"It is proposed that a large proportion of episodes of depression result, at least in part, from the interaction between individuals cognitive vulnerability and the social context in which he or she lives" (Champion & Power, 1995, p.485).

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Kathryn Smith

20089003

PSY3004

Clinical Psychology

"It is proposed that a large proportion of episodes of depression result, at least in part, from the interaction between individuals cognitive vulnerability and the social context in which he or she lives" (Champion & Power, 1995, p.485).

Critically evaluate this claim about the origins of depressive episodes.

Depression is defined as a 'wide spectrum of changes in mood and affective state, ranging from severity from the normal mood fluctuations of everyday life, sometimes called sadness or despondency, to severe psychotic episodes.' (Nicholi, 1998, p.309). Depression results in the inability to take interest in anything as well as being able to perform even the most ordinary tasks. Depressed individuals often feel guilty as well as no self-worth and often think of committing suicide. Clear thinking is diminished and anxiety, lack of energy and enthusiasm is taken over. It is to be believed that one in five become clinically depressed at some stage in their lives (Kessler et al. 1994). Depression has long been an area of key interest for scientific analysis, due to its costs to society. Furthermore, it is a well known epidemiological observation that approximately twice as many women than men become depressed. (Bebbington, 1990; Wiessman & Kierman, 1977). Factors such as menstruation, pregnancy, miscarriage and menopause could be responsible for depression in women, as well as additional responsibilities such as juggling the care of children and employment. It is surprising to know that 330 million people worldwide suffer from depression but only a few will receive treatment. It has been estimated that by the year 2020 major depression will be the world's second most debilitating disease, surpassed only by cardiovascular disease. People who become depressed tend to think about themselves and the world around them differently from people who are not vulnerable to depression (Beck, Rush, Shaw & Emery, 1976).

Beck (1967) discusses what he calls the vulnerability of the depression-prone person as:

‘Attributable to the constellation of enduring negative attitudes about himself, about the world, and about his future.’ He goes onto suggest that the depressive-prone person has become sensitised in childhood and adolescence to certain types of life-situation. These are responsible for establishing the original negative attitudes and are the prototypes of specific stresses, which may later activate these constellations and lead to depression. He indicated that the incidents that set off the feelings and in turn depression are usually quite minor. Beliefs, attitudes and thought processes make them vulnerable to depression.

Since the cognitive revolution of the 1960’s cognitive theories of depression has been dominant, theorists such as Beck (1976), Abramson (1978) and Teasedale (1988) have devised cognitive approaches to examine the origins of depression. In very general terms, cognitive approaches draw support from two major lines of evidence. The first is that clinical depression is associated with increased dysfunctional thinking (APA, 1994). That is, in addition to sadness and/or anhedonia, clinical depression often is associated with negative thoughts about the self, the world, and the future (Beck et al., 1979). Beck’s cognitive theory of depression (Beck, 1967) proposes that individuals who are vulnerable to depression have dysfunctional attitudes which, when activated by stressful life events, cause depression. When people are depressed, they typically report more depressogenic cognitions than do people who are not depressed (Haaga, Dyck & Ernst, 1991). The second line of evidence is that this theory has generated an extremely effective psychotherapeutic treatment for depression.  Cognitive therapy (Beck et al., 1979) is an active directive, educational approach in attitudes, and beliefs. Outcome studies have repeatedly shown that cognitive therapy reduces the level of depression substantially faster that would occur without treatment (e.g. Dobson, 1989; Hollen, Shelton, & davis, 1993; Person, 1993; Robinson, Berman & Neimeyer, 1990).

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Johnson-Laird’s (1983, 1988) theory of mental models overcomes many of the limitations of current cognitive theories of depression. This approach lends itself readily to an account of depression that emphasises both the psychological and the social levels of vulnerability. It proposes that the depression-prone individual is likely to have a narrow range of valued goals and roles with few other sources of self worth. The threat to or loss of an overvalued goal or role should lead to depression, because no other sources, of self-worth are available to the individual.

However, in recent years research has been more focused on ...

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