depression

Question 1

what is depression?

Answer 1

a mood disorder that affects ones emotional state - characterized by low mood/energy levels - current emotional mood is distorted or inappropriate to the circumstances

Question 2

emotional characteristics of depression

Answer 2

lowered mood - more pronounced than the daily experience of feeling lethargic or sad. sufferers often describe themselves as worthless or empty.

anger - on occasion such emotions lead to aggression or self-harming behaviour

lowered self-esteem - sufferers may experience low feelings of self esteem

Question 3

behavioural characteristics of depression

Answer 3

activity levels - sufferers have reduced levels of energy making them lethargic. in extreme cases sufferers cant get out of bed.

disruption to sleeping or eating behaviour - sufferers may experience reduced sleep (insomnia) or increased need for sleep (hypersomnia). appetite may increase or decrease leading to weight gain or loss

aggression and self-harm - may experience increased feelings of aggression towards themselves/others

Question 4

cognitive characteristics of depression

Answer 4

poor concentration - sufferers may find themselves unable to stick with a task as they usually would or might find simple decision making difficult

absolutist thinking - ‘black or white thinking’ when a situation is unfortunate its seen as an absolute disaster

attending to and dwelling on the negative - sufferers may dwell on negative thoughts/experiences

Question 5

what are the cognitive approaches main assumptions when explaining depression?

Answer 5

• individuals who suffer from psychological 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 disorder (abnormality).
• individuals can overcome psychological disorders by learning to use more appropriate cognitions (Learning a new way of thinking).

Question 5

what are schema/schemata?

Answer 5

• an organized pattern of thought or behaviour
• a structured cluster of pre-conceived ideas
• it can be hard to incorporate new information into our schemas

Question 6

beck’s model of depression - what did he propose?

Answer 6

• there is a cognitive explanation as to why some people are more vulnerable to depression than others.
• he suggested there are three parts to this cognitive vulnerability : faulty information processing, negative self-schemas and the negative triad

Question 7

faulty information processing

Answer 7

• people who are depressed make fundamental errors in logic
• depressed people selectively attend to the negative aspects of a situation and ignore the positive aspects
• there is a tendency to blow small problems out of proportion with thinking in terms of black and white and ignoring the middle ground; you are a success or a failure, rather than not good at some things but OK at others.

Question 8

negative self schemas

Answer 8

• a self-schema is a package of ideas that we have about ourselves
• people who have become depressed have developed negative self-schemas and therefore they interpret all the information about themselves in a negative way

Question 9

the negative triad

Answer 9

• beck suggested that people with depression become trapped in a cycle of negative thoughts - they have a tendency to view themselves, the world and the future in pessimistic ways – the triad of impairments
  negative view of the self, the world and the future

Question 10

ellis’ abc model - what did ellis propose?

Answer 10

• good mental health is the result of rational thinking
• there are common irrational beliefs that underlie much depression (poor mental health), and sufferers have based their lives on these beliefs

Question 11

what do the abc stand for?

Answer 11

(A) an triggering action is affected by
(B) an individual’s beliefs which results in
(C) a consequence

Question 12

evaluation of beck - good supporting evidence

Answer 12

much research has supported the proposal that depression is associated with faulty information processing, negative self-schemas and the triad of impairments

Question 13

evaluation of beck - has practical application in CBT

Answer 13

forms the basis of cognitive-behavioural therapy - all cognitive aspects of depression can be challenged in CBT

Question 14

evaluation of beck - does not explain all aspects of depression

Answer 14

theory explains the basic symptoms of depression however it is a complex disorder with a range of symptoms, not all of which can be explained

Question 15

evaluation of ellis - only offers a partial explanation

Answer 15

some depression does occur as a result of an activating event (reactive depression), however not all depression arises as a result of an obvious cause

Question 16

evaluation of ellis - practical application in CBT

Answer 16

ellis’ explanation has led to successful therapy. irrational negative beliefs are challenged and this can help to reduce depressive symptoms suggesting that the irrational beliefs had some role in the depression.

Question 17

evaluation of ellis - does not explain all aspects of depression

Answer 17

does not explain why some individuals experience anger associated with their depression or why some patients suffer hallucinations and delusions

Question 18

biological explanation

Answer 18

• genes and neurotransmitters may cause depression
• 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
• a diathesis-stress approach might be advisable - 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

Question 19

cognitive approach to treating depression - what is cbt?

Answer 19

• cbt is a psychological treatment for depression/other mental health problems
  based on both behavioural and cognitive techniques
• the therapist aims to make the client aware of the relationship between thought, emotion and actions
• cbt can help people to change how they think (‘cognitive’) and what they do (‘behaviour’) so they feel better

Question 20

cbt - what does it involve?

Answer 20

• the sessions involve meeting with a therapist between 5-20 times, for weekly of fortnightly sessions - each session lasting 30-60 minutes
• most cbt therapists use techniques influenced by beck and ellis

Question 21

cbt - patient and therapist/challenging negative thoughts

Answer 21

• patient and therapist work together to clarify the patients problems and identify where there might be negative or irrational thoughts (about self, world and future) to challenge
• these thoughts must be challenged by the patient who must take an active role in their treatment

Question 22

T - cbt - patient as a scientist

Answer 22

• patients are encouraged to test the reality of their irrational beliefs
• they might be set homework e.g. to record when someone was nice to them
• in future sessions if patients say that no one is nice to them the therapist can produce this evidence to prove the patients beliefs are incorrect

Question 23

T - beck’s cognitive therapy

Answer 23

• developed a therapy to challenge the negative triad

1. the client will be assessed to discover the severity of their condition
2. therapist will establish a baseline prior to treatment to help monitor environment
3. therapist will use a process of reality testing
4. therapist may ask client to demonstrate their ability to succeed/do something

Question 24

T - ellis' rational emotive behaviour therapy - what did ellis argue and propose?

Answer 24

- ellis argues that the main cause of emotional distress = irrational thoughts which lack logic - REBT extends the ABC model to ABCDEF D = dispute (challenge the thoughts) E = effect (see a more beneficial effect on thought and behaviour) F = new feelings produced

Question 25

T - rebt - what is the central technique of rebt and what does it challenge?

Answer 25

- the central technique of REBT is to identify and dispute the patient’s irrational thoughts - REBT challenges the client to prove these statements, and then replace them with more reasonable realistic statements (empirical disputing/logical disputing).

Question 26

T - behavioural activation

Answer 26

- a individuals become depressed, they tend to increasingly avoid difficult situations and become isolated which maintains or worsens symptoms - so the goal of treatment is to gradually decrease individuals avoidance and isolation and increase their involvement in activities which increase mood ELLIS

Question 27

T - unconditional positive regard

Answer 27

- ellis recognised that an important element of successful therapy was convincing the client of their value - the therapist provides respect and appreciation regardless of what the client does and says

Question 28

similarities between beck & ellis

Answer 28

- Both use a cognitive explanation - Both are client centred - Both challenge irrational beliefs - Both seek evidence to challenge the beliefs

Question 29

differences between beck & ellis

Answer 29

- Beck’s CBT put the client at the centre of the therapy more so than Ellis’s REBT - Ellis suggests the challenge of beliefs can be vigorous and led by both client and therapist - Beck sets “homework” for the client to seek evidence between sessions - Ellis uses the term “empirical” evidence to dictate that is must be real and not imagined or perceived

Question 30

evaluation - research support

Answer 30

Research support- Ellis claimed a 90% success rate for REBT. March et al compared the effects of CBT with antidepressant drugs and a combination of the two. The CBT emerged as just as effective as medication as well as alongside medication.

Question 31

evaluation - individual differences

Answer 31

Individual differences- it is less suitable for those clients who have high irrational beliefs that are resistant to change. It also may not work for the most severe cases as the patients can’t motivate themselves to engage with the hard cognitive work of CBT.

Question 32

evaluation - alternative treatments

Answer 32

Alternative treatments - the most popular treatment for depression is antidepressants and drugs require less effort from patients.

Question 33

evaluation - support for behavioural activation

Answer 33

Support for behavioural activation - Babyak et al (2000) studied 156 depressed clients and they were split into aerobic exercise, drug treatment and both. Those in the exercise group had lower relapse rates.