Mood (affective) disorders

• Oruc (1997


  Biological Explanation
• Beck (1979)


  Cognitive
• Seligman (1988)


  Learned Helplessness/Attributional Style
• Polymorphism


  A variation in a gene or genes. Different from a mutation it refers to the different expressions that may be present in a normal population, even if that expression occurs infrequently
• Sexually Dimorphic


  Any Differences between males and females of any species which are not just differences in organs or genitalia. These differences are caused by inheriting either male or female patterns of genetic material
• Oruc PPT's


  - Sample of participants aged between 31-70 with a diagnosis of bipolar disorder

  - 42 pps: 25 F 17 M

  - Drawn from 2 psychiatric Hospitals in Croatia

  - Control group of 40 pps with no personal or family history of mental health disorders

  - Matched for sex and age

  16 from bipolar group had at least one first degree relative who had been diagnosed with major affective disorder e.g. bipolar

  - Info was collected from pps and family members

  - Confirmed diagnosis through medical records
• Oruc Procedure


  Genes were chosen since alterations in them = disturbances in specific biochemical pathways with known links to depressive disorders
• Conclusions + Results


  Results showed no significant associations in sample

  
  

  Serotonin is understood to be sexually dimorphic as a neurotransmitter

  
  

  When pps were analysed separately by gender trends for association wth both polymorphisms were observed in females

  
  

  Suggests that polymorphisms in these genes could be responsible for an increased risk of developing bipolar disorder in females only
• Strengths of Biological Explanation

  The measurements are objective. (medical records and DNA testing) This makes them reliable. A further sample could be selected and the procedure repeated

  
  

  There is no subjective interpretation of results which adds to the validity of the explanation

  
  

  No experimenter bias

  
  

  A focus on genetics and neurochemicals can allow the development of therapies, such as drugs, so research in this area has good real world application
• Weaknesses of the Biological Explanation

  The sample size for Oruc (1998) study was limited in terms of sample size which makes generalisation difficult. Typically genetic samples need to be large in order to show significant differences.

  
  

  As an explanation, this could be seen as reductionist as environmental factors such as life events are not taken into consideration

  
  

  There is no one gene or neurochemical wholly responsible for depression ; it is likely to be a combination of factors which is responsible for depression. It is a complex relationship.

  
  

  It could be that the environment could act as a trigger for a genetic predisposition as the diathesis-stress model suggests.
• Genetic Theory


  Some mental disorders are thought to have a genetic basis. As first degree relatives such as parent and siblings share 50% of their DNA, it makes sense that characteristics are transmitted from one generation to the next.
• Studies supporting the Genetic Theory

  McGuffin et al (1996) examined 214 pairs of twins where at least one was being treated for depression. They reported that 46% of MZ and 20% of DZ twin of the patients also had a diagnosis for depression.

  
  

  Bertelsen et al (1977) found that the genetic component of depression varied according to type of depression. The concordance rate was highest for bipolar disorder at 80% for MZ twins and 16% for DZ twins and lower for depression (with lower than 3 episodes) at 36% for MZ and 17% for DZ twins
• Neurochemical Theory


  It is thought that a number of neurotransmitters such as norepinephrine and serotonin may be implicated in depression. Low levels of these are related to depression
• Studies supporting the Neurochemical Theory

  Davison and Neale (1998) highlight how certain drugs like tricyclics are used successfully to increase the levels of norepinephrine and serotonin which demonstrates a neurochemical cause.

  
  

  Oruc et al. (1998) explored genetic relatedness in the serotonin receptor 2c (5-HTR2c)
• The Negative Triad


  A negative and irrational view of ourselves, our future and the world around us maintained by cognitive biases and negative self-schemas

  
  

  For sufferers of depression, these thoughts occur automatically and are symptomatic of depressed people

  
  

  The self - 'nobody loves me.'

  The world - 'the world is an unfair place.'

  The future - 'I will always be a failure.
• Schema


  A 'package' of knowledge, which stores information and ideas about our self and the world around us. These schemas are developed during childhood
• Negative self-schemas


  Information which may come from negative experiences, for example criticism, from parents, peers or even teachers.

  
  

  A person with a negative self-schema is likely to interpret information about themselves in a negative way, which could lead to cognitive biases
• Cognitive bias


  Distorting and misinterpreting information.

  
  

  Depressed people are more likely to focus on the negative aspects of a situation, while ignoring the positives.
• Examples of Cognitive bias

  Over-generalisations e.g. where people make a sweeping conclusion based on a single incident i.e. 'I've failed one end of unit test and therefore I'm going to fail ALL of my AS exams!'

  
  

  Catastrophising - Where people exaggerate a minor setback and believe that it's a complete disaster, i.e. 'I've failed one end of unit test and therefore I am never going to study at University or get a good job!
• Strengths of Cognitive Explanation

  Butler and Beck (2000) reviewed 14 meta-analyses investigating the effectiveness of Beck's cognitive therapy and concluded that about 80% of adults benefited from the therapy.

  
  

  It was also found that the therapy was more successful than drug therapy and had a lower relapse rate, supporting the proposition that depression has a cognitive basis.

  
  

  This suggests that knowledge of the cognitive explanation can improve the quality of people's lives. It therefore has good real world application.

  
  

  Lewinsohn et al (2001) assessed teenagers with no existing history of depression and measured their level of negative thinking. A year later those scoring highest for negative thinking were the ones most likely to be diagnosed with major depression. This would seem to be clear evidence for the negative thinking arising before the depression.

  
  

  Davison & Neale (1998) and later Beck himself believe that the process is two way. Depression leads to negative thinking which in turn worsens the effects of the depressed mood. This is called bi-directional.
• Weaknesses of the Cognitive Explanation

  It doesn't explain all types of depression and all symptoms of depression. Many patients with depression have anger issues that this model cannot explain. Some forms of depression such as bipolar also involve some loss of contact with reality such as hallucinations and delusions which again Beck's model is unable to explain.

  
  

  It can also be seen to be an over-simplification. Biology, particularly genes and brain chemistry are involved in depression. Beck's model doesn't consider these. Similarly he places too great an emphasis on cognitive and doesn't consider the role of factors such as relationships with others.

  
  

  It can therefore be seen as a reductionist explanation.
• What is cognitive restructuring?


  Is a talking therapy, w/ 1-1 interactions between patient and Therapists

  
  

  involves questioning + identifying illogical thinking to determine and change patient's way of thinking
• What does cognitive restructuring begin with?

  Explaining the theory of depression to patients to help the patient understand their way of thinking about themselves/the world contributes to his/her depression
• What is a further stage of cognitive restructuring?

  To train patient to observe + record their thoughts

  
  

  critical in helping them to recognise irrational beliefs and statements
• What happens once the individual is able to recognise their own cognitions?

  The therapists helps them understand the link between thoughts, affect and behaviour + how each affects the other

  
  

  patient is asked to 'catch' automatic, dysfunctional thoughts and record them

  
  

  aids in identifying thoughts in real-life context
• What is the purpose of 'reality testing'?

  to investigate and notice negative distortions in thinking for themselves

  
  

  therapist can use 'reattributing' - discuss whether the cause of problems/failures the patient has experienced are internal or external

  
  

  Patients can refrain thinking about upsetting situation + realise they were not responsible
• When is the therapy completed?

  When the patient is able to employ cognitive restructuring + able to see a reduction in depressive symptoms
• When is Cognitive therapy used?

  in cases where drug treatment is unsuitable
• Wiles et al. (2013) : Proposition

  Proposed that it can reduce symptoms of depression in people who fail to respond to antidepressants
• Wiles et al. (2013) : sample

  469 pps w/ depression

  
  

  randomly allocated - usual care (antidepressants) / care with CBT
• Wiles et al. (2013) : Results

  CBT therapy was 3X more likely to respond to treatment / reduce symptoms
• Learned Helplessness


  Not trying to avoid a negative situation because the past has taught you that you are helpless.
• Attribution


  = the reason given for a particular outcome.

  
  

  INTERNAL: something to do with the person e.g. "I'm not clever enough" rather than "that was a hard exam".

  
  

  STABLE: doesn't change overtime or across situations e.g. "I'm stupid, not just in Maths, but in everything".

  
  

  GLOBAL: factors affecting the outcome relate to a large number of situations e.g. "I'm not good in school, but I am also not good in relationships".
• Self-fulfilling prophecies


  When you become what you have been labelled, which is hard to break out of the cycle.
• Background


  Developed in the 1960s by Seligman and his colleagues.

  
  

  Believed that the phenomenon of learned helplessness might help explain depression.

  
  

  Depression was a direct result of a real or perceived lack of control over the outcome of one's situation.
• Seligman et al. (1988) - aim

  Investigated how well attributional style could predict depressive symptoms.
• Seligman et al. (1988) - sample


  39 p's with unipolar depression; 12 p's with bipolar disorder participated in the study during a depressive episode.

  
  

  P's came from the same outpatient clinic, including a mix of genders and mean age of 36.

  
  

  Compared with a non-clinical control group of 10 participants.
• Seligman et al. (1988) - procedure

  Completed a short form of the BDI to asses severity of symptoms, before completing an Attributional Style Questionnaire, consisting of 12 hypothetical good and bad events.

  
  

  Had to make causal attributions for each one and then rate each cause on a 7-point scale for internality, stability and globality.
• Seligman et al. (1988) - results

  Both bipolar and unipolar were found to have more pessimistic, negative attributional styles than the control group.

  
  

  The more severe the depression score on the BDI, the worse the pessimism on the Attributional Style Questionnaire.
• Strengths

  Seligman used a standardised questionnaires (Beck Depression Inventory and Attributional Style Questionnaire) to assess participants. These are considered valid and reliable measurement tools.

  
  

  Learning theories makes sense in terms of reactive depression, where there is a clearly identifiable cause of depression. People with depression do have the negative cognitions described by Seligman and Beck and so there is a high level of face validity.