CS Wiles: Theories For Depression

Question 1

What was the aim of Wiles: study of depression

Answer 1

To investigate the effectiveness of CBT (cognitive behaviour therapy) in treating depressed people who have no improved after taking medication (treatment resistant depression TRD)

Question 2

Method of Wiles: study of depression

Answer 2

Recruited 469 participants from Bristol, Exeter and Glasgow belling to 73 different GP practises

All participant had treatment resistant depression (TDR) they had been taking antidepressants meds for more than 6 weeks and still showed symptoms of clinical depression. (They all had a Beck Depression inventory of 14 + which measure the symptoms of depression)

Randomly assigned one of two conditions using a computer-generated code:
1. Usual care (antidepressants only)
2. Usual care + CBT (CBT involved 12-18 sessions of about a hour given by a CBT therapist)

Improvements was assessed by measuring symptoms of depression using BDI

Question 3

Results of Wiles: study of depression

Answer 3

At the end of the 6 months 422 participant (90%) remained in the study
-usual care 21.6% had more tan 50% reduction in symptoms
-usual care plus CBT 46.1% had more than50% reduction

At the end of the 12 months 396 participants (84%) remained in the study. Those in unusual care + CBT continued to show much greater levels of recovery and a greater chance of remsssion (I.e their symptoms did not return)

Question 4

Conclusion of Wiles: study of depression

Answer 4

Amongst patients who did not respond to antidepressants, CBT is a useful addition to treatment. CBT plus antidepressant meds is more effective in reducing depressive symptoms Than antidepressant meds alone

The results suggest that these benefits can be maintained over 12 months

Question 5

State 2 strengths of Wiles; theories of depression study

Answer 5

One strength is that it was very carefully designed to control extraneous variables.
One potential extraneous variable was participant differences in the 2 conditions because this was an independent group design (one group usually care the other usual + CBT). It could be that the patients were randomly assigned to groups so there should be no difference. In addition the initial BDI scores for both groups were checked to see that on average, they were similar.
Furthermore the final analysis the figure for comparison was amount of improvement rather than actual level of depression
This means that we can conclude with confidence that changes in the dependent variable (reduction in symptoms) were not attached by a key potential extraneous variable

Another strength of this study is that it focuses on developing a useful theory
The aim of this research was to demonstrate that a well controlled study that combined a more holistic approach to to treating depression can be successful- more successful than antidepressant meds alone which fails two thirds of the people with depression .
Moreover the therapy was relatively cheap at just 343 pounds per year on average. This is equivalent of the cost of some antidepressant meds for a year though others are considerably cheaper.
Such real world usefulness is one of the aim reasons for conducting research.

Question 6

State of weakness of wiles theory of depression study

Answer 6

One weakness us he use of self report methods to determine levels of depression

To be fair it is difficult to assess levels of depression in any other way. However the use of self report meant that participants have to make subjective judgements and may also not have answer statements truthfully. Eg this is one question on the the BDI…
I do not feel sad, i feel sad, i am sad all of the time and can’t snap out for it, i am so sad or unhappy i can’t stand it.
Some people might underestimate how sad they feel or overestimate
This questions the validity of the info collected about depression