Paper 2 Terms: Psychological Treatment of Depression

Question 1

Cognitive Behavioral Therapy

Answer 1

• The underlying cause of depression is maladaptive automatic thoughts that lead to irrational behavior.
• Focuses on specific, well-defined problems.
• Patients are expected to be active and given home assignments, which are then discussed or graded.
• The sessions last about an hour and include checking on the patient’s mood and symptoms, setting a clear agenda, reviewing and evaluating the homework assignment, discussing issues, and setting new homework.
• Lasts for 14-16 months.

Question 2

Socratic Questioning

Answer 2

The therapist uses a series of questions that gradually lead the client to the realization that their beliefs are not rational or supported by evidence.

Question 3

Behavioral Experiments

Answer 3

Techniques designed to counteract maladaptive beliefs.

Question 4

Thought Records

Answer 4

Challenge irrational or unrealistic thoughts.

Question 5

Situation Exposure Hierarchies

Answer 5

The patient lists the most stressful situations or behaviors.

Question 6

Pleasant Activity Scheduling

Answer 6

The patient agrees to do one pleasant activity every day, something they don’t usually do but that brings positive emotions or a sense of competence/mastery.

Question 7

DeRubies et al. (2005)

Answer 7

CBT can be as effective as medication for the treatment of moderate to severe depression, but the exact degree of effectiveness depends on a therapist’s skill and experience.

Question 8

Fournier et al. (2013)

Answer 8

• Medication is more effective than CBT at first, but eventually, after 1-8 weeks, CBT “catches up.”
• CBT seems effective in the short term, but is it an enduring effect?

Question 9

Hollon et al. (2005)

Answer 9

• Compared relapse after halting antidepressants versus CBT.
• Patients withdrawn from CBT were less likely (36%) to relapse than patients withdrawn from medication (76%).
• CBT has an enduring effect, and drugs are good for reducing symptoms but do not target the cause of the disorder.

Question 10

Goldapple et al. (2004)

Answer 10

• PET scans examined changes in the brain underlying the response to CBT compared to antidepressant treatment.
• CBT caused significant metabolic changes in the brain, and the pattern of these changes was distinct from that of patients who responded to medication.
• CBT was associated with more changes in the cortex, whereas antidepressants were associated with changes in the brainstem.