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AQA A2 PSYA4 Psychology
Transcript of AQA A2 PSYA4 Psychology
Diagnosis and Classification
Biological Explantions for Depression
Psychological Explanations for Depression
AQA A2 PSYA4 Psychology:
Depression & Addiction
Sad depressed mood
Loss of interest in pleasurable activities.
Loss/increase in appetite
Loss/gain in weight
Shift in activity level.
Loss of energy
Negative self concept
Need the sad and depressed mood, then 3 others, for 2 weeks or more
Issues with Diagnosis
Inter-Rater reliability is where a patient can be seen by mulitple doctors, and the same diagnosis method used, and the same level of depression being diagnosed
Lobbenstael did a double blind study on inter-rater reliability on a mix of depression-sufferers and non-depression sufferers, found a correlation of .66 agreed diagnosis, only fair inter rater reliability
If there is a genetic link in depression, then those who suffer depression should have first degree relatives with, or with the potential to have depression.
Research has found that 20% of people with depression's relatives had depression, compared with 10% of the entire population, so higher rates of depression within families, so implies a genetic link.
Twin studies are conducted on monozygotic and dizygotic twins, assuming that the twins are raised in relatively the same the same environment, any more similarity between monozygotic twins can be attributed to genes.
McGuffin et al studied 177 proband and their co-twins, found a concordance of 46% for identical twins, and just 20% for fraternal twins, suggesting a genetic role
If an adopted child is raised in a stable, positive environment away from biological parents, and yet gets depression, and their biological parents have also experienced depression, it can be inferred that there is a genetic link
A much higher incidence of depression was found in those adopted whom had parents that suffered from depression.
Le adoptive parents
Le biological parent
Adopted child is depressed
GENES AS DIATHESIS
Gene-stress diathesis: The gene causes the disposition, which causes the person to react in a depressive manner in a stressor situation. If there was a gene influence it would be expected that those with the gene would react differently to a stressor than those without the gene
KENDLER ET AL STUDIED FEMALE TWINS, FOUND THAT WOMEN WIT A DEPRESSED CO-TWIN WERE MORE LIKELY TO SUFFER DEPRESSION AND FOUND THE HIGHEST INSTANCES OF DEPRESSION IN A GROUP THAT HAD BEEN EXPOSED TO NEGATIVE LIFE EVENTS WITH THE GENETIC PREDISPOSITION.
This is sally, she is doing 5 A-Levels and has a genetic predisposition for depression, if her A-levels stress her out she has a higher chance of developing depression than someone without the predisposition
Noradrenaline is produced by the parasympathetic pathway to try and reduce the symptoms of stress, so if there is a deficiency in it, a person will experience far more stress for the same life event as someone who does not have a deficiency.
Bunny et al
the by-products of the presence of noradrenaline were distinctly lower in depressed patients, suggesting a lower amount of noradrenaline
Up- regulation is the process whereby receptors for certain neurotransmitter expand in size, and many more are present, in order to be able to detect any traces of the neurotransmitter that may be present, this occurs because there is not enough of the transmitter
It was found that noradrenaline receptors in the brains of depressed patients were significantly larger and there were a lot more than in your average brain.
Leonard et al
Found that drugs that lowered levels of noradrenaline brought about a depressive state, whereas drugs that increased levels of noradrenaline had an antidepressant effect.
Kraft et al
Studied 96 patients with major depressive disorder and found a dramatic difference in the positive effect when patients took a noradrenaline-serotonin reuptake inhibitor, compared to a placebo, this strengthens the link between these neurotransmitters and depression
Irregular levels of Serotonin are linked to many disorders, including eating disorders, schizophrenia and depression. It it thought that low levels of serotonin cause a depressive state within patients
McNeal and Cimbolic
Examined the spinal fluid of patients with depression, and found much lower levels of serotonin by product, which suggest lower levels of serotonin in the brain.
However, all of the patients examined had previously been suicidal, so although this study provides a link between low serotonin and the most serious of depression, it cannot be used to explain milder forms of depression, as these patients have not been examined.
The fact that prozac and other drugs that selectively inhibit the uptake of serotonin work to improve depressives supports the idea that low serotonin plays a role in depression
Messing with Serotonin
Delgado gave depressed patients who were on antidepressant medication a diet low in tryptophan, which allows for serotonin production, this saw a return of their depressive symptoms, which returned to normal once the diets returned to normal
Major ethical issues up in here- making recovering depressives depressed again? No! Informed consent my arse...how can you know they were of sound mind to consent when they are on meds for mental instability.
This study was repeated in participants who did not have depression, nor a family history of depression, when their diets were altered to be deficient in tryptophan, there was no alteration to mood whatsoever, suggesting another mechanism at play that runs parallel with a reduction in serotonin that allows for the effects to be seen
Cortisol is released by the adrenal glands when experiencing long term stress, cortisol in turn supresses serotonin, which leads to depression
Dexamethasone- less effective in depressive patients which suggests an overactivity of cortisol, which suggests reduced levels of serotonin
Use in conjunction with serotonin point
Mourning and Meloncholia
Freud said when you experience a death of a loved one, (or as a child withdrawal from a loved one) you go through a stage of mourning, which eventually curtails and normal life resumes, but when the mourning continues for a long time, this turns into melancholia, or
. Freud differentiated the two by saying mourning was natural, melancholia is a pathological illness.
Many people who experience depression describe their parents as loveless.
Found increased levels of depression in men who had lost their fathers.
Children who lose their mothers are more likely to get depression.
The Pathology Of Depression
Freud said that when a person dies we experience loss, and a degree of anger and resentment to the person for the abandonment (the audacity of some people), which is then directed inwards, as a method of self punishment, using this to separate them from the deceased, they then return to normal, however, if the process goes wrong people end up in a cycle of self blame and abuse, this is depression according to Freud.
Try to splice both of these into one point, freud says this is why, and this is how, then evaluate.
LESS THAN 10% OF DEPRESSION PATIENTS REPORT A DEATH IN EARLY CHILDHOOD
Beck's Theory of Depression
A depressed person is more prone to negative thoughts because they develop a negative schema as a child, and this gives them a negative outlook on the world and themselves. These thoughts are triggered particularly when a scenario similar to the one that caused the schema in the first place is experienced.
Negative schema are a result of cognitive biases, which is a result of over-generalisation (so because one time the scenario was bad, it will be bad every time) and drawing sweeping conclusions with only a little evidence
These thought patterns result in the negative triad- a pessimistic view of the self, the world, and the future.
Depressed women made more errors in logic than non-depressed ones. It is thought that this is because of the negative schema/cognitive bias combo making them feel like they will fail.
Where be the proven causation up in this theory eh?
When depressed participants given automatic negative comments they became more depressed
OH, THE ETHICAL ISSUES
Test Retest reliability is where a method can be tested multiple times, after any length of time, and it still effectively diagnoses what it is supposed to
Media Influences in Addiction
Risk factors in Developing Addiction
The Theory Of Planned Behaviour
Out of Body and
Near Death Experience
A person tries, but fails to control an unpleasant event, and develops a feeling of not being able to exercise control over life, and so becomes depressed. They are more pessimistic and tend to hold themselves responsible for unpleasant events.
A depressed person thinks the cause of an unpleasant event is either internal (its my fault) stable (one mistake means more will come) and global (mistakes in other life areas are inevitable)
Seligman first spotted it in dogs, one condition dogs were strapped up and received an electric shock that could be stopped by pressing a pad. Another they were strapped up and given shocks with nothing they could do about it. They were then placed in a box, one side electrified, one not. The pad dogs worked out that if they moved they could escape the shocks, the other dogs just sat there and took it.
College students exposed to uncontrollable unpleasant events do worse on cognitive tests: shows that this impairs cognitive function negatively, that may cause depression
Repeated but this time on depressed students and they performed even worse
An expansion of helplessness: a person is very pessimistic, has a negative attributional style and feels like they have no control over unpleasant events. They have negative view of future events.
Women have more of a negative attributional style with men
Assessed weekly- Height of negative attributional style positively correlated with depression symptoms
Negative Attributional Style: Someone who negatively explains away unpleasant things in their life (depressed kid's parents divorce, it's his fault as opposed to his parents just grew apart)
If a person has a negative attributional style, or a genetic predisposition to depression, even the smallest of life events could trigger depression
Women most susceptible to depression if they experience negative life events and have a negative attributional style/genetic predisposition
Gender bias: only women surveyed
Life events cause depression, or depression cause life events? Spiralling depression:
Stress causes depression causes stress causes...
Women rely more on social support and may suffer more in it's absence- this is a life event, trigger depression
Depressed individuals report having low social support, so more susceptible to depression.
and Social Skills
Social Isolation cause depression or depression cause social isolation?
Low social competence predicts depression in pre-school children
Depression is thought to be caused by too little levels of neurotransmitters such as dopamine/serotonin. Normally they are released from neurones, and they activate cells, to stop them working they're reabsorbed or broken down by enzymes. Anti depressants stop this action.
Stop the re-absorption
of neurotransmitter back into the presynaptic nerve, so more is available
Act the same as tricyclics, but only block the reuptake of serotonin, so more is
No difference has been found between the effectiveness of SSRI's and non SSRI's.
Only significant difference found advantage of SSRI's in most severely depressed
Up until severely depressd drugs and placebo have the same effect.
Anti Depressants have reduced efficacy in children, double blind study found no superiority of antidepressants in kids, it is thought that this is primarily due to their different brain chemistry.
SSRI's were found to cause suicidal thoughts, those on SSRI's were twice as likely to attempt suicide than those who were on other treatemtns or a placebo.
Further study on this matter found that SSRI's increased suicide attempts in young adults, had the opposite effect on adults, particularly those over 65
Electro Convulsive Therapy is used on patients where medication and psychotherapy have failed. There are two types of ECT, unilateral, where one electrode is placed in the center of the forehead, and one on the dominant side of the brain, and bi lateral, where one elecrode is placed on each temple. A patient is knocked out, given muscle relaxers and oxygen, and the electric shock is sent through their brain, causing a seizure.
Definitely the seizure as opposed to the electric current that causes the changes.
Improve transmission of neurtransmitters
Improve blood flow to the brain
What about Sham ECT?
Sham ECT is when the person is knocked out but don't receive the electric current, significant difference between ECT and Sham, favouring ECT
Folkerts et al found ECT effective in treatment resistance
Ethical issues with giving sham ECT- as
the participants are
not aware they are
not receiving the treatment- not
One researchers claimed the side effects are:
One researcher concluded that at least 1/3 of ECT receivers experienced memory loss
Another researcher found a significant amount of receivers suffered slowed congitive processes that takes weeks to disappear.
A review of those who had received ECT said that 30% claimed to be in a constant state of perpetuated fear and anxiety.
Uni vs Bilateral
One researcher found that using uni lateral over bi lateral reduced the negtive side effects experienced, yet it's just as effective
700 patients that received ECT were sectioned under the mental health act, 59% of those did not give informed consent, this is necessary because they
need to understand the
Trend that only positive results published, and negative results reported in a positive way.
Influence of family on the development
of addiction can be attributed to environment, however, some studies do suggest a genetic link:
Twin studies found evidence for genetic transmission
First degree relatives of pathological gamblers were more likely to be pathological gamblers
Disruption of the pituitary adrenal response, lower levels of cortisol, because:
Pathological gamblers and recreational gamblers shown two types of video, one with their preferred type of gambling, and one of a neutral stimuluis, such as a rollercoaster ride. The recreational gamblers had significantly increased salivary cortisol after both videos, pathological gamblers had no increase.
Meaning differences in the experiences of arousal from stimulation): Those with a low sensation seeking personality will seek new and novel activities and experiences, high sensation seekers seek more extreme experiences and have a lower appreciation of risk, and anticipate the arousal from the experiences to be more positive than their low counterparts, and so are more likely to gamble
One researcher looked at this and found support for the idea that there are two different types of gambler.
Looked at gamblers who gambled in places like cafes, and gamblers who went to racetracks to gamble. It was found that those who went to the racetrack to gamble scored higher on sensation seeking. It was proposed that the racetrack gamblers were 'active gamblers' and so went out of their way to specifically achieve the arousal from gambling. and 'passive gamblers' those who gambled to avoid unwanted emotional states, such as bordem.
Thought that relapse was down to bordem. It was found that pathological gamblers were more prone to bordem than non- gamblers
Explains why some people respond differently to the same stimulus: why some people become pathological gamblers and some don't, also why some are more resistant to recovery than others, as genes act as a diathesis
The biological approach doe not explain why some forms of gambling are more addictive than others, pour exemple: It was found that those who used video gambling took just a year to become pathological gamblers, whereas those who used horse racing or slots took them on average 3 1/2 years to become addicted
Family studies suggest a heritability of smoking to be between 39% and 80%
Twin studies of identical twins (348) and of same sex fraternal twins (321) found a genetic influence of 42%
A study if 1512 dutch twins found a genetic contribution of 44% compared to 56% to environment.
Effects of Nicotine
Smoking activates Nicotine activated acetyl choline receptors in the brain, which in turn cause a release of dopamine into the brain, giving the smoker a temporary feeling of pleasure, however, as time goes on blood nicotine levels drop and this causes the smoker to have another cigarette to start the process again
Specific gene variant for smoking cigarettes, nicotine dependance, and likelihood of developing smoking related illnesses has been found, those who smoke less than 10 a day are less likely to have this gene variant
Smoking Whilst Pregnant
Research has found that smoking heavily whilst pregnant can give the childre a higher risk of smoking when older and are more likely to become addicted
One researcer looked at expectant mothers aged 17-39 betwween the 1950's and 60's and found that those who smoked heavily during the pregancy (more than 20 a day), the child was no more likely to start smoking, but were twice as likely to become addicted , and were more likely to progress from regular smoking to an addiction, and these findings were independant of the socioeconomic favtors affecting the child.
Thought that relapse can be attributed to genetics: one study found that 54% of the risk of quit failure can be attributed to heritability.
Gambling: The Self Medication Model
Initiation: The Self Medication.
have another problem, and select an addiction, or combination of addictions that they believe will help them, in the case of pathological it can be to overcome the depression associated with poverty etc. Helpfulness of the problem is perceived by the person themselves, hence why damaging behaviour continues.
Maintenance: Role of Irrational Beliefs
have cognitive distortions such as the 'gamblers fallacy' the belief that they are somehow in control of completely random events, believing they someway have a positive effect they interpret losses as 'near misses' and have an exaggerated self confidence in their capability to 'beat the system'. Attribute success to skill, and
failure to chance.
Griffiths compared 30 regularand 30 non regular gamblers' use of fruit machines, and their verbalisations.
Regular gamblers anthropomorphised the machine, claiming it was 'not in a good mood' when a string of losses were experienced. They claimed to be able to outsmart the machine, 'putting only a quid in bluffs the machine' and decribed losses as near misses.
It was found that those who
self medicate with gambling
also more likely to have dependencies on other substances, compared to those who gamble for pleasure.
Major Depressive disorder prevalent in most gamblers
Relapse: Recall Bias and 'Just World' Hypothesis.
gamblers overestimate wins and underestimate and rationalising losses. They think they'll eventually be rewarded for their dedication and are motivated to return for this reward because they believe they deserve win, having lost on multiple occasions.
It is suggested that it is a lack of understanding of statistics and probability that cause the sufferer to believe they can exact control over the outcome of the gamble, however this is challenged by one study of students, some educated in statistics, some not, given a gambling-related cognition test, and no difference was found between the group's susceptibility to irrational cognitions.
Gamblers irational in some forms of gambling related cognition, but had an accurate knowdge in estimating the likelihood of winning, being in line with non-gamblers.
Initiation: Expectancy Theory
Have expectancies of the positive outcome of a behaviour, people believe smoking will alleviate their low mood. Have perceptions of profits and costs, if perceived profits outweigh perceived costs. Behaviour will be initiated
Maintenance: Automatic Processing.
The expectancies become automatic, and unconscious, this explains why some addicts lose control over their behaviour. These expectancies however can be manipulated in order to prevent relapse: If they are told to expect no negative effects from abstaining from the addiction, they are more likely give up for good. Level of expectancies dictate level of addiction.
Assessing Costs and Benefits
People's perceptions of the benefits of quitting affect their ability to quit and likelihood of relapse.
Expectancy and relapse: Inconsistant findings with nicotine patches alone however among adolescents, when accompanied by cognitive behavioural therapy much increased cessation periods.
Smokers expect cigarettes have more of a mositive effect of mood, cravings and weight control over nicotine patches, which explains why there is inconsistent evidence for the effectiveness of nicotine patches.
Based on operant conditioning: Behaviour rewarding so becomes more frequent: Physiological rewards as a result from winning, psychological rewards, social rewards i.e. peer praise from winning, and financial rewards from winning.
The occasional reward they get is enough to continue the behaviour, as gamblers become used to the extended periods of not winning.
Others approve of behaviour, so more likely to repeat the behaviour to gain approval, and continue unabated because the approval is seen as reinforcement.
Conditioned cues & Approach Avoidant Effect
People come to associate sensory cues for gambling, i.e. certain drinks, the sound of machines. Experiencing these stimulants increase the risk of relapse.
Recovered gamblers are encouraged to put themselves in situations that include these stimuli, and build a resistance to them. Their level of ability to resist these stimulations dictate how easily they relapse.
Doesn't explain all forms of gambling, as a lot of forms of gambling do not invlolve an immediate reward, such as betting on sports or horse racing.
Fails to explain why some people do not become addicted, as all people will experience the aforementioned rewards
Report that they use drugs, gambling smoking to cope with everyday hassles i.e. financial/workplace issues
those exposed to extreme stress more vulnerable to addiction, particularly children and adolescents who have experienced parental loss or abuse. PTSD also associated.
Smoking itself doesn't reduce stress until you're hooked, at which point reduces the stress caused by needing a
Two types of alchoholic: Type 1 who drink to reduce negative feelings, type 2 drink to reduce feelings of bordem,
this only explains
some of the type 1
Peer pressure cited as the reason adolescents start smoking: smokers befriend smokers, non-smokers befried non-smokers, encouragement from peers the main reason adolescents start smoking
Social learning theory: learn from those with whom they have the most social contact, after that their experiences smoking dictates whether they continue
Social identity theory:
Adopt group norms that are most in line with the group identity, peers likely to be similar in their smoking habits
Duncan et al claimed that exposure to peer models increases the likelihood of teenagers beginning smoking
Perceived reward instrumental in teenagers starting smoking Eiser.
There is evidence to support, however, it is not clear how much of an influence peers have nor how impervious teenagers are the pressure
Brown et al found that age has a negative effect on the influence of peers, with close friends and romantic partners having more of an effect on attittudes and beliefs than peers.
The idea of there being an addictive personality is attractive because it explains why some become addicted to certain things while others can pick them up and leave them
Neuroticism and Psychoticism
Eyesnck biologically based personality based on 3 things:
Extravertism: extraverts chrinocally under aroused and bored, and seek external stimulation to increase their cortical arousal.
Neuroticism: these people experience anxiety and depression.
Psychoticism: related to hostility and impulsivity.
Francis has found a link between addiction and high scored on neuroticism and psychotisism
Rats: high sensation seeking rats and rats with high impulsivity put into a box with cocaine, the high sensation seeking rats went for lots immediately while the impulsivity rats started on low doses, however it was the impulsive raats that became addicted
Tridimensional Theory of Psychoticism
Cloniger: 3 personality traits that predispose a person to addiction:
Novelty seeking; trying to engage in new experiences
Harm avoidance: Worrying and pessimism
Reward Dependence: The extent to which a individual learns quickly from rewarding behaviour and repeats it.
Hard to determine causation
Thought they might have adistorted dopamine system, it's hypersensitive so have a heightened response to anticipated results, so consequence matters less
Sulken Et Al
Reviewed 140 scenes from 47 films that contained the use of an addiction such as gambling, sex, drugs, after sifting out those too ambiguous to use he was left with 61 scenes.
The drug use scenes were typically contrasted with a boring everyday life and also used to fix problems, i.e. in Human Traffic, where drugs are used to resolve relationship isues, or Traffic, where the drugs are seen as a legit way to rebel against authority.
Smoking in Film
Research has sufgested that there is a significant causal link between watching films containing actors who smoke and then adolescents subsequently smoking themselves. 360 top box office films between 2001 and 2005 were anlysed, it was found that when teenagers watched the films that showed smoking, they were significantly more liely to smoke, even if their social factors were controlled i.e. their parents and peers did not smoke
4384 kids between 11-15 were surveyed to determine their smoker status, they were then resurveyed a year later, it was found the kids who watched the smoking folms were the ones more likely to have taken up smoking in that time, and that having watched smoking films was a 'significant and strong predictor' of whether the child had started smoking that year.
Boyd argued that, although these characteristics of drlms exist, there are also things such as body deterioration, sexual abuse, and theft and murder, that are portrayed as consequences of addiction in these types of films, therefore, it cannot be said that films are the positive reinforcer and the reason for addiction, when they protray just as much bad as good.
Byrne: Films provide enduring stereotypes of drug use that glamourise it, and manipulate the minds of people so that their views and opinions are distorted.
Ethical Guidelines make filmmakers have to portray drugs and unhealthy and harmful to all persons, so that they are not a viable choice. Films also can't protray recreational drug use.
Media and Addiction linked: Brian Wilson of the beach boys used weed and LSD to write songs, and the Cocaine to cope with pressure. Shows how experiementing with drugs ends in addiction.
Corelation not causation
Role of Media in
changing Addictive Behaviour
Because many individuals do not seek help for their problems, or do and there is not enough trained staff to help them, or they lose motivation during the time and stop attending appointments, the media has been used as a way to initiate interventions in people with a 'do it yourself' principle.
Television has been used as a way to intervene in problem drinkers. One T show looked at in 1989 called 'psst...The Really Useful Guide to Alcohol was analysed for it's effectiveness against a control group, and although the 'watching' group had more knowledge of problem drinking post watching the series, they saw no change in attitudes or behaviour
A second TV show was analysed, called 'Drinking Less? DO it yourself!' This study used a mated pairs design of problem drinkers, those who watched the series saw a greater transition from high risk problem drinking to low risk problem drinking, which was still being maintained three months later.
However, there are problems with this study, those that watched the intervention were on the same treatment programme as those who didn't and those who did view it were also receiving weekly help sessions,w hich may have had more of an infce than the TV show. The control group were on a waiting list, as a result they may have drank more to take advantage of theirlettle time left, thus making the gap between results bigger.
Anti Drug Campaigns
Anti drug campaigns are used as a mechanism to attempt to deter young people from taking drugs.
In 2008 in the UK Pablo the dog was used to show people the effects of taking drugs such as cocaine, in one advert a woman has a heart attack, however the effectiveness of this campaign is inconclusive
Between 1998 d 2004 the America government ran a campaign to attempt to deter drug use, by educating, and enabling them to reject drugs, stop the from initiating drug use and convince occaisional users to stop. Talked about negative consequences, self efficacy and resistance skills. However, an analysisby Homik
et al found that it failed to accomplish it's goals, and may have increased marijuana use.
Failed because the deterrents used were 'far from novel' so didn't stick with the kids, and the campaign also implied that drug use was common place, a survey of adolescents found that the campaigns made them feel that all their peers were smoking marijuana, increasing their likelihood of using the drug
Theory claims that people choose an addiction as the resuly of intention, and intention is formend through:
Behavioural attitude, how acceptable the person deems the behaviour to be, and the belief of the consequences of the behaviour.
Social norms: Subjective awareness of social attitude toward that behaviour. What others think about it (injunctive norm), and perceptions of what other people are doing (descriptive norm)
Perceived Behavioural control: How much control they have over the behaviour, if they think they have high control over it, they will do it
This can then be used to tackle drug use before it begins
campaigns typically show effect of the drug and the risks etc, many teens are not risk avoidant, so on america group tackled another area: the attitudes, changing them from kids believing it has no effect on their lives, to showing them how it reduces autonomy and makes achieving aspirations harder. Slater said the target is to change attitudes.
Changing Subjective Norms
Anit drug campaigns now present statistics which show the proportion of a population actually use a drug, this changes the subjective norms, making it less acceptable. i.e. a teen who smokes with all their friends may be under the impression that all people smoke, this would change that, making it less acceptable
Perceived Behavioural Control
Surveyed adults intending to quit and also gave an at home interview, found that although the CBA, SN and PBC all had an influence on intentions, it was the PBC that most predicted the behaviour, as a result, treatment has been focissed on tackling willpower and changing the attitudes of people of hoow much effort is required to quit.
Increased self efficacy feelings increases abstinance. Looking at cognitive factors- those attempting to abstain from drugs who were encouraged in their ability to abstain was linked to optimism and an eventual positive outcome
Using the Internet
Meta analysis of 85 studies found that internet intervention programmes that used TPB in particular were more effective at helping people quit smoking or gambling
Addiction to Sun
Surveyed 1000 people aged between 12-20 on their sun protection behaviour, it was found that the TPB components were the biggest predictor of intentions in sun protection, and the biggest reflector of actual behaviours
Ignores any other irrational extenuating factors that cause a bahevaiour, people find it hard to anticipate their behaviour in real life, particularly if their cognitive ability is impaired. This and strong emotions may explain why people fail too quit when it is in their best intentions to do so
Ignorance of Other Factors
Identification can have a role in tabacco addiction or any other addictive behaviour i.e. identification of the group norms and following to not be rejected.
350 substance abusers in australia surveyed found that recovery was consistently more successful in those who decided themselves rather than having being coerced into recovery.
Self determination theory better
Intention and expectation
Although someone may expect to be in a different place in n years time, they may not actually have the intention to be, this those with expectation are less likely to quit.
Predicts intention rather than behavioural change
Meta analysis found that it was successful in predicting the intention to change rather than the actual change itself occurring. Typically it would mean the intention to make an extreme change in lifestyle, however, doesn't translate intention into action. Can therefore establish 2 phases: The motivational stage in which the decision is made, and the post-decisional phase where the change is initiated and maintained, this model does not detail that process.
Influence of Alcohol ad Drugs
Alcohol and drugs increase gap between intention and performed behaviour, as they reduce cognitive ability, so will divert to distructive behaviours such as gambling and unprotected sex.
Macdonald et al found that alcohol increased intention to engage in unprotected sex and other risky factors.
Uses self report
Uses correlational studies.
Types of Intervention
Methadone created the same effects as heroin, but is less addictive, so iamount of methoadone is increased, while heroin is decreased to nothing, then the amount of methadone decreased.
Some can become just sas reliant on methadone, with those on the treatment selling it to those high dependence individuals for little money.
Resp for 300 deaths in 2007
Thought that dysfunctional serotonin, or dopamine in reward pathways. Those treated with SSRI's improve. Those treated with naltrexone (which reduces dopamine effects, saw reduced desire to gamble
Study used tiny sample for short time, bigger longer study failed to replicate results for SSRI's.
Found significantly reduced gambling thoughts in those treated with naltrexone over 6 weeks
Thought that giving those
in recovery a reward would reinforce their recovery.
Two conditions: Those receiving normal recovery (sessionsd methadone dose) and those receiving normal therapy plus a monetary reward. Upon drug testing there was a 60% drop in those who had had the monetary incentive
However this method does not tackle the actual problem that caused the addiction in the place, and so when the treatment ends, they go back to the drugs or shift the focus of their addiction onto something else
Get people to change their thought patterns when theinkning about their addiction, and how to control their thoughts when they return to a situation like the one that initiated the behaviour in the first place
66 pathological gamblers placed in either CBT treatment or control waiting group. Of those that completed the CBT, 86% no longer fulfilled the criteria for gambling addition, they also expressed greater levels of self control and self efficacy.
Male gamblers evaulated after CBT, found significant gains after treatments, with these maintained one year after treatment.
Public Health Interventions
NIDA: Cocaine Study
47 patients randomly assigned to 1 of 4 interventions:
Group Drug Councelling
CBT and GDC
Supportive-expressive psycho therapy and GDC
Individual Drug counselling and GDC
Induvidual and group worked the best, with only 39% of people reportingdrug use after that. compared with 57% for the CBT and 52% for the GDC alone, and 49% for the SEPT and GDC
Serve the purpose to break the cycle of personal and social problems that result in drug abuse.
Found reduced cocaine use reduced HIV frequency, as it reduced unprotected sex associated with cocaine
Meta analysis of 18,000 participants, repeat telephone calls from counsellor increased odds of stopping smoking by 50% compared to self helpp materials and/or brief counselling. Multiple call back counselling improves cessation
Found that the use of quitline services reduced nicotine dependence
Prevent Gambling in the Young Peepol
Proposed model of tacking gambling in the oung people proposed by Messerlian et al, it focuses on denormalisation (gambling is not normal) protection (from being exposed to gambling negativee effects) prevention (of the behaviour occuring) and harm-reduction (to reduce damage done by gambling.
Important to avoid a major social issue, it has been found that found that gambling at a young age causes strained relationships, delinquency, and criminal behaviour, depression
CBT places emphasis on the role of cognitive dysfuntion in the onset of depression, Beck claiming that if you think negatively about your life, you will continue to be depressed. CBT tackles cognitive distortions and dysfunctional behaviour that contribute to the depressive state.
Asked to think of situations that provoke negative thoughts and link them with feelings, after they, the thoughts are tackled and rationalised in order for the sufferer to see it's not a big deal.
Being active linked with allevated mood, therapists identify an activity for the depressed, then challenge negative obstacles that the sufferer claims stop them doing these things
A meta analysis by Robinson et al found that CBT was superior to no treatment groups
However, when these groups were divided into waiting list no treatment and placebo, CBT showed no significant difference over placebo
15% in the variance in outcome can be attributed to therapist competence
Importance of Homework
Research suggests engagement in homework preducts the outcome of the CBT, those who engage clients in homework improve their benefits in terms of positive outcomes
Found to be suitable for all age groups, had been administered by computer and shown to be just as effective.
0.93 for the BDI 0.63 for the DSM
Keller investigated 524 depressed inpatient and outpatient major depressive disorder and dysthymia sufferers, interviewed at start and after 6 months, found fair to good test retest fair to good overall, fair for dysthymia and poor for major depressive disorder'
Improve it by simplifying method of diagnosis, a simplified version of the DSM found a 95% aggreement level, after only 25% of 2,500 GP's could even list the criteria for depression, means that staff are more easily trained and people can be more readily diagnosed.
Diagnosis unreliable because objective
May not be valid because it is testing for depression while another more prevalent disorder, such as an anxiety disorder, is present, wrong diagnosis, wrong treatment.
extent to which 2 disorders co exist
Representative of that which is being measured
BDI high in content validity because it was put together by professional clinicians
How much it concurs with an already existing test. BDI has High Concurrance with the Hamilton depression scale
Diagnosis may be biased as GP's can diagnose and often base on past knowledge which is not valid
5x high suicide thoughts compared to non-sufferer, triple that if depressed with panic disorder, wrong diagnosis potentially fatal.