depression

• Behavioural characteristics of depression


  activity level (low)

  disruption to sleep and eating

  aggression and self harm
• emotional characteristics of depression


  anger

  lowered self esteem
• cognitive characteristics of depression


  poor concentration

  attending to and dwelling on the negative

  absolutist thinking
• 3 cognitive approaches to explaining depression


  -becks cognitive theory of depression

  -ellis's ABC model

  -Beck's fualty thinking strategies
• Becks cognitive theory of depression


  Faulty information processing

  - when depressed people focus on negatives of the situation Beck suggested that depressed people make errors in processing information from the world

  
  

  Negative self schemas

  - a self schema is a bunch of information about yourself which is used to make interpretations about the world

  
  

  Negative triad

  - when depressed we hold negative beliefs about ourselves, the future and the world
• Becks cognitive triad


  -themselves (helpless and worthless)

  - the world (full of obstacles)

  - the future (hopeless)
• Ellis's ABC model


  A- activating event (eg fired at work)

  B- belief, could be irrational or rational (they had too many staff or they hate me)

  C- consequence, rational beliefs = healthy emotions like acceptance whereas irrational = unhealthy emotions eg depression
• What i musturbatory thinking


  Ellis suggested:

  -Thinking that certain actions lead to happiness (good grades = good son) as it leads to pressure, disappointment and depression
• Beck's faulty thinking strategies


  All or nothing thinking

  Arbitary inferences

  Overgeneralisation

  Catastophising

  Selective abstraction

  Excessive responsibility
• all or nothing thinking


  a tendancy to classify everything into one of two categories eg sucess or failure
• arbitrary inferences


  drawing negative conclusions without having evidence to support them
• overgeneralisation


  incorrect conclusions are drawn from little evidence eg one incident
• catastrophising


  when normal events are percieved as disasters
• selective abstraction


  when a person only pays attention to certain features of an event and ignores factors that could lead to a more positive conclusion
• excessive responsibility


  taking blame excessively for events
• evaluation of becks explanation


  There is supporting evidence

  - research by terry et al found that people with high cognitive vunerability (they had experienced a negative thought process as suggested by beck) were more likely to suffer depression

  
  

  Practical explanations for treatment of depression

  - evident from its application in CBT by identifying negative thughts and challenging them

  
  

  BUT

  
  

  Blames the client rather than situational factors

  -suggests the client is responsible for their disorder

  - may lead to the client or therapist overlooking situational factors like life events or family problems might contriute to the disorder
• 2 cognitive treatment strategies for depression


  CBT:

  - becks cognitive theory

  - ellis's rational emotive behaviour therapy (REBT)
• CBT process overall


  -cognitive, therapist asks the client to become aware of thoughts which contribute to anxiety or depression, this enables the thoughts to be challenged. clients are often asked to find proof of their irrational thoughts

  
  

  -behavioural, client and therapist develop coping strategies to deal with the thoughts, they are often set homework assignments and the client is continually set goals to progress to more rational thinking. this often tests irrational beliefs against reality

  
  

  -behavioural activation, encourages depressed clients to become more active and engage in pleasurable activities- dealing with any cognative obstacles along the way

  
  

  -unconditional positive regard, if the therapist provides respect and appreciation regardless of what the client says or does they feel valued and are more likely to change beliefs and attitude
• becks approach to cbt


  -identifying a thought from the negative triad (world, yourself and the future) + test the reality of them

  -patients might be set homework to record enjoyment, nice encounters etc, anything that attempts to disprove their irrational thought

  -behavioral experiments, changing actions and observing the result
• ellisis approach to cbt (rebt)


  Identify and challenge irrational thoughts by putting in place a disruptive intervention so that a negative consequence to a negative belief doesn't happen
• examples of challenging irrational beliefs/ disruptive interventions (ellis's rebt)


  -emprical argument, is there actual evidence to support

  -logical argument, does the thought follow facts

  -pragmatic argument, is the thought useful to hold onto

  -behavioural experiements, changing behaviours and observing effect
• evaluation of cbt to treat depression


  march et al compared the effects of cbt to antidepressants and found it was just as effective

  - this suggests that cbt should be a first choice treatment of depression

  -however, combining cbt and antidepressants produced most significant improvement

  
  

  downsides:

  cbt appears to be more useful for some people than others, cant be used for all cases

  -patients may not be able to engage with the hard cognitive work required

  - in this case it may be more appropriate to treat with andtidepressant medication to manage symptoms and start cbt when they are more alert and able to focus

  
  

  cbt effectiveness may be due to the relationship with the client and therapist

  -there is not much difference in the effectiveness of psychological therapies, eg cbt vs counselling

  -this may be because they share common factors such as being able to talk to a sympathetic person which suggests that cognitive strategies are not the active component of treatment

  
  

  other treatments are available

  -drug therapies have less effort on the part of the client and can be used in conjunction with another therapy eg a psycho therapy like cbt

  -this may be useful as a distressed client may be unable to focus on the demands of cbt