Competing models of depression Flashcards
Which psychological model of depression dominated in the later Middle Ages?
Scheme of temperaments
- phlegmatic
- > sluggishness and inactivity
- melancholic (i.e. black bile)
- > depressed, apprehensive, resentful, shy
What did Claudius Galen of Pergamon propose in his work “On the nature of man” (2nd century AD)?
4 humours contribute to the formation of character
- blood
- phlegm
- black bile
- yellow bile
What was the Hierarchy of Spirits (vapours) in Galen’s Physiological System (131-201 AD)?
- Animal spirits: Brain (soul)
- Vital spirits: Heart
- Natural spirits: Liver
What was the Hierarchy of Souls in Renaissance Philosophical Psychology (Reisch, 1517)?
“static hierarchy of notability”
- Intellective soul: Brain
- Sensitive soul: Heart
- Vegetative soul: Liver
What did the work of art Melencolia I of Albrecht Dūrer express (1500s)?
Melencolia (depression) = Positive character
- temperament style
- basis for intellectual/imaginative accomplishments
- popular view during
What was the popular view of depression (melancholia) during the Renaissance?
Melancholia = positive character
- something to strive for
What was the view of depression (melancholia) from the minority of artists during the Renaissance?
- Negative connotation
- Associated with impairment
=> debate on the value of melancholia
What was the Kraepilin’s account of depression (1900s)?
Part of manic-depressive illnesses
- occurring in spectrum of conditions (today’s bipolar disorder)
- 3 core symptoms of depression
- independent temporal dynamics of symptoms
=> co-existence of manic and depressive symptoms in mixed state
What were Kraepelin’s core symptoms of depression (1900s)?
- Thought disturbance (inhibition)
- Mood disturbance (empty)
- Will disturbance (inability to decide)
What was Kraepelin’s concept of independent temporal dynamics of the symptoms in depression?
Affective states continuum
- core symptoms vary independently
- different combinations of the symptoms at different time points
=> mixed states
- co-existence of manic and depressive symptoms
How did Sigmund Freud conceptualise depression (1917)?
“Mourning and Melancholia”
> Self-blame
-> depression or adaptive sadness
> Ambivalence in relations with deceased people
-> unconscious anger -> self-directed anger
What was John Bowlby’s model of depression, as presented in his work “The making and Breaking of Affectional Bonds” (1977)?
Depression in Attachment Theory:
- problem in detaching from people
- AND with processing loss
- > Making and breaking of affectional bonds
- > Understanding of depression
What does the revised Learned Helplessness model of depression (Abramson, Seligman, Teasdale, 1978) consist of?
> Attribution theories of motivation
- importance of perceived agency
- > modern cognitive theories
> Depression = negative attribution style
-> cycle of decreased self-worth and vulnerability to depression
What did the modern cognitive theories of motivation supersede?
They superseded the simplistic motivation theories
- Freud: one drive (libido) leads all human striving
What was the limit of the revised learned helplessness model (Abramson, Selgiman, Teasdale, 1978)?
Studies using attributional style questionnaire
- normal scores in remitted depression
- yet, the model suggests person’s attributional style should persist even when depression symptoms have subsided (vulnerability factor outside of depression)
What did Aaron Beck propose as a theory of depression, in “Thinking and Depression” (1963)?
> Idiosyncratic content and Cognitive distorsions
- dominating schemas
> Depression as affective disorder
-> impairment of thought processes (failure to demonstrate evidence)
> Abnormalities in the responses to standard battery of psychological tests
- arbitrary inference
- selective attention
- over-generalisation
- magnification and minimization
> Reciprocal interaction between cognition and affect
What is Beck’s Cognitive Triad (1976)?
Self-critical interpretations
- Negative view of self
- Negative interpretations of current experiences
- Negative view of own future
What were the core ideas of Beck’s Cognitive model of depression (1967, 1978, 1979)?
Underlined effects of certain types of negative cognitions (schemas) in aetiology of depression
- Negative cognitions play causal role in symptoms of depression
- > Base of vicious cycle in development and maintenance of depression
How did Teasdale contest Beck’s Cognitive model of depression (1983)?
> Negative thinking does not cause depression, it produces symptoms
- pessimism
- low-self esteem
- negative outlook
> Biasing thoughts into negative direction
What were the social origins (factors) of depression according to Bowlby?
> Social vulnerability factors of depression:
- early loss of mother
- lack of adequate confidant
- unemployement
- caring for young children
- > made women more susceptible to develop depression, as response to life events
- mediated by low self-esteem and hopelessness
What was the theory of Watson and colleagues on anxiety and depressive disorders?
Positive and Negative Affectivity:
- evidence suggests assessment of Positive/Negative Affect (PA/NA) may improve differentiation of Depression and Anxiety
- predictors of psychiatric disorder
- consistently related negatively to symptoms and diagnoses of depression
- loss of pleasurable engagement
=> Depression: condition of increased negative affect and decreased positive affect
What is the purpose of the attributional style questionnaire?
Test from attributional / learned helplessness model of depression
How is the attributional style questionnaire composed?
12 different hypothetical situations
- 6 good events
- 6 bad events
-> each situation is followed by 4 questions
Scoring based on the answers
- > Attributional style for negative things is:
- internal vs external
- stable vs unstable
- global vs specific
If global, stable and specific = Higher vulnerability to depression
How is Beck’s Dysfunctional Attitude Scale composed?
2 sections of items with their factor loading:
- Perfectionism/performance evaluation
- Dependency
What is the theory of John D. Teasdale on dysfunctional attitudes in depression?
Dysfunctional attitudes might not always be present in people who have recovered from depression
What is the “Differential Activation Hypothesis” of John D. Teasdale?
Only when priming people into negative mood state
will it make them show their dysfunctional attitudes
-> Mood priming procedure
What does the sad mood induction of John D. Teasdale consist of?
Mood priming procedure + Dysfunctional Attitude Scale
- > compare score prior and after playing sad music
- > measure of “Cognitive Reactivity”
=> supports Teasdale’s Differential Activation Hypothesis
=> predict subsequent recurrence of depression in people who’ve remitted
What does the Positive and Negative Affect Schedule of Watson and colleagues (1988) consist of?
- Words that describe different feelings and emotions
- Indicate the intensity (from 1 very slightly/not at all; to 5 extremely)
- Different time periods are allowed
=> 1 score for positive and negative emotions (affect)
What are the limitations of the Attributional Style Questionnaire?
> Hypothetical situations are of different relevance to different people
> People are not asked about emotional relevance of their attribution
=> inconsistent results
What are the limitations of the Dysfunctional Attitude Scale (DAS)?
> Measures “cognition” BUT these are emotionally charged
> Correlates highly with depression scales
-> difficult to dissociate from overall level of symptoms
What are the limitations of the Positive and Negative Affect Schedule (PANAS)?
> Combines emotions of different nature
- assuming only their common positive/negative valence matters in understanding depression
> Individual emotion items have not been validated to probe this assumption
=> assumptions on valence of emotions in depression needs testing
What do explicit tests (tasks) consist of?
> They rely on people’s insight and reflection
> May be biased by social desirability effects
What type of tests did social psychologists develop in response to the limitations of explicit tests (tasks)?
Implicit tests
- e.g. measure social stereotypes
-> Implicit Association Test
Which tasks are becoming popular for their capacity to measure “real” human decisions?
Gambling tasks
- probe economic interactions
What does the Implicit Association Test (IAT) to measure self-esteem consist of?
> Practice and critical blocks
> In critical blocks (step 3 and 5):
- words come up on screen
- participants have to press left/right button
- > indicate whether the word corresponds to “unpleasant or not me” OR “pleasant or me”
What is the underlying theory of the Implicit Association Test (IAT) to measure self-esteem?
It’s easy to make responses with a button to indicate one’s stereotypical association of categories together
What did the unpublished data of Lythe and Zahn (2012) show on the Implicit Association Test (IAT) to measure self-esteem?
Negative results
- median was the same between the 2 groups
- > no difference between people with remitted MDD and healthy controls
What is the limitation of the Implicit Association Test (IAT) to measure self-esteem?
Only broad associations between two categories can be measured
(e.g. “good - me”)
What does the “ultimatum game” gambling task consist of?
Split a sum of money by proposing the split to someone else who can accept OR reject the offer
e. g.:
- fair split of money usually 50%
- if offers are perceived fair or hyper-fair -> acceptance rate goes down
What were the results from the study by Harlé and colleagues (2010) on the “ultimatum game” gambling task?
- People with depression seemed to accept unfair offers more readily than healthy controls
- Problem with cross-sections comparisons between different groups
What is the limitation of gambling tasks raised by Harlé and colleagues in their study on the “ultimatum game” (2010)?
Gambling tasks are always connected to money
-> might not be the best model for every type of social interaction
Why are feelings of self-worthlessness a good candidate for the primary symptoms of depression?
- Transculturally stable
- Part of core Majore Depression syndrome
How is the self contempt bias calculated?
Subtracting the percentage of trials associated with contempt towards self
Minus percentage of trials associated with contempt towards others
What were the findings of the study on the proneness to lower contempt (disgust) towards others vs. self in remitted MDD?
> No overall differences in intensity of unpleasant feelings (remitted depression and medication-free)
-> negative affect theory of depression has some flaws
=> Presence of selective bias towards self-blaming emotions
-> supporting the revised helplessness model of depression
