cognitive Behavioural Therapy

Question 1

DSM-5: Major Depressive Disorder

Answer 1

• criteria A: 5 or more symtomsat least 1 is 1 or 2
  1) Depressed mood
  2) Diminished interest/pleasure
  3) sig weight loss/gain
  4) insomnia/hypersomnia
  5) Psychomotor agitation
  6) Fatigue
  7) feeling worthless
  8) Diminished ability to concentrate -neg consequences of an action
  -Mullins + Lewis (2017) - subphenotyping 9 core symptoms of depression indicated almost 1500 combo of symptoms can fufill diagnosis criteria

Question 2

Depression : genetic factors

Answer 2

-kessler et al : depression common generally, lifetime prevalance = 10-16%
-Kendler et al - identical twin study of 42,000 depression moderately inheritable around 38%

Question 3

Depression: Bugs

Answer 3

-Mares et al - much higher level of blood antibodies to a marker for infectious gut bacteria in depressed people
-> increased translocation of gram-neg bacteria plays role in inflammatory pathophysiology of depression
- Qin et al - 20% increased risk of depression per s.d.

Question 4

Depression: Serotonin

Answer 4

-main concentration of cells is in raphe + related nuclei
- serotonin is quite widespread -> frontal + cortical regions
- ecstacy boosts serotonin

Question 5

Serotonin: Emotional effects of depletion for previously depressed

Answer 5

• Delgado et al- previously depressed patients given tryptophan -free diet for 2 days
  -> over half showed sig increase in depressive symptoms
  -Booji et al reviewed literature + found prior episodes of depression impact serotonin depletion

Question 6

Antidepressants : Treatment effectiveness studies

Answer 6

• Geddes et al -> meta-analysis showed they help prevent relapse even after 2 months of treatment
  -Yatham et al - > showed increased serotonin function in medial frontal gyrus

Question 7

DMN- Amygdala connectivity correlated with depression rating

Answer 7

-Posner et al -> severity of depression ratings correlated with levels of activity between DMN + amygdala

Question 8

SSRI normalisation of DMN activity

Answer 8

-Posner et al-> 10 weeks of treatment with antidepressant drug Duloxetine reduce activity within DMN in depressed patients to normal levels

Question 9

DMN + CBT

Answer 9

• Rubin- Falcone et al -> 14 sessions of CBT reduced neg feelings of bad memories
  -reduced neural response in DMN

Question 9

CBT: depression treatment

Answer 9

• Beck: people dev depression as a result of neg cog
• Maladaptive attitudes/neg schemas
• > Begins in childhood + may lie dormant until adverse event
• cog Triad: once reactivated, neg schemas caused 3 reg thinking:
  1) Neg self thoughts
  2) Neg present thinking
  3) Neg future thinking

Question 10

Roots of CBT: stoicism

Answer 10

-Zeno Of citium
- destructive emotions result from errors of judgement, instead should choose to maintain a will in accordance with nature
-Marcus Aurelium followed his teachings -> if you are distressed external pain is due to your estimate of it
- CBT developed by Aaron Beck

Question 11

Attributional style: Neg Thinking

Answer 11

-Metalsky, Seligman et dl -new students rested for attributional style + asked what grade they’d consider failure
- more internal attributional styles for neg outcome = more severe depressive Mood to low grade - external invulnerable to depressive mood
-Neg attributional style + inclination to learned helplessness is important predictor of vulnerability to depression

Question 12

POS thinking or learned optimism: The secret of happiness

Answer 12

• Seligman identified most pessimistic 25% of students + allocated to control or optimism workshop
  -32 % of controls experienced depressive episodes, only 22 % for workshop

Question 13

Errors in logic maintain cog triad

Answer 13

• Arbitrary inference
• selective abstraction
• overgeneralisation = single neg event applies to all times
• Automatic thoughts = I always mess up

Question 14

Error in logic: selective abstraction

Answer 14

= inappropriate focus on neg aspects of a pos situation
- Bradley + Matthews -> controls VS depressed ppts presented with words + told they either related to unfamiliar/familiar person or self
- depressed ppts recalled fewer pos words + more neg relating to self

Question 15

Error in logic: Arbitrary inference

Answer 15

• neg conclusions from little evidence
  -Leppaanen et al - Happy, sad or neutral faces shown to controls or depressed
  -depressed interpreted neutral faces as neg

Question 16

CBT : Treatment

Answer 16

• Castonguay et al- 4 main phases:
  1) Beh component: increasing activities + mood -> schedule of activities, expected to improve Mood
  2) identifying then challenging neg thoughts, errors in logic -> taught to recognise + record neg thoughts
  3) identifying then challenging Maladaptive attitudes - neg schemas
  4) coping strategies: generated to deal with possible depressive episodes after treatment

Question 17

1st test of cog therapy

Answer 17

• Rush, Beck et al-
  -> 12 week treatment
  -> monitor ppts depression scores for 6 months following end of treatment
  -> CBTs advantage was robustly maintained

Question 18

CBT - long-term follow up:

Answer 18

• Mollon et al - CBT most effective in reducing relapse over long term compared with antidepressants

Question 19

cog therapy test- replication

Answer 19

Blackburn et al
- drugs least effective
- combination treatment most effective

Question 20

meta analysis CBT

Answer 20

-Mendlowicz et al- found to be effective for treating panic disorder, social phobia, OCD, PTSD, insomnia + eating disorders
- CBT is most commonly practiced + researched psychotherapy