Psychopathology- depression

Question 1

what is abnormality caused by in the cognitive explanation?

Answer 1

irrational and negative thought processes i.e., faulty information processing

Question 2

what are the two cognitive explanations for depression?

Answer 2

Beck’s negative triad and Ellis’s ABC model

Question 3

what is beck’s negative triad?

Answer 3

• that someone’s cognition can create a vulnerability to depression
• a person develops a dysfunctional view of themselves because of three types of negative thinking that occur automatically, regardless of the reality of what is happening at the time.

Question 4

what are the three types of negative thinking for Beck’s negative triad?

Answer 4

• negative view of the world = creates impression that there is no hope anywhere
• negative view of the future = reduce any hopefulness and enhances depression
• negative view of one’s self = enhance existing depressive feelings as confirm the existing emotions of low self-esteem

Question 5

what are stems from negative schemas for Beck’s negative triad?

Answer 5

• a schema is a package of ideas and information developed through experience
  -they act as a mental framework for the interpretation of external information
  -a self-schema is the package of information we have about ourselves
  -individuals with depression often have a negative self-schema which is filled with negative information, lowering their self-esteem

Question 6

how is depression maintained by Beck’s negative triad?

Answer 6

-when depressed, due to cognitive distortion, we focus on the negative aspects of a situation and ignore the positives
-individuals also tend to blow small problems out of proportion and think in ‘black and white’ terms
- these cognitive distortions feed into an individual’s own self-perception and views about their place in the world

Question 7

What is Ellis’s ABC model?

Answer 7

Ellis proposed that depression was mainly the result of irrational beliefs about external events
-Ellis claimed that depression was not really the result of the activating event, but more based on the accompanying beliefs about the event

Question 8

What is a model of Ellis’s ABC model?

Answer 8

irrational/ rational beliefs
-
consequences

Question 9

What is the activation part of Ellis’s ABC model

Answer 9

there needs to be an event, like failing an important test or ending a relationship to activate the irrational thoughts

Question 10

What is the beliefs part of Ellis’s ABC model?

Answer 10

Ellis identified a couple of irrational beliefs:
-musterbation= must always achieve perfection
- I can’t-stand-it-itis= it is a major disaster if things don’t happen smoothly
-utopianism= life should always be fair

Question 11

What is the consequences part of Ellis’s ABC model?

Answer 11

emotional and behavioral outcomes of the activation event and irrational beliefs

Question 12

What is Cognitive behavioral therapy (CBT) for depression?

Answer 12

works to try and challenge irrational thinking and ultimately improve the behavior of depressed patients
-CBT works on the basis that our thoughts, feelings, behavior are all connected and influence each other
-Therefore, if we can change one of these factors, it will change the others
- aim of CBT is to help rationalize and challenge depressed patients’ irrational thinking as this can help remove the depressive states patients find themselves in

Question 13

CBT is an umbrella term for many cognitive therapies - what is an ‘umbrella term’?

Answer 13

a word or phrase that covers a wide range of concept belonging to a common category
-i.e: CBT is not a single treatment, there are various individual methods, treatments that count as a type of CBT, CBT is just the name we use to encompass all of these similar treatment methods

Question 14

What is the 4 steps of CBT of depression?

Answer 14

1- identifying negative thinking patterns in depressed patients
2- challenging irrational thoughts of depressed patients
3- skill acquisition and application
4- follow-up

Question 15

What is the identifying negative thinking patterns in depressed patients of CBT for depression?

Answer 15

• they can use a CBT programme designed around Beck’s cognitive explanation of depression, or Ellis’s ABC model
• Beck developed a therapy to challenge the negative triad of the clients: 1) the client will be assessed to discover the severity of their condition. 2) the therapist will establish a baseline, prior to treatment to help monitor improvement

Question 16

What is the challenging irrational thoughts of depressed patients part of CBT for depression

Answer 16

• clients are made aware of their negative thoughts
• through this process, irrational ideas can be replaced with more optimistic and rational beliefs
• e.g: clients move from ‘catastrophising’ (no one will like me) to more rational interpretations
• helps client become more self-accepting

Question 17

What is the skill acquisition and application part of CBT of depression?

Answer 17

• patients will be set homework which may involve putting themselves into situations which they would have previously avoided or perhaps telling a family member or friend how they really feel
• another key element is behavioral activation, where the patient is encouraged to become more active and take part in activities.
• physical activity naturally lifts mood, but many individuals with depression no longer participate in physical activities

Question 18

What is the follow-up part of CBT for depression?

Answer 18

Therapy will usually last 6 sessions but often a therapist will schedule in a follow up session. Within this, the therapist is checking that the treatment was successful and that the patient isn’t relapsing during this session they will check in with the patient about their self management of symptoms and stressors
- refresh skills learned in therapy, discuss questions or concerns the patient may have about the transition, review treatment goals and maintenance of goals.

Question 19

What are the strengths of the explanations of depression?

Answer 19

-has practical applications
-evidence of support
-takes into account other aspects, such as genes and environment

Question 20

what are the weaknesses of the explanations of depression?

Answer 20

-does not fully outline the steps and processes for how sufferer came to think this way
-some psychologist believe that faulty information is actually an ‘effect’ of depression as opposed to a ‘cause’.

Question 21

Explain how practical applications of explanations is a strength?

Answer 21

• has useful applications like CBT
• for example, it had led to development of cognitive behavioral therapy ,CBT, which aims to challenge negative thoughts and behaviors in order to positively change their irrational thought processors. CBT has seen a lot of success, with March et al showing 81% of patients treated with CBT sign of improved
• therefore, it could suggest that the high success rate of CBT validates the cognitive theories
• however, we need to be careful of undertaking a treatment fallacy by assuming the success of treatments can be directly linked to the effectiveness of the theories

Question 22

How is the explanations of depression not explaining the steps and processes of how the sufferer came to think this way a weakness?

Answer 22

• for example, Beck suggests individuals with depression have the negative triad which is caused by cognitive biases. However, he does not explain why someone would have these cognitive vulnerabilities in the first place
• it could be the case that depression is caused by another factor, such as biology, and that these cognitive vulnerabilities are just a symptom than cause
• this limits the extent to which we can practically use these theories and it could be argued that the theory is partially reductionist and lacks explanatory power

Question 23

How does the explanations of depression having evidence to support a strength?

Answer 23

• for example, Grazioli and Terry assessed 65 pregnant women for cognitive vulnerability and depression before and after birth. They found that those women judged to have been high in cognitive vulnerability were more likely to suffer post natal depression
• additionally, coghen et al tracked the development of 473 adolescents, regualry measuring cognitive vulnerability. It was found that showing cognitive vulnerability predicted later depression
  -this illustrates the significant role of cognition in cases of depression. This supporting research therefore makes the cognitive explanation for depression more credible and as such it is more likely to inform practical applications with regards to treatments

Question 24

Why does the explanations of depression taking in account of other aspects such as genes and environment a strength?

Answer 24

• for example, Ellis’s ABC model suggests it is not just faulty internal processing, but the influence of distress on external events as well
• he suggests when something happens with our environment it can trigger irrational thoughts adding to undesirable consequences
• this suggests that although the cognitive approach is still partially reductionist, this does increase the explanatory power of the theory, As a result, we could apply this theory to real life move and it could be used to inform more practical applications.

Question 25

Why does some psychologists saying that faulty information is actually an effect of depression rather than a cause for explanations of depression a weakness?

Answer 25

• the cognitive approach suggests irrational negative thought processes lead to depression, but maybe there is a different cause and irrational, negative thought processes are a symptom.
• for example, studies of attachments have shown that infants who develop insecure attachment to their parents are more vulnerable to depression in adulthood, suggesting development cause for depression. Additionally, there s also a wealth of supporting evidence for the role of brain chemistry in causing depression, suggesting the biological approach may have more weight.
• This suggests a theoretical weakness with the cognitive explanation of depression and reduces its credibility.

Question 26

what are the strengths of the treatment of depression?

Answer 26

-evidence to support
-CBT tackles the root problem of depression

Question 27

what are the weaknesses of the treatment of depression?

Answer 27

• some psychologist argue that improvements with CBT are actually rooted in the therapist-patient relationship
  -the success of CBT could lead to an aetiological fallacy being made, whereby we assume the causes of depression are cognitive because the cognitive treatments are successful

Question 28

How is evidence to support for the treatment of depression a strength?

Answer 28

-for example, a study by March et al compared the effects of CBT with anti-depressants drugs and a combination of the two in 327 adolescents with a main diagnosis of the depression. After 36 weeks, 81% of the CBT group, 81% of the anti-depressants group and 86% of the combination of CBT emerged as just as effective as medication and helpful alongside medication
-this illustrates the effectiveness of CBT in treating depression without the unwanted side effects of medication. Suggests there is good case for making public health care systems, as the patients can see same benefits as medication with out side effects.

Question 29

Why might the success of CBT could lead to an aetiological fallacy being made, whereby we assume the causes of depression are cognitive because the cognitive treatments are successful is a weakness of the treatments of depression?

Answer 29

-there is a risk that because of it emphasis is on what is happening in the mind of the individual patient we may end up minimizing the importance of other factors that could lead to depression. For instance, circumstances such as living in poverty or suffering abuse may also lead to depression and in those cases the focus should be on helping the individual out of the situation, not teaching them coping mechanisms
-therefore, it is important to keep an open mind to causes of depression and not have this view narrowed by the success of certain treatments . Suggest that the inappropriate use of CBT could demotivate or discourage people to change their situation, leading to further issues in the future

Question 30

Why does CBT tackling the root problem of depression a strength on the treatments of depression?

Answer 30

-it tackles the root problem unlike biological treatments like anti-depressants
-This improves the chances that the depressive episode will be short-lived and reduces the chances of relapses further the down the line
-Alternatively, anti-depressants are only supposed to be a short term treatments for severe cases to alleviate their symptoms enough so the individual has the ability to attend counselling. Prolonged use of anti-depressants can cause dependency issues and further health problems, such as serotonin syndrome
-therefore, it could be argued that the effects of CBT are more effective and longer lasting than alternatives, such as medication

Question 31

Why might some psychologists argue hat the improvements with CBT are actually rooted in the therapist patient relationship be a weakness of treatments of depression?

Answer 31

-it may be the quality of this therapeutic relationship that determines any improvements not techniques in CBT, rather than any particular technique that is used.
-Lubortsky has found very little differences between therapies, which supports the view that having someone to talk to who will listen matters the most in recovery from depression.