Depression

• Categories of Depression

  DSM recognises:

  • Major depressive disorder
  • Persistent depressive disorder
  • Disruptive mood dysregulation disorder
  • Premenstrual dysregulation disorder
• Characteristics of Depression

  Behavioural = Activity levels, sleep and eat patterns, aggression or self-harm

  Cognitive = poor concentration, dwell on negative, absolutist thinking

  Emotional = lowered mood, anger, low self-esteem
• Cognitive Explanation : Beck


  Negative Triad - a person's cognitions creates a vulnerability to depression

  • Faulty information processing = ignore positives, focus on negatives
  • Negative self-schema = interprets all information in a negative way
• Components of Negative Triad

  1. Views about the world
  2. Views about the future
  3. Views about self
• Cognitive Explanations : Ellis


  Used the ABC model to show how irrational thoughts affect our behaviour and emotional state.

  Irrational thoughts = any thoughts that interfere with us being happy and free from pain.
• Components of ABC Model


  A - Activating Event

  • Negative event triggers beliefs

  B - Beliefs

  • Rational or irrational

  C - Consequences

  • Rational = healthy emotions
  • Irrational = depression
• Explaining Depression : Strength

  Grazioli and Terry assessed 65 pregnant women for cognitive vulnerability (Negative triad) and depression before and after birth, and found those with high levels were more likely to suffer with postnatal depression.
• Explaining Depression : Strength

  Led to the development of CBT which requires the understanding of how cognitive vulnerability and irrational beliefs can result in depression. March et al conducted research to show that CBT is an effective treatment for depression.
• Explaining Depression : Weakness

  May overlook other factors, e.g. biological approach using genes and levels of serotonin relating to depression. The success of drug therapies suggest that the biological approach has creditable explanations for depression.
• Treating Depression : CBT

  Cognitive Behavioural Therapy is the most commonly used treatment for depression.

  • Cognitive - client and therapist work to clarify problems, identify goals and irrational thoughts
  • Behavioural - change negative and irrational thoughts by putting more effective behaviours in place
• Beck's Cognitive Therapy

  • Identify and challenge thoughts related to the negative triad
  • Help clients test the reality of their negative beliefs
  • Client set homework to gather evidence and test validity of beliefs
  • Therapist used this evidence in sessions to prove client's statements are incorrect
• Ellis's Rational Emotive Behaviour Therapy (REBT)


  Extends the ABC model:

  • D = dispute (irrational thoughts)
  • E = effect (change irrational belief)

  Involves vigorous argument:

  • Empirical argument = dispute whether there is actual evidence to support the negative belief
  • Logical argument = dispute whether the negative thought logically follows the facts
• Behavioural Activation


  Working with depressed individuals to gradually decrease their avoidance and isolation, and increase their engagement in positive mood-boosting activities.
• Treating Depression : Strength


  March et al found that CBT was as effective as antidepressants in treating depression in a sample of 327 adolescents. After 36 weeks, 81% of antidepressant group, 81% of CBT group and 86% of combined group had significantly improved.
• Treating Depression : Weakness


  Patients with severe depression may not be able to motivate themselves to engage in the hard work of CBT, either not attending or concentrating. This treatment is ineffective for the severe cases, alternatives like antidepressants are less effort with a similar effect.
• Treating Depression : Weakness


  Rosenzweig argued that it is the relationship between client and therapist that determines the success of a psychological therapy. This challenges the effectiveness of the methods and techniques used in CBT.