02/21/2025

if it can be experienced it can be conditioned!

things that relieve anxiety doesn’t always make sense

OCD

lack of control phobia: if I have control over stuff then nothing bad can happen. It creates a safety behavior of controls and rules.

• rule governed

• control

an anxiety disorder characterized by either:

-obsession: intrusive and recurring thoughts, impulses, and images that are irrational and appear uncontrollable to the individual

• various forms: thoughts, images, impulses, doubts, etc

• are experienced as distressing: unwanted, threatening, obscene, blasphemous, nonsensical, etc; incongruent with individual’s belief system; attempts are made to resist obsession (doesn’t want the thoughts, images, impulses, doubts, etc).

• Hyper-vigilance to thoughts and feelings

• environment changes: obsessive thoughts shift

  • example — having children can shift the obsession thoughts, feelings, etc.

• general categories:

  • contamination: something external coming to my internal making me sick

    • what if i’m spreading the germs everywhere

  • responsibility for harm: if I have this thought will it actually cause them harm and when

    • if I don’t warn people about the ice and they get hurt, will it be my fault?

  • incompleteness:

    • make sure things are symmetrical or exact

    • everything has it’s place, nothing should be outside of it’s designated place — gaining some control back

  • Unacceptable thoughts with immoral, sexual, or violent content:

    • impulse to stab friends in their sleep

  • superstition conditioning

  • horological conditioning

-compulsions: is a repetitive behavior or mental act that the person feels driven to perform in order to reduce the distress caused by the obsessive thoughts (the activity is not realistically connected with its apparent purpose or is clearly excessive. — not always connected to the “fear/ anxiety” — can evolve

• are motivated and intentional behaviors

• are performed to reduce distress/obsessional anxiety

• commonly reported:

  • decontamination

    • handwashing for 45 minutes after using the bathroom

  • checking

    • returning home after seeing a fire engine to make sure their own house is safe

  • repeating routine activities

    • going through a doorway over and over to prevent bad luck

  • ordering/ arranging:

    • rearraning book on a book shelf in size order

  • mental rituals

    • cancelling a bad thought by thinking a good thought

    • excessive praying to prevent feared disastrous conseuqences

OCPD — organizing : anxiety or personality “disorder”

• social anxiety thats very extreme it becomes a personality “disorder”?

hoarding is hard to treat

02/24/2025

Hoarding

• a subtype of OCD

• thoughts are not intrusive or unwanted

  • can be neutral or positive

• hard to conceptualize excessive saving as compulsive or ritualistic

  • does not seem to result in an escape from (or neutralization of) obsessional anxiety

• difference from a collector and hoarding

  • a collector: has some sort of trading value for many individuals

  • a hoarder: has value for the individual but not necessarily others

    • typically sentimental or monetary

Subtypes

• poor insight and overruled ideation

• individuals who view their obsesional fears and compulsive behavior as reasonable

• more strongly associated with religious obsession, fears of mistakes, and aggressive obsessional impulses

Biological models of OCD

• serotonin Hypothesis

  • OCD arises from abnormalities in the serotonin neurotransmitter system

    • Medications that increase brain levels of serotonin are effective in reducing OCD
      symptoms

  • Structural Abnormalities:

    • Connects regions of the brain that play roles in information processing
      and behavioral responses

    • Examination of glucose utilization in OCD and non-OCD brains

  • Evaluation

    • no explantion as to why serotonin or structural abnormalities cause OC behaviors

    • unable to explain themes and content in OC behaviors

Learning Models

• two-factor theory

  • stimulus that poses no objective threat that comes to evoke onxiety obssional fear

  • avoidance behaviors develop as a means of reducing anxiety

    • superstitious conditioning

• Evaluation

  • operant conditioning has to play a role in maintenance of behaviors

  • little evidence that classical conditioning can account for inset of fear

    • verbal transmission and modeling may account for development

Cognitive behavioral Model

• unpleasent mental intrusions are a normal and universal experience

• cognition in OCD individuals

  • cannot tolerate or dismiss mental intrusions

    • appraise the metnl intrusion as posing a threat

    • believe specific thoughts are indicative of abonormality

  • attempt to inhibit thoughts have paradoxical effects

    • white bear phenomenon

• Behavioral component:

  • compulsive behaviors persist because they are immediately reinforced by reducing anxiety

  • ego- dynamic

• psychodynamic model

  • OC behaviors represent unconscious conflicts between the id(devil) and the superego(angel)

    • accounts for general themes in obsessive thoughts

      • contamination, sex, aggression

    • Aligns with general organizations o the brain

no real age onset.

Depression

Case study: Janet

• needs help with her 5 year old son Adam

• called a mental health center — treatment seeking

  • vague cause it might be for her or the son

• might have previous experience with a “disorder”

• treatment seeking person

• Themes

  • rushed into marriage with David?

  • had to drop out of college after getting pregnant

The Depression Epidemic

• single most common form of psychopathology

  • “the common cold of mental health”

  • affects approximately 33 million american at some point in their life

    • for those >13 yo, lifetime prevalence is about 30% and 8.6% for 12-month prevalence

  • rates of depressive symptoms inclined acrossacross the board during
    COVID-19

• Prevalence rate of depression appears to be increasing while
  the age of onset for first episode decreasing

Gender differences in Depression

• Women are twice as likely, on average, to develop depression

  • Across nations

  • Diagnostic system

• The rates of depression in girls and boys do not differ until about
  age 13, whereat:

  • Girls rates increase sharply and are twice those for men by late
    adolescents

    • Lower age at onset predicts a worse course of the disorder only for females

  • Boys rates remain low and may even decrease.

• “in three decades of research … no one variable has single-handedly accounted for the gender difference in depression

• but some themes have developed”

Socioeconomic Status

• meta-analyses indicate that lower levels of educational attainment associate with depression, as does economic inequality more generally

• Because women have less power and status than men in societies, they are:

  • More likely to experience more chronic pains (poverty, harassment, constrained choices, etc.)

  • More likely to experience interpersonal traumas (e.g. sexual abuse) and highly adverse issues

• Gender differences in biological responses to stress:

• Hypothalamic-pituitary-adrenal (HPA) axis: regulates stress responses

  • It is hypothesized that women are more likely to have a dysregulated HPA response to stress because women are more likely to have exposure to events/situations that contribute to HPA dysregulation

Comorbidity

• Depression is a common comorbid problem with both physical ailments and behavior disorders

  • Evidence suggests that the presence of other problems augers later depression (e.g. anxiety, substance abuse, etc.)

  • Depression can also lead to other comorbid problems

• Transgenerational

  • A large meta-analysis by Goodman et al. (2011) found that maternal depression was significantly related to higher levels of internalizing, externalizing, and general psychopathology and negative affect/behavior and to lower levels of affect/behavior in children

Other Risk Factors

• Divorce

  • The process of divorce usually entails a myriad of stressors (e.g. financial, legal, logistical challenges; emotional and social adjustments)

• Single-parent status, stress, and social support

  • More likely to have depressive episodes, higher levels of chronic stress, lower levels of perceived social support, social involvement and frequency of contact with family and friends

What is Depression?

-Depression: depressed mood and/or loss of interest or pleasure in daily activities or more than two weeks

• Mood represents a change from baseline functioning and is accompanied by impaired social, occupational, and/or educational functioning

• Anhedonia: characterized by a diminished ability to experience pleasure or interest in activities that were once pleasurable

• At least 5 of the following 7 symptoms (present nearly everyday)

1. Significant weight change (5%) or change in appetite

2. Change in sleep (insomnia or hypersomnia)

3. Fatigue/loss of energy

4. Feelings of worthlessness/excessive guilt

5. Concentration difficulties/indecisiveness

6. Psychomotor agitation or retardation

7. Suicidal ideation

Pacific Sleeper Shark: known to be sluggish but has quick bursts of energy

• Conservation withdrawal: strategy of preserving or regaining energy and resources

Patch Behavior (Deer): as the food in a patch becomes depleted, organisms give up on a patch if the rate of return is lower than the return in other patches

• If the overall return drops below the cost, foraging stops

• E.g. foraging may stop and deer will remain motionless even if starving

Learned helplessness: dogs exhibited a lack of escape behavior when unable to control intermittent shocks to their feet

• Led to theory that depressed person expects that they are helpless to control aversive outcomes and behave in accordance with these expectations

• E.g. a dog lying motionless because instead of jumping and getting shocked, they choose to only get shocked – the consequences are unavoidable so they conserve energy

• Situations where any behavioral response is unlikely to achieve some positive outcome (food) or avoid a negative outcome  (shock)

• Biologically driven down regulation of a prepotent (i.e. dominant) reponse

Nesse (2000)

• there are benefits to regulating investment strategies as a function of change in anticipated levels of payoffs

• in certain situations, down regulation of effort and risk taking is an advatage

Wender & Klien (1982 p204)

• “biologically based self-esteem — and mood in general — seems to us to have evolutionary utility .. If one is subject to a series pf defeats, it pays to adopt a conservative game plan of sitting back and waiting and letting others take the risk. such waiting would be fostered by a pessimistic outlook”

Is depression an adaptation

• incentive-disengagement theory

  • the role of depression was to disengage motivation for an unreachable goal

• control theory

  • low mood prompts the consideration of alternative strategies

    • example: low mood elicited by a mismatch between achievements and expectations

• behavioral model

  • low rates of response contingent reinforcement (RCPR)

    • for aversive stimuli

      • response aimed at reducing aversive stimuli are not reinforced

    • for appetitive stimuli

      • response at producing rewards are not positively reinforced (may also be punished)

  • ultimately behavior that is not reinforced (or punished) will extinguish.

Depression as a Disorder

-Lewinsohn’s (integrative) Model:

• decrease in rewards (or increase in costs) in the environment lead to lower response-contingent reinforcement, which increase depressive symptoms

  • person does not engage in activities that provide reinforcement

  • the environment does not provide opportunities for reinforcement

  • inability to access available rewards (skills deficits)

  • environmental changes (example: loss)

• if response depression is adaptive, why is depression a disorder

-Avoidance Behavior

• response depression can create a self-perpetuating feedback loop

  • behavioral repertoire becomes more inhibited/narrow to avoid further negative outcomes, which is maintained through negative reinforcement

    • depressed behaviors serves an avoidance function aimed at all alleviating negative affect

      • excessive drinking, eating, sleeping, etc

      • social withdrawal

    • although avoidance behaviors provide immediate relief, they exacerbate depression in the long-run

behavioral activation— initial motivation to improve mood

• focus on positive reinforcement and engagement as a way to benefit in the long-term

Depression as a Disorder

• Response depression can create a self-perpetuating feedback loop:

  • responses tied to depression (pessimism) can cause impairments that yield additional aversive experiences (or preclude positive ones) that can lead to further depression

• cognition changes to be depressogenic, with particularly with respect to attributions

  • attributions

    • ascribing causal influences for some event

  • in depression, attributions become

    • specific, unstable, and external attributions for positive events

      • something good happens but it was just dumb luck.

      • the good thing that happened goes unapreciated by the individual because they don’t believe good things happen to them.

    • global, stable, and internal attributions for negative events

      • something bad happens and they apply it to everything, the negative event happened because of the individual

    • the more depressed you get a bigger shift of a negative mindset. This allows individuals to stay depressed.

  • a pessimistic attitude— …

-Cognition in Depression (Cognitive Therapy)

• self-schema of the depressed patient

  • cognitive triad

    • negative beliefs about themselves, their circumstances, and future

  • underlie the content of automatic thoughts

    • automatic, internal verbal statements about life experiences

• automatic thoughts using depressed vs. non-depressed cognitive triad

  • “tom passed by without saying hello; I guess he’s really busy today”

    • a positive schema

  • “Tom didn’t acknowledge me because he doesn’t like me - nobody and nobody will”

    • a negative schema — pessimistic mindset

• Cognitive Therapy — tries to slow down the process of automatic negative thoughts

• depression realism theory— individuals obtain depression by having an accurate view of the world

Depression as a Disorder

• Response depression can create a self-perpetuating feedback loop:

  • schema confirmation

    • individuals develop the expectation that desired outcomes are unlikely to occur and that no behavioral response will altar this likelihood

    • this view has consequences on behavior and information processing that exacerbate depression

Gender differences

• psychological differences

  • women are more likely to focus inwards when feeling distressed

  • men are more likely to be action oriented

Depression as a Disorder

-Lewinsohn’s (integrative) Model:

• decreased mood creates cognitive vulnerabilities (example: pessimism) and behavioral model consequences (social withdraw)

• information processing shifts to become more negative

  • negative information more accessible and efficiently processed

  • change toward more negative self-schema

Social Impairments in Depression

• similar to Lewinsohn’s model but more focused on how the social environment responds to the depressed individual

  • an initial event or situation elicits depressive symptoms and support and reassurance-seeking

  • an initially positive social response over time become hostile or resentful to the continued support - and reassurance-seeking

  • individuals either find excuses to create social distance with the depressed person or provide only insincere support or reassurance

    • the depressed person may accurately interpret these as rejection or platitudes and in any case feel socially isolated, furthering depression

Suicide

• suicidal ideation (thoughts) are not uncommon in depression, but do not necessarily translate into an attempt

• most models recognize that suicide risk is a result of the interplay between predisposing (also known as distal or diathesis) and precipitating (also known as proximal, triggering or stress) factors, with some models also specifying a role for developmental factors

• a critical factor is unbearable and inescapable psychological pain, combined with the belief that this situation will not change (hopelessness)

• tends to be an impulse decision

Depression in Men

• the suicide paradox

  • decline in mens functioning

  • although men report depression at lower rates than women, they die by suicide at much higher rates

    • possibly due to differences in coping styles and help-seeking behaviors

    • traditional masculine norms discourage emotional expression, leading men to underreport

      • can lead to suffering in silence

      • stoicism — show no vulnerability

    • men choose a more aggressive and lethal way of suicide, while women choose a more passive ways of suicide

    • women internal — men external

• masked depression — hypothesis

  • depression in men may be “masked” by somatic complaints, workaholism, or antisocial behavior

  • men may express psychological distress through externalizing behaviors (aggression, risk-taking, …) rather than through sadness

What about everyone else?

• transgender and nonbinary individuals report higher rates of depression than their cisgender counterparts, likely due to discrimination and stigma

  • especially among those who cannot access gender-affirming care

• LGBTQ+

  • family rejection significantly increases depression risk among LGBTQ youth, whereas family acceptance acts as a protective factor

antisocial —- harmful, disruptive, or violates social norms. — men are more likely to take it out on society rather than themselves

asocial — a lack of interest in social interaction or a preference for solitude

a support network act as a buffer to depression and anxiety

Addiction

Addictive behavior:

• any compulsive habit in which individuals seeks a state of immediate gratification despite longer-term costs associated with the habit

  • introduction of pleasure of euphoria

    • as it starts it gives you a pleasure high

  • in relief from discomfort

    • progresses to avoidance of negative feelings. — not chasing the pleasure but but the experience of relief from the craving

      • tension/negative mood

      • withdrawal effects

• excessive use of psychoactive substances

  • CNS depressants

    • alcohol, depressant drugs (Valium)

  • Stimulants

    • cocaine, amphetamines (speed), tabacco

  • Opiates

    • morphine, heroin

  • Psychedelics

    • LSD (acid), psilocybin (mushrooms)

• unhealthy behavior with compulsive characteristics

  • gambling

  • eating

  • sexual behaviors

  • video games

Substance Use Disorder — chemical addiction

• a maladaptive patterns of use leading to significant impairment or distress, as manifested by 2 or more of the following over a 12-month period:

  • substance taken in larger amounts or for a larger period that intended

  • inability to cut down or control use

  • time and resources spent in obtaining, using, or recovering from substance use

  • craving

  • failure to fulfill major role obligations

  • social, occupational, or recreational activities reduced because of addiction

  • continued use despite having persistent or recurrent social/interpersonal problems caused or exacerbated by the effects of the substance.

Biological Models of Addiction

• genetic risk

  • predisposition to find effects of psychoactive substances reinforcing

• predisposition for behavioral control problems (impulsive personalities)

  • greater orientation to pleasure-seeking in present

  • ignored potential consequences and risks of behavior

  • foreshortened orientation for the future

• a critical aspect underlying all forms of addiction behavior is the inability to regulate some behavior despite consequent problems resulting from the behavior

  • the immediate consequences tend to be pleasurable

    • positively or negatively reinforced

  • even large future consequences cease to regulate behavior

  • there are some genetic components

• a physiology change that adapts to the substance

  • this builds a tolerance that increases the dosage for the individual.

Temporal Discounting

• used as a model of addictive behaviors:

  • individuals may elect the short-term gratification associated with substance use over the long-term benefits of sobriety

    • individuals with addiction problems do “discount” rewards at a greater rate.

    • further away it is less value is given

    • individuals seek immediate rewards

    • marshmallow test — delay gratification kids did better later on

• Used as a model of addictive behaviors

  • models has been extended to include other factors relevant to the decision to engage in an addictive behavior

    • discounting costs

  • Addiction: choose the reward now instead of later on

Behavioral Models

• the decision

• operant conditioning

  • rewarding effects following behavior will increase the chance that the behavior will occur again

  • substance use

    • pharmacological, social, and environment factors produce rewards following self-administration.

• Classical conditioning

  • drug induced euphoria becomes associated with stimuli present during euphoric state

    • drug taking paraphernalia

    • locations — atypical location

    • behaviors

    • people

Opponent-process theory of addiction

• goal is to achieve a base level of functioning — baseline

  • the body’s reflex to get back to baseline after the introduction of something new like a substance

• opponent-processing

  • any effects of substance on central nervous system (CNS) are automatically by CNS mechanisms that reduce intensity of effects

    • function is to maintain or restore biological homeostasis

  • Two opposing processes

    • process A

      • effects of the substance

      • coffee — exited the body

      • the adrenaline has a quick effect

    • Process B

      • opponent biological response

      • coffee tries to bring the body back to baseline

      • starts a bit after process A

  • Properties of Processes A&B

    • latency to response

      • the time it takes for process initiation

    • Augmentation time

      • the increasing intensity of effects of process over time

    • Decay Function

      • the decreasing intensity of effects of process over time

• Subjective Experience

  • Experience = [A-B]

    • the adrenaline has a quick effect (process A)

    • starts a bit after process A (process B)

  When experience is negative, that is when withdrawal is experienced

  • Amphetmines

    • process A: euphoria, hypervigllance, sociability

    • process B: depression, hyppersomnia, irritability

  • Withdrawal Effects

    • process B last longer than process A

    • process B is aversive

    • if the HIGH felt good then the withdrawal feels awful which creates the craving to an extent

      • you can’t be HUNGOVER if your DRUNK

    • NEGATIVE REINFORCEMENT: I feel awful without the substance so I’ll take more which makes me feel great

  • Withdrawal and Addiction

    • reinitiating of process A is effective in removing aversive effects of state B

      • user learns to employ drug to remove Process B (operant conditioning)

  • Tolerance

    • Brody’s compensatory response (process B) is strengthened through use, weakened through disuse

    • More of substance is required to produce desired effects of process A

      • process A effects remain relatively stable over time

  • cravings

    • body learns cues related to substance intake (classical conditioning)

      • process B initiated when cue is present

      • process B produces withdrawal effects prior to substance intake (craving)

      • user initiates process A to reduce craving (process B)

    • environment matters

    • Craving cues from an environment letting the body know the substance is to be expected

      • some association stay forever, your body trains itself to react to said stimuli

    • withdrawal cues from your body that the drug is gone

      • your body is in the b-process

• Not relevant

  • reverse tolerance: your body becomes sensitized tp the drug

    • the body needs less to experience the substance