AO1

• Depression

  A mood disorder
• Types of depression

  • Unipolar - major depressive episode without manic phase
  • Major depression disorder - severe but short term
  • Bipolar depression - manic depression
  • Persistent depressive disorder - long term or recurring depression
  • Disruptive mood dysregulation disorder - childhood temper tantrums
  • Premenstrual dysphoric disorder - disruption to mood prior/during menstruation
• The cognitive approach to explaining depression looks at mental processes (thoughts, attention, perceptions) and how they affect behaviour.
• Cognitive biases

  • Over-generalisation - assuming that one negative experience will recur in other situations
  • Catastrophising - exaggerating a minor setback and believing that it is a complete disaster
• Cognitive Behavioural Therapy (CBT)

  Commonly used psychological treatment for depression, combining cognitive and behavioural elements
• Beck's cognitive therapy

  1. Identify automatic thoughts about the world, the self and the future (Negative Triad)

  2. Once identified, these thoughts are then challenged

  3. Client is the SCIENTIST: CBT helps client test the reality of their negative beliefs. They encourage client to investigate their beliefs

  4. HOMEWORK: clients might be asked to record when they enjoyed event or when people were nice to them

  5. FUTURE SESSIONS: homework is useful in further session. If client falls back into patterns of thought the therapist can use evidence to prove client's thoughts are incorrect

  6. Reinforcing positive beliefs
• Ellis's Rational Emotive Behaviour (REBT)

  • Extends Ellis's ABC model to ABCDE (D is for Dispute and E is for Effect)
  • The main technique for REBT is to identify and challenge irrational thoughts
• Behavioural characteristics

  Change in activity levels:

  • can be an increase in activity such as restlessness
  • can be a decrease in activity such as social withdrawal

  Change to sleep and eating behaviour:

  • person may suffer from insomnia or may sleep more than usual
  • person may eat more for comfort or experience a loss of appetite

  Aggression and self-harm:

  • person may be aggressive towards themselves through self-harm e.g, cutting and possible suicide attempts
• Emotional characteristics

  Lowered mood

  • person feels hopeless, worthless and empty

  Lowered self-esteem

  • person likes themselves less than usual, with some suffering from self-loathing e.g. hating themselves

  Anger

  • person may often have angry outbursts; this can be directed at themself or others
• Cognitive characteristics

  Poor concentration:

  • person may be unable to focus or they find it hard to make decisions

  Attending to and dwelling on the negative:

  • person suffering holds bias towards negative aspects of situations

  Absolutist thinking:

  • person is likely to think that everything will turn out badly and there is no hope. This is sometimes called 'black and white' thinking.
• Beck‘s cognitive theory of depression

  He proposed a 3 part explanation…

  Faulty information process (cognitive bias):

  • individuals with depression tend to focus on the negative aspects of a situation and ignore the positive.
  • they are prone to distorting and misinterpreting information, a process known as cognitive bias

  Negative self-schema:

  • individual interprets information about themselves in a negative way

  Negative triad:

  1. Negative view of world
  2. Negative view of future
  3. Negative view of self
• Aaron Beck (1967) proposed the cognitive explanation as to why some individuals are more vulnerable to depression than others. Beck suggested an individual's cognition creates this vulnerability
• Ellis proposes that anxiety and depression can result from irrational thinking. These are thoughts that interfere with us being happy and free of pain.

   
• Beck and Ellis both refer to the person in therapy as a ‘client’ because they believed the word ‘patient’ took the power away from the person.
• Ellis’ REBT

  1. therapist identifies irrational thoughts and uses strong arguments to challenge client’s irrational thoughts
  2. therapist intends to break link between negative life events and depression by challenging client’s irrational beliefs
• Behavioural activation in REBT

  • Goal of behavioural activation is to work with individuals to gradually decrease their avoidance and isolation.
  • This should ideally increase their engagement in activities that have been shown to improve mood e.g. exercise
  • Therapist will aim to reinforce such activities.