depression Flashcards
what is depression and how does it feel?
Isolation, social withdrawal, lethargy, physical manifestation, difficulties sleeping, paranoia
Negative self-evaluation
what is the diagnostic criteria for major depressive symptoms including their duration and severity
depressed mood most of the day or nearly every day (children and adolescents this can be irritable mood)
markedly diminished interest or pleasure in all or nearly all activities, most of the day, nearly every day
significant weight loss or weight gain, decrease or increase in appetite
insomnia or hypersomnia
psychomotor agitation or retardation nearly every day
fatigue/ loss of energy nearly every day
feelings of worthlessness or excessive or inappropriate guilt
diminished ability to think or concentrate or indecisiveness
recurrent thoughts of death, suicidal ideation with or without a specific plan,
what is the DSM-5 critieria
5+ symptoms occurring in the same two week period
represent a change from previous functioning
at least one of core symptoms: depressed mood, loss of interest or pleasure
how much these symptoms impair and distress an individual - social and occupational aspects
not due to direct physiological effect of a subsequent or general medical condition
is depression heterogeneous
yes, high degree of variation that manifests in symptoms, course of illness, response to treatment
highly comorbid - over half have anxiety disorders
implications for how we should study and treat depression
the more anxious form of depression is becoming increasingly common
likely to have a number of complex causes
developmental presentaiton of somatic symptoms
6-12 years: headaches, tummy aches, sleep and appetite change
adolescents: headaches, tummy aches, sleep and apetite changes
adults: bodily aches and pains, sleep and appetite change
developmental presentation of behavioural symptoms
6-12 years: irritability, boredom, apathy, fatigue, decreased enjoyment
adolescent: irritability, apathy, boredom, social isolation, increased sexual activity, aggression, self-harm
adults: social isolation, depressed motivation, apathy, self-neglect, self-harm, loss of interest in hobbies, suicide
developmental presentation in functioning
6-12 years: decreased ability to concentrate in school
adolescents: decreased ability to concentrate at school, decreased academic performance, reduced pleasure from activities
adults: unemployment, poor interpersonal relationships, fatigue, financial burden
how prevalent is depression
Globally approx. 350 million people are suffering from depression (WHO, 2017)
Pre covid value - likely to increase
Depression is the single most burdensome disease in the world (WHO, 2014)
Women are more likely to be diagnosed than men (2:1)
Confounds with reporting symptoms, seeking help, speaking about condition, life experiences that would contribute to this
RELAPSE AND RECURRENCE: 50-60% of those with major depression will go on to have further episodes
how can we explain depression
demographic
female, unemployed, low SES, single/divorced
social factors
stressful life events, daily stressors, childhood adversity, social relationships
genetic factors:
family history, specific genes
biological factors:
5-HT, HPA axis, emotional neural circuitry
psychological factors:
information-processing biases, distorted cognitions, personality/temperament
what is beck’s cognitive theory of depression
negative schemas: inflexible core beliefs or attitudes which shape an individual’s view of themselves, the world and the future
can be triggered automatically
lead to biassed information processes
particularly when they are schema congruent - matching negative view of the world
what is the diathesis stress model
negative schemas are often conceived of as symptoms or consequences but are likely to have arisen from early experiences, genetic factors and personality
Not every life event that trigger depression, only schema-congruent ones
Can have these schemas but be resistant to negative life events
what information processing biases exist in depression
tendency for the information processing system to consistently favour stimulus material of a particular type or content
influenced by motivational state, interest, emtoino
affects attention, memory an interpretation
how do information biases effect explicit memory (Bradley et al., 1995)
Prediction: bias in likely to remember negative information
Same as control for all words, except negative words where recall is better
Robust replicated result
Those who aren’t depressed show a bias towards positive things (rose tinted glasses)
how do information biases affect implicit memory?
Stronger priming effect for negative words
Rate frequency of use use out of 5 then complete word stem
Decide whether words are real
For depression related words depressed individuals show stronger priming effects than controls and people with anxiety
how do informational biases affect autobiographical memory (williams et al., 2007)
Autobiographical memory task
Recall event that matches word - must be a memory of a specific event, time and place
Depressed patients slower than controls for positive cues (suicidal individuals) Williams & Broadbent, 1986
Driven by individuals drawing on more inappropriately overgeneral memories
E.g celebration: christmas every year vs mums 50th last June
Categories of events rather than specifics
Overgeneral autobiographical memory a robust finding in depression (& trauma). Correlates with or predicts: • Rumination • Cognitive deficits • Longer depressive episodes • Poor problem solving Predicts risk of future episodes
