Depression

Question 1

What are the behavioural characteristics of depression?

Answer 1

1. Activity levels:
   - Reduced levels of energy, making them lethargic.
   - In some cases can cause sufferers to become agitated.
2. Disruption to sleep and eating behaviour:
   - Includes reduced sleep or an increased need for sleep.
   - Appetite can increase or decrease.
3. Aggression and self-harm:
   - Sufferers are often irritable and can become very half or physically aggressive.
   - Physical aggression can be directed towards the self.

Question 2

What are the emotional characteristics of depression?

Answer 2

1. Lowered mood:
   - Patients offer describe themselves as worthless and empty.
2. Anger:
   - Can be directed at self or at others.
3. Lowered self-esteem:
   - Sufferers feel less like themselves and can extreme cases can include self-loathing.

Question 3

What are the cognitive characteristics of depression?

Answer 3

1. Poor concentration:
   - Sufferers may be unable to stick to a task or find it difficult to make decisions.
2. Attending to and dwelling on the negative:
   - Sufferers are inclined to pay more attention to the negative aspects of a situation.
3. Absolutist thinking:
   - ‘Black or white thinking’
   - If something is unfortunate, patients see it as a disaster.

Question 4

What is Beck’s theory of depression?

Answer 4

• Believed depression stemmed from irrational, faulty thinking.
• Negative interpretations of the world, coming from:

1. Negative world view:
   - Depressed people acquire a negative schema during childhood which makes them adopt a negative view of the world.
2. Faulty information processing:
   - Sufferers become prone to making errors in their thinking.
3. Cognitive triad:
   - Negative view of the self, the world and the future.

Question 5

Evaluate Beck’s theory of depression.

Answer 5

1. Supporting evidence:
   + E.g. Grazioli and Terry assessed 65 pregnant women for cognitive vulnerability before and after birth.
   + Women judged to have a high cognitive vulnerability were more likely to suffer from postnatal depression.
   — However, the study only focuses on one group, so it may not be representative.
2. Practical applications:
   + Beck’s theory has been very influential as the theory forms the basis of CBT.
   + Translates well into a successful therapy that tackles depression.
   — However, depression is very complex.
   — Beck’s theory can’t explain symptoms such as deep anger, hallucinations and buzzard beliefs.
3. Ethical concerns:
   — Implies the individual is responsible for their own faulty thinking, which can be stressful.
   — Can lead to people feeling blamed for thinking in an abnormal way.
   + However, there is an element of free will as people can change their faulty thinking patterns during therapy.

Question 6

What is Ellis’ theory of depression?

Answer 6

• Ellis developed the ABC model.
• He defined irrational thoughts as any thoughts that interfere with us being happy.
• He used the ABC model to explain how irrational thoughts affect us:

Activating event:
- According to Ellis, we get depressed when we experience negative events.
- These can include the ending of a relationship or trigger irrational beliefs.

Beliefs:
- The explanations of the event.
- Can be rational or irrational.

Consequences:
- Can be productive or unproductive depending on the beliefs.
- Irrational beliefs lead to maladaptive consequences and lead to depression.

• Musturbatory thinking- Thinking that certain ideas must be true if one is to be happy such as:
• I must be approved of or accepted.
• I must do well otherwise I am worthless.
• Others must treat me fairly.

Question 7

Evaluate Ellis’ theory of depression.

Answer 7

1. Supportive evidence:
   + Joseph Cohen et al tracked the development of 473 adolescents by regularly measuring their cognitive vulnerability.
   + Those with high cognitive vulnerability were more lily to become depressed in later life.
   + Strength as it demonstrates a relationship between such thinking patterns and depression.
   — Hard to rule out confounding variables in the study such as poor social support.
2. Successful therapy:
   + Led to REBT and the idea that challenging negative beliefs can reduce depression.
   + Supported by research evidence as it suggests that the irrational beliefs have some role in the depression.
   — However, Ellis’ theory explains why some people appear more vulnerable to depression due to their cognitions.
   — Ellis is unable to explain some symptoms such as hallucinations and bizarre beliefs.
3. Does acknowledge situation effects:
   + There is no doubt many cases of depression have been due to the breakdown of a relationship. This is called reactive depression.
   + It is more ethical as it doesn’t blame the patient for their depression.
   — However, the precise role of cognitive records are yet to be determined.
   — Does the activating event cause depression or does depression cause the activating event?
   — Isn’t clear if faulty cognitions are a cause of depression a consequence of it.

Question 8

How is depression treated using Beck’s theory?

Answer 8

• Beck developed cognitive behavioural therapy (CBT) which aimed to identify and challenge faulty thoughts and replace them with more positive thoughts.
• Some techniques used are:

1. Goal setting:
   - The client meets with the therapist to describe their specific problems and to set goals they want to work towards.
2. Challenge negative thoughts:
   - The client is taught to challenge negative thoughts and to replace them with more constructive ones.
   - It is hoped that this way of thinking can help change the client’s behaviour.
3. Dysfunctional thought diary:
   - Clients are asked to keep a record of events leading up to any unpleasant emotions experienced.
   - They are then asked to record the ‘negative’ thoughts experienced and rate how much they believe these thoughts.
   - They are then required to write a rational response to the negative thoughts and rate their belief in the rational response.
4. Homework:
   - The therapist sets regular ‘homework’ assignments.
   - Can include meeting up with friends or writing down when you get a compliment.

• CBT is briefer than many other forms of therapy, with the average number of sessions between 16 and 20.

Question 9

How is depression treated using Ellis’ theory of depression?

Answer 9

• Ellis developed REBT which extend the ABC model to the ABCDEF model:
• Disrupting irrational thoughts.
• Effects of disputing and the effective attitude to learning.
• Feelings that are produced.
• The main technique is to challenge and dispute irrational thoughts and replace them with rational beliefs.
• These can include:

1. Logical disputing:
   - Self-defeating beliefs do not logically follow from the information available.
   - Does thinking this way logically make sense?
2. Empirical disputing:
   - Self-defeating beliefs may not be consistent with reality.
   - Where is the proof?
3. Pragmatic disputing:
   - Emphasises the lack of usefulness of self-defeating beliefs.
   - How is the belief likely to help?

Question 10

Evaluate CBT and REBT.

Answer 10

1. Effective treatment:
   + March studied 327 depressed adolescents. After 36 weeks, 81% of patients who had received CBT said their symptoms had improved.
   + Shows many people have banister fin the throat and provides support that the NHS should offer CBT before antidepressants.
   — However, depression may be so severe in some cases that patients cannot motivate themselves to engage with the hard cognitive work.
   — They may not be able to pay attention to what is happening in a session and may need antidepressants before CBT.
2. Appropriateness:
   — Overemphasises the role of cognition on the cause of someone’s depression.
   — Criticised for not considering other factors such as social circumstances.
   — Some patients may have rational thoughts under some circumstances, so may need to change their circumstance instead of their thoughts.
   — Therefore CBT cannot treat everybody.
3. Cost effective:
   + Relatively short terms unlike antidepressants.
   + Average number of sessions for REBT is several, whereas antidepressants are taken for months or even years.
   + CBT sessions don’t search for deep meanings which some people don’t want - they just want to focus of creating better, so they are more likely to be motivated to complete treatment.
   — However, there are ethical concerns as REBT can be seen as judgemental due to the vigorous argument between the therapist and client.
   — This is a weakness as the therapist can manipulate the client’s behaviour and a risk of someone who is already feeling vulnerable to be psychologically harmed by the vigorous argument.