Depression: Cognition and Treatment Flashcards
What is the hopelessness theory?
People with depression make attributions that are internal, stable, and global (ISG).
What is an internal attribution?
Believe they are responsible for the bad thing.
What is a stable attribution?
This reason they are responsible for bad thing does not change.
What is a global attribution?
This reason they are responsible for bad thing applies to everything.
How do people who fall into the hopelessness attribution react to when good things happen?
Attributions are external, unstable, specific.
What is Beck’s Theory of Depression?
People with depression, or risk of, make negative interpretations of life events because they have information processing biases. They have negative automatic thoughts about self, world, and future.
Do negative automatic thoughts grow with children?
Yes. This cognitive style is more prominent in older children, suggesting role of cognitive development.
What is cognitive behavioral treatment (CBT)?
12-20 sessions in research, longer in real world. Focus on identifying negative automatic thoughts and changing them, adding in behaviors which provide feelings of pleasure and accomplishment.
Does CBT make negative thoughts happier ones?
No. It is about changing perspectives and creating more balance and less distorted thoughts.
Do SSRIs work?
Many SSRIs not approved for youth for 2 reasons:
1. Studies do not show efficacy
2. Blackbox warning
4% of adolescents taking SSRIs report suicidal thoughts compared to about 2% who took placebo.
What is the design for Study 1: Treatment for Adolescents with Depression Study?
A randomized controlled trial comparing fluoxetine (SSRI) alone, CBT alone, Combination therapy (fluoxetine + CBT), and Placebo.
What are the results for Study 1: TADS?
Speed of improvement: Prozac accelerated symptom reduction compared to CBT at 12 weeks. Long-term parity: By week 36, response rates equalized across active treatments. Teens taking ONLY prozac were far more likely to have a suicidal event than teens in CBT.
What is the conclusion for Study 1: TADS?
Combination treatment is best.
What is the conclusion for Study 2: Extended Treatment Duration and Relapse Prevention?
While antidepressants accelerate biological recovery, psychotherapy provides essential protection against relapse and treatment-emergent risks.
How do these treatments work neurally? fMRI studies in SSRIs?
Show reduced limbic system activation= regulating emotions, motivation, behavior, and memory.
How do these treatments work neurally? fMRI studies in CBT?
Shows changes in the frontal lobe activation= motor control, planning, decision-making, language, and personality.
What do the fMRI studies conclude?
SSRIs and CBT have similar end results but they achieve symptom reduction very differently.
