Paper One - Psychopathology (Depression)

• Lowered Mood = Patients often describe themselves as worthless and empty
• Anger = Sufferers are often irritable, and their anger can be directed at themselves or at others
• Lowered Self-Esteem = Some sufferers of depression describe a sense of self-loathing ie. hating themselves

Anxiety Levels = Sufferers of depression have reduced levels of energy making them lethargic, they may struggle to get out of bed. This has a knock on effect for work, education and social life. 

Disruption to Sleep and Eating Behaviour = Sufferers may experience reduces sleep (insomnia) or increased need for sleep (hypersomnia) similarly appetite may increase or decrease leading to weight change. 

Agression or Self-harm = Sufferers can become verbally aggressive eg. ending relationships or becoming physically aggressive eg. cutting or suicide. 

Poor Concentration = The sufferers may find themselves unable to stick with a task as they usually would. or they may find simple decision making difficult. 

Dwelling on the Negative = Depressed people are inclined to pay more attention to negative aspects of a situation and ignore the positives (glass half empty attitude)

Absolutist Thinking = Situations are good or bad, they have black and white thinking. When a situation is unfortunate they see disaster. 

• Beck proposed cognitions cause a cognitive vulnerability to depression.
• If we have a negative self-schema we think negatively about ourself.
• A persons dysfunctional view of themselves results in the negative thoughts about the world, the future and the self. 
• Depressed individuals attend to the negative and ignore the positive, this occurs due to the negative triad. 
• Ellis proposed that an activating event (A) triggers irrational beliefs (B) which produces a consequence (C).
• For example the breakdown of a relationship (A) triggers the belife thst you are unlovable (B) resulting in depression (C). 

• Supporting Evidence = (P) Gazzioli and Terry 2000 - (E) Pregnant women cognitive vulnerability - (E) If it's high before theyre likely to develop post-natal depression - (L) Therefore, cognitions cause depression
• Critique = (P) Only pregnant women - (E) Can't be generalised to men - (E) Only investigates post0natal depression - (L) Other depressions may have other causes 
• Opposing Research = (P) Some characteristics of depression are unaccounted for - (E) Extreme anger - (E) Hallucinations -(L) Incomplete explanation
• Different Explanation = (P) Cognitive is on a psychological level - (E) Cant explain the effect of SSRI's - (E) SSRI's are on a fundamental level - (L) Cognitive and biological approach are a better explanation
• Application = (P) Application to therapy - (E) CBT challenges the negative triad - (E) REBT disputed the irrational beliefs - (L) success reinforces the cognitive basis to depression

• Behavioural activation allows patients to identify pleasurable activitues that they no longer take part in so engagement in such activities should result in a lifting mood. 
• Graded homework assignement is to record when theyre happy to investigate the reality of their negative beliefs
• This can be used in future sessions to prove patient's wrong
• Thought capturing allows identification of negative thoughts and replace them with more relaistic ones
• REBT Ellis disputes the empirical argument asking whther there is evidence to support the irrational beliefs
• The intended effect (E) of dispute (D) is to change the irrational belief (B), so break the link between negative life events (A) and depression (C). 

Time = (P) Hard to access - (E) Waiting lists for trained therapists - (E) Series of sessions - (L) Symptoms may worsen leading to a suicide risk

Effectiveness = (P) March 2007 - (E) Comapred CBT and drugs - (E) CBT is 81% effective same as drugs - (L) Drugs and CBT together are 86% effective 

Acceptability = (P) disruptive to the patients life -(E) active role to complete the homework - (E) bad, patients may lack motivation - (L) Drugs are better as they are passive 

Relapse Rates = (P) Lower than drugs - (E) Thought capturing methods - (E) eg. engage in pleasurable activities - (L) effective long term

Side Effects = (P) No physical side effects - (E) no weight gain, or loss of sex drive as SSRI's do - (E) Beneficial psychologically improved self-esteem - (L) More likely to continue the therapy