the complexities of mood Flashcards
what are emotions
emotions are processes comprising appraisal, motivational, somatic, motor and feeling components (Moors et al, 2013) (i.e. reactive to situations/ events)
what are moods
states
longer lasting, more pervasive
what do prolonged negative emotional experiences lead to?
mood problems
what is the appraisal element of emotion
evaluations of the environment and the person environment interaction
e.g. ‘this is going to be awkard’
environment, self
what is the motivational element of emotion
specific action tendencies or other forms of action readiness
e.g. decision to avoid
what is the somatic element of emotion
peripheral physiological responses
Increased heart rate and sweat palms
what is the motor element of emotion
expressive and instrumental behaviour
run off down alley
what is the feeling element of emotion
subjective experience (FEELINGS ARE A RESULT OF OUR EMOTIONS)
anxious relieved
what is the process of experiencing emotion
appraisal
what are the components of appraisal
experiencing an emotional state involves changes in a number of subsystems or components
this process is continous and recursive
changes in one component feedback to other components
what is the somatic marker hypothesis
somatic markers are emotional reactions with a strong somatic component that supports decision making including rational decision making
somatic - physical bodily sensations
physiological changes to the body in response to the stimulus are relayed to the brain and experienced as an emotion
these over time and learning become somatic markers
associations with different situations
how many pathways are there for the reactivation of the somatic marker ie subsequent behaviours
2
the body loop
the as if body loop
what is the body loop
emotion is evoked by changes in th body projected to the brain - e.g. fight or flight response when coming across a snake
body sensation leads to behavioural reaction via brain
experience somatic reaction and that leads to your behaviour
what is the as-if body loop
cognitive representations of the emotions - imaginging as if you were in the situation - activated in brain without being directly influenced by physical sensations - anticipation of event enough to trigger behavioural response
memory or connection with past experience that leads to anticipation and that leads to the reaction
what did damasio say
emotion is integral to the process of reasoning for worse and for better
do emotions help us to make decisions
yes
emotions allow us to mark things as good bad and indifference
when would a mood state be diagnosed as a mood disorder
when it is negative over a long period of time
what is a mood
Mood can be characterised as a pervasive state. By that, we mean that it is an emotion or set of emotions that have accumulated in a time frame so we can identify them.
what is a mood disorder
a mood disorder is when emotions/feelings (the experience of emotion) become prolonged and/ or frequent/ pervasive.
A mood ‘disorder’ is when emotions cause significant impairment in
social functioning
occupational functioning
self care
what are emotional experiences linked to
Emotional experiences linked with depression include sadness, despair and deep sorrow (Mehu & Scherer, 2015).
Emotional experiences are linked to other components of experience including appraisals so this means that the way we think when we are depressed will be affected.
There are also individual differences in the way we appriase situations. Some people might be more inclined to evaluate situations in a consistently negative way (and so experience negative emotions).
If we have a negative style of appraisal, we are less likely to recognise when good things happen. In other words, we might see life through a tainted lens. It is difficult to say for sure what comes first - our tendency to see things negatively or our experience of depression. This cycle of thinking, feeling, behaviour
what is depression
Depression is considered as a mental ‘illness’ though I might argue it should be considered as a psychological reaction.
Depression is a diagnosis. That means, it is a set of psychological and physical symptoms that tend to appear together and have been named/ labelled in order to inform the development of treatments or interventions.
Negative emotional experiences, when long-lasting can become
negative mood states
Long-standing mood states are known as
mood ‘disorders’
what is a psychological formulation
Understanding contextual factors and their impact is done through information gathering and using that information to form a hypothesis about why something has happened. This is called a psychological formulation.
what is the 5 p model
predisposing precipitating presenting perpetuating protective
what is predisposing
what factors in the person’s life makes them vulnerable to psychological problems?
what is precipitating
what event/ set of events has led to this problem occuring?
what is presenting
what is the problem and how do you/ others know it is a problem?
what is perpetuating
what keeps the problem going?
what is protective
what has the person got in their lives that is positive and can be built on?
what is the most important aspect of the 5 p’s formulation model
One of the most important aspects of this model are the ‘perpetuating factors’. With regards to depression, most of us experience low mood at some point in our lives, and sometimes this can be for weeks or months at a time. However, this is still quite normal in some contexts. Often depressive episodes are short lasting because the person’s mood is affected positively by something else. For example, depression that is triggered by loneliness after a relationship break-up can be affected positively by reactions of friends or even the start of a new relationship. The occurance of positive experiences can lift mood. However, sometimes there are other factors that maintain low mood. Depending on how you understand this, maintenance factors could be your family, your thoughts, your behaviour, your experience.
what is biological vulnerability
Research suggests that biological factors such as genetic inheritance may create a vulnerability to depression (i.e. make it more likely to happen) though there is not a direct cause-effect link
It may be, for example, that there are genetic differences in the production and/ or uptake of certain neurotransmitters known to be involved in depression (e.g. serotonin)
Current thinking is that it is likely to be an interplay of several genes and processes that affect likelihood of developing depression
what are the symptoms of depression
Typical symptoms include weight loss or gain, change in sleep pattern, feelings of lethargy and exhaustion, tearfulness, loss of sex drive, constipation – all very unpleasant and can also cause feelings of anxiety which is often a co-morbid condition to depression
how can depression be maintained by unpleasant physucal symptoms
Unpleasant physical symptoms play a big part in the maintenance of depression e.g. exhaustion and lethargy can stop people from being physically active which then leads to weight gain, constipation and poor physical condition
what do psychoogical approaches suggest
Psychological approaches suggest that people’s depressed feelings, thoughts, or behaviours are linked. Each psychological model might have a different emphasis on the important elements of depression that need to be addressed
what are the 3 NICE recommended treatments for depression & their approach to change :
CBT – Cognitive Behaviour Therapy
IPT – Interpersonal Psychotherapy
BA - Behavioural Activation
what is IPT
IPT – Interpersonal Psychotherapy
what is BA
BA - Behavioural Activation
what does CBT focus on
CBT focuses on unhelpful thinking and behaviour
what does the client do in CBT
In CBT, the client is invited to identify thoughts about themselves, the world and others that are leading them to feel gloomy
The therapist helps the client RECOGNISE these thoughts by getting them to complete ‘thought diaries’
Then, the client completes behavioural experiments to look at the evidence for and against these thoughts – to CHALLENGE their thoughts
whats the aim of CBT
Ultimately, CBT aims for the client to get a more realistic perspective on their situation which should lead to improved mood
what does IPT assume
Mood and life situation (specifically one’s interpersonal situation)are linked
Depression is a medical illness which responds well to treatment
Assignment of the ‘sick role’ (your job is to get better, let yourself off the hook for other things)
the Interpersonal problems targeted by IPT are
role dispute
role transition
complicated bereavement
interpersonal deficits (i.e. long standing problems forming and retaining relationships)
what happens in IPT
Change in problem relationships/ relationship style will improve life and therefore mood
Define the problem (from one of the 4 possible interpersonal problems)
Complete an interpersonal inventory to gain an idea of the nature of the client’s relationships
Agree a focus
Therapist works with client to manage the business of changing the problem relationships, learning skills to form new more helpful relationships, thinking generally about the impact of relationships on the person’s mood.
what is the role of the therapist
Therapist is ‘cheerleader’ and can be quite proactive with advice giving and questioning
what is the behavioural activation framework
A model of depression based on learning theory
When people become depressed a lot of their behaviour functions to avoid unpleasant thoughts, feelings or situations but this also leads to missing out on positive reinforcers (especially social ones)
The therapy is designed to raise their awareness of this and the unintended consequences of their actions (i.e. that, rather than serve to improve the situation, client’s response can make the situation worse)
how does behavioural activation work
Works by targeting the behaviours that maintain depression
Cognitions not targeted but some ways of thinking e.g. ruminating might be characterised as a behaviour which allows the person to avoid other things
Identify goals (short, medium and long term)that are meaningful to the client i.e. fit in with their values and abilities
Activity scheduling (avoided activities, not just pleasant ones), structuring, social skills training, problem-solving
CBT v’s BA
CBT v’s BA
Richards et al (2016) In a randomised control trial, BA, a simpler psychological treatment than CBT, can be delivered by junior mental health workers with less intensive and costly training, with no lesser effect than CBT.
CBT v’s IPT
CBT v’s IPT
Lemmens et al (2015) No differential effects between CT and IPT were found. Both treatments exceeded response in the WLC condition, and led to considerable improvement in depression severity that was sustained up to 1 year.
IPT v’s BA
IPT v’s BA
Not a popular comparison
what does CBT do
CBT has, at its heart, the assumption that our thinking is a heavy influence on our behaviour and that this is a symbiotic relationship.
CBT advocates that therapists work on challenging negative thinking, and a key way of doing this is through experimenting with behavioural change.
what does IPT do
IPT sees a pivotal role for relationships (or lack of) and the interpersonal skills we have. The therapist works with the client to understand their relationship patterns better, and manage the access to positive relationships and promotion of effective interpersonal communication.
what does BA do
BA also promotes behavioural change, but with an emphasis on the role depressed behaviour has in perpetuating the depression through the process of avoidance.
theraputic intervention benefits
The aspect of the therapeutic intervention thought to successfully improve mood is know as the ‘mechanism of change.’ This includes aspects such as ‘therapeutic alliance’ and the adherence of the therapist to the therapy, but the application of theory to practice is also considered important.
what is context
Context just means the ‘background’ to the person’s depression.
This could be individual contexts (e.g. living with domestic abuse) or the wider context of where, and under what circumstances we live. Individual contexts would certainly be important in a psychological formulation.
what is the criticism levelled at models informing psychological interventions
However, there is sometimes criticism levelled at models informing psychological interventions that they don’t always take into account the reality of the world in which a person is living.
intrapsychic phemomena
(e.g. thinking patterns)
nterpersonal phenomena
(i.e. relationships)
factors effecting appraisal
(key appraisals in depressive disorder (Beck, 1987). if a person is living in a violent or impoverished neighbourhood, this is likely to have an impact on anxiety (appraisal = something bad could happen) and dperession (appraisal = I am helpless to change this).
Anxiety and depression often co-exist. It is essential that psychologists take the wider context into account.
Another context (as well as the social and physical background impacting on levels of distress) is the way in which depression is understood. We discussed this a little earlier. It is generally understood that cultures vary in the way depression is described and understood which may make it seem that there are differences in prevelance.
