Explanations for disorders Flashcards
ISSUE with explanations for disorders
It is important that we find appropriate explanations for different disorders. If we are able to find an explanation for disorders such as depression or anxiety, then we may be able to develop treatment that targets the root cause of these disorders, hence effectively reducing or preventing cases.
It is important to be able to evaluate different explanations for disorders, as this can help us to determine to what extent an explanation may be plausible. therapy, which could overcome these negative types of thinking.
Overall eval:
Reductionist explanations cant fully explain the biopsychosocial model
cog explanatiosn for depression
suggested that “automatic thoughts”, which accompany everything we do, may be a cause. He suggested that a change in automatic thoughts could lead to changes in behavior, and noted that patients with depression often had automatic thoughts that were exaggerated, irrational and dark.
Congitive triad
self (im worthless)
World (no one thinks about me)
Future (my future is fruitless)
Negative self-schemata
they are automatic thoughts that are resistant to change. Therefore, it is difficult to change this type of negative thinking, as they are instant and automatically activated. These schemas could be a result of experiences such as a traumatic childhood, excessive criticism, abuse, and bullying.
Faulty thinkin patterns
can lead to irrational thoughts. This can be classified as arbitrary interference, selective abstraction, overgeneralization, personalisation and dichotomous thinking.
Beck theorized that people with depression often have these types of irrational thinking patterns.
This suggests that how people think are what causes problems, rather than environmental factors out of the patient’s control.
if these negative thinking patterns are what cause disorders such as depression, then some treatment methods would be to use cognitive behavioral therapy, which could overcome these negative types of thinking.
CBT pros and cons
Cognitive behavioural therapy
If we can teach u to think in a more positive way, u can get better
It may be positive for the responsibility of recovery to be put on the patient, as it suggests they are able to help themselves get better.
However, they can also blame themselves bc it sounds like theyre being accused of choosing to think that way
counterproductive and can lead to patients feeling distress or guilt.
Pros and cons with that type of thinking
^^ how to measure if theory is true- whether treatment based on it works
If treatment works, then suggests that theory is correct.
BAD
bi-directional ambiguity; it is difficult to determine whether it is our cognitive behavior and the way we think which leads to us developing depression, or whether it is our depression which can change our thinking patterns.
If the latter were the case, then the cause of depression may not necessarily be due to our cognition, and therefore, CBT may not necessarily be effective.
Longitudinal studies, as opposed to cross-sectional ones, could be able to address this issue.
Alloy et al
This was a longitudinal study that tracks depression, its risk and probability. Alloy et al claimed that the way people interpret their experiences cognitively can influence their vulnerability to depression.
Procedure
They had split a sample of participants into low risk and high risk groups depending on the presence of negative cognitive styles, and checked up on them using questionnaires and interviews for 5 years after that.
Results
The results found that near 20% of participants in the high risk group developed depression/ MDD during the next 2 and a half years after the follow up, versus only 1% of the low risk group.
EVAL
However, this study does not look at how participant’s thinking styles may have already been developed from their life experiences, and it is unable to control this factor.
depression was a result of a participant’s cognition may be a reductionist argument. A person’s cognitive thinking may also be affected by their biological aspects, which may lead to different ways of thinking, and eventually depression.
correlational, and does not show a cause and effect relationship between the two.
The study also does not look into many other factors that may affect the rates of depression, such as the difference in depression rates between men and women.
Nolen- hoeksema
investigated levels of rumination in participants, suggested that differences in depression rates between women and men may be due to levels of rumination.
Nolen- Hoeksema found that both women and men who ruminate following the loss of a loved one or when feeling sad were more likely to become depressed and to suffer longer and more severe depression than those who ruminate less. They concluded that rumination appears to predict depressive disorders and depressive symptoms.
Nolen-Hoeksema & Girgus (1994) have outlined three risk factors for depression in adolescence. They argue that girls are more likely than boys to have these risk factors for depression. The risk factors are: 1. Girls are less assertive than boys and score lower than boys on questionnaires that assess leadership ability. 2. Girls are more likely than boys to engage in ruminative coping. An eighteen month longitudinal study has shown that this coping style predicts onset of depression and is associated with more severe symptoms (Just & Alloy, 1997). 3. Girls are less likely than boys to be physically and verbally aggressive and are less dominant in group interactions.
EVAL
This also seems to support the idea that our cognitive behavior may influence our risk of developing depression. However, limitations of the study would be that the study was heavily reliant on self-report data from participants. It would have been more useful to have clinical diagnoses of anxiety and depressive disorders, as this would show firm conclusions about the relationship between rumination and disorders such as anxiety and depression.
Rumination
Rumination is when one obsesses over negative events. They proposed that as women are more likely to ruminate, while men are more likely to distract themselves when feeling depressed, this could lead to increased depression in women. When people ruminate, they recall negative memories from the past, and hence interpret their current situation negatively, and are more pessimistic about their future. However, rumination is obviously not exclusive to women.
Problems w cog explanatiosn for depression
cognitive explanations for disorders such as depression may be plausible,
While Alloy et al’s results seem to suggest that there is a link between cognitive behavior and depression, Nolen- Hoeksema offers an explanation as to why this link may occur, through investigation of rumination. As such, we may be able to apply treatment that is more targeted and focused, as opposed to general CBT, which may increase chances of treatment being effective.
It may be argued that if the treatment based on the theory works, then the theory itself must be correct.
all studies conducted are correlational, with no clear cause and effect shown.
This is because it is not possible to directly influence the independent variable (the cognition of participants), as this is not directly observable.
self-report data, leading to potential inaccuracies in results.
The idea that the theory must be correct due to treatment such as CBT working would also be an example of the treatment etiology fallacy. As CBT does not work in every case, then the theory behind it must not also necessarily be true.
does not take into any account other factors such as biological or environmental factors, leading to a reductionist argument,
SSRI
Drugs called SSRIs (selective serotonin reuptake inhibitors) help increase the amount of serotonin available in the brain, and hence reducing symptoms of depression. If low levels of serotonin cause depression, than perhaps genes that cause people to have lower levels of serotonin could explain why some people become depressed after stressful life events, although the gene that led to depression increases availabe serotonin.
Caspi
Participants were groups of children, and were in 3 groups: participants with two short alleles, participants with one short and long allele of the gene, and participants with two long alleles. This was a longitudinal study, where each participant did a questionnaire that measured their life events, involving events such as problems with money, health or relationships. Another questionnaire tested whether or not they had any previous symptoms of depression, which was used to give each participant a quantitative “depression score”. Caspi found that participants who had at least one short allele and had been through stressful life events showed significant increased in symptoms of depression, and that participants with short alleles were more likely to be diagnosed with depression. Having short alleles also made participants more susceptible to suicidal thoughts after the stressful events, and that they were more likely to report severe symptoms of depression if they had suffered a number of stressful life events. They concluded that the evidence seems to suggest there is a relationship between life events and genes/ biology in causing depression, also known as the diathesis stress model.
This seems to support both the nature and nurture arguments, as both life events, which are environmental factors, and our genes, which are biological work together to increase the chances of developing depression. It seems that in order to become depressed, a person needs both a specific gene and stressful life events. These findings can be useful to clinicians, as it indicates that people with depression may have different causes for their symptoms.
EVAL
Use of correlational data. No cause effect
This information can help us narrow down individuals who are at high risk for depression.
ethical issues, as people are labeled as being high risk for disorders, and this could not only lead to distress, but potentially self-fulfilling prophecies. However, this explanation does not explain the wide range of symptoms that are seen in depressed patients, or differences across cultures. For example, a study by Kleinman found that Chinese patients were more likely to express somatic symptoms such as lower back pains. It is not clear that all symptoms could be explained by genetic arguments alone.
The dv was depression, but these were due to self reported symptoms rather than diagnosis/ based on spec criteria
Therefore, cultural differences in concept of depression may give diff results
Diathesis stress model
relationship between life events and genes/ biology in causing depression
Brown and harris
Procedure
The aim of the study was to investigate how depression could be linked to social factors and stressful life-events in a sample of women.
Approx 450 women in South London were surveyed on their daily life and depressive episodes. They focused on particular life events or particular difficulties faced by the women
These events were later rated in severity by independent researchers.
8% of all the women - had become clinically depressed in the previous year.
nearly 90%) had experienced an adverse life event (e.g. loss of a loved one) or a serious difficulty (e.g. being in an abusive relationship).
Only 30% of the women who did not become depressed suffered from such an adversity.
Only v small no. of women who became depressed had not experienced any adversity.
Social class - measured by the occupation of the husband - played a significant role in the development of depression in women with children. Working class women with children were four times more likely to develop depression than middle-class women with children.
The researchers identified three major factors that affected the development of depression.
Protective factors found to protect against the development of depression in spite of stressors, e.g. high levels of intimacy with one’s husband. These factors lead to higher levels of self-esteem and the possibility of finding other sources of meaning in life.
Vulnerability factors found to increase the risk of depression in combination with particularly stressful life events - called provoking agents in the study. significant vulnerability factors included (2) lack of a confiding relationship, (4) unemployment.
Provoking agents found to contribute to acute and ongoing stress. These stressors could result in grief and hopelessness in vulnerable women with no social support.
Conclusion
The study showed that social factors in the form of life-stress (or serious life-events) could be linked to depression.
The fact that working-class mothers were more likely to develop depression than middle-class mothers showed risk factors associated with social class. low social status leads to increased exposure to vulnerability factors and provoking agents, whereas high social status was associated with increased exposure to protective factors and decreased exposure to provoking agents.
MCEG
The sample size of the original study was relatively large, making the results potentially more reliable.
females were interviewed so the results may not be generalized to men, but the relationship between stressful events and onset of depression might be applicable to men as well.
this study is based on self-reporting of depressive episodes.
correlational research.
Falconer model
Estimates of genetic heritabilty in twin studies is based on falconer model Assumes phenotype (such as the presence of symptoms of MDD_ is compromised of 3 types of influences: genetics, shared environment and ind environment
Kendler et al
Conducted swedish national twin study on MDD
Aim- to compare genetic effects on MDD in males and females, as well as across diff gens.
Used and assessed approx 40,000 twins with DSM 4 criteria of MDD in telephone interview. Approx 8000 twins met criteria for MDD at some point in life, and 300 twins voluntarily discussed history of antidepressant treatment
interviewers also asked questions about the twins “shared environment” - that is, when they were living in the same household - and their “individual-specific environment” - that is, adult personal life events that may make members of the twin pair more susceptible to depression.
Results
Heritability of MDD sig. Higher in women (42%) than men (29%)
No evidence for roles of genetic and environment across generatinons spanning 60 years
Showed sig diff between men and women in terms of genetic predisposition to depression
the correlations were significantly higher in monozygotic than in dizygotic twins.
no correlation between the number of years that the twins had lived together and lifetime major depression.
This study suggests both that the heritability of major depression is higher in women than in men and that some genetic risk factors for major depression are sex-specific.
Conclusion
Though theres some evidence to suggest genes can affect heritability of MDD, the
Flaconer model ignores gene environment interaction (when 2 diff genotypes respond to same environment in diff ways)- influence of genes on depression might not be that straightforward.
Genes can theoretically create susceptibility to certain environemental influences, but environemnt would still be triggering factor.
MCEG
The study is correlational,
No particular genes were isolated and tested in the study.
Information about life-events and depressive symptoms was self-reported. Differences could arise if men are less reliable in their reporting of lifetime major depression than women.
The interviewers did not officially diagnose the twins and they accepted the diagnoses made by clinicians when it was reported by the interviewee; as we know, clinical diagnoses are not highly reliable
very large sample size
Rosenquist, Fowler and Christakis
Investigated possibility of spreading depressive symtpoms from person to person, and suggested the following reasons:
Depression in one person causes it in their friends
Depressed ppl notive each other and become friends
Friends experience same/ similar environments, so experience same symptoms
Method
Obtained data from a longitudinal study investigating risk factors for heart disease in small town Framingham. The framingham heart study (FHS)
Study had tracked info on the ppt’s friends (based on self reports), neighbors (from address), coworkers (based on their job), relatives
To assess symptoms of depression, they used a standardised depression scale
Results
Sig correlation in depressive symptoms between ppl up to 3 degrees of separation
Person’s depression depends on depression of their friend (90% more likely for ppt to get depressed), friend’s friend (40%), and friend’s friend’s friend (37%)
New friends can influence u to become depressedm but becomig depressed doesnt come w acquiring new friends. So it suggests their theory of depression in one person causes dperession in another to be more likely than theory abt depressed ppl notiving each other and becoming friends
Directionality of friendship seems important- in a couple A and B, if A nominated B as friend but not vice versa, if B becomes depressed it doubles chance of A becoming depressed, ut if A becomes depressed, no effect on B
EVAL
Privacy? Tracked ppl close to ppt who might not have given informed consent
BUT, lots of the contacts were already ppt in the study bc of the town being so small
Silberg et al
Gene- environment interaction
When 2 diff types of genotypes respond to same environemnt differntly
Silberg et al
Investigated link between susceptibility to depression and environemtnal factors (stressful life events)
Used data from juvenile twin pairs (around 1400) from age 8 to 16
Depressive symtpoms assesed using child and adolescent psychiatric itnerview
Ratings of past year life events used from interviews w moms
Results
Effects of Negative life events on depressive symptoms in girls is stronger
Maybe bc genetic predispostion causes girls at this age to be more vulnerable 2 these things
