Psychological Problems

Symptoms

• Low moods
• Not enjoying activities, you used to
• Low motivation
• Low self-esteem
• Poor or increased appetite
• Disturbance (prolonged) to routine
• Extreme fatigue
• Isolating yourselves
• Feeling suicidal

£1.7 billion spent per year in UK (on antidepressants, therapy etc)

Estimated that 1.45 million will be depressed by 2026, compared to 1.24 million in 2007

• If family member has depression, other family members may also be diagnosed
• Through genes
• Passing on and inheriting diagnosis of depression

• McGuffin et al found that the concordance rate for MZ twins both developing depression was 46%, whereas that for DZ twins was 20%
• Helps remove stigma if caused by gene and prevents person blaming themselves

Weaknesses

• Reductionist – fails to consider other factors that could explain depression, like stressful life events and faulty thinking patterns
• Deterministic – ignores free will and that people have some control over behaviour and whether they get depressed

• Depression caused by faulty thinking patterns
• May develop negative thought patterns about: the self, the world or the future
• Developing negative thoughts and way of thinking can lead to negative self-schema – causing all info to be perceived negatively

• Practical applications – led to development of CBT, aiming to tackle irrational thoughts
• Free will – considers other factors such as faulty thinking patterns and stressful life events – suggesting we have some control over our own behaviour and whether we get depressed

Weaknesses

• Difficult to tell whether faulty thinking patterns are causes or just symptoms of depressions
• Not applicable to all forms of depression – post-natal depression better explained by hormone imbalances rather than faulty thinking patterns

• To change way patient is thinking (converting irrational, negative thoughts to rational, positive thoughts)
• To help people become aware of their symptoms when they’re thinking negatively

Features

• Challenging irrational thoughts
• Taught to practice more rational thoughts

• Practical applications – effective, longer lasting treatment. Allows patients to take control of symptoms and develop skills to use in the future
• Beltman et al (2010) found that depressed patients treated with CBT showed more improvements than those still waiting for treatment

Weaknesses

• Requires patient wanting to change behaviour – yet symptom of depression is lack of motivation, making it challenging
• Ethical issues – emotionally difficult for participants

Blocking reuptake of serotonin when released from neuron

• Meaning serotonin is available for longer, allowing more opportunity for other neurons to absorb it
• Increasing levels of serotonin (neurotransmitter) in brain, improving mood
• Alleviating depressive symptoms

• Royal College of Psychiatrists found that 65% of depressed patients taking antidepressants showed improvements
• Helps alleviate symptoms enough in order to benefit from CBT – more long term treatment

Weaknesses

• Side effects – insomnia, drowsiness, anxiety, increased suicidal thoughts
• Doesn’t address actual cause of depression – like faulty thought processes

Symptoms

• Feeling of needing addictive substance in order to go about daily routine
• Reducing or stopping use is difficult
• Tolerance – need increasing amount for same effect
• Replacing normal activities with substance abuse
• Withdrawal symptoms – shivering, sweating, vomiting

£488 million spent on substance misuse in UK each year

Estimated 2 million with addiction in UK

• If family member has addiction, other family members may also be diagnosed
• Through genes
• Passing on and inheriting diagnosis of addiction

• Carmelli et al – found that concordance rate for MZ both becoming smokers was higher than that of DZ twins
• Goodwin et al found that a child who grew up with one biological parent with alcohol addiction was more likely to show symptoms of alcoholism themselves, compared to children with no alcoholic parents

Weaknesses

• Reductionist – doesn’t consider environmental or social causes of addiction. In twin studies, twins re brought up in same home environment, so environment could be cause of shared addiction rather than genes

Positive reinforcement – when something positive added to the situation (e.g., feelings of pleasure and rush of positive emotions from taking drugs), encouraged to repeat behaviour

Negative reinforcement – when something negative is removed from the situation (e.g., unpleasant withdrawal symptoms) encouraged to repeat behaviour

• Practical applications – suggests that if behaviour is a result of learning, surely it can be unlearnt

Weaknesses

• Reductionist – doesn’t consider genetic factors and role of genes in causing depression
• Not applicable to entire target population – doesn’t explain why lots of people gamble, drink and do drugs but don’t become addicted. If addiction due to learning, everyone should be addicted

• To understand triggers
• To control/manage symptoms and behaviour

1^st stage – Functional Analysis

• Discussing what emotions or people etc trigger addiction

2^nd stage – Skills training

• Learning skills patients can use to avoid and control addictive behaviours
• g., assertiveness training, coping with cravings, improving motivation

Sometimes keeping a diary

Asked to make notes of times they felt tempted, how they felt, what they did and how that made them feel

• Practical applications – aims to give patients control of their own symptoms, allowing themselves to build up skills to tackle symptoms and build up own support system
• Young et al found that CBT was effective as both short-term and long-term treatment for internet addiction

Weaknesses

Requires motivation, which may be challenging

Methadone causes same spike in dopamine as heroin (without damaging effect). This helps reduce cravings for heroin and withdrawal symptoms after taking it.

• Suck Won Kim found that 75% of gambling addicts showed improvements after taking Naltrexone
• Can help alleviate symptoms (cravings and withdrawal symptom) enough to benefit from CBT

Weaknesses

Could become addicted and dependent on medication drugs, making problems worse long-term

+

stressful life event (triggers gene)

=

higher likelihood of developing depression

Sample size – 847

Longitudinal study – age range – 3-26 years

Groups

• 2 short versions of 5-HTT gene – 17%
• 1 short, 1 long version of 5-HTT gene – 51%
• 2 long versions of 5-HTT gene – 31%
• Measuring stressful life events
• Events between 21-26^th birthday recorded via questionnaire

Measuring depressive symptoms

• Participants completed questionnaire
• ‘informants’  completed questionnaire about participant’s depressive episodes

• 31% experienced no stressful life events between age 21-26
• 17% experienced depression
• 3% attempted suicide
• Groups with at least one short version of 5-HTT gene more likely to develop depression and suicidal thoughts after stressful life event

Conclusions

• There’s is an interaction between 5-HTT gene and stressful life events in causing depression.
• Participants with at least one short version are more likely to suffer from depression than those with two long versions
• Supports diathesis stress model

• Practical applications – can help people become aware of their genetic makeup (and how it may increase susceptibility to developing depression) and need to minimise stressful life events
• High population validity – very large sample so representative of target population and finding generalisable to wider population

Weaknesses

• Social desirability bias– evidence may not be as reliable – participants may exaggerate or underplay symptoms to portray themselves in a more positive light

Protection from harm – completing questionnaire causes participants to relive events, which may be distressing

Sample – 114 from US

Outcome goals

• Ability (motivation) to quit abusing internet
• Ability to control offline activities
• Improved relationship functioning
• Improved offline sexual functioning

12 CBT sessions

Client outcome questionnaire completed after 3^rd , 8^th and 12^th session and after 6 months

• Most common problems
• Time – 96%
• Offline relationships – 85%
• Sexual functioning – 75%
• Most showed continuous improvements in outcome goals and ability to control problem behaviours
• Improvements largely maintained after 6 months

Conclusions

• CBT is an effective method of treating internet addiction as clients reported increase in ability controlling problem behaviours
• CBT provides long term benefits as well, as clients reported increased ratings of control over problem behaviours, 6 months later

• Practical applications – online CBT can be effective, long term treatment for internet addiction – showing that internet addiction can be treated – and is cheaper, more accessible option
• Standardised procedure and high in reliability – all participants asked exact same questions, so data collected in consistent and reliable way

Weaknesses

• Social desirability bias– evidence may not be as reliable – participants may exaggerate or underplay symptoms to portray themselves in a more positive light

Nature

• Biological factors which cause/ contribute to a behaviour
• For example, genes

Nurture

• External, environmental factors that cause/contribute to a behaviour
• Such as stressful life events and faulty thinking patterns

Diathesis Stress Model

• Interaction between nature and nurture
• Genetic predisposition – gene triggered by stressful life event, increasing likelihood of developing depression

Nature

• Genetic explanation
• 5-HTT (at least one short version)
• A1 variant of DDR2 gene

Nurture

• Cognitive theory – faulty thinking patterns
• Operant conditioning theory – learning based of consequences

Diathesis stress model

• Gene inherited from family member
• Triggered by stressful life event

Nature

• Lots of evidence (McGuffin et al 1996, Carmelli et al 1992
• encourages seeking help as removes stigma (genes uncontrollable)
• reductionist
• deterministic

Nurture

• considers wide range of external influences
• practical applications – CBT, or if due to environment, can resolve by changing environment
• ignoring role of genes despite evidence supporting

Diathesis Stress Model

Caspi et al