1. DEPRESSION

2. Symptoms of Depression
There are four main categories that the symptoms of depression fit into:
Cognitive
Behavioural
Emotional
Physical

3. Cognitive Symptoms Low self esteem Guilt Self dislike Loss of libido
Negative thoughts
Suicidal thoughts
Poor memory
Lack of ability to think and concentrate

4. Behavioural Symptoms Loss of appetite Disordered sleep patterns
Poor care of self and others
Suicide attempts
Decrease in sexual activity

5. Apathy (no interest in or pleasure in activities)
Emotional Symptoms
Sadness
Irritability
Apathy (no interest in or pleasure in activities)

6. Loss of energy Aches and pains Sleep disturbance Menstrual changes
Physical Symptoms
Loss of weight
Loss of energy
Aches and pains
Sleep disturbance
Menstrual changes

7. GENETIC STUDIES
McGuffin et al (1995) – 177 Probands – MZ 46% DZ 20% What does this suggest? Possible AO2 AO2 – share the same environment (this needs thinking about here) AO2 – Comorbidity

8. GENETIC STUDIES
Gershon (1990) – Review of TEN FAMILY STUDIES. Depression assessed in FIRST DEGREE RELATIVES of patients with depression. UNIPOLAR DEPRESSION was 7-30% higher than in general popluation. AO2 – share the same environment

9. HARRINGTON (1993)
Adoption study Study of adoptees – biological relatives are more likely to have DEPRESSION than adoptive relatives. 20% of biological relatives 5-10% of adoptive relatives Ao2 - RAISED APART FROM THEIR BIOLOGICAL PARENTS

10. Biochemical explanations of depression
Noradrenaline
And
Serotonin

11. Noradrenaline Deficiency in some circuits leads to depression
Noradrenaline by-products were found to be low in depressed patients ( Bunney and Davis 1965)
AO2 – Not direct evidence…
AO2 – Leonard (2000)
AO2 – Kraft (2005)
What do you conclude from balancing this research (Textbook p237)

12. Serotonin
Serotonin is said to have a calming effect on the brain as it inhibits neural firings.
Low levels of the neurotransmitter serotonin lead to depression as this calming effect is not present and mood becomes unstable as other neurotransmitters are not being regulated.

13. Serotonin
Serotonin by-products were found to be low in the cerebrospinal fluid of suicidally depressed patients (McNeal and Cimbolic 1986 )
AO2 – Direct evidence?
Delgado et al (1990) levels of Tryptophan research – explain what they found
AO2 – Ruhe et al (2007)
AO2 – aan het Rot et al (2009)

14. Drugs previously used to treat high blood pressure i. e
Drugs previously used to treat high blood pressure i.e. reserpine (which reduces the availability of noradrenaline) caused the side effect of depression/suicidal tendencies in some patients.

15. The success of Tricyclic drugs and more recently SSRI’s such as prozac suggests low levels of serotonin are responsible for depression (as these drugs work by increasing levels of serotonin)

16. Non-human animals given drugs that reduce noradrenaline production become sluggish and inactive (symptoms of depression) AO2 anthropomorphism
Mann (1996) found impaired serotonin transmission in people with depression (using PET scans)

17. A02
Unsure whether it is low levels of BOTH, low levels of EITHER or an imbalance compared to each other that causes depression.
MORE RESEARCH NEEDED!

18. AO2 Treatment aetiology fallacy
JUST BECAUSE THE TREATMENT WORKS, DOESN’T MEAN LOW SEROTONIN IS THE CAUSE!
If you take paracetemol to get rid of your headache, it doesn’t mean your body is lacking paracetemol.
Just because SSRI’s increase Serotonin, does not necessarily mean low levels of Serotonin have caused depression. MAY BE OTHER FACTORS.

19. PSYCHOLOGICAL EXPLANATIONS

20. GENERAL AO2 

21. GENERAL A02 

22. Stressful life events
Brown and Harris identified a number of vulnerability factors:
Working class
Single mothers
Inner city location
Parental indifference in childhood or physical/ sexual abuse

23. AO2
Gender bias Correlational evidence – can’t infer cause and effect Practical applications – identifying risk factors allows them to be addressed e.g. Support for single mothers in the welfare system Interviews (in-depth but possibility of interviewer bias)

24. LOCK and KEY EXPLANATION
Early adverse experience forms LOCKS
Activated by KEYS mirroring previous bad experience
This causes depression

25. Examples: Mother left when you were young THEN husband leaves you
Examples: Mother left when you were young THEN husband leaves you. Loss of parent -> loss of job

26. AO2
Has been incorporated into the DSM assessing social and environmental circumstances
Logical
Supporting evidence – Parker et al (1998) found this to be the case in a significant proportion of patients in their sample.

27. In many cases, patients do not report CRITICAL LIFE EVENTS at the onset of their depression.
Many people have ongoing stressors in their lives but do not experience clinical depression.
COULD THE ENVIRONMENT BE A TRIGGER rather than a cause?

28. Cognitive explanations of depression

29. Ao2
 What did it show?
ECOLOGICAL VALIDITY
ETHICS
ANTHROPOMORPHIC

30. SELIGMAN
GROUP ONE– Harnessed up and then let go. GROUP TWO - Dogs subjected to ELECTRIC SHOCK (with no way of controlling this)

31. Day TWO Dogs then placed in a SHUTTLE BOX – The boxes were split into two sides, one where dogs were subjected to electric shocks, one where the dogs were safe. Could avoid shocks by jumping across barrier. Group one dogs jumped over. WHAT DO YOU THINK GROUP TWO DOGS DID?

32. HIROTO, 1974
PPT’s exposed to LOUD, UNPLEASANT NOISE which they couldn’t turn off. Faced in front of a FINGER SHUTTLE BOX (had a handle of the top) Moving handle stopped noise. When NOISE began they PASSIVELY ACCEPTED IT

33. PPT’s who hadn’t been exposed to noise learned to move the handle and stop the noise.

34. Seligman’s hopelessness theory of depression
An attribution is an explanation of why something happens (the cause of behaviour)
Depression results from the explanations people give for their behaviours.

35. Depressed people attribute behaviour to three causes
Internal –coming from within- blame themselves
Stable – an enduring trait-things will always be that way
Global – affects all aspects of life

36. Example
“I’m inadequate, I will always be inadequate and I am inadequate at everything”

37. Evidence for
Metalsky (1987) looked at students who did badly in their psychology exam. Two days after, those who attributed failure to internal, stable and global causes continued to be mildly depressed. Students who made different attributions e.g. ‘the exam was really hard’ had recovered.

38. AO2 – LEARNED HELPLESSNESS
CAUSE or EFFECT? – Does depression cause learned helplessness? ECOLOGICAL VALIDITY – e.g. Hiroto and Seligman

39. Evidence against
Cannot generalise Metalsky’s study to major depressive disorder which is more severe.
Cannot explain where attributions come from in the first place – problems with addressing this.
Do attributions precede or follow depression – difficult to establish cause and effect.

40. Often done in LABS (e.g. Hiroto and Seligman)
When done with humans, samples are often STUDENTS – SAMPLE BIAS.
Much evidence comes from ATTRIBUTIONAL BIAS QUESTIONNAIRE - some researchers believe forces people into a type of thinking that doesn’t reflect that of real life (ANDERSON ET AL, 1994)

41. Beck’s cognitive theory of depression
Emotions are controlled by cognitive schemas (mental constructions of the world).
People’s experiences are understood in the light of these schemas.
Schemas develop as a result of childhood experience.

42. Beck’s cognitive theory of depression
Emotions are controlled by cognitive schemas (mental constructions of the world).
People’s experiences are understood in the light of these schemas.
Schemas develop as a result of childhood experience.

43. Negative thinking
People who become depressed have negative cognitive schemas
This can lead to errors in thinking. Examples include overgeneralisation or selective abstraction.

44. Example
OVERGENERALISATION – drawing a conclusion from a particular event and applying it generally
SELECTIVE ABSTRACTION – forming conclusions based on isolated detail whilst ignoring contradictory evidence

45. Cognitive triad
Errors in thinking can produce a negative cognitive triad – negative views of (1) self (2) world and (3) future “I am worthless, the world is a miserable place, the future is hopeless”

46. Evidence for
Research indicates that compared to nondepressed people, depressed individuals have more negative thoughts about themselves, the world and the future.

47. Evidence against
However, does negative thinking precede the onset of depression or does it result from it.
According to Davison & Neale (1998) ‘ depression can make thinking more negative, and negative thinking can probably cause and worsen depression’.

48. LONGITUDINAL STUDIES
More of these are needed BARLOW and DURAND (1999) Temple Wisconsin study - non-depressed university students First two years of this study suggests NEGATIVE thinking precedes DEPRESSION.

49. 17% of high risk ppts (high scores on negative thinking) at the beginning of the study started went on to develop depression as opposed to 1% of low risk ppt’s (low scores on negative thinking)

50. Evaluation of cognitive theory
takes account of cognitions and looks at depression from the patients perspective. Important to be patient focused. Cognitions may vary from person to person.
PRACTICAL APPLICATIONS– success of CBT based on Beck’s theory (used extensively on the NHS)

51. CAUSE and EFFECT issues
ETHICAL ISSUES– blames the individual for their own negative thoughts
 REDUCTIONIST

52. DIATHESIS-STRESS MODEL
Interaction between DIATHESIS (predisposition) and STRESS (from the environment) Caused by ‘TRIGGERS’. Stressful events may lead to depression. WEISSMAN et al, 1991 – depression rates from people who are SEPARATED/DIVORCED is 3 TIMES HIGHER than in married people.

53. TAKES INTO ACCOUNT different theories (e. g
TAKES INTO ACCOUNT different theories (e.g. Lock and key, genetics) but also accounts for ENVIRONMENTAL FACTORS.