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PFoMH > The Second Wave - The role of cognition and the emergence of cognitive therapy > Flashcards

The Second Wave - The role of cognition and the emergence of cognitive therapy Flashcards

1
Q

What did Epictetus propose that is associated to modern CBT?

A

> The choice of wether something is good or not good
= conscious thought

> There is no absolute

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2
Q

What are the 3 approaches in CBT?

A
  1. Adaptive (coping) skills
    - provide more effective (adaptive) coping responses
    - identify person’s maladaptive coping responses and replace them with a set of more adaptive ones
  2. Problem solving
    - new ways of understanding problems
    - alternative solutions
  3. Cognitive restructuring
    - identify and change maladaptive thinking patterns
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3
Q

Who are the pioneers of cognitive therapy and what are their respective approaches?

A

> Aaron Beck: cognitive therapy

> Albert Ellis: rational emotive therapy

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4
Q

What did the pioneers of cognitive therapy reject?

A

Rejected the psychoanalytical approach

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5
Q

What influenced the pioneers of cognitive therapy?

A

Emerging evidence from cognitive psychology

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6
Q

What was the goal and statement of cognitive therapy?

A

Reduction of emotional distress

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7
Q

What was the statement of cognitive therapy?

A

The emotional state is not a direct consequence of a situation, but mediated

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8
Q

What was Aaron Beck influenced by in his development of a new treatment?

A

His work in psychiatry, treating people with depression

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9
Q

What were the three principles of Aaron Beck in developing a new treatment

A

He stated the need for:

  1. Construct Theory
    - to identify targets that inform a treatment
  2. Testable theory
  3. Test the treatment
    - if it does not change the target - symptoms - it has no clinical value
    - > empirical tests

=> “To construct a comprehensive theory of psychopathology that articulates well the psychotherapeutic approach”

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10
Q

What was Aaron Beck’s continuous cycle of psychotherapy?

A

Construct/refine theory -> Test theory -> Test treatment

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11
Q

Why did Beck develop the Beck Depression Inventory (BDI) (2005)?

A

> Need of a questionnaire for reliable assessment of symptoms

> To assess the patient’s actual experience:

  • mood
  • thinking
  • behaviour
  • physical state
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12
Q

What characterises the Beck Depression Inventory (BDI)?

A

> 21 questions with 4 possible answers

> Assess frequency, intensity, and impact of symptoms

> Not diagnostic
- requires application of clinical criteria, detailed interview with trained clinician or researcher

> Total level of depression-related symptoms

  • “cut-off” scores to group people
  • > minimal, mild, moderate, or severe depression

> ‘Self-report instrument’

  • ‘Patient-reported Outcome Measure (PROM’
  • subjective
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13
Q

What makes a cut-off score arbitrary in the Beck Depression Inventory (BDI)?

A

The scores will be continuously distributed in the population
- very different groups following age, physical health, etc.

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14
Q

What is the opposite assessment of a subjective ‘patient-reported outcome measure (PROM)?

A

Assessment based on expert judgment

- typically through interview with trained clinician or researcher

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15
Q

What is Aaron Beck’s Cognitive Triad of depression (1963)?

A

> Outward expressions of stereotyped pattern of thinking

> Underlying schema based on a set of negative beliefs over 3 areas:

  1. the Self
  2. the World
  3. the Future

= “biased thinking” in depression

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16
Q

What are Aaron Beck’s negative automatic thoughts (NATs)?

A

Negative thinking as first response to trigger event

  • emerging without effort
  • because they’re our thoughts, we tend to think they are true
  • Depressive NATs
  • Angry NATs
  • Anxious NATs
  • Guilty NATs
17
Q

How does a normal reaction to an upsetting event differ from NATs?

A
  • No self-blame

- Search for explanations

18
Q

What are the key characteristics of NATs?

A

> NATs tend to be:

  • negative
  • feel bad
  • uninvited
  • unhelpful
  • believable

> Two-way process between our thinking and our mood:
-> negative thoughts may induce a low mood that may be maintained for a long time by recurring negative thoughts

19
Q

What makes Aaron Beck’s model of depression a cognitive model?

A
  1. Negative thinking maintains depression
    - schemas bias perceptions and memory
    - depressive schema increases negative thinking
  2. It is biased or illogical
    = Cognitive distorsion
    - “Unhelpful thinking styles” (as described to patients)
  3. It ignores evidence
20
Q

What are the 7 cognitive biases found in people with depression?

A
  1. ‘All or Nothing’ thinking
  2. Mental Filtering (selective abstraction)
  3. Magnification and Minimization
  4. Catastrophizing
  5. Personalizing
  6. Overgeneralization
  7. Emotional Reasoning (Labelling)
21
Q

What is the ‘All or Nothing’ thinking bias?

A

Splitting, dichotomous reasoning, black and white thinking

  • sets up for disappointment and failure
  • success isn’t typically celebrated
22
Q

What is the mental filtering (selective abstraction) bias?

A

Confirmatory cognitive bias
- pay more attention to events that support our views

  • depressive bias to confirm negative thoughts
  • > notice failures, ignore successes
  • happens in the moment or when events are recalled later
23
Q

What is the magnification or minimisation bias?

A

Magnify the significance of the negative

- disqualifying the positive

24
Q

What is the catastrophizing bias?

A

Significance of negative event is blown out of proportion
- extreme of magnification

  • illogical leap from one event to a disastrous future seemingly inevitable outcome
  • semi-logical steps between thoughts
25
Q

What is the personalising bias?

A

A person assumes responsibility for events when they cannot fully or partially control them
- often involves other people

  • failure translates into guilt and low self-worth
26
Q

What is the overgeneralisation bias?

A

Hasty conclusion from partial information

- e.g. “never”, “always” in thought process

27
Q

What is the emotional reasoning (labelling) bias?

A

We equate what we feel with what is real
- our feelings and emotions, and language we use to define them influence what we believe

Emotion -> (illogical link) -> Fact
- e.g. “I feel like a failure” -> “I am a failure”

28
Q

How can the emotional reasoning (labelling) bias be reinforced?

A

It can be hard to separate feelings from reality

- especially when combined with other biases such as filtering, personalisation, overgeneralisation, etc.

29
Q

What characterises the language of cognitive distorsions in depression?

A

> The thinking is often marked by polarisation, referring to ourselves or others

> The words used describe unbendable expectations about person’s behaviour or outcomes

> These words can be combined and become more extreme
- e.g. “must always succeed”, “should never fail”)

30
Q

What characterises the “hot cross bun model” - cognitive model?

A

> Triggering event: external or internal
- influences the thoughts

> Bidirectional links between Thoughts, Feelings, Physical sensations, and Behaviour
- influencing each other

> No specific direction of flow

> Dynamic systems with potential of vicious cycle

  • unhelpful thoughts, behaviours, feelings
  • which built up on each other, driving maladaptive processes further
31
Q

What is the role of the schema in Aaron Beck’s model?

A

> Schema acts as filter and transforms an event which then becomes a trigger event

> Schema is not static

  • it updates with new information from our thoughts, feelings and behaviour
  • if these are shaped by a negative schema, the updating reinforces it

=> It is not the event, but the way information is processed and appraised

32
Q

What does Aaron Beck’s model describe?

A

A basic system that, in certain conditions, can become maladaptive and increase the risk of depression and maintain the symptoms over time

33
Q

What is the development of the negative schema in depression according to Aaron Beck?

A

Negative schema is dominant

  • our schema has become biassed by our mood to negatively appraise and filter information negatively
  • > state-based association
34
Q

What does Aaron Beck suggest is the origin of the negative schema in depression?

A

Predisposition

  • negative schema develops over lifetime
  • increases vulnerability to depression in context of subsequent stressors

-> Depressogenic trait

35
Q

What do Beck and Bredemeier suggest is the origine of the cognitive triad of depression (2016)?

A

Combined and interacting influence of 4 factors:
1. Genetic risk

  1. Early experience (e.g. trauma)
  2. Information processing biases
  3. Biological stress reactivity
36
Q

Following the Beck’s cognitive triad of depression, what happens when beliefs are activated by stressful events in a person’s life?

A

The beliefs can feedback and further strengthen information processing biases and stress reactivity

PFoMH (18 decks)

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