Depression Flashcards
Who gets depressed?
10-25% women; 5-12% men; 18-44 year olds
What is depression generally thought to be about?
Loss to domain
What are the cognitive themes in depression as defined by Beck (1979)?
Actual Loss
Perceived Loss
Hopelessness
Helplessness
Who defined the cognitive themes in depression?
Beck (1979)
Of what does the negative cognitive triad consist?
Negative views of the self, world and others.
From where do core beliefs develop?
Childhood
What are the characteristics of core beliefs?
They are absolute and unconditional - ‘I am…’, ‘The world is…, ‘Others are…’
What are dysfunctional assumptions?
Conditions which must be met for a person to have an agreed sense of self.
What words let you know that it’s an assumption?
Should, must, ought, if… then…,
What are cognitive biases the same as?
Negative automatic thoughts
Outline Beck’s model of emotional disorders.
Early experiences -> Formation of conditional and unconditional beliefs -> Critical incident -> Beliefs activated -> Automatic Thoughts
Who recommends CBT for depression?
NICE; DeRubris et al. (1999); Williams et al. (1997)
What is the cognitive protocol for depression?
To monitor NATs
Recognise connections between cognition, affect and behaviour
Examine evidence for/against distorted automatic thoughts and substitute with more reality-orientated interpretations
Learn to identify and alter own dysfunctional beliefs which predispose person to distort experiences
When are behavioural techniques used for depression?
With more severely depressed people
Outline behavioural protocol for the more severely depressed.
Change behaviour to restore functioning to pre-morbid level
Elicit cognition associated with specific behaviours
If a thought is conditional is it a core belief or an assumption?
Assumption
What is emotional reasoning?
Person starts to base thinking on feelings rather than evidence
What do we look for in assessment of depression?
Trigger Thoughts Behaviours Physiology Emotions Activity Listen out for what they want and any avoidance Any doubts?
Name three possible depression formulations
5-factor model (Greenberg & Padesky) 4P's+1 (Weerasekera) Vicious Flower (Moorey, 2010)
What are the petals on the Vicious Flower?
NATs Ruminations and self-attacking Mood/emotion Withdrawal and avoidance Unhelpful behaviours Motivation and physical symptoms
Outline behavioural interventions for depression.
Activity monitoring
Activity scheduling
Comparing ‘planned to do’ with ‘actually did’
Graded task assignment
What should you listen out for in graded task assignment?
Patient wants/wishes/avoidance
Outline the steps for graded task assignment.
Defining the problem
Formulating the project and stepwise assignment of tasks
Immediate/direct observations by patient
Ventilation of patient doubts
Encouraging realistic evaluation of actual performance
Emphasis on reaching of goal
Devising new/more complex assignments with patient
What is the aim of a behavioural experiment?
Find out what happens - NOT testing a hypothesis.
