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Clinical Psychology > 3: Depression > Flashcards

3: Depression Flashcards

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1
Q

What are the 2 ways you can split mood disorders?

A
  1. Depressive disorders
    - major depression
    - Seasonal Affective Disorder
  2. Bipolar disorders
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2
Q

What is the difference between bipolar and depression disorders?

A 
- Pattern of mood shift
Bipolar = high manic + low depression
Depression = normal mood + depression 
- absence of mania in depression 
- cyclical nature
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3
Q

What is dsythymia?

A
  • form of depression that doesn’t have a cyclical nature in mood
  • at least 2 years of depressed mood
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4
Q

What is the difference between the 2 types of bipolar disorders?

A 
B1: 
- periods of depression
- alt w/ full mania
B2:
- episodes of depression 
- alt w/ hypomania (less impairment than full mania)
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5
Q

Although hypomania = less impairment than full mania for B2 patients, what explanation is there for the higher suicide rate among B2 vs B1 patients?

A
  • 24% vs 17% Rihmer + Kiss, 2002

- B1 = full mania = also xp extreme mood elevation vs B2

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6
Q

Accodring to Freud, what is the difference between mood and depression?

A

mourning (mood)

  • world has become poor
  • doesn’t effect how they feel about themselves

melancholia (Depression)
- ego has become poor

  • *sad mood have trigger vs depression
    • sad mood = feeling + emotions vs depression = flattened effect
  • *changes in sleep highly associated with sleep
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7
Q

What is the diagnosis criteria length for depression in the DSM5?

A
  • need to have 5 specific symptoms or more within 2 week period
  • symptoms should not be result of other medical conditions/ medication
  • no history of mania/ hypomania
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8
Q

What are the diagnosis criteria in the DSM5 for depression?

A
  1. depressed mood for most of the day
  2. Loss of interest of things they found enjoyable before
  3. Weight-loss/ hypoinsomia
  4. tiredness/ less movement
  5. diminishing ability of concentrating
  6. recurrent thoughts of death
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9
Q

Why was it an issue when bereavement = no diagnosis of depression regardless of it ticking other boxes in previous DSM?

A
  • why the exception?

- denies ppl help

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10
Q

How is bereavement justified in the DSM5 for the diagnosis of depression?

A

normal vs abnormal response

- abnormal = diagnosis

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11
Q

What are some differences between grief vs depression?

A
  • grief = response to external vs internal
  • grief = think about death vs ideas of taking own life
  • grief = time heals vs not quiet the same
  • grief = intensity difference
  • grief = sudden changes vs continuously there

2 weeks for symptoms to persist is pretty short esp considering grief

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12
Q

Why is major depression considered a syndrome?

A
  • combination of symptoms comming together = wear people down
  • perists
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13
Q

Why is major depression called a mood disorder even tho it has so many symptoms which are not related with emotions?

A
  • affective changes are prioritiesed
  • high negative + low negative mood are KEY symptoms tht must be present
  • high + low positivt affect
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14
Q

What was found when Watson et al (1988) played 3 difference piece of music and asked ppt to share how they felt?

RT:

A
  1. :( minor key slow tempo
  2. major key fast tempo :)
  3. minor key fast tempo = :)/:(

= can feel both happy + sad at the same time = separate dimension and not a continnumu

= can feel posivtie + negative affect
- they fluctuate independently from each other (Watson et al, 1988)
feeling one doesn’t mean you cant feel the other

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15
Q

Who is RT?

A

11 year old who begins to lose interest in his usual activities and engaged in more physical fights
- social withdrawal + isolation
= no signs of feeling depressed/ sad but the low positive affect is noticeable
- often beginning of depression
- showing importance of why this is emphasised in the diagnosis

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16
Q

What did the 2014 study on the general population on loneliness fine?

A

2014:
= 1/10 ppl = have no close friend 2014
= couldn’t count work colleagues as friends
- important since we are spending more time at work
= young ppl saying they haven’t xp love

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17
Q

What did the 2018 BBC survey on loneliness find?

A

2018 BBC Survey
= 33% very often felt lonely
= 40 16-25 = loneliness
- challenges current mindset that mostly old people feel loneliness but actually a large proportion of younger kids do to

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18
Q

What De Jong + Van Tilburg (1999) find about loneliness among over 55 and Asher et al (1984) among elementary school children?

A

De Jong + Van Tilburg, 1999
= 32% over 55 feeling lonely

Asher et al, 1984
= 10% of elementary children report loneliness

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19
Q

social withdrawal + isolation are common features of depression. Why is this important?

A

results in them being lonely

= loneliness is associated with depression + suicidal ideation (Beutel et al, 2017)

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20
Q

What did the animal study on rat by Levine et al (1997) find about cortisol levels when rats were housed alone VS in groups?

A

= know group to alone = sharp increase in cortisol

= alone to new group = cortisol decrease

21
Q

What did Asher et al (2003) find about how humans responded to being socially isolated?

A

socially isolated = stress level go up in humans too

  • loneliness not same as social isolation
  • be around people = still able to feel loneliness

= loneliness = perceived isolation

22
Q

What did Wilson, T.D et al (2014) find when ppt were put in a plain room?

A

majority = found unpleaseant

= some preferred giving electric shocks esp men

23
Q

What does the term humania mean?

A

coined by Taylor, 2012
- normal state of mind is discourse
- perceived as being isolated
since we keep our attention on external things

24
Q

depressed= heightened self focus + consciousness. How did Ingram + smith (1984) justify this?

A

= end up being focused on internal vs external

= more lonely

25
Q

How common is depression?

A

WHO 2012;
5/20% xp depression at least once in lifetime from all ages

  • less/ more depending on where you live/
    = chronic medical conditions + poverty - high change of depression

leading cause of disability world wide
- can = risk factor for physical health conditions

26
Q

What are the 3 reasons for why we should pay attention to major depression?

  1. Suicide
A
  1. Recurrence
  2. Age of Onset
  3. Suicide
27
Q

What are some potential explanation for why there is a higher diagnosis of depression among females than male during adolescence?

A
  • increased/ changes in female role in society
    -men actually less likely to seek help due to stigma
    = high suicide rate in men
  • hormones - oestrogen = sad mood
28
Q

why we should pay attention to major depression: recurrence?

A
  • after initial exp - after 50% will xp again
  • more episode you have the more at risk you are at it reoccurring
    >3 episode = 70-80% risk in the next 12 months
  • often then don’t need an external trigger/ stressor
    = history reducing threshold
29
Q

why we should pay attention to major depression: Age of Onset?

A
  • often thought depression was a late life problem BUT NOW:
  • common age for first depressed = during adolescent
  • Age of onset predicts persistence + severity of depression (Pine et al, 1988)
    = more severe
30
Q

Why has the age of onset for major depression become lower?

A
  • more aware of it and diagnosing it?
    Shift in age actually real as suggested by…
  • same questions asked
  • there is just many more stressors illnesses
  • suicide rates in young people have also gone up
31
Q

why we should pay attention to major depression: Suicide?

A
  • WHO, 2012
    60% suicide takes place when they are xp mood disprders = depression
  • could cut out 80% suicide if we but out depression
32
Q

Describe the timing nature of suicide

A

suicidal ideation - not much time between thinking + doing it

  • 90% unplanned
  • 60% planned and takes place within the first year
33
Q

Why is suicide often difficult to detect?

A
  1. Small time gap between suicide ideation + suicide
  2. often have rational out look
    - 1/3 leave a rational reflection note together
34
Q

What are the 3 explanation here for why depression develops?

A
  1. Bio
    - neurotransmitter imbalance
    - Monoamine hyp
    - genetics
  2. environment
    - traumatic event = learned helplessness
  3. Cognitive
    - Attribution style Theory
35
Q

What is the monoamine hyp?

A

low seretoning + adrenaline/ norepinephrine produces depressed mood (Coppen 1967, Schildkraut 1965)

  • v little evidence LOL
  • pharmaceutical industries latched onto idea = antidepressants widely available
36
Q

How did the monoamine hyp come about?

A

accident:
1. Reserpine - hypertension
- reduced lvl of seretonin = more depressed mood reported as side effect
Harris 1957
2. Isoniazine - tuberculosis
- increased lvl of seretonin = more happy reports
Robitzek et al 1952

37
Q

How do antidepressants work?

A
  • low lvlv at synaptic cleft of serotonin
  • re-uptake naturally
  • drug blocks re-uptake = more left in synaptic cleft
38
Q

antidepressant = 1st approach for severe depression but what are some problem with antidepressants?

A
  1. Many don’t respond
    - remission rate = 50%
    - tend to work better for mild depression
  2. time scale problem
    - drugs = lvl of monoamine normalise quickly
    - but mood doesn’t improve at same rate
    - not sure about how they work
  3. increased risk of suicide - so not good for younger ppl
    (Sharma et al, 2016)
  4. do little to address underlying reasons
    (Hirschfield, 2001)
39
Q

What evidence is there to suggest that genetic has a role to play in the development of depression?

A 
- twins studies
MZ = 60/70 %
DZ = 20/30% concordance
McGuffin et al 1996
- but could be due to shared environment so lack of clarity
40
Q

What is the environmental explanation for the development of depression?

A
  • traumatic event, esp first onset

= learned helplessness (Seligman et al, 1968)

41
Q

What is learned helplessness?

A
  • theory of depression that argues people become depressed following unavoidable negative life events because they learn to become ‘helpless’
42
Q

What evidence is there supporting learned helplessness?

A

research in animals
- animals + uncontrolled shock = nothing could be done to avoid
- part 2 - there is a escape but just passively accept shock
= learnt to become helpless since it was unavoidable

Similar findings in humans with distressing sounds

43
Q

What is an explanation for why people become helpless?

A

= loss of control = the ability to modify outcomes by voluntary responding (Seligman et al, 1968)

having control = more likely to make effort so no control = less effort

44
Q

What are some issues with the learned helplessness theory?

A

TOO simplistic

  • not all life stress = depression
  • not just exp = helpless (Brown + Harris 1978)
  • actually the inference of events?
    (Klein et al, 1976)
45
Q

What did Klein et al (1976) find when depressed + non-depressed ppt were asked to do an anagram after they had been placed in an insolvable situation challenging the learned helplessness theory?

A

= non-depressed exp insolvable = same response as those with depression
BUT
- response could be changed by changing attribution
- internal blame = helplessness

=

46
Q

What did Klein et al (1976) conclude about learned helplessness?

A

helplessness dependent on the attributions people made (Klein et al 1976)
- internal attribution of failure = helplessness

= shift from environmental to psychological
=Attribution style theory

47
Q

According to the attribution style theory, what do depressed individuals attribute the casue of negative events to?

A
  1. Internal vs external
  2. Stable vs unstable
    - never change
  3. Global vs specific factors
    - something which they always do rather than just one-off

= attribution style = long-lasting + pervasive depression

48
Q

Although the attribution style theory suggested to be able to predict depression, why did this theory not pick up?

A
  • same time, another cognitive model was around:

Arron Beck’s model which actually had a treatment

Clinical Psychology (17 decks)

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