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Psychology 1000 - March 13.docx

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Psychology 1000
Laura Fazakas- De Hoog

Psychology 1000 Thursday March 13 Lecture 9 Chapter 16 - Disorders Announcements • Exam grades will be emailed after the makeup exam • Assignment grades will be posted on OWL after they are graded • Research credits are due to be completed the last day of class Practice Exam Question: According to Freud’s theory of psychosexual development, during which stage did the “Oedipal complex” occur? a) Oral stage b) Anal stage c) Phallic stage d) Latency stage e) Genital stage Answer: C – Phallic stage Practice Exam Question: According to Eysenck, individuals who are ____________ tend to have a nervous system that is chronically over-aroused. a) psychotic b) emotionally stable c) extroverted d) introverted e) agreeable Answer: D – introverted Outline: (continued in next class) I. Mood Disorders a. Typology II. Anxiety Disorders a. Phobias b. Panic Disorder c. Obsessive Compulsive Disorder d. Post-Traumatic Stress Disorder III. Psychotic Disorders IV. Somatoform Disorders a. Conversion Disorder & Hypochondriasis V. Dissociative Disorders What is Abnormal Behaviour? • All behaviour is on a continuum • Conceptual Definitions o There is a statistical deviation where abnormal = infrequent o This is a deviation from ideal mental health o We need to take into account cultural norms when defining “ideal mental health”  Not all behaviour that is infrequent is abnormal  eg. an Olympic athlete is not frequent, but it is not abnormal • Practical Definitions o The 3 D’s of Abnormality:  Distressing  Deviance (bizarre or unusual behaviour)  Dysfunction (an ability or loss of efficiency in performing duties/responsibilities) • Surgeon General & DSM-IV: o “A clinically significant behavioural or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (eg. a painful symptom) or disability (ie. impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom Diagnosing Psychological Disorders • Multi-axial Approach I. Clinical Disorders II. Personality Disorders III. General Medical Conditions IV. Psychosocial & Environmental Problems V. Level of Current Functioning (ranges from 0 – 100% perfect functioning) • Diagnosis of a disorder requires: 1. Sufficient symptoms 2. Cause distress 3. Causes impairment in functioning • Psychology Student’s Syndrome o Many psych students find that the various disorders apply to them o Abnormal behaviour is not qualitatively different from “normal” behaviour o Many of us will exhibit similar symptoms o Behaviours are only problematic when they harm or interfere with functioning o Diagnosing friends and romantic partners may lead to conflict Disorders of Childhood • Many disorders are first diagnosed in childhood • Studies of children aged 2-5 and 9-17 found that 20% had symptoms of a disorder (1/2 were very impaired) • Only 40% of children’s mental health issues were treated compared to 75% of children’s physical health symptoms • ADHD (Attention Deficit Hyperactivity Disorder) o 7-10% of children in most countries o Boys were 4 times more likely than girls to have it o Boys more often have a behavioural component o Girls are more often the inattentive type o The causes are unknown  There is some genetic component (identical twins have a higher concordance) 1. Mood Disorders • Mood Disorders: Characterized by emotional disturbances that disrupt physical, perceptual, social and thought processes • Types of Mood Disorders: o Major Depressive Disorder o Dysthymic Disorder o Mania o Bipolar Disorder o Cyclothymia • Prevalence of Mood Disorders: o Depression is one of the most common disorders (12% in females, 6% in males) o Bipolar disorder is less prevalent and slightly higher in males than females Depression • Prevalence: o 1 in 5 adults will experience severe enough depression in their lifetime to require treatment • Emotional Symptoms: o Depressed or dysphoric mood o Anhedonia (loss of pleasure) • Physical Symptoms: o Somatic complaints (headaches, stomach pain, muscular pain) o Motor retardation (immobility) o Sleep disturbances o Weight loss or gain (appetite disturbances) • Cognitive Symptoms: o Distorted thinking:  All or Nothing Thinking • eg. If I don’t get an A on this test, I’m a complete failure  Overgeneralization • eg. I messed up this relationship, so I’ll never have a good relationship  Catastrophizing • eg. Thinking everything is the very worst case scenario  Negative Mental Filter • eg. I’ll never be successful at school, no matter what I do  Disqualify the Positive o Pessimistic, self-critical thinking can also lead to thoughts of suicide o A sense of guilt or worthlessness o Difficulty concentrating o Indecisiveness • DSM IV Criteria: o You need 5 or more of certain symptoms over a 2-week period including:  Recurrent thoughts of death or suicide  Difficulty concentrating  Feelings of worthlessness • Psychotic Symptoms: o Seen in the most severely depressed individuals  Delusions  Hallucinations o Relationship to Depression:  Mood Congruent: Symptoms are consistent with the person’s depressed thinking • eg. “I will be punished for my sins”  Mood Incongruent: Symptoms that inconsistent with the person’s depressed thinking • eg. delusions of grandeur • Course of Major Depressive Disorder: o Average duration of depression (untreated) is 8-10 months  It is usually shorter with treatment o It is a cyclical disorder (people usually have more than one episode in their life)  The median is 4 episodes o Stress often triggers an episode o The onset is any age (most typical during the mid 20’s) • Variants: o Dysthymic Disorder  Symptoms are less severe  More chronic form of depression (longer lasting) o Double Depression  Person suffers Dysthymia and Unipolar Depression  Dysthymia develops first  Major depressive episode occurs later Mania • Prevalence: o Less than 1% of the population o About 10-20% of those who suffer from a depressive episode develop bipolar disorder o There are gender differences  Women tend to have a depressive episode first, and men are more likely to have a manic episode first • Emotional Symptoms: o Inflated self-esteem o Elation or irritation • Physical Symptoms: o Decreased need for sleep • Cognitive Symptoms: o Distractible o Goal directed behaviour • DSM-IV: o The person has to have 4 or more of the symptoms that last at least a week:  Increased need for sleep  Increase in goal-directed activity  Distractible o If it is severe enough that the person is hospitalized, it doesn’t need to last a full week The Moods: Mania vs. Depression Mania Depression Extremely high or agitated A low, miserable, unhappy mood mood Person feel excessively and Feelings of worthlessness unrealistically positive and pessimism Feelings of elation and a Inability to experience strong sense of pleasure pleasure Hyperactive Altered sleep and appetite Grandiose ideas Bipolar Disorder • Characterized by: o Periods of depression alternating with mania o Bipolar I – Mania, but not always depression o Bipolar II – must have major depressive episode o It is also possible to have:  Mixed episodes  Rapid cycling (4 or more cycles of mania and depression within a given year) • Variants: o Hypomania (a lower form of mania) o Cyclothymia (hypomania and dysthymia cycling together)  Must last for 2 years in adults, 1 year in children Video: TVO • Bipolar disorder is a genetic disorder • *It is possible to treat • Many times people don’t realize when an individual has bipolar disorder (sometimes it’s not noticeable) • Being manic is more than just being hyper – there are mood swings and the mania is the elevation • People often don’t want to get treatment because they don’t want other people to know (especially if you’re in a high position), they don’t want to be relegated to a lifetime of taking drugs • Euphoric mania can be somewhat addictive o You have unlimited energy, you find everything fascinating, there is no uncertainty (you know the ‘secrets of the universe’) • There are a lot of successful people who have bipolar disorder Bipolar vs. Depression Bipolar Depression Gender Gender equality Twice as many women who have depression Age Similar onset Similar onset SES High SES (we are Equal opportunity (all not sure why) social classes) Stress Less is known about Stress triggers and the relationship worsens the symptoms • Biological Factors: o Genetic Factors - Twin studies  Depression • Identical – 67% concordance rate • Fraternal – 15%  Bipolar • Identical – 70% • Fraternal – 50%  *Bipolar disorder has a higher genetic contribution than depression does o Depression  Neurochemical Factors: • With depression there are low levels of serotonin and norepinephrine • Antidepressants increase serotonin levels = increased pleasure/motivation  PET Findings: Decreased metabolic activity in the frontal lobe of the cerebral cortex o Mania  There are high levels of serotonin and norepinephrine (the opposite of depression)  Lithium leads to less neural activity = less manic behaviour  *Antidepressants can
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