Session 4a - The role of psychosocial factors in the aetiology of affective disorders

Question 1

The aetiology (causes) of depression can be categorised into what 3 factors?
Can you give an example of each?

Answer 1

Predisposing - genetics/childhood experiences
Maintaining - psychosocial stressors
Precipitating - Life events (often related to losses)

Question 2

Childhood experiences can predispose someone to getting depression. What are some examples of these?

Answer 2

Loss of a parent
Attachment problems
Bulging

Question 3

The quality of attachment (in childhood) can have major effects on the psychological wellbeing in adults. What are the 4 forms of attachment, and what do they mean?

Answer 3

SARD. 
Secure (60%)
Avoidant (15%)
Resistant-Ambivalent (10%)
Disorganised (15%)

Question 4

Explain what is meant by a ‘Secure’ attachment in children?

Answer 4

This occurs in about 60% of children. The caregiver is sensitive and responsive to the child’s needs.
The child uses the parent as a secure base to explore from

Question 5

What are the three forms of insecure attachment?
Roughly what % of children experience each one?
What affect does this have on the child?

Answer 5

1. Avoidant - 15% of children. Associated with caregiver rejecting the child. (Little affection in sharing play; not a close relationship. Not so distressed on departure)
2. Resistant-ambivalent - 10%. Associated with care giver inconsistency (Not using caregiver as a secure base. Needing a lot of reassurance on return and can be angry)
3. Disorganised - 15%. Associated with caregiver being unpredictable or frightened. (Out of the ordinary behaviours on return - e.g. rocking movements)

Question 6

In terms of ‘Identity status in adolescence’ define:
Identity moratorium:
Identity diffusion:

(Did you know: depression was related to Moratorium and identity diffusion)

Answer 6

Identity moratorium - exploring without definite decisions (experimentation)

Identity diffusion - little care about values and conformation. Little integrated sense of ‘self’. Never really sticks to anything

Question 7

In terms of ‘Identity status in adolescence’ define:
Foreclosure:
Identity achievement:

(Did you know: anxiety was related to foreclosure and identity diffusion)

Answer 7

Foreclosure: acceptance of parents/society rules without questioning
Identity achievement: after re-considering a stable identity

Question 8

Poor quality of early life experience with parents can be an important aetiological factor when considering depression. Can you state some examples of poor quality?

Answer 8

Lack of warmth
Lack of a caring attitude 
Overly controlling 
Over protective 
Hostility 

(Other effects of parental factors include: parental mental disorders, divorce, death of a parent)

Question 9

Recovering from depression can be extremely difficult for patients. In terms of their family relationship, what must the family not be like, in order to make a successful recovery?

Answer 9

Critical
Unsupportive
Displaying a negative attitude

Question 10

Bullying can be a major cause of depression in young people. There is strong research to say that the bullies themselves are likely to become depressed also.
According to a study in the BMJ in 2015, what was the % of people who were depressed at 18, if they were frequently bullied at 13?

Answer 10

Frequently bullied at 13: 14.8% depressed at 18.

(Some bullying at 13: 7.1% depressed at 18)
(No bulling at 13: 5.5% depressed at 18)

The background rate for the population to be depressed (background rate) is 5-15%.

Question 11

Woman are consistently found to be more likely to suffer from an affective (mood) disorder than men. What could be the explanation behind this?

Answer 11

Marriage is protective for men, but not as much for woman.
Child care is stressful and often falls to the woman.
Number of depressive episodes relates to the number of children.
Men are more likely to distract themselves form depressed mood/ less likely to admit it, where as, woman are more willing then men to admit being depressed.

Question 12

Marital disturbances correlated with depression. What is the order of likelihood of depression developing of these categories: married, never married and divorced.

Answer 12

Divorced, never married, married

Question 13

Post-natal depression can occur in both men and woman, after the birth of a child. State some psycho-social factors for why this might be so?

Answer 13

Loss of sleep
Hard work (looking after baby)
Obstetric complications

Question 14

Social interaction is found to have a direct positive effect on wellbeing. How do depressed patients appear socially?

Answer 14

Seem lower in self confidence
Socialise less
Less participation in social interaction

Question 15

Risk factors for the development of mood disorders include: poverty, low level of education and a low social class. What role does employment play in developing depression?

Answer 15

Unemployment appears to be a risk factor especially in men

Question 16

Alcohol and depression follow a ‘chicken and egg’ pattern. What does this mean?

Answer 16

That people are unsure as to whether drinking a lot of alcohol causes depression, or that the depression elicits someone to drink a lot.

Ultimately, it was found that depression can lead to addictive/maladaptive coping mechanisms.

Question 17

Life events can trigger someone to enter a depressive state if they affect the normality we are use to. Holmes and Rahe (1967) devised a social readjustment rating scale (SRRS). Turn over to see it!

Answer 17

Social readjustment rating scale (SRRS)

1. death of a spouse
2. divorce
3. marital separation
4. jail term
5. death of a close family member.
6. personal illness or illness
7. marriage
8. fired at work
9. marital reconciliation (reunion)
10. retirement

Question 18

What role do you think religion plays in someone developing depression?

Answer 18

Religion appears to have a ‘protective’ affect over someone either coping with or preventing depression.