Depression

Question 1

What is depression?

Answer 1

• A mood disorder, where the suffering experiences low mood & low energy levels

Question 1

What were the following categories the DSM-5 recongised of depressive disorders and what are these?

Answer 1

• Major depressive disorder- Severe but often short term depression
• Disruptive mood dysregulation disorder- childhood tantrums
• Persistent depressive disorder- Long-term, reoccuring depression, including sustained major depression
• Premenstural dysphoric disorder-Disruption of mood before & or during menstration

Question 2

What three characteristics can behaviour be characterised by?

Answer 2

• Behavioural
• Emotional
• Cognitive

Question 3

What are some behavioural characteristics of depression?

Answer 3

The shift in activity levels: Can be both an increase in activity such as restlessness or a decrease
Affected sleep: This can be an increase in need to sleep & stay in bed or a decrease where suffer from insomnia
Affected appetite: Can be an increase, where person eats more (overeats), or decrease, where the person cannot eat & struggles to eat meals

Aggression & self-harm: Depression can lead individual to be aggressive with themselves & cause self-harm,e.g. cutting

Question 4

What are some of the emotional characterisitcs of depression?

Answer 4

Sadness: The lowered mood is a key defining emotion of depression and can lead the person to feel hopeless
Anger: Can often have angry outbursts- can be directed at themself or others
Lower self-esteem: A person with depression is likely to have lower self-esteem, with some suffering from self-loathing, E.g. Hating themselves or something in particular about themselves

Question 5

What are some cognitive characteristics of depression?

Answer 5

• Poor concentration
• Attending to & dwelling on the negative
• Absoloutist thinking (when a situation is unfortunate it is seen by person as an absoloute disaster)

Question 6

What are the two cognitive explanations of depression?

Answer 6

• Beck’s Negative Triad
• Ellis’s ABC model

Question 7

What is Becks negative triad?

Answer 7

• Beck explains depression as a vulnerability that can be caused by person’s cognition (the way they think) & their negative schemas.
• He suggested there were 3 parts to cognitive vulnerability:
• Faulty information processing
• Negative self-schema
• The negative triad

Question 8

What is faulty information processing?

Answer 8

• When depressed the person tends to ignore the positives in their lives & only focus on the negatives
• The depressed person will blow small problems out of proportion

These cognitive biases cause the depressed person to constantly see themselves as worthless and useless

Question 9

What is negative self schema?

Answer 9

• A schema is a shortcut that acts as mental framework for individual
• A self-schema is framework of information they have about themselves
• When depressed, person will have a negative self-schema, which means they interpret all of the information about or around themselves negatively

Question 10

What is the negative triad?

Answer 10

• Beck suggests that a depressed person has three elements of negative thinking & these are called the negative triad:

Negative view of the self: I am worthless/ unimportant/ useless/ a waste of time
Negative view of the world: Everyone is against me
Negative view of the future: I am never going to amount to anything

Question 11

What are the strengths of Beck’s negative triad explanation?

Answer 11

• Real-world applications:
  Due to the findings of both Beck & following psychologists, it has allowed psychologists & therapists to understand cognitive vulnerability & apply it in treatments such as CBT (Cognitive Behavioural Therapy).
• Cohen et al. (2019) supported Beck’s findings, they tracked 473 adolescents, ensuring they measured their cognitive vulnerability regularly & found that those who had shown cognitive vulnerability predicted depression later on.

Question 12

What are the limitations of Becks negative triad as an explanation?

Answer 12

• Does not explain symptoms of depression, such as why different depressed people may experience different feelings
• Not all irrational thoughts are irrational: Alloy & Abrahamson (1979) found that depressed people had the ‘Sadder but Wiser effect’ where they gave more accurate estimates of the likelihood of disaster than those not depressed.

Question 13

What did Ellis’s ABC model do?

Answer 13

• Suggested depression is caused by irrational thoughts & that rational thoughts cause good mental health.
• Ellis stated that these irrational thoughts interfere with happiness and cause the person to be unhappy.

Question 14

What actually is Ellis’s ABC model?

Answer 14

A: Activating event. This is a negative event that triggers the irrational thoughts, E.g. Losing your job

B: Beliefs.The thoughts which the person associates with the event, & why it happened: These can be either rational or irrational

C: Consequences. Rational beliefs lead to healthy consequences (new job or job searching), Irrational beliefs lead to unhealthy consequences (believing you will never deserve another job, which leads to depression)
Important to note, in Ellis’s ABC model, that unhealthy consequence always leads to depression.

Question 15

What are the strengths of Ellis’s ABC model?

Answer 15

• REBT (a form of CBT) led by Ellis following the ABC model has been successful in treating depression and changing thought patterns.
• It lays the responsibility with the individual & allows them the power to change the way things are.

Question 16

What are some weaknesses of Ellis’s ABC model?

Answer 16

• It only explains reactive depression & not endogenous depression
• Many cases of depression are not traceable to life events & it is not obvious what leads the person to become depressed at a particular time.
• This type of depression is called endogenous depression
• Ellis’s ABC model is less useful for explaining endogenous depression

This means that Ellis’s model can only explain some cases of depression & is therefore only a partial explanation

Question 17

What is CBT? And what are the two forms of CBT?

Answer 17

• Cognitive behavioural therapy
• Beck’s cognitive therapy
• Ellis’s Rational Emotive behaviour

Question 18

How does Beck’s cognitive therapy work?

Answer 18

• Cognitive Therapy is the application of Beck’s theory of depression
  As behaviour is affected by thinking, one way to change maladaptive behaviours is to change the irrational thinking accompanying those behaviours
• The client is encouraged to challenge irrational thoughts directly with help from therapist
• Clients are often set ‘homework’ to record positive events, which can be used in the sessions to help them challenge irrational thoughts
• The client may state that, ‘Everyone hates me’, however, in their homework they recorded a social event they enjoyed thus it is illogical assume that no-one likes them
• Therapist can directly confront the client with evidence to highlight their irrational thoughts or to at least look for other reasons why people may have acted the way they did

Question 19

How does Ellis’s cognitive treatments for depression work?

Answer 19

• REBT extends Ellis’s ABC model to ABCDE (D is for Dispute and E is for Effect)
  The main technique for REBT is to identify & challenge irrational thoughts
  e.g.
  A client talks to their therapist about the fact that everyone hates them
  REBT would challenge this thought & present a strong argument to dispute this idea
  The therapist’s role is to break the link between negative life effects & depression by changing the clients irrational belief
  There are different types of arguments identified by Ellis;
  Empirical arguments: Disputing if there is real evidence to support the irrational belief
  Logical arguments: Disputing if negative effect follows logically from the facts

Question 20

What are the strengths and weaknesses for the cognitive treatments of depression?

Answer 20

Strengths:
- CBT & REBT are quicker treatments than other therapies: Treatments usually last for 16 weeks & can be repeated if they are not successful the first time around.
- March et al. (2007) compared CBT to antidepressants & combination therapy when treating 327 depressed adolescents, they found that after 36 weeks, 81% of the CBT group, 81% of the antidepressant group and 86% of the combination group were all significantly improved, showing CBT is as effective as antidepressants & even more so when used in combination with them.
CBT is very effective in treating mild depression and stopping it from progressing into severe depression

Weaknesses:
- Some clients with severe depression are unable to motivate themselves with the hard work needed for engagement with CBT.
- CBT as with all ‘talking therapies’ is not very good for those clients who do not like to take or express themselves or lack the verbal skills to do so.

• CBT when used to treat depression has a high relapse rate, so, although it is effective at treating depression, there are concerns as to how long those benefits last.