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1. Module 4 Psychopathology Name ................................................................................................................ The learning objectives…
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  • 1. Module 4 Psychopathology Name ................................................................................................................ The learning objectives for this topic are: • Understand issues surrounding the classification and diagnosis of depression. • Describe the clinical characteristics of depression. • Describe and evaluate biological explanations of depression. This booklet • Describe and evaluate psychological explanations of depression. • Describe and evaluate biological therapies for depression. • Describe and evaluate psychological therapies for depression. 1|Page
  • 2. It is important to understand the cause of depression in order to be able to treat it. Episodes of unipolar disorder are often preceded by life events (e.g. loss of job), but some people may be more vulnerable than others in terms of not coping effectively with such life events. This vulnerability could be the result of biological or psychological factors. Using the textbook (pg335) outline how the Nature Vs Nurture debate links to this topic. Biological explanations of depression There are several reasons why biological factors are implicated in the cause of depression: • Depression can run in families • Biological interventions can alleviate symptoms (e.g. the drug Prozac) • Some drugs can cause depression in non-depressed individuals (e.g. Reserpine) • Certain head injuries can give rise to depression Genetic factors Since depression can run in families, researchers have been interested in the role that genes might play. One way of establishing whether an illness is genetically caused is by looking at a family’s history. Gershon (90) looked at 10 family history studies. What was found? Does this definitely mean depression has a genetic cause? Another common way of investigating genetic factors in depression is by means of studying twins, where one twin has depressive disorder and then determining the likelihood of the other twin having the same disorder (the concordance rate). 2|Page
  • 3. Describe McGuffin et al’s (1996) research on twins and unipolar depression. What is the problem with stating that genetic factors are solely responsible for depression? Adoption studies are one way of disentangling genetic and environmental factors, since they look at depressed people who have been adopted at an early age and brought up away from the influence of their biological families. Most of these studies have shown an increased risk in the biological relatives of people with depression rather than the adoptive relatives. For example, Wender et al (1986) found that biological relatives were eight times more likely to have depression than adoptive relatives. The diathesis-stress model states that having a genetic predisposition for depression will make depression more likely in response to environmental stressors. There is evidence in support of this model. Kendler et al’s (92) Virginian twin study found that women who were genetically predisposed to depression (twin diagnosed with the disorder) were far more likely to develop depressive symptoms when faced with negative life events than women less at risk (twin who did not have depression). Biochemical factors Neurotransmitters Depression may be the result of low levels of certain neurotransmitters – namely, serotonin being the most important. These neurotransmitters are known to be associated with the parts of the brain involved in reward (pleasure) and punishment and they help to regulate the hypothalamus which controls physiological arousal and some of the key areas affected by depressive disorder (e.g. sleep, appetite, and sexuality). Originally researchers thought that these neurotransmitters were at a LOW level in people with depression. It’s now thought to be more complex than this. People with depression may have an imbalance of several chemicals in the brain – serotonin, noradrenaline, dopamine and acetylcholine. Serotonin seems to control all of this. The drugs used to treat depression (SSRI’s like Prozac) actually make the low levels of serotonin be used more efficiently. 3|Page
  • 4. Evaluation Hormones High levels of the stress hormone cortisol are often found in depressed people and levels return to normal when they are over the depressed episode. Stressful events trigger the release of cortisol, and often periods of depression are preceded by a stressful event. Elevated cortisol levels also lead to a reduction in serotonin. Dexamethasone suppression test - What does this suggest about the role of cortisol? What are the problems with stating that high levels of cortisol cause depression? What does Strickland et al’s (02) research suggest about the role of cortisol. 4|Page
  • 5. 10-15 % of women meet the criteria for major depressive disorder after child birth – post-natal depression. This has led to speculation that ovarian hormones may play a role. However, it has been found that the majority of women who experience post- natal depression also experience other problems (e.g. adjusting to the role of being a mother) and have had prior episodes of depression. Summarise the strengths and weaknesses of biological explanations of Find out more about post-natal depression at: http://www.netdoctor.co.uk/health_advice/facts/depressionpostnatal.htm depression Strengths Weaknesses 5|Page
  • 6. Psychological explanations of depression Behavioural (Learning) theory Lewinsohn (1974) proposed that depression is a result of a reduction of reinforcement. Certain events, such as losing your job, induce depression because they reduce positive reinforcement from others (e.g. being around people who like you). Depressed people usually become much less socially active. How might friends and relatives respond to this change in a person? Lewinsohn sees people lacking in social skills as those most likely to experience depression, because social ineptness is unlikely to bring positive reinforcement from others. Depressed people typically report having fewer pleasant experiences than non- depressed people (Peterson, 1993). What is the problem with the assumption that depression follows a reduction in pleasant experiences? Another behavioural theory to explain depression is that of learned helplessness. Seligman (1975) found that when dogs were restrained in an apparatus and given electric shocks, they failed to initiate escape behaviour when the restraints were removed. Moreover, they exhibited some of the symptoms of depression found in humans (lethargy, sluggishness, and appetite loss). This led Seligman to explain depression in humans in terms of learned helplessness, whereby the individual gives up trying to influence their environment because they have learned that they are helpless as a consequence of having no control over what 6|Page
  • 7. happens to them. Think of your own example of a situation that may lead to learned helplessness. For example… Evaluation A criticism of Seligman’s view is that his research was based on animals and, therefore, the findings can’t be generalised to humans. How can this criticism be countered? ISSUES and DEBATES: What other evaluation issues does Seligman’s use of animals raise? Learned helplessness makes sense in terms of reactive depression, where there is a clearly identifiable cause of depression. However, one of the biggest problems for the theory is that of endogenous depression. This is depression that has no apparent cause (i.e. nothing bad has happened to the person). 7|Page
  • 8. Cognitive-Behavioural Theory Although Seligman’s account may explain depression to a certain extent, it fails to take into account cognitions (thoughts). Abramson et al (1978) consequently revised the learned helplessness theory to the hopelessness theory. Abramson argued that people who attribute (explaining the cause of something) failure to internal, stable, and global causes are more likely to become depressed than those who attribute failure to external, unstable and specific causes. This is because the former attributional style leads people to the conclusion that they are unable to change things for the better. Note how these two different attributional styles might apply to a person’s thinking in the situation below. EVENT - Fail an exam Internal External Stable Unstable Global Specific More likely to Less likely to become become depressed depressed Evaluation • Seligman (1974) found that those students who adopted the internal, stable and global attributional style were much more likely to become depressed if they failed an exam, than those with the opposite style of external, unstable and specific. • Questionnaires assessing peoples’ attributional style in response to life’s adversities can predict their future susceptibility to depression (Kinderman and Bentall, 1977) • However, Gotlib and Colby (1995) found that people who were formerly depressed are actually no different from people who have never been depressed in terms of their tendencies to view negative events with an attitude of helpless resignation. This suggests that helplessness could be a symptom rather than a cause of depression. Moreover, it may be that negative thinking generally is also an effect rather than a cause of depression. 8|Page
  • 9. Beck’s cognitive triad theory Another cognitive –behavioural explanation of depression (i.e. that focuses on the way people think). Copy the triad from textbook (pg 344-345) and make notes on Beck’s cognitive theory of depression. Focus ONLY on cognitive triad and negative self-schemas. REMEMBER to do outlining and evaluating. 9|Page
  • 10. ISSUES and DEBATES How do explanations of depression illustrate the nature-nurture debate? Biological models generally support nature argument, psychological models generally support nurture argument What model can be applied to depression to incorporate both the nature and nurture side of the debate? Diathesis-stress model How can explanations of depression be considered reductionist? Tend to explain depression in terms of just one simplistic factor ie genes, hormones, the way we think, etc How can explanations of depression be considered deterministic? Some suggest we have no free will in terms of experiencing depression 10 | P a g e
  • 11. Exam Questions 1. (a) Outline clinical characteristics of depression (5 marks) (b) Explain issues associated with the classification and diagnosis of depression (5 marks) (c) Outline and evaluate one or more biological explanations of depression (15 marks) 2. ‘The biological model sees mental disorders as being physical illnesses caused by underlying physiological processes in the body. However, the perception of mental disorders as being equivalent to physical illness has proven to be very controversial.’ Outline and evaluate one or more psychological explanations for depression. Your evaluation should refer to research evidence. (25 marks) 11 | P a g e
  • 12. Extra Notes 12 | P a g e
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