Depression- Psychopathology Revision

Depression- Psychopathology Revision

1. Characteristics

   • Behavioural
     • Activity levels
       • Lethargy
       • Psychomotor agitation
         • Difficulty relaxing
     • Sleep and diet disruption
     • Aggression and self-harm
   • Emotional
     • Lowered mood
       • Empty/worthless
     • Anger
     • Lowered self-esteem
       • Self-loathing
   • Cognitive
     • Poor concentration
     • Paying attention to the negative
     • Absolutist thinking
       • All good or all bad, no in between

2. Explanation

   • Cognitive
     • Beck, 1967
       • Faulty information processing
         • Only focusing on negative aspects
           • Winning £1,000,000 in lottery, but previous winner won £10,000,000
         • Blowing small problems out of proportion
       • Negative self schemas
         • A 'schema' is a package of information developed through experience
           • They act as a mental framework for our interpretation of information
           • A negative self-schema is when we interpret all information about ourselves in a negative way
       • The negative triad
         • World
           • World is horrible place
             • Hopelessness
         • Future
           • Future is bleak
         • Self
           • I am a failure
             • Low self esteem
       • Evaluation
         • Good supporting evidence
           • These faulty cognitions are seen before depression, suggesting they may be the cause, not the effect
         • Practical application
           • CBT
         • Doesn't explain all aspects
           • Can't explain anger or hallucinations
     • Ellis, 1962
       • ABC model
         • A- Activating event
           • Negative events (e.g. bereavement) cause irrational thoughts
         • B- Beliefs
           • Musturbation
             • Always being successful
           • Utopianism
             • Life must always be fair
         • C- Consequences
           • Emotional and behavioural consequences
             • If you aren't always successful, this may trigger depression
       • Depression is result of irrational thoughts
       • Evaluation
         • Partial explanation
           • Only works for reactive depression
         • Practical application
           • CBT

3. Treatment

   • Cognitive
     • CBT
       • Beck
         • Identify negative triad
         • Challenge negative triad
         • Reality testing
           • Patient as scientist
           • Recording when something made them feel good
       • Ellis
         • REBT
           • The ABCDE model
             • D- Dispute
             • E- Effect
           • Identify and dispute irrational thoughts
           • Vigorous argument
             • Empirical
               • Is there any evidence?
             • Logical
               • Does negative thought logically follow from facts?
       • Evaluation
         • It is effective
           • CBT just as effective as medication, and increased improvement rates when combined with drugs
         • May not work on severe cases
           • Have to be motivated enough to engage
           • Can't be sole treatment
         • Some patients don't want to focus on present and future, but their past instead
           • Frustrating
         • Overemphasis on cognition
           • Disregards patient's situation e.g. poverty