PSYC 412 Lecture Notes - Lecture 8: Cognitive Therapy, Cognitive Restructuring, Sukha
14 May 2018
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PSYC 412: Developmental Psychopathology
Mar 14th 2018
Lecture 18: Depression II
Models of etiology & maintenance
• Interpersonal aspects of depression
• Rose (2003)
o Co-rumination: rumination that happens between two people
▪ A paradox: Rose shows that engaging in co-rumination is associated w/
increase in relationship quality but also w/ increase in anxious/depressive
symptoms
o Are some components of co-rumination more problematic than others?
o Using observational task: had 2 adolescent friends come to lab, each identifies
pole thee haig i thei life ot ith the othe peso
▪ Go into lab, talk about problems they identified, make sure you discuss
eah pesos pole. If ou fiish, talk aout soethig else o do
puzzle.
▪ Based on those interactions you can code different types of behaviors the
friends engage in
▪ Findings: dwelling on negative affect specifically was associated w/
depressive and anxious symptoms and was not associated with
friendship quality
▪ In contrast, talking repeatedly about the problem but not focusing on
how bad you feel was associated with friendship quality and closeness
but not depressive or anxious symptoms (no focus on negative affect)
• Reassurance seeking
o Children want others to demonstrate that they care about them
o “oeties ou ask people, like do I look good i this? o do ou like e?
▪ Fieds ad pates usuall epl i affiatie es
▪ But people dot thik the ea it, seek oe eassuae, ad oe
time this becomes incredibly annoying and is extremely invalidating:
punishing the person for engaging in the behavior you want
o Eventually the person will get rejected because of this behavior
▪ We see this in adolescence
o Excessive reassurance seeking is associated with unstable friendships
▪ Also predicts lower-quality friendships as perceived by the friend
▪ The friend of the person engaging in it perceives relationship to be one of
lower quality
• Contagion
o Contagion of depression and attributional styles
o Depessio of est fieds pedits adolesets depession over time
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▪ Having a best friend who is depressed is associated with an increase in
your depressive symptoms over time
o Depressive attributional style of best friends predicts adolescents own
depressive attributional style over time
▪ If the friend tends to make attributions that are stable, very negative,
other friend shows increase in that type over time
o Co-rumination may mediate this
▪ Depression predicts co-rumination which in turn predicts change in
fieds depessio
▪ Someone who has elevated levels of depression engages in more co-
ruminating behaviors with friend and that in turn predicts increase in
fieds depessie ehaios
• Summary:
o There is a biological predisposition toward depression
▪ We ko its heitale, iggest isk fato is haig paet who is/was
depressed
o We think this biological prediction will interact with stressful life events
▪ Diathesis-stress model
o We know there are
▪ A) cognitive patterns associated with depression
▪ B) behavioral problems associated with depression
▪ A) and B) may combine to increase negative experiences, which may
increase depression
Childhood Depression III: Treatment
• CBT model of depression
o CBT works fundamentally with underlying diathesis-stress model
▪ Personal diatheses interact w/ stressful life events to disrupt normal
mood
▪ Then the depression is maintained by negative cognitive & behavioral
processes
o CBT is to target those cognitive/behavioral patterns
• Cognitive processes to target
o Depressogenic thinking: attributional biases that lead to depression
• Behavior processes to target
o Behaviors that may be contributing to negative events, activating the person
o Low reinforcement and negative life events
o Skill deficits: does the person have the skills that they need to develop and
maintain good friendships?
▪ Adolescent or child depressed may have missed out on normative
developmental experiences that other people might have had (e.g. they
may never have dated)
• Depression may begin or deepen as part of a downward emotional spiral
o Something feels bad, and because it feels bad you change your behaviors.
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o Mood geos back down, you have negative thoughts, and that may change your
behavior again – e.g. if ou thik ood likes ou oull stop allig ou fieds
and that will lower your mood as well
o Mood can go down in this negative spiral but we can send it up through the
same type of pattern
▪ A positive event can start a chain of pleasant feeling events and
thoughts
▪ A oo istake is takig too ig of a step, like lets get out of ed s.
lets go to po
▪ Once you get person to get out of bed, think about having them get
dressed, then maybe go to coffee shop for an hour. This can send your
mood up.
• Cognitive techniques in CBT
o Goal is to help youth learn how to
▪ Observe their thoughts, feelings, behaviors
• make the thoughts oue haig saliet to ou so e a hage
them, track how your activities and mood go together
▪ Consider alternative explanations
• Ofte depessed peoples eplaatios fo eets ae iedil
negative and tend to be stable negative attributions
• Is there another explanation for that? Can we find another way to
think about that?
▪ Solve problems and make rational decisions
• There are challenges that come up in life, how can we make good
decisions about managing them?
o Therapy as observation and experiment
▪ Lets see hat happes if e do this, o do that. Mae this ill ake
ou feel ette, lets test it ad see.
▪ Assess the accuracy and affective consequences of their thinking
▪ try correcting your thoughts and see what happens
o Match developmental level
▪ Caeful aout this he oue okig ith kids/adolesets
• Youge kids aet as ogitiel deeloped as adolesets ad
at hadle sae leel ogitie theap that oug
adults/adolescents can
▪ With younger kids use lots of concrete examples, cartoons, target
behaviors
▪ Example of an exercise from a CBT workbook: cognitive restructuring
• Can we identify negative thoughts that are probably associated
with depressed mood, and can we think about what those
thoughts might be?
• Garfield cartoon: the activating event is realizing he left the TV on
all night
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