depression Flashcards
how long does it take to get diagnosed with depression?
symptoms must be present for at least 2 weeks for a diagnosis
what type of disorder is depression?
mood disorder- characterised by low mood, lack of energy + motivation
2 main types, unipolar + bipolar
what are the DSM-5 categories of depression?
- major depressive disorder
- persistent depressive disorder
- disruptive mood dysregulation disorder
- premenstrual dysphoric disorder
DSM-5, what is major depressive disorder?
severe, but often short-term depression
DSM-5, what is persistent depressive disorder?
long-term, recurring depression, concluding sustained major depression
DSM-5, what is disruptive mood dysregulation disorder?
childhood temper tantrums
DSM-5, what is premenstrual dysphoric disorder?
disruption to mood prior to or during female menstruation
what are behavioural characteristics of depression?
- activity levels
- disruption to sleep and eating behaviour
- aggression + self harm
behavioural characteristics of depression- activity levels?
reduced levels of energy (lethargic)= withdrawal from daily life OR some people see increase in levels of activity= restlessness
behavioural characteristics of depression- disruption to sleep + eating behaviour?
either increase or decrease in food consumption. Increase or decrease (insomnia) in sleeping
behavioural characteristics of depression- aggression + self harm?
depressed person may become more aggressive to others and/or self harm (cutting themselves/suicidal behaviour)
what are emotional characteristics of depression?
- lowered mood
- anger
- lowered self-esteem
- loss of interest
emotional characteristics of depression- lowered mood?
sadness + may feel hopeless
emotional characteristics of depression- anger?
negative emotions can lead to anger outbursts + unpredictable mood swings
emotional characteristics of depression- lowered self-esteem?
not liking yourself, self-loathing= can exacerbate sadness + feelings of loneliness
emotional characteristics of depression- loss of interest?
in activities, hobbies etc
what are the cognitive characteristics of depression?
- poor concentration- inability to focus on one task, hard to make decisions
- attending + dwelling on the negative- bias towards recalling unhappy events rather than sad ones
- negative view of the world
- absolutist thinking- if an event= unfortunate they’ll see it as an absolute disaster
what approach is used to explain depression?
Cognitive
cognitive approach to explaining depression- what are the 2 explanations?
Beck’s negative triads
Ellis ABC model
Beck’s negative triad- outline
- explains why some people are more vulnerable to depression than others
- a persons cognitions creates this vulnerability
Beck’s negative triad- what are the 3 parts
- negative self schemes
- faulty information processing
- negative triad
Beck’s negative triad- negative self schemes
- self-schema= package of ideas that we have about ourselves
- negative self-schema= what depressed people have
–> individual only focuses on negative undesirable aspects of themselves e.g. thinking you’ll fail everything
Beck’s negative triad- faulty information processing
depressed people focus on the negative aspects of a situation (it ignores positive), misperceive reality –> blow small problems out of proportion e.g. you’re a success of failure, can’t be not good at some things and ok at other things
Beck’s negative triad- faulty information processing, 5 aspects of it
1) overgeneralisation- make a general conclusion based off a single occurrence
2) personalisation- negative feelings of others are attributed to something about you
3) selective abstraction- focus on one aspect of a situation + overlook positive aspects
4) magnification- exaggerating significance of events
5) minimisation- underplaying positive events + outcomes
Becks negative triad- negative triad
Negative views about the world e.g. ‘everyone is against me’
Negative views about the future e.g. ‘I’m always going to fail’
Negative views about the self e.g. ‘I am unlovable’
Beck’s negative triad- strengths
- has real world applications (CBT- identifies + challenges negative thoughts)= external validity
- support from Grazioli + Terry (2000)–> 65 pregnant woman assessed cog vulnerability + depression b4 + after birth, those with cog. vulnerability= more likely to suffer with post-natal depression
- Clark + Beck (1999)- found that cognitions can be seen b4 depression develops= supports Beck idea that cognition causes depression
Beck’s negative triad- weaknesses
- only explains ‘what’ characterises irrational thinking, not ‘why’ thoughts occur–> lacks explanatory power
- doesn’t consider biological factors
- doesn’t explain all symptoms
Ellis ABC model- outline
Ellis claimed irrational thoughts interfere with happiness–> good mental health= lack of irrational thoughts. Any thoughts that obstruct happiness=irrational
Ellis ABC model- what does the ABC model do?
explains how irrational thought affect mood + behaviour
Ellis ABC model- what does the ABC stand for?
A- Activating event
B- Beliefs
C- Consequences
Ellis ABC model- Activating event
- situations which irrational thoughts are triggered by. e.g. losing a job, relationship breakup
Ellis ABC model- Beliefs
- beliefs are irrational thoughts associated with the event + why it happened e.g. after losing a job ‘i lost my job because I’m useless’
relationship breakup ‘proof that I’m unlovable + will die alone’ - features= masturbation (belief we must always succeed/achieve perfection + ‘I-can’t-stand-it-itis’ (belief it is a major disaster when something doesn’t go smoothly)
Ellis ABC model- Consequences
the consequences of A + B
–> rational beliefs lead to healthy consequences ‘i lost my job but i’ll find a better one’ Irrational beliefs lead to unhealthy consequences ‘I lost my job so I’ll never find a new job, will lose my home etc’ –> unhealthy consequences lead to depression
Ellis ABC model- strengths
- assigns responsibility for individual to manage their thoughts= they have a degree of control –> BUT ethical issues, is it unfair to blame the depressed person –> BUT Ellis designed REBT to help
- real world application (REBT)
Ellis ABC model- weaknesses
- research suggests depressed people are examples of ‘sadder but wiser effect’ e.g. they give more accurate measures of likelihood of disaster than non-depressed therefore their thinking isn’t irrational but actually realistic
- only accounts for reactive depression (individual responds to an activating event), not endogenous depression
- doesn’t explain all aspects of depression e.g. why some ppl experience anger + others experience hallucinations
the cognitive approach to treating depression- 2 applications
- cognitive behaviour therapy (CBT)
- Ellis- Rational Emotive Behaviour Therapy (REBT)
CBT what is it?
- most commonly used psychological treatment
- cognitive element- when there’s negative thoughts that’ll benefit from challenge
- behavioural element- change thoughts + put more effective behaviours into place
- aims to get client to the point they can be independent + use strategies practised over CBT treatment to help themselves
- focuses on ‘here and now’ rather than past
CBT what does it include?
- cognitive restructuring- turning negative thoughts into positive
- guided discovery- challenging negative thoughts + irrational beliefs
- keeping a journal and recording thoughts, feelings + actions between sessions
- activity scheduling + behaviour activation- acting on decisions + avoiding procrastination
- relaxation + stress reduction techniques e.g. visualisation, deep breathing
- role-playing- working through different scenarios that patient finds difficult
- 5-20 sessions which run 30-60 mins where client + therapist meet every week/fortnight
what therapy applies Beck’s theory?
cognitive therapy- it assists clients in identifying negative thoughts (from negative triad) + encourage them to challenge these thoughts with help from therapist–> clients often set ‘homework’ to record positive events
REBT- what did Ellis do to her model?
- Ellis extended her ABC model to ABCDE
D- dispute (irrational thoughts + beliefs)
E- effect (effect of disputing + effective attitude to life)
what does REBT do?
- aims to help client identify + challenge irrational thoughts
- therapist role= break link between negative life effects + depression by challenging irrational belief
- REBT therapists presents robust arguments to dispute ideas e.g. ‘Everything I do ends in failure or disaster’
REBT what are the different arguments?
- empirical arguments- disputing if there’s real evidence to support the irrational belief
- logical arguments- disputing if negative thought follows logically from the facts e.g. does thinking this way make sense?
- pragmatic arguments- disputing how the belief is likely to help you
what is behavioural activation?
gradually decrease avoidance + isolation of a depressed person + increase their engagement in activities
strengths of treatments of depression
- CBT= most popular + successful –> March et al found it was just as successful than drug therapy (post 36 weeks both showed 81% success rate (86% if both used together))
- CBT= allows for patient to develop at their own pace= free will
- CBT identifies + changes unhelpful thinking + behaviour + is effective when used with the right clients (short-term) BUT not all clients tackle depression this way so relies on client preference
weaknesses of treatments of depression
- focuses on ‘here and now’= not appropriate for some ppl who need to revisit past events= limits usefulness
- doesn’t work if client doesn’t express themselves/lacks verbal skills
- less effective for severe cases/clients with learning disabilities e.g. sm1 who can’t motivate themselves to pay attention in session BUT some research now saying this isn’t the case e.g. John Taylor et al- suggest CBT= effective for ppl with learning disabilities
- may not last long-term- Shehzad et al- 42% of clients relapsed into depression within 6 months
