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Lecture

PSYCH 101 Unit XI Psychopathology

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Department
Psychology
Course
PSYCH 101
Professor
Richard Ennis
Semester
Fall

Description
PSYCH 101  Psychopathology:  Unipolar Depression & Schizophrenia  Part I: Unipolar Depression Introduction to Psychopathology: 1) Models of Abnormality: 1. Medical o Behaviour is symptomatic of physiological abnormality 2. Psychodynamic: o Behaviour is symptomatic of unresolved intrapsychic conflicts 3. Humanistic: o Behaviour is symptomatic of inability to fulfill human needs and capabilities 4. Cognitive: o Behaviour is symptomatic of faulty thinking or beliefs about self and the world 5. Behavioural: o Behaviour is maladaptive responding due to faulty learning, not related to pathology 6. Sociocultural: o Behaviour is symptomatic of dysfunctional environments such as family, society, or culture 2) Classifying Psychological Disorders: • Why do we create classifications of mental illness? o Diagnosis…  creates a verbal shorthand for referring to a list of associated symptoms  allows us to statistically study many similar cases, learning to predict outcomes  guides treatment choices 3) Goals of Therapy: • Cure the disorder • Alleviate symptoms/suffering • Shorten duration of episode • Prevent future episodes Criteria of Major Depressive Disorder: • At least 5 of the following: one or both of the first 2, PLUS 3 or more of the rest. Must be present for at least 2 weeks: o Depressed mood most of the day o Markedly diminished interest or pleasure in activities o Significant increase or decrease in appetite or weight o Insomnia, sleeping too much, or disrupted sleep o Lethargy, or physical agitation o Fatigued or loss of energy nearly every day o Daily problems in thinking, concentrating, and/or making decisions o Recurring thoughts of death and suicide Cognitive Symptoms of Depression: • Along with emotional, somatic (i.e. physical), and motivational symptoms of depression, we also have what is known as the cognitive triad o The cognitive triad refers to negative cognitions about self, world, and the future o Depressed people will often intrinsically link the past, present, and future as being negative all together Depression: How common is it? • Depression appears worldwide: o Per year, depressive episodes happen to 6% of men and about 9% of women • Over the course of a lifetime, 12% of Canadians and 17% of Americans experience depression Depression Patterns: • Women are more likely (2X) than men to be depressed, however, this can be misleading o Women are also more likely to report cases of depression, whereas men are not and therefore they do not enter the statistic • There are 3 patterns of depression: Depression recurring (50%), Depression not recurring after recovery (40%), and Chronic Depression with no recovery (10%) • 50% of cases: depression will recur and the episode gets longer and the time between gets shorter  closer and closer to becoming chronic • 40% of cases: depression will never occur again after recovery • 10% of cases: the first onset of the depressive episode causes the person to never recover The Medical Model of Psychology: • Attempts to see mental disorders as an illness • Illnesses are generally caused by: o Infection  When it comes to psychological disorders, infection is generally not considered since a mental illness is not “infectious” o Genetics o Neurostructural o Neurochemical • Biology of Depression: Genetics o There is evidence that genetics can influence depression o DNA linkage analysis reveals depressed gene regions as well as studies involving genes/adoption heritability o The 5-HTT Gene:  Serotonin-transporter gene that instructs the production of a molecule that moves serotonin out of the synapse  A mutation of the gene causes it to increase production of the molecule • Overproduction of the molecule means that serotonin is moved out too quickly  Though the strange thing is, the mutation is more common than depression • This means that lots of people have the mutation for these gene, but not all of them are depressed • Thus, while it is possible to be genetically predisposed to depression, the depression must still be triggered somehow (probably psychologically) in order for it to occur • Neurochemistry of Depression: o Biogenic means that it has a role in affect and motivation o Norepinephrine:  Too low = associated with depression  Treated with tricyclic antidepressants to increase norepinephrine in order to treat depression, but it was found to increase suicidal thoughts o Serotonin:  Too low = associated with suicidal thoughts  Treated with SSRIs (Selective Serotonin Reuptake Inhibitors) like Prozac to keep serotonin in the system; had good effects in alleviating suicide and depression o MAO inhibitors:  inhibits an enzyme that breaks down biogenic amines, and is not selective  Dangerously hypertensive side-effects from foods with tyramine (e.g. fish, cheese, poultry, pork, beans, etc.) • Electroconvulsive Therapy (ECT): o ECT induces a mild seizure that disrupts severe depression for some people o Allows neural re-wiring and might boost neurogenesis Psychoanalysis: • Refers to a set of techniques for releasing the tension of repressed and unresolved inner conflicts • Freud found that unusual symptoms of patients sometimes improved when repressed inner conflicts and feelings were brought to conscious awareness • Techniques: o Free association:  Patient speaks freely about inner conflicts o Interpretation:  Therapist suggests unconscious meanings and underlying wishes to help the client gain insight and release tension • Psychoanalysis was actually a very good style of preventing the recurrence of depression, but fell out of popularity b/c the therapy was lengthy and cost a lot of money Humanistic Therapies: • Humanistic psychology emphasizes the human potential for growth, self-actualization, and personal fulfillment • Therefore its therapeutic techniques attempt to support personal growth by helping people gain self-awareness and self-acceptance o It is a “client-centered therapy” • Assumes that the person is intelligent, verbal, and interested enough to explore their own self • The therapist attempts to analyze the patient’s self-image versus the image of the self they want to be, and the goal is to resolve that discrepancy o Client-centered therapy places the role of the therapist as being a guide, not an autocratic force • Client-centered therapist: o Non-directive  Let insight and goals come from client, rather than dictating interpretation o Genuine  Be truthful and do not put on a therapist façade o Accepting and showing unconditional positive regard  Help the client learn to accept themselves despite any weaknesses o Empathetic  Demonstrate careful attention to the client’s feelings, partly by reflecting what you hear the client saying (active listening) • Summarize and rephrase • Invite clarification and elaboration • Reflect on feelings Humanistic vs. Psychoanalytic Therapy: Humanistic Psychotherapy Psychoanalytic Psychotherapy Goal Promote growth Cure mental illness How to Improve Take responsibility for feelings Bring unconscious conflicts and action into conscious awareness Role of Therapist Provide an environment in Provide interpretations which growth can occur Content of Therapy
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