Depression

Question 1

What is depression

Answer 1

A category of mood disorders, which is often divided into two main types: unipolar(low mood) and bipolar(the high mood followed by a crash of low mood)

Question 2

What are the categories of depression in the DSM-5

Answer 2

Major depressive disorder( short term low mood)

Persistent depressive disorder(long term recurring depression)

Disruptive mood dysregulation disorder(Where children/teens have ongoing irritability, anger and intense anger outbursts)

Premenstrual dysphoric disorder(disruption to mood prior female menstruation)

Question 3

What was Beck’s cognitive theory(cognitive triad)

Answer 3

Consists of 3 parts- negative self-schemes, Faulty information process, negative triad

Question 4

What is a self-schema

Answer 4

A package of ideas that we have about ourselves

Question 5

What might we believe if we have negative self-schemas

Answer 5

“I am ugly” “I am stupid”

Question 6

What are cognitive biases

Answer 6

It is when people who are depressed make fundamental errors in logic. They misperceive reality

Beck proposed that depressed people tend to selectively attend to the negative aspects of a situation and ignore the positive aspects

Question 7

What re the 5 cognitive biases

Answer 7

Overgeneralisation(general conclusion based on a single occurrence

Personalisation(Neagtive feelings are attributed to something about you)

Selective abstraction(Focusing on one aspect, overlook aspects leading to a positive conclusion)

Magnification(Exaggerating significance of events)

Minimisation(Underplaying positive events and outcomes)

Question 8

What is the negative triad

Answer 8

Negative view of self, negative view of the world and negative view of future

Question 9

Positives of Beck’s theory

Answer 9

• Science-based- cognition and Lab
• Practical applications-CBT

Supporting evidence- Grazioli and Terry(2000)- 65 pregnant women assessed for cog vulnerability and depression before and after birth. Those with high cog vulnerability were more likely to suffer from post-natal depression

Question 10

Negatives of Beck’s theory

Answer 10

• Does not consider environmental aspects such as emotion and behavioural effects of depression
• Role of learning ignored
• Person centred

Explains basic symptoms but depression is a complex disorder with a range of symptoms, not of all which are explained

Question 11

What is Albert Ellis’ theory called

Answer 11

ABC Model

Question 12

What did he believe

Answer 12

Depressives mistakenly blae external events for their unhappiness

Their interpretation of these events is to blame for their distress

Ellis believed we have the general goal of happiness in life, with ourselves and others, life choices and situations but normal life is such that these things get blocked. The reaction to the block can either be rational or irrational. If irrational it leads to depression

Question 13

What did the ABCs stand for

Answer 13

A- an action is affected by a
B- An individuals beliefs which results in a
C- A consequence

Question 14

Strengths of Ellis’s theory

Answer 14

Practical applications- CBT

Easy to understand and use

Question 15

Weaknesses of Ellis’ theory

Answer 15

• Partial explanation and very extreme
• Reductionist as it ignores biology/nature
• Very specific
• Thoughts are not necessarily irrational such as feeling sad after losing a job(Alloy and Abramson discovered depressive realists see things as they are

Question 16

What are the assumptions of cognitive treatments

Answer 16

If depression is caused by irrational, negative thinking then changing the thinking will change the behaviour

Aim of cognitive treatments is to turn irrational, negative thoughts into rational and positive thoughts

Question 17

Key characteristics of CBT used for depression

Answer 17

Intended to be brief- 20 sessions over 16 weeks

Focuses on the here and now

Aims to identify and alter negative beliefs and later dysfunctional behaviours that contribute to the depression

Question 18

What are the strategies that CBT uses

Answer 18

Behavioural activation(Focuses on encouraging the client to become more active and engage in pleasurable activity)

Homework(Clients are asked to complete homework between sessions in order to test irrational beliefs against reality)

Thought catching(The client is encouraged to identify and record their automatic negative thoughts and consider how they might challenge these)

Cognitive restructuring(Analysing negative thoughts- changing negative automatic thoughts to rational thoughts)

Question 19

How effective is CBT

Answer 19

Studies found that CBT is slightly less effective over 8 weeks then drugs but CBT treatment is more enduring after 2 years

Question 20

What was Ellis’ therapy called

Answer 20

Rational Emotional Behavioural Therapy(REBT)

Question 21

What are the key ideas of REBT

Answer 21

People are not disturbed by things but rather their views of things

Ellis saw irrational thoughts as causing emotional distress and behaviour disorders

Irrational thoughts cause negative self-statements so REBT involves making irrational and negative thoughts more rational and positive

Extends the ABC model to ABCDEF

Question 22

What is the DEF in ABCDEF

Answer 22

Dispute- disagreeing with the irrational thoughts and beliefs

Effect- effects of disputing and effective attitude to life

Feelings- feelings that are produced

Question 23

What are the three types of disputing

Answer 23

Logical disputing-does this make any sense?

Empirical disputing- where is the evidence for the belief?

Pragmatic disputing- how is this belief likely to help you?

Question 24

How does the process of challenging irrational thoughts actually treat depression

Answer 24

By challenging the irrational thoughts and disputing them, the client should come to the realisation that their beliefs are irrational and thus break the link between depression and the cause(negative life events). This is therefore intended to make them think more rationally of the situation and come out the depressive state.

Question 25

Strengths of CBT/ treatment for depression

Answer 25

• Large body of evidence supporting its effectiveness for r=treating depression. Many studies show that CBT works. For example, John March et al. (2007) compared CBT to antidepressant drugs and also a combination of both treatments when treating 327 depressed adolescents After 36 weeks, 81% of the CBT group, 81% of the antidepressants group and 86% of the CBT plus antidepressants group were significantly improved. So CBT was just as effective when used on its own and more so when used alongside antidepressants. CBT is usually a fairly brief therapy requiring six to 12 sessions so it is also cost-effective.
  This means that CBT is widely seen as the first choice of treatment in public health care systems such as the National Health Service.
• Although the conventional wisdom has been that CBT is unsuitable for very depressed people and for clients with learning disabilities, there is now some more recent evidence that challenges this. A review by Gemma Lewis and Glyn Lewis (2016) concluded that CBT was as effective as antidepressant drugs and behavioural therapies for severe depression. Another review by John Taylor et al. (2008) concluded that, when used appropriately, CBT is effective for people with learning disabilities.
  This means that CBT may be suitable for a wider range of people than was once thought.

Question 26

Weaknesses of CBT/treatments for depression

Answer 26

• The lack of effectiveness for severe cases and for clients with learning disabilities. In some cases depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT. They may not even be able to pay attention to what is happening in a session. It also seems likely that the hard cognitive work involved in CBT makes it unsuitable for treating depression in clients with learning disabilities. Peter Sturmey (2005) suggests that, in general, any form of psychotherapy (ie. any talking’ therapy) is not suitable for people with learning difficulties, and this includes CBT.
  This suggests that CBT may only be appropriate for a specific range of people with depression.
• High relapse rates. Although CBT is quite effective in tackling the symptoms of depression, there are some concerns over how long the benefits last. Relatively few early studies of CBT for depression looked at long-term effectiveness. Some more recent studies suggest that long-term outcomes are not as good as had been assumed. For example in one study, Shehzad Ali et al. (2017) assessed depression in 439 clients every month for 12 months following a course of CBT. 42% of the clients relapsed into depression within six months of ending treatment and 53% relapsed within a year.
  This means that CBT may need to be repeated periodically.