Abnormal psychology

Key emotions in mood disorders depression and mania Depression a love, sad state in which life seems dark and its challenges overwhelming. Mania a state of breathless euphoria, or at least frenzied energy in which people may have the exaggerated believe that the world is theirs for the taking. Unipolar Depression Depression without a history of mania Bipolar disorder a disorder marked by alternating or intermixed periods of mania and depression Five different subtypes of Depression symptoms Emotional, motivational, behavioral, cognitive, and physical. Emotional Symptoms Depression

Sad, dejected, miserable, empty, humiliated, lose sense of humor, get little pleasure from anything, anxiety, anger, agitation. Motivational Symptoms Depression Lose desire to pursue normal activities, lack of drive, initiate and spontaneity. May have to force themselves to go to work, talk with friends, eat meals or have sex. -"paralysis of will" -between 6-15% of people with depression commit suicide Behavioral Symptoms Depression Less active and less productive, spend more time alone and may stay in bed for long periods, may also move and speak more slowly Cognitive Symptoms Depression

-Hold extremely negative views of themselves -consider themselves inadequate, undesirable, inferior and perhaps evil. -blame themselves for unfortunate events and rarely credit themselves for positive achievements. -Pessimism- nothing will ever improve, feelings of helplessness -likely to procrastinate -frequently complain that their intellectual ability is poor. -confused, unable to remember things, easily distracted, unable to solve small problems. Physical Symptoms Depression Headaches, indigestion, constipation, dizzy spells and general pain. Disturbances in appetite and sleep.

Some depressed people eat less, sleep less and feel more fatigued while others eat and sleep excessively. Major depressive episode period marked by at least five symptoms of depression and lasting for two weeks or more. -in extreme cases may include psychotic symptoms such as delusions and hallucinations Major Depressive Disorder people who experience a major depressive episode without having any history of mania receive this diagnosis.

Can be called: -recurrent if its been preceded by previous episodes -seasonal if it changes with the seasons -catatonic if it is marked by either immobility or excessive activity -postpartum if it occurs without four weeks of giving birth -melancholic if the person is almost totally unaffected by pleasurable events.

Dysthymic Disorder people who display longer lasting but less disabling pattern of unipolar depression may receive this diagnosis. -when a Dsythymic disorder leads to major depressive disorder, the sequence is called double depression Causes of Unipolar Depression -Often seem to be triggered by stressful events (more than the general population) -biological, physiological and sociocultural factors -internal and situational factors Biological View of Causes of Depression- genetic factors.

-Genetic Factors: from four kinds of research... ---family pedigree- select a person with unipolar depression (proband) and examine their relatives to see if depression afflicts other members of the family. If predisposition is inherated, probands relatives should have higher rates of depression than population at large. --twin- When an identical twin had depression, 46% chance of other other twin having it as well. with fraternal twins, there was a 20% chance of developing the disorder. --adoption- looked at families of adopted persons who had been hospitalized for the disorder.

The biological parents had higher incidences of severe depression than did the biological parents of non-depressed adoptees. Meant that severe depression is more likely to be caused by genetic factors than mild depression. --molecular biology gene studies- found that individuals who are depressed have an abnormality on their 5-HHT gene, a gene located on chromosome 17 that is responsible for the brains production of serotonin transporters. Biochemical Factors of Depression -Low activity of two neurotransmitter chemicals norepinephrine and serotonin have been strongly linked. -evidence 1.

Certain medications that lowered levels of norepinephrine and serotonin caused depression. 2. discovery of antidepressant drugs that help depression by increasing levels of norepinephrine and serotonin. -believe it is not the activity alone of the neurotransmitters but the interactions between them. -depressed people have an overall imbalance in the activity of neurotransmitters serotonin, norepinephrine, dopamine and acetylcholine. -neuron deficiencies -endocrine system may play a role- abnormally high levels of cortisol hormone and also tied into melatonin hormone. Brain Anatomy and Brain Circuits factors of Depression.

-Brain circuits- networks of brain structures that work together. -Members of the circuit relating to depression- prefrontal cortex (mood attention and immune functioning- lower blood flow in depressed patients), hippocampus (neurogenesis decreases dramatically in depressed patients- reduction in size of hippocampus in depressed people), amygdala (involved in expression of negative emotions and memories- blow flow 50% greater in people with depression) and the Brodmann (smaller in depressed people- "depression switch"- some theorists believe its malfunction might be necessary for depression to occur).

Immune System Factors Depression -immune system dysregulation helps produce depression Psychological Views Causes of Depression -psychodynamic, behavioral and cognitive -psychodynamic has not been strongly supported -behavior view only received modest support -cognitive view received considerable support The Psychodynamic View Causes of Depression -Sigmund Freud and student Karl Abraham developed first psychodynamic explanation for depression. -depression is triggered by major loss -Believe that there are two kinds of people who are likely to become clinically depressed: 1.

Those whose parents failed to nurture them and meet their needs during the oral stage of development- remain over dependent on others throughout their life, feeling unworthy of love and having low self esteem. 2. those whose parents gratified those needs excessively- find the oral stage so pleasant that they resist moving on to subsequent stages. Symbolic or Imagined Loss Freuds proposed concept in which persons equate other kinds of events with loss of a loved one. ie. college student equating failure in a calculus course as the loss of his/her parents- believing they love him/her only when he/she exceeds academically.

Object Relations Theorists idea Causes of Depression The psychodynamic theorists that emphasize relationships, propose that depression results when people's relationships leave them feeling unsafe and insecure. -People whose parents pushed them to either excessive dependance or excessive self-reliance are more likely to become depressed. Anaclitic Depression Sad upon separation and withdraw from their environment. Parental Bonding Instrument A scale that depressed patients fill out which indicates how much care and protection they feel they received as a child.

Many report "affection-less control" (low care and high protection). -Limitations: 1. Do not establish that such factors are typically responsible for the disorder. 2. Many findings are inconsistent The Behavioral View of Causes of Depression. Believe that unipolar depression results from significant changes in the number of rewards and punishments people receive in their lives. -Social rewards are particularly important in the downwards spiral of depression. Research supports to depressed people experience fewer social rewards than non-depressed people. Peter Lewinsohn.

-One of the first clinical researchers to develop a behavioral explanation for depression. -Believed that the positive rewards in life dwindle for some persons, leading them to perform fewer and fewer constructive behaviors. Limitations of Behavior view of causes of Depression. -Relied heavily on self reports from depressed people which could be biased and inaccurate. -reports by depressed people may be influenced heavily by a gloomy mood and negative outlook. -behavioral studies are largely correlational and don't establish that decreases in rewarding events are the initial case of depression.

Cognitive Views of Causes of Depression Believe that people with unipolar depression persistently view events in negative ways and that such perceptions lead to their disorder. -Two most influential cognitive explanations are the theory of negative thinking and the theory of learned helplessness. Theory of Negative Thinking -Aaron Beck --Believes that negative thinking, rather than underlying conflicts or a reduction in positive rewards, lies at the heart of depression. --maladaptive attitudes, a cognitive triad, errors in thinking, and automatic thoughts combine to produce unipolar depression.

People make errors in their thinking; ie. draw arbitrary inferences. Cognitive Triad -Theory of negative thinking -Aaron beck believes some people develop maladaptive attitudes as children, which sets the stage for all kinds of negative thoughts and reactions. -suggests that later in peoples lives, upsetting situations may trigger an extended round of negative thinking, which typically takes three forms: the individuals repeatedly interpret 1. their experiences, 2. themselves, 3. their futures in negative ways that lead them to feel depressed.

Automatic Thoughts -Theory of negative thinking -depressed people experience a steady train of unpleasant thoughts that keep suggesting to them they are are inadequate and that their situation is hopeless. Ruminative Responses -People who generally make ruminative responses during their depressed moods- that is, repeatedly dwell mentally on their mood without acting to change it- experience dejection longer and are more likely to develop clinical depression than people who avoid such ruminations. Learned Helplessness Theory -Martin Seligman.

Developed the learned helplessness theory of depression which holds that people become depressed when they think 1. that they no longer have control of the reinforcements (rewards and punishments) in their lives and 2. that they themselves are responsible for this helpless state Seligman's Research -Worked in laboratory with dog. -Strapped dogs to an apparatus called a hammock, in which they received shocks periodically no matter what they did. -The next day each dog was placed in a shuttle box divided in half by a barrier over which the animal could jump to reach the other side.

When shocks were applied to the dogs they did not jump to the other side but whined and accepted the shocks. -dogs had learned that they had no control over unpleasant events in their lives. learned that they were helpless to do anything to change negative situations. -continued to feel helpless even in a new situation where they could control their fate (shuttle box) Attribution-Helplessness Theory -New version of learned helplessness theory -when people view events as beyond their control, they ask themselves why is this so?

-If they attribute their present lack of control to some internal cause that is both global and stable ("I am inadequate at everything and I always will be"), they may feel helpless to prevent future negative outcomes and they may experience depression. If they make other kinds of attributions, this reaction is unlikely. -internal, global, stable- depression -specific, unstable or external- normal Limitations Theory of Learned Helplessness -Laboratory helplessness does not parallel depression in every respect.

Much of the learned helplessness relies on animal subjects and its impossible to know whether the animals' symptoms do in fact reflect the clinical depression found in humans. -the attributional theory raises difficult questions- what about dogs and rats who learn helpless ness? can animals make attributions, even implicitly? Sociocultural Views of Causes of Depression Believe that unipolar depression is greatly influenced by the social context that surrounds people. -their belief is supported by the finding that this disorder is often triggered by outside stressors. -two kinds of sociocultural views.

1. family-social perspective 2. multicultural perspective The Family-Social Perspective -Consistent with the behavioral theory that declining social rewards is particularly important in the development of depression. -Researchers have found that depressed persons often display weak social skills and communicate poorly. -these social deficits make other people uncomfortable and may cause them to avoid the depressed individual. -as a result, social contacts and rewards of depressed people decrease, and, as they participate in fewer social interactions, their social skills deteriorate further.

Depression social support statistics -people who are separated or divorced display at least three times the depression ate or married or widowed persons and double the rate of people who have never been married. -often the interpersonal conflict and low social support found in troubled relationships seem to lead to depression. -participants who were in unsatisfying relationships were three times more likely to experience a major depressive episode. -people whose lives are isolated and without intimacy are particularly likely to become depressed at times of stress.

Multicultural Perspective Causes of Depression -Socioculture View -two kinds of relationships have caught the interest of sociocultural theorists: 1. links between gender and depression 2. ties between cultural and ethnic background and depression. Gender and Depression -strong link between gender and depression found. -women are twice as likely as men to develop unipolar depression. -women are younger when depression strikes, have more frequent and longer-lasting bouts, and respond less successfully to treatment. Artifact Theory.

Holds that women and men are equally prone to depression but that clinicians often fail to detect depression in men. -perhaps men find it less socially acceptable to admit feelings -depressed women maybe display more emotional symptoms which can be easily diagnosed while depressed men "mask" their depression. -turns out that women are no more willing or able than men to identify their depressive symptoms. Hormone Explanation Holds that hormone changes trigger depression in many women. -research suggests that hormone changes alone are not responsible for high levels of depression in women.

This is sometimes seen as a sexist view point. Life Stress Theory suggests that women in our society experience more stress than men. -on average women face more poverty, more menial jobs, less adequate housing, and more discrimination than men. -women bear a disproportionate responsibility with child care and house work. Body Dissatisfaction Explanation States that females in Western society are taught, almost from birth, to week a low body weight and slender body shape- goals that are unreasonable, unhealthy, and often unattainable.

Peer pressure may produce great dissatisfaction with their weight and body, increasing the likelihood of depression. Lack of Control Theory Picks up on the learned helplessness research and argues that women may be more prone to depression because they feel less control than men over their lives. -victimization of any kind (from burglary to rape) often produces a general sense of helplessness and increases symptoms of depression. Women in our society are more likely than men to be victims. Cultural Background and Depression Research suggests that the precise picture of depression varies from country to country.

-As countries become more westernized, depression seems to take on the more cognitive character it has in the west. -Depressed people in non-western countries are more likely to be troubled by physical symptoms rather than cognitive symptoms. -research has reveled that there are striking differences between ethnic/racial groups in the chronicity (how likely an individual will experience recurrent episodes of depression) of depression. Hispanic and African Americans 50% more likely to have recurrent episodes. -depression distributed unevenly within some minority groups. How might difference in chronicity be explained?

It may be that minority groups in the US are more vulnerable to repeated experiences of depression partly because many of their members have more limited treatment opportunities when they are depressed. -Within these minority populations, the likelihood of being depressed rose along with the individuals degree of poverty, family size, and number of health problems. Bipolar Disorders People with Bipolar Disorder experience both the lows of depression and the highs of mania. -many describe their lives as an emotional roller coaster, as they shift back and forth between extreme moods. -a number of sufferers become suicidal.

Has great impact upon family and friends of sufferer. Symptoms of Mania? People experience dramatic and inappropriate rises in mood. -the symptoms of mania span many areas of functioning- emotional, motivational, behavioral, cognitive, and physical- the same ones as depression, but mania affects those areas in an opposite way. -active, powerful emotions in search of an outlet. -mood of euphoric joy and well-being is out of proportion to the actual happenings in the persons life. -some become irritable and angry, instead, especially when others get in the way of their exaggerated ambitions.

Motivational Symptoms of Mania -Seem to want constant excitement, involvement, and companionship. Enthusiastically seek out new friends and old, new interests and old, and have little awareness that their social style is overwhelming, domineering and excessive. Behavioral Symptoms of Mania -Very active, move quickly as if there is not time to do everything they want to do, may talk rapidly and loudly, their conversations filled with jokes and efforts to be clever or with complaints and verbal outbursts, flamboyance. Cognitive Symptoms of Mania

-Show poor judgement and planning- as if they feel too good or move too fast to consider possible pitfalls. -Filled with optimism, they rarely listen when others try to slow them down, interrupt their buying sprees, or prevent them from investing money unwisely. -many hold an inflated opinion of themselves and their self esteem sometimes approaches grandiosity. -During severe episodes some have trouble remaining coherent or in touch with reality. Physical Symptoms of Mania -Feel remarkable energetic -Typically get little sleep yet feel and act wide awake.

-Even if they miss a night or two of sleep their energy level may remain high. Full Manic Episode considered to be in a full manic episode when for at least one week they display an abnormally high or irritable mood, along with at least three other symptoms of mania. -may include psychotic features such as delusions or hallucinations. Hypomanic Episode When the symptoms are less severe, causing little impairment, the person is considered to be experiencing a hypomanic episode. Bipolar I Disorder People have full manic and major depressive episodes.

-Some of them experience an alternation of the episodes. ie. weeks of mania followed by a period of wellness, followed, in turn, but an episode of depression. -Others have mixed episodes, in which they swing from manic to depressive symptoms and back again in the same day. Bipolar II Disorder -hypomanic- mildly manic- episodes alternate with major depressive episodes over the course of time. -some people with this patter accomplish huge amounts of work during their mild manic periods. Rapid cycling If people experience four or more Bipolar episodes within a one year period.

Bipolar Disorder Statistics -Individuals with bipolar tend to experience depression more than mania over the years. -in most cases, depressive episodes occur three times as often as manic ones, and depressive episodes last longer. -1-2. 6% of adults suffer from bipolar at a given time -Bipolar I more common than bipolar II -equally common in men and women -women experience more depressive episodes and rapid cycling than men. -most common among people which low incomes and those with high incomes. -ages 15-44 Cyclothymic Disorder.

When a person experiences numerous periods of hypomanic symptoms and mild depressive symptoms. -milder form of bipolar disorder -symptoms continue for two or more years interrupted occasionally by normal moods that may last for only days or weeks. -begins in adolescence or early adulthood -equally common among men and women. What causes bipolar disorder? -Biological insights regarding neurotransmitter activity, ion activity, brain structure, and genetic factors. 

Bipolar and Neurotransmitters -Overactivity of norepinephrine. -may be linked to low serotonin activity.

-low serotonin activity accompanied by low norepinephrine activity may lead to depression -low serotonin activity accompanied by high norepinephrine activity may lead to mania -may be tied to abnormal activity of other neurotransmitters, such as GABA, as well. Ion Activity and Bipolar Disorder -Ions play a critical role in relaying messages within a neuron. Ions help transmit messages down a neuron's axon to the nerve endings.

-If messages are to be relayed effectively down the axon, the ions must be able to travel easily between the outside and the inside of the neural membrane.-theorists believe that irregularities in the transport of these ions may cause neurons to fire too easily (resulting in mania) or stubbornly resist firing (resulting in depression).

-Found membrane defects in the neurons of people suffering from bipolar disorder and have observed abnormal functioning in the proteins that help transport ions across a neurons membrane. Brain Structure and Bipolar Disorder -Identified a number of abnormal brain structures in people with bipolar disorder. -Basal ganglia and cerebellum are smaller -lower volumes of grey matter in the brain.

-Their dorsal raphe nucleus, striatum, amygdala, hippocampus, and prefrontal cortex have some structural abnormalities. -dorsal raphe nucleus- one of the brain sights were serotonin is produced. Genetic Factors and Bipolar Disorder -People inherit a biological predisposition to develop bipolar disorder. -Family pedigree studies support this idea- identical twins of person with bipolar disorder have a 40% likelihood of developing the same disorder. Fraternal twins, siblings and other close relatives have a 5-10% likelihood. Genetic Linkage Studies.

Researchers select large families that have had high rates of a disorder over several generations, observe the pattern of distribution of the disorder among family members, and determine whether it closely follows the distribution patter of a know genetically transmitted family trait (called a genetic marker) such as color blindness, red hair, or a particular medical syndrome. -one team of researchers seemed to have linked bipolar disorder to genes on the X chromosomes. Later used techniques from molecular biology linked bipolar disorder to genes on many chromosomes.