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1. Studies- DepressionIssues of classification and diagnosis of depressionParker et al (1999)Reliability – types of symptomsAgreement amongst clinicians that…
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Studies- DepressionIssues of classification and diagnosis of depressionParker et al (1999)Reliability – types of symptomsAgreement amongst clinicians that melancholic depression is associated with more severe symptoms, poor response to placebo medication and good response to ECTGoldberg and Huxley (1992)Reliability- who makes the diagnosis50% of people who are showing depressive symptoms when they go to see their GP are not diagnosed with depressionMaj (2005)Validity- dual diagnosisThe DSM encourages multiple diagnosis to be made where it might not always be appropriate Keller et al (1983)Validity- dual diagnosisDouble depression (dysthymic disorder and major depressive episodes) was observed in 25% of depressed patients.Kua (1993)Validity- cultural differences72% of people in china who first presented with chest pains/headaches were later found to have depression!Biological explanationsGershon (1990)Genetics-family studiesrates of MDD in 1st degree relatives= 7-30%, higher than populationOruc (1998)Genetics-family studiesrates of MDD in 1st degree relatives= 3% more likelyTaylor (1995) Genetics- family studiesrates of MDD -general pop= 1%, 1st Degree relatives= 5-10%Weissmann et al (1984)Genetics-family studiesrelatives of people diagnosed b4 20 had 8x greater chance of being diagnosed than relatives of non-depressedMcguffin (1996)Genetics- twin46% concordance rate for MZ, 20% DZAllen (1976)Genetics- twinMDD, 40% MZ, 11% DZ. Bi-polar= 72% for MZ and 14% DZBierut (1999)Genetics- twinAustralia- 36%- 44%- claimed environ played more of a roleWendler (1986)Genetics- adoptionbiological relatives 8x likely to have depression compared to adoptive relativesMendlewicz et al (1977)Genetics- adoptionbi polar- 7% in biological- 0% in adoptive= stronger genetic influence!!Thase (2002)The role of neurotransmittersPeople with depression have an imbalance between serotonin, neuroadrenaline and dopamineMann et al (1996)The role of neurotransmittersUsing PET scans found impaired transmission of serotonin with people with depressionCarroll (1972)Neuroendocrine factorsTechniques known to suppress cortisol secretion have been found to be successful in depressive patientsNemeroff et al (1992)Neuroendocrine factorsMarked adrenal gland enlargement in those suffering MDDStarkstein and Robinson (1991)Neuroanatomical factorsPost stroke depression is associated with lesions in the left frontal region Powell and Miklowitz (1994)Neuroanatomical factorsMeta-analysis which found structural abnormalities in the frontal lobes of patients with unipolar depressionDrevets et al (2004)Neuroanatomical factorsMRI and PET scans have found enlarged vebtricles, decreased volume in the hippocampus, basal ganglia and pre-frontal cortex in MDD patientsGotlib et al (1991)Female hormonesCombination of hormones and psychosocial difficulties which caused postpartum depressionNolen-Hoeksema (1990)Female hormonesEvaluation- reviewed a number of studies and found no convincing link between depression and levels of female hormoneDalton (1964)Female hormonesFound an Oestrogen-Progesterone imbalanceBiological TherapiesMontgomery (1993)Drugs50% of users of TCA’s relapse within a year if they stop taking itPrien (1988) and Gitlin (2002)Drugs65-75% effectiveness compared to 33% placeboJulien (2005)DrugsSkin patch for MAOI’sJarrett (1999)DrugsMAOI’s much more effective than TCA’s for severe depressionGeoffrey (1991)DrugsCase study of Joseph Wesbecker who shot 20 people and himself after being on ProzacKessler et al (2002)DrugsMaintenance therapy-Patients need to continue taking anti-depressants, even after they have improved in order to reduce relapseLerer et al (1995)ECTCompared efficiency of treatment when given twice to three times weekly- more effective twice weeklyDatto (2000)ECTSide effects- Impaired memories, headaches and Cardiovascular changesRose et al (2003)ECTSide effects- 1/3 complained of persistent memory lossWeiner et al (2003)ECTSide effects- general slowing of cognitionsComer (2007)ECTEvaluation- frightening and forceful form of interventionSackheim (2001)ECTEvaluation- large proportion relapse!Psychological explanationsCoyne (1985)Behavioural explanationsSecondary reinforcement- people often react with annoyance and break free from those depressedSeligman (1974)Behavioural explanationsLearned helplessness- Investigating effects of fear conditioning in dogsMaier and Seligman (1976)Behavioural explanationsLearned helplessness- same study as above but on humansWortman and Brehm (1975)Behavioural explanationsEvaluation- when individuals are placed in situations of helplessness they actually escape the situationHoughton (2008)Behavioural therapies Evaluation- evaluated the effectiveness of BAT in 42 patients- effective, tolerable and low drop out rateBlatt and Zuroff (1992)Psychodynamic explanationLow self esteem, which precedes or accompanies the onset of depression is associated with a history of harsh and critical parentingBifulco (1987)Psychodynamic explanationEvaluation- loss of parents to death or divorce can be linked to later depressionSwaffer and Hollin (2001)Psychodynamic explanationEvaluation- Gave questionnaires to young offenders- those who repressed anger had increased vulnerability to developing depressionBonanno (2004)Psychodynamic explanationEvaluation- Fewer than 10% who experience major losses in early life go on to be depressedEysenck (1952)Psychodynamic therapiesPsychoanalysis doesn’t work- 44% improved compared to 66% of control who improved spontaneouslyElkin (1989)Psychodynamic therapiesIPT was as effective as Cognitive therapy and drug therapy in reducing symptoms, producing more rapid gains in interpersonal functioningSeligman (1974)Cognitive explanationAttributional style questionnaire to depressed students who failed exam- people who have positive attribution style were more likely to recoverDe Vellis and Blalock (1992)Cognitive explanationLink between hopelessness expectancy and depressionNolen-Hoesksema (1992)Cognitive explanationEvaluation- no connection between attributional style and depression in young childrenKuyken (2007)Cognitive behavioural therapyEvaluation- CBT is effective in reducing symptoms of MDD and preventing relapseJarret (1999)Cognitive behavioural therapyEvaluation- CBT and MAOI’s to be equally effective in 108 depressed patientsKeller (2000)Cognitive behavioural therapyEvaluation- Combo of CBT and medication- recovery rates: 55% for drugs, 52% CBT and 85% combinoElkin (1985)Cognitive behavioural therapyEvaluation- Not suitable for people who are rigid and/or resistant to changeSimon (1995)Cognitive behavioural therapyEvaluation- not suitable for people who have high stress levels in response to genuinely difficult life eventsSociocultural factorsBrown and Harris (1978)Life eventsDepressed women in Camberwell London- long term difficulties, having 3 children under the age of 14 and lack of close r’ship= depressionKendler et al (1995)Life eventsHighest levels of depression in women who have been exposed to recent negative life events and who had a genetic predisposition<br />
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