Pyschopathology- Depression (cognitive) Flashcards
What are the main assumptions of the cognitive approach to abnormality?
-People who suffer from psychological disorders have irrational and distorted thoughts and don’t adapt to their environment/situation
-the way you think about the problem rather than the problem itself causes the disorder
-Can overcome psychological problems by new ways of thinking (appropriate conditions)
What are schemas and schemata?
-An organized pattern of thought/behaviour
-A structured cluster of pre conceived ideas
What is diffivult to incorparate into schemas?
-New information
Define major depressive disorder.
Severe but short term depression
Define persistent depressive disorder
Long term or reaccuring depression which includes sustained major depression
What is disruptive mood dysregulation disorder?
Intense and frequent childhood temper tantrums
What is premenstrual dysphoric disorder?
A disruption to mood prior to and or during menstruation ( a severe form of PMS)
Define depression
-A mood disorder- affects your emotional state
-Emotional mood is distorted or inappropriate to the circumstances
-Characterised by low mood + energy and motivation levels +loss of intreast in things that were pleasureable
What are the 3 emotional characteristics of depression?
-Lowered mood
-Anger
-Lowered self esteem
Explain the 3 emotional characteristics
Lowered mood- More severe than the daily experience of feeling lethargic/ sad, feelings of worthlessness/ emptiness
Anger- displayed towards others, outbursts + unpredictable
Lowered self esteem-self-loathing which is likely to exacerbate sadness and feelings of hopelessness
What are the 3 behavioural characteristics?
-Activity levels
-Disruption to sleep and eating behaviour
-Agression and self harm
Explain the 3 behavioural characteritrcis
Activity levels- reduced energy levels- may not be able to get out of bed, lethargic, withdrawal from everyday life (eg. not going to work) or an increase in activity such as restlessness
Disruption to sleep and eating behaviour- insomnia/ hypersomnia (waking up/going to bed very early/late), apetite may increase/ decrease leading to weight loss/gain
Agression and self harm- agression towards themself or others, could lead to suicide
What are the 3 cognitive charcteristics?
-Poor concentration
-Inability to make decisions
-Absolutist thinking
-Attending and dwelling on the negative
-Irrational thinking
-Negative view of the world
-Catastrophising
Explain the 7 cognitive characteristics
Poor concentration- unable to stick with a task
Inability to make decisions- person appears almost ‘paralysed’ with indecision, seemingly unable to commit themselves to one course of action
Absolutist thinking- black and white thinking, all or nothing
Attending and dwelling on the negative- Sufferers may dwell on the negative thoughts and experiences
Negative view of the world- thoughts that everything will turn out badly and that there is no hope
Irrational thoughts- thoughts which do not accurately reflect reality but instead mirror the negative mindset of the depressed person
Catastrophising- an ‘end-of-the-world’ mindset in which even the smallest setback is viewed as a tragedy or emergency
What are the 3 components of becks model of depression?
-Fualty information processing
-negative self schemas
-negative triad
Explain faulty information processing.
-Depressed people make fundamental errors in logic
-They selectively attend to the negative aspects of a situation and ignore the positive aspects:
-IRATIONALLY PERSONALISING EVENTS THAT HAPPEN TO THEM + THE WORLD- e.g,‘The world hates me, even the bus hates me, it didn’t stop for me this morning’
-SEEKING OUT THE NEGATIVE IN EVERY SITUATION-e.g.‘I may have got a promotion but it will mean I have to take on more work’ (an example of negative automatic thoughts)
-CATASTROPHISING- e.g.‘I got a low mark for this essay which means I’m going to fail my exams and end up homeless and broke’
-OVERGENERALISING- e.g.‘I had a date last night but it didn’t go well so what’s the point of dating at all?’
-Blow small problems out of proportion with black-and-white thinking
-Ignoring the middle ground, you are only a success ora failure
Explain negative self schemas
Schema- package of information that has developed with experience
-Self-schema is the ideas we have about ourselves
-DP have negative self-schemas
-Interpret information in a negative way
-a depressed person may develop an ineptness schema, believing they will fail at everything they try
-a depressed person may develop a negative self-evaluation schema, constantly reminding themselves of their own worthlessness
What is the negative triad
-Involves the role of internal mental processes in determining behaviour
-Examples of internal mental processes:Thoughts, information processing and perception
When did Weissman and beck carry out thier study?
1978
What was the aim?
To investigate the thought process of depressed peopl e to establish weather they make use of the negative schemas
What was the result of their expetriment?
-Depressed particpants made more negative assesments than non depressed people
-When given therpay to challenge and change their negative schemas schemas their was an improvement in slef ratings
What was the method?
Thought processes were meausred using the dysfunctional attitude scale (DSA)
-Particpamts were asked to fill out a questionare
on weather they agree/diagreed with statements
What was the conclusion?
Depression involves the use of negative schemas
What is Ellis’ ABC model?
A-Activating event
is affected by
B-Individuals belief
which results in
C- a consequence
According to Ellis what causes irrational thinking and produces undesirable behaviours
Cognitive biases
What is an activating event?
-Albert Ellis suggested that depression arises from irrational thoughts
-Occurs when we experience negative events
What are the belifs about what happend?
Negative evnts trigger irrational belifs
What are the consequences of what happend?
When an activating event triggers irational belifs their are emotional and behavioural consequences G
Give a positive of becks cognitive theory of depression (good supporting evidence)
-Good suporting evidence
-Grazioli & Terry (2000) found that pregnant women who showed vulnerability for depression were more likely to suffer post-natal depression than those without that specific diathesis
-This means that the cognitive approach could be used to identify vulnerability in people and trigger interventions to delay or prevent the progress of depression
-Much research has supported the proposal that depression is associated with faulty information processing, negative self-schemas and the triad of impairments
Give 2 positives of Beck’s cognitive theory of depression (Practical application in CBT) and (personal life events)
-Beck’s cognitive explanation forms the basis of cognitive aspects of depression that can be challenged in CBT
- used to identify, challenge and change irrational thoughts so that depression symptoms recede
-this is a strength of the theory as it demonstrates its external validity i.e. it can be used in real settings to help real people suffering from depression
-Personal life events are taken into account and are recognised as a starting point for the person’s depression
Give a negative of Beck’s cognitive theory of depression (it does not explain all aspects of depression)
-Theory explains all the basic symptoms of depression however it is a complex disorder with a range of symptoms not alll of which can be explained
Give a positive of Ellis’ ABC model (Practical application in CBT)
-Led to succesful therapy
-Irational negative belifs are challenged and this can help to reduce depressive symptoms suggesting the the irrational thoughts have some role in depression
Give 2 negatives of Ellis’ ABC model (only offers a partial explanation) and (responsibility)
-Some depression does occur as a result of an activating event (reactive depression)
-However, not all depression arises as a result of an obvious cause
-It gives responsibility completely to the individual suffering from depression, which in turn could be seen as blaming them
-Although it assigns responsibility for the individual to manage their thoughts, allowing some degree of control as to how to manage the consequences of activating events and beliefs
-This means that the theory takes an idiographic approach which is useful in the study of mental illnesses as no two experiences of depression are identical
Give a negative of Ellis’ ABC model (It does not explain all aspeects of depression) + (why)
-EXplanation does not explain why some individuals experince anger associated with their depression and why some suffer from hallutionations and delusions
-Beck’s theory is useful for highlighting what
-characterises irrational thinking but not why such thoughts occur, or where they come from-
The above observation means that Beck’s theory lacks explanatory power
What are the alternative explanations? Eval
-Biological approach- genes and neurotransmitters may cause depression, sucess of drug therapies suggest neurotransmitters do play a role (medication alters the levels in the neurotransmitters
-Not fully hollistic
-So more appropriate =Diathesis stress- individuals with a genetic vunreablity for depression are more prone to the effects of living in a negtaive enviroment whixh leads to negative irrational thinking
What is the cognutive approach to treating depression
CBT
-BVased on both behavioural and cognitive techniques
-Therpaist aims to make the client aware of the relationship between thought, emotions and actions
-Helps to change how people think (cognitive) and what they do (behaviour)
What does CBT involve?
-Meet with a therapist between 5 and 20 times for weekly and fortnightly sessions
-Each session last between 30-60 minutes
-Most draw on techniques used by Ellis
What are the steps in CBT?
-Paitent and therapist identify patient problems and where negative and irrational thoughts must be challenged by the
-Identify the negative triad
-Patients encouraged to test the reality of thier irrational belifs
-Set homework-o record positive events, which can be used in the sessions to help them challenge irrational thoughts, challenges illogical thoughts
What are the steps of cognitive therapy
-Paitent assessed to determine the severity of their condition
-Establish a baseline to monitor treatment
-Uses reality testing
-Paitent is asked to do a task which demonstrates their ability to succeed
What is REBT?
-Identify and dispute the patient irrational thoughts
-REBT therapist presents robust arguments to dispute this idea
-Empirical argument- disputing whether there is evidence to support the irrational belief
-Logical argument- disputing whether the negative thought follows from the facts
-Replace them with reasonable realistic statements
-therapist’s role is to break the link between negative life effects and depression by changing the client’s irrational belief
-Rational Emotive Behaviour Therapy
-Devolped by ellis
-extends Ellis’s ABC model to ABCDE (D is for Dispute and E is for Effect)
What is behavioural activation?
-Depressed individuals avoid difficult situations and become isolated which maintains/worsens behaviours
-Goal of treatments is to gradually decrease avoidance and isolation and increase their engagement in activities that improve mood
What is unconditional positive regard?
-Involves convincing the client of their worth
-The therapist provides respect and appreciation regardless of what the client says/ does which changes beliefs and attitudes
Give a positive of the cognitive approach (Effective)
-CBT is effective at reducing symptoms of depression and preventing relapse
-Most effective treatment for moderate depression (as effective as antidepressants)
-March et al.(2007) found that CBT was more successful at treating depression in adolescents than drug therapy
-This means that it has good application as CBT is effective in reducing symptoms of depression
-Most effective in combination with drug therapy
-Although CBt may not work in the most severe cases as they cannot motivate themself to engage with therapy
-They can start antidepressants first so cannot be used solely in the worst cases
Give a negative of the cognitive approach (relationship)
-Success may be due to the paitent- therapist relationship
-Little difference between CBT and other psychotherapy
Give a negative of the cognitive approach (past issues
-Some patients want to talk and explore their past
-CBT focuses on present issues
-The emphasis on ‘here-and-now’ may not be appropriate for some people who need to revisit past events as part of their journey to wellness
-This limits the usefulness of the therapy as it may not be effective for all individuals as a treatment of depression
-May be linked to childhood and the root cause
Give a positive of the cognitive approach (economy)
-Positive implications on the economy
-Treatment of mental disorders and peoples ability to work contribute to society
-It is important to find effective treatment as it means a person will have to take fewer days of work
How long must symptoms of depression be present for before a diagnosis can be made?
2 weeks
Explain the nagtive triad
-Negative view of the self: I am worthless/ unimportant/ useless/ a waste of time
-Negative view of the world: Everyone is against me
-Negative view of the future: I am never going to amount to anything
Give a limitation of of the ABC model (does not account for all types of depression)
-can account for reactive depression, where the individual responds to an activating event but not for endogenous depression which develops without anyn accompanying activating event
-This limits the external validity of the theory
EXplain the process of CBT
-Cognitive restructuring/reframing: this involves turning negative thoughts into positive thoughts
-Guided discovery: this involves challenging negative thoughts and irrational beliefs
-Keeping a journal: this involves the recording of thoughts, feelings and actions between sessions
-Activity scheduling and behaviour activation: this involves acting on decisions and avoiding procrastination
-Relaxation and stress reduction techniques: this involves exercises such as muscle relaxation, deep breathing, visualisation
-Role-playing: this involves working through different scenarios which the patient finds challenging
What is the aim of CBT?
to get their client to the point where they can be independent and use strategies practised over the course of the CBT treatment to help themselves
Give the strength of CBT (free will)
-CBT allows the patient to develop at their own pace with the therapist tailoring the sessions to suit each individual
-Thus, CBT embraces, to some extent, free will in its approach
Give a limitation of CBT
-With all ‘talking therapies’, does not work very well for people who do not like to express themselves freely or who lack the verbal or intellectual skills to do so
-This means that the therapy lacks an idiographic dimension as it ignores the experience of the individual to some extent
