depression

• DSM-V


  criteria for diagnosing depression, constant, low mood
• Depression


  form of affective mood disorder, lengthy emotional disturbances, occur from adolescence into mid-20s as average, occurs in cycles with symptoms coming and going, with individual episode lasting between 2/6 months
• diagnosing depression


  five symptoms must be shown for two weeks that is not accountable for by any other medical condition, major depression requires one symptom to be constant, three symptoms is chronic depression
• behavioural characteristics


  weight changes, changes to daily activities, loss of energy, sleep distrubance
• emotional characteristics


  feeling of emptiness, loss of enthusiasm, worthlessness, constant depressive mood
• cognitive characteristics


  memory and concentration, negative thoughts, delusions
• cognitive theory


  Beck's negative triad and Ellis' ABC model
• Negative triad

  negative self-schemas, irrational views about the world, the future and oneself
• selective abstraction


  conclusions are drawn from one part of the situation
• overgeneralisation


  general conclusions based on a single event
• magnification/minimisation


  exaggerations when evaluating a situation
• negative schemas


  triggered in a similar situation to where they were learnt, develop in adolescence and continue into adulthood
• ineptness schema


  expect to fail
• self-blame schema


  overly responsible for misfortunes
• negative self evaluation schemas


  worthlessness
• Beck evaluation


  supporting studies: McIntish and Fisher (found no clear separation of negative thoughts, but one negative perception of self) and Boury (found that depressives misinterpret facts in a negative fashion and feel hopeless about the future)
• Beck evaluation


  issue surrounding cause and effect, it is not evident if cognitive bias and negative thoughts are a cause or result of depression
• Eliss' ABC model


  what is required for 'good' mental health, a result of rational thinking which allows people to be happy and pain free, individuals with depression interpret external events in an irrational way causing undesirable consequence
• ABC model


  A-activating event

  B-beliefs (rational/irrational)

  C-consequence
• Ellis strength

  development of therapies to improve irrational thinking, led to REBT, successfully treat individuals with depression
• Ellis limitation


  alternative credible explanations, research to support biological explanations and drug therapies, raises questions of cognitive theories as complete explanation
• treating - CBT


  cognitive and behavioural elements, cognitive aims to identify irrational and negative thoughts and replace with positive, behavioural encourages patient to test their beliefs
• CBT components


  initial assessment, goal setting, identifying irrational thoughts and challenge, homework
• Beck's cognitive theory CBT


  identify negative thoughts using negative triad, challenge by discussing evidence for and against, test validity of them through homework
• Ellis rational emotive behaviour therapy CBT


  developed D and E, dispute argument, replace with effective beliefs, logical (logic of thoughts), empirical (seek evidence), homework to prove wrong, change beliefs
• CBT evaluation


  research shows effectiveness, March found CBT was as effective as antidepressants, 81% had significantly improved, 86% improved with CBT and drugs, suggests combination may be more effective.=
• CBT evaluation


  most effective treatment for moderate-severe depression and where depression is main problem, David found 170 patients suffering from severe depression ones treated with REBT had better outcomes than those treated with fluoxetine, suggest REBT and CBT are more effective
• CBT evaluation


  directly confronts underlying problems, empowers to control recovery, strength because encourages individual to face their negative thoughts and find a solution, credible, however not effective if participants aren't willing to take part
• CBT evaluation


  issues surrounding CBT within NHS, 'postcode lottery', some regional health services investing heavily in CBT and those individuals time congruent, effective support whilst others do not, means that it is optimistic to believe appointments are ready available to those that need weekly sessions, hard to access therapy
• Beck evaluation

  real world application, application in screening and treating depression, applied in CBT, understanding of cognitive vulnerability is useful in more than one aspect of clininal practice