Cog-Depression

• Depression is a mental disorder characterized by low mood/ energy levels.
• Behavioural characteristics are changes when we experience an episode of depression:

  • Lower levels of energy, making them lethargic
  • Withdraw from work, education and/or social life
  • May experience insomnia or hypersomnia
• Emotional characteristics:

  • low levels of mood - lethargic and sad
  • Often describes self as 'worthless'/'empty'
  • lowered self-esteem, sometimes self-loathing
• Cognitive characteristics are ways in which ppl process info:

  • lowered concentration - unable to stick to one task - interfere with work
  • Pay more attention to neg aspects of situation
  • 'Black and white thinking' - when a situation is unfortunate they tend to see it as an absolute disaster
• The cognitive approach focuses on how mental processes (thoughts, perception and attention) affect behaviour.
• Beck conducted the NEGATIVE TRIAD in which he proposed that there were 3 kinds of neg thinking that contributed to becoming depressed: neg views of the world, the future and the self. Such negative views lead a person to interpret their experiences in a negative way and make them more vulnerable to depression.

  
• Ellis conducted the ABC model and proposed that depression occurs when an activating event (A) triggers an irrational belief (B) which in turn produces a consequence (C) - key to this process is irrational belief.
• This approach stresses the role of cognitive problems such as irrational thinking in abnormal functioning.
• Ellis and Beck both believed that the behaviour model did not take into account mental processes. They believed that the thinking which takes place between a stimulus and response is responsible for the feeling that leads to the response.
• (Beck) Faulty info processing - when depressed we pay more attention to the negative aspects of a situation and tend to ignore the pos. We also tend to blow small issues out of proportion.
• (Beck) Neg self-schemas - 'Package of info' we have about ourselves. Schemas are used to interpret the world so a neg self-schema is where we interpret all info about ourselves in a neg way.
• The 3 forms of neg thinking which make up the neg triad interfere with normal cognitive processing, leading to obsessive neg thoughts, in which a person develops a dysfunctional view of themselves.
• Ellis believed that psychological problems occur if people engage in irrational/faulty thinking to the point where it becomes maladaptive for them so they are not happy and free from pain.
• Ellis's model was designed to explain the response to negative events:

  A - ctiviating event to which there is a reaction

  B - elief/explanation about why the situation occurred

  C - onsequence: Feelings/behaviour the belief causes

  The 'event' is being blamed for the unhappiness being experienced
• S of cog approach to explaining depression:

  • Good supporting evidence - Research has shown that many ppl who have mental disorders show maladaptive thought patterns Gustafson found this in anxiety, depression and sexual disorders.
  • Practical application - Beck's explanation forms the basis of CBT, in which the cog aspects of depression can easily be identified and challenged in CBT, so explanations translate well into therapy.
• W of cognitive approach to explaining depression:

  • The cognitive model ignores other factors which may contribute to mental disorders (role of genetics as there is a genetic component in psychological disorders such as manic depression and schizophrenia.)
  • Partial explanation - Some cases of depression do not follow an event of some kind (reactive depression) but some cases arise with an obvious cause.
• Alloy and Abramson suggest that depressive realists may actually see things for how they really are, and others are viewing the world through rose-coloured glasses. They found that depressives gave more accurate estimates of likelihood of disasters than 'normal' controls - The sadder but wiser effect.
• CBT is the most commonly used psychological treatment for depression. The aim of CBT is to change irrational thoughts and put more effective behaviours into place. Sometimes patients are referred to as 'scientists' as they are testing their own ideas. (BECK/ELLIS)
• Beck's cog therapy is carried out as such:

  1. Assessment - patient and therapist work TOGETHER to clarify the patient's problems
  2. They identify goals for therapy and put together a plan to achieve them (record when ppl are nice to them)
  3. Central task - identify negative/irrational thoughts that would benefit by being challenged
• Ellis's Rational emotive behaviour therapy (REBT) is n extension of the ABC model to ABCD-ispute E-ffect. The central technique of REBT is to identify and dispute irrational thoughts. (A patient may talk about how unfair things are in which an REBT therapist would challenge this irrational belief and so break the link between negative life events and depression)
• Methods of disputing:

  Empirical dispute - whether there is actual evidence to support the negative belief

  Logical dispute - Whether the neg thought logically follows from the facts

  Pragmatic dispute - Aimed at showing client that the irrational belief she/he holds is not helpful
• S of CBT techniques:

  • Effective - March et al compared the effects of CBT, antidepressants and the two together in 327 adolescents with a main diagnosis of depression. After 36 weeks: 81% of CBT group significantly improved, 81% of antidepressant group significantly improved and 86% of combined group significantly improved
  • Psych's within NHS are using it because it is short term/economical
• W of CBT techniques:

  • Very depressed patients may not have the motivation or engagement needed for CBT so may have to have meds first, then CBT, therefore, CBT cannot be used as a sole treatment
  • CBT focuses on the present and the future but many patients may find it frustrating to not be able to explore their past, especially when they can see links between their past and current mood problems.