This essay will look at the second substantive area which is the psychopathology, focusing on depression. Depression is defined as the most common psychological disorders, characterised by disturbances of mood (Willson & Bailey, 2008). Symptoms of depression include (1) difficulty concentrating, remembering details, and making decisions, (2) feelings of guilt, worthlessness, and/or helplessness, (3) feeling of hopelessness and/or pessimism, (4) insomnia, (5) irritability, (6) loss of interest in activities, (7) overeating or appetite loss, (8) persistent aches or pains, (9) persistent sad, anxious, or empty feelings and (10) thoughts of suicide (WebMD, 2016). Reliability of depression diagnoses is consistent among professionals/inter-rater reliability over time (test-retest) (Psychology4A.com, 2016). Predictive, criterion and construct validity represent validity of diagnosis of depression (McLeod, 2016).
There are four models of abnormality based on psychological approach. These are biological, behavioural, psychodynamic and cognitive approaches. The first model of abnormality in this essay will evaluate the biological approach. The biological approach in psychology studies the relationship between the behaviour and the body’s various physiological systems (Willson & Bailey, 2008). Behaviour is caused by genetic factors, biochemistry, physical illness and neuroanatomy. In genetic factors, individuals inherited predispositions to certain illnesses. These predispositions are carried in their genes which pass from one generation to the next (Eysenck, 2006). Research of genetic factors has been carried out in the evidence from family, twin and adoption studies. Evidence from the family studies like Gershon (1990) reviewed ten family studies and found that the rates of unipolar depression in first-degree relatives ranged between 7% and 30%, which is considerably higher than in the general population. It shown that the younger people are when they are first diagnosed with depression, the more likely it is that their relatives also have depressive episodes (Cardwell et al 2003) Another line of evidence from twin studies, researchers look at concordance rates, the extent to which a certain trait in both twins is in “concord” or agreement (Eysenck, 2006). Evidence from adoption studies like Wender et al. (1986), found that biological relatives were eight times more likely to have depression than adoptive relatives (Cardwell et al 2003). Another cause of abnormality lies in the patient’s biochemistry. They are likely to exert their influence of the hardware of the brain. Biochemical abnormalities found in the brain of people diagnosed with depression (Cardwell et al 2003). Some evidence of biochemical changes effects on the symptoms of abnormality comes from drug studies using patients (Eysenck, 2006). Further, there are complex interactions between both genetics and the environment. The primary depressive disorders include bipolar disorder, dysthymic disorder, and schizoaffective disorder which all have some level of genetic predisposition (Elder & Mosack, 2011). Genetics influence the development of depression by about 31 to 42 percent as reported in the research (Elder & Mosack, 2011). Therefore, the biology of the patient is an essential part of developing depression.
The biological approach has both strengths and weaknesses. Use of brain scanning and other modern techniques has identified biological aspects that influence the development of depression. These biological issues can be identified through the use of CT and MRI technology. Scans have revealed that some patients with schizophrenia appear to have brain pathology. Research into behavioural genetics has identified a genetic, or inherited. Drug treatment based on medical model can be very effective in treating conditions such as depression, anxiety disorder and schizophrenia. Determining the efficacy of individual drugs is sometimes difficult. What works for one patient may not work for another. There are also other problems with this approach. The methodology is heavily reductionist meaning that it assumes that the most important aspect of any behavioural disorders are the biological changes in brain, rather than looking more generally at the behavioural symptoms and environmental influences that may also play a role in this process. There is an evidence for a genetic influence, it is assumed that this must interact with non-genetic environmental factors such as stress. Stress is the popular choice for the environmental factors and some disorders involve a genetic vulnerability triggered by stressors known as diathesis-stress. Although drug treatments can provide support for the biological approach, they are not effective for all people with particular conditions (Willson & Bailey, 2008). Additional treatments of biological approach are genetic counselling, eletroconvulsive therapy and psychosurgery. Using scans and evidence can help to underpin what approaches are effective for specific individuals.
Second model of abnormality of this essay will evaluate the cognitive approach. The cognitive approach, often referred to as the cognitive-behavioural approach, became the most popular of the psychological approaches to understanding and treating behavioural disorders (Willson and Bailey, 2008). Seligman’s theory was reformulated in cognitive attributional terms called “hopelessness theory of depression” (Abramson et al. 1978). Hopelessness theory suggested that when people experience failure, they usually try and attribute the failure to a cause. Causal explanations operate on three dimensions of judgement: internal-external, stable-unstable and global-specific. Research supporting the hopelessness theory come from the evidence using Attributional Style Questionnaire devised by Seligman (1974), looked at the students who were depressed after achieving poorly in their exams (Cardwell et al 2003). One of the clearest examples of the cognitive approach to psychopathology is Beck’s (1967) model of depression involves three negative schemata which he called the “cognitive triad”: (1) negative view of the self, (2) negative view of the world, (3) negative view of the future (Willson and Bailey, 2008). According to Beck, the cognitive triad is maintained by the interaction of negative self-schemas and cognitive distortions (Cardwell et al 2003). Further, brain scans using positron emission tomography (PET) to identify patterns in the brain can help to determine whether or not cognitive behavioural therapy is effective in treating the patient (Kuehn, 2013). This can provide information about which treatment mechanism may be appropriate for specific patients.
Further, there is a clear evidence for cognitive biases and dysfunctional thinking and beliefs in depression and anxiety disorders which underscores the need to understand which therapy can aid in assisting patients. Cognitive Behavioural Therapy can be very effective for anxiety and depression. Depression may lead to dysfunctional thinking rather than the other way around for example depression may encourage a focus on the negative aspects of life and the future. The idea of schemata and how they develop is lacking of details similarly it is not always clear how irrational thoughts should be defined and measured. The cognitive approach does not take into account genetic/biological factors in psychopathology. However, it emphasises the important role of cognitive factors in psychological disorders (Willson and Bailey, 2008). Due to the complex nature of depressive disorders, a variety of treatment approaches may be necessary. Cognitive therapy can include 13 principles that a practitioner must consider when delivering cognitive therapy including emotional regulation, communication, acceptance, social skills, cognitive restructuring, problem solving, relaxation, exposure, skills training, self-regulation, positive psychology, cognitive restructuring (O’Donahue & Fischer, 2012). Each of these principles provides information about how cognitive therapy can be introduced and executed to foster positive improvement in patients. Practitioners can work to try different approaches until a breakthrough in treatment is realized. When it comes to psychopathology particularly depression, no one approach is effective alone, not one is better than another.
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