Depression

Question 1

What type of disorder is depression, and how are these disorders characterised?

Answer 1

Depression is a mood disorder. Mood disorders are characterised by strong emotions, which can influence a person’s ability to function normally; a mood disorder can affect a person’s perceptions, thinking, and behaviour.

Question 2

What are two types of depression?

Answer 2

1. Major depression (unipolar depression) - an episode of depression that can occur suddenly.
2. Manic depression (bipolar depression) - alternation between two mood extremes (mania and depression).

Question 3

What are the physical/behavioural symptoms of depression?

Answer 3

1. Sleep disturbances - insomnia or hypersomnia,
2. Change in appetite - people may eat more or less than usual,
3. Pain - especially headaches, joint aches, and muscle ache,
4. Lack of activity - social withdrawal and lack of sex drive.

Question 4

What are the cognitive symptoms of depression?

Answer 4

1. Experiencing persistent negative beliefs about themselves and their abilities,
2. Suicidal thoughts,
3. Slower thought-processes; difficulty concentrating and making decisions.

Question 5

What are the emotional symptoms of depression?

Answer 5

1. Extreme feelings of sadness, hopelessness, and despair,
2. Diurnal mood variation - changes in mood throughout the day, e.g., feeling worse in the mornings,
3. Anhedonia - no longer enjoying activities or hobbies that used to be pleasurable.

Question 6

According to the DSM5, how many symptoms does an individual need to have, and for how long, to be diagnosed with major depression?

Answer 6

5 or more symptoms present nearly every day for at least two weeks.

Question 7

What does the cognitive approach assume about behaviours? how does this apply to abnormality?

Answer 7

That they are controlled by thoughts and beliefs. In this approach, therefore, irrational thoughts and beliefs lead to abnormal behaviours,

Question 8

Who proposed the ‘ABC model’?

Answer 8

Ellis (1962)

Question 9

Explain the ABC model’s workings

Answer 9

Claims that disorders begin with an activating event (A) (e.g., a failed exam) leading to a belief (B) about why this happened. This belief may be rational (e.g., ‘I didn’t prepare well enough’) or irrational (e.g., ‘I’m too stupid to pass this exam’). The belief then leads to a consequence (C), rational beliefs produce appropriate, adaptive consequences (e.g., more revision), irrational beliefs produce maladaptive consequences (e.g. getting depressed).

Question 10

Who proposed/identified the negative triad?

Answer 10

Beck (1963)

Question 11

What is the negative triad?

Answer 11

A triplet of automatic thoughts linked to depression - negative views about,
1. themselves,
2. the world,
3. the future.

Question 12

Strengths of the cognitive approach to explaining depression

Answer 12

1. Offers a useful approach to depression; considers the role of thoughts and beliefs, which are arguably greatly involved in problems like depression,
2. Research support: Hollon and Kendall (1980) developed the Automatic Thoughts Questionnaire to measure the negative thinking associated with depression. Harrell and Ryon (1983) used the ATQ to compare negative thinking in 114 depressed and non-depressed participants. The depressed participants scored significantly higher than the other groups, supporting a correlation between negative thinking and depression,
3. Real life application: Cognitive therapies have often successfully treated depression.

Question 13

Weaknesses of the cognitive approach to explaining depression

Answer 13

1. Faulty cognitions may simply be the consequence of depression rather than its cause. I.e., depression may be caused by chemical imbalances in the brain, which causes people to think very negatively,
2. The person could begin to feel like he or she is to blame for their problems.

Question 14

What does CBT stand for?

Answer 14

Cognitive behavioural therapy

Question 15

What is the aim of CBT?

Answer 15

Aims to identify and change the patient’s faulty cognitions. The idea is that patients learn how to notice negative thoughts when they have them, and test how accurate they are.

Question 16

What is the standard procedure of CBT?

Answer 16

1. The therapist and client identify the client’s faulty cognitions,
2. The therapist then tries to help the client to see that these cognitions aren’t true,
3. Together, they then set goals to think in more positive/adaptive ways,
4. Although the client may occassionally need to look back to past experiences, the treatment mainly focuses on the present situation,
5. Therapists sometimes encourage their clients to keep a diary - they can then record their thought patterns, feelings, and actions.

Question 17

What are the strengths of cognitive behavioural therapy?

Answer 17

1. CBT empowers the patient; puts them in charge of their own treatment by teaching them self-help strategems; means there are less ethical issues than with other therapies, e.g. drug therapy,
2. DeRubeis et al (2005) compared CBT and drug therapy as depression treatments in a placebo-controlled trial. Both treatments were more effective than the placebo after 8 weeks. Generally, the two therapies were similarly effective, but CBT may have been less effective than drug therapy in cases where therapists had less experience,
3. Hollon et al (2005) compared participants from DeRubeis’ et al (2005) study after they were withdrawn from treatment, with participants who had continued drug therapy. Participants who had withdrawn from CBT were significantly less likely than participants withdrawn from drug therapy to have relapsed within a year, and no more likely to have relapsed than patients who continued drug therapy,
4. Brandsma et al (1978) found that CBT is particularly effective for people who put a lot of pressure on themselves and feel guilty about being inadequate.

Question 18

What are the weaknesses of cognitive behavioural therapy?

Answer 18

1. Cognitive therapies may take a long time and be costly. They may be more effective when combined with other approaches,
2. As DeRubeis et al (2005) found out, CBT may only be effective if the therapist is experienced. Patients whose therapists are still gaining this experience may be better off with drug therapy,
3. The person could begin to feel like he or she is to blame for their problems.