Cognitive explanations of Mood disorders

1. Cognitive explanations of Mood disorders Recap

2. Cognitive explanations • Schemas are mental structures that represent our understanding of the world. • They are automatic and require no effort – so for example you know how to climb one stair case you can walk up all staircases. • You fail one exam – you think you will fail them all. • Your parents always argued and then eventually divorced so all couples argue and will ultimately divorce. • Try to think of some examples yourself

3. Negative schemas • When the person with such schemas encounters a situation that resembles the original conditions of the learned schema in some way, even remotely, the negative schemas of the person are activated. • Some negative schemas lead to errors in logic……

4. Negative schemas • Overgeneralisation: Coming to a conclusion without evidence to back it up. For example, imagine your internet broke down at home and you couldn’t fix it. Instead of calling a technician you will think you are a bad and incompetent person.

5. Negative schemas • Magnification or minimisation: All bad events are magnified and good events are minimised. So the inability to find your keys in the morning is a disaster but praise for good work is considered trivial.

6. Negative schemas • Selective perception: Focusing on insignificant details and ignoring the important aspects of a situation. For example your boss tells you how great your work has been over the last few weeks but you chose to remember the one tiny thing they mentioned that you must i.e. make sure you put the cash into the slot not the register.

7. Negative schemas • Absolutist thinking: Everything must be perfect or it will be a disaster. You must not have any arguments in your relationship or it will fall apart.

8. See study to support on handout • Dysfunctional Attitude Scale • What evaluation can you think of?

9. Another study • Perez et al (1999) – Support errors in logic. A group of normal people were made sad by playing sad music, recalling unhappy or sad events and given unhappy stimuli. A clinically depressed group also did this. • The clinically depressed group actually recalled more of the negative aspects from the task than the non-depressed people. This idea is called the ‘negative attentional bias’. Common with real depressed people.

10. Evaluations • There is a shadow over the issue of whether or not the negative thinking comes before depression or is a result of depression. So research in this area is lacking. • Segal & Ingram (1994) – Compared depressed people against recovered depressed people. Found negative thinking to be a consequence of depression rather than causing depression.

11. Exam question • Describe one explanation for the cause of depression/mood disorders/unipolar depression (4 marks)

12. The cognitive triad • These are negative thoughts about the self, their world and about their future. The person believes they are worthless. So if the person has an unpleasant experience they will attribute it to them and their unworthiness. He believes that what is happening now will never change. He will always experience situations in the same way. i.e. studying?

13. Beck’s Attribution ( explanation) Theory I will pair no’s 3 and 4 together to make the following notes…. • The learned helplessness model argues that if a person has an expectation that only bad things will happen to them then there is nothing they can do to prevent it. • If they don’t try then how will they know that they could overcome that problem or pass that exam etc.

14. Beck’s Attribution Theory • The attribution hypothesis aims to answer this reason • There are three dimensions that have been suggested to describe this so…

15. Internal – external attribution A student cannot solve the equation. • They may believe they are stupid (i) even though the equation is solvable • Or he may believe the equation is hugely unsolvable (e) and he isn’t stupid

16. Stable-unstable attributions The student may decide • They couldn’t solve the problem because they are stupid and that will never change (s) • Or it was imply the difficulty of the task (u) they are not stupid the teacher just made it extra difficult or they didn’t get a good sleep the night before

17. Global- specific The student who failed the equation • Believes he probably is no good at solving any type of problems regardless of subjects or situations (g) • Or it is specific only to maths and that particular topic which requires more revision etc (s)

18. Think • In three sentences summarise three attributins a person would make if they suffered from depression • Try to think of an example other than solving an equation…

19. Beck’s Attribution Theory Therefore: • There are three main causal explanation levels: • Internal – When the behaviour is attributed to themselves. • External – Behaviour is attributed to the environment. • Stable – Cause of behaviour is seen to be unchangeable. • Unstable – Cause or behaviour is seen to be changeable. • Global – Cause seems to occur in more than one aspect of a person’s life. • Specific – When the behaviour applies to a particular situation. Metalsky et al (1987) – Their study which supported the theory. Looked at students who had performed badly in a psychology exam. Two days after, those who attributed their failure to unstable, specific causes had recovered. However, those who had their failure to internal, external, stable causes remained depressed.

20. More evaluations • Results from animal studies cannot be generalised to humans, due to different brain cognitions and structures. • Barnett & Gottlib (1988) – Showed that people who were formally depressed are actually no different from people who have never been depressed in terms of their tendencies to view negative events with an attitude to helplessness. • In some cases, helplessness training appeared to improve the performance of participants in laboratory experiments (Workman & Brehm, 1975) As a result it led to a revision of Seligman’s theory with the addition of attributions.

21. Cognitive treatments of depression

22. Three types • Ellis’s Rational Emotive Therapy • Beck’s Cognitive Therapy • Cognitive Behavioural Therapy

23. Ellis’s Rational Emotive Therapy • In 1962 Ellis developed the ABC model of depression An unpleasant experience causes irrational thoughts which leads to negative mood states. Relationship ends, I am such a boring person, depression (cry, fatigue, loss of appetite etc)

24. Ellis’s Rational Emotive Therapy • RET is about replacing the irrational thoughts with more positive ones. • First therapist makes person recognise their negative thoughts • They must decide whether these are logical or irrational – for example do you really have to be liked by everyone – do you like everyone? • Think more positively – Not everyone is going to love me but hey – most people I know like me, I get on with them and anyways its not like I love everyone I meet anyways – so whatever!

25. Ellis’s Rational Emotive Therapy • The crucial step is for clients to have full acceptance of their new rational beliefs • For example – how could you deal with the following scenario • Your friend cannot make it to your birthday lunch at school. What negative thoughts and positive thoughts could occur?

26. Evaluations • Newmark et al (1973) found that 65% of anxious patients and only 2% of normals agreed with the statement “It is essential that everyone be loved by virtually everyone in their community”…. • Therapists who practice RET are said to be generally more argumentative than therapists who practice for example client centred therapy showing less concern for their sensitivities. Thus this therapy is only right for a certain type of client. For example it is best suited to those who are guilty about their own attitudes and so really want to change.

27. Beck’s cognitive therapy • Clients must uncover then challenge their unrealistic and negative beliefs – in other words challenge the cognitive triad • They see themselves as worthless and inadequate, they look at things in a defeatist way and see their world full of obstacles they can’t handle!

28. Stages of Beck’s cognitive therapy • Collaborative empiricism – Client and therapist agree on nature of problem and set achievable goals • The clients negative thoughts are tested out by the therapist by challenging them • The behaviour of the client is noted between sessions – i.e. did they go to work every day this week? • The aim is to make the client accept their negative thoughts are irrational – diary of people who are avoiding them must be logged in a diary – its probably not as often as they think!

29. Cognitive Behavioural Therapy • If the client has successfully managed to change their thoughts to more rational and realistic ideals then ultimately they will also change their behaviours in their daily life. • This usually involves the client adhering to homework assignments such as initiating the conversation, making a deadline, going out to a bar with friends etc…

30. Effectiveness/evaluation of therapies • CBT may be seen as more effective than CT as it deals with the problems directly and indirectly…expand yourself • Beck’s therapy is more sophisticated than Ellis’s. Ellis believes similar irrational beliefs are linked to most mental disorders whereas Beck believes it is specific irrational beliefs that are linked to specific disorders (phobias vs depression). • Engles et al (1993) found that RET was as effective as systematic desensitisation or no treatment across 28 cultures. • Cognitive therapies are overall more successful at treating anxiety disorders and depression compared with other forms of therapies • It is inexpensive, cost effective and used most commonly across UK and USA. Sz is another story