Depression

what is depression

a mood disorder

describe major depressive disorder

requires the presence of at least 5 symptoms and must include sadness or loss of interest and pleasure in normal activities

describe persistent depressive disorder

longer term and/or recurring compared to major depressive disorder

what are the emotional characteristics of depression

sadness

people may feel worthless, hopeless and/or experience low self-esteem and inappropriate guilt

loss of interest and pleasure in usual hobbies

anger

describe anger in depression

could be directed at others or themselves- e.g. self harm

could lead to behavioural characteristics of verbal or physical aggression

what are the behavioural characteristics of depression

depressed mood- may lead to tearfulness

shift in activity levels

hypersomnia or insomnia

change in body weight due to eating habits

movement and speech may become slower

describe negative thinking in depression

automatic and in response to normal or even positive situations

excessive and catastrophizing- jump to the worst possible outcome

describe irrational thinking of depression

thoughts that interfere with a person being happy and free from pain

fuelled by unrealistic expectations of themselves and the world

what are the DSM-5-TR categories for depression

major depressive disorder

persistent depressive disorder

disrupted mood dysregulation disorder

premenstrual dysphoric disorder

what are the cognitive characteristics of depression

loss of motivation

low self esteem

focus on negative things

absolutist thinking- black and white

lack of concentration

what is Beck’s negative triad

negative view of the world

negative view of future

negative view of one self

describe Beck’s negative schema

people with depression acquired a negative schema during childhood- tendency to adopt a negative view of the world

may have been caused by peer rejection and criticisms by teachers

negative schemas are activated whenever the person encounters a new situation that resembled the original conditions in which these schemas were learned

describe Beck’s faulty information processing

ignoring positives- full focus on negative aspects of a situation

blowing small problems out of proportion

what are the aspects of Beck’s approach to depression

faulty information processing

negative self scheme

negative triad

what is Ellis’ view of good mental health

good- thinking in ways that allow people to be happy and free from pain

what is the A in Ellis’ model of depression

activating event

irrational thoughts are triggered by external events

get depressed when we experience negative events

what is the B in Ellis’ model of depression

beliefs

belief that we must always succeed or achieve perfection- musturation

utopianism- the belief that life is always meant to be fair

what is the C in Ellis’ model of depression

consequences

emotional and behavioural consequences from the events triggering irrational beliefs

what are the key elements of CBT

challenging irrational thoughts through direct questioning- disputing

includes evidence to contradict the clients irrational thoughts

more rational thoughts lead to the effect of overcoming depression

describe behavioural activation

goal is to gradually decrease avoidance and isolation- increase engagement in activities that have been shown to increase mood

therapist aims to reinforce mood boosting behaviour

describe becks cognitive therapy

identify the automatic thoughts (negative triad)

thoughts are challenged

client tests reality of beliefs

client as scientist

use of evidence to test beliefs

describe Ellis’ rational emotive behaviour therapy (REBT)

ABCDE model

d= dispute

e= effect

challenging irrational beliefs- intent is change the beliefs

breaking link between negative life events and depression

give weaknesses for the cognitive explanation for depression

doesn’t explain all symptoms of depression- not everyone is the same

can seem to blame the client rather than situational factors- e.g. not considering how life events have influenced the clients mental health

believes cognitions influence emotions but other theories see it as emotions influencing cognitions

alternative explanations- e.g. biological approach- shows that genes and neurotransmitters may contribute to depression

what are the strengths of cognitive explanation for depression

research - women high in cognition vulnerability were more likely to develop post natal depression

some cases of depression follow activating events- fit ellis’ model - reactive depression

support for the role of irrational thinking- hammen and krantz found participants with depression made more errors in logic

evaluate CBT with research support

Ellis – claimed a 90% success rate for REBT 

• Claimed it takes an average of 27 sessions to complete the treatment 

• Reviews of CBT showed that of 75 studies, CBT is superior to no treatment.  

 

• Variation in effectiveness 

• Due to clients no putting their revised beliefs into action and therapist competence.  

 

• Suggests REBT is effective in itself, but client and therapist may limit it's effectiveness 

evaluate cbt with individual differences

• 
  CBT is more suitable for some people than others- less suitable for people who have high levels fo irrational beliefs- that are rigid and resistant to change.  

• Less suitable in situations of high stress 

• Some people do not want direct advice that CBT practitioners would give.  

evaluate cbt using cultural bias

CBT is based on westernised perspectives of how mental health should be treated- may not be relevant for non-western cultures.  

evaluate cbt with support for behavioural activation

• 156 adult volunteers diagnosed with major depressive disorder – randomly assigned to 4 month course of aerobic exercise, drug treatment or a combo of the two  

• Clients in all groups experienced significant improvements 

• 6 months after the end of the study- those in the exercise group had lower relapse rates than those in the medication group.  

• Shows a change in behaviour can be beneficial to treat depression  

evaluate cbt with alternative treatments

• SSRIs

• Require less effort on the part of the client compared to CBT

• Could be used along with CBT- drug treatment could allow them to cope better during the CBT.

Cuijpers et al. Found that CBT is most effective when used with drug therapies.

what does the F stand for in Beck’s ABCDEF

feelings- new emotions that are produced

what is logical disputing in cbt

self defeating beliefs do not follow logically from the information available

what is empirical disputing in cbt

self defeating beliefs may not be consistent with reality

e.g. where is the proof that this is accurate

describe programic disputing in cbt

emphasises the lack of usefulness of self-defeating beliefs

(e.g. how is this belief likely to help me)

describe Ellis’ unconditional positive regard

therapist convincing the client of their value as a human being

if the client feels worthless they will be less willing to consider changing their beliefs and behaviour

however, if the therapist provides respect and appreciation regardless of what the client does and says, this will facilitate a change in beliefs and attitudes