Depression

Question 1

Depression - Characteristics (A01)

Answer 1

Behavioural
Activity levels - lethargy or agitation.
Disruption to sleep/eating - increased or decreased
Aggression and self-harm and irritability.

Emotional
Lowered mood.
Anger towards self and others, leading to behavioural change.
Lowered self-esteem, self-loathing.

Cognitive
Poor concentration - difficulty making decisions.
Attending to and dwelling on the negative - half - empty glass instead of half-full.
Absolutist thinking - ‘black and white’.

Question 2

Beck’s theory (A01)

Answer 2

Faulty information processing - Attending to the negative aspects of a situation.

Negative self-schema - Negative information about ourselves is accessed whenever we encounter a self-relevant situation.

The negative triad - Negative views of the world, the self and the future.

Question 3

Beck’s theory - Evaluation (A03)

Answer 3

Research support - Research shows cognitive vulnerability precedes depression (Clark and Beck, Cohen et al. prospective study of adolescents).

Real-world application - Identify cognitive vulnerability to screen those at risk of depression, then target vulnerabilities in CBT.

Evaluation extra: A partial explanation - Explains patterns of cognition, but cannot easily explain extremes of anger or hallucinations and delusions.

Question 4

Ellis’s ABC model - (A01)

Answer 4

A Activating event - A negative life event that triggers an irrational response e.g. failing a test.

B Beliefs - Beliefs that lead us to overreact to the activating event, e.g. that life must always be fair (‘utopianism’), we must succeed (‘musturbation’).

C Consequences- Depression results when we overreact to negative life events.

Question 5

Ellis’s ABC model - Evaluation (A03)

Answer 5

Real-world application - Irrational thoughts can be identified and challenged by a therapist.

Reactive and endogenous depression - Only explains reactive depression, does not explain cases that do not follow an activating event (endogenous depression).

Evaluation extra: Ethical issues - ABC model places responsibility on the depressed person (victim blaming), but the therapy derived from the model (REBT) does create resilience.

Question 6

Cognitive behaviour therapy - (A01)

Answer 6

Beck’s cognitive therapy - Aims to identify negative thoughts (negative triad) and challenge them (client as scientist).

Ellis’s REBT - ABC + D (dispute) and E (Effect). Aims to identify and challenge irrational beliefs e.g. by empirical argument.

Behavioural activation - Encouraging the depressed person to engage in enjoyable activities.

Question 7

Cognitive behaviour therapy - Evaluation (A03)

Answer 7

Evidence for effectiveness - CBT is as effective as antidepressants, most affective combined (81% vs 86%, March et al.).

Suitability for diverse effects - May not be suitable for severe cases or depression or for people with learning disabilities (e.g. Sturmey).
Counterpoint - Newer evidence suggests CBT is as effective as drugs or behavioural therapies (Lewis and Lewis) and OK for learning disabilities (Taylor et al.).

Relapse rates - Benefits short-term, 42% relapsed after 6 months and 53% within a year (Ali et al.). May need regular repeating.

Evaluation extra: Client preference - CBT effective, at least short-term but some clients prefer to take medication or explore past.