Depression - Cognitive Explanations PDF

What is depression? Depression is a complex disorder affecting a person mentally, emotionally, and physically, characterised by low mood, making the sufferer unable to function normally.These experiences are prolonged, severe and damaging. What is depression? | APA I had a black dog, his name was d...

What is depression? Depression is a complex disorder affecting a person mentally, emotionally, and physically, characterised by low mood, making the sufferer unable to function normally.These experiences are prolonged, severe and damaging. What is depression? | APA I had a black dog, his name was depression features of depression A collection of physical, mental, emotional and behavioural experiences that are prolonged, severe and damaging. We are looking at: Major Depressive Disorder. Reduced activity and productivity. Speaking and moving less. Staying longer in bed. Disturbances in sleep and appetite (up or down). Negative views of self. Feelings of helplessness. Lack of concentration Use this page to complete the ‘person’ on your handout…. cognitive explanations of depression There are two main cognitive explanations that we are going to explore: Beck’s negative triad Ellis’ ABC model Beck’s negative triad ‘Depression is a disorder of thought rather than mood’ (Beck, 1967). It is a result of how individuals think about themselves, their world and their future = the negative triad. Unhappy childhood experiences = negative schemas (patterns of thought and behaviour) = automatic negative thoughts. Events later in life trigger the reactivation of the negative schema and this leads to negative behaviour. Beck’s negative triad Life is full of stresses and challenges! But, negative self-critical ways of thinking lead to faulty logic and flawed interpretations of events. Beck said these errors were cognitive distortions or biases. There are a number of biases for you to know: Can you think of an example of each of these cognitive distortions? Use page 78 to help you if you are unsure… Beck’s negative triad Shahar (2008) suggested that those vulnerable to depression seem to suffer with certain negative self schema: Sociotropic schema: “I will fail at personal relationships” Autonomous schema: “I will fail to achieve goals in life and work” Self-critical schema: “I have many shortcomings”  BECK'S NEGATIVE TRIAD BIIM 1:23-5:10 1. Beck’s triad: Negative views of self, world, future. 2. Negative schemas are made in childhood 3. They are reactivated by stressful events / challenges 4. Your faulty logic and flawed interpretations lead to Cognitive biases: overgeneralisation, magnification etc. 5. Thus, three negative self-schema are associated with depression: sociotropic, autonomous, self-critical. Ellis’ ABC model (a different cognitive explanation for depression) Ellis (1987): emotional problems and associated maladaptive behaviour is the result of irrational thinking. Definition: Maladaptive behavior is defined as behavior that interferes with an individual's activities of daily living or ability to adjust to and participate in particular settings. Ellis’ abc model Something happens There is a belief about the situation There is an emotional reaction to the belief Ellis’ abc model So, it is important to note that it is not the event that gives rise to depression but the beliefs that we have that govern our reaction to those events. We have the goal of happiness! It is the irrational reaction that can give rise to the feelings of depression. Ellis’ abc model Ellis also suggested that people cling to irrational beliefs due to ‘musturbatory thinking’.. This refers to the underlying beliefs that people hold: The three musts…. 1. I must do well and win approval of others or I am no good. 2. Other people must treat me kindly and in the way I expect to be treated 3. Life must be easy and without inconvenience.  ELLIS' ABC MODEL BIIM 5:12 - 8:00 1. Irrational thinking causes emotional problems and maladaptive behaviour. 2. There is an Activating Event (A), which leads to a Belief about the situation (B), which leads to an emotional reaction or maladaptive behaviour (the consequence – C) 3. We cling to irrational beliefs due to Musturbatory Thinking (we MUST do well / MUST be treated kindly / MUST have an easy life) Evaluation of the cognitive explanation of depression Studies have supported the idea that those patients with depression have automatic negative thinking. E.g. Lloyd and Lishman - pg 79 Further research has supported the role of irrational thinking in depression; it seems that depressed participants made errors in logic more often than non-depressed participants. E.g. Hammen and Krantz - pg 79 Evaluation BIIM 8:00 onwards of the cognitive explanation of depression However, it is very difficult to determine whether negative thinking precedes depression or is a symptom of depression because we test those already diagnosed. See page 80 Furthermore, there are alternative explanations for depression - drugs which enhance the level of serotonin in the brain often help depressed patients and therefore this suggests a biological cause to the disorder. See page 80 Nonetheless, these cognitive explanations are extremely useful and have given rise to important therapies. Take 10 minutes to explore this site / watch video: Cognitive Behavioral Thera py Exercises: CBT Interventi ons BIIM CBT Treating depression - the cognitive approach (CBT) Cognitive Behavioural Therapy (CBT) A treatment which focuses on identifying negative beliefs and altering dysfunctional behaviours. https://www.verywellmind.com/what-is-cognitive-behavior-therapy-2795747 Treating depression - the cognitive approach (CBT) Cognitive Behavioural Therapy (CBT) Based on Beck’s negative triad About 20 sessions over 16 weeks Active, directive, focuses on ‘now’ Aims to identify and alter negative beliefs and expectations Aims to alter dysfunctional behaviour that are contributing to maintaining the depression. Person is often set homework; often asked to keep a diary and record any negative thinking. Treating depression - the cognitive approach (CBT) Cognitive Behavioural Therapy (CBT) In order to alter beliefs and change behaviour, strategies are employed: Behavioural activation Thought-catching Cognitive restructuring See page 80 and make notes on 3 strategies…. Treating depression - the cognitive approach (REBT) Rational Emotive Behavioural Therapy (REBT) Based on Ellis’s ABC model The main goal is to challenge irrational beliefs into rational ones so that individuals react in healthy ways. We need to challenge musturbatory thinking They are challenged to Dispute, find Effective attitudes and Feelings (ABCDEF) Disputing e.g. Pragmatic disputing - is this helping you anyhow? Empirical disputing - is there any evidence for what you are saying? Moving onwards.. Increasingly, mindfulness is also being integrated into CBT; this modification adds another aspect to the identification of negative beliefs and the disputing of irrational thoughts that we have already discussed. It focuses on providing practical skills for clients to use. Evaluation of cognitive therapies CBT has been found to be as successful as drug therapies for depression. However, no more successful than simply ‘being in treatment’, so there are concerns over the effectiveness of CBT on its own. Research has found CBT to most effective after the acute phase (when drugs can help); most effective with residual symptoms (i.e. when medication stops). The competence of the therapist seems the most important factor. There are individual differences when looking at effectiveness of CBT; does not work well with those who are rigid and resistant. The flexibility and applicability to many situations really lends strength to CBT.