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This 0 page Class Notes was uploaded by Lynette Walker on Monday December 7, 2015. The Class Notes belongs to Psych 413 at University of Washington taught by Kathryn Monahan in Fall 2015. Since its upload, it has received 14 views. For similar materials see Adolescent Development in Psychlogy at University of Washington.
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Date Created: 12/07/15
Week 10 1130 124 Depression and other internalizing problems gt Categories of problem behaviors o Internalizing mood disorders anxietydepression Links between adolescence sand adulthood Emergences of gender differences Increased prevalence High comorbidity First appearance in adolescence o Externalizing Delinquency Aggression 0 Substance abuse 0 High comorbidity The different behaviors often go hand in hand gt Depression during adolescence 0 De ning depression Complicated involves several domains of an individual s life Emotions overwhelmed sadness apathetic low self esteem irritable A mood change towards negative forms of mood Cognitive pessimistic hopeless o Interpret things in very negative ways Distortions of body image especially seen in girls Motivational apathygtess pleasure experiencedgt less motivation o Withdrawal from social activities Motivated towards suicide as an avoidanceescape Physical Loss of appetite decrease in sex drive loss of energy sleep deprivation o Severity Depressed mood something we all go through once in a while doesn t reach clinical signi cance Depressive symptoms symptoms like MDD but without the continuous experience of it Clinical depression major depressive disorder 2 wks of continual depressive symptoms gt Diagnostic Criteria for Depressive Disorder o Depressed or irritable mood for most of day or for more days than not for at least 2 weeks straight 0 Must also have the presence of 4 of the following Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low selfesteem Poor concentration or dif culty making decision Feelings of hopelessness 0 Symptoms must cause clinically signi cant distress or impairment in social school or other important areas of functioning o 8 of students in study experienced symptoms of MDD within the past year 0 15 of youth will experience MDD symptoms by age 18 gt Graph 0 Deaths from Suicide and homicide between countries 1524 year olds US has highest homicide rates Canada has highest suicide rates gt Adolescent suicide 0 O O 0 Stats 10 of females and 6 of males attempt 30 have suicidal ideations 3rCI leasing cause of deaths among 1524 year olds They don t usually die of natural causes during this period leading cause of death being car accidents 54 used rearms more successful Highest among American IndianAlaskan Natives Lowest among African Americans Nonsuicidal selfinjury Ritualistic selfinjury cutting burning etc used as a coping mechanism to relieve stress 25 of teens report Suicide clusters Gould Jamieson amp Romer 2003 0 Teens who know others who have committed suicide are more at risk for committing suicide themselves gt Risk Factors for Suicide 0 O 0 Psychiatric problem history of depression andor substance abuse History of suicide in the family Being under stress areas of achievement and sexuality a strong risk factors 0 Experiences parental rejection family disruption or extensive family con ict Experiencing 1 increases risk experiencing 2 or more increases risk exponentially These are universal risk factors despite age gender or ethnicity Youth with family members who committed suicide are even more at risk gt Suicide Contagion 0 Johann Goeth German writer published Sorrows of Young Werther A book about a man who commits suicide because of an unrequited love So many young men identi ed with this character that they committed suicide in a ritualistic fashion similar to character 0 1519 year ods are most susceptible o DoseResponse relationship the more exposure to suicide the stronger the in uence 0 Teens who knew someone who committed suicide are 3 times more likely to make an attempt gt Why is adolescence a time of high vulnerability to depression 0 Biological Brain maturation structures in brain that have to do with emotional expression and emotional response mature after pube y Puberty Hormones stress response systems are changing more reactive to stressors Bodily changes can cause issues with self esteem Sleep deprivation Can be a risk factor 0 Cognitive Introspection metacognition Rumination thinking about one thing over and over again 0 Seeing the world in a hopeless mindset Strong tendencies of rumination in women 0 Social Exposure to stress increases Changes in relationships with adults Substance abuse gt Risk factors for depression 0 DiathesisStress model Diathesis predisposition to depression O Someone highly predisposed to depression will experience depression despite the severity or lack thereof of the stressors they experience Someone with a low diathesis will have to experience many strong stressors to develop depression Elements of diathesis Neuroendocrine vulnerability Hormones in the brain Serotonin is a big one Cognitive styles 0 People who think more like Eeyore vs Pooh Bear gt Types of Stress O O O 0 Day to day events or major events Families with high con ict and low cohesion Unpopularity poor peer relationships or friends who are depressed Chronic ie poverty exposure to violence and acute ie health issues death in family stressors gt Gender differences in depression 0 graph X axis age 1220 Y axis Mean depressed mood scores Males stay fairly constant low mean DM scores not much variation 0 Females increases at puberty and continues until young adulthood Gender differences are linked to puberty not age gt Why are girls more vulnerable O O 0 Reactions to puberty Genetic in uence more vulnerable to effects of genetic predisposition than men Genderrole hypothesis Social roles that girls play 0 Have to be feminine more emotional passive maintain social relationships internalize issues Cognitive style Girls ruminate more Sensitivity to interpersonal stress Oxytocin love hormone Issues in maintaining relationships causes stress Coping with stress Strong link between stress and depression Girls experience more stressors 0 Primary coping style xes problem women less likely to use it 0 Secondary coping style distracts from problem gt Treatment 0 Cognitive Behavioral Therapy 12 sessions Helps patient to reinterpret day to day events in a positive way Poking holes in negative pervasive view of world 0 Selective Serotonin Reuptake Inhibitors Prozacantidepressant Altering levels of serotonin for brain to use increase in availability and functioning at synaptic terminals They take about 68 wks to kick in The beginning of treatment is a very dangerous stage 0 Say at day 0 of treatment you are thinking of killing yourself You are apathetic so you don t have the energy or motivation to follow through 0 As your apathy decreases your thoughts of killing yourself don t yet High risk of suicide during that period before 68 wks are up 0 Best when both are used Substance Abuse gt Graphs 0 Alcohol use in the past 30 days measuring 8th graders 10th and 12th graders Xaxis 19762014 Y axis percentage of alcohol use 0 Overall reduction in alcohol use especially in 12th graders over time from 60 to 40 Individuals are more likely to use alcohol as they get older 0 Binge drinking in the past 30 days same grades X AND Y axis are the same as last graph 0 There are lower levels of binge drinking overall still see declining rates 12th graders with the highest rates 0 Cigarette use in the past 30 days same grades Same axis 0 There s a peak around 90 s rst recession then a reduction in use after recession age trend still present 0 Marijuana use in past 30 days o Marijuana use in past 30 days Same axis 0 Peak in late 70 s Woodstock effect 0 Very low around the 90 s 0 Increase in marijuana use after 90 s projected increase in future 0 Age trend still present 0 Other illicit drugs Same axis 0 Peak in 80 s 20 of high schoolers at graduation report using illicit drugs gt Developmental Pathways 0 Gateway Drugs Alcohol and Marijuana Model people who use these substances are disproportionally more likely to escalate to more illicit drug use Does not mean everyone 0 Abuse Mild Moderate Severe Dependence Tolerance o Withdrawal Disruptive to lifestyle substance use disorder 0 They don t all go on to be addicts Precocious Abuse gt substance abuse disorders Experimenters vs Abstainers Shedler and Block 1990 0 Casual experimenters sometimes have better psychosocial outcomes than abstainers 0 Not high usage high usage depression academic failure delinquency mood issues etc gt Impact of Drug use during adolescence o Susceptibility to addiction is higher Delaying use can protect individuals from disorders developing during the lifetime 0 Changes in limbic system Dopamine control makes you feel good 4 F s food fear ght sex How do you get addicted They make you feel good 0 Can no longer feel natural highs from positive dopamine related experiences at a normal intensity being with family eating good food Greater Dopaminergic response during puberty No reversible effects of dopamine effect reduction gt Are adolescents wired for addiction 0 Experiment Exposure to nicotine in rats Selfadministering nicotine infusions per session and amounts of nicotine Adolescent rats selfadminister the drug more with more amounts per dose 0 Graph Alcoholism and age at rst drink comparing men and women 0 X axis age at rst drink 0 Y axis rate of alcoholism 0 Drinking before 14 increased risk of alcoholism gt Alcohol s effects on the brain 0 Impact on memory Suppression effect on hippocampus Inability to form new memories 0 Possibly because of disruption of neuroplasticity Differential effects on adolescents and adults Adolescents are much more vulnerable to negative cognitive effect of alcohol gt Moris Water Maze Task 0 Markwiese et al 1998 Assessing learning in drunk vs sober adolescent and adult rats Rats put into tank of water must swim around to nd the platform to stand on 0 Levels No alcohol low levels of alcohol high levels of alcohol Adolescent rats are more vulnerable to alcohol induced learning impairments at any level Adults effected at high levels
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