Psychology-Ch 14

Stressful Events Often Precede Depression

- About one in four diagnosed with depression have experienced an emotional, financial, or professional trauma within the past month - Moving to a new culture may also lead to depression

Obsessive-compulsive disorder (OCD)

- Characterized by persistent and repetitive thoughts (obsessions), actions (compulsions), or both - Occurs when obsessive thoughts and compulsive behaviors persistently interfere with everyday life and cause distress - Is more common among teens and young adults than older people - Twin studies reveal that OCD has a strong genetic basis

Chronic schizophrenia (also called process schizophrenia)

- Form of schizophrenia in which symptoms usually appear by late adolescence or early adulthood - As people age, psychotic episodes last longer and recovery periods shorten

Acute schizophrenia (also called reactive schizophrenia)

- Form of schizophrenia that can begin at any age, frequently occurs in response to an emotionally traumatic event, and has extended recovery periods - Often positive symptoms that respond to drug therapy

Depression Is Widespread

- Found worldwide; causes must also be common

Genes

- Genetic predisposition to anxiety, OCD, and PTS - Researchers have identifies 17 gene variations associated with typical anxiety disorder symptoms

With Each New Generation, Depression Strikes Earlier (Now Often in the Late Teens) and Affects More People, With the Highest Rates Among Young Adults in Developed Countries

- In North America, young adults three times more likely than their grandparents to suffer—recently or ever—from depression - Some generational affect; young people now more willing to talk openly about their depression

Post traumatic stress disorder (PTSD)

- Is characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia lingering for four weeks or more after a traumatic experience

Behaviors and Thoughts Change With Depression

- Negative aspects on environment consume the depressed - Nearly half of people diagnosed with depression also display symptoms of another disorder (anxiety or substance abuse)

Genetic Influences

- Odds of being diagnosed with schizophrenia are nearly 1 in 100; 1 in 10 for those with diagnosed family member - Risk for adopted children is related to biological parent

Diagnostic classification in psychiatry and psychology attempts to:

- Predict the disorder's future course - Suggest appropriate treatment - Prompt research into its causes

Most Major Depressive Episodes End on Their Own

- Therapy often helps and tends to speed recovery, but even without most people recover - Recovery more likely if first episode strikes later in life, there were few previous episodes, and there is minimal stress and a strong social support system

The Brain

- Traumatic fear-learning experiences can leave tracks in the brain - Fear circuits created within the amygdala result in easy inroads for more fear experiences - Brain scans show higher-than-normal activity in the amygdala of brain scans of people with PTSD when they view traumatic images - Anterior cingulate cortex, a brain region that monitors our actions and checks for errors, is especially likely to be hyperactive in people with OCD

Natural Selection

- We seem biologically prepared to fear certain threats—these are easily conditioned and difficult to extinguish. - Some modern fears may have an evolutionary explanation • Fear of flying may be rooted in our biological predisposition to fear heights and confinement

Women's Risk of Major Depressive Disorder Is Nearly Double Men's

- Women experience depression 1.7 times more often than men (CDC, 2014) - Women's disorders are generally more internal (depression, anxiety, inhibited sexual desire) - Men's disorders are more external (alcohol use disorder, antisocial conduct, lack of impulse control)

Depression's vicious cycle—pieces of the depression puzzle:

1) Stressful events are interpreted through 2) A brooding, negative explanatory style, that 3) Creates a hopeless, depressed state, that 4) Hampers the way the person thinks and acts

Bipolar disorder

A disorder in which a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania - Formerly called "manic-depressive disorder"

Major depressive disorder

A disorder in which a person experiences two or more weeks with five or more symptoms, at least one of which must be: • Depressed mood or • Loss of interest or pleasure

Mania

A hyperactive, wildly optimistic state in which dangerously poor judgment is common

Schizophrenia

A psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression.

Panic disorder

An anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations.

Phobia

Anxiety disorder marked by a persistent and irrational fear of a specific object, activity, or situation

Psychological disorders

Are marked by a "clinically significant disturbance in an individual's cognition, emotion regulation, or behavior"

Anxiety disorders

Are marked by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety;

The Medical Model

By the 1800s the search began for physical causes of mental disorders and for curative treatments. • With the medical model of mental disorders, mental illness is to be diagnosed on the basis of symptoms and treated through therapy,often in a psychiatric hospital. • Reinvigoration of the medical model has come from recent research in genetically influenced brain abnormalities in brain structure and biochemistry.

Rumination

Compulsive fretting; overthinking about our problems and their causes

Dissociative disorders

Controversial, rare disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings

The most common tool for system for classifying disorders is the...

Diagnostic and Statistical Manual of Mental Disorders now in its fifth edition (DSM-5), 2013

Brain Abnormalities

Dopamine Over-activity • Resulting hyper-responsive dopamine system could intensify brain signals, creating positive symptoms - Abnormal Brain Activity and Anatomy • Often low activity in frontal lobes

The Biopsychosocial Approach

General approach positing that biological, psychological, and social-cultural factors all play a significant role in human functioning in the context of disease or illness.

Disturbed Perceptions

Hallucinations: Seeing, feeling, tasting, smelling things that exist only in the mind

Personality disorders

Inflexible and enduring behavior patterns that impair social functioning

Psychotic Disorder

Is marked by irrationality, distorted perceptions, and lost contact with reality.

Negative Thoughts and Negative Moods Interact

Learned helplessness may exist with self-defeating beliefs, self-focused rumination, and self-blaming and pessimistic explanatory style.

Attention-deficit/hyperactivity disorder (ADHD):

Marked by extreme inattention and/or hyperactivity and impulsivity

Nonsuicidal Self-Injury

Non-suicidal self-injury (NSSI) includes cutting, burning, hitting oneself, inserting objects under nails or skin, and self-administered tattooing.

Anorexia nervosa

Person (usually an adolescent female) maintains a starvation diet despite being significantly underweight

Bulimia nervosa

Person alternates binge eating (usually of high-calorie foods) with purging (by vomiting or laxative use), sometimes followed by fasting or excessive exercise

Dissociative identity disorder (DID) (formerly called multiple personality disorder)

Rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities

Binge-eating disorder

Significant binge eating, followed by distress, disgust, or guilt, but without the compensatory purging or fasting that marks bulimia nervosa

Epigenetics

The study of environmental influences on gene expression that occur without a DNA change.

Prenatal Environment and Risk

low birth weight maternal diabetes older paternal age lack of oxygen during delivery maternal prenatal nutrition mid pregnancy viral infection

The Depressed Brain

• Brain activity slows during depression, increases during mania • Left frontal lobe and adjacent reward center become more active during positive emotions • Neurotransmitter norepinephrinescarce during depression; overabundant during mania • Neurotransmitter serotonin scarce/inactive during depression • Depression-relieving drugs increase serotonin supplies • Repetitive physical exercise decreases depression by increasing serotonin

Disorganized Thinking and Speech

• Delusions: False beliefs • May have paranoid tendencies • Word salad (senseless speech) and a breakdown in selective attention Schizophrenia

Understanding Eating Disorders

• Family environment for those diagnosed with anorexia is often competitive, high-achieving, protective • Those with eating disorders often have low self-evaluations, set perfectionistic standards, and are intensely concerned with how others perceive them • Heredity: Disorders seen more in identical twins than in fraternal twins • Cultural pressures: Ideal body shapes vary across cultures and time • Other influences: Low self-esteem, and negative emotions interact with stressful life experiences • Prevention programs have had success; especially effective when interactive and focused on girls over age 15

Diminished and Inappropriate Emotions

• Flat affect: Emotionless, a state of no apparent feeling • Impaired theory of mind: Difficulty reading other peoples' facial emotions and states of mind

Understanding Dissociative Identity Disorder

• Increased dramatically in the late twentieth century. • Is rarely found outside North America. • DID may reflect role playing by people who are vulnerable to therapists' suggestions. • Some psychodynamic theorists view this disorder as a manifestation of feelings of anxiety. • Some learning theorists view this disorder as a response learned when behaviors are reinforced by anxiety-reduction. • Some clinicians include dissociative disorders under the umbrella of posttraumatic stress disorder.

Antisocial Personality Disorder

• Lack of conscience for wrongdoing, even toward friends and family members • Often impulsiveness, fearlessness, irresponsibility

Genes and Depression

• Risk for major depressive disorder and bipolar disorder increases if family member has disorder. • Twin studies data estimated heritability (the extent to which individual differences are attributable to genes) of major depression at 37 percent. • Linkage analysis points to "chromosome neighborhood" to help researchers tease out the genes that put people at risk of depression. • Many genes work together and produce interacting small effects that increase risk for depression.

Genes influence levels of neurotransmitters:

• Serotonin: Influences sleep, mood, attending to threat • Glutamate: Heightens activity in the brain's alarm centers

Nutritional Effects

• What's good for the heart is also good for the brain and mind • People who eat heart-healthy "Mediterranean diet" (heavy on vegetables, fish, and olive oil) have a comparatively low risk of depression as well as lower risk for many other ailments • Excessive alcohol use correlates with depression • Alcohol misuse in fact leads to depression