Analyse etiologies of depression (biological, cognitive and socio-cultural factors)

How the disorder is caused

Biological Factors
Wender et al. (1986)
Nurnberger and Gershon (1982) [Twins studies]
Duenwald (2003)

Burns (2003) [Brain serotonin]
Rampello et al. (2000) [Neurotransmitter Imbalance]

Another biological theory of depression is the cortisol hypothesis. Cortisol is a major hormone in the stress system.

Cognitive Factors
The emphasis in the cognitive level of analysis is on the role of cognitive processes in mental disorders. These cognitive factors are believed to play a direct causal role in disorders such as depression – specifically negative thought patterns.

Aaron Beck (1976) [Cognitive distortions and biases in information processing]
Albert Ellis (1962)

Sociocultural Factors
Social and cultural factors may partially therefore trigger a predisposition to a mental disorder.

Brown and Harris (1978)
Murphy et al (1967) [Cultural considerations]
Marsella (1979) [Individualistic Cultures]

Wender et al. (1986)
Tried to find the genetic factors of depression. Study with biological parents who raised twins and adoptive parents who raised twins. Twins raised up by biological parents were 8 times more likely to be depressed and 15 times more suicidal than twins who were raised by adoptive parents.

Nurnberger and Gershon (1982) [Twins studies]
reviewed the results of seven twin studies and found that the concordance rate for major depressive disorders was consistently higher for MZ twins than for DZ twins. Across the seven studies reviewed, the average concordance rate for MZ twins was 65% while for DZ twins it was 14%. This supports the theory that genetic factors might predispose people to depression. However the fact that the concordance rate for MZ twins is far below 100% indicates that depression may be a result of genetic predisposition and that it is not purely genetic.

Duenwald (2003)
suggest that the short alleles of a gene known as 5-HTT affect the transmission and reuptake of serotonin to increase the chances of a person suffering from depression. But this finding between the gene and depression does not indicate a cause since the data are co-relational.

Burns (2003) [Brain serotonin]
states that although he has spent many years of his career researching brain serotonin metabolism, he has never seen any convincing evidence that depression results from a deficiency of brain serotonin.

Rampello et al. (2000) [Neurotransmitter Imbalance]
found that patients with major depressive disorder have an imbalance of several neurotransmitters, including noradrenalin, dopamine, serotonin and acetylcholine

Albert Ellis (1962)
theory focused on negative cognitive styles as the basis of depression. Specifically, irrational and self-defeating beliefs affect an individual’s interpretation of antecedent or activating events, leading to negative emotional consequences. Irrational beliefs will lead to self-defeating conclusions. Irrational and illogical thinking =self-defeating conclusions, which can lead to depression.

Aaron Beck (1976) [Cognitive distortions and biases in information processing]
AIM: to illustrate how stored schemas about the self interfere with information processing

Beck’s theory proposed three factors that contribute to a person’s cognitive vulnerability to depression. These three factors are known as a cognitive triad and it underlies the information-processing style of depressed individuals. The cognitive triad is a cluster of negative thoughts grouped into three categories: the self, the world and the future. A person develops and maintains these negative core beliefs through a set of cognitive bias such as: over-generalization, selective abstraction (focusing on negative aspects of something) and polar reason (not being able to appreciate ambiguity in interpretations of life). These cognitive biases combine to give the person a negative self-schema, which gives them a fundamentally pessimistic attitude about themselves and making it very difficult for a person to see anything positive in life. This can be contributed to parents or peers early on in life.

It is important to remember that the precise role of cognitive processes is yet to be determined. The maladaptive cognitions seen in depressed people may be a consequence rather than a cause of depression.

Brown and Harris (1978)
Provided the vulnerability model based on the interaction of vulnerability factors and provoking agents. In their vulnerability model of depression, they based a number of factors that could increase the likelihood of depression. The vulnerability factors are:

I. Losing one’s mother at an early age

II. Lack of a confiding relationship

III. More than three young children at home

IV. Unemployment

V. History of child abuse

To investigate the social origins of depression in women

There is a link between recent negative life events and the onset of depression.

Murphy et al (1967) [Cultural considerations]
A study conducted by psychiatrists that covered 30 countries. They found additional symptoms such as:
– Loss of sexual interest
– Loss of appetite
– Weight reduction
– Fatigue
– Self-accusatory ideas

Marsella (1979) [Individualistic Cultures]
Affective symptoms (sadness, loneliness, isolation) are typical individualistic cultures. Cultures that are more collectivist, have larger, more stable social networks to support the individual, therefore somatic symptoms are more common.

A wide range of factors influences depression…
You have to look at it in many different angles in order to not be reductionist. Hard to show the causes of depression and the studies show the symptoms, therefore correlation doesn’t always mean causation.

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