Explaining Depression Flashcards
(21 cards)
What are the 2 explanations of depression?
1) Becks cognitive theory of depression
2) Ellis’s ABC model
Cognitive approach
Explanations of depression follow a cognitive approach, suggesting that depression is due to irrational thoughts, resulting from maladaptive internal mental processes.
Beck’s cognitive theory of depression
American psychiatrist Aaron Beck (1967) suggested a cognitive approach to explain why some people are more vulnerable to depression than others. In particular it is a person’s cognitions that create this vulnerability, i.e. the way they think.
Beck suggested 3 parts to this cognitive vulnerability:
1) Faulty information processing
2) Negative self-schemas
3) The negative triad
1) Faulty information processing
Faulty information processing refers to the biased and irrational ways in which people with depression interpret and think about information from the world around them. They tend to:
- Focus on the negative aspects of a situation and ignore the positives (a cognitive bias).
- Jump to conclusions, often in a negative or pessimistic way.
- Blow problems out of proportion, making small issues seem much worse than they are.
For example, if a person with depression receives both praise and criticism at work. They may only focus on the criticism, interpreting it as evidence of failure or incompetence, despite also being praised.
This distorted thinking contributes to and maintains the negative beliefs and emotions typical of depression.
2) Negative self-schemas
A schema is a ‘package’ of ideas and information developed through experience. They act as a mental framework for the interpretation of sensory information. A self-schema is a package of information we have about ourselves. We use schemas to interpret the world, so if we have a negative self-schema, we interpret all information about ourselves in a negative way. They result in automatically negative cognitive biases.
3) The negative triad
The negative triad revolves around 3 schemas with a persistent automatic negative bias:
- The self - e.g., self-schemas, create feelings of inadequacy and worthlessness, and enhance any existing depressive feelings because they confirm the existence of low self-esteem.
- The world - thinking people are hostile or threatening, and creates the illusion that there is no hope anywhere.
- The future - thinking things will always turn out badly, which also enhances depression by reducing any hopefulness.
Essentially, a person with depression develops a dysfunctional view of themselves because of these 3 types of negative thinking that occur automatically, regardless of the reality of what is happening at the time. It can lead to avoidance, social withdrawal and inaction.
The negative triad develops in childhood but provides the framework for persistent biases in adulthood, leading to cognitive distortions - perceiving the world inaccurately. Cognitive distortions include overgeneralisation, which is when one negative experience results in an assumption that the same thing will always happen, and selective abstraction, whereby people with depression mentally filter out positive experiences and focus on the negative.
Strength - Beck
Point: A major strength of Beck’s cognitive explanation of depression is its significant practical application in the development of effective treatments, particularly Cognitive Behavioural Therapy (CBT).
Evidence: CBT works by identifying and challenging the negative thoughts and beliefs underlying the negative triad. Supporting this, March et al. (2007) conducted a study involving 327 adolescents diagnosed with depression and found that CBT was just as effective as antidepressants. After 36 weeks, 81% of both the CBT group and the antidepressant group showed significant improvement, and the combination group (CBT plus antidepressants) had an even higher improvement rate of 86%.
Justification: These findings highlight the real-world usefulness of Beck’s theory, as it can be translated into therapeutic practice. CBT, which directly stems from his cognitive explanation, has been shown to successfully treat depression in a large number of cases.
Implication: This increases the credibility of Beck’s model as it shows how understanding the cognitive roots of depression can lead to effective interventions. Moreover, on a broader scale, successful treatment through CBT can reduce absenteeism and improve workplace productivity, leading to economic benefits for society.
Counterargument: However, a key limitation of Beck’s cognitive explanation of depression is that it is incomplete and does not account for all aspects of the disorder.
Evidence: While the theory effectively explains the cognitive symptoms of depression, such as negative thought patterns, it fails to consider the wide range of emotional, behavioural, and physical symptoms. For example, individuals with depression often experience emotions like anger and irritability, which are not addressed by the theory. In more severe cases, sufferers may also experience hallucinations or delusions, such as Cotard Syndrome, in which the individual believes they are dead or do not exist.
Justification: This highlights that Beck’s theory only provides a partial explanation, limiting its usefulness in fully understanding the disorder or in guiding treatment for all sufferers—especially those with more complex symptoms which are not accounted for by this cognitive approach.
Implication: Therefore, while Beck’s model has practical benefits, its narrow focus means it may not be applicable to all individuals. A more holistic approach is needed to account for the full complexity and variability of depression, ensuring treatments can be tailored to meet a broader range of needs
Strength - Beck
Point: Beck’s cognitive theory of depression is supported by empirical research.
Evidence: Grazioli and Terry assessed 65 pregnant women for cognitive vulnerability and found that those identified as more cognitively vulnerable were significantly more likely to develop postnatal depression.
Justification: This finding supports Beck’s theory by demonstrating that dysfunctional thought patterns - such as those described in the negative triad - can be used to predict the onset of depression before clinical symptoms fully emerge.
Implication: This strengthens the validity of Beck’s explanation and suggests it can be used to inform preventative strategies. For instance, early cognitive interventions like CBT could be introduced to challenge negative beliefs before depression fully develops, reducing individual suffering and healthcare demands.
Point: On the other hand, the research by Grazioli and Terry has been criticised for the limited and gender-biased nature of its sample.
Evidence: The study only examined 65 pregnant women, which, while a reasonable sample size, lacks diversity in terms of gender, age, and life circumstances.
Justification: By focusing solely on pregnant women, the study introduces gender bias and fails to account for how cognitive vulnerability may manifest differently in men, children, or non-pregnant individuals. Additionally, pregnancy itself may uniquely influence cognitive processes, meaning the findings may not reflect general cases of depression.
Implication: This weakens the population validity of the study and limits the generalisability of the findings. While the research appears to support Beck’s theory, the sample’s restricted demographic reduces the applicability of the conclusions across broader populations.
Weakness - Beck
Point: A limitation of Beck’s cognitive theory of depression is that not all individuals who experience negative or distorted thinking go on to develop depression.
Evidence: Many people may show signs of cognitive vulnerability—such as pessimistic beliefs, low self-esteem, or a negative self-schema—without ever developing clinical depression. For example, individuals who are naturally self-critical or who interpret events negatively may still function well and report stable mental health.
Justification: This suggests that negative thinking patterns alone may not be sufficient to cause depression. Instead, they could be a symptom or consequence of the disorder rather than a root cause. Therefore, the direction of causality between negative thinking and depression is unclear. It questions the idea of whether negative thoughts cause depression, or if depression leads to more negative thinking.
Implication: This weakens the explanatory power of Beck’s model as it does not fully account for why some people with cognitive distortions become depressed while others do not. It implies that other factors—such as biological vulnerabilities or environmental stressors—must also be considered for a more complete understanding of depression.
Weakness - Beck
Point: A significant weakness of Beck’s cognitive explanation is its overreliance on the cognitive aspect of depression, which reduces the complexity of the disorder to just thought processes.
Evidence: Although Beck’s theory effectively highlights how negative schemas, faulty information processing and the negative triad contribute in explaining depression, it fails to acknowledge other important causes. For instance, biological factors such as genetic predispositions or neurotransmitter imbalances have been strongly linked to the onset of depression. Research has shown that low levels of serotonin are associated with depressive symptoms, and the effectiveness of biological treatments like selective serotonin reuptake inhibitors (SSRIs) further supports a biological basis.
Justification: By ignoring these genetic and neurochemical influences, Beck’s theory lacks explanatory power for cases where depression may arise independently of cognitive vulnerability. This makes the theory reductionist, as it oversimplifies a multifaceted mental health condition by attributing it solely to distorted thinking patterns.
Implication: Therefore, while the theory is valuable in explaining certain aspects of depression, its narrow focus limits its applicability. A more holistic approach that incorporates cognitive, biological, and environmental factors would provide a fuller and more accurate understanding of the disorder.
Ellis’s ABC model
- American psychiatrist, Albert Ellis (1962) suggested a different cognitive explanation of depression.
- He proposed that good mental health is the result of rational thinking, defined as thinking in ways that allow people to be happy and free of pain.
- To Ellis, conditions like anxiety and depression (poor mental health) result from irrational thoughts. Ellis defined irrational thoughts, not as illogical or unrealistic thoughts, but as any thoughts that interfere with us being happy and free of pain.
- Ellis used the ABC model to explain how irrational thoughts affect our behaviour and emotional state.
- A = Activating event, B = Beliefs, C = Consequences.
- It is the irrational beliefs which trigger the response, not the event itself.
ABC model
Whereas Beck’s emphasis was on automatic thoughts, Ellis focused on situations in which irrational thoughts are triggered by external events. According to Ellis, we get depressed when we experience negative events and these trigger irrational beliefs. Events like failing an important test or ending a relationship might trigger irrational beliefs. However, any event regardless of whether it has negative connotations, can still evoke a negative response from the depressed patient. This is due to the irrational beliefs the individual has regarding such events, which tend to be pessimistic. Ellis identified a range of irrational beliefs, for example, ‘musturbation’ or ‘mustabatory thinking’ refers to the belief that one must always succeed or strive for perfection, however it also refers to the consequence of not accepting that we don’t live in a perfect world. Additionally, utopianism is the belief in or pursuit of a perfect society where everything is ideal—socially, politically, and morally. Rational beliefs lead to positive consequences whereas irrational beliefs lead to negative consequences.
Strength - Ellis
Point: One major strength of Ellis’ ABC model is its clear and effective application in psychological therapy, particularly Rational Emotive Behaviour Therapy (REBT).
Evidence: REBT directly stems from Ellis’ ABC model and is designed to help individuals identify, dispute, and replace their irrational beliefs that follow an activating event (A) and lead to emotional consequences. By challenging these irrational thoughts—such as “I must be perfect to be valued”—patients are encouraged to adopt more rational, flexible beliefs that promote healthier emotional responses. Numerous studies have demonstrated the effectiveness of REBT and similar cognitive-based therapies in reducing symptoms of depression. For example, David et al. (2008) found that REBT was significantly more effective than placebo treatments and in some cases even more effective than drug therapy.
Justification: This strong practical foundation shows that Ellis’ explanation isn’t just theoretically sound but also has meaningful, positive real-world impact. It helps people manage and reduce their depression by empowering them to change their irrational thought patterns, thereby enhancing their sense of control over their emotional state.
Implication: As a result, this boosts the credibility and validity of Ellis’ model, demonstrating that it is not only useful for understanding depression but also for treating it effectively. Its therapeutic success makes it a valuable contribution to the cognitive approach in treating depression.
Counterargument: Despite its practical value, Ellis’ ABC model and its associated treatment (REBT) may not be effective for all individuals suffering from depression.
Evidence: The model assumes that depression results primarily from irrational thinking and that by changing thought patterns, symptoms can be alleviated. However, not all forms of depression stem from faulty cognition. For example, some individuals experience depression due to significant life events, e.g., bereavement, trauma or biological causes, such as a genetic predisposition or neurotransmitter imbalances. In such cases, addressing irrational beliefs may not be sufficient. Additionally, individuals with severe depression may lack the motivation, energy, or mental clarity to engage in the active, disputational nature of REBT.
Justification: This questions the universality of Ellis’ model and suggests it may be overly simplistic or reductionist by failing to take into account the complex interplay of biological, social, and environmental factors that can contribute to depression, limiting its applicability to more cognitively driven cases.
Implication: Therefore, while the ABC model offers useful therapeutic tools, it should be integrated into a more holistic approach that acknowledges other contributing factors to ensure more tailored and effective treatment for a broader range of individuals with depression.
Strength - Ellis
Point: One strength of Ellis’s explanation of depression is its focus on present thinking patterns rather than unresolved past experiences.
Evidence: According to Ellis’s ABC model, it is not the activating event (A) that directly causes emotional disturbance, but rather the beliefs (B) that the individual holds about the event. These beliefs are typically irrational, such as demanding perfection or catastrophising failures, and they result in negative emotional consequences (C).
Justification: This emphasis on current beliefs and interpretations gives the explanation a clear, structured, and practical framework for understanding depression. Unlike some psychodynamic approaches that delve into childhood trauma or unconscious processes, Ellis’s model provides an immediate and accessible explanation that resonates with many sufferers. It also avoids potentially distressing explorations of the past and instead empowers individuals to recognise and address their current patterns of thought.
Implication: Therefore, the focus on present cognition increases the real-world applicability and relevance of Ellis’s theory. It offers a straightforward and logical account of how irrational thoughts can lead to emotional problems, making the explanation useful both in understanding the condition and informing present-focused interventions like REBT.
Weakness - Ellis
Point: A major criticism of Ellis’s ABC model is that it places too much responsibility on the individual for their mental health issues.
Evidence: The theory suggests that depression arises because of irrational beliefs and faulty thinking patterns. While cognitive factors certainly play a role, this assumption implies that individuals are largely to blame for their condition because they have chosen to think irrationally.
Justification: This can be seen as ethically problematic as it overlooks significant external factors such as abuse, trauma, financial hardship, or discrimination, which can contribute to depression independently of the person’s thinking. Suggesting that individuals are depressed due to their own irrational thinking may lead to feelings of guilt or shame, potentially worsening their emotional state and reducing their willingness to seek help.
Implication: Therefore, although Ellis’s theory has therapeutic value, its tendency to overlook situational and environmental contributors makes it potentially unfair and overly simplistic. A more balanced approach that combines both cognitive and external factors would offer a more compassionate and comprehensive understanding of depression.
Weakness - Ellis
Point: A significant limitation of Ellis’s ABC model is that it provides only a partial explanation of depression.
Evidence: Ellis’s model is particularly effective in explaining cases of reactive depression, which occur as a direct result of activating events—such as losing a job or the end of a relationship. In these cases, irrational beliefs about the event may lead to emotional and behavioural consequences such as low mood or withdrawal. However, not all depression is triggered by identifiable external events. Many individuals experience endogenous depression, which arises without any clear or obvious cause.
Justification: This suggests that Ellis’s cognitive explanation may not fully apply to all forms of depression, especially when no specific event can be pinpointed as the trigger. By focusing mainly on irrational thoughts following external events, the theory overlooks other factors that can contribute to the development of depression.
Implication: Therefore, the ABC model may lack explanatory power in cases where depression occurs independently of life experiences, limiting its overall applicability.
Strength
Point: One strength of the cognitive explanation for depression is its successful application to therapy.
Evidence: Cognitive ideas have been used to develop effective treatments such as Cognitive Behavioural Therapy (CBT), which is based on identifying and challenging negative thought patterns. Research by Lipsky et al. (2007) found that CBT was particularly effective in reducing depressive symptoms in patients, especially when compared with control groups who did not receive therapy. Additionally, Rational Emotive Behaviour Therapy (REBT), which stems from Ellis’s ABC model, also uses cognitive restructuring to help patients manage irrational beliefs and negative emotions.
Justification: The success of these treatments in reducing depressive symptoms supports the cognitive view that dysfunctional thinking plays a key role in the development and maintenance of depression. If changing thought patterns leads to symptom improvement, it suggests that cognition is a meaningful target for intervention.
Implication: This enhances the credibility and practical value of the cognitive explanation, as it not only helps to understand the disorder but also contributes to effective treatment strategies that improve real-world outcomes for sufferers.
Counterargument: However, a limitation of the cognitive explanation of depression is that it does not consider other factors, e.g., biology, which also play a significant role.
Evidence: Family studies and genetic research indicate that there may be a hereditary predisposition to depression, likely involving genes that affect neurochemical activity, such as serotonin. Additionally, the success of biological treatments like SSRIs (Selective Serotonin Reuptake Inhibitors), which alter serotonin levels and alleviate depressive symptoms in many patients, supports the idea of a biological basis.
Justification: These findings challenge the cognitive explanation’s assumption that negative thought patterns are the root cause of depression. Instead, they indicate that depression likely arises from a combination of cognitive vulnerabilities and biological dysfunctions, including neurotransmitter imbalances and inherited traits.
Implication: Therefore, although the cognitive explanation contributes important insights into how thought processes influence depression, it may be too narrow. A more complete understanding and effective treatment of depression would require integrating cognitive, biological, and emotional perspectives.
Strength
Point: The cognitive theory of depression is supported by empirical research.
Evidence: Grazioli and Terry assessed 65 pregnant women for cognitive vulnerability and found that those identified as more cognitively vulnerable were significantly more likely to develop postnatal depression.
Justification: This supports the cognitive explanation by showing that negative thinking patterns can predict future depression, suggesting they play a causal role. It strengthens Beck’s theory in particular by demonstrating that cognitive vulnerability—such as faulty beliefs and negative interpretations—contributes to the development of depression, not just its symptoms.
Implication: This has real-world value, as it means individuals at risk can be identified early through cognitive assessments, allowing for timely intervention using therapies like CBT to reduce the likelihood or severity of depressive episodes.
Point: On the other hand, the research by Grazioli and Terry has been criticised for the limited and gender-biased nature of its sample.
Evidence: The study only examined 65 pregnant women, which, while a reasonable sample size, lacks diversity in terms of gender, age, and life circumstances.
Justification: By focusing solely on pregnant women, the study introduces gender bias and fails to account for how cognitive vulnerability may manifest differently in men, children, or non-pregnant individuals. Additionally, pregnancy itself may uniquely influence cognitive processes, meaning the findings may not reflect general cases of depression.
Implication: This weakens the population validity of the study and limits the generalisability of the findings. While the research appears to support the cognitive explanation, the sample’s restricted demographic reduces the applicability of the conclusions across broader populations.
Weakness
Point: A limitation of the cognitive explanation of depression is that it struggles to account for the full range of symptoms associated with the disorder.
Evidence: Many individuals with depression report experiencing emotions like anger, and those with bipolar depression may go through manic episodes, marked by extreme happiness, excitement, confidence, and intense focus.
Justification: These emotional and behavioural features are difficult to explain through Beck’s emphasis on cognitive vulnerability or Ellis’s focus on irrational beliefs. Such models mainly address negative thinking and low mood, failing to capture the complexity and variety of depressive symptoms.
Implication: This suggests that the cognitive explanation may be too narrow and reductionist, overlooking important emotional and behavioural components of depression and limiting this approach in explaining cases of depression that aren’t predominantly rooted in cognitive distortions.
Strength
Point: There is research evidence which supports the cognitive explanation of depression.
Evidence: Boury et al. (2001) found that patients with depression were more likely to misinterpret information negatively (showing cognitive bias) and feel hopeless about their future, which is consistent with Beck’s concept of the negative triad.
Justification: This supports the idea that distorted thinking patterns are closely linked to depression and validates the cognitive model’s focus on negative interpretations and beliefs as key contributing factors.
Implication: Therefore, the cognitive explanation of depression is strengthened by this evidence, as it demonstrates real-world application. It also provides a solid foundation for treatments like CBT, which aim to challenge and restructure these faulty thought patterns.
