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MAPD 1 > L2: Models of Depression > Flashcards

L2: Models of Depression Flashcards

1
Q

What are the main models of depression?

A
  • Becks cognitive model
  • williams theory of anxiety and depression
  • lemoults cognitive perspective
  • seligmans reformulated helplessness theory
  • hopelessness theory
  • diathesis stress model
  • general model
  • relapse of depression
  • network perspective of depression
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2
Q

how did becks view on cognition change?

A

first he thought cognition caused emotion, but then saw cognition as part of a complex interaction of biological psychological, and social factors

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3
Q

what are the 2 main components of becks cognitiv emodel?

A

cognitive structures underlying emotional disorders and cognitive processes in their onset and maintenance.

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4
Q

What does Beck’s cognitive model look like?

A

(early) learning experiences -> dysfunctional schemata and core beliefs -> activated by critical incident -> maladtipve beliefs/assumptions -> negative automatic thoughts -> depression

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5
Q

what are some common dysfunctional schemata & core beliefs in depression?

A

that you are unlovable
negative cognitive triad about self, world, and future

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6
Q

what does becks cognitive therapy focus on?

A

negative automatic thoughts generated by dysfunctional schemas and logical distortions in thinking.

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7
Q

what does Clarks adaptation of cognitive involve?

A

panic disorder
involves clients tendency to catastrophically misinterpret internal sensations, leading to hypervigilance and avoidance behaviors
-> treatement based on this model

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8
Q

what are some criticisms on clarks adaptation on the cognitive model?

A

con: too focused on a single level of represenetation, suggesting need for higher level representations (not just cognitive), still unclear why individuals differ in their interpretations of threat/sensation
pro: offer a new understanding of panic & anxiety

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9
Q

What are some ccommon maladaptie beliefs/assumptions seen in depression?

A

“If I am not approved by everyone, then I am not worthwhile”
- other Cognitive errors such as overgeneralization, selective abstraction, personalisation, dichotomous thinking, magnification & minimalization and arbitrary inference

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10
Q

what is personalization in depression?

A

blaming one’s self for unwanted external events, when in fact they may have other causes.

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11
Q

what is magnification & minimization in depression?

A

“making a mountain out of a molehill” when unwanted events take place, and to do the opposite when positive events occur

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12
Q

what is arbitrary inference?

A

reaching a conclusion that is not supported or may be disconfirmed by evidence

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13
Q

what is overgeneralization in depression?

A

mistakenly inferring broad general conclusions from isolated unwanted events

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14
Q

what is selective abstraction in depression?

A

taking a detail out of context allowing it to determine your conclusions while ignoring all other explanations

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15
Q

what is dichotomous thinking in depression?

A

thinking in “black and white” terms rather than “shades of gray.” As a result, any experience that is not a complete success is a complete failure.

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16
Q

what is the (loss of) cognitive control symptom in depression?

A

not being able to inhibit, update, and shift appropriately (start to ruminate etc.)
- diminished ability to think or concentrate
- difficulties making decisions
- especially when there is no clear assignment (when u have nothing to do)
- when there is much possibility of ruminating and thinking about personal matters
- many forms of emotional regulation require these skills

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17
Q

What is inhibition?

A

working memory
- holding/manipulating information, regulating attention
- inhibition = “pushing away” irrelevant info

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18
Q

what does the (loss of) cognitive control lead to according to lemoult?

A

cognitive biases & loss of cognitive emotion regulation

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19
Q

what are the 4 cognitive biases in Lemoult cognitive perspective on depression?

A
  • self referential processing bias
  • attention
  • interpretation
  • memory
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20
Q

what is the self referential processing bias?

A

associate self more w underlying negative schemas

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21
Q

what is the attention bias in depression?

A

Selective attention to negative (mood congruent) stimuli
Only for relatively long presentation time
disengagement more effort

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22
Q

what prompted williams to make his model on anxiety & depression?

A

the failure to find global biases in emotional disorders led to him to propose a model in which cognitive biases were specific to specific emotional disorders

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23
Q

what is priming vs elaboration?

A

priming: an automatic stage of processing in which the stimulus may be linked with its representation in long term memory
elaboration: subsequent strategic or resource-demanding processes

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24
Q

what does williams model of anxiety and depression say?

A

anxiety: initial priming/automatic processes are biased TOWARDS the detection of threat (ie individual w dog phobia will automatically process a stimulus as if it was a dog, while someone else might just see it as a four legged table. aka the preattentive processes become “tuned” to detect personally significant simuli) , subsequent elaboration are biased AWAY from the processing of threat (so remember things related to the phobia less)
depression: elaboration biased towards negative things (shown in mnemonic tasks)

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25
Q

why are there doubts about williams model?

A

cus studying attentional biases is hard and often the material used is not personally relevant enough

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26
Q

What did Williams say in his paper on memory and its relation to depression?

A
  • overgeneral memory: difficulty in voluntarily retrieving specific autobiographical memories
  • also in other mood disorder, but not in anxiety or other disorders
  • mood congruent recall: better recall negative events (autobiographical memory test AMT)
  • delayed retrieval of positive memories rather than speeded retreival of negative memories
  • inappropriate retreival strategies that yielded general rather than specific memoreis results in ineffective problem solving skills
  • limits the ability to repair negative mood (relayed recovery, problems in imagining specific future events: diffculty seeing that things may get better)
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27
Q

what were the clinical implications of williams findings on memory x depression?

A
  • training of focusing on specific elements
  • learning to accept negative emotions
  • mindfullness based CT
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28
Q

how did seligman come up with his learned helplessness theory?

A

lab work with dogs
dogs were placed in a shuttle box designed so dog could sometimes move from one side to the other, and sometimes a barrier would go up
-> found that if dogs experienced inescapable shock for number of trials they failed to escape from subsequent shocks even when it was possible to do so
-> learned helplessness, could also account for human conditions like depression?

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29
Q

how did seligman think that learned helplessness theory applied to depression in humans?

A

thought that people who experienced continious non-contingent (unconditional) positive reinforcement throughout childhood could then start to see the worlm in an uncontrollable way even tho in reality control over reinforcement may be possible. become passive.

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30
Q

what were some issues with seligmans original learned helplessness theory?

A
  • empirical failures (students did not become helpless)
  • there were features of depression for which the original theory provided no account (ie the self esteem deficit is not predictable from the experience of unconditional rewards in childhood (which leads to helplessness in adulthood))
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31
Q

what was the reformulated helplessness theory

A

seligman theory + weiners attribution theory
so helplessness still seen to arise from the perception of uncontrollability, the effects were now seen to depend both on type & importance of the event experienced, together w the explanation that the individual produced for the cause of the vent

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32
Q

what was identified to be a vulnerability factor for depression in the reformulated helplessness theory?

A

when ppl make
- internal-stable-global attribution for the cause of negative events (ie due to my personality)
- external-unstable-specific attributions for the cause of positive events (ie due to luck)

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33
Q

how is the support for the reformulated helplessness theory

A
  • mixed support (depends on type of study)
  • weak evidence for a pre existing negative attributional style in individuals prone to depression
  • implicit attributions might not be detected by studies
  • mixed evidence for proposed external-specific-unstable depressive style for positive events
  • theorys excessive focus on causes of events neglects other factors (like consequences & coping mechanisms)
  • Real-world events may override an individual’s characteristic attributional style, affecting their emotional response
  • links between attributional style and emotion may be weakly correlational rather than causal
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34
Q

how did the hopeless theory come about?

A

from the reformulated learned helplessness theory + becks cognitive therapy framework
cus there were problems with the first

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35
Q

how is the hopelessness theory different from the helplessness theory?

A
  • requires only occurrence of negative events, not necessarily uncontrollable ones, unlike learned helplessness theory.
  • emphasis on perceived negativity rather than lack of control
36
Q

what does hopelessness theory say?

A

depressed individuals may blame themselves for events without perceiving them as uncontrollable

37
Q

what is empirical support for hopelessness theory like?

A
  • Some empirical support exists - but it’s been further restricted to apply only to “hopelessness depression.”
  • Support for the role of hopelessness primarily comes from the cognitive therapy literature
38
Q

What is rumination?

A
  • Thinking repetively and passively
  • Relation with onset of depressive episodes
  • Rumination common to depression, GAD, social anxiety, PTSD, and EDs
  • Mediates differences between sexes
  • Prolonged emotional response to stress
  • Poor problem solving behavior
  • Higher levels of social exclusion & victimization
  • plays role in inhibiting negative information & updating info in working memory
39
Q

what are the clinical implications of findings on rumination ?

A
  • change (core) beliefs in cognitive therapy & CBT
  • challenging these thoughts: what is the evidence
  • replacing these thoughts
40
Q

Why do people recover (spontaneously) from depression and why do they often relapse?

A
  • latent processes: some processes have an inactive (latent) state but can me more easily activated by events in vulnerable individuals
  • diathesis stress model
  • cognitive vulnerability if youve been depressed before
  • cognitive reactivity
  • differential activation hypothesis
  • network model (its all related)
41
Q

what does the diathesis stress model say?

A

vulnerability (genetics) + stress = depression

42
Q

what is the differential activation hypothesis?

A

vulnerability does not reside in a dysfunctional attitude per se, but rather in the relative ease with which they are activated in the presence of mild negatvei mood (“dip”)

43
Q

define appraisal

A

value assessment good for me vs bad for me)

44
Q

define schema

A

Mental structure of preconceived ideas about a particular aspect, including features of this concept and the relationships of these features. Holistic and associative. Often not conscious.

45
Q

what was Bowers view on depression?

A
  • cognition is influenced by an interconnected network of nodes
  • Activation of single node partially activates adjacent nodes, resulting in spreading of activation and a processing advantage for related stimuli.
  • argued for persistence of biased cognition beyond the depressive episode
46
Q

What are some deficits observed in executive functioning in depression?

A

Deficits in updating, shifting, and inhibition are observed in executive functioning in depression.

47
Q

When are deficits in working memory observed in depression? why?

A
  • when attention is not constrained by the task
  • opportunity to ruminate
48
Q

Are deficits in processing speed consistent in depression?

A

No, deficits in processing speed are inconsistent and task-dependent in depression.

49
Q

When are deficits in processing speed more likely to be observed in depressed individuals?

A

during current depressive episodes (rather than during periods of remission)

50
Q

what are the most common cognitive biases ppl w depression suffer from?

A
  • biased self referential processing (rumination, more focus on self)
  • attentional biases (more attention to negative things)
  • interpretation bias (interpret ambiguous info as negative)
  • memory bias (more recall for negative info)
51
Q

What is the role of cognitive control in working memory?

A

manages entry and removal of info

52
Q

How do depressed individuals differ in cognitive control compared to healthy individuals?

A

struggle w inhibiting negative info from entering working memory and have difficulty updating or removing negative info once it’s there.

53
Q

What tasks have been used to assess inhibition and updating in depressed individuals?

A
  • inhibition: negative affective priming task
  • updating: , tasks like the affective Sternberg task and directed forgetting task
54
Q

What are the consequences of impaired cognitive control in depression?

A

Impaired cognitive control is associated with rumination and heightened reactivity to stress

55
Q

What is self-referential processing and how is it measured?

A
  • reflects individuals’ underlying negative cognitive schemas
  • measured using tasks like self-referential encoding task (SRET), where participants judge whether emotional adjectives describe them.
56
Q

How do depressed individuals differ in self-referential processing compared to healthy individuals? specifically

A

exhibit more negative self-referential biases, endorsing more negative and fewer positive adjectives, responding more quickly to negative adjectives, and recalling more negative adjectives.

57
Q

What are the consequences of negatively biased self-referential processing in depression?

A

more severe and longer-lasting course of depression

58
Q

What do studies show about self-referential processing in at-risk and formerly depressed individuals?

A

At-risk individuals and those with a history of depression also exhibit negative self-referential biases, which can be primed by negative mood states and predict episode relapse.

59
Q

How have researchers traditionally assessed attentional biases in depression?

A

using tasks like
- emotional Stroop task: infers biases from response latencies
- dot-probe task: measures reaction times to locate a dot behind emotional stimuli.

60
Q

What are the findings regarding attentional biases in depression using the emotional stroop task & dot probe tasks?

A
  • emotional Stroop task: mixed results
  • dot-probe task: depressed individuals have difficulty disengaging from negative stimuli, especially when presented for longer durations or when using faces as stimuli.
61
Q

What is the limitation of the dot-probe task in assessing attentional biases?

A

lacks precision in differentiating initial orienting from subsequent disengagement, as it only assesses attention at one point in time on each trial.

62
Q

How have researchers attempted to overcome the limitation of the dot probe task?

A

Some turned to eye-tracking technology, which provides data on initial engagement and the speed of disengagement from stimuli.

63
Q

What are the implications of memory and attentional biases in depression for interventions?

A

Cognitive Bias Modification (CBM) studies have shown promise in modifying attentional biases, particularly with multiple training sessions using dot-probe tasks, especially in individuals with less severe depressive symptoms or adolescents at risk for depression.

64
Q

What challenges remain in understanding and addressing attentional biases in depression?

A
  • little evidence of transfer of training
  • little consistency in results
65
Q

Are negative interpretation biases exclusive to depressive episodes?

A

No, negative interpretation biases have been found in individuals at risk for depression and even in euthymic individuals with a history of depression, especially under high cognitive load.

66
Q

What challenges have researchers faced in studying interpretation biases?

A

reliance on reaction times as the dependent variable, which may not be sensitive to cognitive processing in depression

67
Q

How do interpretation biases relate to social interactions?

A

Difficulty accurately identifying subtle expressions of emotion may hinder effective interpersonal interactions, potentially contributing to deficits in social skills and interpersonal interactions observed in depression.

68
Q

What is the effectiveness of Cognitive Bias Modification (CBM) in altering interpretation biases?

A
  • positive interpretation biases can be trained through one or two sessions
  • but evidence of transfer of training to other tasks remains inconsistent.
69
Q

what are the memory biases in depression?

A

mood-congruent biases in memory, aka preference for recalling negative info over neutral / positive info

70
Q

How are memory biases typically assessed in research?

A

usually by researchers explicitly assessing memory, by overtly asking participants to recall previously encoded information.

71
Q

What is the nature of memory biases in depression regarding positive stimuli?

A

depressed individuals fail to show preferential encoding of positive information, unlike healthy controls who do exhibit this bias.

72
Q

Are memory biases limited to explicit memory in depression?

A

No, there is also evidence of implicit memory biases in depression, where depressed individuals exhibit preferential recall or recognition of negative versus positive information, even in the absence of conscious thought or intentional effort.

73
Q

What are cognitive emotion regulation strategies, and why are they important in understanding depression?

A

thoughts ppl have following an emotion-eliciting event to cope with or influence the resulting emotional response. Understanding these strategies is crucial for comprehending depression, as they are associated with depressive symptoms and cognitive biases.

74
Q

How is rumination defined, and what are its effects on depression?

A

Rumination is repetitively and passively thinking about negative mood states or their causes and consequences. It is associated with higher levels of depressive symptoms, predicts the onset of depressive episodes, and mediates sex differences in depression prevalence, with females more likely to ruminate than males.

75
Q

Is distraction considered an adaptive or maladaptive emotion regulation strategy in depression?

A
  • adaptive
  • can reduce subjective and objective markers of distress in depressed individuals.
  • However, its benefits may be limited to the short term, and some researchers suggest it could be maladaptive in the long run due to its association with avoidance-related coping strategies and depression.
76
Q

What is reappraisal, and how does it relate to depression?

A

reinterpreting the meaning or interpretation of an emotion-eliciting situation to modify the emotional experience.
Depressed individuals report using reappraisal less frequently than non-depressed individuals.
However, when induced to reappraise in the laboratory, depressed participants show improvements in negative mood similar to healthy controls.

77
Q

How do cognitive emotion regulation strategies relate to cognitive biases?

A

Rumination is associated with difficulties in cognitive control, including inhibiting negative information and updating working memory.
Reappraisal may be undermined by difficulty shifting and updating negative information in working memory.
Distraction’s association with cognitive biases is less clear but may be related to its interference with insight into problems and its potential to distract from negative stimuli.

78
Q

What role do cognitive emotion regulation strategies play in depression, according to recent research?

A

rumination contributes to onset and maintenance of depressive episodes, while reappraisal and, to a lesser extent, distraction, are more adaptive strategies that facilitate stress recovery.
this shows importance of considering cognitive emotion regulation strategies in cognitive models of depression.

79
Q

What is the response styles theory of rumination, and how does it explain depression?

A

The response styles theory posits that certain response styles, particularly rumination, exacerbate depressed mood and negative cognition by passively and repetitively “recycling” negative thoughts. Rumination is associated with higher levels of depressive symptoms and increased onset of depressive episodes, and sex differences in depression prevalence are attributed to differences in rumination

80
Q

How do recent models of depression incorporate deficits in cognitive control?

A

Recent models, such as Joormann’s model, suggest that deficits in cognitive control are central to both cognitive biases and cognitive emotion regulation strategies in depression.

81
Q

What is the current remission rate for individuals treated for Major Depressive Disorder (MDD)?

A

fewer than 40% of individuals treated for MDD achieve symptom remission with initial treatment.

82
Q

How does Cognitive Behavior Therapy (CBT) affect cognitive biases and emotion regulation strategies in depression?

A

CBT associated w
- improved cognitive biases and emotion regulation strategies in depression
- reduced attentional and interpretation and control biases
- increased use of reappraisal, which mediates its effect on symptoms, and it also reduces rumination.

83
Q

What are some alternative or extended therapeutic approaches to CBT for depression, and what evidence supports their efficacy?

A

Mindfulness-based cognitive therapy (MBCT) combines psychoeducation about depression, mindfulness meditation practices, and cognitive-behavioral strategies. Several randomized trials have demonstrated reductions in depressive symptoms and relapse rates following MBCT.
Emotion regulation therapy (ERT) integrates components of CBT, acceptance, mindfulness, and experiential, emotion-focused techniques, showing efficacy in improving symptom severity, quality of life, and cognitive reappraisal.

84
Q

How have researchers adapted CBT to target specific cognitive processes related to depression?

A
  • developed targeted interventions
  • like rumination-focused CBT
  • these interventions have shown significant reductions in symptoms and remission rates, mediated by reductions in rumination.
85
Q

how would you test if an emotional/cognitive process is causally related to an anxious/depressed behaviour?

A

do an experiment where you induce the process in half of the participants and not the other half and then test them on the behaviour

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