Term Paper on "Cognitive Theory"

Term Paper 6 pages (1824 words) Sources: 1+

[EXCERPT] . . . .

Cognitive Theory

Cognition is the process of acquiring knowledge, which includes aspects such as awareness, perception, reasoning, recognition, judgment and imagination (Lexico Publishing Group, LLC 2006). The philosopher Albert Bandura led efforts in developing a social cognitive theory or SCT in defining, predicting and modifying human behavior individually or as a group (Brown 1999). The theory defines human behavior as a triadic, dynamic and reciprocal interaction of personal factors, behavior and the environment. According to the theory, these three factors uniquely determine an individual's behavior. It strongly emphasizes on the role and power of the mind as an active force, which constructs one's reality, selectively encodes information, performs behavior on the basis of one's values and expectations and imposes structure on its own actions. A person forms his or her own reality by the interaction of the environment and his or her own cognitions. These cognitions change over time through maturation and experience. It is, in turn, through an understanding of the processes involved in the construction of reality, which enables experts to understand, predict and change human behavior. Bandura theory suggests that children and adults operate cognitively on their experiences and that their cognitions influence their behavior and development. A person, for example, develops self-efficacy because of a history of achievement in a particular field, by observing the successes or failures of others, from the encouragement of others or from his own physiological state while performing a certain behavior. School is thus a strong source of self-efficacy in its evaluation of student performance and the encouragement or discouragement among students. Bandura also introduced other important concepts, including reciprocal determinism, self-efficacy and the variation of time lapse between cause and effect. Bandura's work has inspired much research on learning and behavior, especially in promoting behavior change. His Social Cognitive or Learning Theory has recently been the most commonly used in public health in studying various health problems from medical therapy compliance and alcohol abuse to immunizations. It has been of specifically fruitful use in the study of moral and value internalization among children in understanding how they are socialized to accept the standards and values of their society (Brown). Bandura's cognitive behavior theory has been also used in treating behavior disorders, such as depression.

Depression is a syndrome, consisting of temporary feelings of sadness, despair and discouragement, decreased pleasure, hopelessness, guilt and disrupted sleeping and eating patterns (Gale Encyclopedia of Psychology 2001). The American Psychiatric Association estimates that approximately one out of five Americans experiences some depression at least once in his or her lifetime. Depression develops from a combination of physical, psychological and environmental factors, which involve a person's body, mood and thoughts. It is viewed genetic inheritance, hormonal imbalance, and other physiological and psychological factors, especially life events, which include developmental traumas, physical illness, intimacy problems, and losses. Cognitive theorists believe that depressed people develop destructive ways of thinking, such as self-blame, focusing on the negative side of events, and extremely pessimistic conclusions. Depression can also develop out of learned helplessness when people lose control of their situations. It is also more common in women than in men in that the tendency is greater in women to dwell in negative events while men have the greater tendency to distract themselves from such events and experiences through their activities. Those who undergo major depression are often almost completely incapacitated, lose the ability to work, socialize and even care for themselves. The most serious complication of depression is suicide. Statistics show that around 60% of those who commit suicide are depressed and that 15% of those diagnosed with depression eventually commit suicide (Gale Encyclopedia of Psychology).

In cognitive-behavioral therapy or CBT, the therapist is also a diagnostician and educator who use performance-based and cognitive interventions to effect or produce changes in thinking, feeling and behavior (Kendall 1995). The theory views depression as involving cognitive distortions and skill deficits. Depressed children keep a cognitively distorted perception of themselves and arrive at universal, fixed and cognitively distorted internal attributions of negative events. Earlier studies showed that while a depressed sample reported such depressive attributions, these were not reported by children who had overcome depression. Depressed children have low levels of self-esteem and social and academic confidence. They evaluated their own performances severely and which they related to distorted perceptions. CBT involves behavioral training in social skills, activity scheduling, relaxation and home assignments. In comparing the treatment outcomes of depressed children using CBT, relaxation training and a wait list, Reynolds and Coats (1986 as qtd in Kendall) discovered a significant decrease in depressive symptoms as compared to the wait list at post treatment and at a five-week follow-up. In a separate study comparing CBT and traditional counseling, CBT produced greater gains, although the reduction of symptoms and depressive cognitions was not maintained at a significant level at the seventh-month follow-up. Furthermore, few studies have been conducted on depression so that there stands a strong need for randomized trials. Depressed children lack motivation and thus need cognitive restructuring to change their distorted thinking, hopelessness, assumptions and perceptions. Affective education will enable this as it teaches about emotions and how they related to thoughts and behavior (Kendall).

CBT has shown to be beneficial and produced lower relapse rates than standard clinical treatment or management (Kirchner 1999). Subjects with major depression of three or more episodes within the last 2 1/2 years and who responded to certain antidepressants and select serotonin re-uptake inhibitors and whose overall response to drug therapy was improving. They were tested every three months for two years. Findings showed that 25% of the patients receiving DBT had a relapse of major depression as compared to 80% receiving standard clinical management. This was interpreted by Fava and associates (as qtd in Kirscher) that CBT after successful treatment with antidepressants is effective in preventing relapses in patients diagnosed with chronic depression. The finding challenges the position that long-term, high-dose drug treatment is the only way to prevent relapse in such patients. It also suggests that the amelioration of residual symptoms after successful medical therapy may be key to preventing relapse (Kirschner).

The subjects for this study were from psychiatric inpatient and outpatient programs at a general hospital in Calgary, Canada and who suffered from chronic depression (Dobson and Drew 1999).The discourses through which they were placed indicated inadequate ability to resist the negative positioning made by others to ward off their depression. It meant that they acquired a negative self-concept unwillingly and unjustifiably. The finding drew attention to the way people are socially positioned by others. The subject patients attributed the blame to others, such as those who interfered with their childhood and made them what they became; betrayal by others in their lives; their powerlessness or helplessness; and poor social practices. As they blamed these others, they saw themselves as blameless, competent and worthy. They insisted that their negative self-concept was not theirs but was forced upon them by the action of others. On the whole, self-blame was not predominant. It suggests that, in place of teaching them to change their distorted self-perception, the therapy may begin by acknowledging their attempt to resist negative positioning and assist them in re-establishing a positive identity. In so doing, they may be more positively positioned by others. This study, which uses a discursive approach to depression, represents only a bit of what the said approach can eventually contribute when further research is conducted, using samples and analysis of the discourses of depressed persons in other contexts, including interactions with spouses and the discovery of alternate negotiations of reality and identity (Dobson and Drew).

This pilot study on Cognitive Therapy intervention used 15 subjects who were HIV-risk drug users in Baltimore for six sessions (Hawkins 2005). They were taught cognitive therapy techniques in order to identify and challenge negative or irrational thoughts related to their addiction and other environmental stressors. The objective was to increase their self-efficacy of control by identifying their beliefs about drug use, self, environment, and the future. The behavioral technique was to have them schedule weekly non-drug activities and implement them when cravings began to increase. It was derived from the theory that low rates of response-contingent positive reinforcement or deriving pleasure from life and significant antecedents to depression. Its tentative findings suggested that depression therapy could be effective in reducing depressive symptoms in injection drug users and efforts at completing successful HIV-risk-reduction intervention should be continued. Self-report, a low sample size and the lack of a control group limited the reliability of this finding (Hawkins).

Male and female socialization experiences and environments have been viewed as leading to the prototypical female sex-role through social devaluation of the role and women's abilities, women's powerlessness and the chronic environmental stressors unique to women (Hurst 1995). CBT, which has been the most prominent approach for the treatment of depression, has been seen as providing little relief or solution to the issue, as it does not address gender differences. Clinicians may have informally discussed the issue… READ MORE

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