Amber Gerdman, Jared Costillo, Brianna Hoskins, Melissa Grady,
and Paula
Slide 2
Criteria from the DSM-IV TR 1.) Presence of two or more Major
Depressive Episodes which are: Depressed mood most of the day,
nearly every day Markedly diminished interest or pleasure in all,
or almost all, activities most of the day Significant weight loss
when not dieting or weight gain Insomnia or hypersomnia nearly
every day Psychomotor agitation or retardation nearly ever day
Fatigue or loss of energy nearly every day Feeling or worthlessness
or excessive or inappropriate guilt nearly every day Diminished
ability to think or concentrate, or indecisiveness, early every day
Recurrent thoughts of death, suicidal ideation without a specific
plan, or suicide attempt.
Slide 3
DSM-IV-TR (cont) 2.) There has never been a Manic Episode, a
Mixed Episode, or a Hypomanic Episode.
Slide 4
Discuss the interaction of biological, cognitive, and
sociocultural factors in abnormal behaviors
Slide 5
Factors There are cognitive, biological, and sociocultural
factors to abnormal behavior, recently, is looked at from an
integrationist perspective. This means that psychologists focus on
how a combination of these factors can be involved in abnormal
behavior, unlike in the past when many times a single factor would
be the focus. Biological factors look at the role of genetics and
heredity in abnormal behavior, cognitive looks at the role of
thought patterns and schema and such, and sociocultural factors
look at the role of enviornment and culture.
Slide 6
Analyze etiologies of one disorder from two of the following
groups: anxiety disorders, affective disorders, and eating
disorders
Slide 7
Etiologies of MDD Biological causes- It has been shown that
genetics may play a role in the MDD, however the main biological
involvement with MDD has to do with neurotransmitters. Many times
part of the cause of MDD has to do with chemical imbalances. When
certain neurotransmitters are inhibited it can result in feelings
of depression. The neurotransmitters known to be associated with
MDD are serotonin, norepineprhrine, and dopamine.
Slide 8
MDD Etiology Cont. Cognitive factor can involve a persons
schema and outlook. People who tend to continually have sad
thoughts or have a negative outlook are at higher risk for
depression because there is a higher chance those thoughts will
continue (think of the brains neuroplasticity and how use or disuse
of neurotransmitters can cause a more or less prevalent
connection).
Slide 9
Describe symptoms and prevalence of one disorder from two of
the following groups: anxiety disorders, affective disorders, and
eating disorders
Slide 10
MDD -Can be diagnosed when someone experiences 2 weeks of
either a depressed mood or loss of interest and pleasure. -Also
requires a person to have at least 4 of these symptoms: insomnia,
appetite disturbances, loss of energy, feelings of wothlessness,
thoughts of suicide, or difficulty concentrating. -Prevalence
Rates: -2 to 3 more times common in women than in men. -Levav
(1997) found prevalence rate to be above average in Jewish males
and no difference between male and female prevalance rates among
the Jewish population. -Major Depressive Disorder is a recurrent
disorder with 80% having subsequent episodes. -Average # of
episodes is 4. Lasting about 3 to 4 months.
Slide 11
Etiology Symptoms are caused by a trigger in an adverse
social/environmental change. Biological origin=primary cause of
depression. Also triggered by negative events. Ex: ) Divorce,
death, fired from job, or serious accident. *Depression is NOT
caused by a single factor, but a combination of factors such as,
genetic vulnerability, neureotransmitter malfunctioning,
psychological problems, life events or lifestyle factors, like
alcohol or drugs.
Slide 12
Cont. Sociocultural factors of MDD can either be something that
causes the disorder over time (such as a person who has been abused
or in a stressful situation for many years). However it can also be
triggered by a single traumatic and extremely saddening event
during a persons life, such as the death of a loved. It is also
important to remember that the cause can be any combination of
these three causes.
Slide 13
Etiology and Therapeutic Approach Etiology of a person
suffering from MDD and the approach to that persons treatment are
inextricably linked for obvious reasons. In order for a person to
be treated the cause (etiology) of their symptoms must be known.
The cause of MDD may not be the same for each patient, therefore
any combination of medical treatment and individual therapy and so
on may be needed depending on the what the type of cause is.
Slide 14
Discuss the use of eclectic approaches to treatment
Slide 15
Eclectic approach Research evaluating treatment has
demonstrated there is a postitive effect if people take action to
cope or change a behavior. Taking drugs, participating in group
sessions in a support group, and taking part in a number of therapy
sessions may all positively contribute to increase mental health.
Eclectic therapy recognizes the strengths and limitations of
various therapies. Rush et al (1977) suggests a higher relapse
rates because patients in cognitive therapy learn skills to cope
with depressions that the patients with drugs do not.
Slide 16
Evaluate the use of biomedical, individual, and group
approaches to the treatment of one disorder
Slide 17
Biomedical approach Is based on the assumption that if the
problem is based on biological malfunctioning, drugs should be used
to restore the biological system. Example: depression involves
imbalance in neurotransmission, drugs restore appropriate chemical
balance. Since 1950s there has become a widespread, and
psychoactive drug account. The drugs typically operate by affecting
transmission in the nervous system of neurotransmitters such as
dopamine, serotonin, noradrenalin, or GABA. The outcome is to
increase or decrease the levels of available neurotransmitters in
the synaptic gap.
Slide 18
Biomedical approach (cont) Antidepressant drugs are used to
elevate the mood of people suffering from depression. The most
common group of drugs used today is selective serotonin re-uptake
inhibitors, which increase the level of available serotonin by
preventing its re-uptake in the synaptic gap Examples: Prozac
(fluxetine) Side effects: vomiting, nausea, insomnia, sexual
dysfunction, or headaches.
Slide 19
Individual approaches Aaron Beck developed the idea of
congitive restructuring. The principles are: Identify negative,
self-critical thoughts that occur automatically Note the connection
between negative thought and depression Examine each negative
thought and decide whether it can be supported Replace distorted
negative thoughts with realistic interpretations of each
situation.
Slide 20
Cognitive-behavioral therapy (CBT) CBT is a brief form of
psychotherapy with around 12-20 weekly sessions, with practice
exercises. First aim: identify and correct faulty cognitions and
unhealthy behavior Client finds out thoughts identified with
depressed feelings Second aim: encourage people to increase
gradually any activities that could be rewarding
Slide 21
Group approaches Most group therapy is couple therapy because
of the strong link with depression and marital problems. Marital
therapies focus of teaching the couple to communicate and problem
solve. Toseland and Siporin reviewed 74 studies comparing
individual and group treatment. 75% was found to be just as
effective as individual treatment 25% was found to be more
effective as individual treatment
Slide 22
Explain cultural and gender variations in disorders
Slide 23
Gender variations Brown and Harris(1978) discovered that 29 out
of 32 women who become depressed had experienced a severe life
event, but 78 percent of women that did experience a severe life
event did not become depressed. One out of five women said that
they became depressed from: 1.Lacking employment away from home.
2.absence of social support. 3.having several young children at
home. 4.loss of mother at an early age. 5.history of childhood
abuse. -Women are two to three more times more likely to become
depressed than men. Also more likely to go through more episodes of
depression as well.
Slide 24
Cultural variations World Health Organization (1983) looked at
depression from a cultural perspective and they found that in Iran,
Japan, Canada, and Switzerland all had common symptoms of
depression. Which were sad affect, loss of enjoyment, anxiety,
tension, lack of energy, loss of interest inability to concentrate,
and ideas of sufficiency, inadequacy, and worthlessness.
Marsella(1979) found that sadness, loneliness, and isolation are
typical symptoms of depression in individualistic cultures.
Cultures that are more collectivists. Ex- have larger and more
stable social networks to support the individual, and where ones
identity is more linked to the group.
Slide 25
Evaluate psych research relevant to the study of abnormal
behavior
Slide 26
Research and theories Department of Health (1990): depression
accounted for about one quarter of all psychiatric hospitals in UK
two or three times more common in women occurs frequently among
members of lower socio-economic groups, and young adults Levav
(1997): prevalence rate above average in Jewish males no difference
in prevalence btw Jewish men and women suggest some groups are more
vulnerable to depression Can be hard for a clinician to diagnose
depression because it could just be a case of the blue
Slide 27
Research and theories cont. Nurnberger and Gershon (1982):
reviewed the results of seven twin studies found that the
concordance rate for major depressive disorder was consistently
higher for MZ twins then for DZ twins Average concordance rates MZ=
65% DZ=14% The evidence from twin studies does not contradict the
view that environmental events and psychological characteristics
play a role long term stress may result in depression b/c people
who have a predisposition are more vulnerable and more likely to
develop depression Duenwald (2003) a short variant of the 5-HTT
gene may be associated with a higher risk of depression The gene
plays a role in the serotonin pathways which are thought to control
moods, emotions, aggression, sleep, and anxiety
Slide 28
Dunewald
Slide 29
Research and theories cont. Catecholamine hypothesis (1965)
this theory says depression is associated with low levels of
noradrenalin. Serotonin is the neurotransmitter responsible.
Delgado and Moreno (2000) found abnormal levels of noradrenalin and
serotonin in patients suffering from major depression. abnormal
levels of neurotransmitters might not cause depression but indicate
that depression influences production o neurotransmitters. Rampello
et al. (2000) Found patients with depressive disorder have an
imbalance of several neurotransmitters---adrenaline, serotonin,
noradrenalin, dopamine Burns (2003) says there is no evidence that
depression results from a deficiency of brain serotonin. Lacasee
and Leo (2005) argue that contemporary neuroscience research has
failed to provide evidence that depression is cause by a simple
neurotransmitter deficiency. They believe the brain is complex and
poorly understood.
Slide 30
Catecholamine hypothesis
Slide 31
Examine biomedical, individual, and group treatment
approaches
Slide 32
Biomedical Drugs: Drugs decrease level of noradrenalin tends to
produce depression-like symptoms. Jankowsy (1972) participants were
given a drug called physostigimine They became very depressed and
experienced feelings of hate and suicide within minutes of taking
drug. Image: effect of physostigimine on the brain