Depression

• depression is a disorder characterised by changes in mood. a diagnosis can be made when 5 symptoms are present for 2 weeks
• emotional effects of depression are low mood, anger and decline in self esteem
• behavioural effects of depression are low activity levels, high levels of sleep, changes in eating patterns and diminished interest
• cognitive effects of depression is poor concentration and inclination towards negativity
• the cognitive approach focuses on how our mental process affect behaviour and can be used to explain depression
• the cognitive explanation of depression consists of: Ellis ABC model and Becks cognitive theory
• Becks cognitive theory of depression explains how some people are more vulnerable to depression then others. he says that a persons cognitions creates this vulnerability
• Beck suggested three parts to this cognitive vulnerability:

  -faulty information processing

  -negative self-schema

  -the negative triad
• faulty information processing (becks theory):states that depressed people attend to the negative aspects of a situation and ignore positives. may tend towards black and white thinking
• negative self-schema (Becks theory): a schema is a package of ideas and info that has developed with experience. a self schema is a package of ideas people have about themselves. people with depression have developed a negative self schema and interpret all info about themselves in a negative way
• the negative triad (becks theory): suggested that people with depression become trapped in a cycle of negative thought. they view themselves, the world and the future in negative and pessimistic ways
• supporting research for becks theory a03: (Clark and Beck)- conducted a review and concluded that not only were these cognitive vulnerabilities more common in depressed people but they also preceded the depression which supports Becks idea that cognitive vulnerability leads to depression
• supporting research for becks theory a03: (Cohen et al)- Conducted a recent study were he tracked the development of 473 adolescents, regularly measuring their cognitive vulnerability. he found that cognitive vulnerability predicts later depression and also confirmed Clark and Becks views.
• Supporting real-world applications for becks theory a03: can be applied to screening and treating depression. Cohen et al concluded that assessing cognitive vulnerability allows psychologists to screen young people and identify those most at risk of developing depression and monitor them. Can also be applied to CBT by altering cognitions that make people vulnerable to depression
• Limiting evidence for becks theory a03: There are some aspects of depression which cannot be explained by becks theory e.g why depressed people feel extreme anger. this means it is only a partial explanation for depression
• Ellis suggested another explanation for depression and states that it is a result of irrational thoughts. Ellis used the ABC model to explain how irrational thoughts affect our behaviour and emotional state.
• A (activating event): Ellis states that we get depressed when we experience negative, traumatic events which trigger irrational beliefs

  B (beliefs): Ellis identified a range of irrational beliefs. e.g musterbation which is the belief we must always succeed and reach perfection

  C (consequences): when activating an event triggers irrational thoughts there are emotional and behavioural consequences-DEPRESSION
• Cognitive behaviour therapy:

  • most commonly used treatment for depression
  • usually 5-10 sessions
  • 30-60 mins per session
  • patient-centred therapy
  • standardised
• Stages taken in CBT:

  1.explaining ideas behind purpose of cbt

  2.specifying and listing problems, usually asked for list of goals

  3.identifying feelings, thoughts and behaviours for each problem

  4.familiarisng clients with concept of distortion or thinking errors

  5.challenging irrational thoughts and generating alternatives

  6.behavioural techniques
• Becks cognitive therapy: cogntive therapy is the application of becks cogntive theory of depression. the idea behind it is to identify automatic thoughts about self, the world and the future. once identified these thoughts must be challenged. Helps clients test the reality of their negative beliefs
• Ellis rational emotive behaviour therapy (REBT): aims to identify, dispute irrational thoughts through different arguments. Vigorous argument-is to forcefully try to change the belief. Empirical argument- involves disputing wether there is actual evidence to support the negative belief. Logical argument-involves disputing whether the negative thought logically follows from the facts
• Supporting evidence for effectiveness of CBT a03: (John march et al)-compared cbt to antidepressants and also a combination of both when treating 327 depressed adolescents. after 36 weeks, 81% of cbt group 81% of antidepressant group and 86% of both group significantly improved. CBT is just as effective and more so when used alongside antidepressants. Also fairly brief so cost effective
• Limitation for CBT, lack of effectiveness for diverse clients a03: In severe cases of depression clients cannot motivate themselves to engage with cogntive work of cbt or may not be able to play attention in sessions which means its not affective for severe cases. Futhemore due to complex rational thinking involved not suitable for individuals with learning disabilities. (Peter Sturmey)-any form of psychotherapy is not suitable for individuals with learning disabilities, this includes CBT
• Supporting evidence for CBT, can be effective for diverse clients a03:

  Recent evidence challenges the idea that effectiveness of CBT is limited to certain groups. (Gemma and Glyn Lewis)-concluded that CBT was just as effective as antidepressants for severe depression. (John Taylor et al)- concluded that when used appropriately is effective for people with learning disabilities
• Limitation for CBT, high relapse rates a03: (Shehzad et al) assesed depression in 439 clients every month for 12m following a course of CBT. Found 42% relapsed in first 6 months and 53% relapsed within a year which shows cbt is not effective long term and may require repeats.
• limiting evidence for Ellis ABC model, ethical issues a03: ABC model locates responsibility for depression purely with the depressed person which can be seen as blaming the depressed person
• supporting evdince for Ellis ABC model, real world application a03: Ellis approach to cogntive therapy is REBT. (David et al)-has evidence to support the idea that REBT can change both negative beliefs and relive the symptoms of depression so it has real world value
• Limiting evidence for Ellis ABC model a03, only explains reactive depression not endogenous: Many cases of depression are not traceable to life events and its not obvious what has caused the persons depression, Ellis model is less useful for explaining this endogenous depression meaning its only a partial explanation
• limiting evidence for explanations of depression, deterministic ao3:

  explanations only describe development of disorder through cognitive processes so are narrow and don't account for genetic predisposition other factors which may play apart
• supporting evidence for explanations to depression, real life application a03:

  Explanations help explain the internal mental processes of a person with depression which allows cognitive psychologists to tailor treatments to fit their specific needs. e.g homework in cbt