Episode Depresif Berat dengan Gejala Psikotik (Studi Kasus dalam Perspektif Psikologi dengan Pendekatan Teori Kognitif Beck)

Duddy Fachrudin

Sari


Episode depresif berat dengan gejala psikotik merupakan bentuk dari depresi berat yang disertai gejala psikotik yang khas seperti waham atau delusi non-bizarre nihilistik, somatik, kemiskinan, ketidakberhargaan, atau adanya keyakinan-keyakinan delusional tentang perasaan bersalah dan sedang dihukum, serta kadang-kadang muncul halusinasi. Keyakinan-keyakinan delusional pada penderita episode depresif dengan gejala psikotik merupakan suatu distorsi kognitif, sebuah pola berpikir yang rancu dan menimbulkan kesalahan secara negatif yang meningkatkan kerentanan terhadap depresi. Studi kasus ini mengkaji klien yang didiagnosis episode depresif berat dengan gejala psikotik dari sudut pandang psikologi dengan pendekatan Teori Kognitif Beck. Seorang laki-laki bernama G, berusia 45 tahun mengurung diri dan tidak mau bertemu dengan saudara-saudaranya. Klien tidak mau mandi serta tidak shalat. Klien merasa ia tidak bisa melakukan apa-apa lagi. Menurut kakak, adik ipar, dan istri klien, klien pernah mengalami kecelakaan ketika bekerja di pabrik dan saat mengendarai sepeda motor sehingga kondisi fisiknya menurun. Klien lalu mendapatkan pemutusan hubungan kerja. Kondisi kejiwaannya terganggu. Hasil integrasi tes psikologi menunjukkan bahwa klien memiliki depresi dan kecemasan berlebihan. Teori kognitif Beck mengenai depresi mencantumkan tiga aktivitas kognitif yang mendasari munculnya sebuah gangguan, yaitu: a) negative triad (pandangan pesimistik terhadap diri sendiri, dunia, dan masa depan); b) skema atau keyakinan negatif yang dipicu oleh peristiwa/ situasi kehidupan negatif; dan c) distorsi kognitif. Negative triad berupa pandangan klien bahwa ia telah gagal, sedang dihukum, dan tidak bisa melakukan apa-apa di masa depan. Skema atau keyakinan negatif klien, yaitu meyakini bahwa karena sakitnya yang dialaminya tersebut membuatnya tidak berdaya. Distorsi Kognitif dalam bentuk overgeneralisasi, yaitu“Saya tidak bisa melakukan apa-apa lagi”.

 

Kata Kunci: depresi, gejala psikotik, keyakinan delusional, Teori Kognitif Beck, negative triad

 


Severe depressive episodes with psychotic symptoms are a form of major depression accompanied by typical psychotic symptoms such as delusions or nihilistic, non-bizarre delusions, somatic, poverty, worthlessness, or delusional beliefs about guilt and being punished, and sometimes appear hallucination. Delusional beliefs in people with depressive episodes with psychotic symptoms are a cognitive distortion, a pattern of thinking that is ambiguous and negatively causes errors that increase susceptibility to depression. This case study discusses clients diagnosed with severe depressive episodes with psychotic symptoms from a psychological perspective with Beck’s Cognitive Theory approach. A 45-year-old man named G locked himself in and didn't want to see his brothers and sisters. Clients did not want to shower and did not pray. The client feels he could not do anything else. According to the brother, sister-in-law, and client's wife, the client had an accident while working in a factory and while riding a motorcycle so that his physical condition declined. The client then gets terminated in work. His mental condition is disturbed. The results of the integration of psychological tests show that the client has depression and excessive anxiety. Beck's cognitive theory of depression lists three cognitive activities that underlie the emergence of a disorder, namely: a) negative triads (pessimistic views of yourself, the world, and the future); b) negative schemes or beliefs triggered by negative life events/ situations; and c) cognitive distortion. Negative triad is the client's view that he has failed, is being punished, and cannot do anything in the future. The client's negative schema or belief, which is to believe that because of the pain he is experiencing makes him helpless. Cognitive Distortion in the form of overgeneralization, which is "I can't do anything else".

 

Keywords: depression, psychotic symptoms, delusional beliefs, Beck’s Cognitive Theory, negative triads


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Referensi


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