depression

• how does the DSM-5 categories depression

  § Major depressive disorder- severe depression but often short-term

  § Persistent depressive disorder- long-term or reoccurring

  §  Disruptive mood regulation- childhood temper tantrums (affects children and adolescence)

  § Premenstrual dysphoric disorder- disruption to mood prior to/ during menstruation.
• explain the behavioural characteristics of depression

  people experiencing depression usually have reduced energy levels which can lead to withdrawal from work, education and social events. In worst cases they may struggle to get out of bed.

  In fewer cases, the opposite may be seen, becoming agitated, pacing around and struggling to relax is known as psychomotor agitation.

  They may also experience sleep disruption, appetite may also decrease or increase leading to weight changes. They may also become aggressive.
• how might a person with depression act

  ·  Avoiding social; events and activities you usually enjoy

  ·  Self-harming or suicidal behaviour

  ·  Difficultly speaking, thinking clearly or making decisions

  ·  Losing interest in sex

  ·  Difficulty remembering or concentration
• explain the emotional characteristics of depression

  Ø Clinical depression is not just having a low mood, although it is a defining emotional element of depression. Patients often describe themselves as feeling worthless or empty.

  Ø Negative emotion can also include anger, which may be directed at themselves or others. Sometimes this may lead to aggressive or self-harming behaviours.

  Ø Self-esteem is reduced in most cases, meaning sufferers like themselves less than usual. some may even feel like they hate themselves.
• explain the cognitive characteristics for depression


  Ø Depression can be associated with reduced concentration levels, making it difficult to continue with things like school and work.

  Ø Sufferers are more likely to dwell on negatives and pay more attention to those aspects in a given situation.

  Ø When an unfortunate situation occurs, sufferers are likely to see it as an absolute disaster (known as catastrophising) even if there may be some positive aspects of the outcome in reality, reduced concentration.
• state the 2 theorist that explained depression from a cognitive perspective


  Beck 1967

  Ellis 1957
• Describe beck's cognitive triad 1967 model


  Beck suggested a person's cognition creates this vulnerability.

  faulty information processing-people experiencing depression focus on the negative aspects of the situation and ignore positive aspects.

  negative self-schema-people with depression  interpret all information about themselves in a negative way

  the negative triad- person develop negative cognition because of 3 types of feeling:

  §  Negative view of the world

  §  Negative view of the future

  §  Negative view of the self
• Describe Ellis' ABC model 


  He suggested a different cognitive explanation of depression. Good mental health is the result of rational thinking, whereas anxiety and depression result from irrational thoughts . Irrational thoughts are any thoughts that interfere with us being happy and free of pain. The ABC model explains how they affect our behaviour and emotional state.

  Activating events- a negative event triggers irrational

  Beliefs- a range of irrational beliefs exist

  Consequences- emotional and behavioural outcome.
• Does research support a link between cognition and depression?

  A research by Grazioli & terry 2000 assessed 65 pregnant women for cognitive vulnerability and depression before/after birth. Those high in cognitive vulnerability were more likely to get post-natal depression. this suggest there is support for the link of cognition and depression.
• Can Ellis’ theory be applied to treatment if so, how?


  Ellis’ explanation has been applied successfully in CBT by challenging irrational beliefs, depression can be reducing (e.g. Lipsky et el. 1980). therefore suggesting Ellis theory can be applied
• Is there any supporting evidence?


  Boury et al. (2001) found that patients with depression were more likely to misinterpret information negatively (cognitive bias) and feel hopeless about their future (cognitive triad). Further to this, Bates et al. (1999) gave depressed patients negative automatic though statements to read and found that their symptoms became worse. These findings support different components of Beck’s theory and the idea that negative thinking is involved in depression. 
• Does the cognitive explanation show causation of irrational thoughts?


  one weakness of the cognitive approach is that it does not explain the origin of irrational thoughts. Since most of the research in this area is correlational, psychologists are unable to determine if negative, irrational thoughts cause depression, or whether a person’s depression leads to a negative mindset. Consequently, it is possible that other factors, for example genes and neurotransmitters, are the cause of depression and the negative, irrational thoughts are the symptom of depression.
• How is the cognitive approach used in the treatment of depression?

  Cognitive treatments for depression are based on the assumption that faulty thinking/thought processes make a person vulnerable to depression. Cognitive Behavioural Therapy (CBT) involves both cognitive and behavioural elements. The cognitive element aims to identify irrational and negative thoughts, which lead to depression. The aim is to replace these negative thoughts with more positive and rational ones
• state the components of CBT


  1. Initial assessment
  2. Goal setting
  3. Identifying negative/irrational thoughts and challenging these:
  4. Either using Beck’s Cognitive Therapy

  Or

  1. Ellis’s REBT
  2. Homework
• Beck's cognitive behavioural therapy


  Aims to identify automatic thoughts about the world, the self, and the future (the negative triad). Once identified, these thoughts must be challenged, and patients are encouraged to test the reality of their negative beliefs. They might be set homework (e.g. to keep a daily diary of something that made them happy or a time someone was nice to them) – “patient as scientist”.
• Ellis cognitive therapy Rational Emotional therapy(REBT)


  Ellis developed his ABC model to include D (dispute) and E (effective). Like Beck the main idea is to challenge irrational thoughts however with Ellis' theory it is achieved through dispute. The therapist will dispute the patient's irrational beliefs, to replace their irrational beliefs with more effective beliefs and attitudes.
• Is CBT more/less effective antidepressants?


  A strength is CBT is more effective than antidepressants. Research by March et al. (2007) studied 327 adolescents with a main diagnosis of depression with different treatments over 36 weeks: CBT-81% significantly, Antidepressants-81% significantly improved, Both-86% significantly improved. This suggests that a combination of both treatments may be more effective
• Does CBT require motivation?


  One issue with CBT is that it requires motivation. Patients with severe depression may not engage with CBT or even attend the sessions and therefore this treatment will be ineffective in treating these patients. Alternative treatments, such as antidepressants, do not require the same level of motivation and may be more effective in these cases. This poses a problem for CBT, as CBT usually cannot be used as the sole treatment for severely depressed patients, who often lack the motivation to attend therapy and to speak about their depression.
• Is there overemphasis of cognition?


  CBT has been criticised for its overemphasis on the role of cognitions as the primary cause of depression. Some psychologists have criticised CBT for not taking into account other factors such as social circumstances which might contribute to a person’s depression. For example, a patient who is suffering from domestic violence or abuse does not need to change their negative/irrational beliefs, but in fact needs to change their circumstances. Therefore, CBT would be ineffective in treating these patients until their circumstances have changed.
• Is the success of CBT due specific techniques?


  The success of CBT may not be due to either of the specific techniques advocate by Beck or Ellis. Rosenzweig (1936) argued that it is the relationship between the client and the therapist which is of utmost importance in determining the success of a psychological therapy. Simply having someone to talk to may be the crucial component in having a positive outcome rather than the specific techniques adopted by the psychologist. This becomes evident compared to studies that show little difference
• what are the positive cycle of activity of behavioural activation?

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