Topic 3: Psychological problems Revision Notes

Drug Treatments for Depression

Selective Serotonin Reuptake Inhibitors (SSRIs) are a primary drug treatment for depression. They work by increasing serotonin levels in the brain's synapses. Serotonin is a neurotransmitter linked to mood. By blocking the reuptake of serotonin, more is available, which can improve mood and reduce depressive symptoms. Common side effects include nausea, insomnia, and sexual dysfunction. Their effectiveness is supported by studies showing a reduction in symptom severity compared to placebo, but they may not work for everyone, and relapses can occur if medication is stopped too soon. Ethical concerns include potential over-prescription and the masking of underlying social or psychological issues.

Drug Treatments for Addiction

Drug treatments for addiction vary depending on the substance. For opioid addiction, agonist drugs like methadone are used; they produce similar but milder effects, reducing withdrawal and cravings. Antagonist drugs such as naltrexone block the effects of the addictive substance, preventing the 'high' and discouraging use. Aversive drugs, like disulfiram for alcohol, create unpleasant physical reactions when the substance is consumed. These treatments aim to manage withdrawal, reduce cravings, or deter substance use. Limitations include side effects, the potential for abuse of agonist drugs, and the fact that they address physical dependence but not necessarily the psychological components of addiction, requiring complementary therapy. Ethical considerations involve informed consent, potential for misuse, and ensuring a holistic approach to recovery.

Evaluation of Drug Treatments

A key strength of drug treatments is their ability to rapidly alleviate severe symptoms, allowing individuals to engage in other forms of therapy (e.g., CBT). They are also relatively easy to administer and widely available. However, a significant limitation is that they often address only the symptoms, not the root causes, potentially leading to relapse if treatment stops. Side effects can be unpleasant, leading to poor adherence. There are also ethical concerns about over-reliance, the potential for addiction to prescribed drugs, and the financial cost to healthcare systems. Research methods like double-blind placebo-controlled trials are crucial for establishing efficacy but can be ethically challenging when withholding treatment from distressed individuals.

Genetic Predisposition

Genetic explanations propose that individuals can inherit a susceptibility to conditions like depression and addiction. This means certain genes or gene combinations increase the likelihood of developing the condition, but do not guarantee it. This is often referred to as a diathesis-stress model, where a genetic vulnerability (diathesis) interacts with environmental stressors to trigger the condition.

Evidence and Research Methods

Twin studies compare concordance rates (the probability that if one twin has a condition, the other twin also has it) between monozygotic (identical) and dizygotic (non-identical) twins. Higher concordance in MZ twins suggests a genetic component. Adoption studies examine individuals adopted at birth to separate genetic influences from shared family environments. Molecular genetics research looks for specific 'candidate genes' linked to these conditions, such as genes involved in serotonin regulation for depression, or dopamine pathways for addiction.

Limitations and Evaluation

A key limitation is that genetic explanations often don't account for 100% concordance in identical twins, indicating environmental factors play a significant role. It's difficult to separate genetic and environmental influences entirely, as even identical twins don't share identical experiences. Reductionism is a criticism, as it simplifies complex conditions to genetic causes, potentially overlooking psychological and social factors. Ethical concerns include genetic determinism and the potential for stigmatisation or discrimination based on genetic predispositions. The focus on genes might also detract from preventative strategies related to environmental factors.

Application to Depression and Addiction

For depression, research suggests a heritability of around 30-40%, with studies linking certain genes affecting neurotransmitters like serotonin. With addiction, genetic factors are thought to influence how individuals process and respond to substances, impacting factors like impulsivity and susceptibility to dependence. For example, some individuals may metabolise alcohol differently due to genetic variations, affecting their risk of alcoholism. However, environmental factors like early trauma, peer group, and availability of substances are equally, if not more, important.

Individual Impacts of Mental Health Problems

Mental health problems can lead to significant distress, impair cognitive functions such as memory and attention, and alter daily behaviour. Individuals may struggle with employment, education, and maintaining social connections. There can be a reduced quality of life and increased risk of physical health issues due to neglect or stress. Self-stigma and public stigma often delay help-seeking, worsening conditions.

Societal Impacts of Mental Health Problems

Society bears substantial costs from mental health problems. These include direct costs for healthcare services (diagnosis, treatment, medication) and indirect costs from lost economic productivity (due to absenteeism, presenteeism, and unemployment). There's also a strain on social services, a potential increase in homelessness, and impacts on community cohesion. Campaigns to reduce stigma are crucial for societal well-being.

Psychological Evidence and Research Methods

Psychological evidence, gathered through various research methods, demonstrates the prevalence and impact of mental health problems. Studies employ surveys to gauge public attitudes towards mental health, correlational designs to identify risk factors, and experimental designs to test the effectiveness of treatments. Qualitative methods, such as interviews, provide rich insights into individual experiences. Ethical considerations like informed consent and confidentiality are paramount in all research.

Classical Conditioning and Addiction

Classical conditioning involves learning by association. An unconditioned stimulus (UCS), like a drug, naturally produces an unconditioned response (UCR), such as pleasure or pain relief. Neutral stimuli (NS), such as particular locations, friends, or drug-related objects, become conditioned stimuli (CS) if they are repeatedly paired with the UCS. Over time, the CS alone can trigger a conditioned response (CR), which might be cravings or withdrawal symptoms, even without the actual drug. This can explain why addicts experience urges in specific environments.

Operant Conditioning and Addiction

Operant conditioning involves learning through consequences. Behaviour is strengthened if it is followed by a reward (reinforcement) and weakened if followed by punishment. In addiction, positive reinforcement occurs when the addictive behaviour (e.g., taking a drug, gambling) leads to desirable outcomes (e.g., euphoria, winning money). Negative reinforcement occurs when the addictive behaviour removes or avoids an unpleasant state (e.g., stopping withdrawal symptoms, reducing stress). Both types of reinforcement increase the likelihood of the behaviour being repeated. The immediate gratification often outweighs potential long-term negative consequences.

Social Learning Theory and Addiction

Social learning theory suggests that individuals can learn addictive behaviours by observing others. This observational learning or modelling occurs when a person watches a role model (e.g., a parent, peer, or celebrity) engage in an addictive behaviour and then imitates it. If the observed behaviour appears to be rewarded (vicarious reinforcement), the observer is more likely to adopt it. This is particularly relevant for the initiation of addiction, especially during adolescence when peer influence is strong.

Evaluation of Learning Theory for Addiction

Strengths include scientific evidence from both human and animal studies supporting conditioning principles. It offers practical applications in therapies like aversion therapy for alcohol addiction, which pairs alcohol with an unpleasant emetic. It is also comprehensive, covering initiation and maintenance through different learning mechanisms. Limitations include its reductionist nature, often overlooking genetic predispositions and individual differences in vulnerability. It may also struggle to fully explain why some individuals become addicted after initial exposure while others do not, and its deterministic view suggests a lack of free will in addiction, which is controversial.