DEPRESSION

A mental disorder characterised by low mood and

energy levels
Support

■ https://challonershigh.sharepoint.com/students/cncl/SitePages/School-Wellbeing-and-Co
unselling-Service.aspx
CHARACTERIST
AO1
ICS OF
DEPRESSION
DSM-5 Categories of Depression
■ To be given a diagnosis of depression, sufferers are required to display at least five
symptoms, every day for at least two weeks.
■ All forms of depression and depressive disorders are characterised by changes to mood
■ The DSM recognises the following categories:

Major Depressive Disorder Severe but often short-term depression

Persistent Depressive Long-term or recurring depression,

Disorder including sustained major depression and
what used to be called dysthymia.
Disruptive Mood Childhood temper tantrums
Dysregulation Disorder
Premenstrual Dysphoric Disruption to mood prior to and/or during
Disorder menstruation
Behavioural Characteristics Reduction in energy
Behaviour changes when we suffer an • Withdrawing from
episode of depression work/education/school life

Disruption to eating behaviour Disturbance to sleeping pattern

• Weight gain or loss • Insomnia
• Feeling tired
• Need for more sleep: hypersomnia

Aggression Self-Harm
• Verbal/physical • Form of cutting
• Suicide attempts
 Emotional Characteristics Lowered mood
• Feelings of sadness
• Feelings of worthlessness

Lack of interest Lack of pleasure in activities

Anger Lowered-Self Esteem

• Directed at self or others • Can lead to self loathing/hating
• These emotions can lead to self themselves
harming behaviours
 Cognitive Characteristics
Process information about aspects of
the world differently from the
‘normal’ ways that people without
depression think
Dwelling on negatives
• Tendency to recall unhappy events
• Glass half empty
Poor concentration
• Slower to respond or make
decisions
• Likely to interfere with work
Absolutist thinking
• Black and white thinking: if a
situation is bad to them it is an
absolute disaster
 THE COGNITIVE
APPROACH TO
EXPLAINING
DEPRESSION
Outline and evaluate the cognitive approach to explaining depression, including:
Becks Cognitive Triad
Ellis’s ABC model
Overview
■ The cognitive approach suggests that
emotional problems are the result of
Cognitive Distortions (irrational thinking)
■ There are 2 key cognitive theories which
attempt to explain depression
– Becks’s cognitive triad
– Ellis’s Irrational thinking (ABC
Model)
 BECKS COGNITIVE
TRIAD/COGNITIVE THEORY OF
DEPRESSION
(1967)
Aaron Beck

Psychologist 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

1. faulty information processing
2. negative self-schemas
3. the negative triad
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) These confirm the existing
emotions of low self esteem.
– Negative view of the world (it is a hostile place) Creates the impression that there is no
hope anywhere.
– Negative view of the future (problems will not disappear, e.g. there isn’t much chance the
economy will get better. Such thoughts reduce and hopefulness and enhance depression
The Negative Triad
Negative views about the
World
“Everyone is against me
because I’m worthless”

Negative views about the Negative views about ones

Future self
“I’m worthless as I’ll NEVER “I’m worthless, inadequate, fat
make anything of myself” and ugly”
Becks Cognitive Triad
(1967)
■ These negative views make a person interpret
their experiences in a negative way and make
them more vulnerable to depression.
■ For sufferers of depression, these negative
thoughts occur automatically and are
symptomatic of depressed people.
■ Beck identified 2 mechanisms that are
responsible for maintaining the cognitive
triad:
– Negative self-schema
– Faulty information processing
Negative Self- Schema

■ A self-schema is a package of ideas that we have about ourselves and everything around
us. They develop through experience.
■ We use schemas to interpret the world so if our self-schema is negative, we interpret
information about ourselves negatively.
■ These negative self-schemas may come from negative experiences - Criticism from
parents, peers or even teachers.
■ Examples of negative self-schemas:
– Ineptness schema: Makes sufferers expect to fail
– Self-blame schema: Makes them feel responsible for any misfortunes
– Negative self-evaluation schema: Constantly reminds them of the worthlessness
Faulty information processing

■ Beck found that depressed people are more likely to focus on the negative aspects of a
situation, while ignoring the positives.
■ These negative aspects distort information; a process known as cognitive bias.
■ Beck detailed many cognitive biases including;
– Overgeneralisations: Making sweeping conclusions based on a single incident; “I
failed one end of unit test so I’m going to fail ALL of my A-level exams”
– Catastrophising: Exaggerating a minor setback and believe it is a complete
disaster; “I’ve failed one end of unit test and therefore I am never going to get into
university and I will never get a job”.
Evaluate

Good Supporting Evidence

Practical application in CBT

Doesn’t explain all aspects of depression

 Good Supporting Evidence

There is a wealth of research which supports Beck’s cognitive theory of depression.

P
Ex Evidence supports the idea that depression is associated with faulty information processing,
negative self-schemas and the cognitive triad of negative thinking.

Grazioli and Terry (2000) assessed 65 pregnant women for cognitive vulnerability and
depression before and after birth. They found that those women judged to have been high in
cognitive vulnerability were more likely to suffer post natal depression.
Evi
Clark and Beck (1999) supports this……

C
This matters as the research suggests that these cognitions can be seen before depression
develops, suggesting that Beck may be accurate about cognitions causing depression.
LB
Practical Application to CBT

P Beck’s cognitive explanation forms the basis of cognitive-behavioural therapy (CBT).

Ex All cognitive aspects of depression can be identified and challenged in CBT.

These include the components of the negative triad, for example, negative views of the self. This is
easy to identify for a patient which means a therapist can challenge them and encourage the patient
Evi to test whether these thought are true.

However, Becks theory doesn't explain all aspects of depression……

Depression is complex
C Jarrett (2013) – delusion they are zombies.

Nevertheless, Beck’s cognitive explanation does translate successfully into most therapy and can be
used on a wide range of patients increasing the impact it has on patients and their well-being.
LB
ELLIS’S ABC MODEL
(1962)
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”
Ellis’s ABC Model (1962)

■ Ellis started by first explaining what is required for “Good” mental health
■ According to Ellis, good mental health is the result of rational thinking; which is
thinking in a way that allows people to be happy and free of pain
■ Ellis defined irrational thoughts, not as illogical or unrealistic thoughts, but as any
thought that interfere with us being happy and free of pain
■ Ellis uses the ABC model to explain how irrational thoughts affect our behaviour and
emotional state.
– A: Activating Event
– B: Beliefs
– C: Consequences
A: Activating Event

■ An event occurs, which triggers irrational thoughts.

■ Ellis suggests, when we experience negative events, these trigger

irrational beliefs

■ For example, a break up, failing a test

B: Beliefs

■ Your interpretation of the event of the event, which could either be

rational or irrational:

– A rational interpretation of the event, could be that you and your

partner were simply incompatible and are meant to be with other
people.

– An irrational interpretation of the event is that you are not

meant to be happy and no one will ever love you.
C: Consequences

■ When an activating event triggers irrational beliefs, there are

emotional and behavioural consequences, including depression.
■ If you believe you must always succeed and then fail at something
this can trigger depression.

■ “I am never going to find love so I wont ever let anyone get close to
me again”
TASK Answer the
questions in the A: Activating event
ABC boxes, you Debbie and her boyfriend split up.
don’t need to
write these down.
You can check Rational Thoughts Irrational Thoughts
your responses on What would a positive reaction be
from Debbie? What could she tell
Who would be at fault? What
would she think about herself?
the next page herself? What will se think about her
future?
B: Beliefs
(about A)
Undesirable Emotions
Desirable Emotions
How would Debbie feel? How would Debbie feel?

Desirable Behaviour
C: Consequences Undesirable Behaviour
How would Debbie behave?
How would Debbie behave? What (of B)
would she look forward to?
TASK
A: Activating event
Debbie and her boyfriend split up.

Rational Thoughts Irrational Thoughts

Debbie tells herself that although it Debbie tells herself that the break
is a sad situation they were not B: Beliefs up is her fault and that she is not
compatible and she may learn from loveable, and so will always fail at
the experience. (about A) relationships.

Desirable Emotions Undesirable Emotions

Debbie feels sad, but is hopeful
that she will have successful Debbie feels guilty that she spoilt
relationships in the future. the relationship and that she is
unlovable.

Desirable Behaviour Undesirable Behaviour

C: Consequences Debbie resolves not to form new
Debbie looks forward to forming relationships as she will only fail
new healthy relationships and tries (of B) and get hurt again.
to learn from her experience.
 Only a partial
explanation

Does have practical

Evaluate
application to CBT

Doesn’t explain all

aspects of depression
Only a partial explanation

Ellis’s ABC model can be seen to just be a partial explanation of why an individual may experience
P depression.

Some depression does occur as a result of an activating event (reactive depression). However, not all
Ex depression arises as a result of an obvious cause.

For example, there is an alternative explanations which suggest that depression is a biological condition,
caused by genes and neurotransmitters.

Evi
Can you find another study to support the idea of depression being caused by our genes….

C
This matter because……..

LB
Practical Application to CBT

Like Beck’s explanation, Ellis’ explanation has led to successful therapy.

P
During CBT, irrational negative beliefs are challenged and this can help to reduce depressive
Ex symptoms suggesting that the irrational beliefs had some role in the depression.

Lipsky et al (1980) supported the idea that by challenging irrational negative beliefs a person can
reduce their depression. They found this worked better for patients than alternative treatments such as
relaxation training.
Evi Furthmore, Boury et al. (2001)
Use this link to help….. (at the bottom on the page)
https://www.tutor2u.net/psychology/reference/explaining-depression-ellis-abc-model
C
This matters because we can confidently offer CBT to patients who are suffering from depression as a
standard treatment to deal with some of their symptoms.

LB
 Does not explain all aspects of Depression

Ellis’s explanation does not explain all aspects of depression.

P
Ex Research has shown that some individuals experience anger associated with their depression and also
some patients suffer hallucinations and delusions.

Evi An additional weakness is that it does not explain the origins of irrational thoughts and most of the
research in this area is correlational. Therefore, we are unable to determine if negative, irrational
thoughts cause depression, or whether a person’s depression leads to a negative mindset.
C
This matters because it suggests the explanation is limited…..

LB