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Clinical Psychology > Depression > Flashcards

Depression Flashcards

1
Q

What is depression?

A

Clinical syndrome distinct from sadness
Impairment in daily functioning
Pervasive feeling of loss/ emptiness, entrapment, worthlessness & hopelessness
Physiological, emotional, cognitive-motivational, behavioural and social symptoms interacting

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2
Q

What is the epistemology of depression?

A

280 million people worldwide
5% adults have depression
Lifetime prevalence of 2-21%
10-15% chronic depression, 35-60% stable recovery
>50% chance of reoccurring if one major episode

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3
Q

Why should caution be taken before a diagnosis?

A

Criticisms of over pathologising/ medicalising disorders, neglecting socio-cultural context

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4
Q

What are the 2 diagnostic categories?

A

ICD-11 (WHO)
DSM-5-TR

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5
Q

What are other syndromes including depression?

A

Seasonal affective disorder
Psychotic depression
Post-natal depression
Adjustment disorder (reactive depression)
PTSD

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6
Q

What are some multifactorial determinants of depression?

A

Sociocultural context
Lifestyle
Life history
Personality
Life chances
Genetics
Drugs/ alcohol

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7
Q

What is depression associated with?

A

Bereavement
Relationship difficulties
Problems at work/ with family
Lack of intimacy
Isolation
Role change

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8
Q

What is the biological approach to depression?

A

Twin & family studies show modest heritability
Neurotransmitters imbalance/ dysregulation
Other brain abnormalities

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9
Q

What is the behavioural approach to depression?

A

Learned helplessness (classical conditioning)
Reduction in positive reinforcers
Social learning theory
Formation of vicious cycles of behaviour maintaining depression

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10
Q

What is the psychodynamic approach to depression?

A

Freud (1917) mourning & melancholia
Comparing depression and grief, both painful states
Grief is sadness rage, no loss of self esteem, depression unaware of loss, anger, loss of self esteem - loss is central to both
Idea of introspection

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11
Q

What is the neo-Freudian approach to depression?

A

Psychoanalysis and psychodynamic psychotherapy
Object relations theory
Depressive vunerability created y caregivers using child toward excessive independence/ reliance
Lose important relationships - depression

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12
Q

What is attachment theory of depression?

A

Attachment is a lasting psychological connection between humans
Child builds internal working model of self and others
Depends on primary caregiver for secure base
Inadequate care leads to self as inadequate, others unavailable & lower self esteem
At times of stress, negative IWM of self & others becomes active, feelings of self worth not strong enough - result in depression

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13
Q

What are cognitive models of depression?

A

Theory of causal attribution - depression more likely if attribution is internal, stable & global
Cognitive-behavioural approach - emotional difficulties due to problems with thinking / recognition of sociocultural context
Interpersonal model

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14
Q

How can we assess depression?

A

Clinical interview
Psychometric questionnaires
Information from others
Importance of comprehensive clinical assessment

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15
Q

What are the 5 core dimensions of depression with examples?

A

Physiological/ sensational - sleep disturbance, appetite change
Emotional/ affective - low mood, emptiness, anger
Cognitive/ motivational - negative cognitive triad, poor concentration
Behavioural - self-harm, lowered activity levels
Social/ interpersonal - withdrawal, disinhibition, rejection

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16
Q

What are different approaches to treating depression?

A

Talking therapy (CBT, counselling, IPT etc)
Medication
Brain stimulation (tDCS, ECT)

17
Q

How has CBT evolved?

A

20-60s - behavioural roots theory
60-70s - behavioural therapy established
80s - cognitive therapy for emotional disorders
Mid 80s - CBT for physical conditions
90s - mushrooming of CBT approaches
2000s - brief CBT models, computerised CBT
2005 + - third wave therapies - IAPT, online

18
Q

What are the aims of CBT?

A

Help client recognise, understand, challenge & change unhelpful thoughts, beliefs, behaviours & assumptions that maintain depressed state

19
Q

What are the core aspects of CBT?

A

Recipricol interaction & determinism between biological, psychological & socio-environmental systems
Primacy of cognition & appraisal processes

20
Q

What is the beckian CBT model?

A

Behavioural learning/ conditioning
3 levels - automatic thoughts, intermediate level thoughts, core beliefs
Cognitive & behavioural feedback loops

21
Q

What are examples of behavioural learning?

A

Classical conditioning (association)
Operant conditioning (consequence)
Social learning (observe others)

22
Q

What are the main CBT strategies?

A

Physiological - breathing
Emotion regulation
Cognitive - cognitive restructuring
Behavioural - contingency management

23
Q

What is cognitive restructuring?

A

Initial target on negative automatic thoughts (NATs) - identify, challenge & change
Explore & challenge intermediate thought processes
Explore how deeper core beliefs link with current thoughts and behaviours

24
Q

What are types of thinking errors?

A

Black & white thinking
Overgeneralising
Catastrophising
Mind reading
Selective filtering
Jumping to conclusions
Labelling

25
Q

How does CBT work?

A

1-2 - develop therapeutic alliance, set goals, emphasise importance of homework, clarify relationships between beliefs, mood & behaviour
3-10 - share formulation, activity monitoring & scheduling, distraction techniques, identify cognitive distortions, modify cognition with cognitive restructuring
11+ - relapse prevention, identify high risk time

26
Q

What are key aspects of the communication style of CBT?

A

Holistic
Educational
Individual tailoring
Goal orientated & structured
Guided discovery
Brief aimed at long-term coping

27
Q

What is interpersonal therapy?

A

Developed by Klerman et al (1974)
Depression understood as response to problems with interpersonal relationships
Focus on difficulties in current relationships & important life events
Recognise role of genetic, developmental & personality
Short-term

28
Q

What are the aims of IPT?

A

Understand onset of depression & fluctuations in depressive symptoms in terms of current interpersonal problems
Develop more effective strategies for dealing with interpersonal problems - encourage confidence
Focus on interpersonal disputes, role transition, loss & interpersonal deficits

29
Q

How does IPT work?

A

Phase 1 - explore difficulties, set goals
Phase 2 - work on solutions, problem solving approach
Phase 3 - prepare for treatment termination, discuss maintainance plan

30
Q

What is the history of IPT?

A

Sullivan 1953 - link between psychiatric & interpersonal problems Develop
Bowlby 1973 - insecure attachment lead to vunerability to psychiatric disorder

31
Q

What is behavioural activation?

A

Brief structured psychosocial therapy
Importance of functional analysis
Depression = reduced engagement with rewarding behaviours
Aims to gradually help client rebuild meaningful engagement & reduce unhelpful behaviours through not being tied to current mood

Clinical Psychology (9 decks)

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