Depression: Cognitive Approach

Q: Harrell and Ryon (1983) - Study Using the ATQ

Research aim: to evaluate the effectiveness of **Hollon and Kendall**’s Automatic Thoughts Questionnaire (ATQ) - a questionnaire designed to identify and measure the occurrence of automatic negative thoughts in depressed patients.

Test yourself on Depression: Cognitive Approach

Test your knowledge with free interactive questions on Seneca — used by over 10 million students.

Beck's Theory of Depression

Beck's cognitive theory of depression suggests that depression is as a result of negative thoughts and views of the world. This can be overcome using cognitive therapy.

Cognitive theories of depression

Cognitive theories of depression take the view that depression is triggered by negative thoughts, interpretations, self-evaluations and expectations.
These dual-risk models propose that depression is triggered by a “cognitive vulnerability” (negative and maladaptive thinking) and by precipitating stressful life events.

Beck's theory

Psychiatrist Aaron Beck's cognitive theory of depression is one of the most well-known.
Beck theorised that depression-prone people possess depressive schemas.
Depressive schemas prompt dysfunctional and pessimistic thoughts about the self, the world, and the future.
It is likely that they develop early in childhood in response to adverse experiences, then remain dormant until they are activated by stressful or negative life events.

Cognitive biases

Beck believed that a dysfunctional style of thinking is maintained by cognitive biases, or errors in how we process information about ourselves.
This lead us to focus on negative aspects of experiences, interpret things negatively, and block positive memories.

Beck's negative triad

Beck's negative triad relates to the negative schemas and cognitive biases that lead to depressive thoughts.
The theory suggests that negative views about the self, the world and the future all lead into a downward spiral and cause a person to think depressive thoughts.

Cognitive therapy

Cognitive therapy is a form of psychotherapy that focuses on how a person’s thoughts lead to feelings of distress. It was developed as an expansion of Beck's theory.
The idea behind cognitive therapy is that how you think determines how you feel and act.
Cognitive therapists help their clients change dysfunctional thoughts to relieve distress.
They help a client see how they misinterpret a situation (cognitive distortion) and how to view situations in a more positive light.

Cognitive Approach to Treating Depression

Ellis’ ABC model is a technique used within cognitive behavioural therapy (CBT). It aims to alter a person’s problematic beliefs, so that events have different consequences.

Cognitive approach

The cognitive approach states that depression can be treated by changing a person’s thoughts and beliefs.

Cognitive therapy

There are various types of cognitive therapy, all of which try to change negative beliefs or negative patterns of thinking.
Some use behavioural techniques, too.
The best known cognitive therapy is CBT - cognitive behavioural therapy.

Ellis' ABC model

Albert Ellis developed an ABC model that can be used in therapy. ABC stands for:
- Activating event - this is the thing that causes the thoughts and feelings
- Belief - this is the person’s thoughts about the activating event (how they interpret it). In the depressed person, the belief may be irrational.
- Consequences - in terms of emotions and actions.

Example of ABC

For example, someone might not receive a reply to a text message (activating event), assume that their friend no longer likes them (irrational belief), and then feel very upset and delete that person from their social media account (consequences - emotions and actions).

Cognitive therapists

Cognitive therapists think that if a depressed person’s beliefs are changed, they will start to interpret events more realistically, resulting in healthier (though not always positive) emotions and more proportionate responses to events.

Evaluation of CBT

Strengths
- Allows the client to take control – builds self-esteem.
- Less reliance on drugs than other methods.
- Does work for many people - Ellis (1957) claimed a 90% success rate for REBT, taking an average of 27 sessions to complete the treatment.
Limitations
- Requires Individual motivation.
- Relies on the competence of the therapist.
- Works best combined with drugs.
- Can be expensive and difficult to access (long waiting lists on NHS).

Evaluation of the cognitive approach

Strengths
- It has practical applications. CBT is a successful therapy which challenges irrational beliefs.
Beck’s Depression Inventory and Hollon & Kendall’s Automatic Thought Questionnare (ATQ) are effective tools for diagnosing depression.
Limitations
- Some types of depression occur with no activating event - reactive depression.
- Ignores biochemical explanations for depression.
- Not all patients are able to engage with CBT or find it useful.

Harrell and Ryon (1983) - Study Using the ATQ

Research aim: to evaluate the effectiveness of Hollon and Kendall’s Automatic Thoughts Questionnaire (ATQ) - a questionnaire designed to identify and measure the occurrence of automatic negative thoughts in depressed patients.

Procedure, results & conclusion

Procedure
- 21 patients with depressions aged between 21-53 were compared with 40 people who did not have depression.
Results
- The ATQ scores correlated highly with therapists scores on depression in individuals. It also compared well to other measures of depression such as the Beck depression inventory.
Conclusion
- The ATQ-30 appears to be a valid and reliable measure of depression-related cognitions in clinical as well as nonclinical populations.

Evaluation

Strengths
- Practical applications for diagnosing depression.
Limitations
- Individual differences in experience and competence of clinicians administrating the test.