PSY210 Exam 1

2013: DSM-5

"Mental Retardation" is now called Intellectual Disability Autism Spectrum Disorder is now more encompassing ADHD: symptoms must be present before age 12 (previously, age 7)

Public Health Significance of Neuroticism Describe the connection between longevity and neuroticism in the general population.

--N significantly predicts longevity in the general population. As N goes up, there's a significant mortality from cardiovascular disease when sex, age, SES, smoking, alcohol, exercise, and initial health are controlled.--Another study: N predicted death from any cause. --About whether N predicts mortality in sick people, the results are more mixed. One study found that in 65-to 100-year-olds with frail health, N wasn't predictive. But in other studies N has-predicted morbidity and mortality in individuals with chronic diseases and cancer. In one cancer study, cancer patients high on N were more likely to die than those low on N.

Public Health Significance of NeuroticismWhat are "shared environmental influences" and "non-shared environmental influences?" Do they influence neuroticism?

--Shared environments are common to members of a family and make them more similar on a trait. --Non shared environments are not experienced by all members of a family (e.g. an automobile accident involving only one sibling) and make members of a family less similar. --Estimates of the magnitude of shared environmental influences on neuroticism from several large twin studies are essentially zero, but there appear to be substantial non-shared environmental influences on neuroticism. --It would be a mistake to conclude that only non-shared environments influence neuroticism, however. It is possible that environments that siblings share, such as the stress of living in poverty, strongly influence neuroticism, but their causal influences do not appear in estimates of shared environmental influences in twin studies... --At this time, very little is known about specific shared and non shared experiences that influence N.

Public Health Significance of Neuroticism What's the problem with retrospective investigations of parenting and neuroticism?

--There are no prospective studies of parenting and a child's later N, so far. Retrospective studies can help with hypothesis generation, but they are subject to serious recall bias.

Results: Prevalence of DSM Dx Germany, Spain, Mexico, Israel:

10-12%

When did the "lunatic asylum" movement start in Europe?

15th-16th century

Results: Prevalence of DSM Dx Ukraine, Colombia:

18-21%

Results: Prevalence of DSM Dx U.S.:

26%

Results: Prevalence of DSM Dx Nigeria, Shanghai:

4-5%

Extraversion

A personality dimension describing someone who is sociable, gregarious, and assertive

Agreeableness

A personality dimension that describes someone who is good-natured, cooperative, and trusting

Which of the following is TRUE?

According to the article you read, a gender difference in depression appears to emerge later for African Americans and Latino teens that it does for European American samples.

Gender Differences in Depression When does the gender difference in depression seem to emerge? What is known about whether any such difference holds for ethnic minorities in the U.S.?

At about age 12 or 13 years, however. The emergence of a gender difference in depression in African Americans and Latinos occurs at later developmental period.

Teens from affluent neighborhoods demonstrate disproportionately high rates of:

CMD Substance abuse Eating disorders

Childhood IQ and Adult Mental Disorders What variables were considered "confounders" in this study? (These are the variables that researchers thought might have been underlying both childhood IQ and adult mental disorders, so their effects are statistically removed.)

Childhood socioeconomic status, number of perinatal insults, low birth weight, and childhood maltreatment.

50-64% of people with serious MI were getting tx

Developed countries

15-20% of serious cases were getting any type of tx

Developing countries

DSM: Cons( to name a few)

Diagnoses stigmatize DSM may pathologize normal behavior

Resilience in Sri Lanka Describe Dr. Fernando's observations after the tsunami in Sri Lanka. Why was she so concerned about Western traumatologists going there to offer counseling?

Fernando watched with increasing unease as scores of Western psychologist, counselors, and PTSD researchers arrived in the disaster zone. Fernando worried that the PTSD symptom checklists did not reflect the culturally particular ways that Sri Lankans experienced psychological suffering after trauma. She worried that by using these checklists mental health professionals from Western countries would be ineffective--or even do harm--unless they understood that Sri Lankans had culturally distant reactions to traumatic events as well as culturally specific modes of healing. Without a deep understanding of the illness, in other words, it would be impossible to treat the disease.

Childhood IQ and Adult Mental Disorders In the Conclusions section, the authors state that how cognitive reserve might be related to adult mental disorders is not well understood, and they suggest some explanations. What are they?

First, lower childhood IQ may be a marker of neuroanatomical deficits that increase vulnerability to certain mental disorders. Second, lower childhood IQ may be associated with adult psychiatric disorders through psychosocial stress. Third, the association between childhood IQ and adult psychiatric disorders may be mediated by mental health knowledge. The fourth possibility is that IQ has a little casual effect on mental health but that, rather, lower IQ is an antecedent to certain mental disorders because it shares some common etiology with them.

1968: DSM II published

Homosexuality declassified as a disorder, "Sexual Orientation Disturbance" remained until 1987 (DSM-III-R)

Childhood IQ and Adult Mental Disorders What is meant by "cognitive reserve?"

Individual differences in brain structure (e.g., density or neuronal synapses) and function (e.g., processing efficiency) though to buffer the effects of neuropathology.

Poverty and Common Mental Disorders in Developing Countries What are the aspects of poverty, described in the article, that are related to risk for mental disorders? Explain why they might be related, too. For example, what is it about social change, gender, etc. that might put people at risk?

Insecurity: poor people stress the anxiety and fear they experience because they feel insecure and vulnerable when their conditions worsen Hopelessness: the psychological impact of living in poverty is mediated by shame, stigma and the humiliation of poverty Social change: epidemiological investigations in many developing countries have attributed the high rates of common mental disorders to factors such as discrimination, unemployment and living through a period of rapid and unpredictable social change Education: higher levels of education may reflect optimal brain development in childhood, which in turn protects from pathological processes that lead to cognitive impairment (or in the case of this review, common mental disorders) in later life Gender: in many developing societies, women bear the brunt of the adversities associated with poverty: less access to school, physical abuse from husbands, forced marriages, sexual trafficking, fewer job opportunities and, in some societies, limitation of their participation in activities outside the home Comorbidity: Poverty is likely to be associated with malnutrition, lack of access to clean water, living in polluted environments, inadequate housing, frequent accidents and other risk factors associated with poor physical health. There is evidence demonstrating the comorbidity between physical illness and common mental disorders, and this association may partly account for the association between poverty and mental disorders.

Childhood IQ and Adult Mental Disorders What is the primary research question in this study? How is this study different in comparison to previous studies that have tried to answer it?

Is lower childhood IQ associated with adult mental disorders? It is longitudinal and prospective.

In the U.S., Dorothea Dix and others lobbied for moral treatment. What went wrong?

It didn't work due to a lack of resources

Resilience in Sri Lanka What's your reaction to what the mother said to the little boy on page 92?

It made me sad.

Dutch physician that coined the term "mental illness"

Johann Weyer

Theory 2: Downward drift:

MI precedes the "drift" into lower SES

Which of the following best illustrates downward drift?

Madeline experiences symptoms of a mental illness, which leads to a series of job losses and a significant drop in income.

Gender Differences in Depression Why might physical and sexual traumas be linked to depression for some people?

Most sexual assaults agains women occur first during hcildhood and adolescence.

Poverty and Common Mental Disorders in Developing Countries What is the gist, or the big picture point(s) of this article?

Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experienced of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders.

Public Health Significance of Neuroticism How might neuroticism be linked to mental disorders? To physical disorders?

N and links to mental disorders: --Genetics: N and mental illness might be linked through overlapping genetics (N and MI could be influenced by the same genes) --Stress: High N folks might live their lives in ways that increase the likelihood of stressful events. For example: N scores of both partners measured before marriage predict future separation or divorce (and divorce predicts mental health problems, substance abuse, and mortality). Another example: N might influence the initiation and maintenance of supportive social relationships(and greater social support is associated with shorter episodes of depression in prospective studies). --Emotional Reactivity: People higher on N respond to negative events with negative emotions more frequently and intensely. They also use fewer problem-focused and more emotion-focused strategies to cope with stress. So it is possible that they cope less well and experience more intense reactions when stress comes, making them more vulnerable to having mental disorders. N and links to physical health problems: --Similar to mental disorders, N might be linked to physical disorders through overlapping genes, experiencing more stress, or experiencing less social support. --In addition, there are two other specific causal mechanisms hypothesized, that may not be involved in mental health problems: 1. higher N might be associated with greater sympathetic arousal and HPA (hypothalamic-pituitary-adrenal) reactivity and therefore with greater alterations of the immune system in response to stressful events. 2. higher N might lead to behaviors that increase the risk for health problems (e.g. smoking, drinking, unprotected sex, and others).

Public Health Significance of Neuroticism What are some Axis I and Axis II disorders that are correlated with neuroticism?

N is "robustly" correlated with many Axis I and II disorders from childhood through adulthood :Depression, GAD, panic disorder, somatoform disorders, anxiety disorders, eating disorders, schizophrenia, alcohol, and drug dependence, dysthymia. --Axis II: Borderline, avoidant, dependent, schizotypal, paranoid, and anti-social PDs. Effect sizes vary.

Public Health Significance of Neuroticism How is neuroticism typically defined in research? How do mean neuroticism scores typically change with age, if at all? Are there gender and SES differences?

Neuroticism is operationally defined by items referring to irritability, anger, sadness, anxiety, worry, hostility, self-consciousness, and vulnerability, which have been found to be correlated with each other in factor analyses... such negative emotional responses to challenges are both frequented out of proportion to the circumstances. In addition, persons high in neuroticism are often self-critical, sensitive to the criticism of others, and feel personally inadequate. The stability of neuroticism, in the sense of maintaining rank-order position relative to other persons, increases with age from adolescence through adulthood, but... MEAN N scores peak in late adolescence and decline moderately through adulthood. Mean N scores of females are slightly but significantly higher than males, and scores tend to be somewhat higher among individuals of lower SES. Most studies of N and mental health that controls for age, gender, and SES have found that N is associated with mental and physical health independent of its correlation with these demographics.

Poverty and Common Mental Disorders in Developing Countries Do the authors believe income level is related to risk for mental disorders? Explain.

No. Multivariate analyses from the Chilean data showed that absolute income levels were not associated with a raised risk when education was taken onto account.

Gender Differences in Depression Are hormonal differences between men and women responsible for the gender difference in depression? Sum up the research on this issue.

No. The evidence that hormonal changes play a direct role in the emergence of gender differences in depression in early adolescence is inconsistent.

Personality:

One's characteristic way of thinking, feeling, and behaving

Resilience in Sri Lanka What are the most important takeaway points from this article?

People from different cultures deal with trauma in different ways.

Poverty and Common Mental Disorders in Developing Countries Distinguish between primary and secondary prevention. Is there evidence that primary prevention efforts work to prevent mental disorders?

Primary prevention is aimed at improving child development and educational outcomes in children living in poverty, and secondary prevention is to strengthen the treatment of common mental disorders in primary health care. A review of interventions aimed at improving nutrition and development in socioeconomically disadvantaged children found strong support for the benefit of psychosocial and nutritional interventions for cognitive development and improved educational outcomes.

1952: First DSM published

Reliability was poor Included comments on etiology (psychoanalytic)

Gender Differences in Depression What is rumination? Why is it problematic? What do you think of her conclusion about its role in women's higher rates of depression?

Rumination is the tendency to focus on one's symptoms of distress, and the possible causes and consequences of these symptoms, in a repetitive and passive manner rather than in an active, problem-solving manner. People who ruminate a great deal in response to their sad or depressed moods have longer periods of depressive symptoms and are more likely to be diagnosed with major depressive disorder. I think it's surprising.

According to the World Mental Health Survey, which of the following had the lowest percentage of people reporting symptoms that corresponded to DSM disorders?

Shanghai

Resilience in Sri Lanka Describe the qualitative study that led Dr. Fernando to understand how Sri Lankans experience trauma.

She began by gathering a sample of local informants from a rural area in the southern province of the country. Instead of quizzing these subjects with a predetermined set of PTSD symptoms, Fernando asked each person to tell her two open-ended stories in their own language. First she asked participants to think of someone they knew who had experienced some type of suffering but was now functioning well. After that story was finished, the subject was asked to describe a person who was functioning poorly after a traumatic event.

Which of the following TRUE, regarding the models presented in class about the effect of personality on risk for mental illness?

Some models suggest that stress is the result of personality factors.

DSM: Pros (to name a few)

Standardization of language and criteria = higher reliability (diagnostic consistency) Provides direction for tx Validation

In India, the Buddha:

Suffering is the result of mental activity

The understanding of which disease, in the 19th century, propelled current thought about the biological view of

Syphilis

Poverty and Common Mental Disorders in Developing Countries Which aspect of poverty was shown to have the most consistent association with the prevalence of mental disorders?

Ten studies showed a statistically significant relationship between prevalence and indicators of poverty, the most consistent relationships being with low educational levels.

Gender Differences in Depression What does the author conclude about the role of hormones in explaining the gender difference?

The available data suggest that the normal hormonal changes do not induce significant depressive symptoms or disorders in women in the general population. However, hormonal changes may trigger episodes of depression or exacerbate existing episodes, perhaps by dysregualting neurotransmitter systems.

Theory 1: Social causation:

The conditions of poverty precede mental illness

1994: DSM-IV published

The first attempt at syncing mental health codes Goal: a worldwide system of nosology for mental disorders

Poverty and Common Mental Disorders in Developing Countries Describe the basic methodology of this study.

The methodology included both a measure of mental disorders and a measure of poverty.

Resilience in Sri Lanka What are the pros and the cons of doing the type of research described in this chapter? Can the results be generalized to people from other cultures? Why or why not?

The pros were that Fernando was able to collect accurate and specific data, but since this research is so specific to Sri Lankans, it is not able to be generalized to people from other cultures, because every culture around the world is different.

Poverty and Common Mental Disorders in Developing Countries What is meant by a "dose-response relationship," mentioned in the discussion of "Education" toward the end of page 611?

The relationship between low educational level and mental disorders may be confounded or explained by a number of pathways: these include malnutrition, which impairs intelectual development, leading to poor educational performance and poor psychosocial development.

Gender Differences in Depression How about genetics? Does this area of research explain the gender difference? In other words, are women more genetically vulnerable than men?

There has not been consistent evidence that women are more genetically vulnerable to depression than men.

Gender Differences in Depression What is meant by "an integrative model?" Give an example.

These factors likely interact in complex ways to produce depression in women. For example, people who have a history of sexual abuse are more likely to engage in rumination, perhaps because they remain hypervigilant for new threats.

Childhood IQ and Adult Mental Disorders Describe the basic methodology of this study and a general description of the participants.

This study overcomes several methodological limitations by using a birth cohort of both men and women who had prospective data on childhood IQ and potential confounders and who were diagnosed with specific mental disorders by means of structured clinical interview rather than hospital records. The participants were members of the Dunedin Multidisciplinary Health and Development Study, a longitudinal investigation of the health and behavior of a complete cohort of children born during a 1-year period in 1972-1973 in Dunedin, New Zealand.

Resilience in Sri Lanka Dr. Fernando concluded that Sri Lankans experience trauma differently than those in the West in two primary ways. Explain them.

Unlike the PTSD symptomatology, Sri Lankans were much more likely to experience physical symptoms after horrible events. Sri Lankans who lost family members or whose lives were otherwise devastated by the tsunami were more likely to complain of aches in the joins or muscles or pain in the chest. Sri Lankans tended to see the negative consequences of an event like the tsunami in terms of the damage it did to social relationships. Those who continued to suffer long after a horrible experience, her research showed, were those who had become isolated from their special network or who were not fulfilling their role in kinship groups.

Gender Differences in Depression Turning to possible psychological explanations... Describe what the author means by an "Interpersonal orientation" and how that might explain the gender difference in depression.

Women are more likely than men to feel strong emotional ties with a wide range of people in their lives, to see their roles vis a vis others (e.g., as daughter, wife/partner, mother) as central to their self-concepts, to care what others think of them, and to be emotionally affected bye events in their live of other people. Thus, women may be more likely than men to overvalue relationships as sources of self-worth, which interpersonal theories of depression have identified as a risk factor for depression.

Gender Differences in Depression Compared to men, are women more biologically reactive when under stress?

Women are more likely than men to have dysregulated response to stress.

Gender Differences in Depression Although women have more first episodes of depression, they are not more likely to have longer episodes than men, nor are they more likely to have recurrent episodes. What could account for this?

Women are more likely than men to use "positive emotions strategies"--purposeful activities to life their moods, such a recalling a positive interaction with a friend or looking at a beautiful scene in nature--to lift sad and blue moods.

Gender Differences in Depression How about poverty? How might it help explain the gender difference in depression?

Women are significantly more likely than men to have incomes below the poverty lines. Adults in poverty are twice as likely as non-poor adults to experience new episodes of major depression.

FFM (Big Five) traits: Does stability increase over time?

Yes, esp. after age 30, then even more after 50

FFM (Big Five) traits: Are they fairly heritable?

Yes, moderately: Heritability Estimates are between .42-.57

Public Health Significance of Neuroticism Do twin studies support the association between neuroticism and mental disorders?

Yes. The article talks about many twin studies, and many are rather large (thousands of twin pairs). N predicts depression, suicide, schizophrenia, and others in twin studies.

Which of the following best describes the study read about in Childhood IQ and Adult Mental Disorders?

an entire group of children born in New Zealand in the early 1970s were given IQ tests in childhood and later, clinical interviews

Neuroticism

anxiety, insecurity, emotional instability

Today, Psychology is defined as the scientific study of

behavior and mental processes

The author of Gender Differences in Depression made the point that if the gender difference in depression in adolescence isn't explained by hormonal differences related to puberty, it might be better explained by early adolescent gender differences in:

body image.

A person who took FFM (Big Five) assessment and scored high on "A" most likely endorsed characteristics such as:

cooperative, kind, and sympathetic

Historical explanations for "abnormal" behavior

demon possession, biology, the mind,

What are the four D's?

deviance, distress, dysfunction, danger

Relativism

emphasize cultural and gender differences in symptom presentation and prevalence rates

Universalism

emphasizes global similarity of MI symptoms, and their underlying biology

Conscientiousness

how dependable, responsible, achievement-oriented, and persistent one is

The article Poverty in Developing Countries stated that in this research, risk for disorders was most clearly predicted by"

one's level of education

Big Five Personality Traits

openness, conscientiousness, extraversion, agreeableness, neuroticism

Social causation theory supported; poverty more often came first. One clear exception:

schizophrenia

Some of the oldest human remains have trephined skulls (with human-made surgical incisions). Anthropologist and historians believe this may be related to the earliest explanations of abnormal behavior, which involved:

supernatural causes, such as demons

As we discussed in class, critics of the World Mental Health Survey say the results may not reflect real country differences, because:

the data was collected through in-person interviews, and self-reports of symptoms are heavily influenced by cultural factors.

What have researchers observed about hot mean N (neuroticism) scores change over the typical lifespan?

they decrease slightly in adulthood.

Openness

willingness to try new things and be open to new experiences

1980: Publication of the DSM-III

•improved specificity and reliability "atheoretical" (hotly debated) acknowledgement of culture