Abnormal Studies Flashcards
Describe Alloy et al’s Study
Investigate role of one’s cognitive style on development of depression
PPTS: non-depressed college freshman with no other diagnosed disorders, half of sample had history of clinical depression, other half didn’t & none demonstrated any symptoms at beginning of study
Given test to measure cognitive style & identified as low or high risk for depression based on thinking patterns
Researchers carried out follow up experiments every 6 weeks for 2.5 years then every 4 months for additional 3 years
Based on questionnaires & structured interviews to identity SLEs, cognitive style & MDD symptoms
In group with no history of MDD: 17% HR students developed MDD vs 1& of LR students, 29% of HR group showed symptoms of MDD vs 6% of LR group
With past history, 27% of HR group relapsed vs 6% of LR group, 50% of HR group showed symptoms vs 26.5% of LR group
Rate of suicidality higher in HR groups (28%) vs 12.6% in LR group
Negative cognitive style played role in onset & relapse of MDD
Method & data triangulation - increasing credibility of findings
Tests to measure cognitive style are highly standardised & highly reliable
Pre-test & post-test design helps to diminish bi-directional ambiguity however study is natural experiment where researcher does not manipulate IV so not possible to establish cause & effect
Link between cognitive style & depression may be more complex than study proposes - domino causality where many factors may play a role e.g. negative conditions lead to stress, stress leads to genetic expression which may then lead to disorder - link not easy to empirically establish
No control over daily lives of individuals - may be different stress levels
No consideration of genetics
Describe Brown & Harris’ Study
Investigate how sociocultural/environmental factors may play role in onset of depression in women
Surveyed 458 women in South London about biographical information & particular life events/difficulties faced by the women
Events were rated in severity by independent researchers
8% of women (37) had become clinically depressed in last year, 90% of these women had experienced an adverse life event e.g. loss of loved one or serious difficulty (e.g. abusive relationship)
Only 30% of women who didn’t become depressed had experienced such an adversity
Social class (measured by husband’s occupation) played significant role in development of depression of women with children
Working class women with children 4x more likely to develop depression than those middle class
Protective factors e.g. high levels of intimacy with one’s husband found to protect against MDD, leading to higher self esteem & finding meaning in life
Vulnerability factors: loss of one’s mother before age 11, lack of confiding relationship, more than 3 kids at home under age 14 & unemployment, increased MDD risk in combination with provoking agents (SLEs) which resulted in grief & hopelessness in vulnerable women with no social support
Social factors in form of SLEs could be linked to depression
Led to new way of viewing depression - one of first studies to investigate social factors
Modern biological research supports vulnerability models
Temporal validity is questionable, social norms & lifestyles have shifted since conducted in1978
Large sample size - increasing reliability
Only females interviewed so not generalisable to men, relationship of SLEs & MDD may not be applicable to men
Based on self-reporting - impossible to determine extent of depression for each woman
Stress hard to operationalise & measure - are SLEs a good measure?
Correlational research
Describe Parker et al’s Study
Compare symptoms which Chinese patients in Malaysia and Caucasian patients in Australia identify with as being an aspect of depression
PPTS: 50 Malaysian patients of Chinese heritage & 50 Australian patients of Caucasian, Western heritage, all out-patients who had been diagnosed solely with MDD
Questionnaire (back-translated to establish credibility) based on 2 sets of symptoms: first, a set of mood & cognitive items common in Western diagnostic tools for depression, second, a set of somatic symptoms commonly observed by Singaporean psychiatrists
Judged extent to which had experienced each of 39 symptoms in last week (4 options - all the time, most of the time, some of the time & not at all) & ranked symptoms on how distressing they were & noted with help of their psychiatrists what the primary symptom was that caused them to seek help
60% of Chinese ppts identified a somatic symptom as what led them to seek help compared to 13% of Australian sample
No significant difference in number of somatic symptoms per group as linked to their depression, however Chinese ppts significantly less likely to identify cognitive/emotional symptoms as a part of their problem
Role of culture evident: more appropriate in Western culture to discuss emotions & depression linked to lack of emotional well-being, however in Chinese culture it is less appropriate & stigmatised
Questionnaire was developed based on cultural evidence relevant to ppts - didn’t use standardised Western questionnaire
Chose ppts based on DSM-IV criteria for diagnosing MDD, demonstrating an imposed etic approach to research, possibly eliminating people from sample who have form of MDD that doesn’t meet Western criteria for diagnosis - may account for similarities in samples, but may inform new manuals
Recalling ‘first symptoms’ open to memory distortion & demand characteristics: West believes its an emotional disorder so may have expected this is correct reply
Malaysia is a very modern & Westernised society - effects of globalisation may account for relatively small differences in data: need research in more cultures to test reliability
Temporal validity: conducted in 2001 before social media which has big impact on accelerating globalisation, maybe more accurate than think as exposed to media from other cultures - universality
Describe Cipriani’s Study
Investigate effectiveness of antidepressants
Meta-analysis of randomised, double-blind control trails of 21 antidepressants
552 trials included with 116,477 ppts over 6 years
Drug treatment of 8 weeks + assessed (may take few weeks to kick in)
All antidepressants more efficacious than placebo in adults with MDD, approx 60% of ppts showed on average a 50% reduction in symptoms
Antidepressants can be effective in treatment of depression
Huge sample size
Controls are good
Double-blind - limits researcher bias
Don’t know how trials done as not carried out by researchers, lowers validity
Describe Keller’s Study
Compare SSRIs, CBT or combination treatment of adults with chronic MDD
Randomly assigned 681 adults with chronic MDD to nefazodone (an SSRI), CBT (psychotherapy) or both
All ppts had baseline score of 20-24 on Hamilton Rating Scale for depression
Satisfactory response defined as a reduction of at least 50% from baseline at weeks 10&12
Raters were blind to conditions
Among 519 who completed study: 55% responded well in SSRI group, 52% in psychotherapy group & 85% in combined treatment group
Combination of two treatments was significantly more efficacious than either treatment alone
2 treatments compared, when together multiple etiologies & treatment styles work better
Snapshot short term period, not seeing if symptoms reduced in long-term (drugs are temporary & don’t address cause so may be higher relapse rates)
More holistic approach
CBT requires active involvement from client, not a passive treatment like drugs so may not be as effective for severe depression but if drugs used too, may allow patient to engage
Describe Wiles et al’s Study
Investigate benefit of holistic approach (CBT & antidepressant medication) compared to antidepressants alone when treating people with treatment-resistant depression
PPTS: 469 patients with treatment-resistant depression randomly put into ½ groups
Usual care: just treated with antidepressants
Usual care & CBT
Before & after measurements of depressive symptoms taken using Beck’s Depression Inventory Questionnaire
After 6 months 21.6% of usual care group & 46.1% of usual care & CBT group had a 50% reduction in symptoms
After 12 months, usual care & CBT group continued showing great improvements
CBT + antidepressant medication is more effective in reducing depressive symptoms than antidepressant medication alone
Extraneous variables were carefully controlled - high internal validity
2 groups had same average depression score at start & ppts randomly assigned to groups
Many real world applications as can be used to inform real treatments - high external validity
Uses self-report methods to determine levels of depression, ppts must judge how depressed they are - may underestimate - affecting validity of study
Describe Kinzie et al’s Study
Investigate cultural barriers to treatment for depression
Carried out blood tests on 41 South-East Asian patients with depression who had been prescribed tricyclic antidepressants in US clinics
Blood tests intended to measure compliance with prescribed treatment
No sign of medication usage was detected in blood of 61% of patients
Only 6 had therapeutic levels of antidepressants in their blood, indicating were taking medication enough for it to be helpful
After a discussion session was held with patients, where benefits & side effects of medication were explained, compliance rates increased
There are cognitive & affective barriers to treatment of patients from different cultures who may doubt efficacy of Western psychiatric medicine or view taking it as shameful but ensuring patients are well educated & informed about treatment may help overcome cultural barriers & improve compliance
Demonstrates impact of culture on treatment & how treatment should incorporate an emic approach & adjust to culture rather than the etic approach of medication
By using blood tests, researchers could obtain objective measures of patient compliance with treatment so didn’t have to rely on self report subject to social desirability bias
Small sample size which only involved South-East Asian countries, questionable whether results may be generalised to other minority groups
Describe Zhang et al’s Study
Test efficacy of Chinese Taoist cognitive psychotherapy (CTCP) an indigenous therapy combining aspects of cognitive therapy & Taoist philosophy on treating patients with GAD
143 patients with GAD were randomly assigned to receive either CTCP, an anxiety-relieving medication or both
Patients were assessed 1 & 6 months after beginning treatment
Patients on medication improved rapidly after 1 month but improvement not sustained after 6 months
Patients receiving CTCP didn’t show much improvement after 1 month but significant after 6 months including improved coping style & lower neuroticism
While medication can deliver short-term symptom reduction, CTCP is more effective for long-term treatment of GAD
Results support indigenous therapies that combine Western style therapy with traditional beliefs
Culturally adjusted treatments may have a higher long-term success rate than non-culturally adjusted treatments
Participants randomly assigned to conditions allowing for cause & effect relationship to be established between treatment & outcome
Combination of culturally & non-culturally exclusive treatments had most beneficial outcome
Role of culture in development & treatment of disorders remains ambiguous
Study did not involve comparison group who received standard CBT so unclear if CTCP is more effective than regular therapy
