1. REVISION UNIT 4: DEPRESSION

2. 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.

3. 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.

4. 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?

5. BIOLOGICAL EXPLANATIONS Describe 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: cortisols FEMALE 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

6. Revision strategy explanationstudiesEvaluation and studies genetic twin kendlerNot 100% c rate: Kendler diatheisis stress model family

7. BIOLOGICAL THERAPIES THERAPIESRESEARCH STUDIES EVALUATION IN TERMS OF EFFECTIVENESS AND APPROPRIATENESS DRUGS: ANTI-DEPRESSANTS MAOIS / TRICYCLICS / SSRI’S Olfson et al (06) high suicide attempts for 6-18 yr olds David et al (09) rodents – prozac Kirsch (08) SRRI’s Furukawa et al (03) placebos Akira (09) increase effectiveness Treat symptoms not cause Combining drugs and psychological treatment ECT Explain the Procedures Levy (1968) – less memory loss Paguin et al (08) ECT valid for severe depression Taylor (07) 80% response for severe depression side effects Use of it 1970-1986 Coffey (1998) risk factors Sackheim (2001) relapse PSYCHOSURGERY Surgery involving removal of neural tissues in the brain Last resort Effectiveness Issues of informed consent

8. Exam style questions:  Outline and evaluate biological therapies as treatments of depression  Outline one biological therapy for the treatment of depression

9. 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)

10. Exam style questions:  Discuss psychological explanations of depression  Outline one psychological explanation of depression  Discuss two or more psychological explanations of depression

11. PSYCHOLOGICAL THERAPIES: how effective and appropriate are they? EXPLANATIONTHERAPYEVALUATION/STUDIES PSYCHODYNAMIC PSYCHOANALYSIS – uses free association/dreams/word association/transference ITP De clerq (1999) Burnard (2002) Carreira (2009 Eysenck (1952) BEHAVIOURALBehavioural therapy – Lewinsohn (1974) Houghton (2008) Herson (1984) La Fromboise and Rowe (1983) COGNITIVECBT – Beck (1976) REBT – Ellis (1962) Whitfield and Williams (2003) Flannaghan et al (1987)

12. 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