L3 - Depression

Question 1

What is depression?

Answer 1

• Sadness, discouragement, pessimism, hopelessness
• Sometimes adaptive e.g low mood helps to disengage individuals from unproductive efforts

Question 2

When does depression become clinically significant?

Answer 2

• Unusually severe or prolonged
• Results in significant impairment at the personal, relational and professional levels

Question 3

What Is major depressive disorder?

Answer 3

5+ symptoms have been present during the same 2-week period and represent a change from previous functioning

Question 4

What are the symptoms of MDD?

Answer 4

• Depressed mood most of the day
• Diminished interest/pleasure
• Significant weight loss/gain, appetite increase/decrease
• Insomnia/hypersomnia
• Psychomotor agitation or retardation
• Fatigue/loss of energy
• Feeling of worthlessness
• Diminished ability to think
• Recurrent thoughts of death

Question 5

What are features of depressive disorders?

Answer 5

• High comorbidity with anxiety/stress
• More prevalent in females than males
• Variety of symptoms: hard to diagnose
• High likelihood of recurrence - increases with number of prior episodes and presence of comorbid disorders

Question 6

What are the genetic causes? (Evidence)

Answer 6

Prevalence of mood disorders 2/3x higher among blood relatives

Question 7

What are environmental causes?

Answer 7

• Stressful life events: 70% of people with a first onset of depression
• Chronic stress
• Social media

Question 8

What is an example of gene-environment interplay?

Answer 8

• Diathesis stress model
• Neurotic individuals have negative appraisal of events and are more likely to experience stressful life events

Question 9

What is the psychodynamic perspective?

Answer 9

• Anger turned inwards
• Response to imagined/symbolic loss
• Similarities between depression and grief

Question 10

What is the behavioural perspective?

Answer 10

• Lack of positive reinforcement
• Lack of the reinforcement capacity of previously reinforcing stimulus
• Increase in negative reinforcement
• No causal link

Question 11

What is the Behavioural Activation Treatment?

Answer 11

• Scheduling daily activities, mastery and pleasure tasks, exploring alternative behaviours to reach goals
• Goals are to increase levels of positive reinforcement and reduce avoidance and withdrawal

Question 12

What is the cognitive perspective?

Answer 12

• Cognitive Depressive Triad: About negative appraisals about the self, the world, the future
• Depressogenic schemas = rigid, extreme and counterproductive way of thinking
• Select, code and evaluate stimuli
• Significance of experiences
• Accompanied by memory biases

Question 13

What is Beck’s Cognitive Theory? (graph)

Answer 13

• Early experience = dysfunctional attitudes/beliefs = depressogenic schemas = cognitive triad
• Depressogenic schemas = severe/mild stressful events = activation of schemas = cognitive distortions = conditional beliefs = NATs (negative automatic thoughts)
• NATs = depressive symptoms = Behavioural, motivation, affective, cognitive, somatic

Question 14

What is Beck’s Cognitive Theory?

Answer 14

• Depressed people have reduced positivity attribution bias
• Cognitive vulnerability predicts onset and recurrence
• Diathesis Stress = stressful life events moderate association between cognitive vulnerability and depression

Question 15

What is Cognitive Behavioural Therapy?

Answer 15

• Our interpretation of events determine our emotional states
• Distorted or irrational thinking patterns lead to emotional problems and maladaptive behaviour
• Result from inaccurate or biased processing of information in the world = cognitive distortions
• e.g NATs (im being boring) = beliefs/distortions (if people know me, they’ll know im useless) = schemas (im unloveable)

Question 16

What are the 10 aspects of cognitive behavioural therapy?

Answer 16

• Emotional reasoning - I felt it so it must be true
• Overgeneralisation - a single negative event is evidence it will always be so
• Mental filter - ignoring positive in situation to focus only on the negative
• Should statements - Unreasonable demands on yourself or others - perfectionism - refusal to be human and fallible
• Labelling - Condemning self/others over a single issue
• Black and white thinking - Using terms like never or always about issues or events
• Personalisation - believing you are the cause of events without evidence
• Mind-reading - believing you can hear people’s thoughts without evidence
• Catastrophising - becoming hysterical and exaggerating
• Fortune telling - dire predictions are made as if they are already fact

Question 17

What is the ABC model?

Answer 17

• Activating event: actual event
• Beliefs: rational/irrational evaluations
• Consequences: emotions, NATs, behaviours, bodily sensations

Question 18

What is the downward arrow technique?

Answer 18

• Identifying deeper thoughts and underlying beliefs and schemas
• Continuous inquiring about the meaning attributed to thoughts/actions
• Therapist introduces alternative interpretations for the patient in order to challenge and restructure their thoughts

Question 19

CBT for depression?

Answer 19

• Brief treatment: 10-20 sessions
• Less focus on early life experiences, focused on here and now
• Empirical in its approach - testing alternative thoughts by collecting evidence
• GOALS:
  1) Bring depression scores back to normal
  2) Identify and challenge NATs through self-monitoring and analysis against cognitive distortions, Socratic questioning and guided discovery
  3) Restructure core beliefs/schemas about self, world and future

Question 20

Is CBT for depression effective?

Answer 20

• 40% reduction in symptoms after 16 week treatment but some relapse
• Meta-analysis suggests antidepressants are more effective than CBT
• In recovered depressive patients, inducing negative mood creates thinking patterns similar to when they are depressed

Question 21

What is mindfulness/third wave CBT?

Answer 21

• Emphasis on changing awareness and individual’s relationship with their thoughts
• Thoughts as mental events - thoughts are not facts
• Decentering - I am not my thoughts
• Effective - 8 weekly group sessions = more effective the more previous depressive episodes you have had