DEPRESSION

Case Formulation for Depression

Case Formulation for Depression

Introduction

The cognitive model of depression is the result of systematic clinical observations and experimental studies (Beck, 1963, 1964, 1967). It is the combination of clinical and experimental approaches made possible the construction of this theoretical model and the formulation of the principles of cognitive therapy.

The Concept of Cognitive Triad

Cognitive triad consists of three major cognitive patterns that determine the patient's idiosyncratic relationship to itself, its own future and their current experience. The first component of the triad associated with a negative attitude to the patient's particular person. The patient feels flawed, inadequate, terminally ill or deprived. His failures, inclined to explain his alleged cognitive, moral or physical defects. The patient convinced that these, imaginary flaws made it worthless, useless creature; he constantly blames and berates himself for them. Finally, he believes he gets deprived of all that brings people happiness and contentment (Miller, 1997, 256-289).

The second component of the cognitive triad is a tendency to negative interpretations of their current experience. The patient seems that the world presents to him extortionate demands, and / or repairs to him insurmountable obstacles to achieving goals in life. In any experience interaction with the environment, he saw only destruction and loss. Bias and inaccuracy of these interpretations is particularly evident when the patient negatively interprets the situation when there is more plausible alternative explanation. If you convince him to reflect on these more conclusive explanation, he might recognize that biased in assessing the situation. Thus, the patient can be brought to the realization that he distorts the facts by fitting them under preformed negative inferences (Brodzinsky, 1990, 98-120).

The third component of the triad associated with negative attitudes towards their own future. Paying towards the future, depressive sees there only an endless series of ordeals and suffering. He believes that destined to the end endure difficulties, disappointments and hardships. Thinking about things that he needs to do in the near future, he expects to fail (Miller, 1997, 256-289).

All other symptoms occurring in depressive symptoms discussed in the cognitive model as a consequence of activation above the negative patterns. For example, if a patient mistakenly believes that he rejected people, his emotional reaction will be just as negative (sadness, anger), as in the case of outright rejection. If he mistakenly believes himself an outcast, he will feel lonely.

Violations of motivation (eg, lack of will, lack of desire) can be explained by the distortion of cognitive processes. Pessimism and hopelessness paralyze the will. If a person always set to kill, if he always expects a negative result, why would he set himself some goals or take on some things? At their extremes, avoiding problems and situations that seem insurmountable and intolerable, takes the form of suicidal wishes. Depressed patient often sees itself as a burden on others and this basis concluded that everything, including himself, would be better if he dies (Post, 2000, 361-372).

Finally, the cognitive model can also explain the physical symptoms of ...