Psychopathology Lessons 08 - 10 (depression) Flashcards
What are the behavioural characteristics of depression?
Shift in energy levels
Social impairment
Weight changes
Poor personal hygiene
Sleep pattern disturbance
Aggression and self harm
What are the emotional characteristics of depression?
Loss of enthusiasm
Constant depressed mood
Worthlessness
Anger
What are the cognitive characteristics of depression?
Delusions
Reduced concentration
Thoughts of death
Poor memory
Negative thinking
Absolutist thinking
Describe the Cognitive Triad by Beck
People become depressed because they have a negative outlook and negative schemas, which often develop in childhood (parents have been overly critical), and continue into adulthood
The three stages of the Cognitive Triad
Stage 1: Negative Thoughts about self (‘I am useless’)
Stage 2: Negative Thoughts about the world (‘I am useless at everything I do’)
Stage 3: Negative Thoughts about the future (‘I will always be useless at everything I do and will never improve’)
Evaluation of the Cognitive Triad
+ Very influential - it is objective, is based on sound experimental research and permits testing
- Cause and effect is not clear - do negative thoughts cause depression or does depression come first? It needs to be investigated further
- The cognitive approach (negative thinking causes depression) criticises the behavioural approach (depression is caused by learning and the environment)
+ There have been attempts to combine the cognitive and behavioural approaches “Cognitive Behavioural approach” - would look at the Cognitive (negative thinking) and the behavioural (classical and operant conditioning and social learning)
+ Supporting evidence - 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) are more likely to suffer postnatal depression
- Does not explain how symptoms of depression might develop
Ellis‘s ABC model
Ellis proposed that depression is caused by irrational beliefs
A = Activating Event (an event in the environment such as exam failure, getting fired from work etc)
B = Beliefs (thoughts associated with the event)
C = Consequences (the emotional response to their beliefs)
Mustabatory thinking can cause negative thinking and can lead to depression (‘I must be loved by everyone’ or ‘I must excel in everything otherwise I am worthless’). The expectations are too high
Evaluation of Ellis‘s ABC model
+ Research support - Bates (1999) found that depressed participants who were given negative thought statements became more depressed, supporting the view that negative thinking helps to cause depression
- Cause and effect needs to be established (does negative thinking cause depression or does depression occur first?)
- It blames the client when looking at causes of depression (overlooking situational factors)
- The biological approach (genes and neurotransmitters cause depression) criticises the cognitive approach - the biological approach would state that biological factors are more likely to cause depression than cognitive factors. Zhang (2005) found a gene related to depression, which makes it 10x more likely for someone to develop depression.
+ The ABC model permits objective testing, allowing for a greater understanding of the causes
+ Supporting evidence that people who develop depression in adulthood tended to experience insecure attachments in childhood (is a link between them)
Cognitive Behavioural Therapy by Beck (CBT)
- The idea is to challenge and restructure NEGATIVE ways of thinking so they become more positive and rational
- Focuses on present experiences
- Can be used individually or in small groups
- The negative thoughts are challenged
- That could use the cognitive triad as the basis
- Patients are encouraged to identify the negative thought (“thought catching”) and to keep a record of events in their life that can challenge the negative thinking
- Reinforcement of positive thoughts is encouraged
Evaluation of CBT
+ Effective for mild depression (stops it from getting worse)
- Drugs/medication are more appropriate for severe depression (CBT not as effective)
- CBT on its own is not very effective to treat depression, so drugs should be used alongside it (more effective if combined)
+ Widely respected (supported by vast amounts of research), cost-effective (used by NHS), economical (compared to other treatments such as the psychodynamic approach)
+ Gets to the root cause of the depressive problem (can uncover the real underlying issues), unlike other treatments such as medication
+ A long-term cure, with lasting positive outcomes (relapse less likely, so less likely to return to need further treatment in the future)
Rational Emotive Behaviour Therapy by Ellis (REBT)
Therapists challenge depressive thinking and show IRRATIONALITY
Patients are told to practice positive and optimistic thinking
The ABC model is reinterpreted in a more positive and logical way
Clients are asked to complete homework assignments
Clients are encouraged to become more active and engage in pleasurable activities
1) Disputing irrational thoughts and behaviours
Logical disputing (does not follow logic)
Empirical disputing (not consistent with reality)
2) Effects of disputing and effective attitude to life
Effective disputing changes self-defeating beliefs into rational beliefs
3) Feelings/emotions
Begin to think in a more positive and rational way
Evaluation of the REBT approach
+ Flannaghan et al. (1997) supports the use of REBT as an effective way to treat depressive stroke victims (suitable treatment and helps people become more positive over time)
+ Research evidence – David (2008) compared 170 depressive patients who had 14 weeks of REBT and compared them to depressive patients who were treated with the drug fluoxetine. Outcomes were compared six months later, and REBT was a better long-term treatment
- Unclear if the distorted negative thinking is the cause of depression or merely a symptom (if a symptom, REBT does not tackle the root of the problem, so depression has not been cured properly)
- Dependent on the clients being articulate (would not work with patients that were unable to communicate clearly, or are uncomfortable to do so)
- Success is dependent upon the skill and expertise of the therapist (the more skilled the therapist, the better the outcomes)
