Treatments and explanations for depression and OCD

Outline Ellis’ ABC model as treatment for depression

Depression is produced by irrational thoughts over unpleasant events. Activating event, irrational beliefs, consequences.

Outline Beck’s negative triad

A cycle of negative thoughts about self, future and world. Involves negative schemas and cognitive biases.

Study to support Ellis’ ABC model

David (2008) REBT and CBT more effective than drug therapy. 60% in REBT group had positive changes. REBT shown to have significant difference on relapse over drug therapy on depression.

Limitation to contradict Ellis’ ABC model

Alternative explanation - biological explanation - genetic tendency to develop depression can be inherited

Study to support Beck’s negative triad

David (2008) REBT and CBT more effective than drug therapy. 60% in CBT group had positive changes. CBT shown to have significant difference on relapse over drug therapy on depression.

Limitation to contradict Beck’s negative triad

Alternative explanation - biological explanation - genetic tendency to develop depression can be inherited

Outline CBT as treatment for OCD

Initially client and therapist set goals for treatment. Then client taught access, mediation and change hypotheses. Access is trained to become aware of own thinking, mediation is that thinking habits will influence thoughts and behaviour and change is that recovery is made by changing cog/beh reactions to negative life events. Uses guided discovery and introspection.

What is access hypothesis?

Trained to become aware of own thinking

What is mediation hypothesis?

Thinking habits will influence thoughts and behaviour

What is change hypothesis?

Recovery is possible by changing cognitive and behavioural reactions to negative life events

What is guided discovery?

Test thinking through observation and experience

One strength of CBT

David (2008) REBT and CBT more effective than drug therapy. 60% in CBT group had positive changes. CBT shown to have significant difference on relapse over drug therapy on depression.

One limitation of CBT

Craighead and Dunlop - meta-analysis found that combined drug and CBT was most effective for long-lasting depression, and sometimes drugs were more effective. Drugs used to alleviate mood so that client can do CBT properly.

One strength of REBT

David (2008) REBT and CBT more effective than drug therapy. 60% in REBT group had positive changes. REBT shown to have significant difference on relapse over drug therapy on depression.

One limitation of REBT

Craighead and Dunlop - meta-analysis found that combined drug and psychological therapy was most effective for long-lasting depression, and sometimes drugs were more effective. Drugs used to alleviate mood so that client can do REBT properly - requires motivation.

What is OCD?

A condition characterised by obsessions and/or compulsions. Obsessions are the irrational thoughts that surround the anxiety and compulsions are the behaviours used to relieve obsessive thoughts.

Outline the two neural explanations for OCD

Brain dysfunction - increased brain activity in front lobes and basal ganglia when facing object of compulsions and obsessions.

Serotonin deficiency - deficiency in levels or metabolism of serotonin. Supported by effectiveness of SSRIs. May be dopamine levels instead as two are linked.

3 evaluation points for neural explanations

1 - cause or effect - abnormalities in brain responsible for obsessions and compulsions or other way round

2 - reductionist explanation - does not take into account environment etc. as biological reductionist

3 - interactionist approach - biological explanations which take into account environmental factors, genetic and neural

Outline the genetic explanation for OCD

Genetic inheritance (proven using twin studies), gene for OCD (SLC1A1 may be dysfunctional in OCD patients), candidate genes (combination of genes)

Study to support genetic explanation - inheritance

Nestadt et al - concordance rate of 68% for MZ and 31% DZ

Study to contradict genetic explanation - inheritance

Grootheest - meta-analysis of twin studies for OCDE and found higher concordance rate for MZ than DZ but never 100%

Outline drug treatment for OCD

SSRIs (delay reabsorption of serotonin at synapse), beta blocker (block effects of noradrenaline/adrenaline in SAM), benzodiazepines (increases GABA effect by mimicking it)