IB Docs (2) Team
MDD: Cognitive explanations
Cognitive etiologies of Major Depressive Disorder
The cognitive approach argues that cognitive processes play a role in our mental health. Cognitive psychologists argue that negative schema and patterns of rumination lead to feelings of helplessness and sadness that are typical of depressive patients.
Before completing the module below, please read the section of the textbook called the Cognitive approach to depression. When reading this section, please make note of the following important concepts:
- Beck's Patterns of Faulty Thinking
- Bidirectional ambiguity
- The Cognitive Triad
- Maladaptive schema
- Response Styles Theory: Rumination
Thinking about theory
Start by watching the following video. This video will review a lot of what you read in the textbook for this topic.
Then read through the following presentation on cognitive theories. There are two key cognitive theories that you should be able to explain:
- Beck's theory of the cognitive triad, irrational patterns of thinking, and negative schemas
- Nolen-Hoeksema's Response Style Theory which is based on the idea that rumination is a necessary condition for depression.
Checking for understanding
Which term would a cognitive psychologist use to describe each of the following scenarios?
1. Everyone thinks that Jeri should try out for the school play. She says that there is no reason to. Although she would love to do it, she knows that she will not get chosen for the play because she can't act.
Ineptness schema. This schema leads one to think that they "can't" - in other words, a sense that failure is guaranteed. It leads to social withdrawal or lack of risk-taking with the goal of avoiding failure.
2. Mark spent over a month working on a ceramic coffee mug with a Prague snow scene on it. When his math teacher sees it, he compliments him on his work. Mark's response is that it was really easy and that it shows that he is still a beginner.
Minimization. In spite of the compliment, Mark sees his work as not of good quality and may even feel that the teacher was patronizing him.
3. Eric was walking to school this morning when a small boy ran right in front of him. The result was that both fell to the ground and had minor injuries. Eric has been anxious all day. He believes that he should have been more careful and that the parents will find him and "go after him." He wishes that he could redo his walk to school this morning.
Self-blame schema. A cognitive schema in which an individual attributes the occurrence of a negative event to oneself, even though there is no reason to do so. The direction of blame often has implications for individuals' emotions and behaviors during and following stressful situations.
4. Elizabeth goes for the first day of her new job. She has a meeting at 10:00 am which starts off with everyone talking about a movie that they had all seen over the weekend. She had not seen the movie so stayed silent. At the end of the meeting, she goes back to her new office. She feels that she should quit because she had shown the others that she was completely incompetent in the morning meeting.
Arbitrary inference. Elizabeth is drawing a conclusion with no relevant evidence. She is not thinking about how she performed in the meeting, but rather how she failed to engage in small-talk at the beginning of the meeting.
5. The HL Economics teacher is unhappy with the quality of the IA rough drafts. She reprimands the class for not putting in enough effort and for not following the guidelines that they were given. Anna had only positive feedback, but after class, she feels guilty and decides that it may be best for her to redo the draft.
Personalization. This is Anna's inability to differentiate between feedback that is meant for those in the class that are not doing good work - and her own performance. She internalizes the feedback from the teacher and feels that she has failed, even though she has positive feedback.
6. William applied early to a top university to study psychology. The university deferred his admission, telling him that although he did not make the early acceptance cut, he would be considered for normal admissions. He is devastated and decides not only to withdraw his application but does not apply to any university.
Overgeneralization. William takes a single situation and generalizes it to all potential offers for university.
Thinking about research
Please read the following two summaries of research that is linked to the cognitive explanation of depression. Then answer and submit the short-answer questions below.
Study 1. Alloy et al (1999)
Alloy et al (1999) used a sample of non-depressed college freshmen with no other diagnosed disorders. Half of the sample had a history of clinical depression; the other half did not. The students with a history of clinical depression demonstrated no symptoms at the beginning of the study.
To begin, the students were given a test to measure their cognitive style. The students were identified as either High Risk (HR) or Low Risk (LR) for depression based on their thinking patterns. The researchers carried out follow-up assessments every 6 weeks for 2.5 years and then every 4 months for an additional three years. The study was based on a combination of questionnaires and structured interviews to identify stressful life events, cognitive style and symptoms of depression.
The results found that in the group with no prior history of depression, 17% of the HR students developed Major Depressive disorder, compared to only 1% of the LR students. In addition, 29% of the HR group showed symptoms of minor depression, compared to only 6% of the LR group.
Among the group with a past history of depression, 27% of the HR group relapsed, whereas only 6% of the LR group did. In addition, 50% of the HR group showed symptoms associated with depression, compared to 26.5% of the LR group.
It appears that a negative cognitive style plays a role in both onset and relapse.
Study 2. Farb et al (2011)
Farb et al (2011) showed 16 formerly depressed patients sad and neutral movie clips and tracked their brain activity using functional magnetic resonance imaging [fMRI]. They compared this to 16 healthy controls. The researchers calculated correlations between emotional reactivity (neural responses to sad vs. neutral film) in patients and subsequent relapse status over an 18 month follow-up period. The prediction was that activity in the medial prefrontal cortex predicted relapse. The prefrontal cortex is the region of the brain that is most active when people ruminate.
The results supported the hypothesis: 10 of the 16 patients relapsed into depression during the 18-month follow-up period. Faced with sadness in the movie clips, the relapsing patients had shown more activity in the prefrontal cortex. These responses were also linked to higher levels of self-reported rumination. On the other hand, the healthy participants showed activity in the visual cortex.
1. Choose one of the two studies and comment on its internal validity.
2. Choose one of the two studies and comment on its ecological validity.
3. Choose one of the two studies and comment on its construct validity.
4. Choose one of the two studies and identify the research method that was used. What is one strength and one limitation of that method?
5. Which of the two studies do you think is better evidence of the role of cognitive factors in Major Depressive Disorder? Justify your position.
Exam tip
Remember that one of the important parts of the ERQ assessment is showing understanding of theory - as well as research. When explaining Beck's theory of Major Depressive Disorder, it is quite complex. Here are some important tips:
- You do not have to give an in-depth explanation of schema theory; simply describe what is meant by "maladaptive schema."
- There are at least six different types of faulty thinking that are described by Beck. You should not list and describe all of them. Simply using one as an example is more than enough to demonstrate knowledge and understanding.
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