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Chapter 13

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University of Toronto Scarborough
G Cupchik

Chapter 13 Emotions and Mental Health in Adulthood Psychiatric disorders: symptoms and prevalence - Depression, sometimes called affective disorder, is intense sadness: a despair that can be painfully persecuting and drains all meaning from life. Most frequently diagnosed in relation to criteria in the American Psychiatric Associations (2000) DSM-IV-TR - Anxiety disorders: come in several forms, all of which involve overwhelming fears together with more protracted moods of disabling anxiety - Psychiatric epidemiology o Psychiatric epidemiology: the statistical study of how frequently disorders occur o Just like in physical health, in psychiatry, the discovery of drugs for disorders has been important, but more important will be prevention o It was slow to take place because it was difficult to agree on criteria for diagnosis of disorders and reliable psychological assessments had not been developed o Some striking findings: Robins and Regier (1991) depression and anxiety states were nearly twice as common in women as in men o Depression is recognized by WHO as single most important chronic condition in the middle years of life o Prevalences: percentage of people suffering from a diagnosed disorder over a specific time o Men have a higher prevalence for disorder of alcohol or drug abuse or dependence as well as antisocial personality disorder o Gender differences are large in prevalence of disorders, which continue trends seen in childhood o There are differences in prevalence as a function of income: people who had few material resources more frequently had a disorder o Cultural factors play an important part in emotional disorders o Tsai and Chentsova-Dutton (2002) found that the prevalence of depression in Western countries is far higher in Eastern countries such as Taiwan and Korea o WHO (1983) studied depression in Switzerland, Canada, Japan and Iran covering a core cluster of symptoms: sadness, joylessness, anxiety and lack of energy. Other symptoms varied in frequency: 57% of patients in Iran reported bodily symptoms compared to 27% in Canada. Other symptoms such as poor appetite and feelings of worthless or guilt were not common to all countries o Evidence is all correlational - Different kinds of depression and anxiety Chapter 13 Emotions and Mental Health in Adulthood o Most usual form of depression is the depressive episode (at least two weeks of either depressed mood or lack of pleasure in daily activities + 4 or more symptoms (Minor would be 2 4 symptoms) o Distinction between major depressive episodes and bi-polar disorder (manic depressive disorder) where depression is preceded or followed by at least one period of mania o Mania is disorder of happiness, exhilaration and pride. Self-esteem is inflated and sometimes become grandiose. (Hypomania is milder form). Usually after mania, a plunge into depression o Anxiety disorders take several forms: unexpected panic attacks with sudden terror or dread with bodily symptoms such as racing heart, dizziness, shortness of breath. People have no idea why it occurs. Anxiety disorders include also phobias (irresistible urges to avoid certain places, things, or activities) o One of the most disabling of such disorders is agoraphobia: fear and avoidance of being away from home. Some agoraphobics fear mainly being in places which they cannot leave without embarrassment. Their area of safety becomes smaller and smaller, often lose all social confidence and isolate themselves. Can be treated but tend to remain anxious people. o Other phobias are mainly troubling rather than disabling (spider, flying, etc.) o A phobia of social interaction (social phobia) can be severely disabling o Second group of anxiety disorders is of obsessions and compulsions. Obsessions are intrusive anxious thoughts such as those of being contaminated by germs. Thoughts occur repeatedly and the person cannot stop them even if they know it is irrational. It is possible that the disorder is a defect in emotional knowledge that a security-motivated action has been completed. o Anxiety disorders include post-traumatic stress disorder which involves intense anxiety, disturbed sleep, flashbacks in which traumatic event is remembered and repeated re-experienced, as well as avoiding the memory of it. Traumas such as war, natural/industrial disasters, criminal assaults (rape) can invoke this disorder. o Trauma: anything that radically violates ones basic assumptions, conscious or unconscious about the world, overturned by violence. o Brewin et al. conclude that the chaotic nature of post-traumatic flashbacks and intense phobic anxiety can be explained in terms of two kinds of memory systems: One that is verbal and subject to the making of meaningful sense of experience Automatically triggered by aspects of situations, external or internal o Historical Landmark: Kraepelins textbook of psychiatryChapter 13 Emotions and Mental Health in Adulthood Psychiatry is the branch of medicine that deals with psychological illnesses Two classifications that attracted attention: manic-depressive psychosis and dementia praecox (which came to be called schizophrenia) In both types of psychoses: patient is deluded Stress and diathesis in the causation of disorders - Stress-diathesis hypothesis: that a disorder is most typically caused by a stress an adversity in the immediate environment, in the presence of one or more predisposing factors, called diatheses (e.g. death of loved one) - Many emotional disorders would not happen if a stress did not occur - Stresses: Life events and difficulties o George Brown and Tirril Harris: found that 89% of women with an onset of depression had a severe life event or difficulty shortly before their breakdown. Developed new method that gave stronger predictions than previously: included Life Events and Difficulties Schedule checklist. o Mrs Trents story about her husband losing her job and her feeling stressed o Shrout (1989) found that clinic patients s
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