Depressive Disorders: Psychological Causes and Treatments PDF

DEPRESSIVE DISORDERS: PSYCHOLOGICAL CAUSES AND TREATMENTS  Two questions to ponder as we think about causes of depression Q1: Why do more recent generations experience more depression? Q2: Why are women twice as likely as men to experience depression?  I. Causes of Major Depre...

DEPRESSIVE DISORDERS: PSYCHOLOGICAL CAUSES AND TREATMENTS  Two questions to ponder as we think about causes of depression Q1: Why do more recent generations experience more depression? Q2: Why are women twice as likely as men to experience depression?  I. Causes of Major Depression: Behavioral Lewinsohn’s behavioral theory of depression: – Stress leads to depression: it reduces rewards and increases punishments; person withdraws Seligman’s learned helplessness theory of depression: – Uncontrollable neg events lead to depression. – BUT: 1/3 of humans (in loud noise study) never became helpless. Q: WHY NOT?  Behavioral Treatments for Depression Behavioral Activation for depression: https://www.psychotherapy.net/video/cognitive-behavioral-depression Contingency management (use of rewards) Improve social behavior/ skills  Causes of Major Depression: Cognitive Is about the power of how you think about things. A humorous example: https://www.youtube.com/watch?v=GXy__kBVq1M &t=163s (0:09 – 2:40) II. Causes of Major Depression: Cognitive 1) The reformulated learned helplessness theory (Lyn Abramson & Martin Seligman): – Cognition, particularly causal attributions, matters. How one explains misfortune is crucial; called explanatory style or attributional style: – The “3 P’s” of pessimistic attributional style: Permanence = about duration, how stable Pervasiveness = about scope, how global (Personalization)  Pessimistic cognitive style: It is correlated with depression, but can it cause depression? Study of psychology undergrads at exam time – Pessimism + “failure” was assoc w depression Study of 400 third graders – Those who tested as pessimists were most likely to get & stay depressed over the next 4 years.  Optimistic cognitive style: With what is it associated? Study of insurance salespeople – Optimists didn’t quit, & they sold 20% more. Study of SAT, GPA, & college achievement – Students who did better in their first year than expected (given previous SAT & GPA scores) had tested as optimists. Study of sports teams (using content analysis) – Teams with optimistic explanatory style did better the next year than previous win-loss record would have predicted.  Optimistic cognitive style: With what is it associated? (cont) Study of physical health – 3 groups of tumor-cell-injected rats: inescapable shock, escapable shock, no shock – Non-shocked: 54% rejected tumor – Inescapable shock: 27% rejected tumor – Escapable shock: 63% rejected tumor! Cognitive Causes of Major Depression cont. 2) Hopelessness theory (Lyn Abramson et al, 1989): Negative events + 3 negative inferential tendencies: 1) infer stable & global causes 2) infer negative consequences from the event 3) infer negative self-characteristics 3) Response Style Theory: Rumination (Susan Nolen-Hoeksema) Need to distinguish brooding from reflectiveness; Pessimism + rumination = strong recipe for depression Cognitive Causes of Major Depression cont. 4) Negative cognitive triad (Aaron Beck) Self World (your experiences) The future 5) Automatic negative thoughts/ attitudes e.g., If I don’t succeed, people won’t like me. I’m worthless. I’ll never have a good relationship. Cognitive Causes of Major Depression, cont. 5) Cognitive errors For example: – Overgeneralization – Magnification (of negatives) – Minimization (of positives) – Selective abstraction Cognitive Treatments for Depression Ex: Aaron Beck discusses severely depressed inpatient: https://www.youtube.com/watch?v=rAAFVtar-oo Ex: Judith Beck demonstrates cog-beh approach with “Abe”: https://www.youtube.com/watch?v=ac5Jct33oUU (up to 14:30 or so) In general: Identify and record automatic thoughts Challenge these thoughts: What evidence? Identify other negative thinking III. Causes of Major Depression: Interpersonal Depression arises from relationship difficulties (which are the most frequently reported stressor associated w depression), such as: Grief and interpersonal loss Interpersonal role disputes Role transitions Interpersonal skills deficits  Interpersonal Theories of Depression, cont. Interactional model of depression (James Coyne): 1) High need for others’ approval, combined with High rejection sensitivity è 2) Excessive reassurance seeking è 3) Others tire of this, and may get annoyed or hostile (èdecreased social support); è 4) More reassurance seeking…  IV. Causes of Major Depression: Psychodynamic Dependency needs, & Introjected hostility theory: Loss/ grief, with anger turned inward regarding relationships with people who have been abandoning or rejecting. Unsafe/ insecure relationships, esp in childhood.  Psychodynamic Therapy for Depression See Jonathan Shedler discuss: https://www.youtube.com/watch?v=YNWy1ksxIDo 1. Focus on emotion 2. Study the avoidance of issues 3. Identify recurring themes 4. Explore the past to understand the present 5. Focus on relationships 6. Focus on the therapy relationship itself 7. Explore fantasy life, the life of the mind  Some Additional Approaches to Psychological Treatment of Depression Acceptance and Commitment Therapy (ACT): Ex: “Thanking your mind: Taking the power out of difficult thoughts” (Russ Harris): https://www.youtube.com/watch?v=206WtwEyqzg (1:46) Interpersonal therapy Couples therapy Culturally-responsive therapy