Cognitive approach: treating and explaining Depression

• Cognitive psychologists believe that in mental disorders such as depression, irrational thinking leads to a warped world-view and the symptoms of mental ill-health. There are two main cognitive models of depression, Ellis’s ABC model and Beck’s Negative Triad. 
• Ellis proposed the ABC model to explain depression
• Ellis’ ABC model

  A – activating event: an event that triggers or acts as a trigger.

  B – belief: the belief a person holds about the phobic stimulus, can be irrational and rational.

  C – consequence: the consequence of ones personal beliefs.
• Beck's negative triad: a person develops a dysfunctional view of themselves and their environment due to three types of negative thinking: negative view of oneself, the future and the world.
• Beck's faulty information processing theory: when depressed a person tends to ignore the positives and focus on the negatives. The depressed person will blow small problems out of proportion. This cognitive bias cause a negative view of themselves.
• Beck's negative-schema theory: A schema is a shortcut that acts as a mental frame work for the individual. A self-schema is the framework of information about themselves. When depressed, a person will have a negative schema which means they interpret information negatively.
• Evaluation of cognitive explanation: + There is a wealth of research supporting a link between faulty information processing, cognitive biases, the negative triad and depression. For example, Grazioli and Terry (2000) assessed the cognitive vulnerability of 65 pregnant women, and found that those with the highest levels of dysfunctional thinking were the most likely to develop postnatal depression.
• Evaluation of cognitive explanation: - Cognitive explanations neglect the role of biology in depression. Research supports the role of genetics in making some people susceptible to depression but not others, perhaps because they manufacture lower levels of the brain chemical serotonin than others do.
• Evaluation of cognitive explanations: not all thoughts are irrational, Alloy and Abrahamson 1979 found that depressed people had the 'sadder but wiser effects' where they gave a more accurate likelihood of disaster than those not depressed.
• There are two main types of treatment: CBT and REBT
• REBT - rational emotive behavioural therapy
• Ellis developed a technique called rational emotive behavioural therapy (REBT) that follows the ABC of his model with:

   D - dispute: the client is trained in identifying and challenging their irrational thoughts using empirical (evidence-based) and logical (reason-based) dispute. 

   E - effect: they measure the effects that the disputation has on their mood, anxiety and behaviour. 
• REBT focuses on disputing the irrational thoughts through arguments and disputations.
• CBT - cognitive behavioural therapy by Aaron Beck
• CBT challenges irrational thoughts by requiring the client to gather evidence of behaviours and incidents, then compare them to the thoughts expressed to check whether they match up.
• CBT sessions take place once a week or once a fort night
• CBT focuses on modifying the negative schema and irrational thoughts - this is called cognitive reconstruction
• Evaluation of treatment: CBT is an effective treatment for depression - March et al 2007 found that CBT was just as effective as medication. Ellis found that 90% of his patients received positive effects from CBT.
• Evaluation of treatments: compared to drugs, CBT and REBT help address the underlying symptoms of depression. Drug treatments just mask the symptoms and can have some negative side effects.
• Evaluation of treatments: CBT may not work for the most severe cases of depression. In severe cases patients cannot motivate themselves to attend sessions.