Psychopathology - Lessons 8-10 (Depression)

Question 1

What is depression?

Answer 1

Depression is a mood disorder characterised by feelings of hopelessness and not responding well to things.

Question 2

How is depression diagnosed? (3)

Answer 2

5 symptoms MUST be present EVERY day for 2 weeks.
The 5 symptoms must include sadness and loss of interest and pleasure in normal activities.
The person will show impairment (symptoms) in general functioning that has not been caused by other emotional events such as the death of a loved one.

Question 3

What are 6 behavioural characteristics of depression?

Answer 3

1 Shift in energy levels
2 Social Impairment
3 Weight changes
4 Poor personal hygiene
5 Disturbed sleeping pattern
6 Aggression and self harm
WASSPD

Question 4

What is shift in energy levels? (2 types)

Answer 4

Some people with depression experience lethargy which is a reduced amount of energy which results in withdrawing activities which they used to enjoy (anhedonia).

Some people with depression have high amounts of energy where individuals become agitated and restless and may pace around or even tear their skin (psychomotor agitation)

Question 5

What are disturbed sleeping patterns? (2 types)

Answer 5

Depression is often characterised by constant insomnia where individuals find it difficult to fall asleep or stay asleep.

Depression can also be characterised by hypersomnia where individuals may require large amounts of sleep or excessively oversleep.

Question 6

What is aggression and self harm?

Answer 6

Sufferers of depression are often irritated easily and can become physically and verbally aggressive. They may also be physically aggressive towards themselves in the form of self harming such as cutting themselves or committing suicide.

Question 7

What are for emotional characteristics of depression?

Answer 7

1 Loss of enthusiasm
2 Constant depressed mood
3 Worthlessness
4 Anger

Question 8

What is Loss of Enthusiasm?

Answer 8

Sufferers of depression may experience a reduced amount of pleasure in everyday activities (anhedonia).

Question 9

What is a Constant Depressed Mood?

Answer 9

Constantly feeling sad and hopeless over large amounts of the day.

Question 10

What is Worthlessness?

Answer 10

Sufferers of depression may have reduced feelings of worth and inappropriate feelings of guilt.

Question 11

What is anger?

Answer 11

Being angry constantly which may be directed at other or one self which could result in self harm.

Question 12

What are six cognitive characteristics of depression?

Answer 12

1 Delusions 
2 Reduced concentration 
3 Thoughts of death
4 Poor memory 
5 Negative thinking/Negative schema
6 Absolutist thinking

Question 13

What are delusions?

Answer 13

Experiencing hallucinations or delusions that concern guilt or punishments to oneself

Question 14

What is reduced concentration?

Answer 14

Depressed people usually have trouble paying attention and have slower thought processes than other people.

Question 14

What are thoughts of death?

Answer 14

Depressed people usually have constant thoughts of death and believe that the world may be a better place without them.

Question 15

What is Poor Memory?

Answer 15

Depressed people usually have trouble with retrieving memories.

Question 16

What is negative thinking? (2)

Answer 16

Depressed people will typically have negative views of the world and EXPECT things to always (negative schema) turn out badly.

This leads to the SELF FULFILLING prophecy where if you expect bad things to happen, they will happen because you subconsciously make them happen.

Depressed people usually ignore all positive factors in their life.

Question 17

What is Absolutist Thinking?

Answer 17

Depressed people tend to think about events and situations in absolutist terms where things are ‘complete disasters’ when they actually just ‘could have been better’ as most situations are not fully good or bad.

Question 18

What is the cognitive explanation for depression?

Answer 18

The cognitive explanation suggests that sufferers of depression often have a disturbance in their thinking where they perceive situations in an unusually negative and irrational way.

Perhaps people with a negative and distorted way of thinking are more likely to develop depression. (Negative thinking leads to depression).

Question 19

What is a negative schema?

Answer 19

A schema is a cognitive framework which helps to organise and interpret information in the brain and help make sense of new information.

Individuals with depression have negative schemes and negative thought processes where they will organise and interpret information and situations in a very negative, irrational and distorted way.

Question 20

Who are two psychologists and their models who utilised the cognitive approach in attempt to explain depression? When?

Answer 20

The Cognitive Triad by Beck (1960)

The ABC Model by Ellis (1957)

Question 21

Why do people become depressed according to Beck?

Answer 21

Everyone has a schema. This is a cognitive framework which helps to organise and interpret information in the brain and help make sense of new information.

Beck believed that depressed people acquired a NEGATIVE schema during their childhood as a result of a parent being overly critical towards them. This made people have a tendency to adopt a pessimistic view of the world which ultimately dominates their thinking.

This negative outlook usually continues into adult life and leads to cognitive biases in thinking. For example, overgeneralisations may occur where a person applies one bad experience to all future similar experiences e.g. if one speech you delivered was bad, the person may think that all the speeches they deliver will be bad.

This negative thinking can lead to depressive thoughts and suicidal tendencies.

Question 22

What are 2 types of negative schemas?

Answer 22

Self blame - where individuals feel as though they are responsible for all misfortunes
Ineptness - where individuals expect themselves to fail at everything

Question 23

What can negative schemas potentially lead to?

Answer 23

Depression and possibly suicide (worthlessness)

Question 24

What is the Cognitive Triad?

Answer 24

Beck argued that the negative schema a person has maintains the cognitive triad - a model which explains the irrational and negative thought processes of three elements in a persons belief system.

Question 25

Describe the three stages of the cognitive triad by Beck:

Answer 25

Stage one: Negative thought about self. Feel worthless and helpless. May criticise themselves at every opportunity. Stage two: Negative thought about the world. Having negative thoughts that extend to the wider world around them where the statements become more global and negative - “I am useless at EVERYTHING” Stage three: Negative thought about the future. Where a person may go on to think negatively about their future where it will NEVER get better where they will “ALWAYS be useless”

Question 26

What are 2 advantages of the Cognitive approach by Beck to explain depression?

Answer 26

1 There is a great deal of research support suggesting that depression is caused by negative thinking/the cognitive triad - Terry (2000) assessed 65 pregnant women for depression and cognitive vulnerability before and after birth, and discovered that women who had high cognitive vulnerability (thought negatively) were more likely to suffer from post natal depression. 2 It has become very influential within Psychology during the last 30 years as the theory of negative thinking causing depression has been based on experimental research that permits objective testing.

Question 27

What are 3 disadvantages of the Cognitive approach by Beck to explain depression?

Answer 27

1 The Cause and Effect are not clear - does negative and irrational thinking CAUSE depression to develop, or does depression develop first from a different source like genetics. These need to be investigated further. 2 The Cognitive approach completely disregards the Behavioural approach as it states that depression is developed through negative and irrational thinking, not learning and the environment around them. 3 Beck's theory does not explain how some symptoms of depression are developed such as anger, hallucinations and bizarre beliefs or believing you are a zombie (Cotard syndrome)

Question 28

Why do people become depressed according to Ellis?

Answer 28

Ellis proposed that depression is caused by irrational and negative beliefs

Question 29

Describe Ellis' ABC Model:

Answer 29

A - Activating Event An incident in someone’s life, such as getting fired from work, which has a negative effect on their mood and outlook. B - Beliefs These are the thoughts that occur after the activating event. These thoughts could be rational ‘the company was over staffed’ or irrational, ‘they always hated me' C - Consequences These are the emotions which are cause by these beliefs. Rational beliefs are likely to lead to healthy emotions for example, acceptance, and irrational beliefs are likely to lead to unhealthy emotions for example, depression.

Question 30

What is Mustabatory thinking?

Answer 30

Mustabatory thinking is where individuals have thoughts that are too idealistic and have expectations that are too high such as 'I MUST be loved by EVERYONE' which will result in disappointment and cause negative and irrational thinking that can be emotionally damaging and lead to depression.

Question 31

What are 3 advantages of the Cognitive approach by Ellis to explain depression?

Answer 31

1 The ABC model is based on scientific/experimental research that permits objective testing which allows room for improvement of the model and provides great understanding of the causes of depression. 2 There is research support for the idea that negative thoughts lead to depression - Bates (1999) found that when participants were given negative thought statements, they became more depressed. 3 Now that psychologists know the cause of depression they can effectively produce effective treatments such as cognitive therapy (turning the bad thought into good ones).

Question 32

What are 2 disadvantages of the Cognitive approach by Ellis to explain depression?

Answer 32

1 The Cause and Effect are not clear - does depression CAUSE negative and irrational thinking to develop OR does negative and irrational thinking CAUSE depression to develop. These need to be investigated further. 2 The biological approach to explain the cause of depression would criticise the cognitive approach as it suggests how genes and neurotransmitters (low levels of serotonin) may cause depression. Zhang (2005) discovered a gene that is closely related to depression that if possessed, makes individuals ten times more likely of developing the illness which the cognitive approach does not describe as an explanation for developing depression.

Question 33

What are the two ways of treating depression?

Answer 33

CBT (Cognitive Behavioural Therapy) - Beck | REBT (Rational Emotive Behavioural Therapy) - Ellis (1975)

Question 34

Describe Beck's method to treating depression? (4)

Answer 34

- The Central Idea behind Cognitive Behavioural Therapy in treating depression is to challenge and restructure negative ways of thinking so that they become more positive and rational. - A key technique used in CBT is thought catching. This is where therapists encourage patients to identify and challenge their own automatic negative thoughts. - CBT encourages patients to act like scientists in the real world and test out their negative and irrational beliefs and replace them with more positive and rational ones (CBT reinforces positive thinking). - Patients would attend weekly sessions where they would evaluate how the experimentation with their thoughts was going.

Question 35

What are 2 advantages, that pair with disadvantages, of Beck's CBT?

Answer 35

1 CBT is very effective to use when a client has mild depression as CBT stops the mild depression from getting much worse (+). However CBT is not very applicable to clients with a severe depressive symptoms, therefore drugs and medication might be more appropriate for them (-). 2 Antidepressant drugs are the most popular treatment for depression and requires less effort than CBT (-). However Cujipers (2013) found that CBT can be very effective when COMBINED with drug therapy (+).

Question 36

What are 4 advantages of CBT?

Answer 36

1 CBT is offered as a cost effective treatment for many disorders by the NHS in Britain. 2 CBT is widely respected and supported by vast amount of research as a therapy for depression 3 Some argue that CBT actually cures depression and doesn’t merely act as a “plaster“ like medication and drugs that tend to not get to the root cause of the problem of depression. CBT has been praised as it tends to get to the root of the depressive problem and uncover the real underlying issues . 4 CBT can be used as a long-term cure for depression. Once a patient has undergone CBT, it has lasting positive outcomes and there is a high chance that the patient has actually been cured and they are less likely to suffer a relapse compared to other treatments such as medication.

Question 38

Describe Ellis' method to treating depression?

Answer 38

The Central Idea behind Rational Emotive Behavioural Therapy in treating depression is to challenge and restructure automatic irrational and negative thoughts and beliefs and replace them with more rational and positive ones. This is done by: - therapists challenging a patient’s irrational thoughts by showing them how irrational they are - making patients practice positive and optimistic thinking - using the DEF model - setting homework assignments to reduce the irrational thinking - behavioural activation (encouraging depressed clients to become more active and engage in pleasurable activities that they used to enjoy).

Question 39

What is the DEF model? Describe it too:

Answer 39

The DEF Model challenges negative thoughts by reinterpreting the ABC Model in a more positive and rational way. The DEF Model has three parts: 1 Disputing irrational thoughts and behaviour - Disputing the irrational and negative thoughts that the patient has. There are 3 ways of disputing: Logical Disputing - is where therapists show patients that their beliefs are not logically follow from the information available to them (just because someone doesn’t say hi to you, does not mean they hate you, perhaps they just did not see you) Empirical Disputing - is where therapists show patients how their beliefs are not consistent with reality (doesn’t make sense that you think everyone hates you if they keep inviting you to come round and hang out). Pragmatic Disputing - is where therapists show patients the lack of usefulness of their beliefs (the belief that everyone hates you is not useful in maintaining friendships) 2 Effects of disputing and effective attitude to life - This refers to the new rational and positive thoughts that occur now that the irrational and negative ones have been disputed 3 Feelings/emotions - this refers to the new feelings and emotions that a person may have now that they have new rational thoughts and effective attitude to life.

Question 40

What are 2 advantages of REBT?

Answer 40

1 Flannaghan (1997) supports REBT as an effective way to treat depressive stroke victims and can help them become more positive over time in terms of their thoughts and behaviour. 2 Research support by David in 2008 stated that REBT is a better long term treatment that drug therapy. 170 depressive patients who had 14 weeks of REBT were found better off than patients who had been treated with drugs after 6 months of their treatment.

Question 41

What are 3 disadvantages of REBT?

Answer 41

1 Unclear if irrational and negative thinking is causing depression or if it is merely a symptom. If it is only a symptom, then REBT is not tackling the underlying cause of depression, only a symptom, and isn’t really curing the mood disorder. 2 REBT is dependent on the depressed clients being articulate about their negative and rational thoughts and feelings. Therefore REBT would not work for people with severe depression who were unable to talk or communicate properly about their irrational negative thoughts and feelings. In this case, other treatment options would have to be used 3 if the therapist/psychologist is not highly skilled, trained or able to form a good rapport with their patient the treatment will not be successful as the treatment is dependent on the skills of the therapist.