Psychopathology Essay Prep - Eoin

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DEPRESSION

Likely question types:

Compare and contrast - two or more aspects or treatments

  • Compare and contrast biological theories of depression
  • Compare and contrast one biological and one cognitive treatment for depression

Critically discuss - Criticism for whatever sources you use, but also pro and con for question topic 

  • Critically discuss the genetic theory for depression 
  • Critically discuss the social impact on depression

Diagnosis

Collishaw (2015) - Clinical diagnosis and treatment of child and adolescent psychiatric disorders increased over recent decades.

McElroy - Average number of symptoms reported higher in those born at the turn of the millennium, compared with those born in the 1990s, 1970s, and 1950s 

Genetics / Heritability 

Wray (2012) - Traditionally, heritabilities have been estimated from families' info from specific hospital registers, but finding sufficient numbers of families can be difficult.

Flint (2014) - “Despite convincing evidence for a genetic contribution to disease susceptibility, there has been a dearth of substantive molecular genetic findings.” 

Caspi et al. (2013) - Serotonin transporter gene (5HTT) + Polymorphism (two short alleles). The specific combination of this and environmental stressors found to predict depression. 

Researchers found that:

  • 7.4% of total disease burden in 2010 attributed to mental health problems
  • Depressive disorders accounted for 40.5% of this (approximately 3% of all burden)
  • Genome-wide association studies – largely failed to identify specific genes associated with depression

Neurological

Pizzagalli et al. (2014) - Anhedonia has emerged as one of the most promising endophenotypes (hereditary bio-marker) of depression. Pizzagalli et al. summarised animal data indicating that "stress negatively affects mesocorticolimbic dopaminergic pathways critically implicated in incentive motivation and reinforcement learning." 

Keren et al. (2018):

  • Meta-analysis of 38 fMRI and 12 EEG studies.
  • Consistent neural aberrations during reward processing in depression
  • Blunted neural response to reward, may be more pronounced in under 18's. 

Social

Cromby (2013) - All experiences require biology, but it's reductionist to reduce experiences to JUST biology. 

Mandelli et al. (2015) - Meta-analysis 26 studies found emotional abuse showed the strongest association with depression. Other associations found were neglect, sexual abuse, domestic violence, and physical abuse.

McElroy - Those in lower SES classes (i.e. those with less income, education etc.) at greater risk of mental distress, but only in more recent generations. 

Gender

Salk et al. (2017) - Women are twice as likely as men to meet the criteria for depression. Possible factors: 

  • Biological (e.g. hormones – findings mixed)
  • Social
    • Girls more likely to be abused
    • Women more likely to be exposed to chronic stress (e.g. caregiving)
    • Women tend to provide more social support to others facing stress; dubbed the ‘cost of caring’
    • Social roles – may intensify self-critical attitudes about appearance

Treatment

Klerman et al. (1984) - Interpersonal psychotherapy: identifying key interpersonal problems, make decisions/develop strategies to solve these issues.

Jackobsen et al. (2017) - Several meta-analytic reviews find that SSRIs are an effective method of treatment for depression.

E Karyotaki (2016) - Combined therapy did produce better maintenance of recovery compared to pharmacotherapy alone at 6-months and 12-months+. 

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