Psychopathology : depression

Question 1

What is depression?

Answer 1

Depression is a mental health condition characterized by persistent feelings of sadness, hopelessness, and a loss of interest in activities that one used to enjoy.

Question 1

What are the two types of depression?

Answer 1

• Major depressive Disorder
• Persistent depressive disorder

Question 2

What are the behavioural characteristics of depression?

Answer 2

• Low activity levels
• Disruption to sleep and eating behaviour
• Agression and self harm

Question 3

What are the emotional characteristics of depression?

Answer 3

• Lowered mood
• Lowered self esteem
• Anger

Question 4

What are the cogintive characteristics of depression?

Answer 4

• Coginitive
  Negative emotions are associtated with negative thoughts
• Poor concetration
• Attending to and dwelling on the negative
• Negative view of the world and expect things to turn out badly

Question 5

What are the coginitive explanations of depression?

Answer 5

• Beck’s negative triad
• Ellis’ ABC model

Question 6

What did Beck state?

Answer 6

• He suggested that some people’s coginitions ie, the way that they think creates this vulnerability
• Beck suggests that there are 3 parts to this vulnerabity :
  1. Faulty Information Processing
  2. Negative self - schema
  3. The negative triad

Question 7

What is involved in the Beck’s negative triad?

Answer 7

A person develops a dysnfuctional view themselves due to 3 types negative thinking
A negative and irrational view ourselves, our future and the world around us.
* According to Beck, negative self-schemas and faulty information processing maintain the negative triad

Question 8

What is involved in faulty processing information?

Answer 8

This refers to the fact that depressed people tend to focus on the negatives of a situation and ignore the poitives
* Blow small things out of proportion
* Experience very black and white black thinking
* Overgeneralisations and catastrophising

Question 9

What is a negative self schema?

Answer 9

A schema is a ‘‘package’’ of ideas and information developed through experience
* They act as a mental framework for the interprentation of sensory information
* Self-schemas are packages of information we have heard about ourselves that we use to interpret the world
* Negative self schema→interpret information about yourself in a negative way

Question 10

What are examples of a negative self-schema?

Answer 10

• An ineptness schema, which make sufferers expect to fail;
• A self blame schema that makes them feel responsible for any misfortunes;
• A negative self-evaluation schema that constantly reminds them of their worthlessness

Question 11

What did Ellis state about depression?

Answer 11

Good mental health is the result of rational thinking
* Ways that allow people to be happy and free from pain
Depression and anxiety result from irrational thoughts
* Not illogical or unrealistic but rather ones that interfere with happiness and being free from pain
* We must always achieve perfection( mustobation)
* Something not going smoothly is an absolute disaster (I-cant-stand-it-is)
* Life must always be fair (utopiansm)
Ellis developed the ABC Model to explain the impact of irrational thoughts on our behaviour and emotional state

Question 12

What does ABC model stand for?

Answer 12

• A- Activating event
• B- Belief
• C- Consequence

Question 13

What is a strength of coginitive explanations for depression?

Answer 13

Strength : Beck’s theory
In a review, Clark and Beck (1999) concluded that cognitive vulnerabilities were not only more common in depressed people but they preceded the depression.

• More recently a prospective study by Cohen et al. (2019) confirmed this.
• Tracked the development of 473 adolescents, regularly measuring cognitive vulnerability and it was found that these vulnerabilities were predictors of later depression.
• Shows that there is an association between cognitive vulnerabilities and depression.

Question 14

What is a weakness of using coginitive explanation for depression?

Answer 14

Limitation : Alternative Explanations
Depression could be a biological condition, caused by genes and neurotransmitters.

• Research focused on the role of serotonin has found lower levels of this neurotransmitter in patients with depression.
• Drug therapies, including SSRIs (Selective Serotonin Reuptake Inhibitors), which increase the level of serotonin, are found to be effective in the treatment of depression, which provides further support for the role of neurotransmitters in the development of depression.
• This therefore casts doubt on the cognitive explanation as a sole cause of the disorder.

Question 15

What is a strength of using coginitive explanations for depression?

Answer 15

Strength : Real world application
Cognitive explanations have been used to develop effective treatments for depression

• Cognitive Behavioural Therapy (CBT)
• Rational Emotive Behaviour Therapy (REBT) which was developed from Ellis’s ABC model.
• These therapies attempt to identify and challenge negative, irrational thoughts and have been successfully used to treat people with depression
• Providing further support to the cognitive explanation of depression.

Question 16

What is a weakness of using cogintive explanations for depression?

Answer 16

Limitation : Endogenous Depression
Cognitive explanations only explain reactive depression.

• Triggered by events and reinforced by beliefs.
• Many cases of depression however cannot be traced back to some life event
• It is not clear what has lead that person to become depressed and this particular time.
• This is known as endogenous depression.
• This means that Ellis’ model can only explain some cases of depression and is therefore only a partial explanation.

Question 17

What does CBT consist of?

Answer 17

Coginitive elements:
* Assessment- client and therapist identify the problems and the goals
* plan is put in place
* Identify and negative irrational thoughts
Behavioural elemnts:
* Work to change unehlpful thought patterns and put more effective behaviours in place
* Homework + patients as scientists

Question 18

What are the two types of CBT?

Answer 18

• Beck’s coginitive therapy
• Rational Emotive Behaviour therapy

Question 19

What is involved in Beck’s cogintive Therapy?

Answer 19

Cognitive therapy is the application of Beck’s cognitive theory of depression.
* It aims to identify and challenge negative automatic thoughts surrounding the world, the future and the self (negative triad)

• Direct challenging.
• Hypothesis testing / testing the reality of their beliefs.
• Homework  E.g. record when people are nice to you; when you enjoyed an event; received positive feedback.
• • Findings can be used in future sessions to prove the client wrong when they make an irrational statement.

Question 20

What is involved in Ellis’ Rational Emotive Behavioural Therapy?

Answer 20

REBT extends the ABC model to an ABCDE model.

• D = Disputing
• E = Effect
• The central idea behind REBT is to identify irrational thoughts (e.g. utopianism) and dispute them through vigorous argument.
• Change the negative belief and break the link between the event and depression.
• Disputing is the hallmark of REBT
• Empirical – does negative have evidence to fact it up
  • Logical – does negative thought logically follow from fact

Question 21

What is behavioural Activation?

Answer 21

As an individual becomes depressed they tend to increasingly avoid difficult situations and become isolated.
* maintains and worsens symptoms.
* The goal of BA is to gradually decrease avoidance and isolation by increasing engagement in activities that have been shown to improve mood.
Exercise, going out for dinner etc.

Question 22

What is a strength of coginitive treatements for depression?

Answer 22

Strength : Research support
Research by March et al. (2007) found that CBT was as effective as antidepressants in treating depression.

• 327 adolescents with a diagnosis of depression
• Compared the effectiveness of CBT, antidepressants, and a combination of CBT and antidepressants.
• After 36 weeks, 81% of the antidepressant group, 81% of the CBT and 86% of the combination group had significantly improved.
• This demonstrates the effectiveness of CBT in treating depression and also suggests that it works well alongside medication as a combination therapy and may even be more effective than just one or the other.

Question 23

What is a weakness of coginitive treatements for depression?

Answer 23

Weakness : Suitability for diverse clients
CBT could be ineffective for more severe cases and people with learning difficulties.

• CBT requires motivation
• Motivation may not be present in the more severe cases of depression won’t be able to engage with the work or pay attention to what is happening in the session.
• It is also possible that the hard cognitive work associated with CBT could make it unsuitable for people with learning disabilities.
• Sturmey (2005) even suggests that psychotherapy of any kind is unsuitable for people with learning difficulties.
• Suggests that CBT may only be appropriate for a specific range of clients.

Question 24

What is a strength of coginitive treatements for depression?

Answer 24

Weakness: Suitability
More recent evidence challenges the idea that CBT is unsuitable for severe depression and for people with learning difficulties.

• Lewis and Lewis (2016) concluded that CBT was as effective as antidepressants and behavioural therapy for severe depression.
• Taylor et al. (2008) concluded that when used appropriate CBT is effective for people with learning disabilities.
• This means that CBT may in fact be suitable for a wider range of people than was initially thought.

Question 25

What is a weakness of coginitive treatements for depression?

Answer 25

Weakness : relapse rates
Although CBT seems to be quite effective in tackling the symptoms of depression there are some concerns over how long the benefits last.

• Some recent study suggest that the long-term outcomes are infact not as good was once thought.
• E.g. Ali et al. (2017) assessed depression in 439 clients every month for 12 months following a course of CBT.
• 42% relapsed within 6 months of ending treatment.
• 53% relapsed within a year.
• This means that CBT may need a to be repeated periodically.