cog approach depression

• List the three behavioural characteristics of depression

  > Activity levels

  > Disruption to sleep and eating behaviour

  > Aggression and Self-Harm
• List the three emotional characteristics of depression.

  > Lowered Mood

  > Anger

  > Lowered Self-Esteem
• List the three cognitive characteristics of depression.

  > Poor Concentration

  > Attending to and dwelling on the negative

  > Negative view of the world and expect things to turn out badly
• Outline Beck's Negative Triad as an explanation of depression

  Where a person develops a dysfunctional view of themselves due to three types of negative thinking (a negative and irrational view of ourselves, our future and the world around us). For suffers of depression, these thoughts occur automatically, regardless of the reality of the situation and are symptomatic of depressed people. According to Beck, negative self-schemas and faulty information processing maintain the negative triad.
• Outline faulty information processing as an explanation of depression.

  This refers to the fact that depressed people tend to focus on the negative of a situation and ignore the positives. They blow very small things out of proportion and experience very black and white thinking. This leads to overgeneralisations and catastrophising.
• Outline the negative self-scheme as an explanation of depression and give examples.

  Self-schemas are packets of information we have about ourselves that we use to interpret the world. If someone has a negative self-schema, then they will interpret information about themselves in a negative way. Some examples are: ineptness schema (expecting to fail), self-blame schema (feeling responsible for any misfortunes) and negative self-evaluation schema (reminds them of their worthlessness).
• Outline Ellis' beliefs on depression the ABC model as an explanation of depression.


  > Good mental health is a result of rational thinking

  > Depression and anxiety come from irrational thoughts.

  > An event occurs (eg fail a test)

  > Beliefs are either irrational or rational.

  > Rational belief may be to assess errors.

  > irrational belief may be that you're stupid and shouldn't study in the future.

  > Emotional and behavioural consequences.
• Evaluate Beck's explanation of depression.

  > Clark and Beck

  > Concluded that cognitive vulnerabilities were not only more common in depressed people, but also preceded depression

  > Cohen et al

  > Tracked the development of 473 adolescents, measuring cognitive vulnerabilities regularly and found they were predictors of depression

  > Association between cognitive vulnerabilities and depression
• Evaluate cognitive explanations for depression using alternative explanations

  > Could be biological - caused by genes and neurotransmitters

  > Research found lower levels of serotonin in depression patients

  > Drug therapies which increase serotonin are found to be effective in treating depression

  > Casts doubt on the cognitive explanation as a sole cause
• Evaluate the cognitive explanations for depression using the real world application.

  > Used to develop effective treatments

  > CBT (Cognitive Behavioural Therapy)

  > REBT (Rational Emotive Behavioural Therapy) developed from Elis' ABC model.

  > These therapies challenge negative and irrational thoughts and successfully treat people with depression
• Evaluate cognitive explanations for explaining depression giving a limitation without mentioning biology.

  > Cognitive explanations only explain reactive depression (triggered by events and reinforced by beliefs)

  > Many cases of depression cannot be traced to a life event

  > Unclear what caused the depression at that time (endogenous depression)

  > Ellis' model can only explain some cases of depression - a partial explanation
• What are the cognitive and behavioural elements to Cognitive Behaviour Therapy?

  Cognitive Elements:

  > Assessment - Client and therapist identify the problems and the goals.

  > Plan is put into place

  > Identify and challenge negative and irrational thoughts

  Behavioural elements:

  > Work to change unhelpful thought patterns via challenging beliefs, hypothesis testing and disputing and behaviour activating.
• What are the two types of Cognitive Behavioural Therapy (CBT) for depression?

  > Beck's Cognitive Therapy

  > Rational Emotive Behavioural Therapy
• Outline the type of CBT for depression proposed by Beck.

  Beck's Cognitive Therapy:

  > Aims to identify and challenge negative thoughts surrounding the negative triad

  > Direct challenging by giving homework to record when people are nice to them, enjoyed an event, received good feedback etc

  > Findings can be used in a future session to prove irrational statements wrong.
• Outline the type of CBT for depression proposed by Ellis

  Rational Emotive Behaviour Therapy:

  > Adds DE to the ABC model

  > D = disputing, E = effect

  > Identify and dispute irrational thoughts through vigorous argument

  > Change the negative belief and break the link between event and depression

  > Uses empirical, logical and pragmatic disputing
• What are the three types of disputing in the REBT treatment for depression and explain them.

  Empirical: Challenging whether there is actual evidence to support the negative belief

  Logical: Challenging whether the negative thought logically follows the facts.

  Pragmatic: Questions whether the belief is actually a helpful one in terms of solving the problem at hand.
• Outline behavioural activation as a Cognitive Behavioural Therapy for depression

  As individuals become depressed, they tend to increasingly avoid difficult situations and become isolated (causing symptoms to be maintained and worsened). The goal of behavioural activation is to gradually decrease avoidance and isolation by increasing engagement in activities that have been shown to improve mood - such as exercising and going out for dinner.
• Evaluate the cognitive approach to treating depression using a strength.

  > Research support - March et al

  > Found that CBT was as effective as antidepressants

  > 327 adolescents with a diagnosis of depression were studied to compare the effectiveness of CBT and antidepressants

  > After 36 weeks, 81% of AD group, 81% of CBT group and 86% of the combination group had significantly improved

  > CBT is effective - especially in combination with ADs
• Evaluate CBT as a treatment for depression using a limitation using the suitability for diverse clients. Give a counterpoint.

  > CBT could be ineffective for people with learning disabilities (LD) as it requires motivation

  > Motivation may not be present in severe cases -> may not pay attention.

  > Hard cognitive work associated with CBT may be unsuitable for people with LDs

  > Sturmey suggests psychotherapy is unsuitable for people with LD.

  > May only be suitable for a specific range of clients

  
  

  > Lewis and Lewis concluded that CBT was as effective as antidepressants and behavioural therapy for severe depression.

  > Taylor et al concluded that CBT is effective if used appropriately.

  > May be suitable for a wider range of people than initially thought
• Evaluate CBT as a treatment for depression using relapsation


  > Concerns about how long the

  benefits of CBT last.

  > Ali et al

  > Assessed depression in 439 clients every month for 12 months following a course of CBT

  > 46% relapse within 6 months

  > 53% relapse within a year

  > CBT may have to repeat periodically.