Major Depressive Disorder and Types of Depressive Disorders

WK1 - Anxiety and Mood Disorders

• DSM-5 is used, called the diagnostic and statistical manual of mental disorders

Types of Depressive Disorders

• Disruptive mood dysregulation disorder
• Major depressive disorder
• Persistent depressive disorder
• Premenstrual dysphoric disorder
• Substance/medication-induced depressive disorder

Major Depressive Disorder Criteria

• Presence of 5 or more symptoms
• Symptoms must be present during a two-week period
• Significant change in usual functioning must be evident
• A persistent sad mood is a key symptom
• Loss of interest or pleasure in activities

Major Depressive Disorder Symptoms

• Recurring sad mood
• Loss of interest in activities
• Significant weight or appetite changes, with more than 5% change in a month
• Altered sleep patterns
  • Sleeping more when depressed and physically exhausted and insomnia
  • Desire to sleep to escape depression symptoms
• Psychomotor agitation or retardation
  • This includes fidgety behavior or reduced and slow movement
• Fatigue and loss of energy, consistently
• Thoughts of worthlessness or guilt that may be delusional
• Difficulty concentrating or indecisiveness
• Recurrent thoughts of death or suicide, or suicidal ideation without a specific plan

Considerations When Excluding Other Causes

• Determine whether DSM is the most accurate explanation
• Perform a tox screen and blood test

Persistent Depressive Disorder

• Considered a chronic disorder
• Spontaneous occurence is more likely with persistent depression over major depression

Persistent Depressive Disorder Criteria

• Depressed mood for at least 2 years in adults, or 1 year in children and adolescents
• Displaying at least 2 of the following symptoms:
  • Poor appetite or overeating
  • Insomnia or hypersomnia
  • Low energy
  • Low self-esteem
  • Poor concentration or indecisiveness
  • Sense of hopelessness

Prevalence of Major Depressive Disorder

• Females are more likely to develop the disorder, occurring 1.5 to 3 times more often

Causal Models of Depressive Disorder

• Genetic heritability increases the odds by 2-4 times
  • In Persistent depressive disorder there is an even heavier genetic loading
• Environmental factors
  • Trauma and abuse during childhood
  • Experiencing a stressful life
• Increased genetic and physiological or psychological vulnerability

Cognitive-Behavioral Model of Depression

• Depression is maintained by a lack of positive reinforcement
• Depression is the result of a person's failure to engage in previously enjoyed activities
• Depression causes a sense of learned helplessness and powerlessness in relation to environment
• There is a tendency to attribute bad things internally and good things externally

Treatments for Depression

• Antidepressant medications like selective serotonin reuptake inhibitors, called SSRIs, are a treatment option
• Biological treatments like electroconvulsive therapy, called ECT, is a treatment option
• Cognitive behavioral therapy, called CBT, is an evidence-based treatment
• Two common CBT strategies:
  • Behavioral activation targets the loss of pleasure/interest, assigning tasks
    • This aims to create positive reinforcement from engaging in activities, to improve mood
  • Cognitive restructuring: helps identify thoughts contributing to feelings of sadness/hopelessness, by evaluating evidence for accuracy

Anxiety Disorders

• The two key constructs are distress and impairment that interferes with functioning
• DSM-5 defines several anxiety disorders although many are not listed here
• Three systems of anxiety are affected:
  • The cognitive system affects what people think when feeling anxious
  • The behavioral system affects what people do
  • The physiological system affects the action of peoples bodies

Specific Phobia

• Expresses fear out of proportion to the actual danger
• Common types
  • Animals
  • Natural environments
  • Blood-injection-injury
  • Situational
  • Other situations involving vomiting or choking
• Usually develops in early childhood, before the age of 10
• Twice as many females are affected than males

Social Anxiety Disorder

• Fear, anxiety or avoidance of social situations where one may be scrutinised or judged by others
• Social interactions that provoke anxiety:
  • Eating in front of others
  • Performing in front of others
  • Meeting someone new

Criteria for Specific Phobia and Social Anxiety Disorder

• Extreme fear in response to stimuli
• Anxiety causes avoidance, or anxiety is present when stimuli cannot be avoided
• Fear is out of proportion to the danger
• Symptoms lasts for 6 months or longer
• Distress or interference in daily functioning
• Symptoms are not explained by other illnesses

Generalised Anxiety Disorder, or GAD

• Is defined by excessive worrying
• Is twice as likely in females than in males

Criteria for Generalised Anxiety Disorder

• Uncontrollable worry
  • About school/work, health, or how one is perceived by other people
• Symptoms present for 6 months or longer
• Exhibits 3 of 6 physiological symptoms, including muscle tension and restlessness
• Distress or impairment in daily living
• Other illnesses are not the cause
• Exhibits hypervigilance
  • Senses the world is dangerous and is constantly on alert for danger

Panic Disorder

• Recurrent, unexpected panic attacks
• Intense fear or discomfort that peaks within minutes
• Seen in children but is diagnosed about twice as often in females

Panic Disorder Diagnostic Criteria

• One panic attack must be followed by at least 1 month of either:
• Persistent anticipatory anxiety about future attacks
• Problematic behavioral changes related to the attacks.
  • Generally reflecting a tendency to misinterpret normal physiological signs of anxiety.
  • Physiological symptoms are interpreted catastrophically in terms of physical health.
  • In other words they think their symptoms mean they are going crazy
• Not being caused by other illnesses

Relaxation Techniques

• Deep breathing can help
• Progressive muscle relaxation done by lying comfortably with eyes closed can help
• Creative visualisation by imagining a safe place reduces anxiety
• Exercise

Panic Disorder Comorbidity

• Meeting criteria for other mental illnesses
• Commonly comorbid with:
  • Depressive disorder
  • Other anxiety disorders
  • Substance use disorders
    • Including self-medicating with substances like alcohol to reduce distress from anxiety symptoms

Aetiology of Anxiety Disorders

• Have first degree relatives with anxiety disorders increase the likelihood
• Temperament characterized by shyness, fear of unfamiliar situations, and withdrawal
• Environmental factors might cause anxiety
  • Experiencing traumatic events
  • Stressful life events
  • Negative parenting behaviors, such as modeling and overprotection

Cognitive Behavior Models of Anxiety Developement

• Three pathways
  • Own direct experience
  • Instructional learning involving danger
  • Vicarious learning, or seeing someone else behave fearfully
• A persons avoidance can serve to reinforce negative thoughts

Treatments for Anxiety Disorders

• First start with Cognitive Behavioral Therapy, or CBT

Other Anxiety Disorder Treatments

• Psychoeducation should be provided -This is done by explaining anxiety is normal and adaptive -And giving a general idea of how anxiety works -Then developing a personalized outlook regarding how the anxiety developed
• Cognitive restructuring involves clients understanding and evaluating their thoughts -To see what evidence support their likelyhood

Exposure for Anxiety Disorders

• A scientific approach encourages thinking like a scientist
• Socratic questioning works for adults
• Deliberately and repeatedly placing oneself in usually avoided anxiety-provoking situations
• Constructing an increase in anxiety, or a hierarchy

Developing and Exposure Hierarchy

1. Identify the feared situation.
2. Break it down into component parts/ steps.
3. List components, rate them 0-100 based on difficulty.
4. Implement the hierarchy.

• Clients need to fully experience the anxiety itself
• Then realize that anxiety itself is not harmful
• Each situation needs to be experienced repeatedly
• Until the fear response is extinguished

Exposure Rational

• Reduces elicited anxiety from the imagination of an avoided situation
• Improves the clients ability to imagine a feared situation

Behavioral Response

• Avoidance is most common
• Missing out on opportunities to discover they can cope w/ feared situations
• Avoidance serves to strengthen and reinforce anxiety

WK2 - Personality

Personality Consists Of

• Consistent patterns of behaviors, thoughts, and emotions
• Defining qualities that differentiate individuals

Consistency of Traits

• Traits tend to remain relatively stable across time and situations
  • Patterns refer to repeated ways individuals interact with the world
  • Shaped by internal factors, such as biology
  • Also shaped by external factors, such as the environment
  • Can change in response to major life events, environmental shifts, or deliberate effort

Uniqueness of Individuals

• Highlights what makes an individual unique and distinct from others
• Shaped by variability in personality traits
  • Interaction of genetic predispositions
  • Life experiences
  • Cultural influences
• Shapes people's experiences and how they navigate the world

Individuality

• Encompasses both innate tendencies and learned behaviours
• Traits used to help predict behaviours, like extroversion versus introversion

Studying Clinical Personality

• Diagnoses and treats mental health conditions -Certain issues may be linked to personality -Can tailor interventions, predict treatment challenges, and guide therapeutic approaches -Traits can predispose individuals to anxiety or depression -And engagement with therapy
• Social interactions can be affected
• Development effects traits throughout life

Nomothetic Approaches to Personality

• Searches for general laws that govern all human behaviour
• Emphasizes universality and generalization
• Studies genetic contributions to personality
• Personality models include Big5 and Eysenck’s three-factor model

Idiographic Approaches to Personality

• Focuses on unique aspects/characteristics of individuals
• Emphasizes individuality over generalization
• Tracks personality development of single person over decades
• Designs therapy plan for person w/ post traumatic stress

Inherited Personality

• This is called nature
• Shaped by the environment, called nurture
• Work together to shape personality

Causation of Personality

• Shaped via a combination of inherited an environmental factors

Main Factors that Shape Personality

1. Genetic factors
   • Influence the function of brain structure, like neurotransmitters
2. Shared environmental factors -Consist of authoritative or permisive parenting styles -And access to resources, socioeconomic status -Plus cultural values
3. Non-shared environmental factors - Like different peer groups can effect attitudes -As do unique life events -And order of birth may cause variable parental attention

Psychodynamic Approach to Personality

• Uses the interaction of ID, EGO, SUPEREGO
• And developed through psychosexual stages

The Id

• ID seeks instinctual pleasure and avoids pain
• Known For instant gratification
• Operates entirely on unconscious level
• Its contains biological drives and instincts

The Superego

• Pushes the individual for moral perfection
• Known for enforcing strict moral guidelines
• It is the moral and ethical component of personality
• Which represents society and all of it's standards
• Develops around age 5-6
• There are two subsystems of The Superego: -Conscience cause guilt -Ego cause ideal aspirations -Might also cause guilt for lying

The Ego

• Delays gratification when necessary through reality
• Achieves balance between the Id and External world
• It is a rational and realistic part of mind
• Which is the executive decision maker
• It balances the impulsive side and the moral constraints

Defense Mechanisms

• Repression push thoughts away
• Denial refuses to accept thoughts
• Attributes own feelings or thoughts towards others called projection
• Reaction formation is acting opposite to true feelings

Psychosexual Stages of Development

• Experience conflicting conflicts between needs and expectations
• Fixation during stages can cause behavioral issues later in life

ONLINE learning

Behavior Therapy

• Personalities should be explained by behavior. And not thoughts
• All these processes happen deep outside of awareness
• Called the unconscious
• (Behavioural Approach is under genetic and Environmental control
• Behaviors are strictly determined

Social Learning Therapies

• Cognition that determines personality is expectancies
• Interaction between traits thoughts
• Expressed through behavior
• Known as Reciprocal determinism

Humanistic approach Therapies

• Motivations relate to personality expression
• Rogers theory of function
• Leading to worth of barries
• As Maslows theory self actualizing tendency

Kinds Of Models

• Humoral model
• Types versus trait models
• Inheritance of Genes

Personality Traits

• Causing behavior
• Residing in brains
• And change personality

Raymond Cattell

• Known as 16 personality

Neil McCrae and Paul Costa

• Known as the BIg 5
  • measure neuroticism

NEO

• PI (personality inventory) -Consists of 181 items

Eysenck

• Had 3 bipolar dimensions
  • neuroticism

Temperament:

• High on extroversion

CAPI

• Is from china
• Has different personality constructs
• Are called factors

Biopsychological Theory

• Affecting by systems

Behavioral Inhibition System, or BIS

• related to reward or avoidance

Personality assessments:

• Early attempts: not related

Phrenology-

• Ideas that brain

Not Evidence

• Early attempts were just evidence

Objective attempts

• Diagnosing with mmpi

Projective tests:

• Present ambiguous

Thematic Theory

• Goes on in image
• Subjective

Tutorial Lecture

Categories

• Types lecture

Lecture:

• Traits
• Genetic
• Impulsive
• Routine

WK3 - Measurement and Intelligence

• Fours main measurement catergories: Aptitude which measures what someone might do Achievement what can be done NOW Intelligence general cognitive function Personality measurement aspects of personal character

• Testing Reliability and viability should be bias. Testing population that represents the test Normal distribution

• Reliability is consistent over time measurements: Alternative same test, over different days and tests Split and repeat halves, find similarities and correleations across repeated split tests

• Test twice and review validity over tests Predicative validity the scores over test Conclude the designed measurement matches theory.

Intelligence is being able to apply and learn and behave.

• Adapt in cognitive ability.
• Underlined in abilities includes: apprehension, correlation, relations and general intelligence.

Components require analysis and good correlation

WK3 - Schizophrenia facts

• Common psychological prevalence is common.
• Symptom domains show in some domains.

Direct costs that are used and used for illness such as:

• health admission costs
• expenses, employment Also involves indirect production such as careers or mortality and illness
• Productivity may decrease as does informal care and lack of income

DALY is potential mortality rates. Diagnoses DSM as statistical diseases and manual cases or diagnosis.

Schizophrenia shows psychotic disorders.

• Symptoms present throughout life for 6 months
• 2 of the follow symptoms that are the 5 main:

Positive fact symptoms which are fact, hallucinations, disorganised, catonia, and negative aspects

Delusions

-False beliefs that are contrary, even if that has high evidence against -persecution -grandeur donot argue with people and build relations

Disoganized is to make up words that are a combo of other words

• word salad

• Tangentiality that associate in topics.

• With little relevance but it is extreme

hallucinations and senses

• auditory is that voices aren't derived from oneself Visual is non existent Olfactory isn't real Gastatory and Tactile is not not real

Disorganised of abnorms in motor skill are related such as: stillness, agitation, purposelessness and postures.

Negative symptoms are affects

• such as less emotions of their flat tone

• and impoverished processes.

• lack and not caring of themselves.

  Characteristics will be declining to decline or less appear

Positive symptoms that shows that are pre domitative shows that indicate positive or negative indication

Aetiology

• Bio factors
• genetic for abnormalities
• Abnormalities and birth.

Social - Low income, distress, poor and isolation

psycho factors- Levels of emotion or criticism Di stess are all model or stress

People are more liekly to show a positive response with an issue. And is managed it.

WK4 –Stress

-stress includes flights survival, recognize

hormones, mobilize, responses to challenges for short and more time. longterm activation leads to stress and affects body problems are digestion, headaches, hearts, sleep, and immune issues or aging

Theory: - appraise primary and challenge to stimulus

• If no then its a benefit, if it does then its a thread, loss

• Time management, prioritized support and counselling is prioritized

• Frustrations come from failure, loss, support and tension

• List pros and cons

• Change Uncertainty and lack idendity

• Social to conform and be happy

Emotional Response

• Warning system

Adaptive includes:

• Relax and support

• Heart and stress hormones is needed for change. A way to feel more better and health and is called cognitive

• health is in later life.