Depression

Question 1

What are the key features of unipolar depression?

Answer 1

5 or more of the following over the same 2 week period:

1. Depressed mood most of the day, nearly every day
2. Diminished interest/pleasure
3. Weight loss/gain
4. Insomnia/hypersomnia
5. Psychomotor retardation/agitation
6. Fatigue/loss of energy
7. Worthlessness/guilt
8. Concentration issues/indecisiveness
9. Recurrent thoughts of death/suicide ideation/plan/attempt

Question 2

What are the differences between MDD and PDD?

Answer 2

• PDD is a longer lasting, less severe form of depression.
• PDD lasts at least 2 years
• Never without symptoms for more than 2 months at a time.
• Fewer criteria:
  
  • Depressed mood more days than not + 2 or more of the following:
  • Poor appetite/overeating
• Insomnia/hypersomnia
• Low energy/fatigue
• Low self-esteem
• Poor concentration/indecisiveness
• Hopelessness

Question 3

What are the early behavioural models of depression?

Answer 3

• Lazarus (1968): “inadequate or insufficient (social)
  reinforcement”
• Rehm (1977): Self-control theory of depression:
  problems with giving sufficient reward – self
  monitoring/evaluation (active process of selective
  perception and encoding into memory) - evidence that
  people who are depressed/non depressed differentially
  reward and punish themselves
• Learned helplessness (Seligman, 1974,5): outcomes to
  uncontrollable aversive events: 1. Motivational deficits; 2.Cognitive deficits; 3. Emotional changes. ->
  Reformulated in attributional theory terms

Question 4

What is the stress-diathesis model of depression?

Answer 4

• Vulnerabilities/predispositions to developing
  depression (diatheses) – biological and psychological
  factors.
• An individual’s diatheses interact with stressful life
  events to prompt the onset of depression.
• Stressors may include grief and loss related to death,
  loss of job, relationship difficulties/breakup, life
  transitions (marriage, retirement, puberty),
  neurochemical and hormonal imbalances and
  drug/alcohol abuse.

Question 5

What is the attributional reformulation of depression (from Seligman, 1981)?

Answer 5

Expectation that highly aversive state of affairs is likely (of highly desired state is unlikely) –>

Expectation that will be able to do nothing to influence this –>

Attributional style: negative events attributed to internal, stable, global causes; positive events to external, unstable and specific causes –>

Greater expected aversive state of affairs and expected
uncontrollability – greater strength of motivational and
cognitive deficits

Question 6

What are the key elements of Beck’s cognitive theory of depression?

Answer 6

1. Negative automatic thoughts: out of the blue,
   immediate, unchallenged by the person that disrupt
   mood leading to downward spiral effect.
2. Cognitive Triad - negative thoughts about self, the world, the future
3. Systematic logical errors/cognitive biases - selective abstraction, minimisation/magnification, overgeneralisation, black and white thinking etc
4. Depressogenic schemas: general, long-lasting
   attitudes or assumptions about the world – influence
   how the person organizes their past, present
   experiences and future hopes/opportunities.

Question 7

What are some examples of depressogenic schemas?

Answer 7

* Dependency Social
isolation/alienation
• Defectiveness
• Incompetency/failure
• Shame/embarrassment
• Unrelenting standards
• Entitlement
• Subjugation
• Vulnerability to harm or
illness
• Fear of losing self
control
• Emotional deprivation
• Abandonment/loss
• Mistrust

Question 8

What are the maintaining factors of depression?

Answer 8

• Negative automatic thoughts

* Behavioural inactivity leading to loss of rewards from the environment

Question 9

What are the risk factors for depression?

Answer 9

• Neuroticism
• Negative childhood experiences
• Heritability