4.1.4 - Depression

Question 1

How many people in the uk have diagnosed depression

Answer 1

16% of the uk

Question 2

What are the emotional characteristics of depression.

Answer 2

• lowered mood
• anger/ irritable
• low self esteem

Question 3

What are the cognitive characteristics of depression

Answer 3

• poor concentration
• absolutist thinking ( always, nothing, never etc..)
• dwelling in the negative

Question 4

What are the behavioural characteristics of depression

Answer 4

• aggression and self harm
• self mediation( drugs, alcohol etc..)
• lower activity levels
• disruption to sleeping and eating behaviour

Question 5

What are the cognitive explanations used to explain depression

Answer 5

• cognitive explanations focus on the notion that the way in which people think can lead to depression
• Beck: idea that negative thinking leads to depression
• Ellis: idea that irrational thinking leads to depression

Question 6

What is Becks theory of depression

Answer 6

• negative self schemas ( the views that people hold about themselves )
• these could come from negative experiences or can develop during childhood ( eg: due to criticism from parents)
• negative self schemas can include an ineptness schema which leads sufferers to believe that they will always fail

Question 7

What does beck say about cognitive biases

Answer 7

• beck found that those with depression were more likely to focus on the ensure aspects of situations while ignoring the positive
• these biases result in information being distorted and can include the ideas of overgeneralisation and catastrophising

Question 8

list 4 cognitive biases

Answer 8

• overgeneralisations
• catastrophising
• arbitrary influence
• selective abstraction

Question 9

What is arbitrary influence

Answer 9

When a conclusion is drawn without sufficient evidence

Question 10

What is selective attraction

Answer 10

A cognitive bias where detail is taken out of context and believed

Question 11

What is becks negative triad

Answer 11

Beck suggested that the negative self schemas and cognitive biases held maintain the cognitive (negative) triad.
- the three points of the triangle include the world, the future, and the self
- negative views on any of these aspects will lead to negative views on the other points of the triad

Question 12

What is Ellis’ explanation for depression

Answer 12

• Ellis suggested that irrational thinking leads to pain and sadness
• he created the ABC model

Question 13

What is the ABC model

Answer 13

• Activating event : the external event that impacts us
• Belief: the activating event triggers an irrational belief
• Consequence: these beliefs lead to consequences which is depression

Question 14

What is ellis’ mustabatory thinking

Answer 14

The idea that certain assumptions or beliefs must be true in order for an individual to be happy
- eg: I MUST be approved or accepted by the people that I find important to be happy
- this thinking must be challenged in order for mental health to improve

Question 15

Explanations of depression A03: not a full explanation

Answer 15

• when diagnosed with depression, may people report feeling intense anger
• beck and Ellis explanations cannot explain this, meaning their explanations are too simplistic
• not all emotional processes are acknowledged so not all cognitive aspects are explained

Question 16

Explanations of depression A03: client blaming

Answer 16

• Ellis has been accused of client blaming as he says depression is only caused by their own irrational thinking
• this is a limitation because the station all factors of the individual are overlooked ( eg: financial, family, health situations)
• if an individual laces the blame on the,selves they may not feel motivated to seek help ( reinforced the -ve thoughts people have about themselves)
• irrational thoughts are also subjective, so the individual may not believe that their thoughts are irrational in the first place
• However client blaming could be a strength because if individuals believe they are the only factor stopping them from being cured, they could be more motivated to seek help as they are in full control
• the treatment is less overwhelming and therefore easier to manage

Question 17

Explanations of depression A03: successful treatments

Answer 17

• both beck and elllis have developed successful treatments
  (CBT and REBT)
• because these therapies are used as treatment in real life, it gives both explanations practical application
• the therapies were also based on beck and Ellis’ theories so the theirs must also be correct so therefore also have explanatory power

Question 18

Explanations of depression: zhang eg al (2005)

Answer 18

• zhang et al (2005) found low levels of serotonin in depresses people and found a gene relates to this which was 10x more common in people with depression
• this is a limitation because the cognitive explanations ignore all biological factors which could potentially cause depression
• therefore if a patients depression is caused by biological factors, beck and Ellis’ methods of treatment will not be very useful.
• both cognitive and biological explanations could be used together to produce the most effective methods of treatment .
• this holistic approach has been shown to be more effective as when patients lack motivation the drugs help them to temporarily overcome this

Question 19

Explanations of depression A03: Ellis doesn’t explain all types of depression

Answer 19

• the ABC model suggests that all depression occurs due to an activating effect
• this is a limitation because this explanation cannot be used to explain endogenous depression where the depression isn’t traceable to life events.
• this decreases the explanatory power of the explanation as it is only a partial explanation for depression
• people could have genetic disposition( vulnerability) to certain genes which make depression more likely.

Question 20

Explanations of depression A03: sadder but wiser effect

Answer 20

• Alloy ad abrahamson (1979) found that people with depression gave more accurate estimates about the likelihood of disaster than non depressed people ( they have a more accurate /realistic perception of life
• this is a limitation because it suggests that people with depression could have ore realistic mindsets and are more able to accept negative events
• This challenges Becks explanation as he claims that people with depression have overly negative and extreme views.

Question 21

How to beck and Ellis believe depression should be treated

Answer 21

Beck: need to change negative thinking to be more positive through CBT
Ellis: need to change irrational thinking to more rational through REBT

—> thoughts create feelings —> feelings create behaviour—-> behaviour reinforces thoughts—

Question 22

What is CBT ( and what strategies are used)

Answer 22

Cognitive behavioural therapy
- intended to be brief 10/20 sessions
- focuses on the present (here and now)

Strategies:
1) behavioural activation
2) homework
3) thought catching
4) cognitive restructuring

Question 23

What is behavioural activation (CBT)

Answer 23

• focuses on engaging the client to become more active and engage in pleasurable activities
• these are rewarding for the clients and are “antidote” to depression
• it is an opportunity to practice challenging negative thoughts that have been associated with these activities.
• event planning is used as it increases the chance of the activity actually being completed

Eg: exercise has been shown to be just as effective as drug therapies

Question 24

What is homework (CBT)

Answer 24

• clients are asked to complete homework between sessions in order to test irrational beliefs about reality
• therapists must set tasks that are achievable as they don’t want to reinforce the negative views the patient already has of themselves
• the therapist may ask the client to keep a record/diary of the tasks which provides an evidence base that their previous thinking was negative or irrational

Question 25

What is thought catching (CBT)

Answer 25

- the therapist encourages the client to identify and record their automatic negative thoughts and consider how they may change these - the speculation is negative and irrational, so the therapists focus on only on the factual elements

Question 26

What is cognitive reconstructing (CBT)

Answer 26

- restructure negative thoughts to overcome cognitive distortions and biases

Question 27

What is REBT

Answer 27

Rational emotional behaviour therapy - psychological problems occur as a result of irrational thinking, so by changing g the thinking it changes the emotions which drives behaviour - it is an extended Verdon of the ABC model- ABC**DEF**

Question 28

What does the ‘def’ stand for I’m the ABCDEF model

Answer 28

**D**ispute irrational thoughts and beliefs **E**ffects of disputing and effective attitude to life **F**eelings that are produced

Question 29

What does ellis say about worth

Answer 29

- Ellis values worth, so if we have conditions of worth places onto us we will be psychologically unhealthy - he stated that we need to feel worth in order to see our worth which helps us feel better - the feeling of worthlessness is removed by unconditional positive reward

Question 30

Treatments for depression A03: individual differences

Answer 30

*Simon et al (1995)* - stated that CBT is less suitable for those experiencing high levels of stress which is linked to realistic stressors in their environments/ lives - these stressors cannot be easily resolved, so changing their thinking will not have a large impact **limitation** because CBT doesn’t take into account individual differences, so isn’t effective for all people

Question 31

Treatments for depression A03: behavioural activation

Answer 31

*babyak et al(2000)* - 156 adult volunteers with major depression were randomly assigned to a 4 month treatment course of either: exercise, drug treatment, combination - all 3 groups showed significant improvements however the combination group showed the largest - this suggests that the behavioural activation aspect of CBT is very effective - a **strength** as it gives the treatment research support

Question 32

Treatments for depression A03: Biological treatments

Answer 32

drugs can be a referable treatment option for some clients - they are easy, less effort and don’t require time commitments - they are cost effective ( CBT is up to £120 p/h and drugs prescriptions are cheap) - drugs are discrete, so avoid all potential shame/ anxiety

Question 33

Treatments for depression A03: economic effects

Answer 33

- mental health problems cost the uk economy £120 billion per year - so has large economical opportunity costs - however when suffering from mental health problems, people are likely to take time off work - this leads to an increase in unemployment and therefore more people are claiming benefits, which lowers the govs revenue from income tax also - if funding is put into CBT and drug therapies, people are able to return to work, so the opportunity cost is worthwhile