IB Abnormal

• Cortisol Hypothesis
• Serotonin Hypothesis
• Genetics

• Fernald and Gunnar
• Mexican children of depressed mothers living in poverty produce less cortisol, indicating stress system is worn out
• High depression prevalence among people with Cushing's disease - which results in excessive production of cortisol

• Nurnberger and Gershon - MZ twins higher concordnace rates than DZ twins
• Duenwald - Particular gene plays a role in serotonin pathways

• SSRIs
• Janowsky et al - fed patients a drug that made them depressed. Shows that mood can by chemically altered
• Others studies generally point to imbalance of neurotransission

• Cognitive triad
• Faulty thinking

• Dichotomous thinking
• Non-logical inference
• Overgeneralisation

• Alloy et al - followed group of young Americans, after classifying them into two thinking styles
• The positive group - almost none contracted depression
• Negative group, 17% contracted depression

• Life events
• Symptoms different in different cultures

• Brown and Harris - 29/32 depressed women had experienced severe life events
• 78% of those who experienced life events DID NOT get depression
• Life events include:
• No outside employment
• Absence of social support
• Several young children at home
• Loss of mother at early age
• History of childhood abuse

• 5% men, 10% women
• 3% personal attack, 20% wounded vets, 50% rape victims
• 15-24% of those who experience traumatic event

• Genetic - some research points to a predisposition
• Noradrenaline - Geracioti found more patients had higher levels of noradrenaline
• Stimulating adrenal glands produced marked flashbacks and panic attacks in PTSD sufferers

• Tend to believe they have a lack of control over lives
• Sutker et al. found that vets with a sense of purpose had less chance of experiencing PTSD

• Kirsch and Sapirstein - lit review of prozac, 25% more effective than placebo,
• Elkin et al. all treatments equally effective, except placebo group. Drug therapy faster
• Kirsch et al - no more effective than placebo
• Blumenthal - exercise in elderly patients as good as SSRI

• Aims:
• Correct faulty thinking
• Increase activities
• Elkin again
• Riggs - adolescents with substance abuse. Treatment with CBT and placebo almost as good as CBT and drugs.

Toseland and Sipori - lit review. 3/4 cases, group as good as individual, 1/4, better than

Foa - CBT. Focuses on reliving experiences in safe environment. HOWEVER, patients may be worse in initial phases

Weine group therapy