Sunday, July 28, 2019

It's all in your body, mind or soul: causal attributions for depression

Given how depression can manifest in different ways, and the multiple methods of intervention from talk therapy to pharmacological to lifestyle change to ECT, it is hardly surprising that people hold mixed opinions on where depression "comes from", and what the best choices are for help-seeking and therapeutic intervention.

A cool new study employed an online survey platform to run an experimental study of how different vignettes emphasising different causal attributions for depression might affect attitudes towards intervention, both in terms of help-seeking and treatment options. Although lifestyle interventions or psychotherapeutic treatment were generally preferred to medical intervention, a vignette that emphasised biological attributions (compared to social or biopsychosocial attributions) for depression reduced the perceived efficacy of less biological treatments

The results suggest that encouraging a less Cartesian, body OR mind understanding of the etiology of depression might affect attitudes towards different intervention modalities. Such an approach may help to overcome ethical concerns the authors raise of "manipulating" patient's attitudes/causal attributions towards major depression. Of course, it can be easier to say this than it is to achieve it, when it is so easy to lapse into traps such as, for example, using phrases like "medical treatment" to mean pharmacological treatment, even though many physicians prescribe things like exercise or going to a therapist for cognitive behavioural therapy.  

Interestingly, a clear majority of respondents to the online survey reported a history of major depression. Those with a personal history tended to rate a more medical approach to treatment more highly than people with no personal history of depression. Having a high proportion of respondents with a personal history of depression is not unusual or surprising, particularly as the study was advertised as examining treatment preferences for depression. It might nonetheless be interesting to see whether one would observe similar results in a large cohort of more clearly "naive" respondents (e.g. with no personal history of depression or history of depression in family/close friends, and who report no training/particular interest in major depression).

Nolan, A. & O'Connor, C. (2019). The Effect of Causal Attributions for Depression on Help-Seeking and Treatment Preferences. Journal of Affective Disorders, 257, 477-485.

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Saturday, July 20, 2019

Revisiting Recall

In a recent Irish Times obituary for actor Karl Shiels, Peter Crawley recalls "...he once played a role in the Gate Theatre, and a role in the Abbey Theatre, on the same damn night, dashing down O’Connell Street to make his entrance" 

Many people's autobiographies contain a wealth of these tidbits alongside the broader changes in life. I think one of the best things to come out of the reminiscence project I was working on with Richard Roche, Caoilainn Doyle and others was the archive we created of participant's memories. Some of my personal favourites include:

Teaching in Nigeria in the 1960's: This one captures a formative time near the start of a young woman's career-the other people in the group were keen to hear of her experiences in Africa.

Early morning weddings and the mail train: A reminiscence that wryly captures the difference between experience in the moment and hindsight, and subtly tells of major changes in Irish society.

Emigration to UK and USA: A familiar experience to many Irish people; this individual emigrated to different countries at different phases in life.

Nuclear war fear: A moment in history from a child's eye view-captures the anxiety of the time, but still packs a laugh-out-loud moment near the end.

Mining in Connacht in the 1950's: Memories of a father's working in the mines, an accident at work and its aftermath.

These are just a handful of selections from the collection. Although material on the internet can disappear over time if it's not maintained, as this archive is on the Digital Repository of Ireland, these recordings will be preserved for posterity. People wishing to make use of this archive for social sciences/humanities research are free to do so-just get in touch!  

Related articles: 

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