Depression (AQA GCSE Psychology): Flashcards

As an increase in the need to sleep, insomnia, or premature waking.

As overeating for comfort, or being unable to eat.

Bipolar depression involves the sufferer swinging between two extreme states of emotion and activity. It used to be known as ‘manic depression’.

Any four of: hugely ‘high’ feelings of euphoria; high levels of activity (creatively, energetically, in a frenzy); a delusional feeling of self-importance; changes in levels of sleep and appetite; and racing thoughts and speech, often talking over others and possibly seeming incoherent.

The manic phase may last weeks or months; when it is over, the depressive phase follows, bringing with it the behaviours common to unipolar depression.

False.

Bipolar depression is highly heritable, whereas unipolar depression may either be inherited or be a result of external factors.

No — there is no known cure, although sufferers can manage their illness via CBT and drug therapy.

The ICD is the International Classification of Diseases — a diagnostic tool used by any medical professional who is qualified to give a diagnosis of both physical and mental disorders.

The ICD is now in its eleventh edition.

Any medical professional qualified to do so — e.g. doctors, clinicians and psychiatrists.

False.

Physical illnesses, such as COVID-19, can also be a focus of the ICD.

It uses the data it has gathered to inform worldwide health initiatives and research into disease, both physical and mental.

Via its classification of the symptoms that determine either mild, moderate or severe depression.

Low mood (dysphoria); loss of interest in activities or hobbies that once brought joy; and reduced energy levels.

The person would need to show two of the three key symptoms, plus another two symptoms.

For someone to be diagnosed with moderate depression they would need to show four or more symptoms in total.

False.

Diagnosing severe depression would need a person to show seven or more symptoms in total.

They should be present all or most of the time, and should persist for longer than two weeks — for mild, moderate and severe depression alike.

The nature side.

That human behaviour such as depression is the result of inherited traits; and the role of neurotransmitters.

Neurotransmitters are chemicals that carry the message chemically across the synaptic cleft — after the signal has travelled electrically down the axon to the terminal buttons.

Molecules of the neurotransmitter which are not passed across the synaptic cleft are taken back up into the axon of the presynaptic neuron, a process known as reuptake.

The key neurotransmitter in the study of depression is serotonin.

The serotonin hypothesis is the idea that low serotonin levels are implicated in depression.

False.

Low levels of serotonin have been linked to depressive symptoms — serotonin is implicated in mood disorders such as depression.

Memory, sleep and appetite.

Lower levels of serotonin in the brains of people with depression, compared to a non-depressed control group — suggesting a link between low serotonin and depression.

The development of antidepressant medications that target serotonin (SSRIs) has been shown to be effective in treating depression — which supports the idea that serotonin plays a role in the disorder.

Because the negative thinking associated with depression can itself change neurons and neurotransmitter production.

False.

Their large-scale systematic review found no consistent evidence of an association between serotonin and depression.

The theory is too simple, as some people with low serotonin don’t have depression.

It proposes that depression results from a biological vulnerability (e.g. low serotonin) combined with a stressor (e.g. divorce, bereavement) — rather than from low serotonin alone.

That mental processes such as thoughts, ideas and perceptions affect behaviour — with irrational and faulty thinking characterising the depressed person’s state of mind.

A schema is a shortcut in thinking that acts as a mental framework for the individual.

A self-schema is the ‘packet’ of information someone has collected about themselves.

As a vulnerability that can be brought about by faulty thinking and negative schemas — a depressed person has a negative self-schema, meaning they interpret all information about themselves negatively.

A schema which means the person believes they will fail at everything they try.

A negative self-evaluation schema means a depressed person will constantly remind themselves of their worthlessness.

False.

Reality does not have any meaning to the depressed person — they are likely to develop a dysfunctional view of themselves even in the face of overwhelming evidence to the contrary.

The three elements of negative thinking a depressed person holds: a negative view of the self, a negative view of the world, and a negative view of the future.

Self: ‘I am worthless / useless / a waste of time’. World: ‘Everyone is against me’. Future: ‘I am never going to amount to anything’.

Attribution refers to how people make sense of their own or other people’s behaviour — e.g. ‘He’s frowning because I’ve annoyed him’.

Seligman — the three dimensions are internal, stable and global attributions, which may be positive or negative depending on the person making them.

Internal: the person always blames themselves for anything that goes wrong (‘it’s my fault, I should have tried harder’). Stable: they think in absolutist ways which persist over time (‘People will never like me again’).

A global attribution means a depressed person over-generalises, so that one specific incident is blown into huge proportions.

Seligman termed this pattern of internal, stable and global attributions the ‘depressive attributional style’.

They make it difficult to see that things can change, and that there is hope.

Dogs given inescapable electric shocks later stopped trying to escape shocks they could have avoided — supporting the idea that people learn to ‘give up’ when facing challenges, leading to depression.

Being in adverse circumstances may condition someone to believe they cannot escape their situation, producing dysfunctional thinking — which may contribute to both negative schemas and a negative attributional style.

Cognitive behaviour therapy (CBT) treats depression by correcting faulty, irrational thinking — which supports the idea that such thinking underlies the disorder.

False.

It may simply be realistic rather than depressive — Alloy and Abramson found that depressed people gave more accurate estimates of the likelihood of disaster than non-depressed people, a finding described as ‘sadder but wiser’.

It is very difficult to operationalise and measure schemas and attributions, as these are cognitive mechanisms which are not easy to distil or pin down.

The biomedical approach to treating disorders.

The physical cause of the disorder — e.g. dysfunctional brain chemistry. Antidepressants re-balance neurochemicals, which in theory should restore the patient’s balanced mood.

The most widely prescribed form of antidepressant is the Selective Serotonin Reuptake Inhibitor (SSRI).

Reuptake occurs when molecules of serotonin do not cross the synaptic cleft — i.e. they have not been transmitted to the postsynaptic neuron — and these ‘spare’ molecules are then taken back up into the presynaptic neuron.

They prevent the reuptake of serotonin in the synaptic cleft back into the presynaptic neuron.

It makes serotonin more accessible in the brain, so more serotonin is available to improve the transmission of messages between neurons.

False.

SSRIs are called ‘selective’ because they mainly affect serotonin, not other neurotransmitters such as dopamine.

Conditions other than depression, such as anxiety disorders.

Low serotonin levels have been linked to depressive symptoms, so ensuring that all available serotonin crosses the synaptic cleft should result in reduced depression.

False.

Drug therapy is cost-effective, which means it has less negative implications for the economy than expensive therapies such as CBT.

The patient is to some extent in charge of their own recovery — they do not have to be hospitalised or undergo intensive psychiatric scrutiny.

Drug therapy over-simplifies the mechanisms of depression — it doesn’t consider the range of possible contributory factors, or how the patient feels about themselves.

A more holistic approach, combining biological and psychological treatment.

Drugs tend to bring side effects which may in some cases make the depression even worse — for example nausea, dizziness, anxiety and suicidal ideation.

Because they mean that patients stop taking their medication.

A cognitive approach — working on the patient’s irrational thinking and cognitive distortions.

False.

Psychological treatments do not use drugs or any invasive methods to treat disorders.

Talking therapy and targeted tasks and exercises, which the patient undergoes either with a therapist to guide them, or on their own as ‘homework’.

Cognitive behaviour therapy (CBT), which works on cognitions — e.g. irrational and catastrophising thoughts.

All-or-nothing thinking — such as ‘everything’s not going right now and it will always be like this’.

The therapist challenges the client’s irrational thoughts.

In disputing, the therapist might ask ‘do you always do badly at school work?’, or ‘Where’s your proof your best friend doesn’t like you any more?’

The client records unpleasant emotions, the automatic negative thoughts linked to them, and a rational response to those thoughts.

In a thought diary, both the automatic negative thoughts and the rational responses are rated for belief on a scale of 1–100%.

The client plans one pleasant activity each day — e.g. making a meal or seeing a film — to build a sense of accomplishment and improve mood.

To get their client to the point where they can be independent and use the strategies practised in treatment to help themselves.

It equips the client with tools — challenging irrational thoughts, thinking more rationally — that they can reuse in future episodes of depression. It therefore offers a long-term solution rather than just fixing the problem now.

CBT treats the whole person and the ‘bigger picture’ of what someone feels and thinks — rather than focusing on constituent parts of depression such as neurotransmitters.

Because it targets the core symptoms of depression — feeling sad, negative thoughts — rather than taking a reductionist approach.

False.

CBT is not for everyone — successful treatment requires a considerable amount of time (months of weekly sessions plus homework) and effort and willingness to change, unlike medication, which is passive.

Many people drop out of CBT, or fail to engage enough to benefit.

The patient has been taking antidepressant medication for more than six weeks and still shows symptoms of clinical depression.

Because it addresses the whole person, rather than just the physical/biological aspect of depression.

Because the two approaches complement each other — antidepressants work to reduce the symptoms of depression, while CBT works to re-frame irrational thoughts and behaviours.

Wiles et al. instigated the CoBalT study to investigate the efficacy of combined drug and CBT therapies.

To investigate how effective combined therapy is for people with depression who are treatment-resistant.

469 treatment-resistant patients with depression from Bristol, Exeter and Glasgow, recruited via 73 different GP practices.

False.

The patients were randomly allocated to one of the two conditions.

Condition 1 — usual care: each patient continued to take the antidepressant they had been prescribed. Condition 2 — usual care + CBT: their usual antidepressant plus 12–18 sessions of CBT, each lasting an hour.

Using Beck’s Depression Inventory (BDI).

At 6 months, 422 participants (90%) remained; in the usual care condition, 21.6% had a 50%+ drop in depressive symptoms.

46.1% — more than double the 21.6% in the usual care condition.

With 396 participants (84%) remaining, Condition 2 continued to show much greater levels of recovery and a greater chance of remission (symptoms not returning) than Condition 1.

That a combined therapy of drugs + CBT is more effective in reducing depressive symptoms than drug therapy alone — and that these benefits can be maintained over 12 months.

It was well-designed to control extraneous variables, using an independent groups design with participants randomly allocated to conditions — reducing the risk that one group happened to be more depressed to start with.

It demonstrated in a well-controlled trial that combined therapy can succeed where antidepressants alone fail — which is the case for two-thirds of people with depression.

False.

The study relies on self-report (the BDI), which involves subjective judgement — participants may under- or over-report how sad they feel (e.g. social desirability bias, with some playing down their symptoms), questioning the validity of the findings.