Psychopathology- depression

Question 1

What are the four depressive disorders ?

Answer 1

• 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

Question 2

What are the 3 behavioural characteristics for depression

Answer 2

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

Question 3

What are emotional characteristics of depression

Answer 3

Anger - directed at others and self
Lowered self esteem - like themselves less than usual, worthlessness
Lowered mood - defining element of depression , emptiness

Question 4

What are the cognitive characteristics of depression

Answer 4

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

Question 5

What are the main points surrounding cog approach of depression

Answer 5

our thoughts influence our emotions which influence our behaviour

Question 6

What are the two cognitive approaches to explain depression

Answer 6

Becks cognitive theory of depression

Ellis ABC model

Question 7

What are the 3 parts of becks cognitive theory

Answer 7

Faulty information processing
Negative self schemas
The negative triad

Question 8

Explain what is meant by faulty information processing

Answer 8

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

Question 9

Explain negative self schemas

Answer 9

A self schema is a package of information we have about ourselves.

Negative self schema - interpret all information about ourselves in a negative way

Question 10

Explain the negative triad

Answer 10

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

Question 11

Outline Ellis’ ABC model

Answer 11

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

Question 12

What is a strength of beck theory (good research evidence)

Answer 12

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

Question 13

What is another strength of becks theory (practical applications)

Answer 13

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

Question 14

What is a limitation of becks theory ( doesn’t explain all aspects)

Answer 14

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

Question 15

What is a limitation of Ellis model (only partial explanation)

Answer 15

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

Question 16

What is a limitation of cognitive expansion for depression

Don’t cause all types of depression

Answer 16

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

Question 17

What is CBT and what does it involve

Answer 17

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

Question 18

Outline becks cog therapy

Answer 18

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

Question 19

Outline Ellis rational emotive behavioural therapy (REBT)

Answer 19

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

Question 20

What is behavioural activation

Answer 20

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.

Question 21

Outline a strength for CBT as treatment of depression

Answer 21

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%

Question 22

What is limitation of CBT as treatment of depression (ability questioned with severe cases of depression)

Answer 22

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

Question 23

What is another limitation of CBT (therapist/patient relationship)

Answer 23

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

Question 24

What is another limitation of cbt (focusing on past rather than future)

Answer 24

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