Lecture 2/3: Depression and the Rise of Cognitive – Behavioural Therapy

Question 1

What broader category is depression apart of?

Answer 1

Mood Disorders

Question 2

What are the main features of depression?

Answer 2

Sadness, discouragement, pessimism and hopelessness

Question 3

Whats the criteria for a depression diagnosis? (DSM-5)

Answer 3

Need 5 of the major symptoms that have been present for 2 weeks at least

Question 4

List symptoms of depression (9) (DSM-5)

Answer 4

o Depressed mood
o Markedly diminished interest
o Significant weight loss/weight gain/appetite change
o Insomnia or hypersomnia
o Psychomotor agitation or retardation
o Fatigue or loss of energy
o Feelings of worthlessness or excessive guilt
o Diminished ability to think or concentrate, or indecisiveness
o Recurrent thoughts of death recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

Question 5

Criteria for persistent depression disorder (DSM-5)

Answer 5

Need two or more of the following, occurring for at least 2 years.

Question 6

List Symptoms of persistent depressive disorder (DSM-5) (6)

Answer 6

o	Poor appetite or overeating 
o	Insomnia or hypersomnia 
o	Low energy or fatigue 
o	Low self-esteem 
o	Poor concentration or difficulty making decisions 
o	Feelings of hopelessness

Question 7

What two things does depression have high comorbidity with?

Answer 7

Anxiety and chronic stress

Question 8

What is the genetic prevalence of mood disorders

Answer 8

2 to 3 times higher

Question 9

What research found stress as a causal factor?

Answer 9

Monroe and Harkness 2005 - Following stressful life events, 70% of people with a first onset suffer with depression within a short period of time after the event. 40% of people have recurrent episodes as the stress continues to be a risk factor.

Question 10

Define Chronic Stress? Give some reserach.

Answer 10

when people experience (potentially) lower levels of stress but on a very regular/daily basis (can be between work and abuse).
Hammen 2005; Monroe et al 2007 – found that chronic stress increased the risk of onset, maintenance and recurrence of major depressive disorder.

Question 11

Define Neurotic Individuals? Give a study

Answer 11

Neuroticism is a personality trait that means they are constantly aware of possible threats.
Kendler, Garnder and Prescott 2003 – Neurotic individuals are more likely to experience a broad range of negative moods, stressful life events and worse recovery prognosis. Neurotic individuals also may suffer with quite a vicious cyclical process.

Question 12

What is the diathesis-stress model - give some research

Answer 12

This theory depicts how genetic vulnerability to something interacts with stressful life events leading to something like depression (often predisposition to gene can be triggered by a certain life event).

Caspi et al, 2003 – found association between stressful life events and the probability of a major depressive episode being moderated by alleles of gene 5 – HTT

Question 13

Social Media impacts on depression - studies

Answer 13

Orben et al 2019 conducted a longitudinal study (12,000 adolescents). They found a small effect of social media use on life satisfaction (specific to female – specific).

Question 14

Behaviour Perspective - Depression

Question 15

Describe Becks cognitive theory (1967)

Answer 15

Interaction between cognitive vulnerabilities and stressful life events. Include NAT which refer to the inner dialogue deep routed in schemas and cognitive distortions. Beck believed to target depression, you target NAT

Question 16

What is abnormal behaviour according to CBT?

Answer 16

Interpretation of events (determining emotional states), distortion of thinking pattern and inaccurate or bias processing of information

Question 17

Cognitive structures according to CBT

Answer 17

NATs- specific, accessible easier to change
Schemas - general, less accessible, harder to change
In the middle was beliefs/distortions

Question 18

Describe ABC model (Ellis and Beck)

Answer 18

Activating belief - (actual event)
Beliefs - (irr/ationl evaluation)
Consequences - (NAT, behaviors, bodily sensations, emotions).

Question 19

How do you identify and challenge deeper thoughts?

Answer 19

Downward arrow technique - keep on asking ‘why, why etc’

Question 20

Contents of CBT for depression Beck et al 1979

Answer 20

10-20 sessions that help clients identify NAT and reality test. Could involve thought diaries, cognitive restructuring

Question 21

(+)Effectivness of CBT for depression: studies

Answer 21

Jarret et al 1999 - over a 10 week trial, CBT was more effective compared to medication
Hollon et al 2005 - analysed relapse and recurrence of depression and fonf CBT led to less of both comapred to medication and placebo.

Question 22

(-) effectiveness studies

Answer 22

Weitz et al 2015 - meta analysis suggesting anti depressents are more effective than CBT
Teasdale 1987/2000 - those recovered have lower threshold for negative words (CBT may not be helpful for negative thoughts). Kuyken and Tsivirkos (2009) - relies on competency of therapist

Question 23

Third Wave CBT

Answer 23

Teasdale 2003 - claimed would be more effective as it focuses on changing thoughts/cog distortions

Question 24

What is MBCT

Answer 24

Mindfulness Based Cognitive therpay

Question 25

Descibe MBCT

Answer 25

distancing from thoughts by noticing out thoughts in a non-judgmental/evaluative way (not attributing meaning/appraisals to the thoughts).

Question 26

Mindfulness meditation

Answer 26

Mindfulness is a skill everyone could use. It is increasing the awareness of the here and now and helps to decentre from thoughts.

Question 27

Effectiveness of MBCT

Answer 27

Teasdale et al 2000 compared the relapse/recurrence of depression between those who are having treatment as usual and MBCT (this was 4-8 weekly group sessions). Those who received mindfulness are less likely to relapse over time and worked well for those with high recurrence rates.