The cognitive approach to explaining and treating depression

Question 1

How does the cognitive approach explain depression in general?

Answer 1

Faulty and irrational thought processes and perceptions. Maladaptive cognitions cause maladaptive behaviours

Question 2

What does Beck believe causes depression?

Answer 2

Negative schemas, together with cognitive biases/distortions, maintain the negative triad. Negative schemas provide a negative framework to view life in a pessimistic fashion

Question 3

When does Beck believe negative schemas develop?

Answer 3

In childhood and adolescence, when authority figures (such as parents) place unreal demands on individuals and are highly critical of them

Question 4

What do negative schemas fuel and are fuelled by?

Answer 4

Cognitive biases which cause individuals to misperceive reality

Question 5

Name three negative schemas

Answer 5

• Ineptness; Expecting to fail
• Self-blame; Feeling responsible for all misfortunes
• Negative self-evaluation; Constantly reminding depressives of their worthlessness

Question 6

Name four cognitive biases

Answer 6

• Arbitrary interference; conclusions drawn in the absence of sufficient evidence
• Selective abstraction; conclusions drawn from just one part of a situation
• Overgeneralisation; sweeping conclusions drawn on the basis of one event
• Magnification and minimisation; exaggeration in evaluation of performance

Question 7

What makes up Beck’s negative triad?

Answer 7

The self - Individuals see themselves as being helpless, worthless and inadequate

The world - Obstacles are perceived within one’s environment that cannot be dealt with

The future - Personal worthlessness is seen as blocking any improvements

Question 8

How does Ellis explain depression?

Answer 8

Individuals mistakenly blame external events for their depression, but it is actually their interpretation of the events that causes their depression. To explain this process he developed the ABC model

Question 9

What is Ellis’ ABC model?

Answer 9

A ctivating event - Something happens in the environment around you

B eliefs - You hold a belief about that event or situation

C onsequence - You have an emotional response to that belief

The activating event triggers an emotion that is seen s true and the consequence is that the individual becomes depressed because they have a negative view of themselves and their ability

Question 10

What does Ellis suggest is the difference between depressed and non-depressed people?

Answer 10

How they perceive themselves

Question 11

What therapy was formed from Ellis’ ABC model?

Answer 11

Rational emotive behaviour therapy (REBT)

Question 12

What does Abramson et al. propose?

Answer 12

A cognitive model seeing the cause of depression as the way individuals attribute reasons to events that occur in their lives. Those with an external locus of control are more vulnerable to depression

Question 13

Who found that depressed individuals have difficulty activating brain areas associated with cognitive control of emotional information?

Answer 13

Beevers et al.

Question 14

What type of depression does the cognitive approach have less success in explaining and treating?

Answer 14

Bipolar depression

Question 15

What other explanations for depression are there?

Answer 15

Genetic and behavioural (learned helplessness)

Question 16

What is the main cognitive method of treating depression?

Answer 16

Cognitive behavioural therapy

Question 17

What is the idea behind CBT?

Answer 17

Beliefs, expectations and cognitive assessments of the self, environment and the nature of personal problems affect how individuals perceive themselves and others

Question 18

What does CBT aim to do?

Answer 18

Assist patients in identifying irrational and maladaptive thoughts and alter them. As maladaptive behaviour is caused by maladaptive thought processes, fixing the thought process fixes the behaviour

Question 19

What other two therapies come under the CBT umbrella and are used to treat depression?

Answer 19

Rational emotive behaviour therapy (REBT) and treatment of negative automatic thoughts (TNAT). The central idea of both is to challenge and restructure maladaptive ways of thinking

Question 20

What are musturbatory beliefs and how many did Ellis identify?

Answer 20

Irrational beliefs that are emotionally damaging and can lead to psychological problems; 11

Question 21

Which cognitive therapy involves reframing?

Answer 21

REBT

Question 22

What does REBT therapy aim to do?

Answer 22

Patients should become more realistic, able to distinguish fact from fiction and don’t perceive things in extreme terms

Question 23

What are the three stages of REBT therapy?

Answer 23

• Education phase - identifying and challenging negative thought patterns
• Behavioural activation
• Event scheduling
  These last two aim to increase physiological activity and participation in social and other activities

Question 24

What did Sandra Embling find?

Answer 24

CBT combined with drug therapy is more effective than CBT alone, and the treatment group displayed more negative emotions at the end of treatment than the beginning, which is necessary for recovery

Those who didn’t improve had personality traits such as sociotropy and perfectionism

Question 25

What is the problem with CBT being too therapist-centred?

Answer 25

Therapists may abuse their power of control over their patients and can lead to patients depending on their therapist

Question 26

What other treatment is there for CBT?

Answer 26

Electroconvulsive therapy - Stimulating the brain through electrodes on the head thought to produce changes in neurotransmitter levels including serotonin and noradrenaline

Question 27

What did March find?

Answer 27

CBT works as well as drug therapy, but are most effective when used together. 86% had successful recoveries when using combined therapies and 81% for each therapy individually