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Psychological Disorders > MDD Psychological models > Flashcards

MDD Psychological models Flashcards

1
Q

What is persistent depressive disorder (fka dysthymic)?

A

milder, chronic depression
for at least 2 years
without remission >2 months

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2
Q

MDD symptoms

4 types

A

emotional= sadness/ numbing +- anxiety, anger, agitation
cognitive= negative self-view, guilt/ self-blame, pessimism/ hopelessness
motivation= trouble starting, physical inertia, indecisiveness
somatic= appetite, sleep, fatigue, libido, hypochondriac
single episode/ recurrent

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3
Q

MDD diagnostic criteria

A 
at least 5 symptoms
nearly daily
for at least 2 weeks
daily depressed mood (for most of the day) +//
daily diminished interest/ pleasure (")
may include psychotic features
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4
Q

Harre+ Finlay-Jones (1986)

emotional talk in history

A 
accidie= boredom, disgust with fulfilling one's religious duties
melancholy= black bile, gloomy, clever men
mopishness= impaired senses, idleness in those born to work
20thC= MDD= accidie+ mopishness= linked to unfulfilling work
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5
Q

Kessler+ Bromet (2013)

A

higher lifetime prevalence in richer countries
median AOO= early adulthood
course= often chronic- recurrent
women lifetime risk roughly double mens (worldwide)
separated/ divorced have higher rates of MDD than married
prevalence decreases with age

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6
Q

Behavioural aetiology

A

Mair+ Seligman (1976)= learned helplessness (perceived uncontrollability of aversive stimuli)
Support:
Hiroto (1974)= non-depressed stopped trying to stop a noise when previously unsuccessful
Lewisohn (1979)= reduced rewards
Constantino (2012)= negative spiral of reduced social rewards

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7
Q

Behavioural Rx

A 
operant conditioning (test uncontrollability)
classical (learn non-depressive association to stimuli)
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8
Q

Behavioural evaluation

A

lab created motivational deficits seen in depression

behavioural Rx rarely used alone

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9
Q

Cognitive aetiology

Who created the attributional reformulation of learned helplessness?

A

Abramson, Seligman and Teasdale (1978)
internal (personal failing)
stable (will persist over time)
global (will persist over different situations)

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10
Q

Depressive attributional style (Beck)

Cognitive aetiology

A

Negative cognitive triad
-pessimism of self, world+ future
(stems from our childhood/ schemata/ how we evaluate)

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11
Q 
Schemata
what is it?
what's it for?
what's it triggered by?
what does it determine?
A

unspoken/ inflexible assumptions/ beliefs
for screening/ discriminating/ processing stimuli
triggered by negative life events
determine content of cognitions+ affective processes

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12
Q

CBT 4 stages

A

education= teach relationships between cognition, emotion and behaviour

behavioural= reinforce/ reality test, pleasant event scheduling (increase engagement/ activity)

cognitive rehearsal= develop coping strategies (detecting thoughts/ bias) and correct dysfunctional thinking

behavioural hypothesis testing= test validity of negative assumptions

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13
Q

Carter+ Garber (2011) longitudinal study predicting MDD onset

A

cognitions ?cause/consequence of MDD
predicted by high negative cognitions (even with low interpersonal stress) or increased stress (regardless of cognitions)

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14
Q

Hiroto (1974)

A

non-depressed volunteers stopped trying to stop a loud noise when their past efforts were unsuccessful
(support for learned helplessness theory)

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15
Q

Lewishon (1979) and Constantino (2012)

A

further support for learned helplessness theory (reduced rewards)

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16
Q

Cognitive aetiology (5)

A 
Negative cognitive triad
Learned helplessness
Schemata
Cognitive biases
Negative automatic thoughts (steady train of unpleasant ideas pop into head)
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17
Q

Moore+ Fresco (2012)

A

depressed people have less illusion of control

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18
Q

Roshanhaei-Moghaddam (2014)

A

MDD patients show relatively similar effects for CBT+ psychopharmacology Rx

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19
Q

Freud’s psychodynamic aetiology of MDD (1917)

A

defence mounted by the ego against the intra-psychic conflict
reaction to loss (real/symbolic/ imagined)- regression to oral stage of dependency
unconscious anger turned upon self- despair/ self-hatred

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20
Q

Blatt+ Homann (1992) core assumptions of modern psychodynamic theories of MDD

A

rooted in early losses
wound reactivated by a recent blow
regression to stage of help/hopelessness
ambivalent feelings= central unconscious conflict
overly seek self-esteem from others
ensuing dependency has a relationship function

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21
Q

Psychodynamic Rx= traditional psychoanalysis

A 
uncover childhood roots of MDD
explore ambivalent feelings towards lost object
-free association
-dream analysis
-analysis of resistance/ transferance
IPT
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22
Q

Klerman (2004) IPT

A

Interpersonal psychotherapy (IPT) focuses on

  • present problems> past
  • MDD use in relationships
  • core problem+ possible solutions
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23
Q

Psychodynamic evaluation

Bornstein (1992)

A

some depressed people= highly dependent

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24
Q

Psychodynamic evaluation

Willoughby (2013)

A

poor parenting is a risk factor for MDD

consistent with attachment theory (Ainsworth+Bowlby, 1991)

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25
Q

Psychodynamic evaluation- Rx depends on accepting what?

A

the internal logic of the psychodynamic theory

26
Q

Psychodynamic evaluation

Lemmens et al (2011)

A

cognitive therapy+ IPT are successful for acute MDD

no consensus about one outperforming the other

27
Q

Social aetiology

Holmes+ Rahe (1967)

A

recent life events

28
Q

Stegena (2012): recent life events…

A

…carry the largest risk of MDD onset in mid-life
middle aged= more vulnerable
- increased responsibilities/ social ties?
-hormonal (menopause increases vulnerability)

29
Q

Brown+ Harris (1978)

Social aetiology

A

vulnerability in women

  • unsupported relationship with spouse
  • no job outside house
  • 3+ young children
  • no serious religious committment
  • loss of mother <11y
30
Q

Social Rx

A

IPT

31
Q

Whisman+ Schonbrun (2010)

A

couples/ marital therapy as effective as individual CT, IPT or psychopharmacology in reducing depression when discord is a problem

32
Q

Social evaluation

A

attention on social/ situational factors

can’t predict who becomes depressed

33
Q

Perris (1991) inborn capacity of gathering/ processing information

A

genetics
post-natal influences
biochemical/ neurophysiological factors (eg ageing)

34
Q

Perris (1991)
active construction of the world
development of cognitive schemata
emergence of self identity

A

genetics, post natal, biochemical

culture, attachment, parental rearing, environmental

35
Q

Perris (1991)
basic dysfunctional assumptions
individual vulnerability
personality characteristics

A

culture, attachment, rearing, environment
systematic perceptual/ processing errors
stressful life events with idiosyncratic meaning

36
Q

Perris (1991)

psychopathology- MDD

A

stressful life events with idiosyncratic meaning

37
Q

Perris (1991) vulnerability reflects relationship between

A

genetic predisposition and one’s history

38
Q

Perris (1991) people are vulnerable to certain events which wouldn’t affect others- depends on

A

personality, cognition, emotional organisation

39
Q

Perris (1991) core of individual vulnerability is

A

dysfunctional self-schemata

40
Q

Perris (1991) time dimension

A 
chronological time (growth/age differences)
social time (eg puberty, marriage, retirement)
historical time (economic climate)
41
Q

Perris (1991) earlier developmental issues have a higher risk of worsening because

A

biased self-verification process

42
Q

Perris (1991) ADD (low what?) in kids correlates with depressive illness

A

low MAO

also increases vulnerability in depression-prone adults

43
Q

Bowlby (cited in Perris (1991)) what determines likelihood of certain cognitive maps (working models/ self schemata)?

A

genetics

44
Q

Perris (1991) earlier onset of MDD due to

A

conflictive home environments
1+ affected parent (heredofamilial/ biological)
dysfunctional rearing from mother (dad= not significant) (psychosocial)

45
Q

Perris (1991) abnormal biohumoral changes are state dependent or trait dependent?
what do they interact with?

A 
state dependent
(often interact with cognitive processes)
46
Q

Perris (1991) what % of patients don’t respond enough to a single Rx (drugs/ CBT)?

A

30-40%

47
Q

Perris (1991) individualised/ integrated Rx program needs

A

constant reappraisal/ self-evaluation of clinician/ therapeutic strategies

48
Q

Stegenga (2012) different vulnerability to life events according to

A

age

implications for identifying/ preventing

49
Q

Maciejewski (2001) life events triples likelihood of MDD in

A

women

50
Q

Stegenga (2012) (dis)agrees with stress-vulnerability model?

A

agrees

- lower stress threshold

51
Q

Stegenga (2012) methodology

A

self-reported questionnaire on major life events
DV= MDD diagnosis in preceding 6 months
wide CIs in men (caution in interpreting)

52
Q

Stegenga (2012) sum of individual life events= same as combined effects of them?

A

false

combined> sum of individual

53
Q

Abramson, Seligman+ Teasdale (1978) the old learned helplessness theory didn’t distinguish between

A

universal/ personal
general/ specific
acute/ chronic

54
Q

Abramson, Seligman+ Teasdale (1978) LHH is

A

learning that outcome= uncontrollable- cognitive deficit- harder to later learn that responses produce that outcome

55
Q

Alloy+ Abramson: non-contingency is harder to perceive when

A

one is winning

56
Q

Clark+ Clark (1939) a major determinant of attitudes to oneself is

A

comparison with others

57
Q

Abramson (1977) self esteem only lowers when

A

it’s just you/ personal helplessness

58
Q

Abramson, Seligman+ Teasdale (1978) Rx

A

reduce catastrophising of uncontrollable outcomes

make people feel more in control

59
Q

Harre+ Finlay-Jones (1986) people with undiagnosed DDs are

A

socially isolated
unemployed/ menial jobs
unable to keep busy- anxious/ depressed

60
Q

Harre+ Finlay-Jones (1986) historically depression was seen as

A

laziness- behavioural/ emotional causes- misery
negligence of moral order- in boring jobs- spiritual vice
St Paul- good/ bad form of depression- God
Boredom- apathy, can cause fear/ misery- misdiagnosis of DD

61
Q

Cognitive biases

A

logic errors in assessing eg selective abstraction

62
Q

Selective abstraction

A

focusing on negative detail

Psychological Disorders (7 decks)

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