Psychopathology - Cognitive approaches to Depression Flashcards

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1
Q

What are the general assumptions of the cognitive approach to depression?

A
  • argues that depression occurs due to
    maladaptive/faulty thinking & irrational beliefs
  • argues that depression can be treated by
    enabling someone to identify, challenge &
    change their thinking patterns
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2
Q

What did Ellis’ think & what is his cognitive model of depression?

A
  • depression is not just the result of unpleasant
    events in someone’s life but how they think
    about it, so different people can respond
    differently to the same situation
- ABC model of understanding people's 
  emotions;
  A = adverse event 
  B = beliefs 
  C = consequences (e.g. depressed feeling)
  • Patient has to think in more rational & realistic
    ways to treat depression
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3
Q

What are the features of Beck’s approach to depression?

A
  • Negative schema
  • Cognitive errors
  • Biased memories

(Nasty Cats Eat Bad Meat)

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4
Q

What is meant by negative schema & what role might they have in depression?

A
  • Schemas are mental representations of the
    world and knowledge
    (often developed in childhood & persist into
    adulthood)
  • these influence how we view
    events
  • If someone’s schema are negative, they will
    be more likely to suffer from depression
    • view things in a negative & pessimistic way
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5
Q

What is Beck’s negative (cognitive) triad?

A
  • 3 types of areas of negative thinking
    associated with depression
  1. Self (I am worthless)
  2. World (no-one can be trusted)
  3. Future (I will never pass)
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6
Q

What are cognitive errors (types)?

A

Types of faulty thoughts:
- Catastrophising
= assuming worst will happen

  • Applying a negative filter
    = only paying attention to negative
    information
  • Misinterpreting events in a negative way
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7
Q

What are biases in memory & how might they lead to depression?

A
  • when someone’s memories of events are
    influenced by their schema
  • someone with negative schema can be
    biased towards remembering negative events
    from their lives, finding it difficult to recall
    positive
  • negative memories can make someone’s
    mood worse, causing a Vicious Cycle
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8
Q

Strengths of the cognitive approach to depression

A
  • Supporting evidence & hypotheses that can
    be scientifically tested
  • effective cognitive treatments (CBT)
    • enhances validity of underlying theory
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9
Q

Evidence for memory biases

A

Clark & Teasdale: Memories
- patients with worse depressed mood in the
morning had more negative memories in the
morning than the evening

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10
Q

Evidence that negative thinking increases vulnerability to depression

A

Lewinsohn
- longitudinal study showing adolescents with
negative attitudes at the start & had
experienced negative life events were most
likely to suffer from depression a year later

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11
Q

Evidence that treatments which change negative thinking are effective in reducing depression

A

Appleby: Postnatal depression
- CBT just as effective at reducing symptoms of
depression than antidepressant medication
- more effective than placebo

Hollon
- CBT has more enduring long term
effectiveness compared to medication

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12
Q

Weaknesses of the cognitive approach to depression

A
  • sometimes thinking is NOT unrealistically
    negative (e.g. bereavement, illness)
  • Biological factors are not taken into account
    (doesn’t provide complete understanding)
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13
Q

Evidence that we may inherit a vulnerability to depression

A

McGuffin: Twins
- higher concordance rate for identical twins
than non identical
- neither 100% concordant so environment;
factors must also be involved

+ evidence that abnormalities in
neurotransmitters are involved in depression
(e.g. serotonin)

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14
Q

What is the aim & process of Cognitive Behaviour Therapy?

A

Aim: To challenge dysfunctional thinking

2 important steps:

  1. Identify the distorted thinking
  2. Challenge the distorted thinking
  • focuses on problems here & now, not past
  • usually lasts between 5 & 20 sessions
  • patient & therapist work collaboratively
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15
Q

How might distorted thinking be identified in CBT?

A
  • using a thought diary (noting mood, thoughts
    & surrounding events)
  • assessment of thoughts in sessions (therapist
    asking questions at times where patient feels
    anxious e.g.”what’s going through your mind”)
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16
Q

What is socratic questioning?

A
  • involved in challenging thinking
  • therapist asks a series of questions to help
    patient discover new ways of thinking and
    realise for themselves that their depressed
    thinking is distorted/maladaptive
17
Q

What is collaborative empiricism?

A
  • involved in challenging thinking
  • Patient & therapist collaborate (work
    together) to challenge distorted thinking in a
    scientific way
  • involves patient gathering evidence, think of
    hypotheses based on that & testing those
    hypotheses
18
Q

Why might CBT be appropriate for depression?

A
  • relatively straightforward, makes sense &
    appears sensible & acceptable to patients
  • time limited (5-20 sessions, 1 per week)
  • may be more cost EFFECTIVE in the long
    term than antidepressants (not cheaper)
19
Q

Why might CBT be inappropriate for depression?

A
  • sometimes lives realistically difficult,
    impossible & inappropriate to alter thinking
  • may not be suitable for people with limited
    verbal skills
  • not suitable for those with sever depression &
    no motivation (medication may be needed
    before engaging in CBT)
  • sensitive issue - can give patients the
    impression that they are to blame & are being
    ‘irrational’