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depression Flashcards

1
Q

depression

A

mood disorder characterised but feelings of despondency and hopelessness
- 2 types : unipolar and bipolar
- unipolar = consistent low mood

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2
Q

diagnosis of depression

A

at least 5 symptoms must be present EVERDAY for 2 weeks
- must include sadness or loss of interte and pleasure in normal activities
- not been caused by other events (eg death of loved one)

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3
Q

behavioural characteristics of depression (6)

A

SHIFT IN ENERGY LEVELS
SOCIAL IMPAIRMENT - reduced levels of social interactions, may distance themselves
WEIGHT CHANGES - significant inc. or dec., some ppl may eat a lot, some may have reduced appetite
POOR PERSONAL HYGIENE - reduced incidence of washing, wearing clean clothes etc
SLEEP PATTERN DISTURBANCE - constant insomnia, difficulty sleeping, or they may sleep a lot, oversleep (hypersomnia)
AGGRESSION AND SELF HARM - may be irritable, physically or verbally aggressive, may self harm, suicide

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4
Q

shift in energy levels - behavioural characteristic of depression

A

reduced amount of energy, fatigue, lethargy, high levels of inactivity
may withdraw from work, education and social life
may have high amounts of nervous energy - become agitated, restless
- PSYCHOMOTOR AGITATION - ma pace around, wring their hands, tear at their skin

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5
Q

emotional characteristics of depression (4)

A

LOSS OF ENTHUSIASM - lessened concern, lack of pleasure in daily activities, hobbies person used to enjoy
CONSTANT DEPRESSED MOOD - ever present, overwhelming feelings of sadness / hopelessness, feeling empty
WORTHLESSNESS - constant feelings of reduced worth, inappropriate guilt, may also have very low self esteem
ANGER - may feel anger towards others or themselves, self harm, depression may arise from feelings of being hurt and wishing to retaliate

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6
Q

cognitive characteristics of depression (6)

A

DELUSIONS - generally concerning guilt, punishment, personal inadequacy, disease, may have hallucinations
REDUCED CONCENTRATION - difficulty paying / maintaining attention, slower thought processes, difficulty making decisions
THOUGHTS OF DEATH - constant, death / suicide, may make plans to die, world is better off without them
POOR MEMORY - trouble retrieving memories
NEGATIVE THINKING
ABSOLUTIST THINKING - see things in black or white, eg ‘it was a complete disaster’, rather than ‘it was good but…’

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7
Q

negative thinking - cognitive characteristics of depression

A

negative view of the world, expect things to turn out badly
tend to have negative EXPECTATIONS about their lives, relationships, the world
- leads to SELF FULFILLING PROPHECY - if you expect -ve things to happen, then they probs will
positives in their life = ignored
cognitive bias

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8
Q

what does negative schema mean?

A

schema = how people think / cognitive framework
- so, negative thinking

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9
Q

what does Beck believe about depression?

A

ppl become depressed because they have a NEGATIVE OUTLOOK, develop negative schemas
- -ve schemas often develop in childhood, parents and adults have been overly critical towards them
- schemas continue into adulthood, causing depressive thoughts

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10
Q

2 examples of negative schemas

A

SELF BLAME - depressed ppl feel they are responsible for all misfortunes
INEPTNESS - depressed ppl expect themselves to fail at everything

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11
Q

cognitive triad

A

negative thoughts about self
negative thoughts about the world
negative thoughts about the future

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12
Q

cognitive triad - stage 1

A

NEGATIVE THOUGHTS ABOUT SELF
- person has -ve thoughts about themselves
- might feel worthless and helpless
- criticise themselves at every opportunity
- eg i’m useless and no good at maths’

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13
Q

cognitive triad - stage 2

A

NEGATIVE THOUGHTS ABOUT THE WORLD
- -ve thoughts extend to the wider world around them
- distorted and -ve thinking continues on a larger scale
- eg ‘i’m useless at everything i do’
— the statement becomes wider / more global and negative

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14
Q

cognitive triad - stage 3

A

NEGATIVE THOUGHTS ABOUT THE FUTURE
- begins to think negatively about their future
- seems bleak and negative
- can cause low self esteem
- thinks -ve and gets depressed about the future
- eg ‘i will always be useless at everything i do, and this will never improve’
— such negative thinking can lead to suicidal thoughts, initially caused by negative thinking
— according to Beck’s cognitive triad

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15
Q

strength of cognitive approach by Beck

A

it has become very INFLUENTIAL within psychology
- during the last 30 years
- especially as the theory has been based on sound experimental research
— objective, permits testing
- seems that distorted & neg. thoughts are common amongst depression patients
— these thoughts play a key role in the development of the illness

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16
Q

limitation of the cognitive approach by Beck

A

CAUSE AND EFFECT is NOT CLEAR
- can we say neg. & irrational thoughts cause depression OR, does depression develop first and cause the neg. thinking
- cause and effect needs to be investigated further
- so psychologists can be sure that neg. thinking causes depression

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17
Q

evaluation of cognitive approach for depression (linked to behavioural)

A

cognitive approach would CRITICISE the Behavioural approach
- BA would state depression is caused by LEARNING and the environment
- whereas cognitive approach would disagree and state neg. thinking causes depression

there have been attempts to COMBINE the cognitive and behavioural approaches
- to form the ‘cognitive and behavioural approach’
- the CB approach would aim to look at both the cog. and behavioural elements to look at causes of depression

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18
Q

strength of cognitive triad

A

great deal of SUPPORTING EVIDENCE
- to suggest that depression is caused by neg. & irrational thinking
- Terry (2000) assessed 65 pregnant women for cognitive vulnerability & depression before + after birth
— found that women who had high cog. vuln. (to think neg.) we’re more likely to suffer post natal depression
- SUPPORTS the cognitive approach
- (that neg. thinking can cause depression)

19
Q

criticism of Beck’s theory

A

does not explain how some symptoms of depression might develop
- some depressed patients show symptoms of anger, hallucinations, bizarre beliefs
— eg Cotard syndrome : believes they’re a zombie
- Beck’s theory fails to account for how these symptoms occur

20
Q

Ellis proposed that depression is caused by …

A

IRRATIONAL BELIEFS
- devised ABC model to explain how irrational & neg. beliefs are formed

21
Q

Ellis’s ABC model

A

ACTIVATING EVENT
- patients record events leading to neg. thinking
- triggered by event in the environ.
- eg exam failure, or getting fired
- this has a neg. effect on their mood and outlook
BELIEFS
- patients record their thoughts associated w the event
- (rational or irrational)
- eg they think they’re useless and stupid for failing an exam
- might record thoughts in a diary or journal so they can keep track of thinking
CONSEQUENCES
- patients record emotional response to their beliefs
- irrational beliefs can lead to neg. emotions like feeling upset
- consequences could be debated w many diff. options
- eg ‘if i fail maths and feel like i’m not good at it, i could feel upset, useless and demotivated, and i might drop out of the course or school’

22
Q

mustabatory thinking (Ellis)

A

this can cause irrational and neg. thinking that can be emotionally draining + lead to depression
- eg ‘i must be loved by everyone ‘ and ‘i must excel in all areas … otherwise i’m worthless’
- individual who holds these beliefs is bound to be disappointed or depressed
— these thoughts are too idealistic and expectations are too high

23
Q

strength of Ellis’s ABC model (evidence)

A

RESEARCH to SUPPORT the model as a cause of depression
- Bates (1999) found that depressed ops who were given neg. thought statements became more and more depressed
— supporting view that neg. thinking helps cause depression
- if psychologists know what causes depression the this can help provide effective treatments for curing it
- (eg cognitive therapy via changing neg. thoughts into positive ones)

24
Q

disadvantage of Ellis’s model➡️

A

CAUSE AND EFFECT
- not clear whether neg. thinking acc causes depression
- or if depression occurs first and this causes neg. and irrational thinking
- cause and effect needs to be established when looking at causes of depression

25
Q

disadvantage of ABC model (ignores…)

A

it BLAMES the client when looking at depression causes
- gives client some power to change the situation and improve their symptoms
- however, it could mean that situational factors that may have helped to cause depression are overlooked
- instead, psychologist examines thoughts alone as a cause

26
Q

criticism of the cognitive approach - ABC model

A

biological approach to understanding depression would criticise cog. approach
- bio approach suggests genes and neurotransmitters may cause depression
— low levels of serotonin
- Zhang (2005) found that there is a gene related to depression
— makes it 10x more likely for someone to develop illness
- bio approach would state that bio factors are more likely to cause depression than cog factors

27
Q

strength of ABC model (based on …)

A

based on sound scientific evidence that permits objective testing
- allows improvement of the model
- and greater understanding for the causes of depression as a whole

28
Q

strength of cognitive approach - ABC model 👩‍🍼

A

supporting evidence that ppl who develop depression in adulthood tended to experience INSECURE ATTACHMENTS in CHILDHOOD
- therefore seems to be a link between insecure childhood attachments contributing to neg. thinking, which can cause depression in adulthood

29
Q

CBT by Beck

A

cognitive behavioural therapy
- central idea is to CHALLENGE and RESTRUCTURE negative ways of thinking
- so they become position and rational
- has a positive influence on patients’ behaviour
- Beck would use the cognitive triad as the basis for his CBT (neg. thoughts abt self, world, future would be addressed)
- focuses on present experiences
- therapist needs to be highly trained

30
Q

CBT - patients

A
  • can be used in individual patients & small groups
  • allows patient to have some control over thinking
  • encouraged to identify their neg. thoughts
    — THOUGHT CATCHING
  • challenge their neg. thoughts and test them out
    — ‘is this really true? it can’t be because …’
  • patient must test out their neg. thinking / hypothesis and act as a scientist
  • encouraged to keep a record of events eg diary entries
  • reinforcement of positive thoughts is encouraged
  • weekly sessions
31
Q

strength of CBT (effective when …)

A

EFFECTIVE when a client has MILD depression
- CBT stops it from getting worse
- so it’s more applicable to clients who have mild symptoms rather than severe symptoms
- if symptoms are very severe, then drugs might be more appropriate than CBT

32
Q

weakness of CBT

A

most popular treatment for depression is anti depressant DRUGS
- require less effort than CBT
- Cujipers (2013) found that CBT can be very effective if it’s combined w drug therapy
- therefore, CBT by itself is not a very effective treatment, and drugs should be used alongside it

33
Q

advantage of CBT (widely respected and …)

A

WIDELY RESPECTED and SUPPORTED by vast amounts of RESEARCH as a therapy
- offered as a cost effective treatment for many disorders by the NHS
- (especially depression)
- quite economical treatment compared to other treatments such as the psychodynamic approach

34
Q

strength of CBT (tends to …)

A

tends to get to the ROOT CAUSE of the depressive problem
- usually cbt can uncover than real underlying issues that caused depression
- good bcs other treatments, like medication, tend NOT to get to root cause
— merely act as a ‘plaster’ that cover up and mask the symptoms
- therefore, CBT actually works as a cure for depression

35
Q

strength of CBT (tends to …)

A

tends to get to the ROOT CAUSE of the depressive problem
- usually cbt can uncover than real underlying issues that caused depression
- good bcs other treatments, like medication, tend NOT to get to root cause
— merely act as a ‘plaster’ that cover up and mask the symptoms
- therefore, CBT actually works as a cure for depression

36
Q

advantage of CBT (less likely to…)

A

can be used as a LONG TERM CURE
- once patient has undergone CBT, it has lasting positive outcomes
- high chance that they’ve acc been cured
- less likely to RELAPSE (compared to other treatments like medication)
- so, cost effective for the NHS
- patient is unlikely to return to hospital needed further treatment in the future
- (relapse rates are low)

37
Q

REBT by Ellis (1975)

A
  • rational emotive behavioural therapy
  • involves making clients think in a more rational ans positive way
  • challenge their thinking and show them how irrational their thoughts are
  • patients told to practise +ve & optimistic thinking, which can have a +ve impact on behaviour
38
Q

REBT: main differences to CBT by Beck

A
  • involves reinterpreting the ABC model to challenge -ve thoughts
    — eg the exam was hard, or not enough revision, instead of patient thinking they are useless and stupid
  • HOMEWORK - patients complete hw between sessions = vital for testing irrational beliefs in the real world and replacing them w more rational ones
  • BEHAVIOURAL ACTIVATION - encourages patients to become more active and engage in pleasurable activites
39
Q

REBT: DEF model

A

DISPUTING irrational thoughts & behaviour
- logical disputing occurs when self defeating beliefs don’t follow logically from the info
- eg ‘does thinking in this way make sense?’
- empirical disputing = when beliefs may not be consistent w reality

EFFECTS of disputing & effective attitude to life
- can change self defeating beliefs into more rational ones
- patient moves away from -ve & irrational thinking
- eg ‘she hasn’t replied bcs she’s busy not bcs she hates me’

FEELINGS / emotions
- patient begins to think in a more positive and rational way
- begin to feel better
- +ve impact on behaviour

40
Q

strength of REBT

A

Flannaghan et al (1997) supports it
- effective way to treat depressive stroke victims
- suggests that it’s a suitable treatment for specific groups of ppl w depression
- help them become more positive over time (thoughts and behaviour)

41
Q

strength of REBT

A

research support
- David (2008) compared 170 depressive patients who had 14 weeks of REBT w patients who were treated w medication (fluoxetine)
- outcomes were compared 6 months after treatment
- found that REBT was a better LONG TERM treatment compared to drug therapy

42
Q

disadvantage of REBT

A

unclear if the distorted thinking is the CAUSE of depression or only a symptom
- if symptoms, then REBT is not tackling the root cause of the depression
- might return in the future
- means that it hasn’t been cured properly

43
Q

disadvantage of REBT

A

it’s dependant on the patient being articulate and able to talk about their thought processes coherently
- wouldn’t work for ppl w severe depression if they were unable to talk or communicate properly
- or those uncomfortable talking abt their feelings
- other treatments would have to be considered (eg medication)

44
Q

disadvantage of REBT

A

success of treatment depends upon the SKILL & expertise of the THERAPIST
- the more skilled, the better the therapeutic outcomes will be
- essential for treatment’s effectiveness
- so, psychologists need to be highly skilled
— + develop a good rapport w client for it to be successful

psychopathology (4 decks)

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