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Chapter 13

Understanding Emotions Chapter 13.doc

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Gerald Chupcik

Understanding Emotions Chapter 13: Emotions and Mental Health in Adulthood Psychiatric Disorders: Symptoms and Prevalence - Some people have periods of extreme emotions: hopeless depression or immobilizing anxiety - Depression or affective disorder: a despair that can be painfully persecuting and drains all meaning from life · Major depressive episode: diagnosed after two weeks; sufferer experiences anhedonia, alongside at least four other symptoms (unable to sleep, slowed actions, lack of energy to do ordinary tasks, inability to concentrate, feelings of worthlessness/guilt, thoughts/plans of suicide) - Anxiety · Overwhelming fears, moods of disabling anxiety, avoidance of fearful stimuli, loss of personal confidence Psychiatric Epidemiology (PE) - PE was slow to be established: it was difficult to agree on criteria for a diagnosis of disorders and because reliable psych assessments had not been developed - Robins and Reiger (1991): depression/anxiety occurs twice as likely in women - Kessler (1994) · Women have a higher prevalence for depression and anxiety · Men have a higher prevalence of a substance abuse disorder, conduct disorder as a child - There is no large gender difference in prevalence of depression/anxiety in children, but the gap grows in adolescence - Cultural factors play a part in emotional disorders: · Higher prevalence in Western countries · Patel et al. found that being poor, having little education and being female were factors in some countries that also had prevalence rates similar to Western countries - WHO (1983) Studied Canada, Japan, Iran, Switzerland: core symptoms included sadness, joylessness, anxiety and lack of energy Different Kinds of Depression and Anxiety - MDD: diagnosed after two weeks; sufferer experiences anhedonia, alongside at least four other symptoms (unable to sleep, slowed actions, lack of energy to do ordinary tasks, inability to concentrate, feelings of worthlessness/guilt, thoughts/plans of suicide) - Minor depression: having 2-4 symptoms - Difference between MDD and BPD: BPD is depression followed/preceded by at least one period of mania · Mania is the disorder of happiness, exhilaration and pride - Anxiety disorders have many forms: · Phobias: irresistible urges to avoid certain places, things or activities o Agoraphobia is most common: fear of leaving home o Not all phobias are debilitating (ie. agoraphobia, social phobia); some are just troublesome (ie. fear of spiders) · Obsessions and compulsions: o Obsessions: repeated actions or rituals. Performing the act temporarily diminishes anxiety o Compulsion: frequently performing a task · PTSD: intense anxiety, traumatic flashbacks, disturbed sleep, avoidance of traumatic stimuli o Brought to attention after the Vietnam War o Brewin et al. define trauma as “anything that radically violates one’s basic assumptions, conscious or unconscious, about the world, especially when the assumptions are overturned by a violent event” o Flashbacks and intense phobias can be explained in terms of two kinds of memory systems: 1. Verbal and subject to the making of meaningful sense of experience 2. Triggered by aspects of situations, external or internal o The traumas are in both memory systems, which are activated, but may not correspond with each other, which adds to intense fear Stress and Diathesis in the Causation of Disorders - The stress-diatheses hypothesis is that a disorder is most typically caused by stress, an adversity in the immediate environment, in the presence of one or more predisposing factors, called diatheses, which are inherent in the person Stresses: Life Events and Difficulties - Brown and Harris (1978) findings: · 89% of women with an onset of depression had a severe life event or difficulty shortly before their breakdown · Women with no disorder: only 30% can suffered a life event or difficulty the year before interview · Severe events: bereavement, marital separation, job loss · Difficulties: long-lasting problems such as a violent spouse, looking after a demanding/chronically ill relative · Brown and Harris developed a Life Events and Difficulties Schedule: checklist of life events and difficulties; used to predict depression · Example of Ms. Trent from the study: her marital issues with her husband were not seen as an event because it could have been caused BY her depression, and not necessarily be the cause OF her depression - Depression is not necessarily irrational: involves sadness, hopelessness, brought on by serious events - Hammen et al: · People who valued their relationships became depressed when a social loss or social disruption occurred - Kendler et al. produced a list of events: · Loss: events such as deaths, losses of means of livelihood · Humiliation: events such as being cheated on/affairs, child delinquency, rape, put-down, public humiliation by loved ones or persons of authority · Entrapment: stuck in an adverse situation with no way out · Danger, a future loss or an event that has yet to realize its full potential - Finlay-Jones (1989): · Interviewed women with depression, anxiety or both or none · Events: future directed, involved danger, diagnosis of cancer, unwanted pregnancy, eviction · Anxiety disorders were triggered by dangers · Depression was triggered by losses Relation between Emotions and Emotional Disorders - Short-term negative moods and emotions are usually caused by events that are setbacks to our projects and concerns - Severe events threaten fundamental life roles - Negative emotions can become long lasting and disabling - Why is anxiety more than normal ‘fear’? · Some people have anxiety based off of fears that have no clear objects · Ohman and Mineka (2001): fear is elicited by appraisals carried out by dedicated neural networks in the amygdala Diatheses Genetic Biases - A high genetic sensitivity of a mechanism that associates certain cues to schemas of danger may explain why some people are generally more fearful that others; independently of whether they experienced something fearful - One way genetic influence on depression could work is in terms of +/- bias of social confidence and dominance, mediated in part by brain mechanisms that use 5HT · Plomin et al examined life events in twins o MZ: more similar to each other than DZ; frequencies in life events were more highly correlated; 20% genetic variance - Caspi et al: identification of a depression-specific gene in humans · Males and females followed for two years; tested for the presence of 5HT transporter gene, which promotes 5HT; assessed for stressful events between ages 21-26 · 5HT transporter gene occurs in two forms: 1. Short form (s) 2. Long form (l): more efficient in promoting 5HT · Results: o (s/l) or (s/s) + adverse life event in their 20s = more likely to become depressed than those with (l/l) + adverse life event in their 20s Previous Episodes of Depression - Brown and Moran (1994): · Those with recurrent episodes: o First episode is caused by the event or difficulty o Subsequent episodes can occur without obvious severe events or difficulty - Segal et al.’s kindling hypothesis: mental patterns becoming established as habits, so that after each episode future activation is made more likely by progressively less stressful events - Two ways to experiencing depression in the absence of a major life stressor; 1. High genetic risk 2. Several previous episodes of depression in a life of substantial adversity Episodes - Women who suffered from neglect or abuse in childhood, are at increased risk for depression and anxiety as adults - Negative emotion schemas of self-in-relationship can increase people’s risk of depression by increasing the chances of circumstances that turn out badly - Whitbeck (1992): parents who are depressed ignore their children. These children lack the care they need and develop difficulties, which makes their parents reject them more - Wainwright and Surtees (2002):asked participants about eight t
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