Depression and OCD Lecture Notes
DEPRESSION
Characteristics of Depression
Emotional
Persistent low mood
Anger
Low self-esteem
Behavioural
Reduced activity levels
Sleeping and eating disturbances
Aggression or self-harm
Cognitive
Poor concentration
Dwelling on the negative
Absolutist thinking (black-and-white thinking)
Explanations for Depression
1. Biological Explanation
Genetics
Depression runs in families.
Concordance rate for identical twins (MZ) is around 40%.
This suggests a genetic vulnerability.
Neurochemistry
Low levels of serotonin are linked to depression.
Serotonin affects mood regulation.
Evaluation
Strengths:
Supported by twin studies.
Has practical applications in drug therapy.
Limitations:
The concordance rate is not 100%, indicating that depression is not purely genetic.
Reductionist approach that ignores cognitive and environmental factors.
Does not explain why individuals may think negatively.
2. Cognitive Explanation
Beck’s Theory – Aaron Beck
Depression is caused by faulty thinking patterns.
Beck identified:
Negative schemas: These develop from childhood experiences.
Faulty information processing: Individuals focus on negatives.
The Negative Triad:
Negative view of self
Negative view of the world
Negative view of the future
Ellis’ ABC Model – Albert Ellis
A = Activating event
B = Belief
C = Consequence
It is not the event that causes depression, but the irrational belief about the event.
Example of irrational beliefs:
“I must be perfect.”
“If I fail, I am worthless.”
Evaluation of Cognitive Explanation
Strengths:
Strong research support showing that depressed individuals exhibit a negative bias.
Cognitive behavioral therapy (CBT) is effective for treatment.
Has real-world applications in therapeutic settings.
Limitations:
Does not explain all cases of depression, particularly those with biological origins.
May lead to blaming the individual for their condition.
More effective at explaining reactive depression than endogenous depression.
Treatments for Depression
1. Drug Therapy (SSRIs)
Example: Fluoxetine
SSRIs (Selective Serotonin Reuptake Inhibitors) block the reabsorption of serotonin in the synapse, which increases serotonin levels in the brain.
Evaluation
Strengths:
Effective for many individuals suffering from depression.
Relatively cheap relative to other forms of therapy.
Easy to administer (oral medication).
Limitations:
Side effects such as nausea and sleep disturbances.
High relapse rates upon discontinuation of medication.
Does not address underlying cognitive causes of depression.
2. Cognitive Behavioral Therapy (CBT)
CBT challenges negative thoughts and replaces them with more rational beliefs.
Key components include:
Cognitive restructuring: Changing irrational thoughts.
Behavioural activation: Increasing engagement in positive activities.
Evaluation
Strengths:
Addresses the root cognitive causes of depression.
Demonstrates long-term effectiveness in alleviating symptoms.
Does not produce physical side effects like medications can.
Limitations:
Often seen as expensive compared to medication.
Requires a high level of motivation from the patient.
May not be suitable for individuals with severe depression.
OCD (Obsessive Compulsive Disorder)
Characteristics of OCD
Emotional
Anxiety
Distress
Behavioural
Compulsions (repetitive behaviours conducted in response to obsessions)
Avoidance of anxiety-provoking situations
Cognitive
Obsessions (intrusive, unwanted thoughts)
Insight: Awareness that the behaviour is irrational despite feeling compelled to act on it
Explanations for OCD
1. Biological Explanation
Genetic Factors
Candidate genes have been linked to serotonin levels in OCD.
There is evidence that OCD runs in families.
Neural Factors
Low levels of serotonin are associated with OCD.
Overactivity has been noted in the orbitofrontal cortex, a brain area involved in decision-making.
Evaluation
Strengths:
Offers scientific credibility through genetic and neural evidence.
Explains the success of SSRIs as a treatment for OCD.
Supported by brain imaging studies that indicate neural involvement in OCD symptoms.
Limitations:
Not all sufferers respond to drug treatments, highlighting individual differences.
Fails to explain the differences in the types or expressions of OCD.
A reductionist approach that ignores learning and environmental factors contributing to OCD.
2. Behavioural Explanation – Two-Process Model
Proposed by O. Hobart Mowrer
OCD is learned through two processes:
Classical Conditioning: A previously neutral stimulus becomes associated with anxiety due to ritualistic behaviours.
Operant Conditioning: Compulsions serve to reduce anxiety (negative reinforcement); therefore, the behaviour is repeated.
Evaluation
Strengths:
Effectively explains the mechanism behind compulsions.
Led to the development of Exposure and Response Prevention (ERP), a successful treatment for OCD.
Has practical applications in therapeutic contexts.
Limitations:
Does not fully explain the presence of obsessions in OCD.
Ignores substantial biological evidence.
Some compulsions occur without a clear conditioning link, which complicates understanding of the disorder.
Treatments for OCD
1. Drug Therapy (SSRIs)
Increases serotonin levels in the brain, alleviating OCD symptoms.
Evaluation
Strengths:
Effective for many individuals with OCD.
Provides a quick treatment option relative to psychotherapeutic approaches.
Limitations:
Associated side effects that some patients may find intolerable.
Symptoms of OCD may return once medication is stopped.
2. Exposure and Response Prevention (ERP)
In ERP, the patient is exposed to anxiety triggers while being prevented from performing their compulsions.
Over time, this leads to a gradual reduction in anxiety through habituation.
Evaluation
Strengths:
Demonstrated high effectiveness in reducing symptoms of OCD.
Results in long-term improvement of symptoms.
Limitations:
Can be distressing for the patient during the exposure phase.
High dropout rates have been noted among individuals undergoing this treatment.