Depression Theories - notes PDF

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Psychodynamic theories Z Object Loss Theory (Ronald Fairbairn, D. W. Winnicott, Harry Guntrip; Gilbert, 2006) X This theory assumes that early psychological developmental issues lay the foundation for depressive responses in later life; that the accomplishment of the first stage of development in which the child is able to form relationships is normal; and that, during second stage of development, the child experiences traumatic separation from significant objects of attachment (usually a maternal object). X Loss may be related to maternal death, illness, or emotional lack of availability and is unexpected and overwhelming. X Depth of loss produces constellation of responses dominated by separation anxiety, grief, mourning, and despair. X This critical object loss event predisposes the child to respond in similar ways to any future losses or significant separation. Z Aggression-Turned-Inward Theory (Sigmund Freud) X This theory assumes that early psychological developmental issues lay the foundation for depressive responses in later life; that the accomplishment of the first stage of development in which the child is able to form DEPRESSIVE DISORDERS AND BIPOLAR DISORDERS 141 relationships is normal; and that, during second stage of development, the child experiences the loss of the significant mothering person. X The loss can be a real or imagined and is unexpected and overwhelming. X The loss may be related to maternal death, illness, or emotional lack of availability or to the birth of a new sibling and the child’s perception of losing undivided, individualized attention from the mother. The child’s initial reaction is anger; however, the child feels unsafe to express this anger openly and directly. This may relate to the child’s fearing further loss if he or she responds with anger or his or her subjective perception that anger is unacceptable. X The child uses defense mechanisms to deal with conflict created by desire for the love object but co-occurring with anger for the love object. X Instead of anger being expressed outward at the maternal figure, it turns inward because it is more acceptable and safer to be angry at oneself than at the mother. X Anger at oneself is rationalized as the child assumes that loss of the mother was related to something bad that he or she did rather than to the caregiver’s actions. X Excessive guilt becomes a manifestation of the process of dealing with aggression experienced with the loss of the mother’s attention. X A similar emotional reaction (such as low self-esteem, excessive guilt, inability to cope with anger, self-destructive impulses) occurs as an adult whenever a loss is experienced. Z Cognitive Theory (Aaron Beck, 1979) X This theory represents a cognitive diathesis–stress model in which developmental experiences sensitize a person to respond to stressful life events in a depressed manner. Cog diathesis-stress model: Behavior as both a result of biological and genetic factors (nature), and life experiences (nurture) X Cognitive theory assumes that people with a tendency to be depressed think about the world

differently than nondepressed people and that depressed people are more negative and believe that bad things are going to happen to them because of their own personal shortcomings and inadequacies. X This thinking promotes low self-esteem and beliefs that the person deserves to have bad things happen to him or her and promotes pessimistic perceptions about the world at large and about his or her future, as well as globalizes the negativity to all events, situations, and people in his or her life. X When confronted by stressful events, these people tend to appraise them and the potential consequences in a negative, hopeless manner and therefore are more depressed than people with different cognitive styles. Z Learned Helplessness-Hopelessness Theory (Martin Seligman) X This theory is a modified aspect of cognitive theory, which assumes that a person becomes depressed due to perceptions of lack of control over PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER REVIEW AND RESOURCE MANUAL, 142 4TH EDITION life events and experiences. These perceptions are learned over time, especially as the person perceives others seeing him or her as inadequate. X Perceptions of lack of control lead to the person not adapting or coping. X The person’s behavior becomes passive and nonreactive because of self- perceptions of personal characteristics of being helpless, hopeless, and powerless....