Psychological problems

What is unipolar depression?

Mental health conditions involving consistent and sever lowering of mood that affect daily functioning.

How long should symptoms be present to be characterised as depression?

Consistent for 2 weeks.

What are the main symptoms of depression?

1. Persistent sadness of low mood.

2. Loss of interest or motivation.

3. Fatigue or low energy.

What are other symptoms of depression?

• Disturbed sleep

• Loss of appetite

• Loss of self confidence

• Suicidal thoughts

• Guilt and self blame

• Agitation or slow movement

What are the 3 stages of depression episodes?

1. Mild - 4 symptoms → daily activity is manageable.

2. Moderate - 5-6 symptoms → serious issues with daily functioning.

3. Sever - 7+ symptoms → worthlessness, self harm and suicidal thoughts.

How has depression changed over time?

• Seligman (1988) → depression increased 10x since 1940s.

• Kings fund (2008) → depression case rise from 1.25 - 1.45m (2026)

• Twenge et al (2010) → 2007 youth more depressed than 1938.

• Hidaka (2012) → found link between depression and modern living.

• Liu Yi Lin et al (2016) → found link between social media and depression in American teens.

How does depression affect individuals?

• Suicide risks, worthlessness, emotional pain that could lead to self harm.

How does depression affect the workplace?

• Low energy and mood leads to more sick or mental health days taken.

• 9.9million sick day between 2014-2015.

How does depression affect healthcare?

• NHS spent more than 1 billion pounds on depression.

How does depression affect society?

• Increased need for antidepressants and therapists.

How do genetics link to depression?

• Hereditary and runs in families.

• Craig Hyde et al (2016) found 17 gene variations linking to depression.

• More likely to develop depression due to gene.

What does the Diathesis stress model show?

1. Gene - inherited predisposition or vulnerability to depression.

2. Environment - stress abuse or life changes can trigger depression.

3. Disorder - develop depression, with diathesis less stress is needed.

Results of McMuffin et al (1996) Twin studies

• Monozygotic twins → 46% both got depressed.

• Dizygotic twins → 20% both got depression.

Strengths of the genetic explanation

1. Evidence → twin studies.

2. Decrease stigma → not always personal weakness.

3. Support free will → environment and choice play key role.

Weaknesses of the genetic explanation

1. Deterministic → gene dosent always lead to depression.

2. Reductionist → ignores nurture.

3. Doesn’t explain how some people with gene don’t get depresses.

What were the features of Aaron Becks cognitive Triad?

1. Cognitive bias → negative thought process created for past experiences.

2. Negative self schemas (views on self).

3. Negative news about future (more adverse situation).

Albert Elis ABC mode:

A. externat or internat activating event.

B. rational or irrational beliefs about event.

C. positive or negative consequences.

Strengths of cognitive explanation:

1. Takes individual events and experiences into account.

2. Utilised in CBT.

Weaknesses of cognitive explanation:

1. Irrational thoughts could be a cause and symptom of depression.

2. Thought processes are hard to point out as the determinant of depression.

What are neurotransmitters?

Chemicals in the nervous system that pass messages form one neurone to another.

What are some antidepressants used in drug therapy?

1. SSRI → Selective serotonin re-uptake inhibitors.

2. SNRI → Serotonin and noradrenaline re-uptake inhibitors.

3. MAOI → monoamine oxides prevent break down of serotonin and noradrenaline.

4. TCA → tricyclics enhance serotonin and noradrenaline.

Strengths of drug therapy:

1. Prevents lack of motivation to attend CBT.

2. Placebo pill aren't as effective.

Weaknesses of drug therapy:

1. Ignores causes of depression.

2. Relapse and addiction is more likely than CBT.

What is cognitive behaviour therapy?

• Systematic approach to address negative thought processes.

• Collaboration between patients and therapist.

What is the procedure of CBT?

1. Patient discusses symptoms with therapist.

2. Identify irrational thought and belief linked to an event.

3. Therapist assists patient to replace irrational thoughts with rational ones.

4. Patient keeps diary to discuss with therapist.

Strengths of CBT:

1. Significant and lasting improvement.

2. Empowers patients and reduce feelings of helplessness.

Weaknesses of CBT:

1. Patient motivation is needed.

2. Therapists influence and abuse of power.

Caspi et al (2003) : Background

• Stressful life events linked to depression.

• Diathesis-stress theory.

• Role of 5-HTT gene on serotonin.

Caspi et al (2003) : Aim

• Investigate why individuals face depression after stressful life events and the contribution of the 5-HTT gene.

Caspi et al (2003) : Sample

• 847 participants from Dunedin Multidisciplinary Health and Development Center.

• Divided into three groups:

  • 2x short gene - 17%

  • 1x long 1x short gene - 51%

  • 2x long gene - 31%

Caspi et al (2003) : Procedure

• Longitudinal study lasted 3-26 years (96% follow up).

• Stressful life events recorded (family, job, health) - 21-26 years old.

• Depression assess a 26 years based on Diagnostic interview schedule.

• Informants questions on participants depression symptoms.

Caspi et al (2003) : Results

• At least 1x short gene + stressful life event lead to increase in depressive symptoms.

  1. 1x short gene > 1x long gene

  2. 1x short > 2x long

  3. 2x short = severe depression.

Caspi et al (2003) : Conclusion

• Found a link between stressful life event, genetic influence and depression.

• Both nature and nurture influence depression.

Caspi et al (2003) : Strengths

• Generalisable → large sample, 847 pp’s.

• Application → doctors can look at both genes and life events as causes of depression.

Caspi et al (2003) : Weaknesses

• Not only genes AND stressful life cause depression gene may not be needed.

• Self reported → over or under exaggerate.

What is addiction?

Want or need of a specific substance or engagement to maintain daily activity or reduce negative thoughts.

What is withdrawal?

Unpleasant physical or psychological symptoms when trying to quit an addiction.

What are the two types of addiction?

1. Dependance disorder.

2. Behavioural addiction.

What are the characteristics of dependance disorder?

• Compelling urge to consume substances.

• Substance tolerance.

• Difficult to stop - physical withdrawal.

• Daily activities subbed for substance.

• Denial.

What are the characteristics of behavioural addiction?

• Need to engage in activity.

• Difficult to reduce frequency.

• Want to increase frequency/risk.

• Substitution and denial.

Dorit Carmeilli et al (1992)

• Higher chance of both monozygotic twins becoming smoker if one does than dizygotic.

Donald Goodwin et al (1973)

• Adopted child with biological alcoholic parents is more likely to show signs of addiction.

Diana Marinez et al (2004)

Have cocaine users more likely to have dopamine receptor gene.

Strengths of genetic explanation of addiction:

1. Scientific studies as evidence support explanation.

2. Controlled environment in twin and adoption studies isolates causes of addiction.

3. Genetic factors within families contribute to the heritability of addiction.

Weaknesses of the genetic explanation of addiction:

1. Reductionist approach ignores social factors.

2. No identification of singular gene.

3. DDR2AI gene is associated with both addiction and autism → question role.

Classical conditioning for addiction:

Positive association with substance or engagement leads to addiction.

SLT for addiction:

Imitation of role models could lead to addiction.

Operant conditioning for addiction:

Addictive behaviour reinforced by positive feeling → more likely to be repeated.

Strengths of learning theory of addiction:

1. Assumptions that addictions could be learned → treatment.

2. Operant conditions observes both biological and external factors.

3. Classical conditioning explains relapse → situation associated with addiction.

Weaknesses of learning theory of addiction:

1. Generally neglects biological factors.

2. Can’t explain why small number of people face addiction despite being in similar conditions.

3. SLT suggests discontinuation if role model stops addiction.

What is drug therapy for addiction?

Medication that aids detox, reduced withdrawal symptoms, combats craving and prevents relapse.

What are some example of the drugs used for therapy?

• Methadone → opiates.

• Nicotine patch/gum → smokers.

• Naloxone → alcoholics and gamblers

Strengths of drug therapy for addiction:

1. Supported by research and evidence.

2. Address short term effects.

Weaknesses of drug therapy for addiction:

1. Similar effectiveness in placebos.

2. Risk of dependancy.

What are the features of CBT for addiction?

• Function analysis uncovers sources and triggers of addiction.

• Skills training finds ways to cope and avoid triggers.

• Patient keeps diary.

Strengths of CBT for addiction:

1. Empowers patients.

2. Backed by research evidence.

Weaknesses of CBT for addiction:

1. Require patient commitment.

2. Skill retention + application may vary.

Young et al (2009) : Aim

• To see how online CBT would be effective in treating internet addicts.

Young et al (2009) : Sample

• 114 participants for online addiction centre in the US.

• Screened for other psychological problems.

• 58% males (porn) and 42% females (chatrooms).

Young et al (2009) : Procedure

• Pp’s had online CBT sessions.

• First sessions: functional analysis.

• Other sessions: skill training

  • Client outcome questionnaire given at 3rd, 8th and 12th session → 6 month follow up.

  • 12 question on 5 point likest sale.

Young et al (2009) : Results

• 30% of males addicted to porn.

• 30% of females addicted to chatrooms.

• 96% spent too much time online.

Young et al (2009) : Conclusion

• Clients found themselves more able to control their online problem behaviours.

• After 6 month symptoms were still better than the start.

Young et al (2009) : Strengths

• Real work application: Online session of CBT might be useful for treating internet addiction. This can encourage people to access treatment.

• Reliability: Using the same questions and rating scales at session 3, 8, 12 and after 6 months.

Young et al (2009) : Weaknesses

• Self reported questionnaires could be invalid and inaccurate.

• Different types of addiction could have different outcome → can’t be generalised.

Nature AO1

• Biological factors influence our behaviours.

• Genes we inherit cause our behavioural characteristics.

  • Criminal behaviour and addiction.

Nature AO3

• Capsi et al found the 5-HTT gene causes depression.

Nurture AO1

• Environmental factors influence our behaviour.

• Our experiences shape us.

  • Stressful life events cause depression, SLT.

Nurture AO3

• CBT confronts irrational thinking as a result of life experiences.

• Caspi et al found that stressful events are needed to be depressed.