Depression

• Depression


  low mood most of the day, lasting nearly every day for weeks or months, affects daily life
• Behaviour symptoms of depression


  • Difficulty falling asleep / sleeping too much
  • Psychomotor agitation (noticeably fidgety) / psychomotor retardation (talking and moving slowly)
  • Significant weight loss / weight gain
  • Significant increase / decrease in apetite
  • Fatigue / loss of energy
  • Loss of interest in activities that previously brought joy
• Emotional symptoms of depression

  • Extreme guilt
  • Feeling of worthlessness
  • Sustained and extreme sadness
  • Low mood
• Cognitive symptoms of depression


  • Suicidal ideation (recurring)
  • Difficulty concentrating
  • Indecisiveness
  • Slowing down of thinking
• What is depression a risk factor for?


  • Anxiety disorders
  • Heart attacks
  • Obesity
  • Substance abuse
• How often are people that had a depressive episode likely to have another one in the future?


  50% chance
• How are depression symptoms represented?


  • episodic
  • typically presented at a full magnitude for a period of time and then gradually reduced
• How can depression be explained in a biological way?


  High cortisol levels have an effect on depression
• Strengths and weaknesses of behaviourist explanations to phobias


  • Success in therapy - good practical application
  • Reductionist - ignores cognitive factors
  • Deterministic - states that we are controlled by our environment
• Systematic desensitisation 


  • Counterconditioning
  • Through using classical conditioning but replacing anxiety with relaxation as a response to the phobic stimulus
  • Individual draws up an anxiety hierarchy, working their way up using relaxation techniques
• Flooding


  • An extreme way to treat phobia
  • Through operant conditioning, however providing no option for avoidance
  • ‘exposure therapy’ - individual exposed to highly feared stimulus and uses relaxation techniques to calm down, extinction of the phobi
• Strengths and weaknesses of systematic desensitisation 


  • Effective treatment (McGrath reported 75% success rate)
  • Suitable for lots of people - wider application
  • More ethical than flooding - graduated exposure
• Strengths and weaknesses of flooding


  • Cost effective - one session
  • Less effective for some types of phobias (e.g. social phobias)
  • Can be traumatising which worsens phobia
• Evidence for behavioural therapy for phobia

  • Ost et al - 52% attributed their phobias to conditioning
  • Barlow & Durand - 50% remembered a specific incident that triggered driving phobia
  • Bandura & Rosental - participants 'acquired fear' from a buzzer through a model acting in pain whilst a buzzer sounded simultaneously
• Biological explanations for phobias 


  • DiNardo - Some phobias explained by evolution
  • Davey - fear of spiders related to certain personality traits
• Aaron Beck's explanations to depression


  Cognitive vulnerability in some people

  1. Faulty information processing
  2. Negative self-schemas
  3. The negative triad
• Faulty information processing 


  • 'Black and white thinking'
  • Selectively attend to negative aspects in a situation
  • Fundamental errors in logic - cognitive distortion
  • Blows problems out of proportion
• Negative self-schemas


  Self-schema: a package of ideas we have about ourselves

  People with depressions interpret all the information about themselves in a negative way
• Weissman and Beck 


  Investigate the thought processes of depressed people using the dysfunctional attitudes scale (DAS), p's filled in a questionnaire ticking whether they agreed or disagreed with statements

  results: p's with depression made more negative assessments than people without, when given therapy there was improvement in their self-ratings

  Conclusion: depression involves the use of negative schemas
• 'The Negative Traid' - Beck's model of depression


  • Negative view of the self (I am incompetent and undeserving)
  • Negative view of the world (it is a hostile place)
  • Negative view of the future (problems will not disappear, there will always be emotional pain)
• Ellis' ABC model


  (A) Activating event

  (B) Belief

  (C) Consequence

  If beliefs are subject to cognitive biases they can cause irrational thinking, producing undesirable behaviours
• Strengths and weaknesses of Beck's theory


  • Good supporting evidence - many research
  • Practical applications in CBT
  • Does not explain all aspects of depressions (complex disorder)
• Strengths and weaknesses of Ellis' theory


  • Offers a partial explanation - not all depressions arises as a result of an obvious cause
  • Practical application in CBT
  • Does not explain all aspects of expressions (anger / hallucinations / delusions)
• Biological approach of depression


  • Hormones, genes and neurotransmitters (serotonin) cause depression
  • Evidence: success in drug therapy (medication alters level of neurotransmitters and reduces the symptoms)
  • Individuals with a genetic vulnerability for depressions are more prone to the effects of living in a negative environment, leading to negative irrational thinking
• CBT


  Cognitive Behavioural Therapy

  Aims to challenge client's irrational and maladaptive thought processes, leading to a change in behaviour
• Beck's CBT


  Challenging negative thoughts about oneself, the world and the future

  Reality Testing - disproving negative thoughts in real life scenarios (are beliefs actually going to happen?)
• Ellis' REBT


  Rational Emotive Behavioural Therapy

  D= Disputing irrational thoughts (empirical / logical)

  E= Effects of new beliefs and attitudes that emerge

  F= Feelings of the emotional response that arise
• Behavioural activation


  Client is encouraged to become more active and take part in pleasurable activities, physical activities naturally lifts mood
• What is the success rate of Cognitive Behavioral Therapy (CBT)?

  55%-85%
• What are the long-term benefits of CBT?

  CBT provides lasting improvements in mental health.
• What is the success rate of CBT when combined with drugs?

  85%
• How does CBT help clients build self-esteem?

  It allows clients to take control of their thoughts and behaviors.
• What is a requirement for patients to benefit from CBT?

  Patients must be motivated.
• What challenge does CBT face with certain patients?

  It can be difficult for patients who struggle with concentration or talking.
• What type of relationship is important in CBT?

  A good relationship between the client and therapist is needed.
• What is a potential issue with the client-therapist relationship in CBT?

  Clients can become dependent on their therapist.
• What does CBT focus on in terms of time?

  CBT focuses only on the present.
• What is a criticism of CBT regarding its cognitive emphasis?

  It may overemphasize cognitive elements without exploring necessary situational changes.
• In what cases might CBT be less effective?

  CBT may not work with severe cases.
• What is a requirement for effective CBT?

  It relies on a well-trained therapist.