✅ L3 - Depression

Question 1

What is the interaction between emotions - feeling - mood

Answer 1

• Emotions: have continuous and recurring components
  -> Normal and functional
  -> Contribute to decision-making and behaviours
• Feelings: subjective experience, result from emotions
• Mood: stable and longer-lasting, more pervasive
  -> Prolonged negative emotional experiences lead to mood problems => may need treatment

Question 2

What is meant by the appraisal theory?

Answer 2

1. A theory that suggests emotions results from an individual’s appraisal of their environment and circumstances.
2. Components of appraisal theory involves:
   - motivational (readiness)
   - somatic/arousal (physiological responses)
   - motor (behaviours)
   - feeling (subjective)
   - appraisal (environment, self)
   => Emotion lays at the centre

Question 3

What are meant by mood disorders?

Answer 3

• A pervasive state: emotions that have accumulated in a time frame.
• Both positive and negative (full spectrum from low mood to elevation)
• Mood disorder: when a mood state is negative, distinctly unusual, or significantly impacting a person’s quality of life.

Question 4

What are the prevalence of depression? What are the 3 factors that contribute to the onset/maintenance of depression?

Answer 4

1. Statistics:
   - One of the most common disorders globally.
   - 5% lifetime prevalence + 10% presenting in GP (UK)
   - 300 million people across all ages suffer from depression (WHO).
   - Most common psychiatric disorder in later life: 10-15% aged 65+.
2. Three factors that contribute to the onset/maintenance of depression?
   - Biogenetic (e.g. physical health, family risk, sex/gender)
   - Psychological (e.g. trauma, coping mechanisms, gender, rumination)
   - Sociocultural (e.g. environmental factors, SES, ethnicity, gender, discrimination)

Question 5

What are the symptoms of major depression?

Answer 5

At least two weeks of:
1. Depressed mood nearly every day
2. Diminished interest or pleasure in nearly every day
3. Plus at least three symptoms:
- Appetite/weight change
- Insomnia or hypersomnia
- Fatigue or loss of energy
- Feelings of worthlessness and/or inappropriate guilt
- Diminished ability to think of concentrate
- Recurrent thoughts of death and suicide

=> Results in distress and/or functional impairment in the person’s life
=> Categorisation of depression severity: sub-syndromal -> mild -> moderate -> severe

Question 6

What are different diagnosis of depression?
(Don’t need to learn all the types of depression and what are those, just need to memorise the main four)

Answer 6

1. Major depressive episodes (characterised by certain specifiers:)
   - Anxious Distress (paired with anxious symptoms)
   - Postpartum (post-birth depression in mothers)
   - Atypical (include unusual features e.g. increased appetite)
2. Persistent Depressive Disorder (less severe than MDD, but long-lasting feeling of sadness and low mood
3. Major Depressive Disorder:
   - Seasonal affective disorder (SAD)
   - Psychotic depression
4. Other Specified Depressive Disorder:
   - Brief Recurrent
   - Short-duration depressive episode (4-13 days)
   - Depressive episode with insufficient symptoms

Question 7

What is the NICE guideline to treat depression in adults?

Answer 7

1. Principal of care:
   - build trusting relationship
   - explore treatment options
   - aware of stigma & discrimination
2. Assessment of symptoms’ severity and risks
   - validated questionnaires
   - understand history of illness & impact on function
3. Choice of treatments:
   - discuss ideas/preferences
   - recommended treatment
   - explain how treatments go

Question 8

How CBT treats depression? Give an example of a behavioural assessment of CBT?

Answer 8

1. CBT is based on the cognitive model that focuses on unhelpful thinking (appraisal) & behaviour
   - core beliefs (self and the word)
   - dysfunctional assumptions, translated into actions as coping strategies.
   - negative automatic thoughts: superficial cognitive level
2. Therapist & client work to challenge these thoughts (e.g. behavioural experiments to improve reactions)
3. Behavioural assessment includes:
   - Activity scheduling (activities that bring pleasure and/or achievement) for depressed patients
   - Exposure techniques, especially for anxious clients
   - Interpersonal skills, such as problem solving - communication - assertiveness skills
   - Emotional regulation, mindfulness or relaxation techniques
   - Improve daily life functioning (e.g. better sleeping and eating, decreasing harmful substance uses)

Question 9

How BA therapy can be used to treat depression? Give example of a typical BA therapy treatment?

Answer 9

What is BA?
- A model of depression based on learning theory
- Avoiding unpleasant thoughts, feelings or situations is a coping mechanism for depressive clients
- BA therapy: raise awareness to change this avoidance behaviour (and its consequences)
—
Example:
1. Works by targeting the behaviours that maintain depression
2. Cognitions not targeted but some ways of thinking (e.g. ruminating might be an avoidance behaviour)
3. Identify goals for clients (short and/or long term)
4. Activity scheduling (avoided activities, not just pleasant ones, social skills training, problem-solving)

Question 10

What is the importance of context in treating depression?

Answer 10

1. What is context?
   - Background to the person’s depression (can be individual contexts or living circumstances)
   - Criticism: psychological interventions don’t always consider the environment/living circumstances of the client.
2. How does context influence mood?
   - Living circumstances affect cognitive appraisal and beliefs -> affect thoughts & feelings
   - Working on intra/interpersonal problems will not impact the living environment (essential for psychologists to account)