Aetiology of Depression Flashcards
(14 cards)
DSM 5 Criteria
Depressed mood - A depressed mood is defined as feeling depressed most of the day, or nearly every day.
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
Sleep difficulties - insomnia
Fatigue or loss of energy nearly every day.
A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down) - called psychomotor changes.
Diminished ability to think or concentrate, or indecisiveness, nearly every day.
Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Normality
Behaviour does not deviate from norms
Is not maladaptive
Abnormality
Deviant from norms
Is maladaptive
Statistically rare
Causing person distress in daily life
Dysfunctional
Having thoughts and/or emotions that are maladaptive
Advantages of Classification Systems
Diagnosis should be more reliable, the same patient diagnosed by different psychiatrists should ge the same diagnosis
Standaradisation of diagnoses helps ensure that clients receive appropriate, helpful treatment
Provides an operationalised definition of disorders, enables research into treatments
Minimises bias in diagnosis
Disadvantages of Classification Systems
Uses results from the psychiatrist not considering cultural or social factors
May be considered an oversimplification
Potential of rover-diagnosis
Problems of defining abnormality
Does all behaviour that violates a societal norm count as abnormal?
Do all things that are “rare” indicate abnormal behaviour?
What is meant by “distress” or “maladaptive”? How are they measured?
Reliability of DSM-5
Most disorders are clusters of symptoms, how many do you need, for how long
Many symptoms cannot be easily & universally measured - depend on self reported data
Culture and gender biases may lead to over or under pathologizstion
Comorbidity: People can be suffering from multiple psychological conditions simultaneously
Reactivity: if patients are aware of being assessed, they may change behaviour
Certainty: we can’t just check your blood or urine to determine mental illness
Problems with Validity of Diagnosis
Heterogeneity of clinical presentation
Classification is based on symptomatology rather than aetiology (causes)
Comorbidity (co-occurrence of diagnoses)
Stability of symptoms
Cut off point (what is significant and what isn’t)
Selecting treatment (needs to be different depending on cultural norms)
Validity can’t be quantified
Sociocultural Approach (Studies)
Kirmayer et al, Brown and Harris
Cognitive Approach (Studies)
Alloy et al, Nolen-Hoeksema
Biological Approach (Studies)
Caspi et al, Rausch
Prevalence of Disorder (Studies)
Brown and Harris, Becker et al
Counterclaim: Nolen-Hoeksema
Methods and Ethics (Studies)
Caspi et al, Brown and Harris
