How we answer the critical questions for each of the sub-topics for Depression depends in part on evidence for other subtopics. It makes sense therefore to put all of the evidence in one place. Please note that there is plenty of material on this blog which did not make it into the resources booklet and which we will not have time to explore specifically in class. Please use Depression category at the bottom of this post and the tags to the left to find material which might interest you.
Biological Explanations Of Depression
What is the evidence that depression is genetic and runs in families? Is this evidence valid?
We’ll answer this one in class, using the text book resources on pages 13-14 of the resources booklet.
What does evidence from drug therapies tell us about the amine hypothesis?
The text book here represents a pretty good start. It explains the fundamental problem that anti-depressants have an effect straightaway but it takes a while for the symptoms of depression to disappear. This suggests that there is something more to depression than a drop in serotonin or dopamine levels. This recently published article about findings from Gurwitz and Shomron (2013) suggests what that something more might be. See if you can work it out. To understand more about the amine hypothesis, go to this news report from NPR. It gives you an idea about how researchers understand the role of serotonin. If you are not clear about how serotonin works, use this extract from the Deeply Depressed video you watched in class. If you want to know more about how antidepressants working on serotonin were first discovered and developed, listen to the first five minutes of this programme. We’ll come back to it again later.
What does research into the serotonin transporter protein gene tell us about what causes depression? What are the implications of this research for how to treat depression?
Start by watching this video sequence from Deeply Depressed. We have already watched part of this programme in class. The article on pages 14-16 of your resources booklet covers the same material: the reference is Caspi et al (2003). Next, go to the extract from a much longer article by David Dobbs on pages 16-17 of your booklet. This refers to a piece of research by Kaufman et al (2004) which you might find quite surprising. Make sure you can summarise the findings of these studies and the implication for the treatment of depression.
Psychological Explanations Of Depression
What is the evidence for the importance of learned helplessness in the development of depression? Is this evidence valid?
We’ll use text book evidence for this and cover the questions in class.
What do studies into the effectiveness of CBT tell us about the importance of negative thinking in the development of depression? Is this evidence valid?
We’ll use the evidence from Butler and Beck (2000). A very good recent analysis of evidence for CBT comes from this article here: see also pages 21-23 of your resources booklet. The reference is to Cuijpers et al (2013). This is a great resource because it enables you to include some analysis of methodological issues.
Why is it important to take account of both biological and psychological explanations of depression?
To answer this question, go back to the material about the Serotonin Transporter Gene in the section above: Caspi et al (2003), Kaufman et al (2004).
How have psychological explanations of depression been used to explain how people can develop resilience?
“Resilience” can be defined as the ability to overcome setbacks and problems. The starting point for psychologists in this area is to work out what is wrong with the thinking of people with depression and then see how people not affected by depression are different. Resilience is being researched by a team at Manchester University. You can read about them in this article which is also in your resources booklet pages 23-24. An extract from the BBC World Service programme on which they appeared is here. The interesting thing about this research is that resilience may have a genetic basis. That is dealt with in this article on page 25 in your resources booklet and can be found online here. Read and listen to as much as you can and see if you can see the link between the explanations we have worked on in class and the research into resilience.
Biological therapies for depression, including their evaluation in terms of appropriateness and effectiveness
What do outcome studies show about the effectiveness of these therapies? Why is this evidence controversial? Should the fact that we are not sure how these therapies work affect our judgement of their effectiveness? What is the evidence about side effects for these therapies? Why is it hard for doctors to predict whether therapy will be appropriate for any given patient?
The route here is simpler than those above. Download this programme: here’s a link to its webpage. You can use what’s here as a good starting point for all of the evaluation questions alongside the sources in the resources booklet. If you want to know more, follow the Prozac tag on the right of this page. The rest of the Deeply Depressed programme will give you some good insights into the experience of people using these therapies. Try this link, or if it doesn’t work, this one.
Psychological therapies for depression, for example, behavioural, psychodynamic and cognitive-behavioural, including their evaluation in terms of appropriateness and effectiveness
Before you start investigating these questions, please have a look at the comments which I have posted: click on the button at the top of this post. You need to use the ideas we have developed about biological therapies when evaluating psychological therapies.
What do outcome studies show about the effectiveness of these therapies? Why is this evidence controversial? Should the fact that we are not sure how these therapies work affect our judgement of their effectiveness?
Start by reminding yourself about Butler and Beck (2000) in your resources booklet and looking back to the link above to the study by Cuijpers et al (2013). You can add to this by looking at the article referring to Wiles et al (2013): see also resources booklet pages 34-35. The controversy here is about how good CBT really is. It is promoted by many as the treatment of choice but you need to consider whether it is any better than the drugs it often replaces. A particular issue is that we do not know exactly what CBT does inside the brain nor exactly how drugs and CBT combine to produce an effective treatment for many people. You need to ask yourself how important you think this question is.
What are the costs of these therapies? Why is it hard for doctors to predict whether therapy will be appropriate for any given patient?
To get an idea of the costs involved in therapy, listen to the first part of this programme. It describes some of the experiences of people using CBT as part of the IAPT programme. If you are having problems streaming this, please try this link here and here. There might be many reasons why therapy might be more appropriate for some patients than others. Therapists are increasingly aware of this and are finding ways of making therapy more accessible to a greater range of people. A fascinating example of this comes from New Zealand. Watch this video and read about the study which goes with it here: see also page 37 of your resources booklet. Since that was printed, an article about online therapy has appeared on the BBC which I have linked on a post of the week here. If you’re feeling brave, the article by James Coyne on the most recent post of the week here is really interesting.