Psychology of Aging Weekly Notes
Psychology of Aging Weekly Notes 22392
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This 3 page Class Notes was uploaded by Kenedy Ramos on Sunday April 17, 2016. The Class Notes belongs to 22392 at Gonzaga University taught by Dr. Wolfe in Spring 2016. Since its upload, it has received 16 views. For similar materials see Psychology of Aging in Psychlogy at Gonzaga University.
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Date Created: 04/17/16
Psychology of Aging Weekly Notes: Depression and Alcohol Use in Elderly People Mental Health Services Prevalence of Depression: 25% of elderly have symptoms of depression but don’t meet the full criteria (some of the symptoms are because of physiological changes rather than pure depression) In 2000, persons over 65 made up 13% of the population and yet accounted for 17% of completed suicides Suicidality is very high in elderly white males, medical problem, substance abuse and lack off social support Men are also more likely to use lethal methods such as guns, hanging, and carbon monoxide poisoning Diagnosing Depression in the Elderly A. 5 or more symptoms for 2 weeks with at least one symptom (sxs) is either depressed mood or loss of interest or pleasure a. Depressed mood most of the day nearly every day, markedly diminished interest or pleasure in all or almost all activities, significant weight loss when not dieting or weight gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate or indecisiveness, recurrent thoughts of death or suicide B. Sxs do not constitute a mixed episode C. Clinically significant distress or impairment in social, occupational, or other important areas of functioning D. Sxs are not due to direct physiological effects of a substance or a general medical condition E. Sxs are not better accounted for by bereavement Confounding Factors in Diagnosis Medical A first in lifetime episode of depression in late life may signal an underlying or comorbid medical illness Depression may precede such conditions are Alzheimer’s or Parkinson’s, may occur during recovery from medical illnesses such as heart attack or stroke, is frequently associated with cancer with 80% of all cancers occurring in persons over 60 Depression Inventories Beck: 21 sxs grouped together, sometimes over or under diagnosed disorders Whooley: asks two questions; have you been bothered by feeling sad, depressed or hopeless and have you been bothered by little interest or pleasure in doing things, very accurate but it did over diagnose slightly Geriatric Depression Scale: short form, 15 questions answered either yes or no, scores greater than 5 suggest depression and scores greater than 10 suggest highly indicative of depression Biology of Depression Stress causes the hypothalamus to release CRH (corticotrophin-releasing hormone). CRH acts on the anterior pituitary to cause release of ACTH (adrenocorticotrophic hormone). ACTH acts on the adrenal gland to release cortisol. Cortisol associated with structural changes to the hippocampus including cell loss. Cortisol appears to cause neuronal cell loss in the hippocampus. Hippocampus is an area of the brain known to be capable of neurogenesis throughout life. Treatment with antidepressants causes increased cell production in the hippocampus. Brain derived neurotrophic factor (BDNF) is known to be upregulated with use of antidepressants. Three major neurotransmitters implicated in depression are dopamine, norepinephrine, and serotonin. Tricyclics are dangerous for the elderly with depression – they have too many side effects that could endanger their health. SSRI’s are therefore used more often than any other type of medication. Psychology of Depression Martin Seligman created the learned helplessness theory by studying dogs who were repeatedly shocked versus dogs who were not shocked. He found that those who were shocked and let free did not move, while those who were not shocked quickly escaped when set free. Seligman applied this theory to humans as a potential explanation for depression, but he also found that there were some people who despite many bad experiences were not depressed and that depressed people thought differently bout bad events. Three Events: Personalization – internal vs. external Pervasiveness – specific vs. universal Permanence – temporary vs. permanent Ex/ Failing a psychology test I’m stupid vs. that test was rigged I’m not good in psychology vs. that was a crappy score I’m never going to graduate vs. it was a one-time thing, not big deal Alcohol Abuse in the Elderly Approximately 50% of persons 65+ use alcohol at least occasionally. People older than 75 are less likely to use alcohol than younger people. Culture/Environmental factors are also at play. Diagnosing Alcohol Abuse A. Maladaptive pattern of use leading to clinically significant impairment or distress with one of the following sxs in the past 12 months: a. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school or home, recurrent use in situations in which it is physically hazardous, recurrent legal problems related to substance use, continued use despite persistent or recurrent social or interpersonal problems caused or exacerbated by effects of using the substance B. Doesn’t meet criteria for alcohol dependence Diagnosing Alcohol Dependence A. Maladaptive pattern of use leading to clinically significant impairment or distress as manifested by 3 or more of the following sxs in the past 12 months a. Tolerance; increased amounts to achieve effects or, diminished effect with use or same amount, Withdrawal; withdrawal sxs if use is stopped or, use of substance to avoid withdrawal effects use of larger amounts over longer time periods than intended, unsuccessful attempts or desire to cut down or control use, a great deal or time spent obtaining, using, or recovering from use, important social, occupational, or recreational activities are giving up or reduced because of the substance abuse, continued use despite knowledge or a persistent or recurrent physical or psychologic problem either caused or exacerbated by substance use
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