Depression and the cognitive approach

• Depression is a mood disorder characterised by low mood and loss of pleasure which causes impairment in general functioning for a prolonged amount of time.
• An emotional characteristic of depression is low mood. This includes feelings of emptiness, worthlessness and hopelessness for a long period of time.
• An emotional characteristic of depression is loss of pleasure. This is when sufferers stop doing things that they used to enjoy.
• A cognitive characteristic of depression is negative schema. This is irrational, negative beliefs about themselves, relationships and the world in general.
• A cognitive characteristic of depression is poor concentration. Sufferers will be unable to stick to a task or make decisions which may interfere with their work.
• A behavioural characteristic of depression is change in appetite. Sufferers may have an increased or decreased appetite which can lead to weight loss or gain.
• A behavioural characteristic of depression is change in sleep pattern. Insomnia or hypersomnia are common.
• A behavioural characteristic of depression is social withdrawal. Sufferers may withdraw from work or social lives.
• To be diagnosed with major depression, a person must experience at least 5 symptoms of depression for more than 2 weeks. At least one symptom must be an emotional symptom.
• Manic depression is when a person alternates between manic episodes, which is when a person experiences a period of high mood, which lasts for at least one week, and depressive episodes, which is when a person experiences a period of low mood, which lasts for at least one week. Bipolar disorder.
• Ellis suggested depression is a result of negative, irrational thoughts and proposed Ellis' ABC model
• Ellis' ABC model:

  • A - activating event causes
  • B - an individuals belief which results in
  • C - a consequence
• According to Ellis’ ABC model, depression is caused by irrational negative beliefs. when a person with depression experiences a negative activating event, they form beliefs about the event that are overly negative. people experience the symptoms of depression as a consequence of irrational negative beliefs.
• Beck 1967 proposed the negative triad of depression. Becks negative triad suggests there are 3 types of negative thinking - negative views about the self, the world and the future
• According to Beck, irrational negative beliefs are caused by a person having a negative schema, which is a framework built up from past experiences. People who have developed negative self-schemas interpret information about themselves in a negative way.
• If new, negative information matches expectations from a person’s negative schema, this information is assimilated into their schema and strengthens the schema and irrational negative beliefs.
• A cognitive bias is when people have a tendency to pay attention to only some of the information that they're given.
• A negative cognitive bias is when a person has a tendency to pay attention to only negative information that they’re given.
• Supporting evidence for negative cognitive bias. Koster 2005 studied participants with major depression compared to a control group and measured reaction time to press a button after a positive, negative or neutral word appeared. Koster et al found people with major depression have a negative cognitive bias as reaction time was greater for negative words than positive or neutral. This is positive as it supports the idea that people with depression have negative cognitive biases.
• People with depression may not always have irrational beliefs. Alloy and Abramson 1979 asked participants with and without depression to estimate how much control they had over a flashing light. They found that participants with major depression estimated more accurately than the control group. This is problematic as the results convey people with major depression don’t have irrational beliefs - their beliefs may be more accurate sometimes.
• Cognitive approach is reductionist to explaining depression as a consequence of irrational negative beliefs. McGuffin et al. found MZ twins had a 46% concordance rate, while DZ twins had a 20% concordance rate. McGuffin et al. concluded depression is likely to be partially inherited. This is problematic because irrational negative beliefs may not be the only cause of depression.
• In cognitive behavioural therapy, the therapist encourages the patient to identify their negative beliefs. The therapist will then challenge these beliefs. The patient is then set homework to gather evidence to test their hypothesis. The therapist and patient will then evaluate the evidence together in the next sessions.
• cognitive behavioural therapy aims to remove the negative beliefs that cause depression.
• Supporting evidence for CBT. Cuijpers et al 2013 conducted a review of all the studies in the US comparing people who received CBT for depression and people who weren’t given CBT for depression and found participants who were treated with CBT experienced a significant improvement in symptoms compared to the control group. This is positive as it suggests CBT is an effective treatment for depression
• However, there are individual differences. CBT isn't an effective treatment for everyone and Cuijpers et al 2013 found the effectiveness of CBT varies between individuals. This is problematic as it limits its usefulness as a treatment for depression.
• CBT may not be as effective as other treatments. Treatments aimed at the biological causes of depression such as neurotransmitters can be more effective than CBT. SSRIs have been found to be effective for treating major depression. This is problematic as CBT is not the only or best treatment for depression. However, CBT does not have unintended negative side effects that drugs may have such as blurred vision and loss of sex drive. This is positive as it is effective without the consequences of drugs.