PSYCH 385, Lecture 9 and 10, 2-9-16 and 2-11-16
PSYCH 385, Lecture 9 and 10, 2-9-16 and 2-11-16 Psych 385
U of L
Popular in Abnormal Psychology
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This 6 page Class Notes was uploaded by Hannah Floyd on Tuesday February 16, 2016. The Class Notes belongs to Psych 385 at University of Louisville taught by Dr. Tamara Newton in Winter 2016. Since its upload, it has received 19 views. For similar materials see Abnormal Psychology in Psychlogy at University of Louisville.
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Date Created: 02/16/16
PSYCH 385-Abnormal Psychology Lecture Notes from 2-9-16 Anxiety Disorders 1. What is Obsessive-Compulsive Disorder? If we break this down into its parts we have an obsession and a compulsion which are related to one another in some way. So we’ll start with an obsession which is an unwanted or intrusive thought or image that causes distress in the person. An example would be “I think I’m going to cut up my sister into little pieces.” To be clear, this thought is unwanted, and causes distress, so these people do not want to carry out these actions and therefore are NOT homicidal. The compulsion is a behavior or thought that attempts to neutralize the thought. In our example this might mean the affected person calls his sister many times a day to see if she is still alive and that he/she hasn’t somehow killed her. These behaviors are often seen as a preventative measure and tend to reduce stress in the person with the obsession. This may occupy many hours in the person’s day and could cause trouble at work and with his or her personal relationships. Some common obsessions coupled with their compulsions would be: - Contamination/washing - Order/ordering - Losing control/counting - Doubt/checking - Possible need/hoarding Quick facts:  This is not too common a disorder with a lifetime prevalence of 2.3%,  the disorder effects both genders equally,  and the age of onset is typically in adolescence or early adulthood. It frequently is comorbid with anxiety and mood disorders, but is itself its own category. It is also comorbid with body dysmorphic disorder. 2. What causes OCD? Psychological Causes: The big theory here is Mowrer’s two-process learning theory which is based on classical and operant conditioning. In classical conditioning a person may have the doubt obsession and need to compulsively check the stove to make sure it is turned off for fear of the house burning down. Turning the stove off is an originally neutral stimulus, you turn the stove on and off every time you cook a meal, but when turning the stove off becomes linked to thoughts like “What if I didn’t turn the stove off and my house burns down?” the person has been classically conditioned. Operant conditioning with this example may look like this, going back into the house to check the stove provides a sense of relief which is a negative reinforcement this relief reinforces the checking which makes it more likely to occur. The problem with this theory is that it doesn’t explain the origin of the obsession. Stress often plays a role as well. So sticking with our stove checking example, say this person who has the checking compulsion did leave the stove on in his last home which led to the house burning down. This would be a good insight into the origin of the obsession and the development of the compulsion, not to mention many people might justify this person for doing this, which may lead them to avoid professional help. Thought suppression is the last psychological cause, it is often a very normal happening. Many a young teenage girl has fallen head over heals for a member of a boy band, the girl may experience an inability to stop thinking about the member have goofy posters in her room and even save her pennies to buy overpriced tickets to attend a concert. So how is this behavior different from OCD? Well normally this behavior is innocent and not maladaptive to the girl, she might spend a few hours a day total thinking about the boy band member whereas a person with a checking compulsion may take hours to leave his or her house in the morning due to checking. Efforts to control these obsessions may actually make them worse for the patient and have an amplifying effect. Biological factors: There is a moderate heritability for OCD. There is also evidence that abnormalities in brain functioning are present. One such example is the orbital frontal cortex-basal ganglia-thalamus circuit in the brain which controls motor behaviors and routines (BG), relay station to cortex (thalamus), and the executive control (OFC). This circuit is evolutionarily conserved, common among vertebrates and related to aggressive, sexual displays and their control. What is meant by “ritualistic, aggressive sexual displays” is this: when an animal is ready to reproduce there is often a mating ritual performed which is triggered by the circuit mentioned above, but if the context of the aggression/sex is bad then the OFC turns off the circuit—unless of course you have OCD. In OCD the mechanism that turns of the circuit is faulty. Using brain imaging researchers have found that in humans with OCD the interactions with the basal ganglia and the thalamus are not regulated but the orbital frontal cortex is overactive but not regulating. 3. How do we treat OCD? There are, as we’ve also seen previously, two categories of treatment, one being therapy and the other being medication. A medication that could treat OCD would be one that affected the neurotransmitter serotonin. The better, most effective treatment would be exposure and response prevention which is exactly what it sounds like. The person is subjected to the stress producing obsession and then is disallowed the pleasure of completing the compulsion. For example, if someone has an obsession centered around contamination they may be asked to touch objects around the room such as knobs, the floor, chair arms, etc., and then will not be allowed to wash their hands for a certain period of time. This allows the person to realize that stress caused by an obsession will go away. The psychologist or therapist will start with the most manageable task (determined by the patient) and then move up gradually. 4. What is Body Dysmorphic Disorder? It is an “excessive preoccupation with a perceived defect in appearance.” This defect is magnified in the person’s mind (or made up entirely) and the person may spend hours in the mirror, a ton of money on beauty products or enhancement agents, or exercise excessively. A person with BDD may seek reassurance from others about appearance, but most often this doesn’t help the person but only makes things worse for them because they often don’t believe the other person’s assurances saying things like, “they just don’t want to hurt my feelings.” It is highly likely to be comorbid with depression. It is similar to OCD in that it contains both an obsession (nose is too big) and a compulsion (constantly checks nose in mirror or hides it) Quick facts:  the general prevalence in the population is 1-2%,  the people with depression prevalence is 8%,  there is no significant gender differences,  age of onset is typically in adolescence. 5. What causes BDD? This is not a well researched disorder but there are some thoughts as to some causes of BDD: - It could be genetic and therefore somewhat able to be inherited. - It could be rooted in cognition meaning that people have thoughts like “If my appearance is flawed I am worthless,” or “No one will accept me if my [insert body part here] looks this way.” o This cognition could be a learned process, or o The person’s appearance could have been subjected to much positive or negative attention in the past - This also could be due to a heightened sense of cultural emphasis on physical attractiveness. - Studies have been conducted where the participants (control and test) were exposed to excerpts of information that had some words related to attractiveness and some unrelated. If you couldn’t guess, the people with BDD paid more attention to the information pertaining to attractiveness. 6. How do we treat BDD? The medication we would use to treat BDD would be an antidepressant of some sort. But, like most of the other disorders in this chapter, therapy is the preferred method of treatment. BDD uses the same therapy as OCD, exposure and response prevention. The person is forced to removed anything bought to hide the defect, like a hat to hide a perceived bald spot, and then is prevented from covering up the defect or checking it in the mirror. PSYCH 385-Abnormal Psychology Lecture Notes from 2-11-16 Mood Disorders (Affective Disorders) 1. What are mood disorders (affective disorders)? There are two categories of mood disorders: depressive disorders (unipolar) and bipolar and related disorders. Unipolar meaning only the experience of depressive episodes and bipolar meaning the experience of manic and depressive episodes. Common factors of both include the following: - The person feels sad, empty, or irritable (or a combination) - The person experiences physical and cognitive changes (they may be lethargic and have trouble thinking straight) - These disorders are both intense and unrelenting causing significant distress, impaired functioning, and risk of harm (themselves or others) 2. What is the difference between a mood and an emotion? The answer lies in the timing. An emotion is generally a quick event like your cat scratched you and it hurt and you got mad at it. You were mad for maybe the next few minutes to an hour (probably depending on how badly it hurt) and then you were back to being you. A mood is when that emotion is drawn out for long periods of time (days, weeks, months and so on). 3. Is a depressive episode always a part of a mood disorders? Nope. In fact, there are two specific instances where a depressive episode is normal and quite common. These are the postpartum “blues” and the time after losing a loved one, or the grieving process. In earlier versions of the DSM this was taken into account and you couldn’t be diagnosed with depression until a certain amount of time after the loss of a loved one. This is no longer a stipulation in the DSM- 5 because psychologists now believe earlier intervention (that does not interfere with the normal grieving process) will prevent relapse and the development of chronic depression. 4. Is depression always a bad thing? No, in fact, it can be both normal and adaptive. This is due to the person being “forced” to slow down and reflect on the situation the person is going through. All the individual feelings involved in depression like sadness, hopelessness, and pessimism are all common things experienced by normal, healthy people around you. 5. What is Persistent Depressive Disorder (Dysthymia)? It is often considered a milder version of major depressive disorder but is more chronic in nature than MDD. The depressed mood must last at least 2 years, there must be a noticeable change in functioning. You must meet these criteria plus two other symptoms in one of the following categories: - Cognitive (having trouble concentrating, feeling foggy) - Emotional (hopeless, low self esteem, low self worth) - Physical (have disrupted sleep and eating) It is possible to have spurts of normal moods but they need to be no longer than 2 months to still maintain a diagnosis of persistent depressive disorder. 6. What is Major Depressive Disorder? MDD has more than persistent depressive disorder generally speaking (the M in MDD think the m in more). It has more symptoms, is more severe, and the depressed mood must persist during most days. The loss of interest in things one used to enjoy, as well as a depressed/sad mood are the two main symptoms which one must maintain for two weeks. Plus, one must pick 4 symptoms out of the bunch listed above (in #5) in any of the three categories. Some of these extra symptoms manifest more severely in MDD than in persistent depressive disorder like the presence of suicidal thoughts, weight loss/gain, and psychomotor retardation. 7. Is there a course for MDD? Yes. It follows the course outlined below: 1. Premorbid functioning: the person is functioning fine before the illness 2. Prodrome: a period of mild anxiety or depression symptoms experienced weeks or months before the onset of MDD (can sometimes help alert caregivers to prescribe medicine) 3. Untreated Episode: this is the meat of the disorder where the person is in the thick of the symptoms. (If you’ve ever seen Twilight where Edward leaves Bella and she sits in her room and the shot scrolls around her showing the seasons changing and she is just sitting there… that’s the image I see when I think of this and I’ll probably reference it again so you may want to familiarize yourself with it. Not required test material though ) 4. Remission: this is the climax of the story, the person comes out of the depression and all symptoms cease for a 2 month period (if it is a full remission) In Chronic MDD there is no remission period for 2 years. This is only present in about 10-20% of cases. What is more common is Recurrent MDD in which the disorder returns after remission and the cycle starts over again. This is present in about 40-50% of the cases.
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