Depression Flashcards
DSM-5 categories of depression
Major depressive disorder - severe but often short term depression
Persistent depressive disorder - long term depression, sustained major depression
Disruptive mood dysregulation disorder - childhood temper tantrums
Pre-menstrual dysphoric disorder - disruption to mood prior and or during menstruation
Behavioural characteristics of depression
Activity levels:
- reduced levels of energy = lethargic -> withdrawal from work, education or preventing leaving the house
- some cases -> psychomotor agitation; cant relax e.g. pacing up and down a room
Disruption to sleep + eating:
- reduced sleep (insomnia), premature waking or increased need for sleep.
- appetite may increase or decrease-> weight gain/loss
Aggression + self harm:
- verbal or physical aggression (irritable); e.g. verbal aggression -> quitting a job
- physically aggression directed at ones self; e.g. self harm or suicide attempts
Emotional characteristics of depression
Lowered mood:
More pronounced than in the daily experience of feeling lethargic/sad. (Often describe themselves as ‘empty’ / ‘worthless’
Anger:
Directed at themselves or others; sometimes -> self harm or aggression
Lowered self esteem:
Like themselves less than usual; more extreme = hating themselves
Cognitive characteristics of depression
Poor concentration:
Unable to stick to a task, or hard to make decisions (usually would be straightforward) - tend to interfere with work
Dwelling on the negative:
In depressive episode; likely to pay attention to negative aspects + ignore positives.
E.g. see glass half empty rather than half full
Recall unhappy events rather than happy ones
Absolutist thinking:
‘Black and white thinking’; when a situation is unfortunate, they see it as a disaster
The cognitive approach to explaining depression (Beck’s negative Triad)
Faulty information processing:
- Focus on the -tive aspects of a situation and ignore the positives; can blow things out of proportion
Negative self schema:
- internal ‘package’ of ideas gained through experience; if person has a negative self schema, interpret the info. About themselves in a negative way.
Negative triad:
A. Negative view of the world - ‘world is a cold place’
B. Negative view of the future - ‘economy won’t get better’
C. Negative view of yourself - ‘I am a failure’
Ellis’s ABC model
General: defined irrational thoughts as anything that interfered with us being happy
ABC model: explain how irrational thoughts effect beh. + emotional state
A - activating event
Get depressed when we experience a negative event -> triggers irrational beliefs
B - beliefs
Belief that we must always succeed; ‘musturbation’. Life is always fair; ‘Utopianism’
C - consequences
When an event triggers irrational beliefs -> emotional & behavioural consequences (depression)
Evaluate Beck’s negative triad
Strength- research support:
Research support for the association of cognitive vulnerability and depression
E.g. ‘Joseph Cohen’; 473 adolescents, meaning cognitive vulnerability, found that C.V predicted later depression
Strength- real world application:
Treatment for depression; understanding cognitive vulnerability applied in CBT.
In general can help find those at risk of developing depression in the future + monitor them
Evaluate Ellis’s ABC model
Strength- real world application:
Psychological treatment of depression; her approach to cognitive therapy = REBT (therapist vigorously argues with the client to alter the irrational beliefs. REBT therefore can change the behaviour + relive symptoms
Limitation- Reactive & endogenous depression:
Only explains reactive depression not endogenous D. ; many cases of depression not caused by life events and is not obvious what has caused it = endogenous depression.
The model isn’t helpful in explaining endogenous D. So a partial explanation
The cognitive approach to treating depression : CBT (cognitive behavioural therapy)
- begins with an assessment; client + therapist identify problems
- make goals for the therapy
- identify the irrational thoughts; to then change them to put effective behaviours in place
CBT: Beck’s cognitive therapy
- cognitive therapy is the application of Beck’s theory of depression
- the therapy helps challenge the negative thoughts + the reality of those thoughts
- set homework; e.g. record events they enjoyed
- therapist can then show this as evidence against the client when challenges arise
CBT: Ellis’s rational emotive behaviour therapy (REBT)
REBT extends Ellis’s ABC model to ABCDE model; D= dispute and E=2.718 effect
- central idea is to identify dispute irrational thoughts
- vigorous argument is hallmark of REBT; to challenge the negative thoughts -> break the negative life events & depression
Different methods of disputing:
Empirical argument - disputing whether there is actual evidence to support the belief
Logical argument - disputing whether the negative thought follows the facts
CBT: behavioural activation
- work to gradually decrease their avoidance and isolation
- and increase their engagement in activities that have been shown to improve mood
E.g. exercise
Evaluate CBT - strength
Strength- evidence for effectiveness
Widely seen as the 1st choice of treatment in public health care; only 12 weeks long and has been proven to be just as effective as antidepressant drugs.
E.g. John march found - effectiveness of both treatments were the same ; 81% (drugs) and 86% (CBT) improved depression in adolescents
Limitations of CBT
Suitability for diverse clients:
Lack of effectiveness for severe cases & people with learning disabilities; severe cases can’t focus in the session & can’t motivate for the work of CBT
Learning disabilities; the cognitive work is too difficult for them
COUNTERPOINT: e.g. John Taylor ‘when used properly CBT is effective for learning disabilities
Relapse rates:
Concerns over how long the benefits last; therefore it needs to be repeated regularly
Doesn’t consistently look at long term effectiveness
