The Cognitive Approach to explaining depression

• Focuses on how thinking shapes our behaviour: the main principle is that thoughts and beliefs are major factors in causing the emotional state of depression
• Abnormality comes through: cognitive distortions (dysfunctional thought processes) or cognitive deficiencies (absence of sufficient thinking and planning)

  A person is in control of their thoughts, so abnormality is a result of faulty control
• What did Beck believe?

  Depression is the result of faulty information processing where individuals: focus on the negative, have black and white thinking, make mountains out of a molehill.

  Depressed people feel as they do because their thinking is biased towards negative interpretations, they have negative views about: the self, the future, the world (society in general)
• What is a negative self-schema?


  When a person interprets information about themselves in a negative way

  (schemas are packages of information we hold internally)
• The Negative Triad?


  Negative views about the world e.g. everybody hates me because i am worthless

  Negative views about the future e.g. I'll never be good at anything because everyone hates me

  Negative views about oneself e.g. i am worthless
• Beck suggests that depressed people have acquired a negative schema in their childhood and adolescence and this leads to them adopting a negative view of the world. Negative schema are activated when the person encounters a new situation that resembles the original conditions when the schema was learnt e.g. there is nothing to look forward to
• Possible causes of negative schema?

  loss of a parent (ties with attachment theory)

  rejection by peers

  criticism by parents

  criticism by teachers

  physical abuse
• What did Beck say about negative schema?

  early trauma = negative schema

  traumatic or negative experiences could lead to negative automatic thoughts (NATs)

  These negative automatic thoughts could cause cognitive biases (logical errors, focusing on certain aspects of a situation while ignoring relevant info)
• Magnification = a tendency to exaggerate the significance of an event
• Minimilisation = the tendency to underplay a positive event
• Arbitrary interference = drawing conclusions on the bases of insufficient or irrelevant evidence
• Overgeneralisation = making a sweeping conclusion on the basis of a sinle event
• Personalisation = the attribution of negative feelings of others to yourself
• All or nothing thinking = a tendency to see things in black and white and ignore the middle ground
• Selective abstraction = a tendency to focus on small, usually negative, aspects of a situation and ignores the wider picture
• Grazioli and Terry:

  65 pregnant women

  self-report - tested if they had cognitive vulnerability and depression before and after having the baby

  repeated measures

  higher cognitive vulnerability before birth led to more post natal depression

  BUT - small sample, self-report, only post natal depression
• Clark and Beck:

  Research review

  support for cognitive vulnerability factors - can be seen before depression - cognition cause depression
• Application: translates well into a successful therapy

  CBT - lasts longer than drugs, costs money, therapists have to be specially trained, each session is 1 hour - faster and can churn out more drugs
• Too basic - can't explain all symptoms of depression - it is much more complex than faulty thoughts e.g. anger, sleep disruption, poor concentration, cotard syndrome (belief they are dead)

  Ignores other factors - reductionist
• Albert Ellis said that good mental health is a result of rational thinking (happy and free of pain) and that abnormality is a result of irrational thoughts.
• He explains depressive/irrational thinking using the ABC model
• Activating event triggers...

  Beliefs which are irrational; this produces...

  Consequences - an emotional response
• The ABC model can be applied to rational beliefs as well - lead to healthy emotions (e.g. amusement or indifference) whilst irrational beliefs lead to unhealthy emotions (e.g. anxiety/low mood)
• It is the irrational beliefs which produces the response, not the event itself.
• Negative Event A / Negative Event A

  Rational Belief B / Irrational Belief B

  Healthy negative emotion C / Unhealthy negative emotion C
• It is not the event but the irrational belief that triggers depression
• Examples of irrational beliefs:

  1. musturbation - it must... (perfectionism) - the belief that we must always succeed or achieve perfectionism
  2. i-can't-stand-it-itis - the belief that it is a major disaster whenever something does not go smoothly
  3. Utopianism - the belief that life is always meant to be fair
• Strengths of Ellis?

  1. Successful therapies e.g. CBT - the idea that by challenging irrational thoughts, depression can be reduced is supported by research evidence (Lipsky et al) - therefore irrational thoughts must have a significant role in depression - supports the validity of the theory
  2. Empowering for client to know they can change
• Weaknesses of Ellis?

  1. By suggesting that a patient is responsible it may encourage them/ therapist to overlook situational factors, e.g. how family/ relationship issues have contributed to their disorder - reductionist
  2. Does not take into account biological factors (neurotransmitter serotonin) - reductionist
  3. Only a partial explanation - explains depression following activating events (reactive depression) but not that arising without an obvious cause
  4. Doesn't explain all aspects/ symptoms of depression e.g. anger, hallucinations nor delusions
• Alternative theory 1:

  Biological - neurotransmitters:

  1. anti depressants such as SSRIs are successful at treating depression. They block reuptake of serotonin and alleviate the symptoms of depression. This suggests that depression has a biological cause.
  2. Additionally, SSRIs are given before CBT for severe depression
• Alternative theory 2:

  Genetics - evidence that depression runs in families

  1. Concordance rates for depression are higher in MZ than DZ - suggesting a genetic element. However, this could be a learnt or copied behaviour, rather than inherited