Explaining depression - cognitive approach

• One explanation for depression is Becks cognitive theory of depression 


  Aaron Beck (1967) proposed a cognitive approach to understanding why some individuals are more vulnerable to depression than others, suggesting that it is the way a person thinks that creates this vulnerability. He identified three key components of cognitive vulnerability: faulty information processing, negative self-schemas, and the negative triad.
• 1. Faulty Information Processing: People with depression tend to focus on the negative aspects of a situation while ignoring the positives. For example, someone might focus on the loss of a job and overlook the other positive aspects of their life. Additionally, they may engage in ‘black-and-white’ thinking, where things are seen as either all bad or all good, without considering any middle ground.
• 2. Negative Self-Schemas: A schema is a mental framework that helps individuals process information based on past experiences. A self-schema refers to the way we perceive ourselves. If a person has a negative self-schema, they interpret all information about themselves in a negative light. This leads them to view themselves as inadequate, unworthy, or incapable, which can exacerbate feelings of depression.
• 3. The Negative Triad: Beck hypothesized that individuals with depression develop a dysfunctional view of themselves through three types of negative thinking. This is known as the negative triad, which consists of negative thoughts about the world, the future, and oneself. These automatic negative thoughts perpetuate feelings of hopelessness and helplessness, key components of depression. Together, these cognitive processes create a cycle that reinforces and maintains depressive symptoms, highlighting the importance of addressing these thought patterns in treatment for depression.
• Another explanation for depression is Ellis cognitive ABC model of depression 


  Albert Ellis (1962) proposed that good mental health results from rational thinking, which allows individuals to be happy and free from emotional pain. He suggested that conditions like depression arise from irrational thoughts—illogical or unrealistic beliefs that interfere with happiness and well-being. To explain how irrational thoughts affect behavior and emotional states, Ellis developed the ABC model.
• 1. Activating Event: According to Ellis, negative events trigger irrational beliefs that lead to depression. These events, such as failing an important exam or ending a relationship, serve as the catalyst for irrational thinking.
• 2. Beliefs: The beliefs we hold about these events—whether rational or irrational—shape our emotional responses. For example, a rational belief might be that a friend who hasn’t responded to a greeting is simply busy and stressed. In contrast, an irrational belief might be that the friend dislikes you and never wants to speak to you again. The way we interpret events can either help us cope or lead to negative emotional consequences.
• 3. Consequences: Ellis argued that rational beliefs lead to healthy emotional outcomes. For instance, if we rationally interpret a friend’s lack of response as a sign of their busyness, we may calmly wait to reconnect. However, irrational beliefs lead to unhealthy emotional outcomes, such as depression. If we irrationally believe a friend dislikes us, we might withdraw from them and end the friendship, which exacerbates feelings of loneliness and sadness.
• In summary, Ellis believed that irrational thinking leads to emotional distress, while rational thinking promotes good mental health. By challenging and replacing irrational beliefs, individuals can improve their emotional well-being and avoid the negative consequences of depression.
• A strength of Beck’s cognitive theory is the strong supporting evidence from research studies. Grazioli and Terry (2000) assessed 65 pregnant women for cognitive vulnerability and depression before they gave birth and found that women with high cognitive vulnerability were more likely to develop postnatal depression. Similarly, Cohen et al. (2019) tracked the development of 473 adolescents, regularly measuring their cognitive vulnerability, and found that those with higher cognitive vulnerability were more likely to develop depression later on.
• These findings support Beck’s theory by demonstrating that cognitive vulnerability, such as faulty information processing, negative self-schemas, and the negative triad, is associated with an increased risk of depression. This empirical evidence reinforces the idea that cognitive factors play a key role in the development of depressive symptoms.
• A further strength of Beck’s cognitive model of depression is its practical applications in screening and treatment. Cohen et al. (2019) concluded that assessing cognitive vulnerability allows psychologists to screen young people, identifying those most at risk of developing depression in the future and providing early intervention to monitor and support them.
• Additionally, understanding cognitive vulnerability has important implications for therapies like Cognitive Behavioral Therapy (CBT). CBT works by helping individuals identify and alter the negative thought patterns that contribute to depression, making them more resilient to future negative life events. This demonstrates that an understanding of cognitive vulnerability is not only valuable for identifying individuals at risk but also for providing effective treatments that target the underlying cognitive processes that contribute to depression.
• A limitation of Ellis’s cognitive model of depression is that it primarily focuses on how life events, or activating events, trigger depression. While there is no doubt that life events can play a role in the onset of depression, some cases of depression occur without any obvious triggering event. This suggests that depression can arise without clear external causes. In particular, endogenous depression, which may be caused by genetic or biological factors,
• cannot be fully explained by Ellis’s model. Since the model emphasizes cognitive factors and external triggers, it is less useful for explaining cases of depression that have a biological or genetic basis. As a result, Ellis’s theory provides only a partial explanation of depression, as it does not account for all the factors that contribute to the disorder.
• Counterpoint: One criticism of Ellis’s cognitive theory of depression is that it overlooks biological factors that contribute to the disorder. Research has shown that depression can be associated with low levels of the neurotransmitter serotonin, which suggests a biological basis for the condition.
• This means that the cognitive approach, which focuses primarily on thought patterns and life events, may be too simplistic, as it does not take into account the complex biological processes that can also play a significant role in the development of depression. By not considering these biological factors, the cognitive approach may provide an incomplete explanation of depression, particularly in cases where the disorder is more influenced by genetic or neurochemical factors rather than cognitive vulnerabilities or external life events.
• A strength of Ellis’s ABC model is its real-world value in the treatment of depression. Ellis developed a therapeutic approach called Rational Emotive Behavior Therapy (REBT), which aims to address irrational beliefs by challenging them and encouraging individuals to provide evidence for their thoughts. If the evidence for the irrational belief is lacking, the therapist helps the individual replace it with more rational and realistic beliefs.
• There is evidence supporting the effectiveness of REBT, such as the findings of David et al. (2018), who showed that the therapy can change negative beliefs and reduce symptoms of depression. This supports the practical application of Ellis’s theory, as it demonstrates that addressing irrational thoughts can lead to improvements in mental health and overall quality of life for individuals suffering from depression.
• Attachment theory suggests that early attachment relationships play a crucial role in shaping an individual’s emotional and cognitive development. Studies have shown that infants who develop insecure attachments to their parents, particularly to their primary caregiver, are more vulnerable to experiencing depression in adulthood. Bowlby’s Maternal Deprivation hypothesis posits that disruptions or interference in the attachment bond between an infant and their primary caregiver, often the mother, can result in long-term cognitive, social, and emotional difficulties.
• This aligns with the idea that early attachment experiences influence brain development and shape emotional and cognitive patterns. If children form maladaptive or unhealthy thought patterns based on their attachment experiences, these patterns are likely to persist into adulthood, influencing their mental health, including vulnerability to depression. Such findings support cognitive theories of depression, which emphasize the role of early experiences in shaping cognitive vulnerabilities and emotional responses.
• Drug treatments for OCD are often considered more cost-effective than other psychological treatments, such as CBT, making them a practical option for public health systems like the NHS. SSRIs are particularly advantageous as they are non-disruptive to patients’ lives, allowing them to take medication without significant lifestyle changes.
• For some patients, drug treatments offer a less demanding alternative, as they can take medication until they feel better, without the need to engage in the intensive work required in therapies like CBT.Support for this approach comes from both patients and doctors, as many prefer the convenience and relative ease of drug treatments compared to more time-consuming and effort-intensive psychological therapies.
• One limitation of drug treatment for OCD is that drugs can have potentially serious side effects. While SSRIs can be effective for many patients, a significant minority may not experience any benefit. Additionally, some patients may experience undesirable side effects. For example, Clomipramine, a tricyclic antidepressant, is associated with more common and severe side effects, such as erection problems, tremors, and weight gain in more than 1 in 10 patients.
• More seriously, 1 in 100 patients may experience aggression, blood pressure disruptions, and heart-related problems.Limitation – These side effects can reduce the effectiveness of the medication, as patients may discontinue treatment to avoid further health issues, ultimately lowering the overall quality of life and making the treatment less effective for managing OCD.
• Although SSRIs are generally effective and their side effects are typically short-term, like all drug treatments, they are not without controversy. One criticism is that the evidence supporting the effectiveness of drug treatments may be biased. Some psychologists argue that research into SSRIs is often sponsored by drug companies, which may influence the results. For example, companies might withhold negative data or selectively report favourable outcomes, as highlighted by Goldacre (2012)..
• Limitation – Such bias can undermine the reliability of the evidence supporting SSRIs, and the potential for biased research may contribute to patients feeling less confident in the treatment. This can lead to discontinuation of medication and ultimately reduce the overall effectiveness of the treatment