effective when combined with other approaches
• the person could begin to feel like he or she is to blame for their problems
• it can be too therapist centered-therapists may abuse their power of control over patients
• for patients, it may be hard to concentrate-overwhelming feelings
• CBT isn’t suitable for patients who have difficulties about their inner feelings, or for those without the verbal skills to do so