PSYC18 Psychology of Emotion
Chapter 13 – Emotions and Mental Health in Adulthood
Psychiatric Disorders: symptoms & prevalence:
Depression and Anxiety are referred to as Emotional Disorders when they reach states to point where
person cannot do ordinary things anymore.
Both are most common non-psychotic psychiatric disorders.
Depression intense sadness/despair that persecutes/drains all meaning of from life.
Principle emotional component ↓pleasurable foal achievement
Major Depressive Episode (MDE)
- ≥ 2 weeks of unbearable sadness/loss in pleasure, and...
- ≥ 4 other symptoms from: unable to sleep, slowed actions, lack E, lack concentration,
worthlessness, or suicide ideation.
Anxiety overwhelming fear + avoidance of what is feared. MDE usually suffered after nervous
Advances most important in improving health were the epidemiological discoveries of how people
caught infectious diseases i.e. to introduce preventative measures (e.g. clean water).
Prevalence – %people suffering from diagnosed disorder.
Epidemiological Evidence – always correlational
Discovery of preventative measures are also more valuable in psychiatry than medications.
Slow to develop due to difficultly in diagnostic criteria.
Depression – most important chronic condition in middle years of life (economic impact, impairment)
Women have higher prevalence of:
≥ 1 MDE in lifetime (21% vs. 13% of men).
Anxiety Disorder (30.5% vs. 19% of men).
Men have higher prevalence of:
Alcohol/drug abuse (35% vs. half of that for women).
Antisocial PD (6% vs. 1% of women).
Gender Differences have larger role in the prevalence of disorders than of emotions.
E.g. boys more likely to have ED; girls more likely to have ID.
Lower Income results in ↑prevalence for any psychiatric disorder.
Cultural Factors play important role in emotional disorders.
Western countries have higher prevalence of depression
Some symptoms (e.g. insomnia, ↓E, ↓concentration, suicidal thoughts) are common to all
countries, while others are not (e.g. ↓appetite, worthlessness/guilt).
Different kinds of depression & anxiety
MDE is most usual form of depression.
Minor depression 2-4 aforementioned symptoms; 10% population. Bipolar Disorder (Manic-Depressive Disorder) depression preceded/followed by ≥ 1 period of mania.
Relative rare (1% prevalence). Heritability = 80% (higher than MDE).
Panic Disorder panic attacks with dread/terror – ↑HR/BP/dizziness/resp. rate.
Phobias urge to avoid places/thing/activities
Agoraphobia – fear/avoidance of being away from home, especially places where they cannot leave
without embarrassment. Can be treated successfully with CBT.
Social Phobia – fear/avoidance of social interaction; prevalence of 13%, more common than agorap.
General Anxiety Disorder (GAD) – ≥ 6 months persistent anxiety/worry; prevalence of 5.1%.
Obsessions are intrusive anxious repetitive irrational thoughts that cannot be stopped
Compulsions are repeated actions/rituals that are performed to diminish anxiety
PTSD intense anxiety/disturbed sleep/flashbacks of traumatic event, with avoidance of anything that
reminds one of it.
Trauma – anything that radically violates someone’s basic assumptions about the world.
Explained by 2 memory systems:
1. Verbal – subject to making meaningful sense of experience
2. Automatic – triggered by aspects of situation
Traumas are represented in memory in both ways, which are repeatedly activated, but do not
necessarily correspond to each other.
Kraepelin’s Textbook of Psychiatry 13 categories; DSM originates from it.
Stress & diathesis in the causation of disorders:
Hypothesis Disorder is most typically caused by stress (adversity in immediate environment – e.g.
death, separation), in the presence of ≥ 1 diatheses (predisposing factors – e.g. genetic/experience in
Many emotional disorders would not happen if a stress did not occur.
Stresses – life events & difficulties:
89% of women with onset of depression (8% of women) had a severe life event/difficulty before it.
Severe events bereavement, separation, & job loss.
Difficulties violent husband or looking after demanding/chronically sick relative.
The Life Events & Difficulties Interview Schedule was developed that was more accurate than checklists.
Asks about 40 areas of life – each stressful event/difficult is written up, with date of recording.
Then rated by research team for degree of long term threat.
Patients suffering depression were 3X more likely to have suffered negative/uncontrollable event.
- Depression is not necessarily irrational; it involves sadness/hopelessness brought on by events
Loss of a role that is highly valued event that most typically causes depression.
Those that value social relationships become depressed when social loss/disruption occurred
- Related to social motivations of attachment and affiliation. Thos that value autonomy & work most likely become depressed with failure in achievement
- Related to social motivations of assertion
In general, these events cause strong negative emotions:
Loss, humiliation, entrapment, and danger (future directed).
Can cause 3X↑ in episodes of anxiety.
Anxiety Disorders most precipitated by danger events.
Depressive Disorders most precipitated by loss events.
Those suffering both typically experience events involving both loss and danger.
Most emotional disorders are responses to events/circumstances.
Relation between emotions and emotional disorders:
Severe life events elicit depression & anxiety is similar to how Lesser events elicit negative emotions.
Short-term negative emotions/moods generally caused by setbacks to projects/concerns
Emotional Disorders generally caused by severe events that threaten fundamental roles, and we
cannot deal with them negative emotions become long-lasting, & disabling.
Same brain regions involved in sadness & depression.
Anxiety disorders involve fear – fear elicited by appraisals from dedicated neural networks that involve
the amygdala overwhelming/disabling since impermeable to upper levels of cognition.
Diathesis: vulnerability factors:
The difference between responding to serious adversity with a negative emotion versus a disabling
Emotional Disorders (as well as emotional patterns) are genetically influenced.
Depression: MZ (29%) show higher concordance rates than DZ twins (15%) moderate genetic risk.
Anxiety Disorder genetic influence also exists.
Genetic Influence on personality (e.g. impulsivity) may affect (↑) occurrence of life events.
I.e. more prone to bring environmental effects upon themselves.
- E.g. forming more problematic relationships.
5-HTT transporter gene
Has two isoforms short (s) and long (l) – long is more efficient at expressing serotonin
(s/s) genotype who suffers a adverse life event is most likely to become depressed
- (s/l) more likely than (l/l) to become depressed.
Low serotonin production is a vulnerability factor for the impact of life event stress of depression.
- Presence of s allele had no influence on depression in the absence of stressful life events.
Previous episodes of depression
Subsequent depression episodes can occur without obvious severe life event/difficulty.
Previous episode of depression m