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EFFECT OF CBT ON ALIENATION AND EMOTIONAL COMPETENCE AMONG INDIVIDUALS WITH DEPRESSION

EFFECT OF CBT ON ALIENATION AND EMOTIONAL COMPETENCE AMONG INDIVIDUALS WITH DEPRESSION

Renuka Joshi,1 Kanchan Yadav2

1Associate Professor and Head of psychology department, D.A.V.(PG)college,
2Research scholar HNB Garhwal University

 

Abstract

Background: The identification of major depression is based not only on its severity but also on persistence, the presence of other symptoms, and the degree of functional and social impairment. In addition to considering the symptoms of the depressive episodes, it is equally important to consider factors that maintain or perpetuate depression because these are potential targets for intervention. It is also clinically apparent that depression, especially when it persists, may lead to secondary disability that compounds, and is difficult to distinguish from depression itself. Features include high levels of anxiety or stress, poor emotional competence, feelings of hopelessness and helplessness, and loss of engagement in outside activities with social withdrawal or alienation. Personality traits also increase the risk of depression when faced with stressful life events.1

Aim:The present study was conducted to investigate the effect of CBT on alienation and emotional competence among individuals with depression.

Method: The sample of the study consisted of 200 individuals with depressive symptoms residing in Dehradun city of around 18-40 years of age. Both male and female subjects were selected through random sampling technique. For measuring depression ADSS [Anxiety, Depression and Stress Scale] scale developed by Pallavi Bhatnagar was administered. For measuring Alienation Al- Scale developed by Hardeo Ojha was used and the scale of Emotional Competencies developed by H.C. Sharma and R.L. Bharadwaj was used to measure emotional competencies of individuals with depression. Each depressive individual was introduced to conventional face-to-face CBT.  Pre test and post test was followed to measure the effect of CBT on alienation and emotional competencies of the subjects. After data collection, statistical analysis was done. The t-test was employed to examine the outcome of the study.

Results: results revealed that there was a significant difference in the alienation level and emotional competencies through Cognitive Behaviour Therapy [based on REBT model] has been stated with the outcome of the study.

Conclusion: The research concludes that men and women both suffer from depression in old age.  However, men were found to have better well-being and women suffered the depression more.  It is obvious that a person who has better well-being not only has better self-esteem and life satisfaction, but also manages stress and problems of life much more easily.

Keywords: CBT, Alienation, Emotional competence, Depression

Introduction

Major depression is a worldwide health problem, which lowers the quality of life of an individual and generates huge costs for the society. As per the study based on the World Health Organization's World Mental Health Survey, India has the highest rate (36 %) of major depression in the world. Traditional psychological interventions, such as cognitive behavior therapy have a strong evidence-base demonstrating their effectiveness in the treatment of depression 2. As outlined in 6th WHO mhGAP intervention Guide, preferable treatment options for depression consist of basic psychological support combined with antidepressant medication or psychotherapy, such as cognitive behaviour therapy, interpersonal therapy, problem-solving treatment or counseling.

Depression refers to a wide range of mental health problems characterized by the absence of positive affect [a loss of interest and enjoyment in ordinary things and experiences], low mood and a range of associated emotional, cognitive, physical and behavioural symptoms distinguishing the mood changes between clinically significant degrees of depression and those occurring ‘normally’ remains problematic and it is best to consider the symptoms of depression as occurring on a continuum of severity.3

People with depression typically prefer psychological and psychosocial treatments such as CBT to medication 4 and value outcomes beyond symptom reduction that include positive mental health and a return to usual functioning .5 significant initiatives are beginning to explore how to maximise the accessibility, acceptability and cost effectiveness of such interventions.

Emotions, whether pleasant or unpleasant, always sustain activity which either maintains or enhances the organism. Incongruent and devaluating experiences are perceived as threats, arousing anxiety or depression and for the self to take some defensive measures. Immature person’s unable to defend against these threats relating to adequacy and worth as they fail to foresee the probable consequences of actions. Which result in disintegration and catastrophic psychological break-downs? Emotional competence refers to individual differences in identifying expressing, understanding, regulating, and using emotions .6 People who are emotionally healthy are in control of their emotions and their behavior. They are able to handle life’s challenges, build strong relationships, and recover from setbacks.

The psychological experience of alienation, in general, involves basic process features which are reflected at both interpersonal and societal levels of analysis. Specifically, it is assumed that an individual's alienation develops within the context of an ongoing relationship between himself and some other entity—a person, group, society, or culture, for instance. The experience of alienation is brought about through a decline in the quality of one's relationship with a particular context, and this perceived deterioration evokes dissatisfaction with the present situation and a yearning for something better which has been either lost or, as yet, unattained. There is vast amount of evidence that ‘lack of attachments’ is linked to a variety of ill effects on health, adjustment and well-being’7 and In today’s societies, social relationships are all but invisible because our perceptions are dominated by the concept of individuality.

In CBT, the cognitive model proposes that dysfunctional thinking (which influences the patient’s mood and behaviour) is common to all psychological disturbances. When people learn to evaluate their thinking in a more realistic and adaptive way, they experience improvement in their emotional state and in their behaviour. Modification of their underlying dysfunctional beliefs produces more enduring change.8

Many studies have been undertaken to study the influence of depression on emotional competence and alienation but there is a dearth of studies related to the effect of CBT on emotional competence and alienation of individual with depression.  Aim- aim of the present study is to explore the possible effect of CBT on emotional competence and alienation of individual with mild and moderate depression.

Objectives

1.       To compare the effect of CBT intervention on depression.

2.       To compare the effect of CBT on alienation of depressed individual.

3.       To compare the effect of CBT intervention on emotional competence and its dimensions of depressed individual.

Hypotheses

1.       Pre-post test of individual will differ significantly on depression.

2.       Pre-post test of depressed individual will differ significantly on alienation.

3.       Pre-post test of depressed individual will differ significantly differ on emotional competence and its dimensions.

Method

Sample

The sample of the study consists of 200 individuals [100 males and 100 females] selected from general population residing in Dehradun city, the age range of the subjects was 18 – 40 years. The screening tool i.e. ADSS [Anxiety, Depression and Stress Scale] was administered to select the individuals with mild and moderate depression. The subjects were matched on educational and SES.

Tools

1.       Anxiety, Depression and Stress scale developed by Pallavi Bhatnagar, [2011] was used to assess depression in subjects.

2.       Emotional competence scale developed by R. Bhardwaj and H. Sharma, [2007] was used to measure five emotional competencies namely adequate depth of feeling, adequate expression and control of emotions, ability to function with emotions, ability to cope with problem of emotions, ability to cope with problem of emotions and encouragement of positive emotions separately as well as whole.

3.       Alienation scale developed by Hardeo Ojha,[2010]. Which measures six factors of alienation namely, powerlessness, normlessness, meaninglessness, social isolation, self estrangement, cultural estrangement was used.

Procedure

The sample was screened out on the basis of scores in depression level on ADSS scale. The target sample was introduced to face-to-face CBT [REBT based] intervention by the researcher herself and their Emotional competence and alienation were measured with the help of Emotional competencies Scale and Alienation Scale, respectively, before and after intervention. However, out of 200 target sample only 76 subjects could be successfully completed the CBT intervention under the specified parameters out of which 32 were males and 44 were females.

Results

Table 1 Mean, SD, and t-value of subjects on depression, alienation and various dimensions of emotional competence [Male] N=32

Variables    

Pre-test

M1

Pre-test

SD1

Post-Test M2

Post-Test SD2

t-value

Depression

4.25

1.77

2.25

0.68

4.22**

Alienation

59

9.15

52.63

6.05

2.32*

Adequate depth of feeling

16.5

5.33

19.13

3.88

1.59

Adequate expression and control of emotions

16.13

4.75

17.13

4.69

0.6

Ability to function with emotions

18.81

4.28

20.63

3.46

1.32

Ability to cope up with problem emotions

18

5.16

19.25

4.45

0.73

Enhancement of positive emotions

19

5.32

20.38

3.70

0.85

Total Emotional competence

88.56

15.38

99.13

11.49

2.20*

 

 

** - significant at 0.01, *- significant at 0.05

The table 1 indicates the difference achieved by the subject [Male] due to the effect of CBT on depression, alienation, emotional competence and its dimensions. Result clearly states the significant difference between pre and post test of subject on depression after the CBT intervention. Comparison of pre and post intervention on alienation depicts significant difference and comparison of pre and post intervention on adequate depth of feeling, adequate expression and control of emotions, ability to function with emotions, ability to cope up with problem emotions, and enhancement of positive emotions reveals that there is no significant difference achieved after CBT intervention, however, a comparison of post test result indicated significant difference on total emotional competence.

Table 2 Mean, SD and t-value of subjects on depression, alienation and various dimensions of emotional competence [Female] N=44

Variables        

Pre-test

M1

Pre-test

SD1

Post-Test M2

Post-Test SD2

t-value

Depression

3.92

1.02

2.33

0.82

5.94**

Alienation

51.92

11.59

50.33

6.42

0.59

Adequate depth of feeling

19.29

4.55

21.17

4.12

1.5

Adequate expression and control of emotions

19.46

3.97

21.58

3.20

2.04*

Ability to function with emotions

19.88

3.73

20.25

4.15

0.33

Ability to cope up with problem emotions

20.75

3.85

23.17

3.06

2.41**

Enhancement of problem emotions

19.88

4.22

21.25

3.99

0.82

Total Emotional competence

99.71

15.43

109.13

12.41

2.33*

 

** - significant at 0.01, *- significant at 0.05

The table 2 indicates the difference achieved by the subject [Female] due to the effect of CBT on depression level, alienation and emotional competence and its dimensions. Result clearly states the significant difference between pre and post test on depression of subjects after the CBT intervention. Comparison of pre and post intervention on alienation depicts no significant difference. Comparison of pre and post intervention on adequate depth of feeling, ability to function with emotions, and enhancement of positive emotions reveals that there is no significant difference achieved after CBT intervention, however, a comparison of pre and post test result indicated significant difference on adequate expression and control of emotions, ability to cope with problem emotions and total emotional competence of the subjects.

Discussion

To test the proposed hypotheses the obtained data was statistically analyzed by computing means, SDs, and t-values. The results in pre test revealed that the significantly depressed individuals screened through this study are having high alienation and low emotional competence score. The results are in agreement with a recent study, which evaluated the relations between social and emotional competence and mental health,9 according to this study, it is possible that stressful events cause both emotional processing and management problems [i.e. low social and emotional competence] and low mental health. The post intervention result on depression has strengthened the use of CBT intervention in reducing depression, which is in agreement of many earlier studies. Moreover, Cognitive behavioural therapy has proved to modify the dysfunctional neural circuitry associated with anxiety disorders or depression.10

Difference on alienation was found to be significant among males, though no significant difference was found among females. This is in line with earlier studies that have established that social anxiety and depression are related to social isolation, 11,12 concerning gender differences, it is also assumed that both depression and alienation will be higher in females than in males. Therefore, it shows more efforts will be needed to help out females from the clutch of alienation.

In an earlier study found that poor emotional intelligence skills lead to increased depression.13 In line with these findings,9 showed that individuals who are able to manage the emotions of others seem to respond less intensively to stressful situations and also exhibit less depressive symptoms. The findings of the present study supports poor emotional competence among depressed subjects and post intervention results indicated difference in pre and post test scores on total emotional competence among males to be significant. While, their female counterparts showed significant difference in adequate expression and control of emotions, ability to cope with problem emotions, enhancement of positive emotions along with total emotional competence. These results get support from previous studies 14 indicating that emotional competence significantly improved after receiving CBT intervention.

The present investigation therefore accepted the first hypothesis “pre and post test of individual will differ significantly on depression” at 0.01 levels and concludes the positive effect of CBT in lowering down depression. Though the second hypothesis is accepted as significant difference was found on alienation among male subjects, there was no significant difference found on alienation of female subjects. Thus, the second hypothesis is accepted and this study concludes that CBT intervention can lower down alienation among males in a better way as compare to females. The third hypothesis is accepted and inference can be drawn that CBT intervention influence emotional competence along with total emotional competence in a positive direction.

Assuming that the phenomenon of depression is as complex as most other human behaviour, it now appears that a complex multidisciplinary approach will be needed to understand it. Hence, the study derives a conclusion that individuals with depression are required to introduce targeted CBT intervention which should focus on major aspects such as emotional competence and alienation for better outcome.

References

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11.     Ciarrochi, Joseph and Scott, Greg (2006)“the link between emotional competence and well-being: a longitudinal study” , British Journal of Guidance and Counselling, 34:2 , 231-243.

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14.     Popularity, Friendship Quantity, and Friendship Quality: Interactive Influences on Children’s Loneliness and Depression. Journal of Clinical Child and Adolescent Psychology. 2003: Vol. 32; No. 4, 546–555

15.     Boivin, M., Hymel, S., & Bukowski, W. (1995). The roles of social withdrawal, peer rejection, and victimization by peers in predicting loneliness and depressed mood in childhood. Development and Psychopathology, 7, 766-785.

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17.     Hallam,W.T.,Olsson,C.A.;Oconnor,M.Association between adolescent  eudaimonic behaviours and emotional competence in Young Adulthood,Journal of happiness studies 2013:aug 23;1-13