Abnormal and Human Relationships

Transcranial magnetic stimulation (TMS)

A noninvasive technique for treating depression. A device is placed against the scalp above the prefrontal lobe, sending magnetic pulses into the brain, to stimulate electrical activity in the prefrontal lobe. Each session in 30 min, with a course involving 3-5 treatments per week over 4-6 weeks. It is thought to stimulate neural activity in the networks related mood regulation, around the anterior cingulate cortex, in the prefrontal lobe, and the amygdala. It is assumed that depression could be caused by low patterns of connectivity in neural networks between the frontal lobe (rational thinking) and limbic area (emotion). Once treatment is stopped, patients may relapse as seen with medication. See Drysdale et al 2017 and the 4 biotypes of depression. Effectiveness varied with biotype in a sample of 154.

March et al 2004

Aim: To compare SSRI and CBT treatment in adolescent depression. Sample: 439 adolescent patients diagnosed with MDD at 13 clinics in the USA. Method: Randomized, controlled trials. Four conditions, which participants were assigned to randomly. 1: Fluoxetine (SSRI) only 2: CBT only 3: Fluoxetine and CBT 4: Placebo Treatment over 12 weeks, after which depression was assessed on a clinical rating scale for adolescents. Placebo and fluoxetine only conditions were a double blind design (not possible for CBT), so neither researcher or participant knew what they were getting. Result: Rates of response to treatment were - 35% for placebo - 43% for CBT only - 61% for fluoxetine only - 71% Fluoxetine with CBT All treatment led to reduced suicide risk measured at baseline. Only questionable due to CBT being hard to keep standardized, as it may affect its effectiveness.

Givens et al (2007)

Aim: To investigate the effect of ethnicity of depression treatment preferences. Sample: 75,000 of varying ethnic and cultural backgrounds. Method: Survey. Result: cultural attitudes and stigma about depression lead to different preferences. - African-Americans, Asian-Americans and Latinos prefer counselling over medication. - European-American respondent prefer medication over counselling (contested by other research) - South-Asian respondents prefer self-management more than European-Americans. - Ethnic minority respondents were less likely to think medication would be effective and more likely to believe in counselling and prayer to be effective.

Fischer (2008)

Aim: To investigate the role of neurochemcials in attraction and love. Sample: Participants who were in love and people who had been rejected by a love interest. Method: MRI scans. Results: Romantic love was correlated with dopamine activity in regions associated with addiction, that light up neural networks for rewards. For those recently rejected, the neural networks for rewarding behavior were especially active suggesting that love is almost obsessive like an addiction. There were links between love and attraction and neurotransmitters like dopamine and serotonin, and hormones like oestrogen and testosterone.

Cooper et al 1972

Aim: to investigate reliability of diagnosis of depression and schizophrenia Researchers had American and British psychiatrists diagnose patients based on watching video recordings of clinical interviews. American psychiatrists diagnosed schizophrenia twice as many time as British psychiatrists, while the British diagnosed twice as many with mania or depression. Conclusion Indicates a low reliability of diagnosis caused by cultural differences and perceptions of symptoms.

Marsella (2003)

Argues that depression takes a primarily affective form in individualistic cultures (feelings of loneliness and isolation dominate). In more collectivist societies somatic symptoms dominate, such as headaches. Depressive symptom patterns differ across cultures because of cultural variation in sources of stress, as well as resouces for coping with stress.

Kirmayer (2001)

Broad analysis of culture and treatment. Argues the meeting of a patient and a clinician is a kind of intercultural encounter. Some cultures see mood disturbances as moral or social issues, not disorders. This is connected to some cultures favoring externalizing symptoms in a somatic way e.g. via tension in the head or back. In Japan, before SSRIs were popularized, depression was treated using anti-anxiety drugs like Xanax, as anxiety was more socioculturally acceptable than depression, and so diagnosed more. Some cultures encourage free expression, while others focus on harmony.

Strong reciprocity

Cooperating with others and punishing those who do not cooperate. Comes at a personal cost that may not be repaid. We help even if we may not have to. We help more if punishment is a risk.

Social exchange theory

Cost-benefit evaluation determines whether a relationship is maintained or not. Short-term inequality is fine, as long as the balance is restored. Equity theory argues that this is too reductionist, and that relationships are more dependent on the perception of equality. (See Diamond and Butterworth 2008). Criticized on the cross-cultural level of application. In Jamaica it has been found that being over-benefitted was preferred.

Example of the difficulty of creating a standard definition for abnormal behavior

DSM-III (Diagnostic and Statistical Manual of Mental Disorders, 1980) stated that homosexuality is only abnormal if the individual has negative feelings about his or hers sexual orientation. People's attitudes towards homosexuality simply changed, and so has the opinion on whether it is abnormal or not.

Hollon et al 2005, Rupke et al 2006

Found CBT to have lower rates of relapse compared to those taking antidepressants. 24 months after treatment had successfully led to remission, 82% CBT patients were still in remission, whereas only 45% of those taking antidepressants were in remission.

Hartfield (1979)

Found in a study of 2000 couples found that those who felt deprived or under-benefited cheated sooner after marriage and with more partners than those who felt either fairly treated or over-benefited. Those who found their relationship to be perfectly equitable were more likely to think that their relationship would still be intact in 1 year and in 5 years. Interestingly, both those who felt under-benefited and those who felt over-benefited were generally more doubtful of their relationship lasting.

Serotonin pathways

Functions: - Mood - Memory processing - Sleep - Cognition Used to counter MDD symptoms by increasing serotonin levels in the synaptic gap. Does not mean it is an etiology of depression.

Empathy-altruism hypothesis

Hypothesis build upon by Batson. Argues altruistic behaviour comes from empathy. Altruistic behaviour has been observed most when empathy is high. Little altruistic behaviour was observed in low-empathy and difficult escape conditions. For the high empathy conditions, escape difficulty or ease played a minimal role.

Universalism versus relativism

In sociocultural psychology, most tend to adopt the view that treatments working in one group will also work for another cultural group. Others don't think that is the case.

Ethical considerations of diagnosis:

Labelling - Self-fulfilling prophecy. One is a person with schizophrenia, one isn't schizophrenic. Stigmatisation: A label sticks and it may influence social interactions with society. Kandel argues that viewing mental disorders as a brain disorder instead, gets rid of this stigmatization. Deinstitutionalisation: Institutionalisation has been found to be ineffective and starts with diagnosis. instead some use community health initiatives, like the USA, but this is yet to be fully researched in terms of effectiveness.

Griner and Smith (2006)

Meta-analysis of 76 studies with a total sample of 25000 participants. Only studies with quantitative measures for effectiveness. - Most frequently the treatments were adapted to account for cultural values - Found a moderately strong benefit of culturally adapted interventions: average effect size from to pre- to post-intervention was 0.45. - Both individual and group formats of intervention was considered - Same-race participant groups were 4 times more effective than mixed-race participant groups (effect 0.49 vs 0.14) - Acculturation was observed as older participants were more responsive to culturally adapted treatment than younger participants. - Clinician speaking the native language was more effective than speaking English (effect size 0.49 vs effect size 0.21) - Non-published studies were also looked at to prevent publication bias (No difference was found in the findings between published and nonpublished studies)

Fatal attraction theory

Qualities that were initially attractive become annoying or distressing leading to the relationship terminating. For example someone fun may becomes annoying or immature in the long run.

Morry (2007)

Several studies exploring the similarity-attraction hypothesis between cross-sex friendships. Participants were to rate friendship satisfaction and similarity with their friend. It was found that perceived similarity, whether true or not, was a major factor for friendship satisfaction. Those with higher friendship satisfaction also tended to have higher similarity scores. Better friends see each other as more similar. Morry argues we see those we like as being similar, so similarity predicts attraction. Cognitive factor of attraction. Perceived similarity, i.e. the cognitively evaluated similarity, was more important than actual similarity.

Stereotypes, prejudice and discrimination

Stereotype: Belief Prejudice: Attitude Discrimination: Behaviour

Eclectic approach

Treating psychological disorders using several orientations at once, such as antidepressants, cognitive therapies and humanistic therapies.

Prisoner's dilemma

Two participants are prisoners suspected of a crime. If one confesses, the other will receive a severe penalty, while the other one's reduced. If both confess, they receive heavy penalties both. If both deny the crime (cooperate) they receive a medium penalty. Confessing means they compete, denying means they cooperate.

Scheff (1966) Calling someone e.g. schizophrenic may cause

self-fulfilling prophecy

Factors influencing the diagnosis of a psychological disorder

- Concepts of normality and abnormality - Diagnostic classification systems - Clinical biases in diagnosis - Reliability and validity of diagnosis.

Cultural factors of treatment

- Culture may affect treatment preferences (e.g. biological, cognitive or alternative) and administration of functional treatment. - The clinician's ability to understand the patient figuratively and literally. - Tailored treatments are more effective, but lack empirical data right now, time consuming. - Culture-specific treatment could promote stereotyping. - Cultural-specific behaviour may seen as abnormal by outsiders. - Access to treatment - Abnormality should be considered from the viewpoint of the patient. - therapeutic alliance between patient and clinician (trust)

MDD in the DSM-V

- Lowered mood most of the time most days. - Reduced interest or pleasure in activities - Significant change in weight - daily insomnia or hypersomnia - reduced or agitated motor activity - fatigue - feelings of worthlessness or inappropriate guilt - diminished concentration and cognition - recurrent thoughts of death, suicidal ideation, suicidal plan. Mild: 2-3 symptoms moderate: 4+, difficulty continuing normal activities. Severe: Several symptoms causing distress, loss of self-esteem, ideation of worthlessness, somatic symptoms typically present. Duraction: 2 weeks though most episodes last longer.

Clinical bias in diagnosis

- Overdiagnosis. Mental disorders have been found to spread e.g. via popculture. It may also stem from the fear of clinicians of being criticized if they don't diagnose, so they play it safe. Some also argue that today, behaviour previously seen as normal, is now pathologized e.g. shyness is labelled as avoidant personality disorder. The same with behaviour appropriate some places not being appropriate in others. - Double argues psychatrists in particular rely too much on biomedical factors like brain abnormalities.

Model of decision making for bystanders

- Pluralistic ignorance: We used others to evaluate the nature of an event, if others don't respond, we don't either (ambiguity). - Diffusion of responsibility: We feel less responsible the more people there are. - Evaluation apprehension: People fear public embarrassment if they help. If they don't feel qualified, they won't help. Bystanderism also takes place online.

Elkin et al (1989)

28 clinicians worked with 250 patients randomly assigned to one of four 16-week conditions: - Interpersonal psychotherapy - Cognitive behavioural therapy - Antidepressant medication and clinical management - Placebo and clinical management All patients showed significant reduction in symptoms over the 16-week period. Showed that placebo performed the worst, medication and clinical management the best and the two other (interpersonal psychotherapy and CBT) were only a bit behind medication. When severity of disorder was included they found that the three treatment groups had no significant difference in effectiveness for mild or moderate depression, but there was clear advantage of medication in cases of severe depression. So in the 16-week interval drugs were more effective than placebo and faster and more effective than psychological treatment for severe depression.

Rosenhan and Seligmann (1984)

7 criteria for abnormality: - Suffering - Maladaptiveness - Irrationality (incomprehensible) - Unpredictability - Vividness and unconventionality: does the person experience things that is different from most people (in your own immediate surroundings, not norms)? - Observer discomfort - Violation of moral or ideal standards (regularly)

Negative state relief model

A model for altruism by Cialdini, in which altruism is explained as being an attempt at relieving one's own stressed state, when observing people in need of help. It introduces a somewhat selfish element to altruism. (Cognitive)

Social cognitive theory and altruism

A sociocultural explanation for altruistic behaviour. Characteristics of people, associated with greater likely of displaying altruistic behaviour, may be learnt from observing parents or teachers. These characteristics could be a great sense of law and order and social responsibility. Non-punishment orientated discipline in childhood has also been associated with altruistic behaviour. This discipline emphasizes the consequence of one's actions instead, perhaps leading to more altruistic personalities. Altruism may be influenced by more factors, like peer influences, and not be as consistent and integrated into a person's own personality, as suggested by the empathy-altruism model and the kin selection theory suggests. Altruism may be a question of normative conformity to social norms.

ABCS

Affective symptoms (mood) Behavioural symptoms Cognitive symptoms Somatic symptoms

Whiting (1976)

Aim: Investigating the cultural differences in prosocial behaviour. Sample: kids between the ages of 3 and 11 in 6 different cultures (Kenya, Mexico, Philippines, India, Japan and the USA). Method: Naturalistic observation. Kids observed at home and in the community, and prosocial related to food preparation, childcare, household chores, etc. was noted. Results: Found that Kenyan kids were the most prosocial, and American kids the least prosocial. Cross-cultural differences in pro-social behavior are correlated with the children's involvement in their responsibilities of family life i.e. traditionalist societies seem to grow prosocial behaviour, more so than modern societies where kids are paid to do chores if they have any at all.

Buss (1989)

Aim: Study regarding mate selection. Sample: more than 10000 people across 37 cultures (opportunity sample, not random. Poor rural areas not included in most cases) Method: Correlational study using survey data on age preferences and the ranking of 18 mate characteristics. Participants were asked to rate each characteristic from 0-3 with 0 being irrelevant and then asked to rank 13/18 of the characteristics by importance. The main focus was one financial prospects, good looks, chastity and ambition. Findings: Some things in mate selection was universal for humans: - In 36/37 cultures women ranked financial prospects as more important than men - In 37/37 cultures men preferred women younger than themselves - In 37/37 women preferred men older than themselves - In 23 cultures, males rated chastity as being more important than women did. (CROSS-CULTURAL DIFFERENCE) The self-report data was compared to demographic data, to ensure the answers were representative and authentic. The evolutionary view of attraction is often seen as being reductionist. For example kindness and intelligence were ranked higher than financial stability overall, indicating that there might be more to attraction than just choosing the safest bet. Social norms also change and this influences what is seen as attractive features both physically and personality-wise.

Pincay and Guarnaccia (2006)

Aim: To investigate Latino treatment preferences. Sample: Method: Focus group. Method: Focus group conversation was transcribed. Results: Latinos expressed valuing being able to take care of one's own problems before seeking help. The "straight talk" of therapy was preferred to medication, which was seen as a last resort, and feared the possible side effects or dependency issues. It may suggest why Latinos do not seek help immediately when experiencing depressive symptoms. Can be used to support the GLADP-VR.

Moss-Racusin et al (2012)

Aim: To investigate the role of gender bias in academic sciences. Sample: 127 science faculty members at US universities. Method: Randomized, double-blind experiment. Participants were asked to evaluate an application for a laboratory position. The name of the applicant was either John or Jennifer but the application was identical otherwise. The applicant was evaluated based on competence, hireability, how much they would offer in starting salary and willingness to mentor. Results: Both male and female faculty members discriminated against the female applicant, offering the male applicant a higher starting salary, rated him as more competent and were more willing to mentor "John". Using a sexism scale, the participants were also evaluated for unintentional negativity towards women. Those who scored high, tended to rate Jennifer as more incompetent.

Regier et al. (2012)

Aim: To test the reliability of the DSM-V in real life for a selected number of disorders. Sample: 11 different academic centres in the US and Canada. Method: Patients were screened at a psychological treatment site based on the DSM-IV and presented symptoms. Participants were then diagnosed by two clinicians working separately blind to each others' diagnosis. Clinicians entered the diagnosis in an internet system, allowing for statistical analysis. Findings: 23 different diagnosis were gathered with big enough sample sizes. It found that the reliability was very good for 5/23 of the diagnoses, good for 9/23 and questionable or unacceptable in 9/23. Depression and anxiety disorder were among the diagnoses of questionable reliability..

Ahmad and Reid (2008)

Aim: to evaluate the role of listening styles in the maintainance of arranged marriages. Sample: Indo-Pakistani couples from arranged marriages in Vancouver Canada. Method: Survey about marital satisfaction, listening styles and traditional orientation to marriage. Results: The role of elders in arranging the marriage and gender-based division of labour was correlated with lower levels of interpersonal listening and marital satisfaction. This shows that listening to understand the partner e.g. by paraphrasing, is more constructive for a relationship than listening to respond, where one is listening while formulating an answer in their head. The listening style for understanding was linked to belief about equality in marriage and marital satisfaction. If one doesn't expect marriage equality, one doesn't listen and is dissatisfied with the marriage.

Sherif et al (1961) Robber's Cave

Aim: to explore group conflict and group dynamics (realistic conflict theory: conflict arises due to limited resources between groups). Sample: 22 Boys between 11-12 years old. Method: Naturalistic experiment. Stage 1: bonding stage between the two groups to create social norms through activities like swimming. The two groups were unaware of each other. They adopted names. The Rattlers and the Eagles. Stage 2: Competition stage. Competitions like baseball arranged. During the baseball the groups were observed to discriminate against each other. A prize was promised to the winning team - nothing for the losing team (little resources). Verbal aggression became violent aggression like ransacking their huts. Stage 3: Reducing friction stage. The children were asked to evaluate the other group. Mostly negative terms were used an they evaluated themselves positively. Superordinate goals were used to diminish conflict, like them working together to collect money to go watch a movie. Results: Living together did not diminish conflict, but working together did. Some argue realistic conflict theory can be denounced as conflict can arise simply if the groups perceive each other as rivals.

Piliavin et al (1969)

Aim: to investigate factors of bystanderism Sample: opportunity sample of 4,400+ participants of varying ages, ethnicities and gender. About 43 participants per trial. Method: Field experiment. Standardized procedure using for collecting quantitative and qualitative data. Took place on a New York subway. 103 trials in total done by 4 researchers. Two researchers took turns playing either a drunk or someone ill with a cane. The actor would stagger and then collapse motionless on the floor with the face up and eyes open. A third researcher would prompt helping behaviour in some conditions. The other two observed and collected data like speed of help, if the model intervention provoked action and what comments people made. Results: The cane-carrying victim received help in 95% of cases, whereas the drunk received help in 50% of cases. There was little evidence of diffusion of responsibility, as more people helped quickly when one person took an initiative. The drunk was deemed as a greater cost to help due to embarrassment and risk, then the crane victim. The cost of just standing by outweighed the cost of helping. In later studies diffusion of responsibility was found as 75% helped when alone, whereas 53% helped when others were present.

Nook et al (2016)

Aim: to investigate if prosocial behaviour would persist over time when stemming from conformity. Sample: 102 participants from a freelance workplace. Method: Experiment online. Participants were paid 1 dollar for participating and given 1 dollar extra that could be donated. 100 charity donation trials conducted online, where there was a charity logo on each trial, with a manipulated indicator for the mean donation. In the stingy condition, the mean donation was 0.25 dollars In the generous condition the mean was 0.75 dollars. Results: Participants in the generous condition generated more than the stingy group and donations also increased for the generous group, but not the stingy group. Generous group displayed prosocial conformity. In a later trial with 104 participants, the set up was identical, only the donation trials were split into two, with 100 distraction trials between. The 50 donation trials before the distraction, had the mean indicator, the 50 after didn't. Prosocial conformity was observed in the generous group even after the model of behaviour was no longer present, indicating long-term effects of observing prosocial behaviour. It is unsure whether the participants were debriefed about the fake mean indicator or not, although the study was approved by an ethics board. It's sample is non-representative.

Latané and Darley (1968)

Aim: to investigate the effect of pluralistic ignorance and diffusion of responsibility. Method: Experiment with 3 conditions. Participants were asked to fill out a questionnaire in a closed room, observed by researchers through a one-way mirror. Smoke would start filling the room from under a door. Response time was measured. Condition 1: The participant was alone Condition 2: The participant was with 3 other participants Condition 3: The participant was with 3 confederates sitting passively. Results: The participants alone responded 75% of the time. Participants with others responded 38% of the time. Participants with the nonreactive confederates responded 10% of the time.

Regan et al (1972)

Aim: to investigate the negative relief state theory for altruism. Sample: 40 females. Opportunity. Method: Field experiment conducted in a mall with 2 conditions guilt/no guilt. A male confederate would ask the participants to take a picture of him for a project. Guilt condition: the camera was broken and the confederate blamed the participant. No guilt condition: the camera was broken and the confederate assured the participant it wasn't their fault. Later the confederate would cross paths with the participants, and drop candies on the floor without noticing. Results: 55% of those in the guilt condition helped in the second part of the experiment. 15% helped in the no-guilt condition. According to the negative state relief model, this was due to the participants in the guilt condition trying to relieve their negative feelings by helping, which was not necessary for the no-guilt condition.

Wedekind and Furi (1997)

Aim: to investigate the role of major histocompatibility complex (MHC) (body odours supposedly reveal something about immunological compatibility) in mate selection. Difference in MHC genes was hypothesized as being more attractive. Sample: 120 male and female. Method: Experiment. Six t-shirts had been worn for 2 days straight, and the participants were then asked to rate them after pleasantness. Result: Higher ratings of pleasantness was given when the wearer of the t-shirt had a very different MHC than the participant smelling it. Interestingly, a male participant rated a t-shirt the most pleasant, that had been worn by another male and not a female. It was found to be the most MHC dissimilar to the participant.

Drysdale et al (2017)

Aim: to investigate the role of neural networks in depression. Sample: 1188 Americans and Canadians. Method: Correlational study using fMRI scans. Examined resting-state MRIs and investigate blood oxygen signals over 258 network nodes across the brain, using AI to conduct analysis. They correlated patterns of connectivity in primarily the frontal lobes and limbic system, with symtpoms of depression (anhedonia: loss of pleasure in usual activities, psychomotor difficulties, anxiety and insomnia). Patients were divided into subgroups and the abnormality in the neural networks were correlated to the groups. Results: correlation was found between neural network activity and the incidence of depression. This may be a new etiology of depression and raise a need for reevaluation of depression subtypes to account for biological factors. They also found that biomarkers predicted responsiveness to transcranial magnetic stimulation (biological treatment of depression by stimulating the deep brain and modulating connectivity of neural networks) more effectively than clinical diagnosis, as the response to TMS varied across biotypes (validity of diagnosis questioned)

Levine and Crowther (2008)

Aim: to investigate the role of social identity theory and bystanderism. Participants: females Method: Experiment and questionnaire. were asked to imagine a scenario where a man and woman interacted violently. The participants were either told they were walking alone, with friends, strangers or fellow students. A questionnaire was the used to determine the participants' willingness to help. Results: Participants were more likely to intervene on their own than with others, but it was also found that if they were with a friend group, help was more frequent if the group size was bigger. Feeling as part of an ingroup increases sense of responsibility and willingness to act, challenging the diffusion of responsibility idea, as it indicates that it depends whether the group and victim is part of the same ingroup or an outgroup. Can be connected to prosocial behaviour.

Shorter variants of the serotonin transporter gene (5-HTT)

Associated with depression and anxiety. People may be more prone if they have this genetic predisposition. Some argue it leads to susceptibility of social sensitivity. Found to be more common in East Asians, although this does not correlate with higher depression prevalence (Chiao and Blizinsky 2009). It was found that while East Asians have twice the rate of having this gene, East Asians have half the prevalence rate of depression compared to Europeans and North Americans. They didn't have data from all countries, as not all countries collect data related to depression prevalence rate or the rate of the particular gene variations. In East Asia depression tends to have somatic symptoms like back- and headaches. This may be explained by cultural factors. Collectivism may have developed in East Asia because of the transporter gene, making them more socially sensitive and so collectivism was developed to counter depression.

Prosocial behaviour versus altruism

Both helping behaviours, but altruism involves some cost for the helper and is a type of prosocial behaviour. Always link back to question when using altruism to answer questions about prosocial behaviour. Prosocial behaviour and altruism may be inborn in humans, as indicators of altruistic behaviour has been observed experimentally in infants (Warneken and Tomasello 2006).

CBT

Cognitive behavioural therapy (spawned from Beck's theory) CBT techniques: - Socratic questioning: Guiding the patients towards realizing that their thoughts are irrational - Behavioural experiments:Counteract maladaptive beliefs, e.g. the client has a blief that they then have to test by for example participating in a class some days and not participating other days to see if it's awkward and embarrassing. - Thought records: Keeping track of irrational thoughts and the relevant situations proving/disproving the thought - Situation exposure hierarchies: Make a list of stressful situations and then starting from the bottom doing said things until they're no longer stressful. - Pleasant activity scheduling: Having the patient do 1 pleasant activity every day that they don't normally do. CBT provides coping skills and strategies in the long run.

Wampold 2007

Compared psychotherapy with medicine. Found that psychotherapy was more effective than widely used and evidence-based practices like medical interventions in cardiology, asthma, influenza vaccine and cataract surgery. Suggests the three common factors of effectiveness of psychotherapy are particularly vital: - Client's willingness to trust in the therapists skill. - Formation of working alliance with the client. The way treatment is delivered is important. - Placebo effects.

Kiesler and Baral (1970)

Conducted an experiment where two groups of men were given a fake IQ test. Afterwards one group was told they had scored "off the charts" where the other was told that there had to be some kind of misunderstanding, due to the very low scores. The men were individually given their scores, and were then told to wait in a room. While in the room, a very attractive woman would walk in. It turned out, that the men who had just received a confidence boost, were more likely to engage in conversation, than the men with battered self-esteems.

Siege et al (2007)

Correlational study. Used fMRI scans to show that depressive participants had increased amygdala activity, which is often associated with depression, when it came to emotional tasks, but reduced prefrontal cortex activity for cognitive tasks. After 14 weeks of CBT, this trend was reversed. CBT is hard to evaluate as a whole as the treatment is adjusted to the individual. The prefrontal cortex arguably lessens hyperactivity in the amygdala. Anti-depressants have been found to limit activity in the amygdala, while CBT enhances activity in the prefrontal cortex. Both stabilise activity in neural networks between the amygdala and prefrontal cortex. More brain regions are related to depression though.

Amok

Culture-specific mental disorder found in South-east Asia, characterized by a period of brooding followed by a violent outburst.

DSM-V

Diagnostic and Statistical Manual of Mental Disorders. Made by the APA, tailored to American psychiatrists but widely used. Combordity is addressed. ICD-10 and DSM-V try to allign themselves to avoid conflicting diagnoses. It includes cultural idioms of distress (sayings that convey a meaning dependent on the culture, e.g. over the moon=happy) and cultural explanations or perceived causes. Includes gender-specific symptoms where relevant. Criticized for not being fully supported by field trials. Considered difficult to use. Some argue the symptoms are explained from a female model more so than a male model. This may cause higher prevalence rates in females, causing clinical bias. Criticized for leading to diagnostic inflation, as more and more behaviour is labelled as abnormal due to the definitions. Criticized for being focusing on symptoms not etiology. (it is categorizational, not dimensional)

Cost reward model of helping

Emotional and cognitive processing. Physiological arousal: The bystander feels a physical response to a situation. Labelling the arousal: the physical response if interpreted to see whether help is needed in the situation. Evaluating the consequences: cost-benefit evaluation of intervention. In less ambiguous, emergency situations people are more likely to help.

Aaron Beck (1967) cognitive theory of depression

Empirically supported theory. 3 elements of depression. 1. cognitive triad (pessimistic automatic thoughts): the self (i am worthless), the world (no one notices me) the future (things will only get worse) 2. Negative self-schemata maybe caused by excessive criticism, abuse in family or bullying. 3. faulty thinking patterns e.g. personalization or overgeneralization.

Parental investment

Evolutionary explanation for why females tend to be pickier than males about their mates. The choosier sex is usually also the one investing the most in the upbringing of young. In humans, women are obligated to 9 months of pregnancy after mating, childbirth and the caretaking of the baby for several years after, whereas men can leave right after mating. This explains why women have been found to prefer older men with a stable income over men of equal or younger age with less stable incomes. There is a certain heterosexual bias in evolutionary theories.

George et al (2010)

Found that patients receiving TMS were 4 times more likely to achieve remission, than those receiving placebo treatment with no magnetic stimulation.

Mukherjee (2012)

Found the effect of antidepressants to be negligible in people with mild-moderate depression, with much the same effect being achieved through placebo, whereas for severe depression they were substantially effective. Contested by Kirsch (2014), finding that 75-82% of the effectiveness of antidepressants could be addressed to the placebo effect through a meta-analysis involving all variations of depression.

Prevalence rates of depressive disorders

Globally: Appears to be increasing. Trends of depressive disorders being more common in females than males and more common among 20-50-year-olds than 50+. More prevalent in individualistic societies, females, income inequality. USA: Kessler et al (2005) suggested that the lifetime prevalence rates for MDD is 16.6% for US adults. The apparent higher prevalence in the USA than in other places is more likely to be attributed to better mental health awareness and reporting.

Cognitive bias in diagnosis

Jill Klein suggests the following: - The representativeness heuristic - The availability heuristic - Overconfidence - Confirmation bias - Illusory correlation bias Wellbery adds the following: - Anchoring bias - Framing bias To avoid these biases Wellbery argues on should try to have: - Meta-cognitive awareness of one's biases - Reflective reasoning - The use of a spectrum of diagnostic possibilities, rather than previous cases. - diagnostic checklists to reduce errors.

Murder of Kitty Genovese 1964

Kitty was raped and murdered late one night, while passive bystanders looked from their windows in Queens. No one called for the police until after she was dead.

GLADP-VR

Latin American Guide for Psychiatric Diagnosis. Developed in 2000, and made to account for sociocultural contexts within the Latin American communities, such as unemployment, migration, intolerance and environmental degradation. This should be beneficial for both patient and clinician. It also includes comments on how to apply the ICD-10 in a Latin American context. The diagnostic model is focused on the individual, not the symptoms. Unlike the ICD-10 it also includes an assessment of personal well-being and contributing factors to health. It is favored in Latin America as it is integrated, personalized and culturally sensitive.

Diamond and Butterworth (2009)

Lesbian relationships were found to be based on friendships, that then developed into romantic relationships, whereas gay men tend to value sexual intimacy of emotional intimacy in the early stages. This supports the evolutionary idea of women being more choosy than men. These characteristics may be doubled in same-sex relationships. In 2008 they also argued that male-male relationships divide chores amongst themselves, whereas female-female relationships chores are usually done in collaboration. Different perceptions of equity.

MDD

Major depressive disorder (DSM-V). Recurrent, debilitating depressive episodes. Difficult to treat due to the variety of etiologies and expressions of symptoms. Response to treatment depends on the individual and can evolve an extended period of trial and error. Combining CBT and antidepressants has been found to be 75% effective, whereas CBT or antidepressants alone are only effective 60% of the time (Hollon et al 2005).

Smith and Glass 1977

Meta-analysis of 375 studies on counselling and psychotherapy, finding that 75% were better off than nontreated individuals. It would have been 50/50 otherwise.

Collins and Miller (1994)

Meta-analysis of studies about self-closure and its influence on liking and attraction. Both questionnaires and laboratory experiments were included so the data was triangulated (validity). Results: - People who disclosed more about themselves were preferred over people who didn't. - People disclosed information to people they liked. - By disclosing, the discloser grew to like the person they disclosed to more. - It is more important how intimate the information is, than how often you disclose.

Knapp (1978)

Model for relationship change. Applies to both friends, romantic relationships and family. Communication and self-disclosure are essential for maintaining a relationship (and terminating it). Steps may be skipped. Relationship escalation: - Initiating. Make an impression. Superficial - Experimenting. Explore what common ground you have. - Intensifying. Less formal, increase in self-disclosure. More time together. - Integrating. Me and you becomes we. Partners consider each other before making plans - Bonding. Public announcement. Relationship termination: - Differentiating. We becomes you and me. Differences emerge. - Circumscribing. Touchy topics are avoided. Boundaries set up to ensure personal space. - Stagnating. Relationship deteriorates but doesn't terminate due to external factors like kids. - Avoiding. Effort made to avoid contact. Physical separation in some cases. Conversation avoided. - Terminating. Explicit or implicit, partners separate. May not be deliberate. Friends may move apart.

Prevalence

Proportion of the population that had had the disorder over a given time period. Usually estimated through random samples and reported in past-year prevalence or lifetime prevalence. Prevalence rates can vary across gender, not necessarily due to biological factors but due to socio-cultural factors like status. It may also be due to gender bias.

Ketamine

Psychedelic drug used to treat serious treatment-resistent depression. It is the last option in most cases. Depression is often associated with feelings of being disconnected, and so the psychedelic effects may help one to feel reconnected with people and the Earth. (Solovitch 2016) Treatment consists of 6 instravenous drips over a 2 week period at about 1/10 the dosage used for anesthesia. 60-75% of patients respond to the treatment, which is high. The drug seems to overstimulates brain cells, turns neural networks on and off with anti-depressant effect and it might promotes synaptogenesis. Synaptogenesis is desired in the hippocampus, which is associated with mood regulation. Not all respond well, though, some not liking the dissociative state and relapse is common, yet it may provide some relief.

Self-disclosure

Revealing personal/intimate information about oneself to others. Usually connected to trust and so is a sign of trusting behaviour. It is connected to an increase in attractiveness when done in appropriate contexts, as it shows trust and can lead to self-validation for the discloser if they feel accepted..

Stereotype formation

Social identity theory: Stereotypes used to boost the ingroup and lower the outgroup. Self-categorization: stereotypes adopted when joining a new ingroup. (Countered by social REcategorization - outgroups become ingroups: Robber's Cave i.e. Sherif et al 1961 where the Eagles and Rattlers ended up working together to collect money to go to the movies together) Social cognitive theory: Stereotypes learnt from surroundings Illusory correlation Grain of truth hypothesis gatekeeper theory

Expression of symptoms

Some theorists argue that women internalize symptoms of depression whereas men externalize them. Women dwell on negative thoughts, while men turn to substance abuse. The same symptoms may be expressed differently across genders and may lead to different diagnoses.

GAD-7

Spitzer et al (2006) A brief seven-item measure for assessing generalized anxiety disorder. It's a scale asking participants to rate how often they feel bothered by certain problems such as: - Feeling nervous, anxious or on edge. - Not being able to stop or control worrying. - Being so restless that it is hard to sit still. Generalized anxiety disorder is characterized by not being able to control an excessive feeling of worry or anxiety, even though there is nothing to be anxious about. Anxiety disorders are as a whole more prevalent in the USA than depressive disorders. Anxiety disorders tend to be more prevalent in females, in working-aged people 18-60, in regions of conflict and in places with higher economic status (Baxter et al 2013)

Similarity-attraction hypothesis

States that the more similar we are in age, interest, physical attractiveness, status, etc. the more attracted we are to one another. It is thought that similarity is reinforcing, i.e. makes people feel better about themselves and their believes, and prevents conflict. Some argue it's more complicated than just similar people attracting each other, and say that between similarity and attraction, there must be some cognitive mental evaluation. Positive evaluation of the traits/attitudes of person, leads to positive evaluation of the person themselves and so they appear attractive. Cognitive evaluation determines the "quality" of potential mates. Montoya et al 2004: Cognitive evaluation was found to predict attractiveness, but similarity was not found to predict attractiveness on its own. Klohnen et al 2003: Partners perceived as similar to our ideal self are found to be more attracted.

Jenkins Hall et al 1991

Study aimed to investigate the effect ethnicity had on diagnosis. Method: European American therapists were asked to watch a video of a clinical interview and then evaluating the patient. There were four different women the therapists had to evaluate: there was a non-depressed European American and African American patient, and a depressed European American and African American patient. Result: The two non-depressed patients were evaluated more or less equally, but the therapists rated the depressed African American woman with more negative terms and saw her as less socially competent than the European American woman.

Serotonin hypothesis

Suggest that depression is caused by low levels of serotonin. This was due to certain drugs known to deplete serotonin had depression-inducing side-effects. This may indicate that serotonin has direct or indirect benefits for some sufferers of MDD. The chemical imbalance theory has flaws such as: - not all get better when given antidepressants, which should be the case if a chemical imbalance was the root cause of depression. - Drugs decreasing serotonin levels are also used as antidepressants. - It may be fueled by commercial pharmaceutics. - There is no evidence for SSRIs being more effective than placebos. - Presenting the chemical imbalance theory as scientific to patients, may be considered a violation of informed consent.

Theory of mutualistic collaboration/interdependence theory

Suggests that cooperation stems from foraging humans being interdependent in their relationships to be more efficient and to be able to compete against other groups. The cooperation bred norms and societal values to ensure conflict-free cooperation when the group grew in size. Conformity may arise to ensure group coordination. Evolutionary explanation for why we work together. Idea is that humans in groups are more innovative.

Social penetration theory

Suggests that self-disclosure is like an onion with layers. This means that more intimate information is disclosed to people you have a more intimate relationship in. There are degrees to intimacy.

Cultural competence

The ability to interact with people of a different culture effectively. - recognize own sociocultural identity and biases - understand cultural bias built into diagnosis and treatment of mental disorders - working with others (e.g. interpreter) to make a valid diagnosis Used to effectively tailor treatment to cultures. Necessary to make valid diagnoses in the presence of cultural idioms of distress. Ode-ori is a somatic idiom from Nigeria, a symptom of anxiety, described as peppery feelings. This could be interpreted as a psychotic conditions by someone without cultural competence, rather than as a symptom of anxiety disorder.

Comorbidity

The presence of more than one mental disorder. E.g. depression and anxiety disorders have rates of comorbidity between each other.

Sexual selection

The traits setting males and females apart evolved for mating purposes, not survival purposes. The idea is that it increases reproductive advantages. It has 2 main processes (Buss 2007). 1. Intrasexual competition: same-sex people compete to gain access to better mates. 2. Intersexual competition: Strategies used to attract the opposite sex. These to processes are said to have influenced each other overtime, so intersexual competition affects the intrasexual competitions for example. Females like a trait, so males compete over who expresses this trait the most.

Theory of reciprocity

Theory based on social exchange theory. Relationships depend on people's perception of reward and cost. Reciprocity occurs during: Self-enhancement (helping a partner feel good about oneself) Self-verification: We also seek people who match and support our beliefs. People tend to think more favorably about the partner, than the partner thinks of him/herself.

Empathy-altruism theory (Batson 1981)

Theory suggesting that people help others because of empathy with their needs. This is based on a cost-benefit evaluation from one's own perspective in true altruistic situations would promote taking action. It requires empathy. One may intervene due to empathy towards the distress of another, or in an attempt to reduce personal distress.

Brown and Harris 1978

To investigate if certain social vulnerability factors played a role in triggering depression. 458 women interviewed with semi-structured interviews. 4 themes emerged: - 3+ children under the age of 14 - lack of intimate relationship with significant other - unemployment - loss of own mother before the age of 11 years

Jacobsen et al (1996)

Used the "dismantling design (splitting a treatment to test for which component is the most effective)" for cognitive behavioural therapy of depression. Randomly assigned 150 patients with major depression to one of three conditions: 1. treatment focused exclusively on the behavioural activation component of CBT (home assignments to rehearse certain patterns of behaviour, and so on) 2. Treatment that combined behavioural activation and the teaching of skills to modify automatic thoughts 3. The full CBT treatment including a focus on the modifcation of the core schema. Turned out that the full treatment did not result in better outcomes than the two incomplete ones, neither after the therapy had concluded or at the six-month follow-up.

Kin selection theory of altruism

We are more likely to express altruism towards relatives. Altruism came about because it helps close relatives. The genes, not the individual, survive. It is a theory from the 70s, but today it is often believed that kin matters less than simply being a part of a social group. Rather than kin selection, it may be group selection. Simmons et al 1977: Study evaluating the role of kin selection theory in kidney donation. 86% of parents agreed to donate a kidney for their children, while 47% agreed to donate to siblings. Similarity in age and sex also increased willingness to donate, suggesting that while kin selection theory may be somewhat valid, there is likely other factors too. Feelings of oneness, have been found by Caildini, to be linked with higher levels of altruism. This has connection to why kin selection may be a thing.

Stereotypes in diagnosis

When confronted with patients from a different ethnicity, clinicians may be ruled by their first hand impression, shaped by stereotypes that could lead to discrimination in diagnosis. Patients may do the same and be reluctant to trust what the clinician says.

Extended contact hypothesis

When two members from different social groups develop a relation, the ingroups attitudes towards the outgroup tend to become less discriminating. For this to be effective, some level of interdependence is usually required, so that the groups interact.

Mindfulness-Based cognitive therapy

an approach that combines elements of CBT with mindfulness meditation to help people with depression learn to recognize and restructure negative thought patterns. Focuses on living in moment and not to overgeneralize bad experiences. It has found to help especially in cases of chronic depression, as it provides coping strategies to be employed in the long run. It may be a treatment not to cure depression, but to live with it. It has lower rates of relapse than other treatments including antidepressants and CBT.