Psychopathology - Depression Flashcards
How do you diagnose depression?
The patient must show at least five symptoms every day for two weeks
The five symptoms must include sadness or loss of interest and pleasure in normal activities
The person will show impairment in general functioning that has not been caused by other events, for example, the death of a loved one
What are the behavioural characteristics of depression?
Shifting energy levels: depressed, people might have reduced amount of energy, resulting in fatigue or lethargy. Some depressed people might have high amounts of nervous energy, where they become agitated and restless. This is called psychomotor agitation.
Social impairment: there are reduce levels of social interactions with friends and relations.
Weight changes: a significant increase or decrease in weight is associated with depression. Some people eat a great deal more and depressed and some people have reduced appetite.
Poor personal hygiene: depressed people often have reduced incidence of washing and wearing clean clothes
Sleep pattern disturbance: depression is often characterised by constant insomnia, and alternatively, they might require large amounts of sleep and might oversleep hypersomnia
Aggression and self-harm: sufferers of depression off an irritable and can become physically or verbally aggressive. They might also be physically aggressive in the form of self harming.
What are the emotional characteristics of depression?
Loss of enthusiasm: depression is often characterised by a lesser concern with pleasure in daily activities or hobbies
– Constant depressed mood: ever present, and overwhelming feelings of sadness/hopelessness and feeling empty
– Worthlessness: constant feelings of reduced worth and or inappropriate feelings of guilt. They may also experience low self-esteem.
– Anger: the person might feel anger directed towards others, or themselves, and depression may arise from feelings of being hurt and wishing to retaliate
What are the cognitive characteristics of depression?
Delusions: some depressive patients will experience delusions concerning guilt, punishment, personal inadequacy or disease. Some will also experience hallucinations, which could involve all senses.
– Reduced concentration: they can be a difficulty in pain/maintaining attention. They might have slower thought processes, the normal and difficulty making decisions.
– Thoughts of death: depressed, people will have constant thought of death, and all suicide, believing that the world will be a better place without them
– Poor memory: depressed people have trouble retrieving memories and might have poor memory in general
– negative thinking: depressed people off and have a negative view of the world they tend to have negative expectations about their lives and relationships in the world in general. This leads to the self-fulfilling prophecy whereby you expect bad things to happen and therefore they probably will
– Absolutist thinking: most situations are not all bad all good, but suffers of depression tend to think in this format and think about events in absolutist term such as “it was a complete disaster “ Rather than “ that was good, but there are a few things that could’ve been better. “
What is the cognitive approach to explaining depression?
The cognitive approach to explain depression involves Beck’s cognitive triad and Ellis’s ABC model. This model proposes that individuals who are suffering from depression often have a distorted and negative thinking people who think in a negative or rational way might be more prone to developing depression.
Describe CBT
- based on the cognitive triad by Beck, cognitive behavioural therapy aims to challenge and restructure negative thinking, so thoughts become more positive and rational
- CBT can be used on individuals / small groups
– afterwards the depressed patient thinks in a more positive way which can alleviate depression
– Beck uses the cognitive triad as the basis for his cognitive behavioural therapy where negative thoughts about self, world, and future would be addressed
- patients would be encouraged to identify negative thoughts “thought catching “, the patient would act as a scientist, and would be encouraged to challenge these negative thoughts and test them out
– Patients would be encouraged to keep a record of events in their life to help challenge their negative thinking, e.g. diary, entries, or birthday cards
– Positive thoughts would be positively reinforced through praise
- The aim of this therapy is cognitive restructuring; learning to identify, dispute, and therefore change, irrational thoughts.
Strengths of cognitive behavioural therapy by Beck
One strength of CBT is that it is very effective when clients have mild depression. A CBT stops the depression from getting worse. Therefore it is applicable to clients who have mild symptoms of depression. To treat severe depression drugs or medication might be more appropriate.
- One advantage of CBT is that it is widely respected and supported by a lot of research. it is a cost-effective treatment for many disorders and it is quite economical compared to other treatments such as the psychodynamic approach
- Another advantage would be that it tends to get to the root cause of the depressive problem. Usually can uncover the real underlying issues that cause the depression in the first place and this is a very good point because other treatments such as medication did not get to the root of the problem and just treats or rather masks the symptoms
- Another advantage is that it can be used as a long-term cure for depression and once the patient has undergone CBT it has lasting positive outcomes and they are less likely to suffer a relapse compared to other treatments. Therefore it might be more cost-effective for the NHS because when a depressed patient has successfully completed CBT treatment, they are very unlikely to return to the hospital and need further treatment.
Describe rational emotive behavioural therapy, REBT
- This was developed by Ellis (1994)
- the therapy involves challenging automatic negative thoughts = making depressed clients think in a more rational and positive manner
- The therapist uses logical arguments to challenge negative thinking and show patients how irrational their thoughts are (empirical arguments are also used, using data to challenge defeating beliefs)
- Depressed patients are told to practice positive and optimistic thinking which can have a positive impact on their behaviour
- Homework is also assigned to the depressed clients between therapy sessions, and it is vital for testing irrational beliefs out in the real world in order to replace them with more rational and positive beliefs
- Behavioural activation: CBT encourages depressed clients to become more active and engaging pleasurable activities so the therapist would encourage active participation because depressed clients often do not engage in these activities.
Strengths of Ellis REBT approach to treating depression
One advantage, is that Flannaghan et al (1997,) supports the use of REBT as an effective way to treat depressive/victims. This suggests that REBT is a suitable treatment for specific groups of people which can help them become more positive over time
Another advantage is that there is research evidence to support the use of CBT as a therapy for depression David (2008), compared 170 depressive patients who had 14 weeks of REBT to those who are treated with a drug and the outcomes were compared to 6 months after the treatment. It was found that are EBT was better for long-term.
What does the cognitive model propose?
(abt depression)
The cognitive model proposes that individuals who are suffering from depression often have distorted and negative thinking. People who think in a very negative or irrational way might be more prone to developing the illness of depression.
Describe becks cognitive triad
- beck (1960)
- depression is caused by a negative outlook which cause negative schemas. Negative schemas often develop in childhood whereby parents or adults have been overly critical towards them. The negative schemas continue into adulthood and provide a negative framework, whereby life is viewed in a negative way. This could cause depressive thoughts.
- symptoms of negative schemas: Self blame ( they are responsible for all misfortunes), Ineptness ( expect themselves to fail at everything) so overgeneralisation
The Cognitive triad: AO1:
- Negative thoughts about self: The person might feel worthless and helpless. They criticise themselves at every opportunity, e.g. “I am useless and I am no good at Mathematics”
- Negative thoughts about the world: The negative and distorted thinking continues on a larger scale, “I am useless at everything I do.” The statement becomes more global and negative.
- Negative thoughts about the future: The person thinks negatively and gets depressed about the future, e.g. “I will always be useless at everything I do, and this will never improve.” Such negative thinking can lead to suicidal thoughts/ low self-esteem
Strengths of becks cognitive approach (as an explanation of depression)
1) A strength of the cognitive approach is that it has become very influential within Psychology during the last 30 years, especially as the theory has been based on sound experimental research that is objective and permits testing. It seems that distorted and negative thoughts are very common amongst patients who have depression, and these negative thoughts play a key role in the development of the illness. (+).
3) The cognitive approach would criticise the Behavioural approach when examining causes of depression. The behavioural approach would state that depression is caused by learning and the environment, whereas the cognitive approach would disagree and state that negative thinking causes depression to occur (-) There have been attempts to combine the cognitive and behavioural approaches together to form the “Cognitive Behavioural approach.” The CB approach would aim to look at both the cognitive (negative and irrational thinking) and behavioural (classical and operant conditioning and social learning) elements in order to look at causes of depression. (+)
4) There is a great deal of supporting evidence to suggest that depression is caused by negative and irrational thinking, as well as the cognitive triad. Terry (2000) assessed 65 pregnant women for cognitive vulnerability and depression before and after birth. It was found that women who had a high cognitive vulnerability (to think negatively) were more likely to suffer post natal depression. This supports the cognitive approach that negative thinking can cause depression (+)
Describe Ellis’s ABC model
Ellis proposed that depression is caused by irrational beliefs. He devised the ABC model to explain how irrational and negative beliefs are formed:
A = Activating Event: Patients record events leading to negative thinking and this is triggered by an event in the environment around them such as exam failure, or getting fired from work. This activating event has a negative effect on their mood and outlook
B = Beliefs: Patients record their thoughts associated with the event (these can be rational or irrational), an example is that they think they are useless and stupid for failing the exam. Examples might be recording thoughts in a diary or journal so they can keep track of their thinking
C = Consequences: Patients record the emotional response to their beliefs. Irrational beliefs can lead to negative emotions such as feeling upset. The consequences could be debated with many different options e.g. “If I fail Maths and I feel that I am not good at it, the consequences could be that I feel upset, useless and demotivated, and it could lead to me dropping out of the course or school
Mustabatory thinking: AO1
Ellis identified that mustabatory thinking can cause irrational and negative thinking that can be emotionally damaging and can lead to depression.
These include ‘I must be loved by everyone’ and ‘I must excel in all areas….otherwise I am worthless’. An individual who holds these beliefs is bound to be disappointed or depressed, because these thoughts are too idealistic and the expectations are too high!
Strengths of Ellis’s ABC model
1) There is research to support the idea of Ellis’s ABC model as a cause of depression. Bates (1999) found that depressed participants who were given negative thought statements became more and more depressed supporting the view that negative thinking helps to cause depression. If psychologists know what causes depression (negative thinking), then this can help provide effective treatments for curing depression (cognitive therapy via changing negative thoughts into positive ones). (+)
5) The ABC model of depression is based on sound scientific evidence that permits objective testing. This allows improvement of the model and a greater understanding for the causes of depression as a whole. (+)
6) There is supporting evidence that people who develop depression in adulthood, tended to experience insecure attachments in childhood. Therefore there seems to be a link with insecure childhood attachments contributing to negative thinking which can cause depression in adulthood (+)
Weakness of cognitive behavioural therapy by Beck
- One weakness of CBT is that the most popular treatment for depression is anti-depressant drugs, because they require less effort in general however Cujipers (2013) found that CBT can be very effective when combined with drug therapy, so maybe it should be used alongside drugs to be more effective
