cognitive explanations of mood disorders

Cognitive explanations of Cognitive explanations of Mood disordersMood disorders

RecapRecap

Cognitive explanationsCognitive explanations

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

Negative schemasNegative schemas

When the person with such schemas When the person with such schemas encounters a situation that resembles the encounters a situation that resembles the original conditions of the learned schema original conditions of the learned schema in some way, even remotely, the negative in some way, even remotely, the negative schemas of the person are activated.schemas of the person are activated.

Some negative schemas lead to errors in Some negative schemas lead to errors in logic……logic……


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


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


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


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

See study to support on handoutSee study to support on handout

Dysfunctional Attitude ScaleDysfunctional Attitude Scale

What evaluation can you think of?What evaluation can you think of?

Another studyAnother study

Perez et al (1999) –Perez et al (1999) – Support errors in logic. A Support errors in logic. A group of normal people were made sad by group of normal people were made sad by playing sad music, recalling unhappy or sad playing sad music, recalling unhappy or sad events and given unhappy stimuli. A clinically events and given unhappy stimuli. A clinically depressed group also did this. depressed group also did this.

The clinically depressed group actually recalled The clinically depressed group actually recalled more of the negative aspects from the task than more of the negative aspects from the task than the non-depressed people. This idea is called the non-depressed people. This idea is called the ‘negative attentional bias’. Common with real the ‘negative attentional bias’. Common with real depressed people. depressed people.

EvaluationsEvaluations

There is a shadow over the issue of whether or There is a shadow over the issue of whether or not the negative thinking comes before not the negative thinking comes before depression or is a result of depression. So depression or is a result of depression. So research in this area is lacking.research in this area is lacking.

Segal & Ingram (1994)Segal & Ingram (1994) – Compared depressed – Compared depressed people against recovered depressed people. people against recovered depressed people. Found negative thinking to be a consequence of Found negative thinking to be a consequence of depression rather than causing depression. depression rather than causing depression.

Exam questionExam question

1.1. Describe one explanation for the cause Describe one explanation for the cause of depression/mood disorders/unipolar of depression/mood disorders/unipolar depression (4 marks)depression (4 marks)

The cognitive triadThe cognitive triad

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

Beck’s Attribution ( explanation) Beck’s Attribution ( explanation) TheoryTheory

I will pair no’s 3 and 4 together to make the I will pair no’s 3 and 4 together to make the following notes….following notes….

The learned helplessness model argues that if a The learned helplessness model argues that if a person has an expectation that only bad things person has an expectation that only bad things will happen to them then there is nothing they will happen to them then there is nothing they can do to prevent it.can do to prevent it.

If they don’t try then how will they know that they If they don’t try then how will they know that they could overcome that problem or pass that exam could overcome that problem or pass that exam etc.etc.

Beck’s Attribution TheoryBeck’s Attribution Theory

The attribution hypothesis aims to answer The attribution hypothesis aims to answer this reasonthis reason

There are three dimensions that have There are three dimensions that have been suggested to describe this so…been suggested to describe this so…

Internal – external attributionInternal – external attribution

A student cannot solve the equation. A student cannot solve the equation.

They may believe they are stupid (i) even They may believe they are stupid (i) even though the equation is solvablethough the equation is solvable

Or he may believe the equation is hugely Or he may believe the equation is hugely unsolvable (e) and he isn’t stupidunsolvable (e) and he isn’t stupid

Stable-unstable attributionsStable-unstable attributions

The student may decideThe student may decide

They couldn’t solve the problem because They couldn’t solve the problem because they are stupid and that will never change they are stupid and that will never change (s) (s)

Or it was imply the difficulty of the task (u) Or it was imply the difficulty of the task (u) they are not stupid the teacher just made it they are not stupid the teacher just made it extra difficult or they didn’t get a good extra difficult or they didn’t get a good sleep the night beforesleep the night before

Global- specificGlobal- specific

The student who failed the equationThe student who failed the equation

Believes he probably is no good at solving Believes he probably is no good at solving any type of problems regardless of any type of problems regardless of subjects or situations (g)subjects or situations (g)

Or it is specific only to maths and that Or it is specific only to maths and that particular topic which requires more particular topic which requires more revision etc (s)revision etc (s)

ThinkThink

In three sentences summarise three In three sentences summarise three attributins a person would make if they attributins a person would make if they suffered from depressionsuffered from depression

Try to think of an example other than Try to think of an example other than solving an equation…solving an equation…

Beck’s Attribution TheoryBeck’s Attribution TheoryTherefore:Therefore:

There are three main causal explanation levels:There are three main causal explanation levels:Internal – Internal – When the behaviour is attributed to themselves. When the behaviour is attributed to themselves. External – External – Behaviour is attributed to the environment. Behaviour is attributed to the environment. Stable –Stable – Cause of behaviour is seen to be unchangeable. Cause of behaviour is seen to be unchangeable. Unstable –Unstable – Cause or behaviour is seen to be changeable. Cause or behaviour is seen to be changeable. Global –Global – Cause seems to occur in more than one aspect of a person’s life. Cause seems to occur in more than one aspect of a person’s life. Specific –Specific – When the behaviour applies to a particular situation. When the behaviour applies to a particular situation.

Metalsky et al (1987) –Metalsky et al (1987) – Their study which supported the theory. Their study which supported the theory. Looked at students who had performed badly in a psychology exam. Looked at students who had performed badly in a psychology exam. Two days after, those who attributed their failure to unstable, specific Two days after, those who attributed their failure to unstable, specific causes had recovered. However, those who had their failure to internal, causes had recovered. However, those who had their failure to internal, external, stable causes remained depressed. external, stable causes remained depressed.

More evaluationsMore evaluations

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

Cognitive treatments of Cognitive treatments of depressiondepression

Three typesThree types

Ellis’s Rational Emotive TherapyEllis’s Rational Emotive Therapy

Beck’s Cognitive TherapyBeck’s Cognitive Therapy

Cognitive Behavioural TherapyCognitive Behavioural Therapy


In 1962 Ellis developed the ABC model of In 1962 Ellis developed the ABC model of depressiondepression

An unpleasant experience causes irrational An unpleasant experience causes irrational

thoughts which leads to negative mood thoughts which leads to negative mood

states. Relationship ends, I am such a states. Relationship ends, I am such a boring person, depression (cry, fatigue, boring person, depression (cry, fatigue, loss of appetite etc)loss of appetite etc)


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


The crucial step is for clients to have full The crucial step is for clients to have full acceptance of their new rational beliefsacceptance of their new rational beliefs

For example – how could you deal with the For example – how could you deal with the following scenariofollowing scenario

Your friend cannot make it to your birthday Your friend cannot make it to your birthday lunch at school. What negative thoughts lunch at school. What negative thoughts and positive thoughts could occur?and positive thoughts could occur?

EvaluationsEvaluations

Newmark et al (1973) found that 65% of anxious patients Newmark et al (1973) found that 65% of anxious patients and only 2% of normals agreed with the statement “It is and only 2% of normals agreed with the statement “It is essential that everyone be loved by virtually everyone in essential that everyone be loved by virtually everyone in their community”….their community”….

Therapists who practice RET are said to be generally Therapists who practice RET are said to be generally more argumentative than therapists who practice for more argumentative than therapists who practice for example client centred therapy showing less concern for example client centred therapy showing less concern for their sensitivities. Thus this therapy is only right for a their sensitivities. Thus this therapy is only right for a certain type of client. For example it is best suited to certain type of client. For example it is best suited to those who are guilty about their own attitudes and so those who are guilty about their own attitudes and so really want to change.really want to change.

Beck’s cognitive therapyBeck’s cognitive therapy

Clients must uncover then challenge their Clients must uncover then challenge their unrealistic and negative beliefs – in other unrealistic and negative beliefs – in other words challenge the cognitive triadwords challenge the cognitive triad

They see themselves as worthless and They see themselves as worthless and inadequate, they look at things in a inadequate, they look at things in a defeatist way and see their world full of defeatist way and see their world full of obstacles they can’t handle!obstacles they can’t handle!

Stages of Beck’s cognitive therapyStages of Beck’s cognitive therapy

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

Cognitive Behavioural TherapyCognitive Behavioural Therapy

If the client has successfully managed to If the client has successfully managed to change their thoughts to more rational and change their thoughts to more rational and realistic ideals then ultimately they will also realistic ideals then ultimately they will also change their behaviours in their daily life.change their behaviours in their daily life.

This usually involves the client adhering to This usually involves the client adhering to homework assignments such as initiating homework assignments such as initiating the conversation, making a deadline, the conversation, making a deadline, going out to a bar with friends etc…going out to a bar with friends etc…

Effectiveness/evaluation of Effectiveness/evaluation of therapies therapies

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

cognitive explanations of mood disorders

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