Depression

Question 1

Behavioural characteristics

Answer 1

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

Question 2

Emotional characteristics

Answer 2

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

Question 3

Cognitive characteristics

Answer 3

Poor concentration - difficulty making decisions.

Attending to and dwelling on the negative - half-empty glass instead of glass half-full.

Absolutist thinking - ‘black and white’

Question 4

Beck’s theory: faulty information processing

Answer 4

Attending to the negative aspects of a situation.

Question 5

Beck’s theory: negative self-schema

Answer 5

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

Question 6

Beck’s theory: the negative triad

Answer 6

Negative views of the world, self and future.

Question 7

Beck’s theory: evaluation

Answer 7

• Research support -> Research shows cognitive vulnerability precedes depression (Clark and Beck, Cohan et al. prospective studies of adolescence).

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

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

Question 8

Ellis’s ABC model: A

Answer 8

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

Question 9

Ellis’s ABC model: B

Answer 9

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

Question 10

Ellis’s ABC model: C

Answer 10

Consequences
Depression results when we overreact to negative life events.

Question 11

Ellis’s ABC model: evaluation

Answer 11

• Real world application -> Irrational thoughts can be identified and challenged by therapists.
• Reactive and endogenous depression -> Only explains reactive depression, doesn’t explain cases that do not follow an activating event (endogenous depression ).
• Ethical issues -> ABC model places responsibility on the depressed person (victim blaming), but the therapy from the model (REBT) does create resilience.

Question 12

Beck’s cognitive therapy

Answer 12

Aims to identify negative thoughts (negative triad) and challenge them (client as scientist).

Question 13

Ellis’s REBT

Answer 13

ABC + D (dispute) and E (effect). Aims to identify and challenge irrational beliefs e.g. by empirical argument.

Question 14

Behavioural activation

Answer 14

Encouraging the depressed person to engage in in enjoyable activities.

Question 15

CBT evaluation

Answer 15

• Evidence for effectiveness -> CBT is as effective as antidepressants, most effective combined (81% vs 86%, March et al.)
• Suitability for diverse clients -> May not be suitable for severe cases of depression or for people with learning difficulties.
• 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.
• Client preference -> CBT effective, at least short-term but some clients prefer to take medication or explore the past.