PSYCHOPATHOLGY: Depression Flashcards
(15 cards)
Definition of depression
A mental disorder characterised by low mood and low energy levels
2 key characteristics:
1) feeling depressed for most of the day
2) diminished interest or pleasure in activities
Behavioural characteristics of depression
- Low activity levels/ less movement
> reduced levels of energy, making them lethargic - Disruption to sleeping
- Disruption to eating (weight gain or loss)
- Agression and self harm
> they can often become irritable, sometimes verbally and physically aggressive
Emotional characteristics of depression
- lowered mood
> feelings of worthlessness and emptiness - anger
> at themselves and others - lowered self-esteem
> self loathing
Cognitive characteristics of depression
- Poor concentration
>cant stick on a task
-dwelling on the negative/ negative schema
> they have a bias to recalling unhappy events
> they focus on the negative aspects of situation
- Absolutist thinking
> they think about all bad or all good terms
>”black and white thinking”
> “when a situation is unfortunate, they tend to see it as an absolute disaster
Cognitive explanations: Ellis’s ABC model
> description<
= depression occurs from irrational thoughts
- Activating event — a triggering event that leads to a …
- Belief — an irrational belief
- Consequence — irrational belief leads to unhealthy emotions and consequences
Eg.
A: u get fired
B: the company was overstaffed, Or they had it out in for you since the beginning
C: depression
MUSTABATORY THINKING = irrational beliefs in detail= source of irrational belief
- thinking certain ideas must be true for an individual to be happy
- an individual who holds these assumptions is bound to de disappointed and eventually get depressed
Cognitive explanations: Ellis’s ABC model
> Evaluations<
1)+ IT HAS PRACTICAL APPLICATIONS
- led to the development of CBT
- the idea that CBT and challenging irrational beliefs can reduce depression is supported by research (Lipskey et al 1980)
>this in turn supports the basic theory because it suggests that irrational beliefs have roles in depression
2) - ITS ONLY A PARTIAL EXPLANATION: DOESNT EXPLAIN NON-REACTIVE DEPRESSION
- there is no doubt that depression can be caused by activating events, this is called REACTIVE DEPRESSION
- this is different from kinds of depression that arise without an obvious cause
- this means the ABC only applies to some kinda of depression and therefor only a partial explanation
> hence it is more beneficial for us to combine the biological and behavioural approach to achieve a more holistic explanation
3) - IT DOESNT EXPLAIN ALL ASPECTS OF DEPRESSION
- despite Ellis describing why some people appear to be more vulnerable to depression than others ( as a result of their cognitive approach)
- his model doesn’t explain the anger associated with depression
- or the fact that some patients suffer from hallucinations and delusions (psychosis)
Cognitive explanations: Beck’s theory of Depression
> description<
- explains why people are vulnerable to depression
=Beck suggests that depression is due to faulty information processing
> which leads to negative thoughts
Beck claims that negative schemes and cognitive biases maintain the triad.
— the triad is a combinations of:
1) negative views of ones self
2) negative views of the world
3) negative views of the future
— A schema is a package of knowledge
- according to Beck, depressed people posses negative self-schemas, which may come from negative experiences (eg. Criticisms)
— cognitive biases
- beck found that people who are depressed are more likely to focus on the negative aspects of a situation while ignoring the positive
- prone to distorting this information AKA cognitive bias
Cognitive explanations: Beck’s theory of Depression
> evaluations<
1) + IT HAS GOOD SUPPORTING EVIDENCE
- Grazioli and Terry (2000).
> assessed 65 pregnant women for cognitive vulnerability and depression before and after birth
> they found that those women judged to have high cognitive vulnerability were more likely to suffer post natal depression
-these cognition’s could be seen before depression develops, suggesting that Beck may be right about cognition cause in depression, at least in some cases
2) - IT DOESNT EXPLAIN ALL ASPECTS OF DEPRESSION
- Becks theory explain the basic symptoms of depression, however depression is complex
- some depressed patients are deeply angry and cannot explain extreme emotions
- doesn’t explain the occurrence to Psychosis and delusion
Cognitive explanations: Alternative explanations
- the biological approach to understanding mental disorders suggests that genes and neurotransmitters may cause depression
>eg there is research that supports the role of low levels of neurotransmitters, serotonin in depressed people
> has also found that the gene related to this is 10x more common in people with depression (Zhang et al 2005) - also excessive drug therapies for treating depression suggests that biology plays a significant role
- the diathesis stress approach may be advisable
> suggest that individuals with genetic vulnerability for depression are more prone to the effect of living in a negative environment
> suggests that depression can’t be explained by the cognitive approach alone
Cognitive therapies: CBT (cognitive behaviour therapy)
> general rational<
- to change/ modify negative schemas/ irrational thoughts to help reduce depression
Cognitive therapies: CBT (cognitive behaviour therapy)
> definition<
Methods for treating mental disorders, based on both cognitive and behaviour techniques
- from the cognitive viewpoint, the therapy aims to deal with thinking
> dealing with challenging negative and irrational thoughts
Cognitive therapies: CBT (cognitive behaviour therapy)
> general facts<
- it is one of the most common therapies given by GP’s in the UK
> to make sure you don’t become dependant on drugs (addicted)
> to counter the side effects of drugs - it begins with an assessment in which the patient and therapist identify current problems
> irrational thoughts (that will benefit from being challenged)
>future goals - most CBT therapists draw form both Beck’s and Ellis’s models for CBT
Cognitive therapies: CBT (cognitive behaviour therapy)
> Beck’s cognitive therapy<
1) the idea is to IDENTIFY the irrational thoughts / negative triad
2) once identified, thoughts must be CHALLENGED
-3) Patient is TREATED AS A SCIENTIST
> they generate their own reasons for their depression and then they are tested in the therapy room
4) Patients are set homework such as record when they enjoyed an event or when people were nice to them
5) in future sessions,the patients may doubt their progress, such as no one is nice to them, or there is no point going to events, —- the therapist can produce EVIDENCE that the patient’s statements are incorrect
THIS IS CALLED REINFORCING THEIR POSITIVE THOUGHTS AND RECONSTRUCTING THEIR COGNITION
Cognitive therapies: CBT (cognitive behaviour therapy)
> ellis’s rational emotive behaviour therapy< EREBT
A: activating event
B: belief that is irrational
C: consequence
D: dispute
E: effect
— Central technique = ARGUMENTS —
- an REBT therapist would IDENTIFY negative thoughts and CHALLENGE this as an irrational belief.
- this would involve VIGOROUS arguments and RATIONAL CONFRONTATION
-the intended effect is to CHALLENGE the automotive negative thoughts and irrational beliefs to break the link between negative life events and depression
— Behavioural Activation —-
- alongside the purely cognitive aspects of CBT, the therapist may also work to encourage a depressed patient to be more active, and engage in enjoyable activities
- this behavioural activation will provide more evidence for the irrational nature of beliefs
— Types of disputes —
> Empirical argument = arguing whether there is accurate evidence to support a negative belief
Logical argument = arguing whether the negative thoughts logically follows the facts
Cognitive therapies: CBT (cognitive behaviour therapy)
> evaluations<
1) + IT IS EFFECTIVE
- study by March et all (2007) compared the effects of CBT with an anti-depressant drug and a combination of the two
> in 327 teenagers with a diagnosis of depression
>after 36 weeks
81% of the CBT group
81% of the anti-depressant group
And 86% of the combination were significantly improved
>CBT emerged to be just as effective as medication and helps along side it
2) - CBT MAY NOT WORK FOR THE WORST CASES OF DEPRESSION
- some patients with severe depression may not be able to motivate themselves to engage with the hard cognitive work of CBT
> they may not be able to concentrate on what’s happening
-to combat this people may start on anti depressants then commence CBT when they are more motivated
-so CBT cannot be the sole treatment for all cases of depression
3) - SUCCESS MAY BE DEPENDENT ON THE PATIENT-THERAPIST RELATIONSHIP
- there are chances that the quality of the relationship between therapist and patient is what determines the success of CBT rather than any particular cognitive technique
- many comparative views (Luborsky et al 2002) find a very small differences between the effectiveness of therapies, which supports the view that simply having an opportunity to talk to someone who will listen is what matters most
4) - SOME PATIENTS REALLY WANT TO EXPLORE THEIR PAST (psychotherapy)
- CBT focuses on the present and future
- so it neglects the patients that are aware of teh link between their childhood experiences and current depression and want to talk about their experiences
- they can find the present-focus nature of CBT very frustrating.
