1. Explanations and treatments
Depression
Explanations and treatments

2. What are the key assumptions of the cognitive approach?

3. Key Assumptions of The Cognitive Approach
Individuals who suffer from mental disorders have distorted and irrational thinking – which may cause maladaptive behaviour.
It is the way you think about the problem rather than the problem itself which causes the mental disorder.
Individuals can overcome mental disorders by learning to use more appropriate cognitions. If people think in more positive ways, they can be helped to feel better
Life events happen, and people in general will have an adaptive response to them.

4. Cognitive Approach explanations
There are a number of cognitive explanations of depression which believe that the disorder is the result of disturbance in ‘thinking’
They focus on an individual’s negative thoughts, irrational beliefs and misinterpretation of events as being the cause of depression.

5. faulty information processing negative self-schemas
Aaron Beck
Suggested there is a cognitive explanation as to why some people are more vulnerable to depression than others.
He suggested three parts to this cognitive vulnerability
faulty information processing
negative self-schemas
the negative triad

6. 1. Faulty Information processing
Beck believed that people who are depressed make fundamental errors in logic
Proposed that depressed people tend to selectively attend to the negative aspects of a situation and ignore the positive aspects
Tendency to blow small problems out of proportion with thinking in terms of black and white and ignoring the middle ground;
you are a success or a failure, rather than not good at some things but OK at others.
Beck proposed there were different errors in logic… also known as cognitive distortions… more on this in a moment!

7. 2. Negative self-schemas
We know that a schema is a building block of knowledge, a ‘package’ of ideas and information that has developed with experience!!
A self-schema is a package of ideas that we have about ourselves
People who have become depressed have developed negative self-schemas
they interpret all the information about themselves in a negative way
Shahar et al (2008) suggest that there are 3 types of negative self schema …. More in a moment

8. Research! Weissman and Beck (1978)
AIM: to investigate the thought processes of depressed people to establish if they make use of negative schemas
PROCEDURE: thought processes were measured using the dysfunctional attitude scale (DAS). Participants were asked to fill in a questionnaire by ticking whether they agreed or disagreed with a set of statements. For example, ‘people will probably think less of me if I make a mistake’.
RESULTS: they found that depressed participants made more negative assessments than non-depressed people. When given some therapy to challenge and change their negative schemas there was an improvement in their self-ratings
CONCLUSION: Depression involves the use of negative schemas

9. 3. The negative triad
Building on the idea of maladaptive responses, Beck suggested that people with depression become trapped in a cycle of negative thoughts
They have a tendency to view themselves, the world and the future in pessimistic ways – the triad of impairments
Negative view of the self (I am incompetent and undeserving)
Negative view of the world (it is a hostile place)
Negative view of the future (problems will not disappear, there will always be emotional pain)

10. Beck’s Model of Depression (1979) ‘The Cognitive Triad’
Negative Triad (3 negative schemata)
negative view of the self
negative view of the world
negative view of the future
Negative view of the self (I am incompetent and undeserving
Negative view of the world
it is a hostile place
Depression
Negative view of the future problems will not disappear, there will always be emotional pain
Negative Automatic Thoughts
Beck built on the idea of maladaptive responses, and suggested that people with depression become trapped in a cycle of negative thoughts
Negative view of the self (I am incompetent and undeserving)
Negative view of the world (it is a hostile place)
Negative view of the future (problems will not disappear, there will always be emotional pain)
Attributions are internal or external ( the cause is seen as internal (it’s my fault’, or due to external circumstances beyond their control
Attributions can be specific or global, i.e. The cause may be specific to a particular event or apply to all events
Attributions can be stable or unstable (the individual consistently makes the same types of attribution, or they can vary over time and situation)
In depression attributions for negative events are internal, global and stable.
Attributions for positive events are external, specific and unstable. 10

11. Albert Ellis
Ellis proposed that good mental health is the result of rational thinking
Argued that there are common irrational beliefs that underlie much depression (poor mental health), and sufferers have based their lives on these beliefs
For example: “I must be successful, competent and achieving in everything I do if I am to consider myself worthwhile”

12. Ellis’ ABC model Ellis suggested that …
(A) an action is affected by
(B) and individual’s beliefs which results in
(C) a consequence
If beliefs are subject to cognitive biases (in the same way as Beck’s) then they can cause irrational thinking which may produce undesirable behaviours.
Example:
Emma overhears a remark made in class ‘she really gets on my nerves’. It could have referred to anyone but Emma believes that she is unworthy and people don’t want to be friends with her. She withdraws from the friendship group and becomes more and more isolated and depressed.

13. Undesirable Behaviour
A: Activating event
Debbie and her boyfriend split up.
Rational Thoughts
Debbie tells herself that although it is a sad situation they were not compatible and she may learn from the experience.
Irrational Thoughts
Debbie tells herself that the break up is her fault and that she is not loveable, and so will always fail at relationships.
B: Beliefs
(about A)
Desirable Emotions
Debbie feels sad, but is hopeful that she will have successful relationships in the future.
Undesirable Emotions
Debbie feels guilty that she spoilt the relationship and that she is unlovable.
Desirable Behaviour
Debbie looks forward to forming new healthy relationships and tries to learn from her experience.
Undesirable Behaviour
Debbie resolves not to form new relationships as she will only fail and get hurt again.
C: Consequences
(of B)

14. Reflection
Depressed people undoubtedly have negative thoughts but do the negative thoughts help cause depression, or do they merely occur as a result of being depressed? Cause or effect? What came first… the negative thoughts or the depression?

15. Evaluation of Beck’s theory
It has good supporting evidence
Much research has supported the proposal that depression is associated with faulty information processing, negative self-schemas and the triad of impairments
It has practical application in CBT
Beck’s cognitive explanation forms the basis of cognitive-behavioural therapy. All cognitive aspects of depression can be challenged in CBT.
It is limited as it does not explain all aspects of depression
The theory explains the basic symptoms of depression however it is a complex disorder with a range of symptoms, not all of which can be explained

16. Evaluation of Ellis’ theory
It only offers a partial explanation so has limitations
Some depression does occur as a result of an activating event (reactive depression). However not all depression arises as a result of an obvious cause
It has practical application in CBT
Like Beck’s explanation, Ellis’ explanation has led to successful therapy. Irrational negative beliefs are challenged and this can help to reduce depressive symptoms suggesting that the irrational beliefs had some role in the depression.
It does not explain all aspects of depression
This explanation also does not explain why some individuals experience anger associated with their depression or why some patients suffer hallucinations and delusions

17. Alternative explanations
The biological approach to understanding mental disorders suggests that genes and neurotransmitters may cause depression
The success of drug therapies for treating depression suggest that neurotransmitters do play an important role; the medication alters the levels of specific neurotransmitters and reduces the symptoms.
At the very least, a diathesis-stress approach might be advisable, suggesting that individuals with a genetic vulnerability for depression are more prone to the effects of living in a negative environment, which then leads to negative irrational thinking .

18. Exam question
Yasmin has just been made redundant. She takes this very hard and finds herself suffering symptoms of depression. When questioned, Yasmin says that the situation is unfair and that she is ashamed.
How would you put the sequence of events into Ellis’s ABC model?
What kinds of irrational thinking is Yasmin displaying?
Does Yasmin have any symptoms that Ellis’s model would struggle to explain?
How might you go about challenging these thoughts if you were a cognitive behavioural therapist?

19. Treatment for Depression
CBT
Treatment for Depression

20. CBT evaluation
Complete the sheet