Paper 2 Flashcards

MDD

(Major Depressive Disorder)

Structure of Essay:

  • Paragraph 1
    • Same for etiology prompt and prevalence rate prompt
  • Paragraph 2
    • Different for etiology prompt and prevalence rate prompt
    • Begins the same, but ends differently between biological, cognitive, and sociocultural etiology prompts
  • Study 1 (biological/cognitive/sociocultural/prevalence rates)
  • Study 1 Evaluation
  • Study 2 (biological/cognitive/sociocultural/prevalence rates)
    • Will be the same biological/cognitive/sociocultural/prevalence rates as study 1
  • Study 2 Evaluation
  • Study 3 (biological/cognitive/sociocultural/prevalence rates)
    • For biological etiology prompt, choose cognitive or sociocultural study for a counter argument discussing alternate explanations for MDD
    • For cognitive etiology prompt, do not need a 3rd study as Haefell et al. has sociocultural explanations in it as well
      • plus Beck’s theory is explained in paragraph 2, meaning there is enough research
    • For sociocultural prompt, do not need a 3rd study as Haefell et al. has cognitive explanations in it as well
    • For prevalence rates prompt, do not need a 3rd study
      • Payne (2012) is simply repetitive in nature when discussing the other two studies
        • It doesn’t add to the overall essay
  • Study 3 Evaluation
    • Same criteria as above

Paragraph 1:

  • Mental health condition
    • Sadness
    • Hopelessness
    • Lack of interest or pleasure in activities
  • Enduring condition that can significantly impact daily life, relationships, and ability to function
  • Symptoms
    • Depressed mood
    • Diminished interest
    • Significant changes in weight and appetite
    • Insomnia or hypersomnia
    • Psychomotor agitation or retardation
    • Fatigue
    • Feelings of worthlessness
    • Diminished ability to think and concentrate, indecisiveness
    • Recurrent thoughts of death, suicidal ideation or attempt
  • Diagnosis of MDD
    • 5+ of symptoms above need to have been present during same 2 week period
    • Symptoms represent change from previous functioning
    • One of the symptoms present must be either depressed mood or loss of interest/pleasure

Etiology

Paragraph 2:

  • Etiology: the cause, set of causes, or manner of causation of a disease or condition
  • Etiology of MDD is a complex interplay of many factors (Problem is that it is multifactorial)
    • Biological
    • Cognitive
    • Sociocultural
  • There are ongoing debates about what causes of major depressive disorder are the most influential, as well as how different causes and factors interact with one another
    • (Area of uncertainty)

Biological

Paragraph 2 (cont.):

  • Genetic
    • Diathesis-stress theories: predict that an individual’s reaction to stressful events depends on their genetic make-up.
    • If an individual has a specific genotype, then interaction with the environment may cause these genes to be expressed.
  • Neurotransmitters
    • Depression can be thought of as a chemical imbalance in the brain
    • Low levels of serotonin associated with major depressive disorder

Capsi et al. (2003):

  • Aim
    • To determine whether there is evidence for a gene-environment interaction for a mutation of the serotonin transporter gene, 5-HTT
  • Sample
    • 847 New Zealand 26-year-olds
    • Members of a cohort that had been assessed for mental health on an every-other-year basis until they were 21.
  • Procedure
    • Split into 3 groups based on their 5-HTT alleles
      • Mutation for the 5-HTT gene has the short alleles
        • Roughly 43% of people have the shorter alleles
      • Group 1: 2 short alleles
      • Group 2: 1 short allele, 1 long allele
      • Group 3: 2 long alleles
    • Participants filled out a “Stressful life events” questionnaire
      • asked them about the frequency of 14 different events between 21-26 years old
        • e.g, financial, employment, health and relationship stressors
    • Participants were assessed for depression
  • Results
    • People who had inherited one or more short versions of the allele demonstrated more symptoms of depression and suicidal ideation in response to stressful life events
      • effect was strongest for those with three or more stressful life events
    • Simply inheriting the gene was not enough to lead to depression
      • gene’s interaction with stressful life events increased one’s likelihood of developing depression

Capsi et al. (2003) Evaluation:

  • Observational study
    • Establishes correlational relationship between variables
  • Large sample size
    • Increases the reliability of the results
  • Demographically restricted sample size (New Zealand 26 year olds)
    • Limits external validity

Wilhelm et al. (2006):

  • Sample
    • 127 males and females from a town in New Zealand
    • Are all part of a longitudinal prospective study looking at mental health
  • Procedure
    • Sample was monitored for over 25 years
    • At five-year intervals, scientists recorded any major life events and signs of depression
  • Results
    • 80 percent of those with two short 5-HTT genes became depressed after three or more negative life events in a year
    • 30 percent of those with long 5-HTT genes became depressed after three or more negative life events in a year
    • Found that childhood maltreatment predicted adult depression only among individuals carrying a short allele and not among those carrying the longer allele

Wilhelm et al. (2006) Evaluation:

  • Observational study
    • Establishes correlational relationship between variables
    • More research is needed before a clear relationship between a gene and depression can be established.
  • Longitudinal study
    • Natural style of observation
    • Boosts ecological validity

Cognitive

Paragraph 2 (cont.):

  • Cause of depression is found in how people think about their reality, whatever that reality may be
    • Rather than in neurotransmitters, genetics, or in tragic life events
  • Aaron Beck’s theory
    • Depression is caused by cognitive distortions and illogical thinking processes
    • These patterns of faulty, negative thinking lead to a grim, hopeless view of the world, and often result in depression
    • Some kinds of cognitive distortions identified by Beck
      • Selective attention
        • Only focus on the negative aspects of an event
      • Magnification
        • Exaggerate the importance of negative life events
      • Overgeneralization
        • Draw broad conclusions on the basis of a single negative life event
    • Cognitive distortions may result in frequent seemingly uncontrollable negative thoughts
      • Beck’s Negative Triad
        • Negative thoughts about oneself
        • Negative thoughts about the world
        • Negative thoughts about the future

Alloy et al. (1999):

  • Aim
    • To determine if cognitive styles can predict who will become depressed
  • Sample
    • 347 American college freshmen
    • No prior disorders
  • Procedure
    • Given a questionnaire to determine their thinking style
      • Categorized as either positive or negative
    • Participants were then followed for 6 years
      • Rates of depression were measured
  • Results
    • Participants with negative thinking styles has higher rates of depression than participants with positive thinking styles

Alloy et al. (1999) Evaluation:

  • Study supports Beck's cognitive theory of depression, as it suggests that patterns of negative thought can lead to depression
  • Observational study
    • Establishes correlational relationship between variables
    • More research is needed before a clear relationship between a gene and depression can be established.
  • Longitudinal study
    • Natural style of observation
    • Boosts ecological validity
  • Use of questionnaire instead of observation to deduce participant thinking style
    • Opens the door to confounding variables
      • Participants may not want to seem negative, so they answer questions to reflect themselves positively
    • Limits internal validity
  • Large sample size
    • Increases the reliability of the results
  • Demographically limited sample
    • Reduces external validity

Haefell et al. (2013):

  • Aim
    • Investigate whether thinking style and risk for depression can be influenced by the people around you
  • Sample
    • 103 American college students who were randomly assigned a roommate during their first year in college
  • Procedure
    • Participants completed an online questionnaire to measure cognitive vulnerability and depressive symptoms 1 month, 3 months, and 6 months after arriving on campus
  • Results
    • Participants who were randomly assigned to a roommate with high cognitive vulnerability became more vulnerable themselves
      • Cognitive style can be influenced by the social environment, especially by people you spend a lot of time with
      • Cognitive style is not a fixed trait, can change depending on the situation and social context
    • Participants that developed increased cognitive vulnerability after 3 months had nearly twice the level of depressive symptoms after 6 months compared to students who didn't show an increase in cognitive vulnerability
      • Change in cognitive style can increase the risk of depression

Haefell et al. (2013) Evaluation:

  • Support for Beck's cognitive theory of depression, demonstrating how changes in cognitive style can increase risk of depression
  • Results are highly applicable to real-life treatment of mental illness
    • Suggests that risk of depression can be substantially reduced by avoiding overly negative people
  • Observational study
    • Establishes correlational relationship between variables
  • Demographically limited sample
    • Reduces external validity
    • More research should be done on other cultural and age groups to see if these results can be generalized

Sociocultural

Paragraph 2 (cont.):

  • Environmental factors are a large cause for MDD
    • Relationships with other people is also an influence

Brown and Harris (1978):

  • Proposed a model of depression outlining how vulnerability factors interact with triggering stressors to increase the risk of depression
  • Sample
    • 458 women from London
  • Procedure
    • Surveyed participants on the history of life events and depressive episodes
    • Semi-structured interviews were used to gather in-depth information about history of life events and depressive episodes
  • Results
    • 4 social vulnerability factors were likely to provoke depression in women (when combined with chronic social stressors)
      • 3+ children under 14 years old
      • Lack of intimate relationship with husband/boyfriend
      • Lack of employment
      • Loss of mother before age of 11 years
    • Social factors are involved in the process of the development of depression

Brown and Harris (1978) Evaluation:

  • Observational study
    • Establishes correlational relationship between variables
  • Demographically limited sample (only women from London)
    • Can’t be generalized to men
    • Can’t be generalized to other cultures
    • Limits external validity
  • Naturalistic methods of gathering information
    • Boosts ecological validity

Haefell et al. (2013):

  • Aim
    • Investigate whether thinking style and risk for depression can be influenced by the people around you
  • Sample
    • 103 college students who were randomly assigned a roommate during their first year in college
  • Procedure
    • Participants completed an online questionnaire to measure cognitive vulnerability and depressive symptoms 1 month, 3 months, and 6 months after arriving on campus
  • Results
    • Participants who were randomly assigned to a roommate with high cognitive vulnerability became more vulnerable themselves
      • Cognitive style can be influenced by the social environment, especially by people you spend a lot of time with
      • Cognitive style is not a fixed trait, can change depending on the situation and social context
    • Participants that developed increased cognitive vulnerability after 3 months had nearly twice the level of depressive symptoms after 6 months compared to students who didn't show an increase in cognitive vulnerability
      • Change in cognitive style can increase the risk of depression

Haefell et al. (2013) Evaluation:

  • Results are highly applicable to real-life treatment of mental illness
    • Suggests that risk of depression can be substantially reduced by avoiding overly negative people
  • Observational study
    • Establishes correlational relationship between variables
  • Demographically limited sample
    • Reduces external validity
    • More research should be done on other cultural and age groups to see if these results can be generalized

Prevalence Rates

Paragraph 2:

  • Prevalence rates measure how many individuals may be diagnosed with the disorder
    • They are numerical measurements of the demographics of disorders
  • Prevalence rates are not universal
    • They constantly change and are influenced by cultural variations and biases
  • Prevalence rates of MDD have led to the prediction that MDD will be the 2nd leading cause to disability by 2020
  • Point prevalence rates measure the proportion of a population that is diagnosed with disorders like MDD at one point in time
  • Period prevalence rates measure the proportion of a population that is diagnosed with disorders like MDD during a given period of time
  • Types of period prevalence rates
    • 12-month period prevalence rates measure the proportion of a population that is diagnosed with disorders like MDD during a given 12-month period
    • Lifetime prevalence rates measure the proportion of a population that has been diagnosed with a disorder like MDD at least once during their lifetime
  • Several factors influence prevalence rates (problem is that prevalence rates have various variables that influence them, making it difficult to predict and understand) (various factors lead to inaccuracies in prevalence rate measurements)
    • Expression of symptoms
      • Differ culturally
      • Somatization
        • Expressing psychological problems through physical symptoms
    • Reporting Bias
      • People interpret MDD differently
      • Cultural stigmas related to reporting MDD
    • Classification systems
      • Used to diagnose disorders
      • Vary in symptoms of MDD globally
    • These variables all influence how people interpret, report, and diagnose disorders like MDD, consequently impacting measurements of prevalence rates of MDD

Furnham and Malik (1994):

  • Aim
    • Investigate cross-cultural beliefs about depression
    • Noticed British Asians were rarely diagnosed with MDD
      • They wondered if they were generally healthier than Native British people, or if they didn’t make as much use of mental health facilities
  • Sample
    • 152 female British participants
    • 2 age groups (young and middle-aged)
    • Half of them were Native British and half were of Asian origins
  • Procedure
    • Filled out a questionnaire about their symptoms and beliefs about depression
  • Results
    • Perceptions of depression differed among British and Asian participants
      • Asian participants thought that depression is temporary and can be fixed by a job outside home
    • Differences were less pronounced in the younger group
      • Globalization gradually erases cultural differences
    • Cultural differences exist in the way depression is perceived/interpreted
      • Affects the rates at which depression is diagnosed
    • People from traditional collectivist societies tend to report depression more to relatives and less to professionals
      • Affects the rates at which depression is diagnosed

Furnham and Malik (1994) Evaluation:

  • Observational study
    • Establishes correlational relationship between variables
  • Observed multiple age groups
    • Reduces effect of age confounding variables
    • Increases internal validity
  • Demographically restricted sample
    • Can’t be generalized to men
    • Can’t be generalized to other cultures
      • E.g., Asian Americans may be more similar to “native” Americans than British Asians are to their native counterpart
    • Low external validity

Kleinman (1982):

  • Aim
    • To investigate if neurasthenia (a vague medical condition characterized by fatigue, headache, and irritability) in China would be similar to depression in DSM-III
  • Sample
    • 100 Chinese patients who were diagnosed with neurasthenia
  • Procedure
    • Interviewed participants using structured interviews based on DSM-III diagnostic criteria
  • Results
    • 87% of the patients could be classified as suffering from depression
      • 90% complained of headaches, 78% of insomnia, 73% of dizziness, and 48% of various pains
      • Depressed mood was only given as the main complaint in 9% of the cases
    • Neurasthenia is similar to depression
      • Neurasthenia could be a specific Chinese way of expressing depression in somatic (physical) ways
    • Somatization is the cultural mode of distress in China, psychologization is the common mode of distress in the West
      • These differences make the process of MDD diagnosis more difficult, impacting the accuracy of prevalence rates measurements
      • An alternate explanation may be that Chinese individuals may often visit physicians instead of psychologists due to their somatic interpretations of their symptoms, leading to a decrease in the measured prevalence rates

Kleinman (1982) Evaluation:

  • Observational study
    • Establishes correlational relationship between variables
  • Demographically limited sample
    • Reduces external validity
    • More research should be done on other cultural groups to see how their perceptions of depressive symptoms change
  • Based on DSM-III guidelines in 1982
    • Updated DSM-V guidelines have better diagnostic characteristics than the older versions, making diagnosis easier and prevalence rate measurements more accurate
    • Low temporal validity