Depression

• depression 


  is a mood disorder which last for long period of time
• Beck's negative triad


  A pessimistic and irrational view of three key elements in a person's belief system
• Cognitive approach key assumption

  • Our thoughts influence our emotions, which influence our behaviour
• Schemas


  Develop in childhood and adolescence, when authority figures place demands on individuals and are highly critical of them. Negative schemas then come into adulthood providing a negative framework to view life in a pessimistic fashion.
• Cognitive errors


  • Catastrophizing
  • All or nothing
  • Over generalisation
  • Selective abstraction
  • Global judgements
• Negative triad


  1. View of the self - individuals see themselves as being helpless, worthless and inadequate

  2. View of the world - obstacles are perceived as not being able to be dealt with

  3. View of the future - personal worthlessness is seen as blocking any improvements
• Cognitive bias


  Negative schemas lead to cognitive biases and are reinforced by cognitive biases. Whenever we are faced with a stressful or challenging situation people with negative schemas tend to faulty logic and flawed interpretations of events.
• Ellis's ABC model


  A - Activating event (negative event in the environment)

  B - Beliefs (rational or irrational)

  C - Consequences (emotional response to the belief)
• Mustabatory thinking


  The source of irrational thinking, where certain ideas or assumptions MUST be true in order for an individual to be happy. The three most important irrational beliefs are: 1) I MUST be approved of or accepted by people I find important, 2) I MUST do well or very well, or I am worthless, 3) The world MUST give me happiness, or I will die.
• strengths of the cognitive approach to explaining depression

  • practical applications as are used in CBT
  • research evidence to support ( Lloyd and lishman 1975 )
• weaknesses of the cognitive approach to explaining depression

  • may not be that straight forward (Cuijpers et al 2013)
  • does not show that irrational thinking causes depression
  • patient is seen as responsible for psychological disorder
  • depresses people can be a rational reflection of reality (Alloy and Abrahmson 1979)
• cuijpers et al 2013


  found that CBT was most effective when combined with drugs (e.g. SSRI's)
• Lloyd and Lishman 1975


  gave Pp with depression stimulus words in repose to which they were required to recall pleasant or unpleasant experiences from their past. they found that Pp with low levels of depression respond faster when recalling pleasant memories than those Pp with deeper depression, with response times increasing with the severity of depression.
• Alloy and Abrahmson 1979

  found that depressed people tended to be more accurate when rating likelihood of disaster than 'normal' controls and called it the 'sadder but wiser' effect
• CBT


  cognitive behavioural therapy
• CBT


  • Challenging irrational thoughts for treating depression
• CT


  Cognitive therapy is bored of the complex approach that depression is a result of distorted thought processes
• Identifying irrational thoughts


  1. Therapist works with patient to help them identify irrational thinking and maladaptive thoughts

  2. Client is encouraged to record automatic negative thoughts and thoughts on how to challenge these

  3. Asking questions like: What is the evidence for such negative thinking? Are there alternative explanations? How might others respond? How does it affect me to think so negatively? What thinking errors am I making?
• REBT


  Ellis's rational emotive behavioural therapy, aims to change irrational beliefs into rational beliefs
• behavioural element


  part of the therapy aims to alter dysfunctional behaviours that are contributing to or maintaining the depression
• strengths of CBT as a treatment for depression

  • supportive research ( march et al, TADS team)
  • teaches skills that tackle the problem
• limitations of CBT as a treatment for depression

  • not effective for everyone (simon et al)
  • relies on the assumption that the individual can change their own thought patterns
• march et al


  found, using 327 adolescence with depression, after 36 weeks, 81% of CBT were better and 81% of antidepressants were better. and 86% of the combination of both were better and showed clinically significant improvements
• TADS team


  found that when CBT was compared to fluoxetine therapy in adolescents, after 36 weeks the two treatments had equal success. but suicidal events were more common in participants receiving fluoxetine (14.7%) than combination of therapy (8.4%) or CBT (6.3%)
• simon et al 


  suggests that CBT is not suitable for people who have high levels of stress that reflect realistic stressors in the persons life, as the therapy can not resolve these and can therefore not help the depression