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Part 2- L2.docx

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Gareth Treharne

Part 2- L2 Disorders as aberrant cognition Depression - Features of depression o Affect  Sadness, loneliness emptiness, irritability o Motivation  Loss of interest  Yearning for escape  Paralysis of the will o Cognition  Negative self-conception  Pessimism  Guilt  Negative interpretations of experiences o Behaviour  Reduced activity o Physical  Retarded movement  Fatigue  Weight change, up or down  Appetite, up or down  Sleep, a little or a lot  Libido, up or down - Aetiology (the cause of a disease) o Genetic factors  46% concordance with MZ twins  20% concordance with DZ twins  Genes involved in the synthesis of serotonin from tryptophan and the transmission of serotonin at the synapse  Norepinephrine metabolism  Genes can influence affective of SSRI o Biological  Norepinephrine and serotonin implicated (associated) in cause of depression  Mood is result of interaction between both serotonin and norepinephrine systems  Also dopamine and acetylcholine  Limbic system is major brain area involved in depression o Sociocultural  Poor, ethnic minorities, poor social or marital support, divorce, separation, child abuse, neglect  Combination makes people more prone  Jobless, 11X more likely  Low income 10X more likely  Women – experience more responsibilities and lower life qualities than men.  Men more able to distract selves from depressing event than women - Explanation o Psychodynamic (Freud)  Similar to grieving  Regresses to oral stale as defence mechanism against overwhelming distress  Introjection × Direct their feelings of loved one into themselves × Anger > result of unresolved conflict × Pathological if long term o Behavioural  Operant learning processes  Low rate of positive social reinforcement > low mood  Behaviour results in sympathy and attention × Establish a further reinforcement schedule × Secondary gain- individual is rewarded for their depressive behaviours o Learned helplessness  Individual learns they are unable to control physical/social environment o Cognitive  Result of three key attribution processes × Internal/external  Did the outcome arise as a result of the person or the situation? × Stable/unstable  Will the result happen every time is it changeable or random? × Global/specific  Does the outcome occur in all situations or only in a specific instance? × “It’s my fault, it will always go wrong, and this is just typical life” - Treatment o Biological interventions  Antidepressants × Serotonin level  Tricyclic’s  14% of people will stop using because of side effects  SSRIs  Better than tricylic  56%/ 8% dry mouth  39%/8% constipation  SNRIs  × Monoamine oxidase inhibitors (MAOI)  Improvement of 50% of people o Electroconvulsive therapy × Once weekly gradually to once monthly × 7% of people with ECT and antidepressants compared to 48% receiving only antidepressants relapsed o Psychological interventions × Cognitive therapy × Interpersonal psycho therapy - DSM5 o Symptoms  Depressed mood × Most of the day × Almost daily  Diminished interest or pleasure × Most of the day × Almost daily  Weight loss/gain × Increased/decreased appetite  Psychomotor agitation, retardation  Fatigue, loss of energy  Feelings of worthlessness × Excessive/inappropriate guilt  Diminished ability to think × Indecisiveness  Re-occurring thoughts of death × Suicidal ideation × Suicide attempt o Distressed and impairment o Cannot be due to  Drugs  Bereavement  Psychosis  A medical condition  Mania Psychoanalytic (Freud) theory - Predates behavioural theory - Components of the psyche o Id  driven by the basic instincts of sex and aggression  driven by the basic instincts of sex and aggression  Pleasure principle  Maximise immediate gratification  Greedy, demanding, no self-control o Ego  Realistic component of personality  Reality principle  Maximise gratification BUT within certain constrains o Superego  Moral and societal values  Acts as the conscious  Creates feeling of guilt id social norms are violated - Five stages of psychosexual development o Oral  Gratification through oral means  Sucking, crying, exploring objects with mouth  18-24 months, child only has id o Anal stage  Gratification through anal means  42-48 months old  Toilet training is first time they become aware of their actions  Learns to gain gratification from others  Parental demands= praise o Phallic stage  5-6 years old  Super ego begins to develop  Oedipal complex × Boys > sexual desire for mother > rivalry with father
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