Introduction
It can be denoted that cognitive theory is a theory of abnormality and an approach to psychology that tries to make an explanation of human behavior by understanding thought processes. Therefore, it is primarily focused onindividual’s beliefs rather than their behavior with depression stemming out of the methodical negative disruptions and bias in the thinking processes. Cognitive theory is also referred to as cognitive psychology, and it is a subdivision of psychology that focuses on the way human beings carry out information processes. It makes a consideration of how received information is processed and how the treatment of such information influences responses. Overall, cognitive psychology concerns itself with what takes place in the human brain that liaises input (stimulus) and response (output). The paper underlies linking a DSM-V psychological disorder- depression- to the cognitive psychological theories.
Notably, cognitive psychologists study internal processes such as attention, perception, memory, language, and thought processes among others. They pose queries like how do human beings get information from the outside world; how do thinking errors lead to negative behaviors and emotional distress; how do human beings store information and later process it; in what way does a breakdown in our perceptions bring about errors in our thinking.All forms of cognitive psychology revolve around four basic characteristics. These include a relationship that is collaborative between a client and a psychological therapist; the conviction that distress of a psychological nature is generally the result of an interruption in cognitive processes; a focus on changing cognition to realize desired changes in behavioral processes and emotion, and an educational approach that is and treatment that is time-limited and concentrates on specific problems.
The two main approaches to cognitive theory include cognitive therapy and behavioral therapy; CT focuses on getting rid of psychological distress, and BT has to do with the elimination of negative behavior. One of the major cognitive theorists can be denoted to be Aaron Beck who highlighted that people suffering from depression appraised events in an adverse way. The cognitive theorist identified three mechanisms that he attributed to depression as discussed in the paper in detail- the cognitive triad, negative self-schemas and faulty or errors existing in logic.
Depression through the Lens of Cognitive Theory
As aforementioned, cognitive theory posits that depression comes about due to faulty, maladaptive, or irrational cognitions that take the form of distorted judgments and thoughts. Depressive cognitions i.e. depressive thoughts and feelings can be learned observationally (socially) as is the case when minors in a dysfunctional family unit look at their folks and fail to effectively come to terms with traumatic events or stressful experiences. Giosan et al. denotes depression as the third largest malady to the global disease burden, outranking comorbidities such as heart disease (Giosan, Muresan, & Moldovan, 2014). According to a renowned and perhaps a venerated cognitive theorist called Aaron T. Beck, “negative thoughts, brought about by dysfunctional beliefs are characteristically the primary reason for depressive symptoms.”
Beck’s cognitive theory can then be attributed to the maturation of depression. The more negative thoughts a person goes through, the more depressed the said person becomes. What’s more, according to Aaron T, Beck, there is a trilogy of schemas i.e. dysfunctional belief themes that dominate the thought processes of depressed individuals. Schemas are maladaptive or adaptive attitudes and beliefs that become active due to the trigger life stressors present. A number of occurrences in the external environment of an individual can also act as precursors to adaptive and maladaptive beliefs. In essence, it is the manner in which we interpret the world as a whole and our surroundings that determine our mental health. So as to treat depression, clients need to get rid of their negative attitude first; to treat their maladaptive interpretations, perceptions, and conclusion as testable hypotheses.
The role of a cognitive approach in the study of depression is to assist clinical psychologists, and their respective clients examine substitute interpretations of and to come up with contradictory proof which gives a backing to more adaptive patterns. With respect to the cognitive theory of depression posited by Aaron T. Beck that the behavioral consequences of psychopathology will be dependent on the content of cognitive structuring (Giosan, Muresan, & Moldovan, 2014). The cognitive school of thought terms the relationship between clients and clinical psychologists as collaborative empiricism; this is because it revolves around a collaborative enterprise between clients and therapists so as to bring about therapeutic change (Mascella, 2013).
It is common knowledge that there is nothing a psychologist can do in the event that a clinical depression patient remains silent in the course of the visits to the doctor. The patient has to share all the symptoms with the psychologist first and give an account of the current negative situations in his or her life; this way there will be aproper determination of what fashion of CBT a psychologist will take. Cognitive Behavioral Therapy revolves around dealing with the root cause of the depression first before resorting to medication. Basic cognitive psychology perceives depression to be as a result of negative attitudes and fears arising from difficult situations and challenges; depression in and of itself is a symptom of a much deeper problem. With such insights, psychologists look to treat the attitude first and the depression later.
The cognitive trilogy talked about by Aaron T. Beck includes the negative view of oneself, the negative view of the world and lastly, the negative view of the future. Jointly, the above-mentioned themes are referred to as the Negative Cognitive Triad. When these three beliefs are present in an individual’s thoughts and feelings i.e. cognition, then depression is bound to occur (if it has not net manifested itself yet). The cognitive triad has also been perceived as a vicious cycle or patterns in the thought processes of an individual that is depressed and are characterized by the negative perception of the self; the negative view of the world, and the negative view of what the future holds.
With respect to the negative view of the self, an individual perceives himself or herself as unworthy, insufficient, or deficient. A negative perception of the world revolves around a fear to interact with the environment; any interactions with the environment are deemed to be representative of deprivation or defeat. Finally, a flawed and negative perception of the future makes the depressed individual lose hope; in his or her mind she/he thinks that difficulties experienced at present or suffering will go on forever and ever.
As mentioned, negative schemas may be accrued to traumatic events during the childhood of an individual. The negative schemas such as the death of a sibling or a parent predispose a person to depression. Therefore, it is plausible to denote that an entity who has acquired a cognitive triad without predisposition to negative schemas may not necessarily develop or mature depression. There requiresto be negative schemas to activate cognitive biases that continue to dominate a depressed mind.
In his theorization, Beck identified a number of negative prejudices in the processing of information which he called logical errors. The errors can be connoted to be self-defeating and can lead to anxiety or depression. Arbitrary inference is attributed to a person coming to negative conclusions when there lacks supporting data. Selective abstraction denotes a focus on the adverse outcomes of any situation or event. Logical errors can also be denoted to underlie magnification or minimization of challenges or difficulties. Magnification entails making problems appear greater than they actually are with minimization being the reduction of possible solutions to make them negligible. Cognitive bias leads to logical errors where the exposed entity personalizes negative events. He or she sees everything in black and white.
In a nutshell, the cognitive approach to studying depression focuses on the beliefs of people as opposed to their behavior. Depression in and of itself comes about as a result of systematic negative biases individuals develop in their thought processes. Behavioral, emotional, and physical symptoms come about from cognitive abnormalities. This is a direct connotation that persons who are faced with depression; and PTSD in its elevated form, have different thought processes in comparison with people that are clinically normal. It is also worth mentioning that the cognitive approach makes an assumption that alterations in thought processes usually precede or come before the beginning of a depressed mood in a patient.
Etiology of Depression; a Cognitive Approach
Symptoms of depression come about when the attributions for events in the surroundings of an individual are founded upon attitudes and belief systems that are maladaptive. The cognitive model of depression has brought about sufficient scientific proof to base its hypothesis that maladaptive cognitions (thoughts and feelings) come before and bring about disorders relating to depression. Beck for instance, found compelling evidence that shifts or deviations from realistic and logical thinking is always present at every depression level be it mild, neurotic, or severe psychotic. However, the etiology of depression has not been well understood. There are factors such as dysfunctional cognitions (as mentioned), demographics, prior major depression and early negative schemas. From the highlighted contributing factors, it can be connoted that the Beck’s cognitive model can best be attributed to explaining depression and thus, widely used (Giosan, Muresan, & Moldovan, 2014).
Some characteristic themes are usually present in the ideation of depressed individuals that differ considerably from that of individuals devoid of any manner of depression. These themes have to do with low-self-evaluation; exaggeration of challenges, problems, and difficulties; notions of deprivation; criticism of the self; self-commands, and the wish to run away or die are at most times present in any one individual that is depressed.
The cognitive model of depression makes an assumption that revolves around three basic schools of thought a) the cognitive triad-negative perception of the self, the world, and the near future, b) schemas or patterns of maladaptive beliefs and patterns, and c) cognitive errors-faulty thought processes that are paired with negative and often times unreal depiction of reality (Beck et al., 1979; Beck 1967). The role that is played by cognitive processes in behavioral patterns and emotion is a critical factor in the determination of how any one individual will interpret, perceive, and attach specified meanings to occurrences in the external environment. With respect to the cognitive model, psychological distress is resultant from several factors, inclusive of an individual’s learning history, genetic composition, and social influences. The predispositions characteristic to a person will also depend on their nature, perceptions and personality since such is given shape by schemas, assumptions that are developmentally acquired, and cognitive structure.
Assessment
Assessment includes the utilization of self-report evaluations and structured clinical interviews for DSM-IV that can be administered during the treatment process among other assessment tools.The following can be denoted as some of the assessment tools (Giosan, Muresan, & Moldovan, 2014).
The structured clinical interview for DSM-IV can be connoted to be the most broadly used diagnosis exam that is utilized to establish DSM-IV Axis one disorders. It is fashioned to be adjudicated by a mental health professional and consists of an overview, temperament episodes, and anxiety disorder modules. The overview is attributed to the collection of socio-demographic data such as drug usage and psychological treatment history.
The Beck Depression Inventory-II (BDI-II) can be stated to be one of the most widely utilized self-report measures of identifying depression symptoms. The assessment includes 21 items where the individual is referring to various psychological and physical symptoms such as feeling sad, guilty or hopeless.
The Expectancies of the therapeutic outcome are evaluated utilizing for items on the Likert scale. The scores of the scale range from 0-32 and quantify the efficiency of the treatment in reduction of the symptoms accrued to the disorder.
The Automatic thoughts questionnaire is a self-evaluation report that is used to analyze depression-related thoughts, with validity and test-retest reliability.
Diagnosis
The diagnosis of an individual or a person suffering from depression is a difficult endeavor. Currently, the doctor or physician has to distinguish between the different mood disorders such as major depression, dysthymia or some other variant type or kind of disorder (Corey, 2013). The diagnosis of depression cannot be conducted through the use of laboratory testing and thus, to diagnose depression, the physician must observe or hear about some specific symptoms of depression. This may be through the use of standard queries directed at revealing the patient’s health status. The manifestation of depression can occur in a myriad of ways which continues to make its diagnosis a bit difficult.
The doctor can utilize some of the assessment tools mentioned to diagnose depression. It can include a full diagnostic evaluation that discusses the socio-demography and determining whether one has had a history of mental illness. The diagnosis may include detecting some of the following symptoms: –
- Sadness
- Loss of motivation and enjoyment
- A lack of sleep/insomnia
- The recurrence of thoughts and feelings of hopelessness
- Loss of concentration and fatigue almost on a daily basis
Treatment Prognosis; Expected Outcomes
Cognitive behavioral treatment (CBT) is a compelling treatment for depression. Scott denotes that there is substantial empirical evidence for the utilization of cognitive therapy in the treatment of minor to moderately severe major depression (Scott, 2001). At the heart of CBT is a presumption that an entity’s state of mind is expressly identified with his or her patterns of thought. Contrary, illogical reasoning influences an individual’s temperament, conduct, and even the physical state. The objective of cognitive behavioral therapy is to help an entity figure out how to perceive negative patterns of thought, assess their validity, and supplant them with more advantageous or positive approaches to thinking (Wills &Sanders, 2013).
Therapists who hone CBT intend to help their patients change their patterns of conduct that originate from cognitive biases. Negative contemplations and conduct incline a person to depression and make it almost impossible to escape its perpetual progressions. At the point when patterns of thought and behavior are modified, according to theresearcher, so is the temperament. However, CBT for depression can be connoted to be a broad category that can include a multiplicity of different treatment approaches.
Treatment protocol:
- CBT depends on two particular undertakings: psychological rebuilding, in which the therapist and patient cooperate to change thinking designs, and behavioral initiation – in which patients figure out how to defeat obstructions to taking an interest in agreeable exercises. CBT concentrates on the immediate present: what and how a man thinks more than why a person feels that way (Bennett-Levy, 2003).
- CBT concentrates on particular issues. In individual or group sessions, problem thinking and behaviors are identified, prioritized, and tended to.
- Patients working with their therapists are approached to characterize objectives for every session and also longer-term objectives. Longer-term objectives may take a few weeks or months to accomplish.
CBT can be connoted to be one of the most effective treatments as regards mild to moderately severe acute depression (Westbrook, Kennerley & Kirk,2011). However, as other therapeutic or pharmacological interventions, it can be suggested to have its own limitations. One of the limitations is that the therapist only exists as a personal trainer and it can be a challenge to concentrate and feel motivated when an individual is depressed. A study conducted through randomized clinical trials showed that there was a positive outcome or result with cognitive therapy as regards relapse prevention as compared to the use of medication (Mascella, 2013). Cognitive treatment is a cooperative ‘hypothesis testing’ approach that utilizes guided disclosure to distinguish and re-assess distorted perceptions and dysfunctional convictions (Scott, 2001).
Be that as it may, the normal misguided judgment that CT basically utilizes a fixed set of behavioral and cognitive techniques is disheartening (Segal, Williams & Teasdale, 2001). The treatment is not just procedure driven. The interventions are chosen on the premise of a psychological conceptualization that interestingly recognizes the possible core negative convictions of that individual and clarifies the onset and support of their depression.
Therefore, it is plausible to denote that CBT is an effective treatment plan for individuals suffering from depression (Bados, Balaguer, & Saldana, 2007). It is focused on particular triggers and problems that can be attributed to activate depression for every case. Depression and anxiety are unpleasant disorders and can lead to detrimental consequences such as committing suicide and reducing the productivity of an individual. Beck’s cognitive therapy for depression has been highlighted to be well-established treatment by the American Psychological Association’s Taskforce on promotion and Dissemination of Psychological procedures (Scott, 2001). Also, a myriad of meta-analysesstudies has shown the effectiveness of CBT for depression. The utilization of cognitive therapy techniques is beneficial in augmenting a person’s perceived fitness and can in turn result in more positive outcomes.
References
Bados, A., Balaguer, G., & Saldana, C. (2007). Outcome of cognitive-behavioral therapy in training practice with anxiety disorder patients. British Journal of Clinical Psychology, 46(4), 429-435.
Bennett-Levy, J. (2003). Mechanisms of Change in Cognitive Therapy: The Case Of Automatic Thought Records And Behavioral Experiments Behavioral And Cognitive Psychotherapy, 31(3), 261-277.
Corey, G. (2013). Theory and practice of counseling and psychotherapy. Australia: Cengage Learning.
Giosan, C., Muresan, V., & Moldovan, R. (2014). Cognitive evolutionary therapy for depression: A case study. Clinical case reports, 228-236.
Mascella, V. (2013). Depression: causes and treatment. Estudos de Psicologia (Campinas), 1-5.
Scott, J. (2001). Cognitive therapy for depression. Oxford Journals, 101-113.
Segal, Z., Williams, J., & Teasdale, J. (2001). Mindfulness-Based Cognitive Therapy for Depression: A New Approach for Preventive Relapse. New York: Guilford Press.
Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behavior therapy. Los Angeles: SAGE.
Wills, F., Sanders, D. (2013). Cognitive behavior therapy. Los Angeles: SAGE.