Studied by 8 people
Cockram et al (2010) - EMSM
Aim -
Test early maladaptive schema model
Participants -
220 Australian & New Zealand Vietnam War veterans
Method - It was a two-part study.
(Part 1) Examined the role of maladaptive schemas in development of PTSD
Method:
Given a Young Schema Questionnaire
Veterans diagnosed with PTSD scored higher on the questionnaire compared to veterans not diagnosed with PTSD
Veterans with PTSD reported more negative childhood experiences with parents and in early childhood
(Part 2) Measure effect of cognitive restructuring
Schema-based therapy aimed at changing the maladaptive schemas
Measured on symptoms of PTSD of war veterans
Two groups compared:
PTSD patients who had schema-based therapy
PTSD patients who didn’t have schema-based therapy
Findings -
(Part 1):
Suggested that early maladaptive schemas have an important role in development or maintenance of PTSD in Vietnam veteans
Research indicated negative or stressful early life experiences may make one more vulnerable to PTSD in adulthood
(Part 2):
Symptoms of PTSD and anxiety improved significantly for schema-focused therapy group
Demonstrate schema processing playing a significant role in disorder
Can’t conclude that maladaptive schema is sole causd of PTSD
General Link -
Shows etiology of EMSM might be related to PTSD
Veterans who scored higher on the questionnaire were diagnosed with PTSD; those that scored lower were not diagnosed with PTSD
Negative childhood experiences can help increase the chances of developing PTSD
Demonstration that schema processing plays significant role in the disorder
Can’t conclude that maladaptive schema is sole cause of disorder.
Critical Thinking - Alternative Explanations
Every war veteran goes through different experiences. Maybe more participants in the group that did not undergo therapy went through worse experiences than others, making them more prone to developing PTSD.
Strengths - Cross-Cultural Investigation which may limit cultural bias
Limitations - Relies on personal accounts and statements from the veterans
Bolstad & Zinbarg (1997) - External Locus of Control
Aim:
Investigate if sexual abuse in childhood results in the victim external locus of control
Method:
Participants were 117 female undergraduates.
The women were asked to fill in the Participant Profile Form (PPF) that collected data on childhood abuse, the PTSD symptom scale and the I-E scale which measures one’s locus of control.
Findings:
The findings showed that the participants who had experienced repeated or multiple cases of sexual abuse had a lower perception of control – or an external locus of control. This was also associated with greater PTSD symptoms after having been victimized as an adult.
General Link:
This study shows that the cognitive etiology of External Locus of Control can increase the risk of development of PTSD because the Participants who had experienced sexual abuse had a lower sense of control also had greater PTSD symptoms compared to those who scored lower on the PPF
Critical Thinking:
This study may have limitations in the data because it is self-reported which may lower the validity of the data, additionally, the results may not be generalizable to others such as Men and other age groups due to low population validity because the study was only conducted on undergraduate women
Limitations:
→ Self-reported data is not reliable.
→Maybe sexual assault victims were not comfortable opening up about their experience yet.
→Ethical consideration asking them questions about their experience could trigger bad memories if they do have PTSD.
→Only women were studied, so the results cannot be generalized to men.
Padesky & Hammens (1977) - MDD (Major depressive disorder)
Aim - Investigate the artifact hypothesis for differences in prevalence rates by gender
Procedure
Sample: University students, male and female
P were given scenarios linked to depression
Rate degree by which the person should seek help
Results
No significant difference between genders
Limitation - low ecological validity
Link - Study demonstrates that the artifact hypothesis can’t be used to explain prevalence rates.
Amenson & Lewinsohn (1981) - MDD
Aim - Evaluate the validity of the artifact hypothesis under naturalistic conditions
Procedure
Sample: Participants recruited through mailing announcement to residents of Eugene and Springfield, Oregon.
Assessed for depressive symptoms twice
938-item questionnaire and 8-9 months later an interview
Results
No significant difference between genders and rate of reporting.
Limitation - low generalizability
Link - Study demonstrates that there are no difference patterns in prevalence of depression between gender
Ethical Considerations - Protection from undue harm
Nolen-Hoeksema (2000) - Cognitive Etiologies
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
Aim - Carry out prospective study of the role of rumination on symptoms related to depression
Procedure
Sample size - 1132 participants randomly selected
Interviewed twice over one year period & given number of tests
Given rumination & coping questionnaire
Results
Participants who showed signs of MDD at the time of first interview had a significantly higher score on ruminative responses than those who did ot show signs of MDD
Rumination appears to more consistently predict onset of depression rather than duration
Limitation - Self reported questionnaires: may be biased
Link - Demonstrates correlation between rumination and MDD
Farb et al (2011) - Cognitive Etiologies
Aim - Investigate if brain responses to watching a movie would predict the onset of depression
Procedure
Sample size- 16 healthy controls, 16 formerly depressed participants
Formerly depressed patients watch sad and neutral movies
Brain activity tracked in fmri
Questionnaire measuring their adaptive/maladaptive modes in face of emotional challenges
Researchers also measured severity of depression in patients
Monitored after for 18 months
Predicted that activity in the medial prefrontal cortex predicted relapse
Results
10/16 of patients relapsed: faced with sadness, the relapsing patients showed more activity in frontal region of the brain
These responses also linked to higher rumination
Limitation - Limited in its ability to conclusively determine the neural predictors of depressive relapse due to small sample size and limited number of scans
Link -
Suggests that there are important differences in how formerly depressed people respond to emotional challenges that predict future well-being
TADs - Biological Etiologies (Serotonin)
Aim - Examine the short-term and long-term effectiveness of drug treatment and psychotherapy for the treatment of depression in adolescents
Procedure
Sample - 13 clinics, ages 12 to 17, diagnosed with MDD
Stage 1 - Acute treatment (12 weeks)
Randomly assigned conditions
Stage 2 - Consolidation treatment (6 weeks)
Placebo ground left trial
Stage 3 - Continuation of treatment (18 weeks)
Results
All treatments outdid placebo
Limitation - Personal values can impact results
Link - Study demonstrates that antidepressants can be used to help depression
Ethical Considerations - Right to withdraw
Cai & Thompson - Biological Etiologies (Serotonin)
Aim - Investigate if increasing serotonin levels in the brain would reverse depression in rats
Procedure
Examined brains of rats and mice repeatedly exposed to various mildly stressful conditions
Rats showed depressive symptoms
No longer would feel rewarded with sugar water
Results
Depression could not be attributed to low serotonin
Antidepressants restored behavior
Limitation - Animal study
Link - Study demonstrates that depression is not caused by serotonin imbalance
Kendler et al (2006) - Biological Etiologies (Genetic Predisposition)
Aim - To compare the heritability of MDD in men and women
Procedure
Sample size - 42,000 twins from swedish twin registry
Interviewed the twins within the same month
Cross generational
Results
38% of heritability of depression
Limitation - did not officially diagnose twins: relied on clinician diagnosis that aren’t very reliable
Link - Demonstrates that depression is the cause of genetic predisposition
Ethical Considerations - Confidentiality
Caspi et al (2003) - Biological Etiologies (Genetic Predisposition)
Aim - Role of 5-HTT gene in depression
Procedure
Sample Size - 847 New Zealand peeps
Assessed mental health of participant on regular basis and divided into three groups
Group 1: two short alleles
Group 2: one short and one long alleles
Group 3: two long alleles
Participants asked to fill in a “Stressful life events” questionnaire: asked them about different events in their life
Assessed for depression as well
Results
People who had inherited one or more short versions of teh allele demonstrated more symptoms of depression and suicidal ideations in response to stressful life events
Limitation - doesn’t account for discrepancies: people who develop mental health issues but don’t have genetic predisposition
Link - Demonstrates genetic predisposition and it’s correlation to MDD
Ethical Considerations - Informed consent/Right to refuse or withdrawal
Caspi et al (2003) - Sociocultural Etiologies (Diathesis Stress Model)
Aim - Role of 5-HTT gene in depression
Procedure
Sample Size - 847 New Zealand peeps
Assessed mental health of participant on regular basis and divided into three groups
Group 1: two short alleles
Group 2: one short and one long alleles
Group 3: two long alleles
Participants asked to fill in a “Stressful life events” questionnaire: asked them about different events in their life
Assessed for depression as well
Results
People who had inherited one or more short versions of teh allele demonstrated more symptoms of depression and suicidal ideations in response to stressful life events
Limitation - doesn’t account for discrepancies: people who develop mental health issues but don’t have genetic predisposition
Link - Demonstrates that gene-environment interactions can relate to depression
Ethical Considerations - Informed consent/Right to refuse or withdrawal
Wilhelm et al (2006) - Sociocultural Etiologies (Diathesis Stress Model)
Aim - Investigate the correlation between the 5-HTT gene and mental health
Procedure
DNA samples from 127 participants
Longitudinal case study, 25 years
Every 5 years major life events and signs of depression were recorded
Results
80% with two short alleles became depressed after 3 major events
Limitation - correlational study
Link - Study demonstrates that mutation of 5-HTT can increases the likelihood of developing depression
Wang et al (2014) - Electroconvulsive Therapy
A: To investigate the effectiveness of ECT for severe OCD
P: Researchers investigated the courses, effects and after- information about 3 ECT patients (who had received 8, 3 and 4 courses respectively).
F: In all cases the patients’ OCD and depression symptoms improved and remained stable at regular follow-ups
C: ECT may play an effective role at treating severe OCD
Critical Thinking -
Very small sample size
Only applicable to severe cases
Eddy et al (2004) - ERP (Exposure Response Prevention)
A: To investigate the effectiveness of ERP on OCD.
P: A meta-analysis
F: ERP led to a clinically significant improvement for about 68.8% of patients who completed the programme, compared with 56.6% Cognitive Therapy (CT) patients who made a comparable level of improvement. However, CT had a higher recovery rate of 49.8% compared with 38.2% for ERP.
C: ERP was deemed most effective at reducing symptoms, but CT patients were more likely to make a full recovery.
Williams and Grisham (2013) - CBM (Cognitive Bias Modification)
A: To investigate the effectiveness of CBM on OCD
P: A volunteer sample of 89 adults with O/C symptoms did a task that involved imagining themselves in 164 situations targeting OCD core beliefs. They completed a self-report questionnaire measuring the severity of their symptoms. Then participants in the positive condition, all scenarios had positive endings while in the control condition there was a mix. Participants had their interpretational bias measured.
Behavioural tasks: imagining a loved one in a car crash and rating their distress.
Contamination task: number of wipes used on mouse/keyboard covertly counted.
Perfectionism: they were given very little time to write up the procedure for the next participant and asked to rate their faith in the writing.
F: A significant difference in interpretational bias between conditions (p < 0.01). Participants in positive condition had a clear shift towards a positive bias, but only to do with the statements relating to OCD and not general bias.
C: The task targeted the participants’ core OCD beliefs and not just general bias. Severity of symptoms beforehand was not a factor in effectiveness. CBM therapy would be an effective treatment for anyone with mild or severe OCD symptoms.
Critical Thinking - The therapy is usually conducted over weeks or months, not a single session as in this study: low ecological validity?
Only short-term effects were measured
The tasks were not individualised to the participants’ own OCD symptoms as they would be in real CBM
The participants had not received a diagnosis of OCD, so generalizations should be made cautiously
Nicolini (2017) - Cultural Differences in OCD Treatment
A: investigate the influence of cultural diversity on manifestations of OCD and identify factors of cultural diversity that significantly impact OCD symptoms.
P: review of literature using keywords related to OCD, culture, cultural identity, and religion. The review covered ten years and focused on studies examining the relationship between culture and OCD across different countries and regions.
F: OCD symptoms did not significantly vary across cultures. However, religion affected the content/severity of obsessions. For example: US: Christian obsessions related to sin, guilt, and morality were frequently reported. India: Hindu obsessions related to purity, pollution, and religious rituals were more common. Saudi Arabia: Muslim obsessions related to religious rules and rituals, such as cleanliness and prayer, were frequently observed.
The review also highlighted the importance of considering other cultural factors, such as educational background, access to health services, and food, in understanding the influence of culture on OCD and its treatment.
C: Cultural diversity does not seem to alter the main symptoms of OCD. However, cultural factors like religion and religiosity can impact the content and severity of OCD symptoms.
Critical Thinking:
Comprehensive research, thorough literature review spanning 10 years increases validity
Including only research from the most recent decade is a strength (higher temporal validity) and a weakness (excludes older studies that could provide valuable insight)
Williams et al (2012) - Cultural Differences in OCD Treatment
A: Examine the barriers that prevent African Americans with OCD from receiving treatment
P: 71 AA adults with OCD took the Barriers to Treatment Participation Scale and Barriers to treatment questionnaire (BTPS, BTQ).
F: 6 of the 7 major barriers were cost, stigma, fear of therapy, feeling it wouldn’t help, feeling no need, and logistic issues. Compared to European American online sample (n=108) there were unique concerns including not knowing where to find help and fears of discrimination.
C: Fear of shame in requesting treatment differs between cultures, along with many other barriers.
Critical Thinking:
Only includes one culture
Doesn’t consider religions aspects
Validity of questionnaire as a method?
Doesn’t say what treatment participants ultimately received
High temporal validity
Note
Flashcard