L5 - Depression

Question 1

How are psychopathological conditions defined?

Answer 1

Using the 4 Ds

Distress
Dysfunction
Danger
Deviance from norms

Question 2

What is the DSM-5 definition of psychological conditions?

Answer 2

A clinically significant disturbance to someone’s cognition, emotion regulation or behaviour that reflects a dysfunction in the psychological, biological or development processes underlying mental functioning.

Question 3

What are the core symptoms of depression, how long do they need to be present and how many need to be present in order for depression to be diagnosed according to the DSM-5?

Answer 3

At least 2 weeks + 1 symptom of:

Feelings of sadness/ low mood

Loss of interest in usual activity

Question 4

What are the other common symptoms of depression and how many need to be present for depression to be diagnosed according to the DSM-5?

Answer 4

At least 5 of these other symptoms needs to accompany the core symptoms:

Change in appetite, losing/ gaining weight

Sleeping too much/ little (insomnia)

Fatigue + low energy most days

Feeling worthless, guilty and hopeless

Inability to focus/ concentrate that interferes with daily life

Movements are unusually slow/ agitated

Suicidal ideation/ suicide attempts

Question 5

What must these symptoms cause?

Answer 5

clinically significant distress or impairment in social, occupational or other important areas of functioning

A medical professional must determine that the person’s symptoms don’t have another cause

Question 6

Is the prevalence of depression increasing across generations + what research is there to show this?

Answer 6

Yes!

Liu et al (2019) - The no. of incident cases of depression worldwide increased from 172 million in 1990 - 258 million in 2017 (49.9%)

Collishaw (2015) - clinical diagnosis + treatment of child and adolescent psychiatric disorders increased over recent decades

Patalay and Gage (2019) - increased in emotional problems born in early 00s compared to those born in the early 90s

Question 7

What can explain this change in prevelance?

Answer 7

Medicalisation of ‘normal’ problems –> a significant increase in diagnosis by GPs and increase in antidepressant prescription (Dorwik and Frances (2013)
Reasons:
Patients could be presenting distress as depression
Misdiagnosis from GPs
Perception of MH as a ‘disease’ –> leads to increase in prescriptions

Overestimation of problems –> due to the raise in public awareness about MH problems does lead to more accurate reporting OR an interpretation of milder forms of distress as MH disoreders

Question 8

According to Wolbert et al., (2019) how much is spent on research into mental illness each year?

Answer 8

£9 per person affected by mental illness

Question 9

What are the biological risks factors for depression?

Answer 9

Heritability estimates:
Twin studies - approx. 37%
General pop. - approx 32%
–> shows that genes pay a significant role but aren’t the sole factor

Neurotransmitters:
Low activity of serotonin, dopamine, norepinephrine are linked to depression
Serotonin –> treatment

Neural Regions:
Karen et al., 2018
Meta-analysis - 38 fMRI + 12 EEG studies showed blunted neural response to reward + is more pronounced in >18s

Question 10

What are the social/ environmental risk factors for depression?

Answer 10

Childhood Trauma:
1) Emotional abuse - strongest association with depression
2) Neglect
3) Sexual abuse
Significant associations with domestic violence and physical abuse.

Resilience to negative life events

Question 11

What are the psychological risk factors for depression?

Answer 11

Negative Triad Theory –> Aaron Beck
Unconscious sets of beliefs that influence negative views of self, world + future resulting in info processing biases

Question 12

What are the gender differences in depression?

Answer 12

Women are 2x more likely to have depression (Salk et al., 2017)

This isn’t simply due to men under-reporting depression (Parker and Brotchie, 2010)

Question 13

What are the possible factors that cause these gender differences?>

Answer 13

Girls more likely to be abused

Women more likely to be exposed to chronic stress (caregiving)

Women tend to provide more social support to others facing stress

Social roles - may intensify self-critical attitudes about appearance

Question 14

What causes depression?

Answer 14

A combination of all 3 factors

Question 15

What medications are used to treat depression?

Answer 15

SSRIs –> often the 1st line pharmacological treatment for depression + are an effective method (Jackobsen et al., 2017)

Question 16

What are the different therapies used to treat depression?

Answer 16

Psychoanalysis - treats depression as a response to loss

CBT - addresses schemas and coping strategies (i.e. challenges dysfunctional thoughts + replaces with rational beliefs)

Client-centred therapy - disturbance in ability to reach full potential

Social skills training - treats the inability to communicate and socialise appropriately

Question 17

How effective are these therapies?

Answer 17

Cuijpers (2019)
Moderate-to-large effect sizes for depression + anxiety disorders –> smaller for psychoses and bipolar disorders

Findings can be deems as optimistic due to publication bias, low quantity of trials and a lack of research into long-term goals.