lecture 8

Question 1

What is an emotion?

Answer 1

processes comprising appraisal, motivational, somatic, motor and feeling components
prolonged negative emotional experiences lead to mood problems which may then require treatment.

Question 2

Process of experiencing an emotion
- system of appraisal

Answer 2

Moors et al (2013) - APPRAISAL
Experiencing an emotional state involves changes in a number of subsystems or components
This process is continuous and recursive
Changes in one component feedback to other components

Question 3

APPRAISAL THEORY - 5 COMPONENTS

Answer 3

appraisal: evaluations of the environment and the person environment interaction

-Motivational: specific action tendencies or other forms of action readiness

somatic/arousal: peripheral physiological responses

Motor: expressive and instrumental behaviour

Feeling: subjective experience (FEELINGS ARE A RESULT OF OUR EMOTIONS

Question 4

Somatic marker hypothesis

Answer 4

somatic markers are emotional reactions with a strong somatic component that support decision making, including rational decision making (NB. somatic means physical bodily sensation)
Physiological changes to the body in response to a stimulus are relayed to the brain and experienced as an emotion
These, over time and learning become ‘somatic markers’ – associations with different situations

Question 5

two pathways for the reactivation of the somatic marker pathways
1) body loop

Answer 5

emotion is evoked by changes in the body projected to the brain
Body sensation leads to behavioural reaction via brain

Question 6

2) as if body loop

Answer 6

cognitive representations of the emotions activated in the brain without being directly influenced by physical sensations – anticipation of the event enough to trigger behavioural response
memory/ connection with past experience leads to anticipation leads to reaction

Question 7

Depression –facts and figures

Answer 7

One of the most common disorders worldwide
World Health organisation (2018) 300 million people of all ages around the world suffer from depression
In 26 countries, depression was the primary driver of disability (Mentalheath.org.uk)
13% of people presenting to their GP have depression (King et al, 2008)
Life-time prevalence rate in UK: 5% (Peveler et al., 2002)
Most common psychiatric disorder in later life: 10-15% of population aged 65+ suffer significant depressive symptoms (Iliffe, 2003)
Depression will become the 2nd most common cause of disability worldwide (after heart disease) by 2020 (WHO)

Question 8

Using psychological models to understand and treat depression5 P’s

Answer 8

Predisposing - what factors in the person’s life makes them vulnerable to psychological problems?

Precipitating - what event/ set of events has led to this problem occurring?

Presenting - what is the problem and how do you/ others know it is a problem?

Perpetuating - what keeps the problem going?

Protective - what has the person got in their lives that is positive and can be built on?

Question 9

Biopsychosocial model

Answer 9

bio - logical vulnerability
biological factors such as genetic inheritance may create a vulnerability to depression
likely to be an interplay of several genes and processes that affect likelihood of developing depression

Question 10

Psychological approachrs + 3 NICE recommendations

Answer 10

Psychological approaches suggest that people’s depressed feelings, thoughts, or behaviours are linked
3 NICE recommended treatments for depression & their approach to change :
CBT – Cognitive Behaviour Therapy
IPT – Interpersonal Psychotherapy
BA - Behavioural Activation

Question 11

depression: understanding CBT framework
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Answer 11

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Question 12

GENERAL pointa about IPT

Answer 12

Mood and life situation (specifically one’s interpersonal situation)are linked
Depression is a medical illness which responds well to treatment
Assignment of the ‘sick role’ (your job is to get better, let yourself off the hook for other things)

Question 13

Interpersonal problems targeted by IPT are

Answer 13

role dispute
role transition
complicated bereavement
interpersonal deficits (i.e. long standing problems forming and retaining relationships)

Question 14

Formulation to intervention - IPT

Answer 14

Change in problem relationships/ relationship style will improve life and therefore mood
Define the problem (from one of the 4 possible interpersonal problems)
Complete an interpersonal inventory
Agree a focus
Therapist works with client to changing the problem relationships, learning skills to form new more helpful relationships, thinking generally about the impact of relationships on the person’s mood.
Therapist is ‘cheerleader’ -proactive with advice giving and questioning

Question 15

Understanding depression in Behavioural Activation framework

Answer 15

A model of depression based on learning theory
When people become depressed a lot of their behaviour functions to avoid unpleasant thoughts, feelings or situations but this also leads to missing out on positive reinforcers (especially social ones)
The therapy is designed to raise their awareness of this and the unintended consequences of their actions

Question 16

Formulation to intervention - CBT

Answer 16

CBT focuses on unhelpful thinking and behaviour
In CBT, the client is invited to IDENTIFY thoughts about themselves, the world and others that are leading them to feel gloomy
The therapist helps the client RECOGNISE these thoughts by getting them to complete ‘thought diaries’
Then, the client completes behavioural experiments to look at the evidence for and against these thoughts – to CHALLENGE their thoughts
Ultimately, CBT aims for the client to get a more realistic perspective on their situation which should lead to improved mood

Question 17

Formulation to intervention (BA)

Answer 17

Works by targeting the behaviours that maintain depression
Cognitions not targeted but some ways of thinking e.g. ruminating might be characterised as a behaviour which allows the person to avoid other things
Identify goals (short, medium and long term)that are
Activity scheduling (avoided activities, not just pleasant ones), structuring, social skills training, problem-solving

Question 18

CBT v’s BA
evidence

Answer 18

Richards et al (2016) In a randomised control trial, BA, a simpler psychological treatment than CBT, can be delivered by junior mental health workers with less intensive and costly training, with no lesser effect than CBT.

Question 19

CBT v’s IPT

Answer 19

Lemmens et al (2015) No differential effects between CT and IPT were found. Both treatments exceeded response in the WLC condition, and led to considerable improvement in depression severity that was sustained up to 1 year.

Question 20

IPT v’s BA

Answer 20

Not a popular comparison

Question 21

summary of CBT IPT and BA

Answer 21

CBT - assumption that our thinking influences our behaviour and they interact

BA has an emphasis on the role depressed behaviour has in perpetuating the depression through the process of avoidance. Behaviour change aims to manage that avoidance.

IPT sees a pivotal role for relationships (or lack of) and the interpersonal skills we have.

Question 22

• How does context influence mood? appraisals

Answer 22

What beliefs might these environments engender about yourself, the world, and others (key appraisals in depressive disorder (Beck, 1987).
It is essential that psychologists take the wider context into account