Abnormal Psychology K/U

Psychological Treatment

Beck (1967): Cognitive Theory for Depression

• Thought patterns and beliefs have the potential to cause MDD

  • Particularly focuses on automatic thoughts (ie. thoughts that are not registered on a conscious level; sub-vocal semi-conscious narrative that accompanies daily life)

  • Characterizes how one’s life experience is processed

• Automatic thoughts of those with depression were often found to be negative, exaggerated, and irrational (negative appraisals)

  • These negative thoughts may translate to more negative behaviour

• Automatic thoughts are an aspect of the cognitive triad (beliefs about the world, oneself, and the future)

Cognitive Behavioral Therapy (CBT):

• Aims to address maladaptive thoughts and irrational behaviour through cognitive reconstructing and behavioral activation

  • Requires the patient to be active in their treatment (even given homework)

• Pulls from a variety of different techniques including Socratic questioning, behavioral experiments, and thought records)

Evaluation

• Generally lack negative side effects and reduces the chances of relapse

  • The long-term effect is one aspect of effectiveness

• Success may be dependent upon the skill of the therapist

  • Makes this type of treatment inherently inequitable

  • Less privileged individuals may not receive as effective psychological treatment as a result

• Takes a long time to have an effect and therefore is not suitable for more severe situations

Biological Treatment

Serotonin Hypothesis

• Patients with MDD have been found to have abnormal levels of certain neurotransmitters such as serotonin, dopamine, and noradrenaline

  • Reduced serotonin levels lead to depression (?)

• Lots of directional ambiguity with this theory since there are no established cause-and-effect relationships

Antidepressants

Tricyclic Antidepressants: prevents the reuptake of a multitude of different neurotransmitters and thus cause many negative side effects such as weight gain and dizziness

Monoamine Oxidase (MAO) Inhibitors: MAO breaks down neurotransmitters, thus inhibiting it allows neurotransmitters such as serotonin to remain in the synaptic cleft for longer, increasing the likelihood of it attaching to receptors

Selective Serotonin Reuptake Inhibitors (SSRIs): focuses solely on serotonin, limiting side effects and thus making it a better option for research 

Evaluation

• Cannot incorporate culturally specific elements such as traditional values and stories

• Can be a faster method of alleviating symptoms and improving day-to-day living

  • May be particularly useful for more severe cases with dangerous symptoms (eg. suicidal ideation)

• May lead to negative side effects and may not work as intended for all patients

  • Also may not target the root cause of depression and simply address specific symptoms

Role of Culture in Treatment

Internal Model of Illness: an individual’s beliefs about a disorder that is impacted by outside factors such as culture (influence schematic representations of disorders)

• Culture may play an important role in treatment as a result

  • An etic approach assumes that disorders and associated behaviours occur identically in all societies/individuals

  • An emic approach believes that a variety of factors are involved in treatment such as values, morals, and lifestyle

• To culturally connect with certain populations, the addition of folk stories or values may be incorporated into the therapies used

• Even if culturally-specific therapies exist, immigrant populations may lack the knowledge or means needed to access these services

  • A lack of bilingual therapists may add to this barrier

Major Depressive Disorder

• Characterized by extended periods of depression

  • At least two weeks for diagnosis

• Patients may experience symptoms such as suicidal ideation and a lack of motivation

Effectiveness of Treatment

• Treatment outcomes

  • Encompasses the duration of improvement (long-term vs short-term benefits)

  • The extent of improvement (how much did quality of life improves or symptoms decrease)

• The reporting of effectiveness may come from therapists who will generally be biased towards a more positive evaluation

  • Even if clients provide evaluation, they may not have the needed understanding of the therapy to provide an informed response

• Psychological therapies are very different across practitioners and it may be difficult to find a measure to compare each one