depression Flashcards
define depression
a mood disorder defined by a consistent and long-lasting sense of sadness
what are the behavioural categories of depression?
changed activity levels
aggression
changed sleeping and eating patterns
behavioural categories of depression: changed activity levels
may result in psychomotor agitation or an inability to wake up and get out of bed in the morning
high anxiety levels
Anhedonia - decreased ability to feel pleasure/ lose of interest
behavioural categories of depression: aggression
towards oneself and towards other
may be self-harm
verbal or physical
behavioural categories of depression: changed sleeping and eating patterns
insomnia and obesity or constant lethargy and anorexia
what are the emotional characteristics of depression?
lowered self-esteem
constant poor mood
high levels of anger or guilt
emotional characteristics of depression: lowered self-esteem
sense of self-loathing
lasting months at a time
high in severity
emotional characteristics of depression: constant poor mood
feeling worthless and empty
lasting months at a time
high in severity
emotional characteristics of depression: high levels of anger or guilt
towards oneself and others
may be self-harm
helplessness and feeling of no value compared to others
what are the cognitive characteristics of depression?
absolutist thinking
selective attention towards negative events
poor concentration
cognitive characteristics of depression: absolutist thinking
jumping to irrational conclusions
seeing situations as disasters
everything is black and white
cognitive characteristics of depression: selective attention towards negative events
dwelling on negative aspects rather than positive
bias towards recalling unhappy events
negative self-schemas
cognitive characteristics of depression: poor concentration
the consequent disruptions to school and work add to feelings of worthlessness and anger
leading to poor decision making
assumptions of the cognitive approach
- Individuals who suffer from mental disorders have distorted and irrational thinking – which may cause maladaptive behaviour.
- It is the way you think about the problem rather than the problem itself which causes the mental disorder.
- Individuals can overcome mental disorders by learning to use more appropriate cognitions. If people think in more positive ways, they can be helped to feel better.
what did Aaron Beck do?
developed a cognitive explanation of depression - Beck’s Cognitive Triad (1967)
what are the components to Beck’s cognitive triad?
three schemas with a persistent automatic negative bias
the self
the world
the future
leads to avoidance, social withdrawal and inaction
what are cognitive distortions?
Beck found that depressed people focus more on the negative aspects and ignore the positives - may distort and misinterpret information and perceive the world inaccurately = cognitive bias
define and explain types of cognitive distortion
over-generalisations - one negative experience results in an assumption that the same thing will happen every time
selective abstraction - mentally filtering out positives and focusing on negatives
what is a schema?
package of knowledge which stores information and ideas about our self and the world around us - usually developed during childhood
what did Ellis do?
He explained depression using the ABC model (1962) - according to Ellis, good mental health is the result of rational thinking which allows people to be happy and pain free, whereas depression is the result of irrational thinking, which prevents us from being happy and pain free
what are the three stages of the ABC model?
Activating event
Beliefs
Consequences
explain activating event
an event occurs which triggers irrational thoughts
can be big or small e.g. missing the bus
explain beliefs
the interpretation of the activating event is either rational or irrational
e.g. rational belief ex is not right for you, irrational belief now unlovable
explain consequences
rational beliefs lead to healthy emotional outcomes whereas irrational beliefs lead to unhealthy emotional outcomes
what is mustabatory thinking and how can it impact on one’s mental health
consequence of not accepting we don’t live in a perfect world: Beck said ‘there are 3 musts that hold us back: I must do well, you must treat me well, the world must be easy’
failure to achieve unrealistic goals leads to disappointment
alternative explanations of depression
- The biological approach to understanding mental disorders suggests that genes and neurotransmitters may cause depression
- The success of drug therapies for treating depression suggest that neurotransmitters do play an important role; the medication alters the levels of specific neurotransmitters and reduces the symptoms
- At the very least, a diathesis-stress approach might be advisable, suggesting that individuals with a genetic vulnerability for depression are more prone to the effects of living in a negative environment, which then leads to negative irrational thinking.
describe the diathesis-stress model
suggests that certain genes create a vulnerability for mental disorders and that after an activating event or trauma, mental disorders develop in these individuals
how does the cognitive theory explain depression?
depression is due to irrational thinking and cognitions that are skewed towards negative thoughts
strengths of Ellis’ theory
- application to therapy - cognitive ideas have been used to develop effective treatments for depression including cognitive behavioural therapy (CBT) and rational emotive behaviour therapy (REBT) - attempt to identify and challenge negative, irrational thoughts and have successfully used to treat people with depression
weaknesses of Ellis’ theory
- does not explain the origins of irrational thoughts - unable to determine if negative, irrational thoughts cause depression or whether a person’s depression leads to a negative mindset - possible that other factors are the cause of depression and one of the side effects are negative, irrational thoughts e.g. genes and neurotransmitters
- genetic research suggests a predisposition to depression is inherited - biological aspect to depression
strengths of Beck’s theory
- research to support the proposal that depression is associated with faulty information processing, negative self-schemas and the negative triad - cognitions can be seen before depression develops - Grazioli and Terry (2000)
- diathesis-stress model explains that negative thinking is a vulnerability triggered by life experiences
- Beck’s cognitive explanations forms the basis of CBT - all cognitive aspects of depression can be challenged in CBT
weaknesses of Beck’s theory
- does not explain the origins of irrational thoughts - unable to determine if negative, irrational thoughts cause depression or whether a person’s depression leads to a negative mindset - possible that other factors are the cause of depression and one of the side effects are negative, irrational thoughts e.g. genes and neurotransmitters
- genetic research suggests a predisposition to depression is inherited - biological aspect to depression
what does CBT stand for?
cognitive behavioural therapy
what is CBT?
involves both cognitive and behavioural elements to attempt to change negative schemas and challenge irrational thoughts through cognitive restructuring
cognitive elements to CBT
aims to identify irrational and negative thoughts which lead to depression and replace them with more positive ones
behavioural elements to CBT
encourages patients to test their beliefs through behavioural experiments and homework
how does CBT work?
patient is seen as a scientist -generate hypotheses about validity of irrational thoughts - realise they don’t match reality - this changes schemas and irrational thoughts are discarded
thought catching - identify irrational thoughts of negative triad
hwk task to keep a diary of negative thoughts to identify situations that cause negative thinking
behavioural activation - take part in activities you used to enjoy
Beck’s cognitive therapy
help the patient to identify negative thoughts in relation to themselves, the world and the future using Beck’s negative triad
challenge irrational thoughts by discussing evidence for and against them
patient encouraged to test the validity of their negative thoughts using homework to challenge these thoughts
Ellis’s rational emotive behaviour therapy
attempts to change negative schemas and challenge irrational thoughts through cognitive restructuring
developed the ABC model to include Dispute and Effective
how does REBT work?
dispute: therapist confronts client’s irrational beliefs
empirical arguments challenge client to provide evidence for irrational beliefs
logical arguments attempt to show beliefs don’t make sense
effect: reduction of irrational thoughts lead to better consequences in future
shame-attacking exercise: client performs behaviour they fear to others - shows they can act against their emotions and cope with unpleasant experience and survive other’s disapproval and that most people don’t notice/care about our actions
what does the ABCDE model stand for?
Activating event
Beliefs
Consequences
Dispute
Effect
differences between CBT and REBT
CBT: client helped to figure out irrationality of their thoughts themselves by acting as a scientist
REBT: therapist explains irrationality of thoughts through disputation
strengths of CBT
research evidence demonstrates its effectiveness in treating depression - March et al (2007) found that CBT was as effective as antidepressants - examined adolescents with depression comparing CBT with antidepressant both groups (81%) improved significantly however 86% of the CBT and antidepressant group improved significantly
drug therapies have side effects whereas CBT does not
weaknesses of CBT
requires motivation - some patients may not engage with CBT resulting in ineffective treatment so antidepressant may be best in these cases
may be criticised for its overemphasis on the role of cognitions - suggests that a person’s irrational thinking is the sole cause of depression and doesn’t take into account other factors - ineffective in treating patients with different circumstances e.g. domestic violence
since there is a genetic component - drug therapies may be more effective
time consuming and expensive
how is depression treated using the cognitive approach?
it’s treated using CBT which is a combination of cognitive therapy and behavioural therapy
