Abnormal psychology: Cognitive theories of depression

essay by cheryl yow


Scenario:
26 year old Mary has been depressed for months.
Her boyfriend of two weeks left her. Rita, her
childhood friend suggests that Mary sees a
therapist. Mary replies, ‘What is the point?’
 I think I am meant to be alone, I can never find
one who can love me, and I have nothing
special to offer.’


Rita assures her that she has many positive
qualities, e.g.; ‘You look great, you have a good
job, you are educated and not to forget what a
sincere friend you are’. Mary is hardly
 impressed and says, ‘What good looks?
Remember in university, I only got referred to as
‘pretty’, not beautiful.I am no more special than
anyone else, my job is average, I am not the CEO,
I am never going to be really successful, and I am
only a graduate, not even with honours. I just
cannot excel at anything, if I was meant to be
happy like you, why should I have inherited my
mother’s illness; she suffered just like I am’.


Question:
Describe how a cognitive therapist would explain
why Mary is experiencing depression.



Cognitive theories of depression emphasize the role
of irrational thought processes. American psychiatrist
Aaron Beck proposed that individuals learn to view things
negatively during early childhood. Depressed people tends
to view themselves, their environment and the future
negatively because of errors in thinking. Depressed people
commonly acquired negative views through abusive rearing
style of parents, critical parents, loss of loved one or
social rejection of friends . This could give rise to
‘depressive’ personality traits – self-criticism,
excessive scepticism, gloominess, pessimism, and people
with these traits appear at greater risk for depression.
We will look into the cognitive explanation for Mary’s
depression by looking into the cognitive revolution and
the three major features of cognition- depressive
cognitive triad, cognitive errors (arbitrary inference,
over-generalisation), negative schemas as well as learned
helplessness and hopelessness theory.



The ''cognitive revolution'' emerges as a reaction against
behavioral interpretations of depression. Behavioural
approaches to depression were popular until the early 1980’s
after which they were overtaken by cognitive perspectives.
Behavioural theorists ignore the impact or meaning of the
emotions in depression, instead they saw emotions merely
as drive mechanisms implicated in the processes of positive
and negative conditioning. Modern cognitive theories emerged
when psychologists, rejecting exclusively consequence-based
explanations of behavior, began to elaborate their own
interpretations of learning. Cognitive perspective, in
understanding depression, focuses not on observable
responses but on the inferred mental processes. Cognitive
processes and activities such as information processing,
mental representations, and expectations are central
to the cognitive interpretation of depressions.


Regarding Mary’s case, her boyfriend of two weeks has left
her and she has been depressed for months. Any breaking off
of a relationship is upsetting, it can cause anxiety which
later leads to depression. The quality and quantity of time
they spent together during those 2 weeks is an important
consideration- from having one or two short dates a week
to living together everyday for two weeks -the longer one
spends with the other the more time for bonding thus it
gets harder to part. A relationship that short may not have
impacted most people, however it all depend depends on the
context and the meaning an individual attaches to a
relationship. It depends how intense the relationship was,
have they already reached a point where they were
already intimate physically or were they just merely
holding hands. The more intimate a couple is the harder
it is to lose the other. Again, whether a person in this
situation would have depression also depends on the
individual’s personality. Mary’s boyfriend whom she had
only known for 2 weeks had left her and she was depressed
for months, yet another person in the same situation might
just cry for a night or two and then choose to start
partying to meet other potential suitors. Thus depending,
how intense andhow intimate the relationship has developed
in those two weeks and also the individual’s personality,
depression may or may not occur.



Beck suggests that depression is due to dysfunctional
cognition. There are three major features of cognition.
Firstly, the ‘depressive cognitive triad’: this consists
of negative cognitions concerning oneself (e.g. “I am
undesirable, worthless and inadequate”), the world
(e.g. the world is defeating and overly demanding), and
the future (e.g. “I am always bound to fail and to suffer”).
Mary comments that she was only referred as ‘pretty’ not
beautiful, that she is not more special than anyone else,
she is only a graduate and her job is average shows her
extreme self negativity. ‘I think I am meant to be alone,
I can never find one who can love me,..’, ‘I am never going
to be really successful.’ tells us that Mary is certainly
very negative about her immediate world and her future.



Secondly, faulty thinking or cognitive errors in the
cognitive triad of which a number of errors have been
identified, e.g. arbitrary inference and
overgeneralization. Arbitrary inference refers to a
depressed person who focuses on the negative rather
than the positive aspects of a situation – even the
smallest setback becomes a major tragedy. In Mary’s
case leaving a boyfriend of only 2 weeks seems to her
more like she is leaving a boyfriend of 2 years. When
Rita, her best friend, suggests that Mary should see a
therapist, she replies, ‘What is the point?’ I think I
am meant to be alone, I can never find one who can love
me, and I have nothing special to offer.’ This reflects
Mary’s negative attitude even when the break-off was
months ago.


Overgeneralisation, another form of cognitive errors,
is when one tends to overgeneralise one’s negative
situation as we can see from Mary’s response that she was
meant to be alone and that she will not be able to find
someone who could love her and that she ‘just cannot excel
at anything’. Mary overgeneralizes the negativity of her
one break-up and believes that her future holds impending
gloom for her. In time these practiced thinking errors
becomes ‘automatic negative thoughts’. People are usually
only partially aware of their automatic thoughts; however
they exert a great influence over how they view the world
and accordingly behave.



Thirdly, schemas; these are hypothetical cognitive
structures that influence the screening, coding and
organization of environmental information. Negative schemas
are learned from early unfortunate interactions with the
environment, especially with significant others. Beck
theorized that individuals may develop a deep-seated
negative schema after some negative events during childhood.
Early experience can shape maladaptive attitudes and beliefs
in the child. Dysfunctional schemas (e.g. “I must do
everything perfectly or else I’m a failure”) can predispose
people to distort events in a way that leads to depression.
It is thought that dysfunctional schemas and beliefs can lie
‘dormant’ for a number of years until a series of events
‘re-awaken’ the schematic beliefs which then activate the
cognitive triad.Mary could not believe that she could be
happy - ‘why should I have inherited my mother’s illness;
she suffered just like I am’. Though inheriting her
mother’s depression, Mary will be more vulnerable to
stress and depression, but also growing up with a
depressed mother (the environment) could even
further intensifies her vulnerability to it. Becks
suggests these cognitive errors and schemas are automatic,
unconscious, individual individuals might not even know
they are thinking negatively or illogically. Thus
depressive cognition seems to emerge from automatic
processing of information and distorted views.


Learned helplessness theory, a related but differing
cognitive perspective is proposed by Seligman (1975,
cited by Barlow & Durand, 2009). Learned helplessness
is a learned belief that one cannot control the outcome of
events. In this view depression is seen as faulty learning
regarding personal locus of control that is -when one is
subjected to negative events seen as outside of one’s
control - hopelessness, passivity and depression result.
Rats that received occasional shocks, can cope with them
by doing something to avoid them ( pressing a lever).
However, if they are not able to do something to avoid
these shocks, they will become anxious, helpless and
depressed as they had no control over difficult
life events. Seligman suggests that learned helplessness
(also referred to as conditioned helplessness) occurs in
individuals as a form of depression.Long-time exposure to
uncontrollable and inescapable events leads to apathy and
pessimism . When all attempts to escape or avoid negative
situations have failed, people give up and an attitude
of learned helplessness develops. In Mary’s case, if she
feels that she is not in control of this negative
situation she might lapse into learned helplessness.



Another cognitive perspective suggests that depression
results not only from ‘learned helplessness’ but also
from hopelessness. The hopelessness theory attributes
depression to a pattern of negative thinking in which
people blame themselves for negative life events and view
the causes of those events as permanent. Thus people with
depression often experience feelings of guilt, self-blame
and worthlessness. They may interpret a minor failing on
their part as a sign of incompetence or interpret minor
criticism as condemnation. In some cases, people with
depression may experience psychotic symptoms, such as
delusions (false beliefs) and hallucinations (false
sensory perceptions). People with major depression may
experience such extreme emotional pain that they consider
or attempt suicide.



Mary’s depression, according to cognitive perspective is
due to faulty cognition during childhood (much influenced
by her mother who also has depression): depressive
cognitive triad, cognitive errors (arbitrary inference,
over-generalisation), negative schemas that leads to learned
helplessness and hopelessness theory. Once we understand and
spot these cognitive errors and distorted schemas we can
correct it to prevent potential depression.


(1416 words)





Reference:

Barlow, D.H., & Durand, V.M. (2009, 2005). Abnormal psychology:
An integrative approach (5th ed.). Belmont, CA: Wadsworth.