Psychopathology - Cognitive approaches to Depression Flashcards
(19 cards)
What are the general assumptions of the cognitive approach to depression?
- argues that depression occurs due to
maladaptive/faulty thinking & irrational beliefs - argues that depression can be treated by
enabling someone to identify, challenge &
change their thinking patterns
What did Ellis’ think & what is his cognitive model of depression?
- depression is not just the result of unpleasant
events in someone’s life but how they think
about it, so different people can respond
differently to the same situation
- ABC model of understanding people's emotions; A = adverse event B = beliefs C = consequences (e.g. depressed feeling)
- Patient has to think in more rational & realistic
ways to treat depression
What are the features of Beck’s approach to depression?
- Negative schema
- Cognitive errors
- Biased memories
(Nasty Cats Eat Bad Meat)
What is meant by negative schema & what role might they have in depression?
- Schemas are mental representations of the
world and knowledge
(often developed in childhood & persist into
adulthood) - these influence how we view
events - If someone’s schema are negative, they will
be more likely to suffer from depression- view things in a negative & pessimistic way
What is Beck’s negative (cognitive) triad?
- 3 types of areas of negative thinking
associated with depression
- Self (I am worthless)
- World (no-one can be trusted)
- Future (I will never pass)
What are cognitive errors (types)?
Types of faulty thoughts:
- Catastrophising
= assuming worst will happen
- Applying a negative filter
= only paying attention to negative
information - Misinterpreting events in a negative way
What are biases in memory & how might they lead to depression?
- when someone’s memories of events are
influenced by their schema - someone with negative schema can be
biased towards remembering negative events
from their lives, finding it difficult to recall
positive - negative memories can make someone’s
mood worse, causing a Vicious Cycle
Strengths of the cognitive approach to depression
- Supporting evidence & hypotheses that can
be scientifically tested - effective cognitive treatments (CBT)
- enhances validity of underlying theory
Evidence for memory biases
Clark & Teasdale: Memories
- patients with worse depressed mood in the
morning had more negative memories in the
morning than the evening
Evidence that negative thinking increases vulnerability to depression
Lewinsohn
- longitudinal study showing adolescents with
negative attitudes at the start & had
experienced negative life events were most
likely to suffer from depression a year later
Evidence that treatments which change negative thinking are effective in reducing depression
Appleby: Postnatal depression
- CBT just as effective at reducing symptoms of
depression than antidepressant medication
- more effective than placebo
Hollon
- CBT has more enduring long term
effectiveness compared to medication
Weaknesses of the cognitive approach to depression
- sometimes thinking is NOT unrealistically
negative (e.g. bereavement, illness) - Biological factors are not taken into account
(doesn’t provide complete understanding)
Evidence that we may inherit a vulnerability to depression
McGuffin: Twins
- higher concordance rate for identical twins
than non identical
- neither 100% concordant so environment;
factors must also be involved
+ evidence that abnormalities in
neurotransmitters are involved in depression
(e.g. serotonin)
What is the aim & process of Cognitive Behaviour Therapy?
Aim: To challenge dysfunctional thinking
2 important steps:
- Identify the distorted thinking
- Challenge the distorted thinking
- focuses on problems here & now, not past
- usually lasts between 5 & 20 sessions
- patient & therapist work collaboratively
How might distorted thinking be identified in CBT?
- using a thought diary (noting mood, thoughts
& surrounding events) - assessment of thoughts in sessions (therapist
asking questions at times where patient feels
anxious e.g.”what’s going through your mind”)
What is socratic questioning?
- involved in challenging thinking
- therapist asks a series of questions to help
patient discover new ways of thinking and
realise for themselves that their depressed
thinking is distorted/maladaptive
What is collaborative empiricism?
- involved in challenging thinking
- Patient & therapist collaborate (work
together) to challenge distorted thinking in a
scientific way - involves patient gathering evidence, think of
hypotheses based on that & testing those
hypotheses
Why might CBT be appropriate for depression?
- relatively straightforward, makes sense &
appears sensible & acceptable to patients - time limited (5-20 sessions, 1 per week)
- may be more cost EFFECTIVE in the long
term than antidepressants (not cheaper)
Why might CBT be inappropriate for depression?
- sometimes lives realistically difficult,
impossible & inappropriate to alter thinking - may not be suitable for people with limited
verbal skills - not suitable for those with sever depression &
no motivation (medication may be needed
before engaging in CBT) - sensitive issue - can give patients the
impression that they are to blame & are being
‘irrational’
