Depression

Question 1

What is depression?

Answer 1

A mental disorder characterised by low mood and low energy levels

Question 2

What is the cognitive approach?

Answer 2

The term ‘cognitive’ has come to mean ‘mental processes’, so this approach is focused on how our mental processes (e.g. thoughts, perceptions, attention) affect behaviour

Question 3

What is the negative triad?

Answer 3

Beck proposed that there are three kinds of negative thinking that contribute to becoming depressed: negative views of the world, the future and the self.
Such negative views lead a person to interpret their experiences in a negative way and so make them more vulnerable to depression

Question 4

What is the ABC model?

Answer 4

Ellis proposed that depression occurs when an activating event:
(A) triggers an irrational belief
(B) which in turn produces a consequence
(C) i.e. an emotional response like depression.
The key to this process is the irrational belief

Question 5

Emotional characteristics of depression

Answer 5

• Lowered mood - lowered mood is still a defining emotional element of depression but it is more pronounced than in the daily kind of experience of feeling sad. People with depression often describe themselves as ‘worthless’ and ‘empty’
  
  • Anger - people with depression also frequently experience anger, sometimes extreme anger. This can be directed at the self or others. On occasion such emotions lead to aggressive or self-harming behaviour - hence why this characteristic appears under behaviour characteristics too
  • Lowered self-esteem - self-esteem is an emotional experience of how much we like ourselves. People with depression tend to report reduced self-esteem, in other words they like themselves less that usual. This can be quite extreme, with some people with depression describing a sense of self-loathing, i.e. hating themselves

Question 6

Cognitive characteristics of depression

Answer 6

• Poor concentration - depression is often associated with poor levels of concentration. The person may find themselves unable to stick with a task or make decisions
  
  • Attending to and dwelling on the negative - people are inclined to pay more attention to negative aspects of a situation and ignore the positives. Also have a bias towards recalling unhappy events rather than happy ones
  • Absolutist thinking - ‘black and white thinking’ this means that when a situation is unfortunate they tend to see it as an absolute disaster

Question 7

Behavioural characteristics of depression

Answer 7

• Activity levels - typically people with depression have reduced levels of energy, making them lethargic causing them to withdraw from work, education and social life. It can also have the opposite effect - psychomotor agitation - where individuals struggle to relax and may end up pacing up and down a room
  
  • Disruption to sleep and eating behaviour - a person may experience reduced sleep (insomnia) or an increased need for sleep (hypersomnia). Appetite may increase or deceasing leading to weight gain or loss FYI these will count as two separate characteristics (sleep and eating)
  • Aggression and self-harm - individuals are often irritable and can become verbally or physically aggressive. Depression can also lead to physical aggression directed against the self. This includes self-harm, often in the form of cutting, or suicide attempts

Question 8

What is the A part in Ellis’ model

Answer 8

Activating event.
Ellis focused on situations in which irrational thoughts are triggered by external events. We get depressed when we experience negative events and these trigger irrational beliefs. The activating event is therefore the negative event, such as getting fired at work.

Question 9

What is the B part in Ellis’ model

Answer 9

Beliefs.
You hold a belief about the event or situation. This may be rational (e.g. ‘the company was overstaffed’) or irrational (‘I was sacked because they’ve always had it in for me’)

Question 10

What are the range of irrational beliefs

Answer 10

Mustabatory thinking (the belief that we must always succeed or achieve perfection)
Utopianism (the belief that life is always meant to be fair)
I-can’t-stand-it-itis (the belief that it is a major disaster when something doesn’t go smoothly).

Question 11

What is the C part in Ellis’ model?

Answer 11

Consequence.
You have an emotional response to your belief. Rational beliefs lead to healthy emotions (e.g. acceptance), whereas irrational beliefs lead to unhealthy emotions (e.g. worthlessness). These unhealthy emotions are seen as true and this leads to depression.

Question 12

What happens in the ABC model? And what is the difference between depressed and non-depressed people?

Answer 12

The activating event triggers an emotion that is seen as true and the consequence is that the individual becomes depressed because they have a negative view about themselves and no confidence in their ability.
Other people who do not tend towards depression may react completely differently The difference between depressed and non-depressed people is therefore how they perceive themselves.

Question 13

What are the 3 parts to cognitive vulnerability?

Answer 13

• Faulty information processing
• Negative self-schemas
• The negative triad

Question 14

What happens in faulty information processing?

Answer 14

When depressed, we attend to (focus on) the negative aspects of a situation and ignore the positives. We also tend to blow small problems out of proportion and think in ‘black and white’ terms.

Question 15

What does having a negative self-schema mean?

Answer 15

We use schemas to interpret the world, so if we have a negative self-schema we interpret all information about ourselves in a negative way.

Question 16

What happens in a negative triad?

Answer 16

A person develops a dysfunctional view of themselves because of the three types of negative thinking that occur automatically, regardless of the reality of what is happening at the time. These three elements are called the negative triad

Question 17

What are the 3 elements in the negative triad

Answer 17

· Negative view of the self – where individuals see themselves as being helpless, worthless and inadequate e.g. ‘I am just plain and undesirable, what is there to like? I’m unattractive and seem to bore everyone.’ These thoughts enhance existing depressive feelings because they confirm the existing emotions or low self-esteem.
· Negative view of the world (life experiences) – where obstacles are perceived within one’s environment that cannot be dealt with e.g. ‘I can understand why people don’t like me. They would all prefer someone else’s company. Even my boyfriend left me.’ This creates the impression that there is no hope anywhere.
· Negative view of the future – where personal worthlessness is seen as blocking improvements e.g. ‘I am always going to be on my own, there is nothing that is going to change this.’ These thoughts reduce hopefulness and enhance depression.

Question 18

RWA

Answer 18

Both theories have important applications as they have led to the development of cognitive behavioural therapy as a way of treating depression. Beck – Beck’s theory forms the basis of CBT. All cognitive elements of depression (including the negative triad) can be identified and challenged in CBT. This means that a therapist can challenge them and encourage the patient to test whether they are true.
Ellis – Ellis’ theory has led to a successful CBT. His idea that by challenging the negative, irrational beliefs a person can reduce their depression is supported by research evidence [you would need to add some from lesson 8].

These are strengths of the theories because they translate well into successful therapies (suggesting the theories are externally valid) and suggest that negative/irrational cognitions play some role in the development of depression and so they are at least somewhat valid explanations of depression.

Question 19

Weakness of depression theories (cognitions)

Answer 19

Cognitive explanations of depression share the idea that cognitions cause depression. This is linked to the idea of cognitive primacy, which suggests that emotions are influenced by your cognitions (i.e. the cognitions come before the emotions). This is certainly the case sometimes, but not always. Other theories of depression see emotions as influencing your cognitions.

Therefore, the explanations may not be completely valid as in some cases the direction of causality (cause and effect) may be the opposite to that proposed by the cognitive explanations (emotions cause cognitions instead of cognitions causing emotions), and so they cannot be considered to be complete explanations of cases of depression.

Question 20

Weakness of depression theories (not complete)

Answer 20

Both explanations cannot explain all of the symptoms of depression. For instance, some depressed patients are deeply angry, some suffer hallucinations, and very occasionally some suffer Cotard syndrome, the delusion that they are zombies. The explanations cannot easily explain these cases.

This suggests that the explanations cannot be considered to be completely valid as they can’t explain all cases of depression.

Question 21

Weakness of depression (Ellis)

Answer 21

Some cases of depression follow activating events. Psychologists call this reactive depression and see it as different from the kind of depression that arises without an obvious cause. This type of depression is much more difficult for Ellis’ model to explain.

This suggests that Ellis’ ABC model only applies to some kinds of depression (those that follow activating events) and so it can only be considered a partial explanation of depression.

Question 22

Supporting evidence (Beck)

Answer 22

A range of evidence supports the idea that depression is associated with faulty information processing, negative self-schemas and the cognitive triad of negative automatic thinking. For example, research has found that women judged to have been high in cognitive vulnerability were more likely to develop post-natal depression. Additionally, a review study concluded that there was solid support for each cognitive vulnerability factor. The cognitions could be seen before depression develops.

This suggests that Beck may be right about cognitions causing depression, at least in some cases, so the theory may be internally valid.