Depression

Question 1

Behavioural characteristics

Answer 1

Change in activity levels - some experience lethargy, some experience agitation (increased activity levels)
They may neglect personal hygiene
Disruption to sleep - insomnia or hypersomnia
Disruption to eating behaviour - overeating, under eating
Aggression

Question 2

Emotional characteristics

Answer 2

Low mood - feeling sad, hopeless or empty
Feelings of worthlessness
Anger

Question 3

Cognitive characteristics

Answer 3

Negative schema - negative views about themselves, the world and their future
Poor concentration

Question 4

Cognitive explanations of depression

Answer 4

Underlying assumption is that depression is the result of disturbance in ‘thinking’. Is a consequence of faulty and negative thinking about events and can be managed by challenging this thinking.

Question 5

Negative triad

Answer 5

Beck 1967
Depressed people have acquired a negative schema during childhood and tend to adopt a pessimistic view of the world.
These schemas are activated whenever a new situation resembles original conditions of schema
Negative schemas lead to cognitive biases in thinking. E.g. overgeneralisations

Question 6

Negative schemas and cognitive biases maintain the negative triad

Answer 6

This is an irrational view of three elements in the person’s belief system

The self
The world
The future

Question 7

Evaluation +

Answer 7

Great deal of supporting evidence that negative and irrational thinking causes depression.
Terry (2000) assessed 65 pregnant women for cognitive vulnerability before and after they gave birth. Women who had high cognitive vulnerability were more likely to suffer post-partum depression

Question 8

Evaluation -

Answer 8

Cause and effect is not always clear. Can we say these thoughts cause depression, or does depression develop first and cause these thoughts ?
Triad doesn’t explain how some symptoms might develop such as anger. Also doesn’t explain manic phases in bipolar disorder.

Question 9

ABC Model

Answer 9

Ellis (1962)

A= activating event = incident in life
B = beliefs = thoughts that occur after activating event, can be rational or irrational
C = consequences = emotions caused by belief
e.g. rational -> acceptance, irrational -> depression

Question 10

Evaluation ABC Model +

Answer 10

Research support. Bates (1999) found that depressed participants who were given negative thought statements became more and more depressed, supporting the view that negative thinking helps cause depression.

Question 11

Evaluation ABC Model -

Answer 11

Although it gives client some power to change situation and improve their symptoms, it blames client for their depression.

Question 12

CBT

Answer 12

Central aim of cognitive behavioural Therapy is to change/modify negative/irrational thoughts and so alleviate depression.

Question 13

Cycle

Answer 13

Thoughts create feelings, feelings create behaviour, behaviour reinforces thoughts

Question 14

Beck’s CBT part 1

Answer 14

First step is to identify irrational thoughts/negative triad, known as thought catching . Patient is then encouraged to generate a hypothesis to test validity of their irrational thoughts, known as patient as scientist.

Question 15

Becks CBT Part 2

Answer 15

Several strategies are used to test patients hypothesis. May be asked to gather data about behaviour and incidents and then compare evidence with hypothesis to see if they match. Patient may be asked to complete homework assignments between sessions to test irrational thoughts out and evaluate evidence.
Could be asked to keep a diary to record events and identify situations where negative thinking occurs.

Question 16

When patients report positive thoughts

Answer 16

they are praised by the therapist which provides positive reinforcement.

Question 17

Aim of Becks CBT

Answer 17

Cognitive restructuring: learning to identify, dispute and therefore change, irrational thoughts.

Question 18

Rational emotive behavioural therapy

Answer 18

Ellis (1994) developed a CBT therapy for depression - REBT. This therapy aims at challenging automatic negative thoughts and replacing them with rational beliefs.

Question 19

How does REBT work

Answer 19

Therapist uses logical arguments to show patients that their self-defeating beliefs do not logically follow from available info.
Therapist also uses empirical arguments to show patients their beliefs are not consistent with reality.

Question 20

Patients undertaking REBT are encouraged to

Answer 20

engage in behavioural activation; becoming more active and taking part in pleasurable activities. Many depressed patients often do not engage in activities that they used to enjoy.

Question 21

Evaluation of CBT +

Answer 21

March et al (2007) found CBT was as effective as antidepressants. Most effective treatment is both.

David (2008) found that CBT is better in long term. Compared 170 patients who had 14 weeks of CBT with those who took drug fluoxetine. Six months later, CBT people were less likely to relapse.

Question 22

Evaluation CBT -

Answer 22

Requires commitment and motivation, those with severe depression may not engage or attend sessions thus ineffective. Alternative treatments like antidepressants don’t require same motivation.

CBT attempts to address root cause assuming it is irrational thoughts. CBT suggests irrational thinking is primary cause, disregards other factors or circumstances such as DV.

Relies on patients self reporting as thoughts can’t be objectively observed or measured. Could be unreliable, hard to verify.