Abnormal Psychology Flashcards
Psychological disorder
A characteristic set of symptoms that may range in security, associeted with disturbance in behavior, cognition, emotion and interpersonal relationships
Depression
Causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home.
Treatment of disorder
Biological
Psychological
Role of culture in treatment
Effectiveness of treatment
Antidepressants
Depression could be caused by a chemical imbalance in neurotransmitters
Serotonin hypothesis
Depression could be treated by increasin serotonin levels
SSRI’s
Have been found to relieve depressive symtoms in around 70% of patients.
This relief usually occurs after 4 to 8 weeks of treatment
Ketamine
Depression could be caused by a neural network dysfunction (neural rigidity and failure to comunicate)
Cognitive-behavioral therapy
Depression could be caused by maladaptive automatic thoughts that lead to irrational behavior
Mindfulness
Depression could be caused by rumination of negative thoughts, feelings and beliefs about the past and the future
Mindfulness hypothesis
Depression could be treated by fostering awareness of one’s mental and emotional states and keeping it focused in the here and now
Effectiveness of treatment
Depends on the severity of the disorder
Can be different on the short and long term
May be difficult to meassure on an individual level
Placebo effect
Cultural factors can influence complience with treatment
Beliefs about mental illness
Beliefs about treatment
Beliefs about the relationship with the therapist
Cultural models of illness must be considered
What do patients do?
Clinician and patient should stablish a common interpretation of the disorder and frame it culturally appropriate terms
Culturally appropriate terms
Treatment must make sense to the patient
Treatment must be culturally sensitive
Culturally sensitive treatment
Ecological validity framework
(To what extend can the findings of a study be applied to the real life of population)
Areas that can be adapted to increase ecological validity
Language
Persons
Metaphors
Content
Concepts
Goals
Method
Context
Arnone et al (2013)
Biological treatment:
Aim: to investigate wether gray matter loss in the hypocampus changes in response to antidepressants.
Procedure: Quasi-experiment. Participants were 64 depressed patients and 66 healthy controls.32 depressed patients were treated with citalopram for 8 weeks.All individuals underwent MRI scans to measure grey matter concentration in their hippocampi at the beginning and after 8 weeks.
Results:All participants with depression had reduced amounts of grey matter in their hippocampus at the beginning of the study, compared to the healthy controls.
After 8 weeks, participants with depression who were treated with citalopram had an increase in grey matter with some of the participants also experiencing decreases in depressive symptoms.
Conclusion:Antidepressants seem towork by increasing grey matter in brain areasthat have experiencedmatter loss related to depression.
Siegel et al (2021)
Biological treatment:
Aim: to investigate the efficacy of prolonged infusion of ketamine in reducing depressive symptoms.
Procedure: Quasi-experiment. 23 individuals who were suffering from treatment resistant depression and 27 matched non-depressed controls. Depression level was measured using the MADRS (Monstgomery-Asberg Depression Rating Scale) at baseline, 24 hours, 2 weeks and 8 weeks. Researchers also utilized resting state fMRI to examine changes in brain regions associated with depressive etiology and compared those images to the non-depressed controls.
Results:All participants had markedly reduced scores on the MADRS (29 at baseline; 15 at 8 weeks post infusion). Participants in the ketamine condition had statistically significant decrease in hyperconnectivity within the limbic system and an increase in connectivity between the limbic system and the frontal areas of the brain
Conclusion:A single prolonged infusion of ketamine provides a tolerated, rapid, and sustained response in treatment-resistant depression and normalizes depression-related hyperconnectivity in the limbic system and frontal lobe
March et al (2007)
Psychological treatment:
Aim: to examine short-term and long-term effectiveness of antidepressants, psycholotherapy or a combination of both.
Procedure: Randomized control clinical trial. Participants were 439 adolescents (12–17-year-olds) from the USA diagnosed with major depression. They were assigned toone of four groups: control (no treatment), cognitive-behavioral therapy only,fluoxetine only, or a combination of CBT and Fluoxetine. Participants’depression scores were measured after 12 weeks, after 18 weeks and after 36 weeks.
Results:Participants in all three treatment options improved significantly more than participants in the control group. Atthe 12 weeks mark CBT is less effective thanthe other two treatments, but after 36 weeks it is as effectiveas Fluoxetine. The combination of treatmentswas related to the highest improvement.
Conclusion:Both therapy and antidepressants (alone and in combination)are effective to treat depression.
Mason and Hargreaves (2001)
Psychological treatment:
Aim: to investigate the therapeutic benefits of MCBT (mindfulness-based cognitive-behavioral therapy) from the parent’s subjective perspective
Procedure: Unstructured interviews. 7 participants who had undergone a MBCT treatment course were asked open-ended questions. Participant responses in verbatim interview transcripts were coded and organized into categories.
Results:MBCT helped individuals with depression ‘come to terms’ with their depression in three main ways: (1) through the development of mindfulness skills, (2) by developing an attitude of acceptance, (3) by becoming better able to ‘live in the moment’. An inductive content analysis revealed eight main categories: preconditions of a depression, changes to well-being (cry for help; breaking point), depression and associated distress, initial negative experiences with MBCT, coping skills, group support, acceptance, relaxation.
Conclusion: MBCT helped participants come to terms with their depression, by internalising skills they could use in everyday life, and by changing their own attitudes towards depression.
Kenzie et al (1987)
Cultutre in treatment:
Aim: to investigate complience of treatment in southeast asian patents of depression.
Procedure: Participants were 41 depressed (using DSM-3 criteria) Southeast Asian patients who underwent long-term treatment of depression with tricyclic antidepressants (TCA) in US clinics. Their TCA blood levels were examined.
Results:A therapeutic level of medicine was only found in 15% of the patients. No detectable TCA levels were .found in 61% of the patients. This indicates a high incidence of non-compliance with the treatment. Cambodian patients were significantly more compliant than Vietnamese and Mien patients. After patient education and a discussion of problems and benefits of medicine, compliance improved with Vietnamese and Cambodians but not with the Mien
Conclusion: Cultural and educational factors influence compliance with medicine and responsiveness to education. The non-compliance rates probably reflect cultural beliefs about illness and medication usage. Cultural attitudes towards authority may lead to hide noncompliance, as not to offend the clinician.
Naeem et al (2012)
Culture in treatment:
Aim: to develop a culturally sensitive CBT programme.
Procedure: Interviews. 9 patients diagnosed with depression who attended an outpatient clinic in Pakistan were asked about their thoughts about the disorder, its causes and treatments, as well as their views on psychotherapy. All interviews were conducted in Urdu and tape recorded. The interview data were collated with field notes.
Results: Physical symptoms were mentioned more often than psychological symptoms. Despite perceiving the symptoms as disruptive, all patients continued their daily activities. No patient recognized depression as an illness, and only one had heard this term before. Causes of mental illness were attributed to “tensions and trauma”, “thinking too much” and “worries”. Most patients had been referred to the clinic by relatives. Most patients believed they could be cured with “good quality medicine”.
Conclusion:The interviews helped the authors develop CBT for local use. They gained an insight into the language used by patients to describe their experiences and could focus on the interpretation of certain somatic symptoms as signs of depression.
