Psychopathology- L8-10

Question 1

What is needed to be diagnosed for depression?

Answer 1

• at least 5 symptoms present everyday for two weeks
• symptoms must include sadness it loss in interest in normal activities
• person will show impairment in general functioning not caused by other events

Question 2

Behavioural characteristics of depression (DADA)

Answer 2

• disruption to sleep (insomnia, hypersomnia)
• change in activity levels (lethargy, - lack of energy, anhedonia - withdrawal from hobbies, neglect personal hygiene, increased energy ( nervous energy)
• disruption to eating behaviour ( significant increase or decrease in weight - eat lot, eat less)
• aggression ( irritable, physically or verbally aggressive, Self harm - cutting, suicide)

Question 3

Emotional characteristics of depression ( ALF)

Answer 3

• anger ( anger towards others or self, SH, depression may arise from feelings of being hurt and wishing to retaliate)
• low mood ( ever present and overwhelming feelings of sadness / hopelessness/ emptiness
• feelings of worthlessness ( constant feelings of reduced worth / inappropriate guilt, low self esteem

Question 4

Cognitive characteristics of depression (NP)

Answer 4

• negative schema ( negative view of world, themselves, future - leads to self fulfilling prophecy, positive factors ignored)
• poor concentration (difficulty in paying attention, cannot stay on task for long, slower thought processes, trinkets retrieving memories)

Question 5

Assumption of Cognitive explanation of depression

Answer 5

• depression is a result of disturbance in ‘thinking’
• depression is a consequence of faulty and negative thinking about events
• can be managed by challenging this faulty thinking

Question 6

What did Beck believe about negative schemas?

Answer 6

• Beck (1967) believed depressed people acquired a negative schema during childhood, so tend to adopt pessimistic view of world
• May be caused by parental/ peer rejection and criticism from teachers

Question 7

When are negative schemas activated?

Answer 7

• whenever person encounters a new situation that resembles original situation where schema was learned

Question 8

What do negative schemas lead to?

Answer 8

• lead to cognitive biases in thinking

- e.g. overgeneralisations ( I am stupid) on the basis of one small pieces of negative feedback (failing one test)

Question 9

How is the negative triad maintained?

Answer 9

Through negative schemas and cognitive biases

Question 10

What is the negative triad?

Answer 10

An irrational view of three elements in the persons belief system : the self, the world, the future

Question 11

Evaluation of the Negative Triad ( Strength)

Answer 11

+ Supporting evidence to suggest negative and irrational thinking causes depression:

Terry (2000) assessed 65 pregnant women for cognitive vulnerability before and after birth. Found women with high cognitive vulnerability = more likely to suffer post-
partum depression.

Supports the cognitive approach that negative thinking can cause depression.

Question 12

Evaluation of the Negative Triad (Weaknesses)

Answer 12

• Cause and effect is not clear. (Do negative and irrational thoughts cause depression, or vice Versa?)
• can be criticised, does not explain how some symptoms of depression might develop. (Some depression patients are very angry and Beck’s theory fails to account for this, or the manic phases experienced by patients with Bipolar Disorder.)

Question 13

What was Ellis’ theory?

Answer 13

Ellis (1962) proposed depression is caused by irrational beliefs- devised the ABC model to explain how they are formed

Question 14

What is the ABC model/ what does it stand for?

Answer 14

A= activating event (incident in someone’s life e.g fired from work)

B= beliefs ( thoughts that occur after activating events, rational (they were overstuffed) or irrational (boss had it in for me)

C= consequences ( emotions caused by beliefs, rational = healthy emotions e.g acceptance, irrational= unhealthy emotions e,g, depression)

Question 15

Evaluation of ABC model (strengths and weakness)

Answer 15

+ Supporting research to support idea of ABC model as cause of depression - Bates (1999) found depressed patients who were given negative thought statements became more depressed (supports idea negative thinking causes depression)

• Blames client for depression - although does give client some power to change situation and symptoms

Question 16

What are the cognitive treatments for depression?

Answer 16

Cognitive behavioural therapy (CBT) , Rational emotive behavioural therapy (REBT)

Question 17

What is the aim of CBT?

Answer 17

to change irrational thoughts and so alleviate depression

Question 18

What is Becks CBT? ( steps)

Answer 18

1. Identify irrational thoughts ( thought catching)
2. Patient encouraged to generate hypothesis to test validity of irrational thoughts (patient as scientist)
3. Strategies used to test patients hypothesis - gather data about behaviour and incidents and compare with hypothesis to see if they match
   - complete homework in between sessions to test irrational thoughts in real world and evaluate evidence
   - keep a diary to record events and identify situations where negative thinking occurs so they can be targeted
4. When patients report positive thoughts they are praised by therapist (positive reinforcement)

Question 19

What is the aim of CBT?

Answer 19

Cognitive restructuring : learning to identify, dispute, and change irrational thoughts

Question 20

What is Ellis’ Rational Emotive Behavioural therapy/ steps (REBT)

Answer 20

1. Therapist uses logical arguments to show self -defeating beliefs do not logically follow from info available (friend doesn’t say hello, doesn’t mean they hate you might not see you)
2. Therapist uses empirical arguments to show patients their self - defeating beliefs are not realistic ( doesn’t make sense to believe everyone hates you when they keep asking u to hang out)
3. Patients doing REBT encouraged to engage in behavioural activation: becoming more active and taking part in pleasurable activities

Question 21

Aim of REBT

Answer 21

Ellis developed REBT to challenge automatic negative thoughts and replacing them with rational beliefs

Question 22

Evaluation of CBT (strengths)

Answer 22

+ March et al. (2007) found CBT was as effective as antidepressants in treating depression. Researchers examined 327 adolescents with depression, looked at effectiveness of CBT, anti-depressants and combination. After 36 weeks, 81% of the anti-depressant group and 81% of the CBT group significantly improved.
86% of the combination group had significantly improved = suggests combination of CBT and anti-depressants is the most effective treatment.

+ David (2008) found CBT is a better treatment for depression in the long- term than anti-depressants.
He compared 170 patients who had 14 weeks of CBT against patients who were treated with the drug fluoxetine. 6 months later, found patients who received CBT less likely to have relapsed.

Question 23

Evaluation of CBT ( weaknesses)

Answer 23

• CBT requires commitment and motivation. Patients with severe depression may not engage with CBT, or attend sessions = treatment will be ineffective. Anti depressants= not same level of motivation, maybe more effective in these cases. Problem for CBT= CBT cannot be used as sole treatment for severely depressed patients.
• CBT assumes the root cause of depression is irrational thought processes. Can be criticised, suggests irrational thinking is primary cause of depression and ignores other factors that may contribute to a person’s depression. E.g. domestic violence abuse= don’t need to change irrational thoughts, but change circumstances.

Therefore CBT would be ineffective in treating these patients until their circumstances have changed.

• CBT relies on patients self-reporting their thoughts as thoughts cannot be objectively observed or measured. Self-reports = may be unreliable, difficult to verify accuracy