Module 3: Psychological Problems Flashcards
Name symptoms of unipolar depression
- Lowering of mood, tiredness unrelieved by rest, lack of motivation
- Poor sleep, poor/increased appetite, lack of enjoyment in previously enjoyed activities, low self-esteem, feelings of guilt, suicidal thoughts
What is required for a unipolar depression diagnosis?
- One main symptom present most time/days for two weeks
- One other symptom present at some point
How are the different severities of unipolar depression identitified/classified?
- Mild: 4 symptoms
- Moderate: 5-6 symptoms
- Severe: 7+ symptoms and general feelings of worthlessness
Why is depression more commonly diagnosed now than in the past?
- Reduction of stigma
- Increasing knowledge of mental health
- Modern life more stressful and so more likely to cause depression
What are the effects of depression on an individual?
Increased risk of suicide (suggested 10-15% of people with severe depression commit suicide)
What are the effects of depression on society?
- Time missed from work: behind on work –> guilt –> worsens depression, company must cover workload
- Cost of treatment: antidepressants expensive, not enough trained therapists
What studies give evidence for the genetic explanation of depression?
- Craig Hyde et al. (2016), 17 gene variations linked to depression, more likely to develop if family member has it
- Peter McGuffin et al. (1996), identical twins more likely to be depressed if the other one is than non-identical twins
What is the diathesis-stress model of depression?
Some are genetically predisposed to develop depression but only develop it if exposed to stress that activates the gene
What are the strengths of the genetic explanation of depression?
- Lessens stigma (cannot be blamed for depression)
- Research evidence
What are the weaknesses of the genetic explanation of depression?
- Deterministic (assumes people have no free will over being depressed)
- May be reductionist (fails to take life events into account)
Describe Aaron Beck’s cognitive explanation of depression
Cognitive triad: negative view of world –> negative view of self –> negative view of future –> (repeat)
- Example of cognitive bias (negative self-schema)
- Leads to magnification (negative exaggeration)
Describe Albert Ellis’ cognitive explanation of depression
ABC Model: Activating event (stress) –> Beliefs (either rational or irrational) –> Consequences (rational belief (true) –> no depression, irrational belief (untrue) –> depression)
What are the strengths of the cognitive explanation of depression?
- Acknowledges life events, takes nature/nurture into account
- Practical applications (CBT)
What are the weaknesses of the cognitive explanation of depression?
- Can’t tell if negative thoughts a cause or symptom
- Post-natal depression more likely caused by hormones (unclear event)
What are the aims of cognitive behavioural therapy?
- Help change the way the patient thinks
- Help change the way they act to improve symptoms
What is the process of cognitive behavioural therapy?
- Patient discusses symptoms (thoughts, feelings, behaviours)
- ‘Homework’, change ways of thinking & write down feelings
What are the strengths of cognitive behavioural therapy?
- Evidence: Beltman et al. (2010), CBT patients improved more than non-CBT
- Longer lasting treatment (skills permanent, drugs temporary)
- Gives patients self-determination
What are the weaknesses of cognitive behavioural therapy?
- Relies on patients recognising symptoms and wanting to change (lack of motivation a main symptom)
- Ethical issue: patient told their ways of thinking are ‘wrong’, therapist may abuse power
What are the four types of antidepressants?
- SSRI, block re-uptake of serotonin, make is available for longer
- SNRI, block re-uptake of serotonin and noradrenaline
- MAOI, prevent enzyme monoamine oxidase from breaking down serotonin and noradrenaline
- TCA, prevent reabsorption of serotonin and noradrenaline
What are the strengths of drug therapy as a treatment for depression?
- Improves symptoms so allows patients to access other treatments (CBT)
- Evidence: Royal College of Psychiatrists study
What are the weakenesses of drug therapy as a treatment for depression?
- Side effects (diabetes, insomnia, suicidal feelings)
- Helps symptoms, not cause (relapse upon treatment stopping)
What are the symptoms of addiction (dependence disorder)?
- Feeling of needing to take the substance
- Stopping very difficult
- Physical withdrawal symptoms (shaking, sweating, vomiting)
- Tolerance to substance
What is required for an addiction diagnosis?
At least three symptoms present for a month OR for repeated occasions over a year
Describe features of addiction
- Evidence that the substance is harmful is ignored
- Friends, family and previously enjoyed activities ignored in favour of substance
- More tolerance –> more of the substance must be used for the same effect
Describe the incidence of addiction
- Difficult to measure: definition changes (internet/video games now included), relationship changes (past medical drugs now illegal)
- Addiction is rising: alcohol/drugs now cheaper, increase in reported drug use
What are the effect of addiction on individuals?
- Neglect people and previously enjoyed activities
- Spend money on addiction
- Substance may be harmful
What are the effects of addiction on society?
- Time away from work, workload must be covered
- Costs government money to treat
- Criminal behaviour to fund addiction, cost government money to manage
Give evidence for the genetic explanation of addiction
- Dorit Carmelli et al. (1992) - identical twins more likely than non-identical
- Donald Goodwin et al. (1973) - adopted children with addicted bio parent more likely
What gene has been linked to addiction?
DDR2 gene - dopamine receptor
What are the strengths of the genetic explanation of addiction?
- Evidence (twin and adoption studies)
- Explains why some are more prone to addiction than others
What are the weaknesses of the genetic explanation of addiction?
- Reductionist, doesn’t take social factors into account (twins studies - same home life)
- No single gene found, DDR2 also linked to autism
Explain the conditioning theory as a learning explanation for addiction
Classical conditioning:
- Learned through association, associate substance with positive feelings
- Want to feel goods –> substance
Operant conditioning:
- Behaviour –> positive outcome –> behaviour repeated (positive reinforcement)
- Withdrawal –> negative outcome (negative reinforcement)
Explain social learning theory as a learning explanation for addiction
- Behaviour learned from role models
- More likely to try a familiar substance
What are the strengths of learning theory as an explanation of addiction?
- Treatment, assumes a behaviour can be unlearned
- Classical conditioning explains relapse
What are the weaknesses of learning theory as an explanation of addiction?
- Ignores biological factors (though operant conditioning does consider dopamine)
- Doesn’t explain why some are more prone to addiction than others
Explain the process of CBT as a treatment for addiction
- Functional analysis: understand triggers
- Skills training: how to cope with cravings, assertiveness training (peer pressure), improving motivation, homework (diary of when/where patient feels tempted)
What are the strengths of CBT as a treatment for addiction?
- Builds up skills, patient has self-determination
- Evidence: Young’s 2007 study found CBT effective for internet addictions
What are the weaknesses of CBT as a treatment for addiction?
- Patient must be motivated (in contradiction with symptoms)
- Skills gained doesn’t guarantee behaviour will stop (evidence: Morgenstern and Longabaugh’s 2000 study on alcoholics)
What are the uses of drug therapy as a treatment for addiction?
- Reduce withdrawal symptoms
- Reduce cravings
- Certain drugs can also help behavioural addictions (gambling and sexual activity)
What are the strengths of drug therapy as a treatment for addiction?
- Evidence: Suck Won Kim et al. (2001) gamblers helped more by naltrexone than placebo
- Helps patients access CBT by reducing symptoms
What are the weaknesses of drug therapy as a treatment for addiction?
- Mixed evidence: John Krystal et al. (2001) alcoholics, no difference between naltrexone and placebo after 12 months
- Patients may become addicted to treatment drug
What was the procedure of Caspi et al. (2003) Influence of Life Stress on Depression?
- 847 participants in three groups: 2 copies of short 5-HTT gene (controls serotonin levels), one short & one long, and two long copies
- Answered questionnaire on life events from 21st to 26th birthday and depression symptoms
What were the results of Caspi et al. (2003) Influence of Life Stress on Depression?
- Depressed participants more likely to have two short genes and have experienced a stressful life event
- Interaction of nature and nurture
What are the strengths of Caspi et al. (2003) Influence of Life Stress on Depression?
- Large sample size, generalising more accurate
- Useful for doctors (know to look for both short 5-HTT gene and stressful life event)
What are the weaknesses of Caspi et al. (2003) Influence of Life Stress on Depression?
- Short gene may make people more prone to stressful life events
- Questionnaire self-report, may be unreliable
What were the aims of Caspi et al. (2003) Influence of Life Stress on Depression?
- Why stressful life events lead to depression in some and not others
- Does a variation of the 5-HTT gene make a stressful life event more likely to lead to depression
What were the conclusions of Caspi et al. (2003) Influence of Life Stress on Depression?
- Interaction between genetic factors and stressful life event in causing depression
- Interaction of nature/nurture
What were the aims of Young (2007) CBT with Internet Addicts?
- Investigate effect of CBT as a treatment for internet addictions
- See how behaviours improve during and after treatment
What was the procedure of Young (2007) CBT with Internet Addicts?
- 114 participants with no other mental health problems
- Had weekly online CBT for 12 weeks
- Filled in a Likert-type scale (1-5) questionnaire on symptoms on weeks 3, 6, 12 and 6 months after
What were the results of Young (2007) CBT with Internet Addicts?
- Symptoms improved over 12 weeks
- Symptoms still better than before CBT after 6 months
What are the strengths of Young (2007) CBT with Internet Addicts?
- Shows online CBT is effective
- Same questions and rating scale (standardised procedure)
What are the weaknesses of Young (2007) CBT with Internet Addicts?
- Self-report may be unreliable
- Different types of internet addiction identified but not distinguished, results average
Describe nature and how it relates to mental health problems
- Biological factors (genes)
- Explains why some develop addictions/depression and others don’t
- Explains why some relapse and others don’t
- Caspi et al. (2003) 5-HTT gene
Describe nurture and how it relates to mental health problems
- Environmental factors, assumes babies are blank slates and that experienced influence behaviour
- Basis for treatment, learned behaviours can be unlearned
- Cognitive explanation of depression & learning theory for addiction
- CBT works for both suggesting nurture influence
Describe interactions between nature and nurture in mental health problems
- Caspi et al. (2003) combination of 5-HTT gene and stressful life event
- Gene makes people prone, triggered by stressful life event
