ERQ Sample 3

Major depressive disorder (MDD) is a diagnosis that is commonly done to people who have been showing depressive thoughts such as suicide and moods for at least a duration of 2 weeks. MDD can be recognised also when the disorder interferes with the normal life activities of the person. These negative feelings of worthlessness and loss of interest in activities are usually accompanied by irregular sleeping and eating patterns. These are all symptoms that are examples of the ABC’S (Affective, Behavioural, Cognitive, and Somatic symptoms). As there are many cognitive aspects of this disorder, there are also theories that try to explain these negative symptoms (ABC’S). Affective symptoms such as feelings of sadness, Behavioural symptoms such as passiveness, Cognitive symptoms such as general negative views, Somatic symptoms such as irregular sleeping patterns). However, the most supported theory of cognitive factors, such as one's reasoning, beliefs and thoughts, that outlines the causes of depression is that of Beck’s theory. Beck argued that people have what is called ‘automatic thoughts’, which are negative schemas about oneself, like worthlessness and loss. Therefore, Beck suggested that there is a causal relationship between automatic thoughts and depression. There are three components to Beck’s theory. ‘The Cognitive Triad’, where one may have negative thoughts of the world, negative thoughts of himself and/or negative thoughts of the future. The second component of Beck’s theory is having a negative schema that may have been triggered by a childhood traumatic experience. The last element of Beck’s theory implies that one has cognitive biases, in other words, negative beliefs that lead to ‘Faulty thinking’ like exaggeration and personalisation. The concept that depressive behaviour is linked to faulty thinking is backed up by research.

Alloy et al, for example, wanted to show how negative cognitive patterns influence the trigger of depression. They carried out a longitudinal study, with the participants being healthy American college students, who were split into two groups based on whether they had a high risk of negative cognitive biases (high-risk group) or low risk of negative cognitive biases (low-risk group). This was done with the help of questionnaires. This was also a prospective study as they were tested at the beginning of the study and then were followed for 6 years after that, through self-report questionnaires and interviews. Findings showed that 17% of people in the ‘high risk’ group had developed MDD in contrast to the ‘low risk’ group, where only 1% of people had developed depression. A strength to this study is the fact that it was a prospective study, meaning that participants were observed in the beginning as well, which is crucial, as there is something to compare the findings of the end of the study with. Another strength is the use of several data collecting methods, both interviews and self-reported questionnaires, in order to get a deeper understanding of each participant. Although the study backs up Beck’s theory of faulty thinking, it does have limitations. Several data collecting techniques were used, however, one can not entirely rely on self-reported data as the data may be inaccurate due to social desirability effect. There is also the limitation of Treatment Aetiology Fallacy, which is a fallacy that explains that just because the treatment was successful does not mean that the cause of the disorder was identified.

A study that shows that people with MDD are likely to show negative attention biases is that carried out by Caseras et al. They carried out a study where participants were shown a series of pictures in pairs, with one being a ‘negative’ picture and the other being either ‘positive’ or ‘neutral’. These pictures were shown for 3 seconds only, whilst researchers observed the participants using eye-tracking technology. Researchers were looking for biases in initial orienting, in other words, which picture did the participants first gravitate towards. Secondly, researchers were looking for how long the participants looked at the pictures, in other words, the maintenance of attention. When analysing the data, Alloy et al decided to split the participants based on their findings into two groups - participants who showed depressive symptoms and participants who did not show depressive symptoms. Findings were that participants in the ‘showed depressive symptoms group’ showed a pattern of negative cognitive bias, as they gazed longer at the negative pictures (maintenance of attention) than the positive and neutral ones. However, there were no significant biases that were found in the initial orienting of the participants. Though there were no findings in the initial orienting of participants, there was a pattern that was found in the maintenance of attention. This is supported by Beck’s theory, as people with more negative thoughts are drawn to observing and thinking about the negative views of the world. However, that’s also a limitation, as the study does not show that participants were depressed. In order for a person to be depressed, one has to be in that state of mind for at least 2 weeks in order for it to be considered depression. Three seconds is not enough to label or diagnose the participants as depressed.

To conclude, it is not possible to entirely agree with the statement that automatic thinking leads to depression, as we do not know whether negative thinking is the reason for depression or if depression leads to negative thinking. Since I was looking at cognitive based studies, it is still hard to carry out a study that eliminates all biological and sociocultural factors. However, Beck’s cognitive theory is applicable and has been used to help us understand to some degree the difference of thinking between depressed and non-depressed people. Beck’s theory of self-schemas has been applied to better understand depression as well. A strength of cognitive studies is that MDD is testable especially through longitudinal and prospective studies where people are observed for a long period of time. Method triangulation, which shows various ways of getting similar results is also a reliable data collecting technique. Alloy et al and Caseras et al both are either longitudinal or use multiple data collecting ways to get a result which support Beck’s theory.

1022 words