Paper 2 - Option 2: Abnormal Psychology Flashcards
Biological Treatments
Biological Approach
Aims to explain psychological phenomena due to biological etiology where every psychological process originates from internal physiological processes.
Dysfunctional brain patterns with biological origins should be treated with biochemistry.
Psychological Treatments
Cognitive Approach
Based on the assumption that humans are information processors, and that humans absorb information through processing and memory encoding.
General
MDD
Major Depressive Disorder.
Classified as a persistent low mood and/or anhedonia.
Other common symptoms include detrimental effects on sleep and appetite, impairment of daily functioning, and suicide ideation.
Biological Treatments
Serotonin
Serotonin (5-HT) is a neurotransmitter which modulates mood, sleep and appetite.
Biological Treatments
Selective Serotonin Reuptake Inhibitor (SSRI)
Selective Serotonin Reuptake Inhibitors.
Based on the serotonin hypothesis.
Prevents re-absorption of serotonin back into pre-synaptic neuron, increasing amount of serotonin in the synapse.
Strengths and Limitations
Easily accessible.
Participant compliance.
Side effects (e.g. headaches, weight changes, aches).
Biological Treatments
The Serotonin Hypothesis
Posits that MDD is due to a deficit in serotonin.
Psychological Treatments
Cognitive Behavioural Therapy
Psychotherapy assumes that MDD is caused by Beck’s cognitive triad (negativity towards self, others and the world).
CBT aims to change underlying negative cognitions especially maladaptive thinking patterns.
Due to thoughts preceding moods which precedes behaviours, therefore replacing maladaptive thinking patterns with adaptive thoughts can improve mood and therefore behaviours.
Treats depression by confronting it with patient.
Assumption: Negative/inaccurate beliefs about oneself and the world can be critically examined and then corrected, alleviating depression.
- Depressed individuals must identify negative/self-destructive thought patterns and challenge through a psychotherapist and opening of thoughts/beliefs/experiences.
If CBT works, patient learns to recognise distorted thinking and reframe it immediately before negative depression.
Strengths and Limitations
Less side effects (no pharmalogical side effects).
Empowerment and improvement of self-efficacy.
Less compliance (overcoming stigma).
Accessibility (geographical, time consuming, expensive).
Study - General
March et al
Human true experiment.
Aim
Looking into the Serotonin hypothesis and the most effective treatment for MDD.
Method
Adolescent MDD patients from various USA clinics participated in three stages (12 week treatment administration intervals with depression assessed at end of each interval).
Assigned randomly to 4 treatment conditions: Fluoxetine (SSRI) alone, CBT alone, fluoxetine and CBT combined, Placebo (no therapuetic effect).
SSRIs were controlled using a double blind design (no-one knew what patient was receiving).
CBT were unblinded as therapy environment is obvious.
Results - First Stage
Had an effect:
35% of placebo group (expectancy effect and benefit of placebo). Discontinued from here.
61% of fluoxetine (better short term)
44% of CBT.
71% of combined (best when both).
Results - Third Stage
Had an effect:
81% of fluoxetine.
81% of CBT (as effective long term).
86% of combined (still the best).
Critical Thinking
Strengths
High external (population) validity - Patients taken from different clinics in US.
Limitations
Correlational; not causation.
Study - Biological Treatments, Cognitive Treatments
Dunlop et al
Human correlational study.
Theoried that MDD is not unitary and that symptoms of depression might be better explained by underlying neural networks and ‘biotypes’ of depression.
Aim
To investigate the effectiveness of CBT and antidepressants for different biomarkers of depression.
Method
Numerous participants were assigned to SSRI or CBT condition.
Participants underwent resting-state fMRIs for baseline data.
Treated for 12 weeks and then treatment effectiveness was assessed using a depression rating scale and computer analysis using AI correlates patterns of brain connectivity with effectiveness of medications.
Results
When treatment matched biotype, 74% of participants improved.
When did not match, failed for 86%.
Study - Biological Treatments
Arnone et al
Human True Experiment
Aim
To investigate the role of SSRIs in neurogenesis and role in reducing symptoms of depression.
Method - MRI
39 currently depressed (MDD), 25 in remission, 66 healthy controls underwent MRIs.
Results - MRI
Currently depressed patients had reduced grey matter in hippocampus compared with healthy and remission groups.
Method - Antidepressants
Most of currently depressed were treated with citolopram SSRI for 8 weeks.
After 8 weeks, patients’ hippocampi were measured again.
Results - Antidepressants
Depressed participants who were assigned to SSRI condition had increase grey matter with some experiencing decreased depressive symptoms.
Critical Thinking
Strengths
High internal validity (operationalised DV) - MRI isolated variable.
Limitations
Correlational; not causation.
Validity enhanced if there is a true control group.
- Random allocation of different groups from same depressed sample.
- May have not been done due to ethics (more ethical to give everyone treatments).
Role of culture
Etic (Individuals) Approach
Examines applicability of western models in non-western contexts.
Methods based on extreme position that Western mainstream model of psychotherapy is universal.
Risk of underestimating overarching effect of cultural frameworks.
May result in minimum attention being given to cultural competence.
Role of culture
Emic (Cultural norms) approach
Explores phenomenological variations/culture-specific phenomena in indigenous cultures.
Must be practiced within the context of a particular culture.
Seeks to make major adjustments in theories/techniques in therapeutic practices across cultural groups.
Highlights the importance to be aware of his/her own culture and worldview.
Ideal for (culturally competent) clinicians to train and learn the culture of every ethnic group.
- Insurmountable hurdle to cover all cultures; train clinicians on every ethnic group.
Role of culture
Combined approach
Attempts to generate more nearly-universal models of phenomena that are valid for a broader range of cultures.
Better off focusing on serving clients from one’s own cultural heritage
- Too many cultures to learn with too much complexity to master.
Depression may have universal aspects that are shared by all cultures (global etic) and aspects that are common to some cultures (regional etic) as well as unique aspects (emic).
- To be fully effective, treatments should be more culturally-specific to account for individual factors (e.g. age, gender, ethnicity, culture)
Study - Role of Culture
Kinzie et al
Naturalistic observational study
Application/limitation of etic approach - Compliance approach.
Aim
Investigates cultural barriers to treatment for depression.
Method
Blood tests on 41 South-east Asian patients with depression who have been prescribed antidepressants in US clinics.
Measured compliance with prescribed treatments.
Results
No sign of medication usage was detected in 61% of patients’ blood.
15% of patients had therapeutic levels of antidepressants in blood (medication is helpful).
Discussion - When benefits and side effects of medication were explained, compliance rates increased.
Study - Role of Culture
Givens et al
Correlational cross-cultural survey
Explains why ethnic minorities are less likely to receive depression treatment.
Stigma can affect person’s willingness to care/accept treatment.
Aim
Investigates role of ethnicity in preferences for depression treatments.
Method
A survey administered to more than 75000 participants of varying ethnic/cultural backgrounds.
Results
Suggests that cultural attitudes and stigmas about depression lead to cultural differences in treatment preferences.
Majority of African, Asian-Americans and Latinos preferred counselling over medication.
South Asians preferred self-management more than European-American.
Ethni minority respondents were less likely to view medications as effective
Second study
Examined stigmas associated with treatment of depression between European-Americans and African-Americans.
Significant differences in treatment acceptibility rates (European-Americans had strong preferences for medication over spiritual counselling).
