Depression

  • Created by: aryan26
  • Created on: 12-02-19 10:03
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  • Depression
    • More severe frequent and long lasting feelings of low mood
    • Classified as a mood disorder, sometimes called unipolar depression
    • Emotional characteristics
      • Reduced positive emotions and increased negative
      • Intense felelings of sadness, emptiness, hopelessnessand worthlessness
      • Loss of the ability to experience pleasure
      • Low self-esteem: emotional experience of how much we like ourselves
      • Negative a motions such as anxiety or anger
    • Cognitive characteristics
      • Thinking patterns reflect negative emotions
      • View themselves negatively- believing they are worthless
      • Bias towards seeing things in the worst possible light
      • Future is viewed negatively- view that nothing will get better
      • Poor concentration,indecisiveness and thoughts of death
    • Behavioural characteristics
      • Reduced activity- loss of energy and motivation
        • Withdrawal from activities and relationships
      • Some are in a more agitated state- psychomotoragitation e.g. restlessness and pacing
      • Changes in sleeping and eating
      • Aggression and self-harm
    • cognitive explanations
      • main cause is cognition- irrational or unhelpful thoughts=negative emotional states which lead to depression
      • Beck's negative triad
        • negative schemas can develop in response to unhappy childhood experiences
          • these can create systematic cognitive biases: everything is viewed in a negative light
        • overgeneralisation: making general conclusions about single negative events
        • magnification: exaggerating small problems into larger ones
        • identified a negative triad of thinking which is a pessimistic, irrational view about the self, the world and future
        • evidence to support the role of negative thinking-
          • Boury et al: used becks depression inventory to monitor student's negative thoughts
            • depressives misinterpret things negatively and feel hopeless about the future
        • no evidence of cause and effect: Temple-Wisconsin study
          • measured students thinking styles every few months- 17% of students who scored high on tests of negative thinking went on to become depressed
            • 1% on low scores
        • criticised for blaming the patient- may overlook other factors such as situational or biological
          • if these factors were resolved they may no longer think negatively
    • Ellis' ABC model
      • people mistakenly blame external events for their illness
      • A= activating event   B=beliefs about the event  C=consequence
      • activating event (A) triggers irrational beliefs which are seen to be true (B)
        • consequence is that they become depressed (C)
      • difference between depressed and non depressed individuals is self-perception
      • both assume irrational beliefs cause depression- evidence suggests that depressed people are more accurate in jusdgements
      • practical applications- development of cognitive behavioural therapies
    • cognitive approach to treatment
      • based on the assumption it is caused by the way the patient views themselves and the world
      • identify maladaptive thought processes and replace with adaptive thoughts
      • rational emotive behavior therapy (REBT)
        • the main idea is to challenge irrational thoughts, however, with Ellis’s theory this is achieved through ‘dispute’ (argument).
        • logical dispute – where the therapist questions the logic of a person’s thoughts
          • for example: ‘does the way you think about that situation make any sense?
        • empirical dispute – where the therapists seeks evidence for a person’s thoughts,
          • for example: ‘where is the evidence that your beliefs are true?’
        • Pragmatic disputing- emphasises the lack of usefulness in self defeating beliefs
          • for example: 'how likely is it that this belief will help me?'
        • Following a session, the therapist may set their patient homework. The idea is that the patient identifies their own irrational beliefs and then proves them wrong.
        • Cuijpers: reviewed 75 studies and found that CBT was superior to no treatment
          • especially effective if combined with drug therapy
          • David: compared REBT, Beck's CBT and antidepressants- equally effective at end of treatment
            • at a 6month follow up REBT was more effective
            • effectiveness depends on many factors: as much as 15% of the variance depends on therapist competence
              • requires commitment Ellis believes takes an average of 27 sessions: not suitable for some
                • ethical problems: blames the patient- may lead to self-blame and guilt
        • fails to address environmental causes and ignores biological basis
          • expensive: anti-depressants are cheaper and reduce symptoms in a few weeks with little effort from the depressive
            • may be more costeffective: DeRbubeis- relapse rates are lower. initial higher cost may be worth it

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