Studieboek - Depression
28 important questions on Studieboek - Depression
What are several presentations of depressive disorders as mentioned in the book? (4)
2. Disruptive mood disorder
3. Pre-menstrual dysphoric disorder
4. Dysthymia
What are common symptoms of factors underlying all depressive disorders? (8)
2. Changes in weight and appetite
3. Changes to sleep patterns
4. Being agitated or slowed up
5. Loss of energy
6. Feeling worthless or guilty
7. Poor concentration and decision making
8. Suicidal thoughts and images
In what way do depressive cognitions present themselves in the form of images? (3)
2. Particularly intense negative imagery of the future that reflects suicidal ideation (flashforwards) that are associated with an elevated risk of suicide
3. Fewer positive images experienced
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What (process) biases or prone to depression? (3)
2. Confirmation bias
3. Memory bias
How are primary symptoms of depression often exacerbated?
What are the maintenance cycles that form feedback loops that form a diagnosis-specific vicious flower? (6)
2. Rumination/self-attack
3. Withdrawal/avoidance
4. Unhelpful behavior(s)
5. Mood/emotion
6. Motivation/physical symptoms
What do the goals of CBT for depression usually include? (4)
2. Helping clients counteract negative cognitive biases and develop a more balanced view of themselves, the world, and the future
3. Restoring activity levels, especially those that bring a sense of pleasure/achievement
4. Increasing active engagement and problem-solving
What is the general course of treatment for depression? (5)
2. Introduce the cognitive model and how it may apply to this client
3. Begin to work on reducing the symptoms using behavioral or cognitive strategies and introduce relapse training as soon as possible
4. Identify and test problematic cognitions through records, discussion, and BEs
5. Identify and modify unhelpful UAs and/or core beliefs as necessary
What are the components of CBT for depression? (4)
2. Early-stage cognitive strategies (distraction and counting thoughts)
3. Main cognitive behavioral work of monitoring and testing ATs
4. Relapse management, including working with DAs and/or core beliefs, and revising earlier strategies
On what idea is activity scheduling based?
For what aims is the Weekly Activity Schedule (WAS) used for self-monitoring?
How can the WAS be used as a planning tool to improve mood? (3)
2. Focus specifically on doing more of the things that give some sense of pleasure, purposefulness, and achievement
3. Doing BEs to test out negative cognitions about activity
What is a graded task assignment and how is it used?
What is the evidence on exercise as a treatment element in depression?
What do the NICE guidelines state regarding exercise?
What are the recommendations as to how the problem of lack of pleasure in activity scheduling can be tackled? (2)
2. Convey the idea of pleasure as a continuum
What are possible problems with graded task assignments? (2)
2. Too little (BEs can help assess a client's capabilities)
What are the phases in cognitive work in classic CBT? (2)
2. Tackle unhelpful cognitions more directly (aim to consider carefully and find alternative perspectives if appropriate)
What strategies work in the first phase of cognitive work (to help the client get some symptom relief)?
What are the goals of early-stage cognitive strategies? (2)
2. Allows the client to get some distance from NATs and negative images
What are the considerations to give medication as a treatment for depression? (3)
2. Less concern about dependence and withdrawals than for anxiolytic
3. No conflict between pharmaceutical treatment and psychological therapy
What are important notions about dealing with suicidality? (2)
2. Any sign of suicidal ideation should be responded to, even if this means breaking confidentiality (make this clear to the client)
What are the important risk factors for suicide? (7)
2. A history of suicide attempts, or a family history of suicide
3. Medical seriousness of any previous attempts
4. Severe hopelessness
5. Attraction to death
6. Recent losses or separations
7. Misuse of alcohol
What is an important aim when exploring and working with reasons for suicide?
What are important aspects to include in a conversation in which suicide is being discussed? (6)
2. The reason for suicide (escape unbearable or to solve an external problem)
3. Building up with the client reasons for living vs. reasons for dying (including past reasons for living)
4. Exploring beliefs leading to hopelessness and using guided discovery to elicit information that may be inconsistent with those beliefs
5. Working on a problem area that has a high probability of being resolved fairly quickly to decrease hopelessness
6. Using problem solving for 'real-life' problems
Why can teaching structured problem-solving be effective for depressed patients?
What are the main steps in structured problem-solving? (8)
2. Brainstorm on possible solutions
3. Work out which (combination of) solutions is the best
4. Weigh up solutions
5. Pick the solution that offers the most favorable balance
6. Use the principle of small steps once a solution has been identified
7. Put the first step into action and review how it went
8. Continue this process until the problem is solved or there are no possible solutions
What are the potential problems when working with depressed clients? (5)
2. Hopelessness and 'yes, buts' (remain realistically optimistic and understand that it's part of the syndrome. Also, 'yes, buts' can reflect extremely fixed beliefs: schema-focus)
3. Slow pace (adapt and monitor the process with BDI to pick up small but steady changes)
4. Feedback in sessions (encourage because of possible misinterpretation due to negative bias)
5. Relapse (relapse management and offer continuation therapy due to relapse of 50% within two years)
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