Abnormal Psychology: psychological disorders

1
Abnormal Psychologypsychological disorders

• Part I

2
Introduction to psychological disorders

• Symptomology refers to identification of the
  symptoms.
• Etiology refers to finding out why people
  suffer from a disorder.

3
Introduction to psychological disorders

• When discussing a disorder, there is data which
  assist in the diagnosis
• Prevalence rate it measures the total number of
  cases of the disorder in a given population.
• Lifetime prevalence (LTP) is the percentage of
  the population that will experience the disorder
  at some time in their life.
• Onset age is the average age at which the
  disorder is likely to appear. Knowing the average
  onset age can determine how likely it is that a
  person who begins to show specific symptoms at a
  specific age can be diagnosed reliably.

4
Introduction to psychological disorders

• Classifications of abnormal behavior
• Anxiety disorders have a form of irrational fear
  as a central disturbance. Example PTSD
• Affective disorders are characterized by
  dysfunctional moods. Example Major Depressive
  Disorder
• Eating disorders are characterized by eating
  patterns which lead to insufficient or excessive
  intake of food. Example Bulimia

5
Depression

• Depression is one of the most common
  psychological disorders.
• People who are depressed have very low moods and
  low levels of self esteem.
• They lack motivation, and think that everything
  is black and that they will never be happy again.
  
• The cause of depression is inconclusive. Current
  research suggests that there are biological,
  cognitive, and social factors involved.
• Treatments include drugs and different kinds of
  therapy.

6
Symptoms of major depressive disorder

• In order to find out why people suffer from
  depression, different levels of analysis are
  used
• Biological factors may include peoples genetic
  makeup and biochemical factors.
• Cognitive factors may include thought of
  hopelessness, pessimistic thinking patterns, or
  feelings of low self-esteem.
• Social factors may include the stress of poverty,
  loneliness, or troubled personal relationships.

7
Symptoms of major depressive disorder

• Affective feelings of guilt and sadness lack of
  enjoyment or pleasure in familiar activities or
  company
• Behavioral passivity lack of initiative
• Cognitive frequent negative thought faculty
  attribution of blame low self-esteem suicidal
  thoughts irrational hopelessness, may also
  experience difficulties in concentration and
  inability to make decisions.
• Somatic loss of energy, insomnia, or
  hypersomnia weight loss/gain diminished libido.
  
• These symptoms interfere with normal life
  activities, like work and relationships.

8
Affective disorders major depressive order

• Major depressive disorder can be diagnosed when
  an individual experiences two weeks of either a
  depressed mood or loss of interest and pleasure.
• In addition, the diagnosis requires the presence
  of four additional symptoms, such as insomnia,
  appetite disturbances, loss of energy, feelings
  of worthlessness, thoughts of suicide, or
  difficulty concentrating.

9
Affective disorders major depressive order

• Major depressive disorder is relatively common,
  affecting around 15 of the people at some time
  in their life (Charney and Weismann 1988)
• Levav (1997) found the prevalence rate of
  depression to be above average in Jewish males
  and there is no difference of prevalence between
  Jewish men and Jewish women.

10
Affective disorders major depressive order

• Depression tends to be a recurrent disorder, with
  about 80 experiencing a subsequent episode, with
  an episode typically lasting for three to four
  months. The average number of episodes is four.
  In approximately 12 of cases, depression becomes
  a chronic disorder with a duration of about two
  weeks.

11
Prevalence of Current Depression US Adults by
2006 and 2008
Age Group Percent Experiencing Depression
1824 11.1
2534 9.3
3544 8.7
4564 9.6
65 6.9
12
Prevalence of Current Depression US Adults by
2006 and 2008

• This study found the following groups to be more
  likely to meet criteria for major depression
• persons 45-64 years of age
• women
• blacks, Hispanics, non-Hispanic persons of other
  races or multiple races
• persons with less than a high school education
• those previously married
• individuals unable to work or unemployed
• persons without health insurance coverage

13
Etiology of major depressive disorder

• There is now some evidence that changes in the
  level of certain neurotransmitters and hormones
  can precipitate a depressive episode.
• It is also likely that many cases of clinical
  depression are triggered by negative events in a
  persons life.
• Examples divorce, the death of a partner or
  child, a serious accident, or being fired
• Sometimes depression appears to be a response not
  to a particular event, but to long-term
  circumstances.

14
Etiology of major depressive disorder

• There may be an association between stress and
  depression, but it is important to realize that
  many people who are subjected to high stress do
  not develop a depressive disorder.
• There are important individual differences in
  vulnerability .
• The risk of becoming depressed is related to a
  number of factors, which can include
• Genetic predisposition, personality and early
  history, cognitive style, coping skills, and the
  level of social support available.

15
Etiology of major depressive disorder

• Depression is not caused by a single factor, but
  stems from a combination of factors, which may
  include
• Genetic vulnerability, neurotransmitter
  malfunctioning, psychological problems, or
  particular life events or lifestyle factors, such
  as misuse of alcohol or drugs.
• It is not possible for any doctor/psychologist to
  find the cause of depression in any individual.
• Treatment aims to alleviate symptoms, and help
  the individual cope.

16

• ________________ is the average age at which the
  disorder is likely to appear. Knowing the average
  onset age can determine how likely it is that a
  person who begins to show specific symptoms at a
  specific age can be diagnosed reliably.

17

• ________________ is the average age at which the
  disorder is likely to appear. Knowing the average
  onset age can determine how likely it is that a
  person who begins to show specific symptoms at a
  specific age can be diagnosed reliably.

• Symptomology

• Onset age

• Prevalence rate

18

• _____________________refers to identification of
  the symptoms.

19

• _____________________refers to identification of
  the symptoms.

• Onset age

• Prevalence rate

• Symptomology

20

• Which of the following is not true of depression?
• Depression is one of the most common
  psychological disorders.
• People who are depressed have very low moods and
  low levels of self esteem.
• They lack motivation, and think that everything
  is black and that they will never be happy again.
• The cause of depression is easily determined.
• Treatments include drugs and different kinds of
  therapy.

21

• Which of the following is not true of depression?

• Depression is one of the most common
  psychological disorders.

• People who are depressed have very low moods and
  low levels of self esteem.

• They lack motivation, and think that everything
  is black and that they will never be happy again.

• The cause of depression is easily determined.

• Treatments include drugs and different kinds of
  therapy.

22
True or false?

• Major depressive disorder can be diagnosed when
  an individual experiences one week of either a
  depressed mood or loss of interest and pleasure.

23

• Major depressive disorder can be diagnosed when
  an individual experiences one week of either a
  depressed mood or loss of interest and pleasure.

• True

• False

24

• ________________disorders are characterized by
  eating patterns which lead to insufficient or
  excessive intake of food.

25

• ________________disorders are characterized by
  eating patterns which lead to insufficient or
  excessive intake of food.

• anxiety

• eating

• affective

26

• _________________disorders have a form of
  irrational fear as a central disturbance.

27

• _________________disorders have a form of
  irrational fear as a central disturbance.

• anxiety

• eating

• affective

28
TRUE OR FALSE

• It is not possible for any doctor/psychologist to
  find the cause of depression in any individual.

29

• It is not possible for any doctor/psychologist to
  find the cause of depression in any individual.

• True

• False

30
True or false

• Depression is not caused by a single factor, but
  stems from a combination of factors.

31

• Depression is not caused by a single factor, but
  stems from a combination of factors.

• True

• False

32

• ____________________ it measures the total
  number of cases of the disorder in a given
  population.

33

• ____________________ it measures the total
  number of cases of the disorder in a given
  population.

• Prevalence rate

• etiology

• Symptomology

34
True or false?

• Treatment aims to cure symptoms, and help the
  individual cope.

35

• Treatment aims to cure symptoms, and help the
  individual cope.

• True

• False

36

• Which of the following are is not likely to meet
  criteria for major depression
• persons 45-64 years of age
• women
• blacks, Hispanics, non-Hispanic persons of other
  races or multiple races
• persons with less than a high school education
• unmarried people

37

• Which of the following are is not likely to meet
  criteria for major depression

• persons 45-64 years of age

• women

• blacks, Hispanics, non-Hispanic persons of other
  races or multiple races

• persons with less than a high school education

• unmarried people

38

• _________________disorders are characterized by
  dysfunctional moods.

39

• _________________disorders are characterized by
  dysfunctional moods.

• Anxiety

• Affective

• Eating

40

• ________________ refers to finding out why
  people suffer from a disorder.

41

• ________________ refers to finding out why
  people suffer from a disorder.

• Symptomology

• Prevalence rate

• etiology

42
The Biological level of analysis genetic and
biochemical factors in depression

• Genetic researchers argue that genetic
  predisposition can partly explain depression.
• Nurnberger and Gershon (1982) reviewed the
  results of seven twin studies and found that
  major depressive disorder was consistently higher
  for MZ (identical) twins than for DZ (fraternal)
  twins.

43
The Biological level of analysis genetic and
biochemical factors in depression

• Environmental events play a role on depression as
  well.
• Long-term stress may result in depression for
  some people because they have the genetic
  predisposition which makes them more vulnerable
  to depression than other people.

44
The Biological level of analysis genetic and
biochemical factors in depression

• Duenwald (2003) have suggested that a short
  variant of the 5-HTT gene may be associates with
  a higher risk of depression. This gene plays a
  role in the serotonin pathways which scientists
  think are involved in controlling mood, emotions,
  aggression, sleep, and anxiety.

45
The Biological level of analysis genetic and
biochemical factors in depression

• Catecholamine hypothesis aka the serotonin
  hypothesis suggested by Joseph Schildkraut in
  1965. According to this theory, depression is
  associated with low levels of noradrenaline,
  making the neurotransmitter serotonin
  responsible.

46
The Biological level of analysis genetic and
biochemical factors in depression

• Janowsky et. al (1972) demonstrated that drugs
  which decrease the level of noradrenaline tend to
  produce depression-like symptoms. Participants
  were given a drug called physostigmine became
  profoundly depressed and experienced feelings of
  self-hate and suicidal wishes within minutes of
  taking the drug.
• The fact that a depressed mood can be
  artificially induced by certain drugs suggests
  that some cases of depression may stem from a
  failure in neurotransmission. Also drugs that
  increase noradrenaline tend to be effective in
  reducing the symptoms of depression.

47
The Biological level of analysis genetic and
biochemical factors in depression

• Delgado and Moreno (2000) found that abnormal
  levels of noradrenaline and serotonin in patients
  suffering from major depression.
• Rampello et. al (2000) found that patients with
  major depressive disorder have an imbalance of
  several neurotransmitters, including
  noradrenaline, serotonin, dopamine, and
  acetylcholine.

48
The Biological level of analysis genetic and
biochemical factors in depression

• Burns (2003) says that although he has spent many
  years of his career researching brain serotonin
  metabolism, he has never seen any convincing
  evidence that depression results from a
  deficiency of brain serotonin.
• Lacasse and Leo (2005) argue that contemporary
  neuroscience has failed to prove that depression
  results from a deficiency in neurotransmitters.
  They say the research shows that the brain is
  very complex and not understood.

49
The Biological level of analysis genetic and
biochemical factors in depression

• Burns, Lacasse and Leo criticize the serotonin
  theory because drugs that affect serotonin levels
  are heavily advertised and the most prescribed in
  our society for depression and other
  psychological disorders. Example Prozac

50
The Biological level of analysis genetic and
biochemical factors in depression

• The cortisol hypothesis cortisol is a major
  hormone of the stress system and the reason for
  focusing on this is that it has always been
  obvious to clinicians that stress can predispose
  an individual to psychological as well as
  physical disorders.
• Also, patients with major depressive disorder
  have high levels of cortisol, which is present in
  large amounts when individuals are stressed. This
  shows a link between long-term stress and
  depression. Studies that show this involve
  victims of child abuse.

51
The impact of poverty on child depression

• Fernald and Gunnar (2008) Children between the
  ages of 2.5 and 6 were identified in a house to
  house survey in low-income areas of urban Mexico.
  The Scale was administered to mothers of all
  children. Salivary cortisol samples were taken in
  children. The children were administered several
  cognitive tests. Results revealed that higher
  levels of maternal depressive symptoms were
  associated with lower baseline cortisol levels in
  their children. These low levels indicate that
  the stress system if worn out leaving the
  children susceptible to depression, autoimmune
  disease. Socioeconomic status has a huge impact
  on health both physical and psychological.

52
Cognitive level of analysis cognitive factors in
depression

• Cognitive theories of depression suggest that
  depressed cognitions, cognitive distortions, and
  irrational beliefs produce the disturbances of
  mood.
• Ellis (1962) proposed the cognitive style theory,
  suggesting that psychological disturbances often
  come from irrational and illogical thinking. On
  the basis of dubious evidence or faulty
  inferences about the meaning of an event, people
  draw false conclusions, which then lead to
  feelings of anger, anxiety, or depression. Ellis
  contends that irrational beliefs such as My
  work must be perfect together with My last
  essay did not receive the top grade- can easily
  lead to self-defeating conclusions- Since I did
  not receive the highest grade, I am stupid.

53
Cognitive level of analysis cognitive factors in
depression

• Beck (1976) suggested a theory of depression
  based in cognitive distortions and biases in
  information processing. Becks cognitive
  distortion theory of depression is based on
  schema processing where stored schemas about self
  interfere with information processing. Schemas
  influence the way people make sense of
  experiences.

54
Cognitive level of analysis cognitive factors in
depression

• Beck observed that depressive patients exhibited
  a negative cognitive triad characterized by
• Overgeneralization based on negative events.
• Non-logical inference about the self.
• Dichotomous thinking black and white thinking-
  and selective recall of negative consequences.

55
Cognitive level of analysis cognitive factors in
depression

• Beck states that negative cognitive schemas are
  activated by stressful events. The depressed
  person tends to overreact. Also if a person has
  negative expectations about the future, the
  depression can continue in a vicious circle.

56
Sociocultural level of analysis social and
cultural factors in depression

• Brown and Harris (1978) carried out a study
  concerning the social origins of depression in
  women. The researchers found that 29 out of 32
  women who became depressed had experienced a
  severe life event, but 78 of those who did
  experience a severe life event did not become
  depressed. They discovered that life events which
  resembled previous experiences were more likely
  to lead to depression. On the basis of this,
  brown suggested a vulnerability model of
  depression, based on a number of factors that
  could increase the likelihood of depression.

57
Sociocultural level of analysis social and
cultural factors in depression

• Such life events were, for example
• Lacking employment away from home
• Absence of social support
• Having several young children at home
• Loss of mother at an early age
• History of child abuse

58
Sociocultural level of analysis social and
cultural factors in depression

• Diathesis-stress model is an interactions
  approach to explaining psychological disorders.
  The model claims that depression may be the
  result of a heredity predisposition, with
  precipitating events in the environment.

59
Sociocultural level of analysis social and
cultural factors in depression

• World Health Organization (1983) has looked at
  cultural considerations linked to depression and
  identified common symptoms of depression in four
  countries Iran, Japan, Canada, and Switzerland
• Symptoms sad affect, loss of enjoyment, anxiety,
  tension, inability to concentrate, ideas of
  insufficiency, lack of energy, inadequacy, and
  worthlessness.

60

• Murphy et. al. (1967) conducted by psychiatrists
  that covered 30 countries. They found additional
  symptoms such as
• Loss of sexual interest
• Loss of appetite
• Weight reduction
• Fatigue
• Self-accusatory ideas

61

• Prince (1968) claimed that there was no
  depression in Africa and various regions of Asia,
  but found that the rates of reported depression
  rose with westernization in the former colonial
  countries.
• Kleinman (1982) showed that in China
  summarization served as a typical channel of
  expression and as a basic component of depressive
  experience. The Chinese rarely complain of
  sadness or depression.

62

• Marsella (1979) argues that affective symptoms
  (sadness, loneliness, isolation) are typical of
  individualistic cultures. In cultures which are
  more collectivist have more somatic symptoms as
  headaches are more common.

63
Gender considerations in major depressive disorder

• Williams and Hargreaves (1995)Women are two to
  three times more likely to become clinically
  depressed than men, and they are likely to
  experience several episodes of depression.
• Many researcher argue that the reasons for
  depression are rooted more in social causes that
  in biological ones.

64
The theory of social factors in depression Brown
and Harris (1978)

• Brown and Harris (1978) found that in its first
  onset depression usually happens for a reason, a
  serious adversity. They interviewed 458 women in
  South London, and found that 37 of them (8 per
  cent of the total) had become clinically
  depressed in the previous year. Of the 37 women
  who became depressed, 33 (almost 90 per cent) had
  suffered an adverse life event (such as a
  bereavement) or a serious difficulty (such as
  being in a relationship with an abusive husband).

65
The theory of social factors in depression Brown
and Harris (1978)

• This compared with only 30 per cent of the women
  who did not become depressed suffering such an
  adversity. In only four of the 37 women who
  became depressed was their onset of depression
  unrelated to any adversity. If, when a serious
  life event or difficulty struck, the women in
  Brown and Harriss study lacked a protective
  factor such as social support from an intimate
  relationship in their life, their risk of
  suffering a breakdown was much increased.

66
The theory of social factors in depression Brown
and Harris (1978)

• Brown and Harriss work is a fine example of a
  piece of social science research that was done
  really well, and that had an important effect.
  The finding that most people did not get
  depressed because there was something wrong with
  their personality, but because there was
  something wrong in their lives, transformed how
  depression was seen by general practitioners and
  psychiatrists in Britain.

67

• Most of the serious life events that cause
  depression are losses, either of important
  relationships or roles or of life projects that
  were fundamental to peoples identities.
  Protective factors such as social support
  described by Brown and Harris were parts of
  peoples lives that enabled them to feel
  themselves even when substantial losses occurred.
  For people who were protected in this way, a
  serious adversity could cause sadness or anger,
  but seldom the hopeless and disabling despair
  that put them at risk of abandoning children and
  spouses in suicide attempts.

68

• Social stress plays a role in triggering many
  depressive episodes, but demonstrates that social
  factors may increase an individuals vulnerability
  to depression. Social support may offer
  protection against the effects of stressful
  events.

69
Questions!
70

• Catecholamine hypothesis aka the ____________
  hypothesis suggested by Joseph Schildkraut in
  1965.

71

• Catecholamine hypothesis aka the ____________
  hypothesis suggested by Joseph Schildkraut in
  1965.

• serotionin

72

• Nurnberger and Gershon (1982) reviewed the
  results of seven twin studies and found that
  major depressive disorder was consistently higher
  for _________ twins than for _________ twins.

73

• Nurnberger and Gershon (1982) reviewed the
  results of seven twin studies and found that
  major depressive disorder was consistently higher
  for _________ twins than for _________ twins.

• MZ DZ

• DZ MZ

74
True or false?

• Rampello et. al (2000) found that patients with
  major depressive disorder have an perfect balance
  of several neurotransmitters, including
  noradrenaline, serotonin, dopamine, and
  acetylcholine.

75
True or false?

• Rampello et. al (2000) found that patients with
  major depressive disorder have an perfect balance
  of several neurotransmitters, including
  noradrenaline, serotonin, dopamine, and
  acetylcholine.

• True

• False

76
True or false?

• Burns (2003) says that although he has spent many
  years of his career researching brain serotonin
  metabolism, he has never seen any convincing
  evidence that depression results from a
  deficiency of brain serotonin.

77

• Burns (2003) says that although he has spent many
  years of his career researching brain serotonin
  metabolism, he has never seen any convincing
  evidence that depression results from a
  deficiency of brain serotonin.

• True

• False

78
True or false?

• Janowsky et. al (1972) demonstrated that drugs
  which decrease the level of noradrenaline tend to
  produce depression-like symptoms. Participants
  were given a drug called physostigmine became
  profoundly depressed and experienced feelings of
  self-love and suicidal wishes within minutes of
  taking the drug

79

• Janowsky et. al (1972) demonstrated that drugs
  which decrease the level of noradrenaline tend to
  produce depression-like symptoms. Participants
  were given a drug called physostigmine became
  profoundly depressed and experienced feelings of
  self-love and suicidal wishes within minutes of
  taking the drug

• True

• False

80

• _________________ model is an interactions
  approach to explaining psychological disorders.
  The model claims that depression may be the
  result of a heredity predisposition, with
  precipitating events in the environment

81

• _________________ model is an interactions
  approach to explaining psychological disorders.
  The model claims that depression may be the
  result of a heredity predisposition, with
  precipitating events in the environment

• Medical

• Diathesis-stress

• Working

82

• The ________________hypothesis it is a major
  hormone of the stress system and the reason for
  focusing on this is that it has always been
  obvious to clinicians that stress can predispose
  an individual to psychological as well as
  physical disorders.

83

• The ________________hypothesis it is a major
  hormone of the stress system and the reason for
  focusing on this is that it has always been
  obvious to clinicians that stress can predispose
  an individual to psychological as well as
  physical disorders.

• serotionin

• cortisol

84
True or False?

• Marsella (1979) argues that affective symptoms
  (sadness, loneliness, isolation) are typical of
  collectivist cultures. In cultures which are more
  collectivist have more somatic symptoms as
  headaches are more common.

85

• Marsella (1979) argues that affective symptoms
  (sadness, loneliness, isolation) are typical of
  collectivist cultures. In cultures which are more
  collectivist have more somatic symptoms as
  headaches are more common.

• True

• False

86

• Prince (1968) claimed that there was no
  depression in _____________and various regions of
  Asia, but found that the rates of reported
  depression rose with westernization in the former
  colonial countries.

87

• Prince (1968) claimed that there was no
  depression in _____________and various regions of
  Asia, but found that the rates of reported
  depression rose with westernization in the former
  colonial countries.

• Africa

• Australia

• Canada

• Unites States