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25 Cards in this Set
- Front
- Back
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Clinical Characteristics of Depression |
Depressed Mood, sadness Guilty about short comings, worthlessness Social Withdrawal, restlessness Change in sleep patterns, energy levels and appetite |
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Issues with Reliability when diagnosing and classifying depression |
DSM Diagnosis - Keller, 1995. - Inter-rater is 'fair to good', test-retest is 'fair at best. Zanarini also. Five out of nine symptoms must be met, a one item difference may cause unreliability.
Classification - Beck, 1995. - 26 outpatients - two therapy sessions a week apart. .93 correlation of test-retest reliability. |
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Evaluation of Reliability (x4 PEE) |
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Issues with Validity when diagnosing and Classifying depression |
DSM Diagnosis - McCullough, 2003. - Compared 681 outpatients - overlap in depressive symptoms. Difficulty in classifications. |
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Evaluation of Validity (x4 PEE) |
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Biological Explanations (Genetics) |
Family Studies - First Degree Relatives of probands 20% depression rate, compared to 10% for population at large. (Harrington) Twin Studies - 177 probands. 46% concordance rate with monozygotics, 20% for fraternal. Adoption studies - Higher incidence of depression in proband families than non-proband. Genes as diatheses - Genetic predisposition acting with environmental stressors. Kendler, 1995. - co-twin of depressed individuals were more likely to have become depressed without this presumed genetic vulnerability.
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Evaluating Biological Explanations (Genetics) x3 PEE |
(Zhang et al. 2005) - Mutant gene starves brain of serotonin 10 times more prevalent in depressed patients. It results in a 80% reduction of normal serotonin levels. (Caron et al.) Patients with the mutation responded badly to Serotonin meds. Comorbidity - Two illnesses occur simultaneously with the same cause. Kendler et al found higher incidence of mental illness in twins when looking at Depression and Anxiety rather than just depression.
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Biological Explanations (Neurotransmitter Dysfunction) |
Noradrenaline - low by products of Noradrenaline in urine of depressed individuals. (Bunney) - post mortem found brain 'up-regulation'
Serotonin - Low serotonin by-product found in cerebro spinal fluid of depressed individuals. Introduction of Prozac and antidepressants confirmed the connection. |
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Evaluating Biological Explanations (Neurotransmitter Dysfunction) x3 PEE |
Noradrenaline - (Leonard), support from the fact that noradrenaline increase drugs show antidepressant effects. (Kraft) - SNRIs - 96 patients much better than a placebo. Serotonin - (Ruhe) Serotonin reducing drug causes relapse in patients in remission. Confirms link.
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Biological Explanations (Cortisol Hypersecretion) |
Cortisol is high in depressed individuals/goes down once depressions goes. Dexamethasone suppression is shorter for depressed people, suggesting an overactive hypothalamic-pituitary-adrenal axis. |
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Biological Explanations (Cortisol Hypersecretion) x3 PEE |
(Strickland) - No increase in cortisol levels in a depressed women group. Elevated cortisol levels in some people with severe life events - not depressed though. (O'Keane and Marsh) Pregnancy causes high cortisol levels, potential depression. |
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Psychological Explanations (Psychodynamic) |
Mourning Melancholia - Loved one lost - Mourning - return to normal/constant melancholia. Unconscious harbouring of negative feelings for loved ones, when lost, feelings turn inwards, causing depression. |
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Evaluating Psychological Explanations (Psychodynamic) x3 PEE |
(Shah/Waller) - Depressed individuals called parents affectionless, supporting loss. (Barnes and Prosen) - Most depressed individuals had lost their fathers in childhood. (Bifulco) - evidence that children who lost mother's were more likely to experience depression later in life. |
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Psychological Explanations (Cognitive) |
(Beck) - Negative schema. Cognitive biases. Negative view of themselves, the world and the future. (Seligman) - Inability to deal with circumstances. Lack of control. View that they are helpless. Negative attributional style. (Abramson) - Hopelessness - pessimism. View they cannot change situation. |
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Evaluating Psychological Explanations (Cognitive) x3 PEE |
14 meta-analyses - CBT effective in 80% of adults (Hammen and Krantz) - found depressed women made more logical errors. - supports Beck (Hiroto and Seligman) - Students exposed to uncontrollable events were more likely to fail on cognitive tasks.
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Explanations (Sociocultural) |
Life events may activate depression in genetically vulnerable. Depressive attributional style causes minor events to trigger depression. Depressed individuals have bad social networks. |
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Evaluating Psychological Explanations (Sociocultural) x3 PEE |
Link between early bereavement and depression. Brown and Harris research only used British women. Low social competence has predicted the onset of depression in primary age children (Cole) |
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Biological Therapies (Antidepressants) |
Tricyclics - Blocks the re-uptake of Serotonin and Noradrenaline. SSRIs - Block the re-uptake of Serotonin mainly and increase the quantity to excite the neighbouring cells. Acute, continuation, maintenance. |
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Evaluating Biological Therapies (Antidepressants) x4 PEE |
Kirsch (2008) - concluded that SSRIs are only advantageous in cases of severe depression. Even the placebo benefited moderately depressed people. SSRIs had no significant difference with non-SSRIs (Papakostas) (Hammen) - Antidepressants appear less useful when given to children and adolescents. (Turner) Publication bias showing a positive outcome to antidepressants. Even negative outcomes were presented positive. |
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Biological Therapies (Electro convulsive therapy) |
Used in severely depressed of suicidal patients. Electrode placed on non dominant side of brain (unilateral) or both sides (bilateral). Short acting anaesthetic. Nerve blocking agent to prevent a fit. 0.6 amps is ran through the head. This produces a seizure and is usually given 3 times a week. |
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Evaluating Biological Therapies (Electro Convulsive Therapy) x4 PEE |
(Gregory) - ECT compared with 'sham' ECT. ECT has been shown to work. (Folkerts) - ECT is effective in treatment-resistant depression. 18 studies with 1144 people showed ECT is more effective as short term treatment than drugs. out of 700 patients the DOH found that 59% of patients had not consented. |
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Psychological Therapies (Cognitive Behavioural Therapy) |
Emphasises the role of maladaptive thoughts and beliefs. Thought Catching - Linking the thoughts and the way you feel. Recording any negative emotions felt and the realistic thoughts that may counter these thoughts. Behavioural activation - Doing things that one used to enjoy. |
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Evaluating Psychological Therapies (Cognitive Behavioural Therapy) x4 PEE |
(Robinson) Meta analysis found CBT was superior to no treatments. However, CBT isn't significantly better than placebos. (Kuyken and Tsivrikos) Found therapist competence attributes to 15% of the variance outcome. CBT appears to be successful for all groups of people. (Selmi) CBT can be applied through computers. - Low levels of drop-out. |
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Psychological Therapies (Psychodynamic interpersonal therapy) |
Exploratory rationale - linking symptoms to current problems Shared understanding - Therapist tries to understand how the patient is feeling. Staying with feelings - Attempt to realise feelings in a therapeutic environment. Focus on difficult feelings - Individual may express emotions unaware. They may appear strange when talking about things of great emotional significance. Gaining insight - Therapist points out relationship types. Sequencing of interventions - Different aspects of the model are put in to a coherent manner Change - Therapist acknowledges and encourages the changes made during therapy. |
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Evaluating Psychological Therapies (Psychodynamic interpersonal therapy) x4 PEE |
(Paley) Outcomes of PIT are equivalent to CBT. (Barkham) PIT and CBT are equally effective, but both experience recurring symptoms after 12 months. (Guthrie) - PIT helps with those who have dysfunctional relationships. Patients were randomly allocated to receive 12 weeks of PIT. It was found that PIT was more effective than any other group. |
