REVISION UNIT 4: DEPRESSION

WHAT ARE THE KEY AREAS OF THE SPECIFICATION?

1. CLININCAL CHARACTERISITICS 2. ISSUES SURROUNDING THE CLASSIFICATION AND

DIAGNOSIS OF DEPRESSION, INCLUDING RELIABILITY AND VALIDITY

3. BIOLOGICAL EXPLANATIONS OF DEPRESSION FOR EXAMPLE, GENETICS, BIOCHEMISTRY

4. BIOLOGICAL THERAPIES OF DEPRESSION, INCLUDING THEIR EVALUATION IN TERMS OF APPROPRIATENESS AND EFFECTIVENESS

5. PSYCHOLOGICAL EXPLANATIONS OF DEPRESSION FOR EXAMPLE, BEHAVIOURAL, COGNITIVE, PSYCHODYNAMIC

6. PSYCHOLOGICAL THERAPIES FOR DEPRESSION AND INCLUDING THEIR EVALUATION IN TERMS OF APPROPRIATENESS AND EFFECTIVENESS.

CLINICAL CHARACTERISTICS

Outline clinical characteristics of depression Outline three clinical characteristics of depression What is depression? How does it affect people? And who is it likely to affect? What are the different types of depression recognised by the

DSM-IV-TR? What is the diagnositic criteria for depression? (i.e. 2 wks) What are the signs/symptoms of depression? ------------ KEEP IT CONCISE ------------------- Q may vary from 5 / 6 / 9 marks.

ISSUES SURROUNDING THE CLASSIFICATION AND DIAGNOSIS OF DEPRESSION, INCLUDING RELIABILITY AND VALIDITY EXAM STYLE QUESTIONS: Describe and evaluate issues in classifying or diagnosing

depression Discuss the issues which apply to diagnosing depression To what extent are diagnoses of depression reliable and

valid? ---------------------------------------------------------- WHAT YOU NEED TO KNOW: What are the different ways of classifying depressive

disorder? –(reliability) How is diagnosis confirmed? – (reliability) How valid are the diagnostic categories? (validity) What are the issues surrounding differential diagnosis and

how do they relate to validity? (validity) What other issues affect the validity of diagnosis?

BIOLOGICAL EXPLANATIONSDescribe each factor and

evaluate

GENETIC FAMILY STUDIES: Gershon(1990)Weissman (1984), Oruc et al(1998)

ADOPTION STUDIES: Wendler (1986)

TWIN STUDIES: Allen (1976), Bierut (1999), Kendler (2006)Andrews (1998), Sevey (2000)

BIOCHEMICAL AMINE HYPOTHESIS: Mcneal and Cimbolic (1986), Mann(1986), Delack (1995), Zhou (2005)NEUROENDOCRINE FACTORS: cortisolsFEMALE HORMONES: PND-Cooper (1988). PMD-Dalton (1964). MD low levels oestrogen

NEUROANATOMICAL Head injuries – prefrontal lobes. Starkstein and Robinson (1991), Powell and Miklowitz (1994), Nemeroff et al (1992)

Describe and evaluate (two or more)

Discuss MOST

IMPORTANT: MUST MAKE REFERENCE TO RESEARCH STUDIES

Revision strategy

explanation studies Evaluation and studies

genetic

twin kendler Not 100% c rate: Kendler diatheisis stress model

family

BIOLOGICAL THERAPIESTHERAPIES RESEARCH STUDIES EVALUATION IN TERMS OF

EFFECTIVENESS AND APPROPRIATENESS

DRUGS:ANTI-DEPRESSANTSMAOIS / TRICYCLICS / SSRI’S

Olfson et al (06) high suicide attempts for 6-18 yr oldsDavid et al (09) rodents – prozacKirsch (08) SRRI’sFurukawa et al (03) placebos

Akira (09) increase effectivenessTreat symptoms not causeCombining drugs and psychological treatment

ECT Explain the ProceduresLevy (1968) – less memory lossPaguin et al (08) ECT valid for severe depressionTaylor (07) 80% response for severe depression

side effectsUse of it 1970-1986Coffey (1998) risk factorsSackheim (2001) relapse

PSYCHOSURGERY Surgery involving removal of neural tissues in the brain

Last resortEffectivenessIssues of informed consent

Exam style questions:

Outline and evaluate biological therapies as treatments of depression

Outline one biological therapy for the treatment of depression

PSYCHOLOGICAL EXPLANATIONS

1. PSYCHODYNAMIC EXPLANATIONS:Freud (1917) / Bowlby (1965), Bifulco et al (1987), Abela (2007), Swaffer

and Hollin (2001)EVALUATION – Difficult to test, effects of loss of parents, significance of

findings

2. BEHAVIOURAL EXPLANATIONS:Lewinsohn (1974) Learning Theory, Seligman (1974) Learned Helplessness,

Rehm (1977), Rice and Mclaughlin (2001)EVALUATION – not complete, Ferster (1973), Inconsistent findings

3. COGNITIVE EXPLANATIONS:Beck (1974) Hopelessness theory, Beck’s cognitive theory of depression,

Boury (2001), Saisto et al (2001), Mcintosh and Fischer (2000)EVALUATION- Effective, successful, negative thinking linked

4. SOCIO-CULTURAL EXPLANATIONS:Diathesis-stress model. Genetic disposition and reaction to stressful

life/environmental factors. Leavey (2007), Cox (2007), Takaaki (2007)

Exam style questions:

Discuss psychological explanations of depression

Outline one psychological explanation of depression

Discuss two or more psychological explanations of depression

PSYCHOLOGICAL THERAPIES: how effective and appropriate are they?

EXPLANATION THERAPY EVALUATION/STUDIES

PSYCHODYNAMIC PSYCHOANALYSIS – uses free association/dreams/word association/transferenceITP

De clerq (1999)Burnard (2002)Carreira (2009Eysenck (1952)

BEHAVIOURAL Behavioural therapy – Lewinsohn (1974)

Houghton (2008)Herson (1984)La Fromboise and Rowe (1983)

COGNITIVE CBT – Beck (1976)REBT – Ellis (1962)

Whitfield and Williams (2003)Flannaghan et al (1987)

Exam style questions:

Outline one psychological therapy for the treatment of depression

Discuss psychological therapies Discuss the effectiveness and

appropriateness of two or more psychological therapies

Outline and evaluate psychological therapies as treatments of depression