Julia Wong IB 1 Psychology Affective Disorder: Depression Etiology:

April 17, 2013 Dr. Galvez

Major depressive disorder is influenced by the interaction between biological and psychological factors. Biological factors may include the physiological activity of neurotransmitters and hormones. Environmental factors also play a role in the precipitation of depression. Evidence shows that negative or stressful events in a persons life such as divorce, death of a loved one, or serious accident may trigger clinical depression in an individual. It is important to know that there is no single factor that causes major depression, but rather it stems from the combination of multiple factors. This may include genetic vulnerability, psychological problems, or particular life events or lifestyle factors, such as misuse of alcohol or drugs. It is not possible for psychologists to pinpoint the cause of depression. Treatment usually aims to alleviate the symptoms and identify possible psychosocial factors to be able to help the individual to cope. Biological Level of Analysis: Genetic researchers argue that genetic predisposition may predispose some people to develop depression more easily than others. Nurnberger and Gershon (1982) reviewed the results of 7 twin studies with monozygotic and dizygotic twins in which one pair had been diagnosed with depression. He found that the concordance rate (which is the inheritance of two related individuals) is higher for monozygotic twins (65%) compared to dizygotic twins (14%). This supports the hypothesis that genetic factors might predispose some people to depression. Long-term stress may result in depression in some individuals who have this genetic predisposition because it makes them more vulnerable and susceptible in developing depression compared to those that do not have this genetic predisposition. However, because the concordance rate was not 100%, this means that genetics are not entirely to blame, but that other factors may have influenced depression as well. Another biological explanation is neurotransmitters. Joseph Schildkraut (1965) developed the "catecholamine hypothesis", which became the "serotonin hypothesis". His theory states that depression is associated with low levels of noradrenaline. Janowsky et al. (1972) suggested that depression may stem from an imbalance in neurotransmitters. He gave participants a drug called physostigmine that decreased noradrenaline in their body, and found that participants became profoundly depressed and experienced feeling of self-hate and suicidal wishes within minutes of having taken the drug. The fact that certain drugs can artificially induce depression suggests that some cases of depression might stem from a disturbance in neurotransmission.

Another important biological theory of depression is the cortisol hypothesis. Basically, cortisol causes depression. Cortisol is a stress hormone, and it has always been obvious to clinicians that stress can make one more susceptible to a multitude of disorders. Also, patients with major depression have higher levels of cortisol. This is because high levels of cortisol impair the function of noradrenaline receptors. Cognitive Level of Analysis: Ellis (1962) suggested the cognitive style theory, which states that psychological disturbances come from irrational and illogical thinking. On the basis of dubious evidence, people draw false conclusions, leading to anger, anxiety, and depression. (Example: I didn't get a good grade on the test, therefore I am stupid) Beck et al. (1976) suggested that cognitive distortion theory of depression, which are ways in which our mind convinces us of something that isn't true. He proposed that a person's cognitive vulnerability to depression is based on negative schemas, which are activated by stressful events. This gives the person a pessimistic attitude about themselves, the world and the future, making it very difficult for the person to see anything positive in life. He observed that depressive patients exhibited a negative cognitive triad characterized by: Overgeneralization based on negative events Non-logical inference about oneself Dichotomous thinking black-and-white thinking and selective recall of negative consequences (Example: You love me or you hate me) Another study by Alloy et al. (1999) supported Becks cognitive distortion theory. He followed a sample of young Americans in their twenties for 6 years. Their thinking styles were tested and they were placed in the "positive thinking group" and the "negative thinking group" according to their ways of thinking. After 6 years, they found that only 1% of those in the positive thinking group developed depression compared to 17% of those in the negative thinking group. The results indicate that there may be a link between negative cognitions and depression. However, it is still not clear whether depressive thinking patterns causes depression or if this negative thinking is merely a consequence of having depression. If negative cognitive style does cause depression, then replacing negative cognitions with positive could help improve the persons condition. This is exactly what cognitive behavioural therapy aims to do. Sociocultural Level of Analysis To derive oneself to think negatively about themselves and their lives may mean that they must have been influenced in some way by social or cultural factors. No doubt that bad lifestyle and intense stress contribute to peoples moods. Brown and Harris (1978) carried out a study concerning the social origins of depression in women. He found that 29 out of 32 women who were depressed had experienced a "severe life event", but only 78% of women who experienced a "severe life

event" were not depressed. They discovered that life events similar to past experiences were more likely to lead to depression. Brown suggested the "vulnerability model of depression", which is based on number of factors that could increase likelihood of depression such as: Loss of mother at an early age History of childhood abuse Lacking employment Absence of social support Having several young children at home. Browns study led to the widely accepted "diathesis-stress model", which claims that depression is the result of hereditary predisposition with precipitating events in the environment. Culture may also influence our onset of depression, as some cultures discourage depression more than others. For example, Marsella (1979) argues that affective depressive symptoms (sadness, loneliness, isolation) were more prevalent in individualistic cultures than in collectivist cultures. Individualist cultures tend to be more independent while collectivist cultures have larger and more stable networks to support the individual, and discourage depression. The sociocultural approach seems to clearer as we tend to be depressed when we are under stress or when we are lonely and without friends.