Psychopathology Flashcards
(120 cards)
1
Q
What is the statistical definition of abnormality?
A
Defining normal or abnormal according to the number of times we observe it. When a behaviour is statistically infrequent it is regarded as abnormal.
2
Q
Which definition of abnormality uses the normal distribution curve?
A
Statistical definition of abnormality.
3
Q
What is the normal distribution curve?
A
A graph in which the majority of people will fall in the middle of, with the minority being at either extreme of the graph.
4
Q
What is an example of abnormality that supports the statistical definition of abnormality?
A
IQ. The average IQ is 100 and most people have an IQ of 85 - 115. 2% of people score under 70 and are regarded as abnormal. These people would probably be diagnosed with intellectual disability disorder.
5
Q
Name 2 strengths of the statistical definition of abnormality.
A
Any from:
- real life application in diagnosing intellectual disability disorder. This is useful to clinical assessment.
- gives quantitive data which is objective and therefore reliable.
- there is no value judgement. Behaviour is not seen as unacceptable, merely less frequent e.g homosexuality.
- statistical evidence that a person has a mental disorder can justify requests for psychic assistance.
6
Q
What are 2 weaknesses of the statistical definition abnormality?
A
Any from:
- unusual characteristics can be positive and requires no treatment e.g. high IQ scores.
- not everyone benefits from a label. If they are happy, capable of work etc a label could have a negative effect.
- depression is common in the UK but is still considered abnormal.
- a person may score one above what is classes as abnormal e.g. IQ of 71 would be classes as normal but the person may still need help.
- ignores cultural factors. What is statistically normal in one culture may not be in another.
7
Q
What is the socials norms definition of abnormality?
A
Behaviour which conforms to the social norms is normal and behaviour that does not is abnormal
8
Q
What is a social norm?
A
Unwritten rules for appropriate conduct we expect and behaviour we don’t expect.
We make a collective judgement of what is right.
9
Q
What does a psychopath have?
A
Antisocial personality disorder
10
Q
What are some traits of a psychopath?
A
Impulsive, aggressive, irresponsible
Absence of pro social internal standards
Failure to conform to lawful or culturally normative ethical behaviour
11
Q
What are two strengths of the social norms definition of abnormality?
A
- real life application - diagnosing antisocial personality disorder
- it seeks to protect society from the effects an individuals abnormal behaviour can have on others
12
Q
What are two weaknesses of the social norms defintion of abnormality?
A
- it is not the sole explanation, there are other factors to consider in defining abnormality e.g. failure to function adequately.
- social norms vary between cultures and over time as attitude change.
13
Q
what is the failure to function adequately defintion do abnormality?
A
- can no longer cope with the demands of every day life.
E.g unable to maintain basic standards of nutrition or hygiene.
E.g unable to hold down a job to maintain relationships with others.
14
Q
What are some things people experience when they fail to function adequately? (Name 3)
A
Personal distress
Maladaptive behaviour
Unpredictability
Irrationality
Observer discomfort
Violation of moral standards
Unconventionality
15
Q
What is assessment of functioning?
A
It asses how well individuals cope with every day life. Clinicians use the GAF (global assessment of functioning scale). This rates their level of social, occupational and psychological functioning.
16
Q
What are two strengths of the failure to function adequately definition of abnormally?
A
- it asses the degree of abnormality (GAF is a continuous scale) so can decide who neeeds psychiatric help.
- recognises the personal experience and perception of suffers.
17
Q
What are two weaknesses of the failure to function adequately definition of abnormally?
A
- abnormality is not always accompanied by failure to function e.g. Harold Shipman murdered 215 patients. This is abnormal but he didn’t show dysfunction.
- normal abnormality - suffering distress because of grief is psychologically healthy. The definition can’t account for this.
18
Q
What does the deviation from ideal mental health definition of abnormality definition focus on?
A
Identifying who deviates from being psychologically heathy and has an absence of wellbeing.
19
Q
What are Jahoda’s characteristics of ideal mental health?
A
Positive attitude
Self actualisation
Autonomy
Resisting stress
Accurate perception of reality
Environmental mastery
20
Q
the deviation from ideal mental health definition of abnormality definition focuses o behaviours and characteristics that are seen as _____. The more characteristics individuals fail to meet, the more ____________ they are.
A
Desirable
Abnormal
21
Q
What are two strengths of the deviation from ideal mental health definition of abnormality definition?
A
Targets areas of dysfunction - important for treatment of different disorders.
Goal setting- can identify what is needed to achieve normality. Personal goals can be set and achieved facilitating self-growth.
22
Q
What are two weaknesses of the deviation from ideal mental health definition of abnormality definition?
A
Over-demanding criteria - most people do not meet all the ideals. According to this definition most of us are abnormal. They are ideals rather than actualities.
Subjective criteria - many of the criteria are vague and difficult to measure. Diagnosis is largely reliant on self-report from patients who are ill (may be unreliable).
23
Q
What type of disorder is a phobia?
A
A type of anxiety disorder
24
Q
What are the ‘characteristics’ of a phobia?
A
- interferes with daily living.
- excessive, uncontrollable, extreme fear.
- conscious avoidance of the feared object or situation.
- the extent of the fear is out of proportion to any real danger presented by the phobic stimulus.
25
How many people will suffer from a phobia at some point in their life?
10%
26
What are the 3 types of phobia according to the DSM 5?
- specific phobia
- social phobia
- agrophobia
27
What is a specific phobia?
Phobia of an object, such as an animal or body part, or situation such as flying or having an injection.
28
What is social phobia?
Phobia of a social situation such as public speaking or using public toilets.
29
What is agraphobia?
Phobia of being outside or in a public place
30
What are the 3 characteristics of phobias?
Emotional
Behavioural
Cognitive
31
Describe the emotional characteristics of a phobia.
Anxiety - an unpleasant state of arousal
Fear - the immediate and extremely unpleasant strong response
32
Describe the behavioural characteristics of a phobia.
Panic - crying, screaming, running away, fainting, collapsing, vomiting
Avoidance - avoiding coming into contact with the phobic stimulus
Endurance - the individual remains in the presence of the phobic stimulus but continues to experience high levels of anxiety, often frozen still
33
What are the cognitive characteristics of a phobia?
Selective attention to the phobic stimulus - if the individual can see the phobic stimulus it is hard to look away from it.
Irrational beliefs - a phobic may hold irrational beliefs in relation to the phobic stimulus.
Cognitive distortion - the phobic perceptions of the phobic stimulus may be distorted.
34
What does the behavioural approach use to explain phobias?
The two way process model
35
What are the two parts of the two way processing model - Mowrer 1960?
Acquisition by classical conditioning
Maintenance by operant conditioning
36
What is acquisition by classical conditioning in the two process model?
Classical condition develops a phobia which can be generalised to similar objects
37
What is Maintenance by operant conditioning in the two way processing model?
Negative reinforcement - individual avoids the phobic stimulus yo avoid the fear and anxiety they would have suffered.
Positive reinforcement - reduction of the fear is a desirable consequence.
The avoidance behaviour is more likely to be repeated in the future as it has been reinforced.
The phobia is therefore maintained.
38
What are 2 strengths of the two process model?
- good explanatory power - explains how phobias could be maintained over time. Explains why patients need to be exposed to the phobic stimulus. Once a patient is prevented from practicing their avoidance behaviour, the behaviour cases to be reinforced and so it declines.
- DI gallo 1996. Reported that 20% of people exercised traumatic car accidents developed a phobia of travelling in cars, especially at speed.
- the effectiveness of behaviourist treatment e.g systematic desensitisation in addressing phobic symptoms is effective.
39
What are two weaknesses of the two process model?
- an incomplete explanation of phobias. The two factor theory doesn’t mention that evolutionary factors probably have an effect in phobias. Eg we easy acquire phobias of things that have been a source of danger in our evolutionary past. Eg biological preparedness - the innate pre disposition to acquire certain fears.
- phobias don’t always follow a trauma. Sometimes people are not aware of having a related bad experience to their phobia.
- trauma doesn’t always lead to a phobia. - the behaviourist viewpoint is weakness by the fact that not everyone experienced traumatic events e.g car accidents develop a phobia.
40
What are the 2 behavioural approaches to treating phobias?
Systematic desensitisation
Flooding
41
Describe the 3 stages in systematic desensitisation.
1. Anxiety hierarchy - put together by the patient and the therapist. A list of situations related to the phobic stimulus that provoke anxiety in order of least to most anxiety provoking.
2. Relaxation therapy - therapist teaches the patient relaxation methods
3. Exposure to anxiety hierarchy - if patient remains calm they can move up the hierarchy.
42
What are 2 strengths of systematic desensitisation?
- patients prefer it compared to other methods e.g flooding. This is reflected by low refusal and attrition rates.
- it is suitable for a wide range of patients e.g some people with anxiety have learning difficulties and may find it hard to understand what s happening or engage with cognitive therapies that require you to reflect on what you’re thinking.
43
What are 2 weaknesses of systematic desensitisation?
- ethical considerations - can be psychologically harming.
- symptom substitution - when a phobia is overcome it may be replaced by another one.
44
Describe how flooding works.
1. Immediate/ full expose to phobic stimulus
2. Prevention of avoidance
3. Continue until the patient is calm/ fear is extinguished
45
What is flooding?
Exposing the phobic patients to their Phobic stimulus but without the gradual build up in an anxiety hierarchy.
46
What is a positive of flooding?
Cost effective - quick treatment = less cost
47
what are 2 weaknesses of flooding?
-can be psychologically harmful as it is a highly traumatic experience
- cannot treat complex phobias e.g agoraphobia
48
How long does flooding typically last?
1 session
49
How long does systematic desensitisation typically last?
A few months of sessions
50
what does OCD stand for?
Obsessive compulsive disorder
51
What are the two components of OCD?
Obsessions - internal component
Compulsions - external component
52
What are obsessions?
Recurring, intrusive thoughts, images etc. – things that people think about, often inappropriate ideas not based on reality e.g. deadly germs lurk everywhere, which lead to extreme anxiety
53
What are compulsions?
What people do as a result of the obsessions
Uncontrollable urges to repetitively perform tasks and behaviours
e.g. hand washing to get rid of germs)
They are an attempt to reduce distress/prevent feared events (even though they probably won’t)
54
What are the behavioural characteristics of OCD?
**Compulsions**
- Compulsions are repetitive (Sufferers feel compelled to repeat a behaviour)
E.g. handwashing, counting, praying, tidying/ordering objects like CDs or tins of food
- Compulsions reduce anxiety
Compulsive behaviours are mostly performed to try and manage the anxiety caused by obsessions
E.g. compulsive handwashing performed as a response to obsessive fear of germs
**anxiety**
Attempt to reduce anxiety by keeping away from situations that trigger anxiety
E.g. sufferers who wash compulsively may avoid coming into contact with germs
55
What are the emotional characteristics of OCD?
Anxiety and distress
-Unpleasant emotional experience due to the anxiety that accompanies the obsessions and compulsions
Accompanying depression
-The anxiety can be accompanied by low mood and lack of enjoyment in activities
Guilt and disgust
-As well as anxiety and depression, other negative emotions such as irrational guilt are felt
Disgust may be directed against something external e.g. dirt or at the self
56
What are the cognitive characteristics of OCD?
Obsessive thoughts
- Thoughts that recur over and over again
These vary between person to person but are always unpleasant
E.g. worries of contamination from germs or door being unlocked and intruder coming in
Insight to excessive anxiety
- they are aware their obsessions and compulsions are not rational
Catastrophic thoughts
- worst case scenarios
Hyper vigilance
- show attentional bias– constant alertness for potential hazards and focussed on anxiety-generating stimuli
Irrational beliefs
57
What are the genetic explanation to explaining OCD?
The explanation centres on OCD being inherited through genetic transmission.
What is probably passed down from one generation to the next is genetic vulnerability, not the certainty of OCD
The diathesis stress model suggests certain genes leave some people more likely to suffer a mental disorder – an environmental stress (experience) is necessary to trigger the condition
58
What research has been done into the genetic explanation of OCD - what were the problems with this?
Twin and family studies.
The problem with twin studies is separating the relative influences of genes and environment.
With the introduction of DNA profiling, more recent attention has been upon gene-mapping studies – comparing genetic material from OCD sufferers and non-sufferers.
59
What is a candidate gene?
A gene which creates vulnerability for OCD.
60
What is an example of a candidate gene involved in OCD?
The 5HT1-D Beta gene
It is implicated in the efficiency of transport of serotonin across synapses.
61
Why is OCD polygenic?
It is not caused by one gene, but several genes are involved.
62
What is a case study that supports OCD being polygenic?
Taylor 2013
found evidence that up to 230 different genes may be involved in OCD
63
Why are there different type of OCD?
OCD is aetiologically heterogeneous - the origin of OCD has different causes.
There is also evidence to suggest that different types of OCD may be the result of particular gene variations.
64
What are two strengths of the genetic explanation for OCD?
- There is good supporting evidence.
**Lewis (1936)**
Observed that of his OCD patients 37% had parents with OCD and 21% had siblings with OCD
- Twin studies.
**Nestadt et al (2010)**
Reviewed previous twin studies and found that 68% of identical twins shared OCD as opposed to 31% of non-identical twins.
This strongly suggests a genetic influence on OCD. (However there must be environmental influences on the disorder, or the concordance rate between MZ and DZ twins would be 100%).
65
What are two weaknesses of the genetic explain for OCD?
- Environmental factors can also trigger or increase the risk of OCD. It’s not just genes.
**Cromer et al (2007)** found over half the OCD patients in their sample had experienced a traumatic event and OCD was more severe in those with more than one trauma
- Too many candidate genes.
Pinning down all the genes involved in OCD has not been fully successful.
It appears several genes are involved and each genetic variation only increases the risk by a fraction.
This means that a genetic explanation is unlikely to ever be useful as it provides little predictive value.
66
What does the neural explanation of OCD state?
The genes associated with OCD are likely to affect the levels of key neurotransmitters as well as structures of the brain
67
What is serotonin believe to regulate?
Mood
68
What is the role of serotonin in OCD?
If a person has low levels of serotonin then normal transmission of mood-relevant information does not take place.
Mood and sometimes other mental processes are affected.
Low levels of serotonin may be linked to obsessive thoughts and anxiety.
69
___ scans have shown relatively low levels of serotonin activity in the brains of___ patients
PET
OCD
70
What are the frontal lobes in the brain responsible for?
logical thinking and making decisions
71
PET scans have shown that OCD sufferers can have relatively high levels of activity in the frontal lobe. What is this associated with?
Impaired decision making (e.g in hoarding disorder)
72
What is the frontal lobe thought to help?
The frontal lobe is thought to help initiate activity upon receiving impulses to act and then to stop the activity when the impulse lessens
73
How does an OCD sufferer’s frontal lobe dysfunction?
OCD sufferers may have difficulty in switching off or ignoring impulses, so they turn into obsessions resulting in compulsive behaviour
74
What is the parahippocampal gyrus associated with? How does this function in OCD?
Processing unpleasant emotions functions.
Functions abnormally.
75
What are two strengths of the neural explanation of OCD?
- There is some supporting evidence
There is evidence to support the role of some neural mechanisms in OCD.
For example some antidepressants work purely on the serotonin system, increasing levels of this neurotransmitter. Such drugs are effective in reducing OCD symptoms.
This suggests that the serotonin system is involved in OCD.
- Hu (2006)
Compared serotonin activity in 169 OCD sufferers and 253 non-sufferers.
Found serotonin levels were lower in the OCD patients.
This supports the idea that low levels of serotonin are associated with the onset of the disorder.
76
What are two weaknesses of the neural expiation of OCD?
- Problems with cause and effect.
There is evidence to suggest that various neurotransmitters and structures of the brain do not function normally in OCD sufferers.
However this is not the same as saying this abnormal functioning causes the OCD.
These biological abnormalities could be a result of the OCD rather than its cause.
- The serotonin-OCD link may be simply co-morbidity with depression.
Many people who suffer OCD become depressed.
Having two disorders together is called co-morbidity.
This depression probably involves disruption to the serotonin system.
The serotonin system may be disrupted in many patients with OCD because they are depressed as well.
77
Hyperactivity in the _______ _________may be linked with repetitive actions (compulsions)
basal ganglia
78
how does the biological approach treat a OCD?
Drug therapy
79
How do drugs aim to treat OCD?
Increase the level of serotonin in the brain
80
Name an antidepressant drug.
SSRI’s - Selective serotonin re uptake inhibitor
81
How do SSRI’s work?
By preventing the re-absorption and breakdown of serotonin SSRIs effectively increase its levels in the synapse
The serotonin therefore continues to stimulate the postsynaptic neuron
This compensates for whatever is wrong with the serotonin system in OCD
82
What can SSRI’s be paired with?
Cognitive behavioural therapy
83
Why are SSRI’s often paired with CBT ?
The drug means they can engage more effectively with the CBT
84
What are two alternatives to SSRI’s?
Tricyclics and SNRI’s (serotonin-noradrenaline reuptake inhibitors)
85
What are tricyclics?
An older type of antidepressant that is sometimes used e.g. Clomipramine
These have the same effect on the serotonin system as SSRIs
Clomipramine has more severe side effects than SSRIs
Generally reserved for those who don’t respond to SSRIs
86
What are SNRIs?
Serotonin- noradrenaline reuptake inhibitors
SNRIs increase levels of serotonin and noradrenaline – another neurotransmitter.
87
What are 2 strengths of the biological treatment for OCD?
- drug therapy is affective in tackling OCD symptoms. There is clear evidence for the effectiveness of SSRIs in reducing the severity of OCD symptoms, therefore improving quality of life (Soomoro et al - 2008)
- Drugs are cost-effective and non-disruptive.
An advantage of drug treatments in general is they are cheap compared to psychological treatments.
They don’t require a therapist to administer them and are a user-friendly form of treatment (people used to taking medication for illness)
88
Describe the Soomoro et al (2008)
Reviewed 17 studies of SSRIs versus placebo treatments involving 3097 patients
Found SSRIs to be effective in the short term in treating OCD compared to those in the placebo conditions
Effectiveness seems to be greatest when SSRIs are combined with a psychological treatment (usually CBT)
Typically symptoms decline significantly for around 70% of patients taking SSRIs
Of the remaining 30%, alternative drug treatments or combinations of drugs and psychological treatments will be effective for some
Drugs can therefore help most people with OCD
89
What are two disadvantages of using drugs to treat OCD?
- drugs can have side effects. Although drugs like SSRIs are often helpful to OCD sufferers, a significant minority will get no benefit
Some also suffer side effects such as indigestion, blurred vision and loss of sex drive
These side effects are usually temporary
For those taking Clomipramine, side effects are more common and can be more serious.
More than one in ten patients suffer erection problems, tremors and weight gain
More than one in a hundred become aggressive and suffer disruption to blood pressure and heart rhythm
Such factors reduce effectiveness because people stop taking the medication.
- some cases of OCD follow trauma. It may therefore be inappropriate to treat cases that follow a trauma with drugs as the ocd may not have a biological origin.
90
Describe the side effects of SSRIs
Some also suffer side effects such as indigestion, blurred vision and loss of sex drive
These side effects are usually temporary
91
Name one of the DSM-5 categories of depression.
One from:
- major depressive disorder
- persistent depressive disorder
- disruptive mood deregulation disorder
- premenstrual dysphoric disorder
92
What are the emotional characteristics of depression?
-Lowered mood/feeling sad
Feeling worthless and empty
-Anger (sometimes extreme) – directed at self or others
-Lowered self-esteem (how much we like ourselves)
Can be quite extreme – self loathing
93
What are the behavioural characteristics of depression?
-Activity levels
Reduced levels of energy – lethargic (Withdraw from work, education, social life)
Opposite may also occur - Psychomotor agitation (can’t relax/pacing up and down)
- Aggression and self harm
Irritable, verbally/physically aggressive (Relationship and employment problems)
Physical aggression directed at self (cutting or suicide)
- Disruption to sleep and eating
Reduced sleep (insomnia) particularly premature waking
Hypersomnia (increased need to sleep)
Appetite may increase or decrease (weight loss/gain)
94
What are the cognitive characteristics of depression?
-Poor concentration
Unable to stick to tasks/making decisions difficult
Likely to interfere with their work
-Attending to and dwelling on the negative (ignore positives)
See the glass half empty, not half full
Bias towards recalling unhappy events rather than happy events
-Absolutist thinking (black and white thinking)
E.g. when a situation is unfortunate they see it as an absolute disaster
95
What are the 2 cognitive approaches to explaining depression?
Beck’s cognitive theory of depression
Ellis’s ABC model
96
What was Beck’s cognitive theory of depressions emphasis on?
Automatic thoughts
97
What are the 3 components to Becks cognitive theory of depression?
1. Faulty information processing
2. Negative self-schemas
3. The negative triad
98
What is faulty information processing?
When depressed we attend to the negative aspects of a situation and ignore the positives
I might focus on the fact that the previous week someone had won £10 million rather than the positive of what I could spend £1 million pounds on
We also tend to blow small problems out of proportion and think in ‘black and white’ terms
99
What are the 4 cognitive biases in faulty information processing?
Arbitrary inference - conclusions drawn in the absence of sufficient evidence
Selective abstraction - conclusions drawn from just one part of a situation.
Overgeneralisation - sweeping conclusions drawn on the basis of a single event
Magnification and minimisation - exaggerations in evaluation of performance.
100
What are negative self schemas?
A self-schema is the 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.
E.g. depressives expect to fail, feel responsible for all misfortunes, see themselves as worthless
101
What is the negative triad?
1) negative view of the self where the individual sees themselves as being helpless, worthless and inadequate e.g. ‘nobody loves me’. Such thoughts enhance any existing depressive feelings because they confirm the existing emotions of low self-esteem.
2) negative view of the world where obstacles are perceived within one’s environment that cannot be dealt with e.g. ‘the world is a cold, hard place, everything is beyond my control’ this creates the impression that there is no hope anywhere
3)negative view of the future where personal worthlessness is seen as blocking any improvements e.g. ‘I will always be useless so what’s the point applying for the job?’. Such thoughts reduce any hopefulness and enhance depression.
102
What are 2 strengths of Beck’s cognitive theory of depression?
-It has good supporting evidence
Boury et al (2001)
Monitored students’ negative thoughts with the Beck depression inventory (BDI)
Found depressives misinterpret facts and experiences in a negative fashion and feel hopeless about the future
However the sample is somewhat limited as only students were studied
This limits the extend to which findings can be generalised
It has practical application in CBT
It forms the basis of cognitive behaviour therapy (CBT)
All cognitive aspects of depression can be identified and challenged in CBT including the components of the negative triad that are easily identifiable
A therapist can therefore challenge them and encourage the patient to test whether they’re true
103
What are 2 weaknesses of Beck’s theory of depression?
It doesn’t explain all aspects of depression
Beck’s theory neatly explains the basic symptoms of depression but depression is complex
Some depressed patients are deeply angry – Beck cannot easily explain this extreme emotion
Some sufferers of depression suffer hallucinations
Other approaches may explain depression better
The behavioural explanation sees depression as a learned condition.
E.g. negative life events may incur a decline in positive reinforcements and may even lead to learned helplessness (individuals learn that they seemingly can’t bring about positive life outcomes)
104
what does Ellis’s ABC model focus on when explaining depression?
External events
105
What is stage ‘A’ in Ellis’s ABC model?
A: Activating Event
Ellis focused on situations/external events – something happens in the environment around you
(different to Beck who emphasised automatic thoughts)
E.g. your teacher tells you she’s unhappy with your work
106
What is stage ‘B’ of Ellis’s ABC model?
B: Beliefs
You hold a belief about the event or situation e.g. you see yourself as a failure.
People may hold a variety of irrational beliefs e.g. you must succeed at everything or life should be fair
107
What is stage ‘C’ of Ellis’s ABC model?
C: Consequences
You have an emotional response to your belief, for example a feeling of worthlessness
108
What is a strength of Ellis’s ABC model?
It has practical application in CBT
Like Beck’s explanation, it has led to a successful therapy
By challenging irrational negative beliefs, a person can reduce their depression
109
What are 2 weaknesses of Ellis’s ABC model?
It doesn’t explain all aspects of depression
Although Ellis explains why some people appear to be more vulnerable to depression than others due to their cognitions, it doesn’t explain the anger associated with depression or hallucinations and delusions
A partial explanation
There is no doubt that some cases of depression follow activating events – Psychologists call this ‘reactive depression’ and sees it as different from the kind of depression that arises without an obvious cause
This means Ellis’s explanation only applies to some kinds of depression and is therefore only a partial explanation for depression
110
what case study disproves Ellis’s ABC model?
Wender et al (1986)
Found that adopted children who develop depression were more likely to have a depressed biological parent
Even though adopted children are raised in different environments
This implies biological factors are more important than cognitive ones
111
What is the cognitive way of treating depression?
Cognitive behavioural therapy
112
How does CBT therapy work?
1) Firstly an assessment (patient and therapist identify the problem)
2) Identify negative or irrational thoughts that will benefit from challenge
3) Work to change these negative and irrational thoughts
113
How would Beck’s theory of depression treat someone with depression using CBT?
Identify automatic thoughts about the world, self and future (negative triad) then challenge them
As well as challenge these thoughts directly, patient asked to investigate the reality of their negative beliefs – homework (e.g. to record when they enjoyed an event/people nice to them)
Sometimes referred to as ‘patient as scientist’ – investigating the reality of their negative beliefs as a scientist would
114
How would Ellis treat someone with depression using CBT?
Rational emotive behaviour therapy (REBT)
A= Activating event: patient records events leading to disordered thinking e.g. exam failure
B= Beliefs: patient records negative thoughts associated with the event, such as ‘I am useless and stupid’
C= Consequence: patient records negative thoughts or behaviours that follow e.g. feeling upset and thinking about leaving college
REBT involves reframing and challenging negative thoughts by reinterpreting the ABC in a more positive, logical way
115
What is the educational phase of REBT?
Patients learn the link between thoughts, emotions and behaviour.
Vigorous argument to dispute and change irrational belief and break the link between negative life events and depression
116
What is behavioural action when treating depression?
This is introduced after the education phase
Therapist encourages depressed patient to become more active and engaged in enjoyable, rewarding activities
Aims to increase physiological activity and participation in social and activities
117
What may a a therapist tell a depressed patients to do between CBT sessions?
Between sessions, patient is given goals to boost self esteem
Hypothesis testing of negative thoughts
E.g. testing the belief that they’re incapable of being included in conversation by talking to strangers in social situations
(only set tasks they can succeed at as failure will reinforce the belief)
118
What type of CBT does Ellis use to treat depression?
Rational emotive behaviour therapy (REBT)
119
what are 2 strengths of using CBT to treat depression?
-It has no side effects
Other treatments e.g. drug therapy (antidepressants) may have side effects e.g. constipation, anxiety, insomnia, headaches, weight gain, dizziness which are not an issue with CBT
This is a strength of CBT and may encourage more
people to try it out
-It is effective according to research
Lincoln et al
Used a questionnaire to identify stroke victims who had developed clinical depression
19 patients were then given CBT sessions for four months, resulting in reduced symptoms
This suggests CBT to be a suitable treatment for specific groups of depressives
120
what are 2 weaknesses of using CBT to treat depression?
-CBT may not work for all cases
In some cases depression can be so severe that patients cannot motivate themselves to engage with the hard cognitive work of CBT
Depressed patients commonly find concentrating difficult and may not be able to pay attention to what’s happening in the session
Patients may be treated with antidepressant medication initially and commence CBT when they are more alert and motivated
This is still a limitation as it means CBT cannot be used as a sole treatment for all cases of depression
As CBT is a ‘talking therapy’ it isn’t suitable for those who have difficulties talking about their inner feelings or for those without the verbal skills to do so
- Ethical concerns
CBT may be too therapist centred
Therapists may abuse their power of control over patients, forcing them into certain ways of thinking
Depressed patients may be particularly vulnerable and influential
Patients can also become too dependent on their therapists
