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Psychopathology - Cognitive Approach to Depression (Explanation (2 models:…
Psychopathology - Cognitive Approach to Depression
Explanation
cognitions = mental processes (e.g. thoughts, perceptions, schemas etc.)
depression is therefore thought to be due to faulty cognitions, such as irrational beliefs or overly negative thoughts
2 models: Beck's Negative Triad and Ellis' ABC Model
Beck's Negative Triad
says people develop depression from thinking negatively about themselves, the world and the future
these negative views are usually based on a combination of negative schemas and cognitive biases
negative schemas are based on traumatic/unhappy early experienes
3 types of negative schema
ineptness schema (expecting to fail)
self-blame schema (feeling responsible for failure)
negative self-evaluation schema (constant reminder of worthlessness)
negative schemas lead to cognitive biases as they influence the way we perceive ourselves and others, and can cause misinterpretations
3 types of cognitive bias
arbitrary inference (conclusions drawn in the absence of sufficient evidence)
selective abstraction (conclusions drawn from just one part of a situation)
overgeneralisation (sweeping conclusions drawn on the basis of a single event)
the depressive's negative schemas, cognitive biases and behaviour maintains the triad of negative thinking
Ellis' ABC Model
suggested the cause of depression the interpretation of events - which were based on irrational thought patterns
A: activating event
is accompanied by a belief about why the event happened
B: belief
this belief will lead to a consequence/result as it influences the behaviour
rational belief = desirable emotions and behaviour
irrational belief = undesirable emotions and behaviour
continued irrational beliefs can lead to depression, or other disorders, such as anxiety
C: consequence
consequence is usually in the form of an emotional response, which could cause a behavioural response
schemea = a knowledge structure about how an aspect of the world works
Evaluation of Explanation
Supporting evidence
:red_flag: Boury et al.: supported Beck as they monitored student's negative thoughts and found depressives misinterpret facts in a negative way
can criticise as it isn't clear whether depression is a cause or consequence - does one influence the other or vice versa
:red_flag: Koster et al.: supported Beck's cognitive bias as they found depressed students took longer to disengage from negative words
Strengths
therapies for depression based on cognitive explanations have been proven most effective
other approaches are taken into account to explain why some people develop negative thinking (e.g. childhood, genes etc.)
Weaknesses
Beck's triad separation is unnecessary as research hasn't found a clear separation of negative thoughts
not all people with depression have negative beliefs and cognitive biases
Treatment
CBT: cognititive behavioural therapy
an umbrella term for multiple therapies
aims to change negative beliefs and change them into a more positive, adaptive way of thinking
can achieve this by identifying irrational thoughts and challenging them with evidence to the contrary
clients and therapists work together to set new behavioural goals to show clients there existing schemas are faulty
most common type of CBT: REBT (rational emotive behaviour therapy)
Ellis' version of CBT
generally involves 15 sessions
stage 1: education phase (clients learn the relationship between thoughts, emotions and behaviour using ABC model. irrational thoughts are identified)
reframing (challenging irrational beliefs and identifying rational alternatives)
stage 2: behavioural activation and pleasant event scheduling (increase physical activity/socialising to improve mood and energy)
stage 3: hypothesis testing (achievable goals are set between sessions, this will challenge the irrational beliefs. MUST be achievable or else will reinforce negativity)
Evaluation of Treatment
Supporting evidence
:red_flag: Department of Health: reviewed research papers of different treatments and found CBT most effective
however, didn't endorse CBT alone, but in combination with another
:red_flag: Hollon et al.: demonstrated the effectiveness of CBT over drug therapy as it has the lowest percentage of relapses within 12 weeks
Strengths
CBT is more effective long-term than drug therapy
less side effects, techniques can continued to be used after treatment, less object dependent
most effective psychological treatment for moderate to severe depression and most effective in preventing mild to severe transition
Weaknesses
essential to have well-trained therapist for CBT to be effective, NHS doesn't always have sufficient professionals to provide weekly sessions
ethical issues (therapists have lots of power over patients to influence their thinking, patients can become too dependent)