Psychopathology- depression Flashcards
What are the four depressive disorders ?
- major depressive disorders (MDD) severe but often long term
- persistent depressive disorder - long term or recurring depression including sustained major depression and dysthymia
- disruptive mood disregulation disorder - childhood temper tantrums
- premenstrual dysphoric disorder - distruptrion to mood prior to and or during menstruation
What are the 3 behavioural characteristics for depression
Shift in activity levels- lethargic - reduced or heightened levels of anxiety also called psychomotor agitation
Disruption in sleep and eating behaviour - reduced sleep insomnia, increased need hypersonic . Eating may increase or decrease
Aggression and self harm - verbal and physical
What are emotional characteristics of depression
Anger - directed at others and self
Lowered self esteem - like themselves less than usual, worthlessness
Lowered mood - defining element of depression , emptiness
What are the cognitive characteristics of depression
Attending to and dwelling on negative - pay attention to negatives rather than positives in situation.
Absolutist thinking - think unfortunate situations are an absolute disaster. Black and white thinking
Poor concentration- unable to stick with a task they usually would find it hard to make decisions
What are the main points surrounding cog approach of depression
our thoughts influence our emotions which influence our behaviour
What are the two cognitive approaches to explain depression
Becks cognitive theory of depression
Ellis ABC model
What are the 3 parts of becks cognitive theory
Faulty information processing
Negative self schemas
The negative triad
Explain what is meant by faulty information processing
When depressed be pay more attention to the negative aspects of a situation, blow things out of all proportion and think in ‘black and white’ terms
Explain negative self schemas
A self schema is a package of information we have about ourselves.
Negative self schema - interpret all information about ourselves in a negative way
Explain the negative triad
Three types of negative thinking that occur automatically regardless of what is happening
- negative views of the world- no hope anywhere
- negative views of the future - reduces hopefulness and enhances depression
- negative views of the self - confirm low self esteem, enhance existing depressive feelings
Outline Ellis’ ABC model
Depression is the result of irrational thoughts.
Not illogical or unrealistic but interfere with us being happy and free of pain
A- activating event -> some negative event we experience
B- irrational beliefs triggered by activating event.
Eg musterbation- ability we must always succeed
I-can’t-stand-it-itis - major disaster when something goes wrong utopionism-life meant to be fair
C- consequences, emotional and behavioural - depression
What is a strength of beck theory (good research evidence)
Strength - good supporting evidence
Grazioli and terry (2000)
Assessed 65 pregnant women
For cognitive vulnerability and depression before + after birth
Women - high cognitive vulnerability = more likely to suffer post natal depression
Cognitions appear before depression , supports idea they cause depression
What is another strength of becks theory (practical applications)
It forms the basis of cognitive behavioural therapy
Components of negative triad
Easily identified and challenged
Patients can tests the reality of their cognitions
Translates well into a successful therapy
What is a limitation of becks theory ( doesn’t explain all aspects)
Doesn’t explain all aspects of depression
Depression complex
Eg Depressed patients deeply angry and some suffer hallucinations
Beck can’t explain this extreme emotion or sensation
Beck theory only explains one aspect of depression
What is a limitation of Ellis model (only partial explanation)
Only partial explanation of depression
Some cases of depression follow activating events
This is called reactive depression
Viewed as Different type of depression - compared to arises without obvious causes
Ellis explanation only applies to some kinds of depression
What is a limitation of cognitive expansion for depression
Don’t cause all types of depression
Explanation Tied up with concept of cog primacy - emotions are influenced by thoughts
Not always the case
Other theories- see emotions -> anxiety, distress stored as physical energy that emerges after event that caused them.
May be reason why link between anger and depression not clear in cognitive theories
Cognitions are not always the root cause of depression
What is CBT and what does it involve
Most common treatment to depression.
Begins with an assessment in which patient works with therapist to identify the patient’s problem.
They jointly identify goals and work to them together.
One of the central tasks is to identify where there might be negative or irrational thoughts so work can be done to challenge these thoughts and put more effective behaviours into place.
For example setting homework - use as evidence
Outline becks cog therapy
Identify negative thoughts within negative triad
Help test reality of beliefs and investigate them
‘Patient as scientist’
Set homework eg recording positive events
Used as evidence to challenge negative beliefs
Outline Ellis rational emotive behavioural therapy (REBT)
Extends ABC model to ABCDE model
Dispute and effect
Central idea is to identify and challenge irrational thoughts. Involves vigorous argument, designed to challenge irrational beliefs.
Different methods of disputing: Empirical - disputes weather there is actual evidence to support irrational belief. Logical - disputes weather irrational thoughts follow from facts.
Pragmatic- disputes the usefulness of irrational beliefs to self
What is behavioural activation
Therapists would encourage a depressed patient to be more active and and engage in activities they used to find enjoyable. This will provide more evidence for the nature of the irrational beliefs.
Outline a strength for CBT as treatment of depression
Just as effective as medicine
March et al (2007) compared the effects of CBT with antidepressant drugs and a combination of the two in 327 adolescents with a main diagnosis of depression. After 36 weeks, 81 of CBT group, 81% or antidepressant group and 86% of the combo were significantly improved. Suggests that it is just as effective as other treatments → advocate for using CBT as the first choice for public healthcare systems.
Combination should be used more - 86%
What is limitation of CBT as treatment of depression (ability questioned with severe cases of depression)
May not work for the most severe cases.
In some depression cases, the patient cannot motivate themselves to engage with the CBT work.
treat patients with antidepressants until they are more receptive to CBT
CBT can sometimes not be a standalone therapy for depression
What is another limitation of CBT (therapist/patient relationship)
Success may be due to patient/therapist relationship.
Rosenzweig (1936) suggested that differences between different psychotherapies are small. The thing they all have in common is the quality of patient-therapist relationship.
The opportunity to just talk to someone that will listen more important than therapy itself
What is another limitation of cbt (focusing on past rather than future)
Overemphasises of the importance of cog factor
Eg patient wants to explore past
Basic principles is about focusing on what happening in person mind rather environment or their past.
May be link to depression from past
Frustration in patients and hinder recovery
