Depression

Question 1

Who gets depressed?

Answer 1

10-25% women; 5-12% men; 18-44 year olds

Question 2

What is depression generally thought to be about?

Answer 2

Loss to domain

Question 3

What are the cognitive themes in depression as defined by Beck (1979)?

Answer 3

Actual Loss
Perceived Loss
Hopelessness
Helplessness

Question 4

Who defined the cognitive themes in depression?

Answer 4

Beck (1979)

Question 5

Of what does the negative cognitive triad consist?

Answer 5

Negative views of the self, world and others.

Question 6

From where do core beliefs develop?

Answer 6

Childhood

Question 7

What are the characteristics of core beliefs?

Answer 7

They are absolute and unconditional - ‘I am…’, ‘The world is…, ‘Others are…’

Question 8

What are dysfunctional assumptions?

Answer 8

Conditions which must be met for a person to have an agreed sense of self.

Question 9

What words let you know that it’s an assumption?

Answer 9

Should, must, ought, if… then…,

Question 10

What are cognitive biases the same as?

Answer 10

Negative automatic thoughts

Question 11

Outline Beck’s model of emotional disorders.

Answer 11

Early experiences -> Formation of conditional and unconditional beliefs -> Critical incident -> Beliefs activated -> Automatic Thoughts

Question 12

Who recommends CBT for depression?

Answer 12

NICE; DeRubris et al. (1999); Williams et al. (1997)

Question 13

What is the cognitive protocol for depression?

Answer 13

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

Question 14

When are behavioural techniques used for depression?

Answer 14

With more severely depressed people

Question 15

Outline behavioural protocol for the more severely depressed.

Answer 15

Change behaviour to restore functioning to pre-morbid level

Elicit cognition associated with specific behaviours

Question 16

If a thought is conditional is it a core belief or an assumption?

Answer 16

Assumption

Question 17

What is emotional reasoning?

Answer 17

Person starts to base thinking on feelings rather than evidence

Question 18

What do we look for in assessment of depression?

Answer 18

Trigger 
Thoughts
Behaviours
Physiology
Emotions
Activity
Listen out for what they want and any avoidance
Any doubts?

Question 19

Name three possible depression formulations

Answer 19

5-factor model (Greenberg & Padesky)
4P's+1 (Weerasekera)
Vicious Flower (Moorey, 2010)

Question 20

What are the petals on the Vicious Flower?

Answer 20

NATs
Ruminations and self-attacking
Mood/emotion
Withdrawal and avoidance
Unhelpful behaviours
Motivation and physical symptoms

Question 21

Outline behavioural interventions for depression.

Answer 21

Activity monitoring
Activity scheduling
Comparing ‘planned to do’ with ‘actually did’
Graded task assignment

Question 22

What should you listen out for in graded task assignment?

Answer 22

Patient wants/wishes/avoidance

Question 23

Outline the steps for graded task assignment.

Answer 23

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

Question 24

What is the aim of a behavioural experiment?

Answer 24

Find out what happens - NOT testing a hypothesis.