Studied by 21 people
Major Depressive Disorder (MDD)
Diagnosed when an individual experiences at least 2 weeks of either a depressed mood or a loss of interest & pleasure.
Affective symptoms
The way people react emotionally and their ability to feel emotions.
Cognitive symptoms
The ability to rationalize, remember, and concentrate at their usual level. The thoughts individuals have about themselves, other people, and their intentions.
Behavioral symptoms
The way that the individual behaves, activities they participate in or withdraw from, and psychomotor movements (e.g. moving or speaking slowly).
Somatic symptoms
Physical changes that the individuals may experience.
Biological Etiologies
Factors related to genetics and biological inheritance that contribute to the development of depression.
Twin studies
Research studies that compare the concordance rates of depression amongst monozygotic (identical) and dizygotic (non-identical) twins to investigate the role of genetic factors.
Concordance Rate
The rate of probability that two people with shared genes will develop the same behavior.
Aaron Beck Cognitive Behavioral Therapy
A therapeutic approach that focuses on identifying and challenging negative thoughts and developing coping strategies to improve emotional regulation.
Cognitive Triad
Three deeply negative beliefs about aspects of reality that a depressed person may have about the self, the world, and the future.
Negative Self-Schemas
Have been developed throughout a person's life, influencing their perception of themselves and the world.
Faulty Thinking Patterns
Patterns of thinking that are distorted or negative, contributing to depressive symptoms.
Gene-environment interaction
The interplay of genes and the physical and social environment, when a person's genes and their environment interact to produce a particular trait or outcome
Natural experiment
A study design that takes advantage of naturally occurring events or conditions to investigate causal relationships.
Rumination
The tendency to think repeatedly about negative thoughts or experiences, which can contribute to the development and maintenance of depression.
Brown's Vulnerability Model of Depression (BVMD)
A model that suggests that when there are more risk factors than protective factors in the environment, one is likely to develop depression.
Protective factors
Factors that help protect against the development of depression, such as high self-esteem and finding meaning in life.
Vulnerability factors
Factors that increase the risk of depression when combined with stressful life events, such as loss of a mother at a young age, lack of a confiding relationship, having multiple young children at home, and unemployment.
Provoking agents
Stressful life events that contribute to acute and ongoing stress, leading to depression in vulnerable individuals with no social support.
Prevalence rates
The percentage of individuals within a population who are affected by a specific disorder at a given time.
Useful to identify which groups are more vulnerable to a disorder, and therefore develop preventative methods and treatments.
Diathesis Stress Model for Depression
A model that suggests that a mental disorder develops when an individual has a vulnerability or predisposition combined with exposure to stressful life events.
SSRIs
Selective serotonin reuptake inhibitors, which are a type of antidepressant medication that affects serotonin levels in the brain.
Synapse
The junction between two neurons where neurotransmitters are released and received.
Placebo effect
The psychological and contextual factors associated with receiving treatment that can lead to perceived benefits, even if the treatment itself is not effective.
Cognitive Behavioral Therapy (CBT)
A psychological treatment approach that aims to change negative thought patterns and behaviors to alleviate symptoms of depression.
Cognitive Therapy Techniques
Specific, well-defined problem-solving techniques used in cognitive therapy, such as Socratic questioning, behavioral experiments, thought records, situation exposure hierarchy, and pleasant activity scheduling.
Socratic questioning
A technique used in cognitive therapy where the therapist asks probing questions to help the patient explore the root of their beliefs and thoughts.
Behavioral experiments
A technique used in cognitive therapy where the patient is assigned certain behaviors to carry out and record their thoughts and feelings about it, helping them challenge and change their beliefs.
Thought records
A technique used in cognitive therapy where the patient records any evidence that goes against their beliefs, helping them realize they have been ignoring contradictory evidence.
Situation exposure hierarchy
A technique used in cognitive therapy where the patient gradually exposes themselves to anxiety-provoking situations in a hierarchical manner, helping them overcome their fears.
Pleasant activity scheduling
A technique used in cognitive therapy where the patient schedules in one pleasant activity each day to increase positive experiences and improve mood.
Efficacy of Cognitive Therapy
The effectiveness of cognitive therapy in treating moderate to severe depression, shown to be comparable to antidepressant medications in a randomized clinical trial (RCT).
Randomized Clinical Trial (RCT)
A research design where participants are randomly assigned to different treatment conditions to compare the effectiveness of different interventions.
Hamilton Depression Rating Scale
A scale used to measure the severity of depression symptoms, often used as a dependent variable in studies evaluating the effectiveness of depression treatments.
Therapist's Skill and Experience
The competence and expertise of the therapist can influence the effectiveness of cognitive therapy in treating depression.
Enduring Effects of CBT
The long-lasting effects of cognitive therapy in preventing relapses and reducing symptoms beyond the end of treatment, shown to be more effective than continued antidepressant medication in a study.
Relapse Rate
The percentage of patients who experience a return of depressive symptoms after a period of improvement or recovery.
Kendler et al (Bio Etiologies, Correlational) Aim
To investigate concordance rates between MZ twins and DZ twins for depression.
Kendler et al (Bio Etiologies, Correlational) Method
Correlational analysis based on data obtained from questionnaires of modified DSM-IV criteria.
This study incorporated 15,493 pairs of twins and was conducted between 1998-2003 in Sweden.
Kendler et al (Bio Etiologies, Correlational) Procedure
Twins were phoned by researchers trained to administer the questionnaire that was based on the criteria for MDD from the DSM-IV.
Of the twins contacted, 8056 pairs were found to meet the criteria for an episode of MDD at some point in their lives.
Kendler et al (Bio Etiologies, Correlational) Results
Results indicated that there was a higher level of concordance between MZ twins than between DZ twins. The estimated level of concordance across genders was 0.38 for MZ twins, which was in line with previous research found in other parts of the world.
Rates higher for females (0.44) than males (0.29).
Kendler et al (Bio Etiologies, Correlational) Conclusion
As MZ twins share 100% of their DNA and DZ twins only share 50%, this indicates that genetic factors do play a role onset of MDD and it must, at least to a certain extent, be heritable.
However, there must also be other factors at play, as if MDD was purely based on genetics, we would expect to see a perfect correlation between MZ twins.
Kendler et al (Bio Etiologies, Correlational) Evaluation
Strengths
The study appears to confirm previous research, strengthening the reliability of the findings
Very large sample size taken from a single population (~15,500)
Limitations
Correlational = no manipulation of the IV (genes), therefore, a cause and effect relationship cannot be established.
No particular genes were isolated and tested in the study
Information about life-events and depressive symptoms was self-reported
Making a clinical diagnosis by telephone may be considered of questionable validity
Caspi et al (Bio Etiologies, Socio Etiologies)
5HTT gene length vs. vulnerability to depression
Diathesis = vulnerability (genetic)
Stress = environmental factors
Gene-environment correlation: The idea that genes and the environment are not completely independent and can, in fact, influence each other.
This means that genes may influence the environment.
Joiner et al (Cog Etiologies, Natural) Aim
To investigate the role of dysfunctional thinking patterns on the development of depressive symptoms and anxiety.
They hypothesized that the dysfunctional thinking patterns would have an impact on the development of depressive symptoms but that anxiety would not.
Joiner et al (Cog Etiologies, Natural) Method
The study is a natural experiment and used questionnaires as a data collection method.
Sample was 119 American university students who were enrolled on an abnormal psychology course.
Joiner et al (Cog Etiologies, Natural) Procedure
The natural stressor that the students would experience was the midterm examinations. Students were assessed 2 weeks before the exams and 2 weeks after.
To assess the students, there were three tests that were given.
The Dysfunctional Attitudes Scale [DAS] - This test measures thinking patterns such as vulnerability, need for approval, perfectionism and the need to impress. This was taken only before the mid-term exams.
The Cognitive Checklist [CCL] - Half of the questions determine automatic thoughts linked to depression; the other half, linked to anxiety. This test was taken both before and after the exams.
The Beck Depression Inventory [BDI] - A standardized assessment to measure levels of symptoms linked to depression. This test was also taken both before and after the exams.
Joiner et al (Cog Etiologies, Natural) Results
The researchers found an increase in the scores on the The Beck Depression Inventory [BDI] only in students who had higher scores on the DAS and who had failed an exam.
Students who had a higher score on the The Dysfunctional Attitudes Scale [DAS] but did well on the exams showed no significant increase in their BDI score.
For the students who had lower scores on the DAS, even if they received low grades, did not experience depressive reactions.
When looking at the scores for the The Cognitive Checklist [CCL] , there was a correlation between having higher scores on the depressive thinking patterns questions and the increase in the BDI scores if a student failed an exam.
There was no significant correlation between the higher anxiety scores and an increase in BDI scores if a student failed an exam.
Joiner et al (Cog Etiologies, Natural) Conclusion
From these results it appears that the presence of dysfunctional thinking patterns, as measured by the DAS scale, in combination with a stressful life event seems be predictive of someone experiencing depressive symptoms, as measured by the BDI scale.
It also appears that depressive thinking styles, as measured by the CCL scale, correlate with depressive symptoms, as measured by the BDI scale, when combined with a stressful life event.
Joiner et al (Cog Etiologies, Natural) Evaluation
The study measures depressive symptoms, as measured by Beck's Depression Index, however, this is not the same as clinical diagnosis for MDD.
The sample was also quite specific and this could lead to issues of population validity and this could cause issues in relation to generalizing the findings of the study to populations outside of the one used in the study.
Nolen and Hoeksema (Cog Etiologies, Prevalence Rates) Aim
To carry out a prospective study of the role of rumination on symptoms related to depression.
Nolen and Hoeksema (Cog Etiologies, Prevalence Rates) Method
~1100 participants
Randomly selected from a community sample of adults in the San Francisco area.
Chosen by random-digit dialing of telephone numbers.
Nolen and Hoeksema (Cog Etiologies, Prevalence Rates) Procedure
Participants were interviewed two times over a period of one year. All of the participants were interviewed in person in their own home for 90 minutes.
The tests included were:
The Beck Depression Inventory (BDI)
Hamilton Rating scale for depression
Structured Clinical Interview for DSM Disorders (SCID)
Beck Anxiety Inventory (BAI)
They were given a rumination and coping questionnaire, designed by the researchers. For example, on the questionnaire they were asked to rate how often they think, “Why do I react this way”, “I think about how sad I am”, or “I think that I will lose my job if I don’t get better.”
Nolen and Hoeksema (Cog Etiologies, Prevalence Rates) Results
Showed signs of MDD at the time of the first interview → significantly higher score on ruminative responses than those who did not show signs.
Never been depressed → significantly lower rumination scores than the other participants.
Been depressed but improved → lower rumination scores than those who remained chronically depressed.
Nolen and Hoeksema (Cog Etiologies, Prevalence Rates) Conclusion
The study found that both men and women who ruminate more following the loss of loved ones are more likely to become depressed and to suffer longer and more severe depression than those who ruminate less.
Nolen and Hoeksema (Cog Etiologies, Prevalence Rates) Evaluation
The Response Styles Theory is supported by biological evidence - such as the Farb study.
The study relied on self-report questionnaires rather than diagnoses through clinical interviews.
Originally there were ~1300 participants. It was those with the strongest symptoms that dropped out – which means that there may have been a bias introduced into the study.
No information was available on whether the participants living with depression were receiving treatment or how other protective factors may help them to cope with their disorder. The results may have been influenced by uncontrolled confounding variables.
Brown and Harris (Soc Etiologies, Prevalence Rates) Aim
To investigate how depression could be linked to social factors and stressful life events as seen through Brown’s Vulnerability Model of Depression (BVMD)
Brown and Harris (Soc Etiologies, Prevalence Rates) Method/Procedure
458 women in South London were surveyed on their daily life and depressive episodes.
Researchers focused on particular life events or difficulties faced.
Events were later rated in severity by independent researchers.
Brown and Harris (Soc Etiologies, Prevalence Rates) Results
~8% of women were diagnosed with depression, nearly 90% had experienced an adverse life event (e.g. loss of a loved one) or a serious difficulty (e.g. being in an abusive relationship).
Only 30% of the women who did not become depressed suffered from such adversity.
Social class - measured by the occupation of the husband - played a significant role in the development of depression in women with children.
Working-class women with children were 4x more likely to develop depression than middle-class women with children.
Brown and Harris (Soc Etiologies, Prevalence Rates) Conclusion
The researchers identified three major factors that affected the development of depression: Protective factors, vulnerability factors, and provoking agents.
The study showed that social factors in the form of life stress (or serious life events) could be linked to depression.
The most significant vulnerability factors were (1) Loss of one's mother before the age of 11, (2) lack of a confiding relationship, (3) more than three children under the age of 14 at home, and (4) unemployment.
Therefore, low social status leads to increased exposure to vulnerability factors and provoking agents, whereas high social status was associated with the opposite.
Brown and Harris (Soc Etiologies, Prevalence Rates) Evaluation
Semi-structured interviews get an in-depth understanding of the participants' situation as they see it themselves. This increased the credibility of the results.
The sample size of the original study was relatively large, making the results potentially more reliable.
However, only females were interviewed so the results may not be generalized to men, but the relationship between stressful events and the onset of depression might also apply.
Based on self-reporting of depressive episodes. Therefore, it is impossible to accurately determine the actual extent of depression for each of the women interviewed.
Correlational → other variables were not controlled, so biological vulnerability may play a role. Because there is no manipulation of an independent variable, the findings cannot determine cause and effect.
Buss (Formation of Human Relationships)
Over 10,000 participants from 37 different cultures.
He used questionnaires to find out mate preferences of men and women
He found universal similarities in the mate preferences of men, and also for women
Results:
Males prefer females who are younger.
Females prefer males who are older
Females value “financial prospects” more than males
Males are more concerned with good looks than females
Males are more concerned with chastity than females
Buss (Formation of Human Relationships) Link
Because the male/female preferences were consistent across cultures, cultural factors weren’t as influential, so it is more likely an underlying biological drive that results in these preferences.
If it were culture playing a role then there would be a greater difference in preferences across cultures.
FOR EXAMPLE:
Males prefer females who are younger.
Female fertility decreases with age and the risks of having children increase. A male can have a higher chance of successful procreation if his mate is fertile, which is why he may prefer a younger female.
Females prefer males who are older;
Females value “financial prospects” more than males
Because being pregnant and raising children requires a lot of time and effort from the female, she may require a male to provide other resources like food and shelter. Older males have a higher chance of having high status and access to resources (and their fertility doesn’t decrease with age).
Buss (Formation of Human Relationships) Cultural Explanation
Females from collectivist cultures placed a higher value on social status and ambition.
Alternatively, females from individualistic cultures placed a lower value on these traits.
Males from individualistic cultures placed less emphasis on domestic skills.
Alternatively, males from collectivist cultures placed more value on these skills.
Buss (Formation of Personal Relationships) Evaluation
Middle/upper class and urban people were primarily sampled. Possible that lower and rural populations may have different mate preferences. Thus the sample from each culture may not be representativeness of the whole culture/country. (population validity)
It is possible that maybe mate preferences are due to cultural factors such as enculturation, social cognitive theory, or patriarchal systems rather than evolution.
It’s assumed that cross cultural similarities must be due to evolution. However, we live in a globalizing world so maybe our preferences come from this shared “global culture”
Wedekind (Formation of Human Relationships)
To investigate the influence of MHC genes on female mate choice.
The Major Histocompatibility Complex is a group of genes that plays an important role in the immune system. Dissimilar MHC in parents produces a stronger immune system in the offspring. MHC information may be encoded by body odor.
Correlational; ~50 female and ~50 male students (mean age 25) typed for their MHC.
Female participants were asked to report if they were using oral contraceptives.
The men were asked to wear a T-shirt for 2 nights.
The T-shirts were given to female participants who were asked to rate the odor of six T-shirts each: 3 worn
Each T-shirt was placed in a box and women sniffed the contents through a hole in it.
On a scale from 0 to 10, women scored the odor of every T-shirt for intensity, pleasantness and sexiness.
Women who did not take oral contraceptives rated the odor of MHC-dissimilar men as more pleasant than that of MHC-similar men.
In women who were taking oral contraceptives this tendency was reversed: body odour of MHC-similar men was rated more pleasant than that of MHC-dissimilar men.
Ratings of intensity did not differ.
Body odors of MHC-dissimilar men reminded women of their own mates or ex-mates.
Researchers concluded that MHC similarity may indeed be a factor of sexual attraction.
Oral contraceptives imitate steroids that are naturally released during pregnancy. The authors explain this by saying that this may lead to the reversal of odor preferences so that women prefer relatives (probably because they help take care of the baby).
Wedekind (Formation of Human Relationships) Link
These results provide support for an evolutionary explanation of the formation of personal relationships. Because the women rated shirts with different MHC genes than their own as more attractive, this means it is possible that our olfactory system has evolved in way to detect these genes to promote survival of our offspring.
Being attracted to a potential mate’s scent (possibly through pheromones) increases chances of procreating and thus producing the offspring would have a robust immune systems due to the broad range of MHC genes.
This evolutionary adaptation plays a role in the formation of personal relationships to ensure our genes are passed and greater chances of survival are provided to the offspring to continue the process.
Wedekind (Formation of Personal Relationships) Evaluation
All women did the smelling and rating of attractiveness. Possible these results don’t apply to men because they may have evolved differently and thus now have different biological/olfaction systems (population validity)
The men had to wear the shirts over a couple nights so it’s impossible to control what they were doing. Maybe other factors (e.g. what they ate) impacted the smell of their sweaty t-shirts rather than their MHC genes
Study argues that pheromones influence attraction to smell and detection of genes, however, no pheromone was identified or isolated. Maybe our olfactory system is detecting something else (sweat/body odor?)
Individualism vs Collectivism
Levine et al (Formation of Human Relationships)
11 cultures (college students)
Compared the importance of love in getting married
“If a person had all the qualities you desired, would you marry them if you weren’t in love with them?”
Yes, No, Neutral (were the choices)
Indian, Pakistani and Thai participants were more likely to answer “yes” (collectivist cultures)
American, British and Australian participants were more likely to answer “no”
Levine et al (Formation of Human Relationships) Evaluation
Population validity (college aged)
Self-reported data
Correlational study
(instead of bidirectional ambiguity think about a 3rd possible variable that could influence love and marriage beside indiv. vs coll.)
E.g. could religious beliefs be a factor? USA, UK and Australia are Western, predominantly Christian countries, compared with Muslim, Hindu and Buddhism for Pakistan, India and Thailand, respectively.
Communication and Marital Satisfaction
___ plays an essential role in ___.
It is not just frequency or intensity of arguments, but also how the couple communicates.
Couples who engage in healthy communication patterns are more likely to have higher ___ and avoid divorce.
Thus, one key role of ___ in personal relationships is that is helps maintain healthy and happy relationships.
Gottman’s Four Horsemen of the Apocalypse
___ has identified the “___”. These are negative communication patterns.
The demand/withdraw pattern; aka stonewalling
Contempt
Criticism
Defensiveness
Stonewalling leads to marital dissatisfaction because if one partner has an issue to discuss with their partner and that partner withdraws/stonewalls, then that issue is never resolved.
This leads to problems accumulating over time, which could lead to separation / divorce.
The ratio of positive to negative communication patterns can influence the marital (dis)satisfaction.
The demand/withdraw pattern could decrease positive to negative ratios of communication.
Gottman and Levenson (Communication in Relationships)
73 couples studied over 4 years
Dr. John ___’s “laboratory”
An ordinary apartment called the “The Love Lab”
Couples are observed over weekends (cameras set-up)
Interviews are also held with researchers where participants had to discuss 3 topics
One neutral, one pleasant, one source of conflict
“Rapid Couples Interaction Scoring System” is used to determine patterns of communication.
Marital satisfaction and other opinions of the relationship is also measured
Two types of couples were identified:
Regulated couples and non-regulated
Regulated = ratio of positive to negative communication increases throughout a discussion
Regulated couples had higher marital satisfaction
Non-regulated couples were 3 times more likely to divorce and were less affectionate, less joyful and angrier towards each other
Gottman and Levenson 1992 (Communication in Relationships) Link
This study links to personal relationships because it shows that communication can have an impact on marital satisfaction.
If couples have a low positive to negative ratio of communication patterns they are more likely to divorce because they have higher marital dissatisfaction.
In other words, if couple avoid using negative communication such as demand/withdraw (aka stonewalling) they will likely have a happier and healthier relationship.
Gottman and Levenson 1985 (Communication in Relationships)
Similar procedures as the 1992 study:
21 participants measured over 3 year period in ___’s “Love Lab”
Communication patterns were measured along with physiological arousal
Results:
Blood pressure and heart rate (ie stress response) were positively correlated with marital dissatisfaction
Biological Explanation for Stonewalling
Gottman has identifies that about 85% of males are stonewallers and that during arguments, male stress levels (physiological arousal) are higher and take longer to reduce than female stress levels.
A difference in testosterone levels might be an explanation for this. During threat (e.g. a wife starting an argument with her husband) increased testosterone increases activity in the amygdala (radke), which increases stress.
High stress levels predict stonewalling, so it might be a stress reduction strategy that males employ.
Attributions
If someone makes a positive attribution it means they think the reason for their partner’s good behaviour is due to internal factors (e.g. their personality) and bad behaviour is attributed to external factors (e.g. the actions of others).
A negative attribution is the opposite – good behaviour is a result of external factors and bad behaviour is blamed on the person (internal factors).
Fincham (Why Relationships End)
Aim: To measure correlations between attributions and marital satisfaction.
Method:
Participants were 130 couples from the USA, who had been married for 15-20 months.
Marital satisfaction was measured using the Quality Marriage Index (QMI) and data was collected over three times using questionnaires during an 18th month time period.
Results:
One result showed that marital satisfaction was negatively correlated with causal attributions at the beginning of the study (-.44) and after 18 months (-.41).
Conclusion:
When partners make a negative attribution of their partner’s behavior (e.g. by explaining a negative behavior was due to dispositional and internal factors) their marital satisfaction decreases.
This finding supports many other studies that show the same thing – how we attribute our partner’s behavior can affect our marital satisfaction, which is one reason why relationships might deteriorate and eventually end in divorce.
Fincham (Why Relationships End) Link
When partners make a negative attribution of their partner’s behaviour (e.g. by explaining a negative behaviour was due to dispositional and internal factors) their marital satisfaction decreases.
This finding supports many other studies that show the same thing – how we attribute our partner’s behaviour can affect our marital satisfaction, which is one reason why relationships might deteriorate and eventually end in divorce.
Graham and Conoley (Why Relationships End)
Aim: To see if stress affected marital quality, but also if couples’ attributions could moderate this effect (i.e. increase or decrease it).
Method:
The participants were 58 mostly white (93%) middle-class couples from Texas, USA.
Stress was measured using a standard measure of stress experienced in the past 12 months.
Attributions were measured by giving 10 hypothetical situations and asking participants how they would attribute (explain) this behaviour if it was done by their partner, including if they would attribute the behaviour to an internal or external cause.
The measure of marital quality was also measured using standard questionnaires.
Results:
The results supported the researchers’ hypothesis that the attribution style would moderate the relationship between stressful events and marital satisfaction. In other words, stressful events had less of an impact on marital satisfaction for those couples who were more likely to make positive attributions of their partner’s behaviour, compared with those who were more likely to make negative attributions.
Conclusion:
Attributions can act as a buffer between stress and marital satisfaction.
Graham and Conoley (Why Relationships End) Link
This study shows that the cognitive approach can help explain why a relationship may change or end because attributions can act as a buffer between stress and marital satisfaction. If a couple experiences stress in their relationship, but use positive/external attributions, this stress will have less of an impact on their relationship as they are not blaming it on their partner’s internal attributions such as their personality. Using negative attributions in a stressful situation occurs will reduce marital satisfaction and possibly lead to divorce.
Note 
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