Abnormal Psych, Etiologies (and Prevalence) Review

DSM-V (American Psychiatric Association)

Diagnostic and Statistical Manual of Mental Disorders: a handbook used by psychiatrists in the US to identify and classify symptoms of psychiatric disorders. Standardized system for diagnosis based on factors such as the person's clinical and medical conditions, psychosocial stressors and the extent to which a person's mental state interferes with his or hers daily life.

ABCS's of symptoms (of depression)

A-ffective symptoms: emotional elements, including fear sadness, anger

B-ehavioral symptoms: observational behaviors, such as crying physical withdrawal from others, and pacing.

C-ognitve symptoms: ways of thinking, including pessimism, personalization, and self-image

S-omatic symptoms: physical symptoms: facial twitching, stomach cramping, and absence of menstruation (amenorrhoea).

Stigma

A mark of disgrace associated with a particular circumstance, quality, or person -- often attached to those diagnosed with a psychological disorder, especially when seen as an ongoing, primarily medical matter

Self-fulfilling prophecy effect

When someone begins to act or think as they are expected to; for example when someone is labeled as mentally ill, they may begin to act mentally ill.

Point prevalence of a disorder

The measure of the total number of cases of the disorder in a given population, currently (sort of a snapshot of "right now")

Period prevalence of a disorder

The percentage of the population that will experience the disorder at some point in time (perhaps over one year, or a lifetime)

Factors limiting accuracy of prevalence measures

1. Risk factors = prevalence measures miss fact that some groups may be more or less "at risk" due to circumstances (e.g., refugees from war, being of low socioeconomic status, etc.)

2. Differences in SELF-REPORTING due to culture (e.g., depression and gender differences between men/women due to expectations on how to "handle" sadness/depression; stigmatization can be an issue)

3. Differences in DIAGNOSIS, by mental health professionals (e.g., interpreting client's reported symptoms differently due to gender)

Padesky & Hammen (1977)

To investigate whether expression of depression is different in men compared to women -- 972 male/1,300 female single college students completed the Beck Depression Inventory (BDI) -- No significant differences on the overall severity of their depression

HOWEVER, significant differences in the types of expression of symptoms:

Men = loss of ability to cry, loss of social interest, sense of failure, somatic (bodily) responses

Women = Cognitive indecisiveness, affective self-dislike/sadness

While equally depressed, men and women's expression of symptoms may be impacted by gender-role expectations, with men potentially "masking" symptoms behind somatic complaints and social withdrawal

This may lead to underreporting of depression in men, who may not display "traditional" affective symptomology

Onset

The average age at which the disorder is likely to appear

Etiology

The study of the factors involved in a disorder's manifesting itself (its causes)

Multi-axial approach

Understanding that psychological disorders are complex. There are no simple causes -- there are genetic, physical, mental, emotional, environmental, and cultural factors at play in almost all of them.

Diathesis Stress model

Interactionist approach to explaining psychological disorders -- claims that depression may be the result of a predisposition (biological = genetics, cognitive = negative self-schema from childhood, sociocultural = several factors) with environmental stressors then acting as "triggers."

selective serotonin re-uptake inhibitors (SSRI's)

The most common group of antidepressant; increase the level of available serotonin by preventing its re-uptake.seroti

Serotonin hypothesis

Because there is a correlation between low levels of serotonin and depression, it was believed that low levels of serotonin leads to depression - but this theory is challenged today.

Lacasse and Leo (2005)

Argue that contemporary neuroscience research has failed to provide evidence that depression is caused by a simple neurotransmitter deficiency

Kendler, et al (2006)

To determine the influence of genetics in major depressive disorder -- Participants = over 15,000 twin pairs listed in the national Swedish Twin Registry - some were MZ's, some were DZ's

Researchers used team of trained interviewers to carry out telephone interviews between 1998-2003 - assessed lifetime MDD prevalence using modified DSM-V criteria

Also asked about "shared environment" (did they live in the same household?) and about personal life events that might've made one twin more susceptible to MDD than the other

8,056 twin pairs met the diagnostic criteria

Heritability was significantly higher in MZ's than DZ's

Overall, heritability = 0.38

Genetics does appear to play a statistically significant role in MDD prevalence, within a population

Border et al (2019)

Meta-analysis, critical review of two decades of research on genetics and depression vulnerability -- concluded that 18 "candidate genes", each of which had been studied in at least 10 journal articles each, were no more related to MDD vulnerability than any other randomly-selected genes -- so, impact of genetics on the development of MDD is much more complicated than previously thought

cognitive distortions

Irrational, inaccurate thoughts that people have about environmental events -- contribute to depression

Automatic thoughts

an unspoken, semi-conscious "narrative" that accompanies everything you do -- with depressed clients, these automatic thoughts are typically dark, exaggerated, and irrational

Cognitive Triad

Negative cognitions (thoughts) about self, world (=other people) and future can trigger depression

Beck (1967)

Interviews and research into self-reports of people suffering from MDD - patients were compared with a group of non-depressed patients undergoing psychotherapy, matched for age, sex, and social position -- found that depression is the product of negative self-schemas, which develop early in life, heavily influenced by parents - so, abuse, bullying, excessive criticism

Lewinshohn et al. (2001)

Longitudinal study of 1,500 adolescents - given a test to measure levels of "dysfunctional beliefs" - those who began the study with high levels dysfunctional beliefs were more likely to develop depression after a stressful life event than those with low to moderate levels

Brown & Harris (1978)

A study of social origin of depression. Found on average that 82% of those who became depressed had recently experienced at least one severe life event or major difficulty. They also found evidence that of a pronounced social class effect. Established that social stress plays a decisive role in triggering many depressive episodes, but it also demonstrated that social factors may increase an individual's vulnerability for depression.

Hammen, et al (1993)

Conducted a longitudinal study which concluded that having a dysfunctional family, with high levels of stress, made children more vulnerable to depression in adulthood

These children:

1. were less likely to develop effective communication and interpersonal skills

2. Had lower self-esteem

Less likely to develop effective stress-coping strategies