Annotated Bibliography

Long-Term Depression

Krystal Smith

PSY 326 Research Methods

Instructor: Gary Boyles

May 15, 2018

Introduction

Many people are affected by many different types of Mental Health Conditions all over the world. Health issues do not in any way discriminate in terms of race, age and it doesn’t care if you are poor or rich and therefore Mental Health is of no exception. Depression is one of the most known Mental Health Condition which is witnessed to affect about 50% of people. Almost every individual is able to spot someone who is suffering from it. A person can either suffer from chronic depression or long-term depression. People suffering from depression can either have an external-unstable attribution or internal-stable attribution types of styles. As a result of these thinking patterns, these individuals deny themselves the credit of success as they are always seen to blame themselves in case of any failure. An individual may be affected by depression through an inclined personal attribution which is initiated by the individual suffering from social identities. Other studies also indicate that social identities may decrease the chances of symptoms showing. According to Gillard et al (2010), a study was conducted in 2015 about”the self-management of long-term depression; the learning from the patient, a qualitative study”. This study was carried out to determine if self-management together with support services could assist in dealing with long-term depression. The study also targeted on the ways on how individuals suffering from this mental health condition managed it as there was very little known pertaining depression and self-management and how it was effective.

Method

According to Houle et al (2013), the research used had qualitative properties and he described this approach as “descriptive approach”. Through seeking insight, there was a better understanding of the case context which was being studied. By using these qualitative characteristics and since there were no variables manipulated, the only way of getting information was through observing the patients hence the study considered non-experimental. They used data which was previously collected through interviews as well as direct observation of patients in a natural setting. Characteristics of age, ethnicity, gender, and depression, as well as variation sampling, were some of the ways used in recruiting patients who participated. During recruitment which was done after the MINI, the participants were invited for an individual interview. This interview of participants was semi-structured and in-depth. It contained questions on how individuals experienced depression and the self-management ways. For qualitative interviews of the participants, the concerned team employed transcribed verbatim and audio taped interviews. Ethical considerations in the interview process were given high priority:

• Employment of a verbal consent after an initial informed written consent

• Anxiety and distress during the interview process were minimized by the use of skills by the interviewers.

• Participants chose their place of interviews

• Audio recording could be stopped at any time

• The end of the interviews was marked by positive feedback

The researchers associated empathy and experience led to the participants opening up and being honest in recounting their details concerning self-management as they never felt judged for being unusual. This method of participant selection created a stronger connection between the researcher and the participants.

Ethical Aspects

The approval of the study was done by the South Yorkshire Research Ethical committee. All through the study, the participants remained cooperative and were very comfortable as they were conversant with it. Before getting into the study, there were numerous things that the participants were supposed to do. First, the participants were requested to complete a questionnaire which provided information like service use, participants` experience of depression as well as demographics. The questionnaire also requested the participants if they wanted group interview or individual interviews. Participants who opted for the interviews and met the exclusion/inclusion criteria were invited for interviews for verification. Experienced clinicians like psychiatrists, clinical psychologists, and mental health nurse consultants were used in carrying out this diagnostic interview by the use of MINI diagnostic framework which included the criteria for long-term depression.

The inclusion criteria were:

• Structured diagnostic interview to be used to individuals with dysthymia

• Re-currency of the main depressive disorder

The exclusion criteria applied were:

• Individuals with dementia.

• Individuals under the age of 18 years.

• Individuals who could not converse in English.

• Individuals not residing in South Yorkshire.

After all this, a diverse range of participants was obtained through the use of a meaningful and maximum variation sampling. They were chosen to base on the characteristics relevant to the goal of the study so as to explore shared and varied experiences. The sampling characteristics used included; ethnicity, gender, depression, other health conditions and service use.

Results

According to National Collaborating Centre for Mental Health (2010) , the research found the 4 super-ordinate: experienced depression, self-management strategies, the self and the wider environment. These four super-ordinate themes were as follows together with their sub-themes.

Experience of depression

This subordinate described dealing with the experience that the participants had regarding depression and the most important features to them.

Arrays of emotional, cognitive and physical symptoms were reported. The participants also explained how they felt about depression, its effects on their lives as well as its interaction with other conditions of health. This theme comprised:

• Fluctuation and cycles

• Uniqueness and similarities

• Long-term nature

The self

This theme dealt with how aspects of the participants themselves had power in their depression management. The key features were:

• Confidence

• Motivation

• Hope

The wider Environment

The wider environment illustrated how its aspects had an impact on the capacities of the participants regarding their self-management of depression. It included:

• Discrimination and stigma

• Services

• Information

Self-management strategies

This theme focused on the broader aspects regarding self-management that are effective and important to the participants. In the study, each participant chose a personalized strategy which suited his/her needs. Each selection was made up of different activities, strategies, and self-help tools. The self-management strategy comprised:

• Choice and control

• Individuality

• Holistic view

• Developing strategies

On the other hand, the focus group validated information gain from the one on one session. The group analysis gave convergent data with the one for individual interviews. The interim findings were validated by feedback from the participatory workshop (Richards, 2011).

Discussion and Conclusion

From this study, I believe that a great task was done which tried to avoid bias. They made sure that the policy and the procedure were not corrupt and the data/information was right.

Having different interviewers, I believe that the study was strong and the information obtained was not bias and the patients` stories were not confused. Also, the participants were very honest and open because the interviewers were very friendly and close. The study also contributed to a new understanding pertaining longer-term depression and self-management from the patients` perspective (Simco, McCusker and Sewitch, 2014).). Promising findings regarding the recovery approach use for individuals with long-term depression have also been identified. Finally, I believe that a more focused research would be more beneficial.

References

Gillard, S., Betton, V., Green, K., Holt, B., Lucock, M., Miller, S., ... & White, S. (2010). The barriers and facilitators of supporting self care in Mental Health NHS Trusts.

Grieken, R. A., Kirkenier, A. C., Koeter, M. W., Nabitz, U. W., & Schene, A. H. (2015). Patients' perspective on self‐management in the recovery from depression. Health Expectations, 18(5), 1339-1348.

Houle, J., Gascon-Depatie, M., Bélanger-Dumontier, G., & Cardinal, C. (2013). Depression self-management support: a systematic review. Patient education and counseling, 91(3), 271-279.

Marcus, M., Yasamy, M. T., van Ommeren, M., Chisholm, D., & Saxena, S. (2012). Depression: A global public health concern. WHO Department of Mental Health and Substance Abuse, 1, 6-8.

National Collaborating Centre for Mental Health (UK. (2010). Depression: the treatment and management of depression in adults (updated edition). British Psychological Society.

Richards, D. (2011). Prevalence and clinical course of depression: a review. Clinical psychology review, 31(7), 1117-1125.

Simco, R., McCusker, J., & Sewitch, M. (2014). Adherence to self-care interventions for depression or anxiety: A systematic review. Health Education Journal, 73(6), 714-730.