Week 8 Lecture 8 - emotions, moods, disorders

Question 1

What is an emotion?

Answer 1

Emotions are:
processes comprising appraisal, motivational, somatic, motor and feeling components (i.e. reactive to situations/ events)

Question 2

What is a mood?

Answer 2

moods are states (i.e. longer lasting, more pervasive).

Question 3

What does prolonged negative emotional experiences lead to?

Answer 3

prolonged negative emotional experiences lead to mood problems which may then require treatment

Question 4

How do we experience an emotion (Appraisal theory)?

Answer 4

Moors et al (2013) describe this as a process of APPRAISAL which consists of a number of components:

• Experiencing an emotional state involves changes in a number of subsystems or components
• This process is continuous and recursive
• Changes in one component feedback to other components

Question 5

What are the components of appraisal theory?

Answer 5

• appraisal (env., self)
• motivational (specific action tendencies/ readiness)
• somatic/arousal (physiological responses)
• motor (expressive/instrumental behaviour)
• feeling (subjective experiences)

Question 6

What is the somatic marker hypothesis (Damasio)

Answer 6

• somatic markers = emotional reactions with a strong somatic component that support decision making, including rational decision making
• Physiological changes to the body in response to a stimulus are relayed to the brain and experienced as an emotion
• These, over time and learning become ‘somatic markers’ – associations with different situations

Question 7

What are the 2 ways that Damasio suggested for the reactivation of the somatic marker pathways?

Answer 7

1. the ‘body loop’ - emotion is evoked by changes in the body projected to the brain - e.g. ‘fight or flight’ when seeing a snake
   - Body sensation leads to behavioural reaction via brain
2. the ‘as-if body loop’ - cognitive representations of the emotions activated in the brain without being directly influenced by physical sensations – anticipation of the event enough to trigger behavioural response
   - memory/ connection with past experience leads to anticipation leads to reaction

Question 8

What function does emotion serve?

Answer 8

• Damasio (2000) ‘Emotion is integral to the process of reasoning for worse and for better’
• Patten (2011) notes “Education is still, by and large, stuck in the Hellenistic tradition of the Western world that regards the intellect as supreme and emotion as a detractor, by‐product or, more recently, as a type of intelligence.”

Question 9

Are there individual differences in the experience of depression?

Answer 9

• yes
• individual differences in the way we appraise situations. Some people might evaluate situations in a consistently negative way
• having a negative style of appraisal = less likely to recognise when good things happen
• It is difficult to say for sure what comes first - our tendency to see things negatively or our experience of depression

Question 10

What does the 5 P’s formulation model suggest?

Answer 10

This model suggests the following factors need to be understood to explain mental health problems

Question 11

What is the 5 P’s formulation model?

Answer 11

• Predisposing - what factors in the person’s life makes them vulnerable to psychological problems?
• Precipitating - what event/ set of events has led to this problem occurring?
• Presenting - what is the problem and how do you/ others know it is a problem?
• Perpetuating - what keeps the problem going?
• Protective - what has the person got in their lives that is positive and can be built on?

Question 12

What is the bio aspect of the biopsychosocial model?

Answer 12

• Research suggests that biological factors e.g., genetic inheritance may create a vulnerability to depression though there is not a direct cause-effect link
• e.g., maybe there are genetic differences in the production and/ or uptake of certain neurotransmitters known to be involved in depression
• it is likely to be an interplay of several genes and processes that affect likelihood of developing depression

Question 13

What can be the physical symptoms of depression?

Answer 13

Typical symptoms include:
- weight loss or gain, change in sleep pattern, feelings of lethargy and exhaustion, tearfulness, loss of sex drive, constipation

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

Question 14

What is the psycho aspect of the biopsychosocial model?

Answer 14

Psychological approaches suggest that people’s depressed feelings, thoughts, or behaviours are linked

Question 15

What are 3 NICE recommended treatments for depression?

Answer 15

CBT – Cognitive Behaviour Therapy
IPT – Interpersonal Psychotherapy
BA - Behavioural Activation

Question 16

What is the formulation model for CBT?

Answer 16

• thoughts/ cognitions
• behaviour / doing
• feelings / emotions
• physical symptoms

Question 17

What is the focus of CBT?

Answer 17

• to break the cycle by breaking the link between thoughts ans behaviours
• challenge thoughts
• increase meaning and pleasure in behaviours

Question 18

Ultimately what is the aim of CBT?

Answer 18

CBT aims for the client to get a more realistic perspective on their situation which should lead to improved mood

Question 19

What is the formulation for IPT?

Answer 19

• Mood and life 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)

Question 20

What interpersonal problems are targeted by IPT?

Answer 20

• role dispute
• role transition
• complicated bereavement
• interpersonal deficits (i.e. long standing problems forming and retaining relationships)

Question 21

What happens in IPT intervention?

Answer 21

• Change in problem relationship(s) (style) will improve life and mood
• Define the problem
• 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.
• Therapist is ‘cheerleader’ and can be quite proactive with advice giving and questioning

Question 22

How is depression understood under a BA framework?

Answer 22

• 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
• The therapy is designed to raise their awareness of this and the unintended consequences of their actions

Question 23

How does BA intervention work?

Answer 23

• 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 that are meaningful to the client
• Activity scheduling (avoided activities, not just pleasant ones), structuring, social skills training, problem-solving

Question 24

When CBT was compared to BA, what was found?

Answer 24

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.

Question 25

When CBT was compared to IPT, what was found?

Answer 25

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.

Question 26

Is IPT often compared to BA?

Answer 26

no –> not a popular comparison

Question 27

What is the overall assumption of CBT?

Answer 27

assumes that our thinking is a heavy influence on our behaviour and that this is a symbiotic relationship

Question 28

What is the overall assumption of BA?

Answer 28

emphasises the role depressed behaviour has in perpetuating the depression through the process of avoidance

Question 29

What is the overall assumption of IPT?

Answer 29

emphasises the pivotal role for relationships (or lack of) and the interpersonal skills we have

Question 30

What is the “mechanism of change”?

Answer 30

the aspect of the therapeutic intervention though to successfully improve mood

Question 31

Is context important in depression?

Answer 31

yes

Question 32

Hows does context influence mood?

Answer 32

• Through the impact of appraisals and feelings on mood.

Appraisals:
- What beliefs might environments engender about yourself, the world, and others
- e.g., 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 depression (appraisal = I am helpless to change this
- It is essential that psychologists take the wider context into account
- Working on intrapsychic phenomena (e.g. thinking patterns) or interpersonal phenomena (i.e. relationships) will not impact on the physical environment of the individual client