Lecture Twelve Psychopathology, Unipolar Depression, and Schizophrenia

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Published on 16 Oct 2011
School
University of Waterloo
Department
Psychology
Course
PSYCH101
Professor
Lecture 12: Psychopathology and Unipolar Depression
Outline
Intro to Psychopathology
Models of abnormality
Major classifications of mental disorders (DSM)
Unipolar Depression
Diagnosis and symptomology
The Medical Model
Four possible causes
Treatment
The Psychodynamic Model
Causes and treatment
The Cognitive-Behavioural Model
Cognitive mechanisms of depression
Treatments
The Humanistic Model
Client-centred and existential therapies
The Socio-Cultural Model
Group and family therapies
Community psychology
Clinical depression has been called the common cold of psychopathology. It affects at
least 10% of the population at some point in their lives. Schizophrenia however is far
less common, affecting 1.7%.
Models of Abnormality
1. Medical: behaviour is symptomatic of physiological abnormality
2. Psychodynamic: behaviour is symptomatic of unresolved
intrapsychic conflict
3. Behavioural: behaviour is maladaptive responding due to faulty
learning; not symptomatic of underlying pathology; treat the behaviour
itself
4. Cognitive: behaviour is symptomatic of faulty thinking or beliefs
about self and the world
5. Humanistic: behaviour is symptomatic of inability to fulfill human
needs and capabilities
6. Socio-Cultural: behaviour is symptomatic of dysfunctional
environments; such as family, society, or culture
The perspectives do not necessarily contradict each other; rather they seem to
borrow ideas from one another.
The DSM (the diagnostic statistical manual):
oNow in its 4th edition, called DSM-IV
oSought to bring the abnormality models together to agree on
symptomology, and in turn helps to diagnose
oDisorder classifications include:
Disorders first diagnosed in infancy, childhood, and adolescence
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Delirium, dementia, and other cognitive
Substance related
Schizophrenia and other psychotics
Mood disorders
Anxiety disorders
Somatoform disorders
Factitious disorders
Dissociative
Sexual and gender identity
Eating
Sleep
Impulse control
Unipolar Depression
Depressive episodes are common people have bad days, it is inevitable. We
need to ensure that when depression is diagnosed, that it is actually abnormal and
not a random occurrence.
oDiagnostic criteria for major depressive episodes:
At least 5 symptoms must be present within a two week period in
order to deem a person “clinically depressed”. This personality
must be opposite from who you normally are.
Symptoms include:
Depressed most of the day
Diminished interest or pleasure in activities
Significant weight loss/gain when not dieting/decrease or
increase in appetite
Insomnia/hypersomnia
Psychomotor agitation/retardation
Fatigue
Feelings of worthlessness/excessive guilt
Difficulty concentrating
Recurrent thoughts of death and suicide, without a specific
plan/attempts at suicide
Most of these symptoms, such as suicidal tendencies and lack of
motivation, tend to contradict each other. In this example, lack of
motivation stops the patient from committing suicide while
depressed.
The Medical Model
oFour possible causes:
Germ: you can “catch” depression as though it were a virus
Genetics: You inherit a predisposition to the disorder.
i.e.: the 5HTT gene
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Neuro-anatomical: a structural problem with your nervous system
causes you to get the disorder.
Neuro-chemical: neuro-transmitters effected and in turn triggers
the disorder.
oThe Catecholamine Hypothesis:
Includes norepinephrine, epinephrine, and dopamine.
A study was conducted initially to find a cure for the common
cold, where instead they stumbled upon this theory.
This drug increases levels of norepinephrine, and in turn
alleviates the symptoms of depression.
“Tricyclical Antidepressants” treatment of choice
oElevated levels of norepinephrine and serotonin
oSerotonin was believed to be responsible for
suicidal thoughts and norepinephrine for depression
in general.
oThese antidepressants, while they alleviated the
symptoms while on the pills, did not cure
depression.
oT.A’s were found to have a correlation with
dependence and addiction.
SSRI’s (Selective Serotonin Re-uptake Inhibitors):
oScientists found most of the correlation between
amines and depression resided in simply serotonin.
oNow this is usually the first choice of treatment
oInhibits re-uptake of serotonin, thereby increasing
levels without adding
oProzac
oHas fewer side effects and is less addictive than the
T.A’s
oTends to diminish reoccurrence of the disorder
The last resort MAO Inhibitors
oMono-amine oxidate inhibitors
oNot selective, very risky
oSide effects include:
Taken with alcohol, cheese, fish, etc.
often results in death
Psychodynamic Model
oBelieve that it is the result of an unresolved conflict that results in anger
being turned inwards, and thereby leading to depression.
i.e.: Debbie’s Electra Issues patient has to overcome her hatred
towards her mother that she had been internalizing and directing at
herself.
oTreatment lasts 1-2 years (being that of therapy).
oIf left untreated, 50% of clinical episodes heal themselves.
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Document Summary

Clinical depression has been called the common cold of psychopathology. It affects at least 10% of the population at some point in their lives. Schizophrenia however is far less common, affecting 1. 7%. Disorders first diagnosed in infancy, childhood, and adolescence. Unipolar depression: depressive episodes are common people have bad days, it is inevitable. We need to ensure that when depression is diagnosed, that it is actually abnormal and not a random occurrence: diagnostic criteria for major depressive episodes: At least 5 symptoms must be present within a two week period in order to deem a person clinically depressed . This personality must be opposite from who you normally are. Symptoms include: depressed most of the day, diminished interest or pleasure in activities, significant weight loss/gain when not dieting/decrease or increase in appetite. Insomnia/hypersomnia: psychomotor agitation/retardation, fatigue, feelings of worthlessness/excessive guilt, difficulty concentrating, recurrent thoughts of death and suicide, without a specific plan/attempts at suicide.

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