Depression

Question 1

Give some behavioural characteristics of depression.

Answer 1

Activity levels
Typically people with depression have reduced levels of energy, making them lethargic which has a knock on effect so they tend to withdraw from work, education and social life. In extreme cases this can be so severe that the person cannot get out of bed.

Disruption to sleep and eating behaviour
Depression is associated with changes to sleeping behaviour. A person may experience reduced sleep (insomnia) or an increased need for sleep (hypersonia). Similarly, appetite and eating may increase or decrease leading to weight gain or weight loss.

Aggression and self-harm
People with depression are often irritable, in some cases they become verbaly or physically aggressive. This can have serious knock-on effects on a number of aspects of their life. For example, someone experiencing depression may display verbal aggression by ending a relationship or quitting a Job.
Depression can also lead to physical aggression directed against the self. This includes self-harm.

Question 2

Give some emotional characteristics of depression.

Answer 2

Lowered mood
The key emotional characteristic of depression is a depressed mood or feelings of sadness. They will experience feelings of worthlessness, a lack of interest in activities etc.

Anger
Although people with depression tend to experience more negative emotions and fewer positive ones, during episodes of depression, the experience of negative emotion is not limited to sadness and they a frequently experience anger. This can be directed at the self or others.

Lowered self-esteem.
People with depression tend to report reduced self-esteem. This can be extreme.

Question 3

Give some cognitive characteristics of depression.

Answer 3

Poor concentration
Depression is associated with poor levels of concentration. The person may find themselves unable to stick with a task as they usually would or they may find it hard to make decisions that they would normally find straightforward.

Dwelling on the negative
When experiencing a depressive episode, people are inclined to pay more attention to the negative aspects of a situation and ignore the positives.

Absoloutist thinking
Most situations are not all good or all bad but when a person is depressed they tend to think in these terms. This is sometimes called ‘black-and-white thinking’.

Question 4

3 main aspects of Beck’s cognitive approach to explaining depression.

Answer 4

-Faulty information processing
-Negative self schema
-The negative triad

Question 5

What is it meant by faulty information processing?

Answer 5

When depressed people attend to the negative aspects of a situation and ignore the positives. E.g if someone is depressed and they win the lottery, they may focus on the fact that a week before someone had won £10 million rather than focusing on the fact that they had won £1 million.

Question 6

What is a schema?

Answer 6

A schema is a cognitive framework of ideas and information developed through experience.

Question 7

What is a negative self schema?

Answer 7

People use schemas to interpret the world so if someone has a negative self-schema they interpret all information about themselves in a negative way.

Question 8

What are the three aspects of beck’s negative traid?

Answer 8

a) Negative view of world.
b) Negative view of the future.
c) Negative view of the self.

Question 9

Strength of Becks cognitive approach to explaining depression.

Answer 9

There is research evidence to support it. For example, Alloy followed the thinking styles of young Americans in their early 20s for 6 years. Their thinking style was tested and they were placed in the ‘positive thinking group’ or the ‘negative thinking group’. After 6 years the researchers found that only 1% of the positive group developed depression compared to 17% of the negative group. These results indicate there may be a link between cognitive style and the development of depression.

Question 10

Give a limitation of beck’s cognitive approach to explaining depression.

Answer 10

It is only a partial explanation for aggression. Although there is a clear association between cognitive vulnerability and depression, there are some cognitive aspects of depression that are not explained in the model. For example, anger, hallucinations and delusions. This shows that Becks negative triad cannot fully explain the cognitive side of depression.

Question 11

Outline Ellis’ ABC model.

Answer 11

A- Activating event.
Situations in which irrational thoughts are triggered by external events.

B- Beliefs
Ellis identified a range of irrational beliefs. E.g musturbation, I-cant-stand-it-itis.

C- Consequence
When an activating event triggers irrational beliefs there are emotional and behavioural consequences.

Question 12

Give an example of an activating event.

Answer 12

Ending a relationship.

Question 13

Give three examples of irrational beliefs associated with depression.

Answer 13

-Musturbation
-I-can’t-stand-it-itis
-Utopianism

Question 14

Define musturbation.

Answer 14

The belief that we must always achieve perfection.

Question 15

Define I-cant-stand-it-itis.

Answer 15

The belief that it is a major disaster when things don’t go smoothly.

Question 16

Define utopianism.

Answer 16

The belief that life is always meant to be fair.

Question 17

Give a strength of Ellis’ ABC model of explaining depression.

Answer 17

One strength of Ellis’ ABC model is its real-world application in the psychological treatment of depression. Ellis’s approach to cognitive therapy is called rational emotive behaviour therapy or REBT. The idea is to vigorously argue with the depressed person in the hope that the therapist can alter the irrational beliefs that are making them unhappy. There is some evidence to support the idea that REBT can change negative beliefs and relieve the symptoms of depression. This means REBT has real-world value.

Question 18

Give a limitation of Ellis’ ABC model.

Answer 18

One limitation of the ABC model is that it is controversial. It locates responsibility for depression purely with the depressed person. Critics say that this is effectively blaming the depression person, which is unfair.

Question 19

What is the most commonly used psychological treatment for depression?

Answer 19

CBT

Question 20

How does CBT work?

Answer 20

CBT begins with an assessment in which the client and the cognitive behaviour therapist work together to clarify the clients problems and jointly identify goals for the therapy and put together a plan to achieve them. CBT then works to change negative and irrational thoughts and put more effective behaviours in place.

Question 21

Outline Becks cognitive therapy.

Answer 21

The idea is to identify automatic thoughts about the world, self and future and once identified challenge these thoughts. It also helps them to test the reality of their negative beliefs. They may be set homework such as to record when they enjoyed an event or when people were nice to them.

Question 22

Outline Ellis’ Rational emotive behaviour therapy.

Answer 22

REBT extends the ABC model to an ABCDE model where D stands for dispute and E stands for effect. The central technique is to identify and dispute (challenge) irrational thoughts. E.g a client might talk about how unlucky they have been and an REBT therapist would identify and challenge this belief. This would involve a vigorous argument with the intended effect to change the irrational belief.

Question 23

What is the name of Ellis’ therapy for treating depression?

Answer 23

Rational emotive behaviour therapy.

Question 24

Strength of the cognitive approach for treating depression.

Answer 24

One strength of CBT is the large body of evidence supporting its effectiveness for treating depression. Many studies show that CBT works. For example, March compared CBT to antidepressant drugs and also a combination of both when treating 327 depressed adolescents. After 36 weeks, 81% of the CBT group, 81% of the anti-depressents group and 86% of the combination group were significantly improved. This means CBT is a good first choice of treatment for depression.

Question 25

Limitation of the cognitive approach to treating depression. (may not work in extreme cases)

Answer 25

A limitation is that cognitive treatments of depression may not work in the most severe cases of depression. In some cases, depression can be so severecan notatients cannot motivate themselves to take on the hard cognitive work required for CBT. Where this is the case, it is possible to treat patients with antidepressants first before starting CBT. This is a limitation as it means that CBT can not be used as a sole treatment for all cases of depression.

Question 26

Limitation of the cognitive approach to treating depression. (relapse rates)

Answer 26

a further limitation of CBT for the treatment of depression is its high relapse rates. Although CBT is quite effective in tackling depression symptoms, there are concerns over how long the benefits last. E.g in one study Ali assessed depression in 439 clients every month for 12 months following a course of CBT. 42% of patients relapsed within six months. This means that CBT may need to be repeated periodically.