Depression

• Depression: a mental disorder characterised by low mood and low energy levels.
• Behavioural characteristics of depression

  Reduced energy levels

  Disruption to sleep and eating behaviour

  Aggression or self harm
• Emotional Characteristics of Depression

  • Lowered mood
  • Anger
  • Lowered self esteem
• Cognitive characteristics of depression

  • Poor concentration
  • Attending and dwelling on the negative
  • Absolutist thinking
• Cognitive approach to explaining depression

  Becks negative triad- a persons cognitions create a vulnerability to depression
• Becks negative triad: Faulty information processing

  • when depressed people attend to the negative aspects of a situation and ignore the positives
  • tend to lean towards more 'black and white' thinking
• Becks negative triad: Negative self schema

  A self schema is the package of information people have about themselves. People use schema to interpret the world, so if someone has a negative schema they interpret all information about themselves negatively
• Becks negative triad:

  Beck proposed that there are 3 kinds of negative thinking that contribute to becoming depressed

  • negative view of the world
  • negative view of the future
  • negative view of self
• Ellis' ABC model:

  conditions like depression result from irrational thoughts- thoughts that interfere with us being happy.
• Ellis' ABC model

  • Activating event- triggers irrational thoughts
  • Beliefs- belief that we should always be perfect: 'musturbation'
  • Consequence- emotional and behavioural, depression
• A03 for becks negative triad:

  Research support

  • Cognitive vulnerability refers to the way of thinking that may predispose someone to becoming depressed e.g negative self schema etc
  • Beck concluded that cognitive vulnerabilities were more common in depressed people and preceded the depression
  • This was confirmed in a prospective study by Cohen et al that tracked the development of 473 adolescents regularly measuring cognitive vulnerability and found those with it later had depression
  • This shows the association between cognitive vulnerability and depression - increases reliability and credibility
• A03 for becks negative triad

  Real world application

  • Used in screening to find who is most at risk of developing depression so they can be monitored.
  • Can be applied to CBT which works by altering the cognition which is making that person depressed, making them more resilient
  • Practical value
• A03 for becks negative triad

  Partial explanation

  • Some aspects of depression cannot be explained by cognitive explanations such as feeling extreme anger or experience hallucinations.
• A03 for Ellis' ABC model

  Real world application:

  • Used in REBT which involves arguing to alter the irrational belief that are making them unhappy
  • David et al concluded evidence to support the idea that REBT changes both negative beliefs and relieves that symptoms of depression
  • Therefore showing the link between irrational beliefs and depression, practical value
• A03 for Ellis' ABC model

  Doesn't explain endogenous depression

  • Many cases of depression are not traceable to one specific 'activating event' these are known as endogenous cases of depression
  • Can only explain reactive depression- triggered by an activating event
  • Partial explanation
• A03 for Ellis' ABC model

  Ethical issues

  • Locates responsibility for depression purely with the depressed person, blaming them which is unfair.
  • However this can be useful in making some people have resilience and drive to feel better.
• Cognitive behaviour therapy: aims to change the way a client thinks by challenging irrational thought processes, and this will lead to a change in behaviour as a response to new thinking patterns
• CBT:

  Cognitive therapists help clients to recognize the negative thoughts and errors in logic that cause them to be depressed. The therapist also guides clients to question and challenge their dysfunctional thoughts, try out new interpretations, and ultimately apply alternative ways of thinking in their daily lives. The clients learn to discriminate between their own thoughts and reality. They learn the influence that cognition has on their feelings, and they are taught to recognize, observe and monitor their own thoughts.
• What does the behavior part of Cognitive Behavioral Therapy (CBT) involve?

  Setting homework for the client to do, such as keeping a diary of thoughts.
• What is the purpose of the tasks given to clients in CBT?

  To help clients challenge their own irrational beliefs.
• How does the client prove their unhelpful beliefs wrong in CBT?

  By identifying their beliefs and providing evidence against them.
• What might a patient do to challenge the belief that everyone hates them?

  Record each time someone was nice to them in a journal.
• What role does the therapist play when a patient presents irrational beliefs?

  The therapist points towards the journal as counter-evidence to prove the patient's beliefs irrational.
• What concept does the example of the patient keeping a journal illustrate in CBT?

  The idea of 'patient as scientist'.
• Ellis’s rational emotive behaviour therapy (REBT) aims to identify the patient’s thoughts and challenge them as irrational, leading to a vigorous argument.
• What does REBT do?

  This may be a logical argument (i.e. the belief doesn’t follow on logically from the facts) or an empirical argument (there is no evidence to support the irrational belief). Thus, this aims to change the irrational belief and to break the link between negative life events and depression. Through behavioural activation, patients are encouraged to engage in enjoyable activities, to provide further counter-evidence for their irrational beliefs.
• A03 for treatments for depression:

  — = CBT may not be an appropriate treatment for all cases of depression, and particularly the most severe cases. This is because those with severe depression may not be able to attend the regular CBT sessions, due to a lack of motivation/ an inability to get out of bed in the morning, and also may feel completely hopeless i.e. that they are beyond help. This means that CBT cannot be used to address all cases of depression, and arguably is not suitable for cases which need help the most!