depression

Question 1

what is depression?

Answer 1

a mental disorder that is characterised by low mood and low every levels

Question 2

what depressive disorders does the DSM-5 recognise?

Answer 2

major depressive disorder- severe but short term
persistent depressive disorder- long term or recurring major depression
disruptive mood dysregulation disorder- childhood temper tantrums
premenstural dysphoric disorder- disruption to mood around menstruation

Question 3

what are the behavioural characteristics of depression?

Answer 3

lowered activity levels (for example: finding it hard to get out of bed, or being agitated), disruption to sleep and eating behaviour (for example eating or sleeping more than usual or less), aggression towards others, self harm

Question 4

what are the emotional characteristics of depression?

Answer 4

a lowered mood (for example: feeling worthless, unhappy and ‘empty’), anger, which can be directed towards the self or others , lowered self-confidence and self-esteem

Question 5

what are the cognitive characteristics of depression?

Answer 5

poor concentration (for example: being unable to stick to and finish a task), dwelling on the negative (for example: only focusing on the bad aspects of the situation and ignoring the positive aspects), absolutist thinking, where things are percieved a perfect successes or disasters, with nothing in between

Question 6

what are the 2 cognitive approaches to explaining depression?

Answer 6

becks explanation of depression

ellis’ ABC model

Question 7

what are the 3 steps in becks explanation of depression?

Answer 7

faulty information processing
negative self-schema
becks negative triad

Question 8

what is the step ‘faulty information processing’ in becks explanation to depression?

Answer 8

• depressed people are more likely to focus on the negative aspect of situations, ignoring positives
• they distort and misinterpret info (e.g. overgeneralisations, catastrophising)
• so depression comes from faulty cognitions

Question 9

what is the step ‘negative self-schema’ in becks explanation of depression?

Answer 9

• a schema is a ‘package’ of knowledge, which stores info. and ideas about our self and the world around us
• these are developed during childhood. depressed people have negative self schemas, which come from negative experiences (e.g. criticism from parents, peers, teachers)
• those with a negative self schema interpret info about themselves in a negative way, which can lead to faulty cognitions

Question 10

what is the step ‘becks negative triad’ in becks explanation for depression?

Answer 10

• faulty cognitions and negative self schemas maintain the negative triad, a negative and irrational view of ourselves, our future and the world around us
• for sufferers of depression, these thoughts occur automatically

Question 11

what is becks negative triad?

Answer 11

↗️ negative views about the world ↘️
negative views about the future ⬅️ negative views about oneself

Question 12

what can the negative triad lead to?

Answer 12

• overgeneralisation
• magnification of problems (seeing them as more important than they are)
• selective perception (focusing on the negative)
• absolutist thinking (all or nothing)

Question 13

what does ellis believe causes depression?

Answer 13

people can become depressed depending on their responses to events/stresses etc in life

Question 14

what are the 3 stages of Ellis’ ABC model to explain depression?

Answer 14

A- activating event
B- belief
C- consequence

Question 15

what is the stage ‘Activating event’ (A) in ellis’ explanation of depression?

Answer 15

an activating event is the external situation that there is a reaction too
(e.g. bereavement, relationship breakdown, losing a job…)

Question 16

what is the stage ‘belief’ (B) in ellis’ explanation to depression?

Answer 16

a belief is why the individual thought A happened
- irrational beliefs are often linked with thinking in terms of:
1) ‘musts’ (“i must pass this exam”- he calls this ‘musterbation’ - the belief that we must always succeed or achieve perfection)
2) utopianism - the belief hat life is always meant to be fair

Question 17

what is the stage ‘consequence’ (C) in ellis’ explanation of depression?

Answer 17

the results of the activating event followed by irrational beliefs so it is depression

Question 18

AO3: how is ‘there is good supporting evidence’ a strength to becks cognitive explanation to depression?

Answer 18

the evidence supports the idea that depression is associated with faulty information processing, negative self schemas and the cognitive triad of negative automatic thinking. for example Grazoli and Terry assessed 65 pregnant women for cognitive vulnerability and depression before and after birth. those women judged to have been high in cognitive vulnerability were more likely to suffer from post-natal depression.
Clark and Beck reviewed research on this topic and concluded that there was solid support for all these cognitive vulnerability factors. these cognitions can very seen before depression develops, suggesting that beck may be right about faulty cognitions ad negative self schemas can cause depression.

Question 19

AO3: how is ‘it has practical application in CBT’ a strength to becks cognitive explanation of depression?

Answer 19

becks cognitive explanation forms the basis of a cognitive behaviour therapy (CBT). all cognitive aspects of depression can be identified and challenged in CBT. these include the components of the negative triad that are easily identifiable . this means a therapist can challenge them and encourage the patient to test whether they are true. this is a strength of the explanation because it allows an understanding of cognitive vulnerability that is useful in more than one aspect of explaining depression.

Question 20

AO3: how is ‘it doesnt explain all aspects of depression’ a limitation to becks cognitive explanation of depression?

Answer 20

becks theory explains the basic symptoms of depression, however depression is complex. some depressed patients are deeply angry and beck cannot easily explain this extreme emotion. some sufferers of depression suffer from hallucinations and bizarre beliefs. very occasionally depressed patients suffer. with cotard syndrome, the delusion that they are zombies (jarret). becks theory cant easily explain these cases. therefore becks theory is a partial explanation to depression.

Question 21

AO3: how is ‘it has practical application in CBT’ a strength to ellis’ explanation to depression?

Answer 21

a strength of ellis’ explanation is that, like becks explanation, it has led to successful therapy. the idea that, by challenging irrational negative beliefs, a person can reduce their depression, it is supported by research evidence (e.g. Lipsky et al. 1980). this in turn supports the basic theory because it suggests that the irrational beliefs had some role in the depression.

Question 22

AO3: how is ‘it offers a partial explanation to depression’ a limitation to ellis’ explanation of depression?

Answer 22

there is no doubt that some cases of depression follow activating events. psychologists call this reactive depression and see it as different from the kind of depression that develops without an obvious cause. this means that ellis’ explanation only applies to some kinds of depression and therefore is only a partial explanation to depression.

Question 23

AO3: how is ‘it doesnt explain all aspects of depression’ a limitation to ellis’ cognitive explanation of depression?

Answer 23

although ellis explains why some people appear to be more vulnerable to depression than others as a result of their cognitions, his approach has the same limitations as becks. it doesn’t easily explain the anger associated with depression or the fact that some patients suffer from hallucinations or delusions.

Question 24

what is CBT a a way of treating depression?

Answer 24

it is a talking therapy that also involves cognitive and behavioural therapy. it helps individuals to manage their depression by changing the way they think and behave

Question 25

what is becks cognitive therapy to treating depression?

Answer 25

he believed that the idea behind cognitive therapy is to identify automatic thoughts about the world, the self and the future (negative triad). and once identified these should be challenged. this is the central component of the therapy. as well as challenging these thoughts directly, cognitive therapy aims to help patients test the reality of their negative beliefs
this might be something along the lines of being set homework such as to record an event that made the patient happy or when people were nice to them. this can be referred to as the ‘patient as scientist’, investigating the reality of their negative beliefs in a way scientists would. in future sessions if patients say that no one is nice to them or there is no point in going to events, the therapist can produce the evidence and use it to prove the patients statement wrong.

Question 26

what does REBT stand for?

Answer 26

rational emotive behaviour therapy

Question 27

how did Ellis use REBT (CBT) as a treatment for depression?

Answer 27

REBT extends the ABC model to the ABCDE model, D for dispute and E for effect. the central technique for REBT was to identify and dispute irrational thoughts. for example; a patient may spew about how they feel really unlucky or may say how unfair things have been. the therapist would identify these as thoughts of utopianism and challenge them as an irrational belief. this involves a vigorous argument which the intended effect is to change the irrational belief so it then breaks the link between the negative life events and depression.

Question 28

why is the vigorous argument very important within Ellis’ REBT therapy?

Answer 28

it is very important in REBT as Ellis identified it as different ways of disputing. for example; an empirical argument involves disputing where there is actual evidence to support the negative belief. logical arguments involve disputing where the negative thought logically follows from the facts.

Question 29

what is behavioural activation?

Answer 29

is is when alongside the purely cognitive aspects of CBT, the therapist will also try to encourage severely depressed patients to be more active and engage in enjoyable activities. this behavioural activation will provide more evidence for the irrational nature of beliefs.

Question 30

AO3: how is ‘CBT is effective’ a strength to the cognitive approach to treating depression?

Answer 30

March et al. compared the effects of CBT with that of antidepressant drugs and a combination of the two in 327 adolescents. after 36 weeks, 81% of the CBT group, 81% of the drug group and 86% of the CBT and drug group significantly improved. this suggests that CBT is just as effective as antidepressants and is helpful alongside the drugs. there is then a good case for making CBT the first choice of treatment in unlicensed health care system such as the NHS which are often lacking funds.

Question 31

AO3: how is ‘CBT may not work for the most severe cases of depression’ a limitation to the cognitive approach to treating depression?

Answer 31

this is because CBT requires motivation. patients with severe depression may not engage with CBT, or even attend the sessions and therefore this treatment will be ineffective in treating these patients. for example, antidepressants don’t require as much effort or motivation. this poses an issue for CBT, as CBT therefore cant be used as a sole treatment for severely depressed patients.

Question 32

AO3: how is ‘the success of CBT may be due to the quality of the therapist-patient relationships’ a limitation to the cognitive approach to treating depression?

Answer 32

Rosenweig suggested that the differences between different types of psychotherapy may be quite small. but all psychotherapies have in common the patient-therapist relationship. it may be that the quality of this relationship determines success rather than any particular technique used.

Question 33

AO3: how is ‘ it may end up minimising the importance of the circumstances in which the patient is living’ a limitation to the cognitive approach to treating depression?

Answer 33

some psychologists have criticised CBT, as it suggests that a persons irrational thought is the primary cause for their depression and CBT doesn’t take into consideration other factors. for example, a patient who is suffering from domestic violence or abuse, does not need to change their irrational beliefs, but in fact need to change their circumstances. therefore, CBT would be ineffective in treating these patients until the circumstances have changed.