Shape of the Day Learning Intentions

- Notes - I will be able to

- Video clip describe mood
- Notes disorders
- TedX video clip - I will be able to
- Notes describe anxiety
disorders
 DSM-5
- In psychiatry & psychology, diagnostic
classification aims to describe a disorder, predict
its future course, imply appropriate treatment,
and stimulate research into its causes
-American Psychiatric Associations Diagnostic
and Statistical Manual of Mental Disorders
nicknamed DSM-IV but then DSM 5
-The DSM uses a "multiaxial" system for
assessment. This assessment model is designed
to provide a comprehensive diagnosis that
includes a complete picture of not just acute
symptoms but of the entire scope of factors that
comprise mental health.
 Axis I listed the primary or principal diagnoses that
needed immediate attention; this included recording
of clinical disorders as well as Other Conditions That
May Be a Focus of Clinical Attention (e.g., life
stressors, impairments in functioning; APA, 2000, p.
27).
e.g., a major depressive episode, an exacerbation of
schizophrenia, or a flare-up of panic disorder.
Axis II contained pervasive psychological issues such
as personality disorders, personality traits and
mental retardation (now intellectual disability
disorder) that shaped responses to Axis I disorders
so was predisposing the person to the axis 1
problem
The Axes of Diagnosis
Axis III was intended to cue reporting of medical
or neurological problems that were relevant to
the individuals current or past psychiatric
problems.
For example, someone with severe asthma may
experience respiratory symptoms that are easily
confused with a panic attack, or indeed, which
may precipitate a panic attack
The Axes of Diagnosis
Axis IV required clinicians to indicate which of nine
categories of psychosocial or environmental
stressors influenced client conceptualization or care
(e.g., recent divorce, death of partner, job loss).
Finally, Axis V included the opportunity to provide a
Global Assessment of Functioning (GAF) rating, a
number between 0 and 100 intended to indicate
overall level of distress or impairment.
 Axes I, II and III have been eliminated in the
DSM-5 (APA, 2013). Clinicians can simply list
any disorders or conditions previously coded on
these three Axes together and in order of
clinical priority or focus (APA, 2013).
DSM-5 published in 2013
Classifies psychological disorders by their symptoms
Guidebook for mental health professionals
Criteria for 22 major categories of mental disorders,
subdivided into 100s of disorders

Major criticisms:
People who don't need diagnosis and treatment will get it
Labeling is disabling labels are applied to the whole
person (she is schizophrenic) versus seeing that the
individual is suffering from a particular disorder
 Anxiety and Mood Disorders
Ch. 16 Psychological Disorders
The DSM-5 added a new category of disorders called
Obsessive-Compulsive and Related Disorders
(OCRDs) (also called Obsessive-Compulsive
Spectrum Disorders in the research literature).

The OCRDs category includes the familiar obsessive-

compulsive disorder. It also includes two newly defined
disorders with obsessive-compulsive features.
These are hoarding disorder and excoriation (skin-
picking) disorder. Also included in the new OCRD
category are body dysmorphic disorder
(previously classified as a Somatoform Disorder)
and trichotillomania (hair-pulling, previously
classified as an Impulse Control Disorder).
ANXIETY DISORDERS
Anxiety disorders: psychological disorders
characterized by distressing, persistent
anxiety or maladaptive behaviors that
reduce anxiety
There are several types of anxiety
disorders, including:
generalized anxiety disorder
panic disorder
phobias

obsessive-compulsive disorder
Generalized Anxiety
Disorder

An anxiety disorder in which a person is continually

tense, apprehensive, and in a state of autonomic
nervous system arousal
Tension and apprehension might be observable
through furrowed brows, twitching eyelids,
trembling, perspiration, fidgeting
Concentration is difficult (worrying all the time)
2/3 of the sufferers are women
 Panic Disorder

An anxiety disorder marked by

minutes-long episodes of intense
dread in which a person
experiences terror and
accompanying chest pain, choking,
or other frightening sensations
The fear of having a panic attack
becomes a problem itself, possibly
leading to agoraphobia (fear or
avoidance of situations in which
escape might be difficult or help
unavailable when panic strikes)
Panic Disorder
Smokers have 2 to 4 times more risk of a first-time panic
attack
Phobia
An anxiety disorder marked by a persistent,
irrational fear and avoidance of a specific object
or situation
specific phobia: fears that are selective,
persistent, out of proportion (e.g. heights, seeing
blood)
social phobia: an intense fear of being scrutinized
by others
person avoids potentially
embarrassing social
situations
Phobias
Just the As.
Ablutophobia- fear of washing or bathing.
Acousticophobia- fear of noise.
Alektorophobia- fear of chickens.
Alliumphobia- fear of garlic.
Amathophobia- fear of dust.
Ambulophobia- fear of walking.
Anthrophobia or Anthophobia- fear of
flowers.
Anuptaphobia- fear of staying single.
Arithmophobia- fear of numbers.
Obsessive-Compulsive Di
sorder
An anxiety disorder characterized by
unwanted repetitive thoughts (obsessions)
and/or actions (compulsions)
Obsessive thoughts and compulsive behaviors can be called
a disorder when they are so persistent that they interfere
with the way we live or when they cause distress
For some people with the disorder, obsessions & compulsions
lessen over time
*1950 study found that for most subjects, the obsessions and
compulsions had gradually lessened, though only 1 in 5 had
completely recovered.
Hoarders video clip

https://www.youtube.com/watch?v=XQqldk_Bg3
o
 Common Obsessions & Compulsions
Among Children & Adolescents with Obsessive-
Compulsive Disorder
Thought or Behavior % Reporting
Symptom
Obsessions (repetitive thoughts)
Concern with dirt, germs, or toxins 40%
Something terrible happening (fire, death, 24
illness)
Symmetry, order, or exactness 17

Compulsions (repetitive behaviors)

Excessive hand washing, bathing, tooth 85
brushing, or grooming
Repeating rituals (in/out of a door, up/down from 51
a chair)
Checking doors, locks, appliances, car brake, 46
homework
Howard Hughes, a
billionaire, developed
obsessive-compulsive
disorder. He was afraid of
germs, and so avoided
contact with possible
sources of dirt (including
other people) and
constantly washed his
hands.
He was obsessed with the
size of peas, and used a
special fork to sort them by
size. Also, he compulsively
said the same phrases over
and over again.
 Explaining Anxiety
Disorders

Freuds psychoanalytic perspective assumed that,

starting in childhood, people repress intolerable
impulses, ideas, and feelings and that this
submerged mental energy sometimes produced
symptoms like anxiety
Todays psychologists have turned away from Freud
to two contemporary perspectives:
Learning

Biological
 Explaining Anxiety Disorder
Learning Perspective
Fear conditioning:
General anxiety is linked with classical
conditioning of fear
Inthe laboratory, when rats were given
unpredictable electric shocks, they later became
anxious and apprehensive in their lab environment
58% of those with social phobia experienced their
disorder after a traumatic event
For many victims of post-traumatic stress disorder
(PTSD), anxiety increases with any remainder of
the trauma
 PTSD Post-Traumatic Stress
Disorder

PTSD is an anxiety disorder that can develop after

going through a severely threatening,
uncontrollable event that included a sense of
helplessness and fear
e.g.war, assault, road accident, natural disaster,
rape
 Still missing essays from:
- Addison
- David
- Armin
- Franczesca
- Joanna
- Andersan
- Pourochista
- Erinn
- Gavin
- Charlotte
Shape of the Day Learning
Intentions
- Notes - I will understand
- Video? the explanations
- Notes for anxiety
- Activity? disorder
- I will be able to
explain what
bipolar disorder is
- I will understand
what depression is
- I will understand
the different
explanations for
Post-Traumatic Stress
Disorder
Symptoms include:
Haunting memories (flashbacks)
Nightmares
Social withdrawal
Jumpy anxiety
Insomnia
Suffered by about 15% of war veterans (higher
among those who experienced heavy combat),
50% of people kidnapped, tortured, or raped, and
4% of people who experienced a natural disaster
Some psychologists believe that PTSD is
overdiagnosed, and most people are quite
resilient to traumatic experiences
Explaining Anxiety Disorder

Learning
Perspective
Stimulus generalization:
Remember that generalization is the tendency
(once a response has been conditioned) for
stimuli similar to the conditioned stimulus to
bring out similar responses
ex. A person who is afraid (conditioned
response)
of heights (conditioned stimulus) after falling
might later generalize that fear
to planes
Explaining Anxiety Disorder
Learning Perspective
Reinforcement:
After phobias & compulsions develop,
reinforcements help maintain them
Avoiding or escaping the feared situation
reduces anxiety thus reinforcing the phobic
behavior
Compulsive behaviors similarly reduce anxiety
Observational learning:
Learn fear by observing others fears
 Explaining Anxiety Disorder
Biological Perspective
Natural Selection:
We are biologically prepared to fear threats
that had been faced by our ancestors
Therefore phobias focus on dangers faced by
our ancestors (e.g. snakes, closed spaces,
heights, storms, darkness)
Compulsive acts typically exaggerate behaviors
that help our survival
Explaining Anxiety Disorder
Biological Perspective
Genes:
Some people seem more genetically
predisposed to particular fears & high
anxiety
Identical
twins often develop similar
phobias, sometimes even when raised
separately
Explaining Anxiety Disorder Biological Perspective
Physiology:
Anxiety disorders are biologically measurable as an
over arousal of brain areas involved in impulse
control and habitual behaviors
PET scans of people with obsessive-compulsive
disorder reveal unusually high activity in the frontal
lobes (A PET scan is a medicine imaging test that
creates images of body function and metabolism.
PET imaging can be used to evaluate normal and
abnormal biological function of cells and organs.)
Fear learning experiences can traumatize the brain,
by affecting the amygdala
When amygdala is damaged it affects sensitivity to stimuli
associated with strong emotions. For example, Adolphs,
Russell, and Tranel (1999) found that patients were able to
tell when a face was sad or happy, but could not tell a slightly
sad face from a very angry face: they all just looked
"unhappy.
Link to TEDx OCD
speaker
https://www.youtube.com/watch?v=iRWN4UvWl
bI
MOOD DISORDERS
Mood disorders: psychological disorders
characterized by emotional extremes
 Two new disorders have been added: Disruptive Mood
Dysregulation and Premenstrual Dysphoric Disorder.
The DSM-5 no longer has a separate category of disorders for children.
Instead, disorders are grouped together into diagnostic categories that
share similar features and presumed etiologies. This disorder applies to
children up to age 18 with persistent and frequent irritable episodes of
behavioral dysregulation.
The Grief/Bereavement exclusion for depression has
been removed!
Premenstrual dysphoric disorder Symptoms include at least 5 of the
following most months in the days before a woman starts menstruating:
Affective lability (mood swings, feeling suddenly sad or tearful)
Irritability or anger or increased interpersonal conflicts, feeling overwhelmed
Depressed mood, feeling of hopelessness, or self-deprecating thoughts
Anxiety, tension, feeling of being on edge, decreased interest in usual
activities
Difficulty in concentration, getting tired easily, or lack of erngy, change in
appetite, food cravings, sleep too much or insomnia, physical symptoms ex.
Joint or muscle pain, weight gain
Mood Disorders
Depression is the common cold
of psychological disorders.
In fact:
Depression is the number one
reason for people to seek mental
heath services
It is the leading cause of
disability worldwide
Mood Disorders
Depression is a response to past and current loss. (As
opposed to anxiety which a response to a future threat)
It acts as a signal for our body to take protective measures!
Depressive disorders are characterized by extremely sad
moods & a lack of energy that disrupts a persons normal
ability to function in their everyday life
Two emotional extremes of mood disorder:
(1) major depressive disorder
(2) bipolar disorder
 A mood disorder in which a person
Major Depress experiences 2 weeks or more of
ive Disorder -depressed moods
: -feelings of worthlessness
-decreased interest or pleasure in
activities
-weight gain/loss
-inability to sleep or too much sleep
-thoughts of death/suicide
for no apparent reason.
(Dysthymic Disorder)
Persistent Depressive
Disorder:
A depressed mood that lasts most of the day, nearly
every day, for two years or more
It is less severe than major depressive disorder, but it
lasts longer
Experience chronic low energy & self-esteem, have
difficulty concentrating or making decisions, and sleep
& eat too much or too little

Dsm 5 renamed dysthymia as persistent depressive

disorder two years for adults, one year for kids
Some depression facts:
Compared with men, women are twice as
vulnerable to major depression, even more so if
they have been depressed before
Most major depressive episodes self-terminate
Stressfulevents related to work, marriage, and
close relationships often precede depression
With each new generation, the rate of depression
is increasing
Disorder is striking earlier (now often in late
teens)
Depressed people, however, reach REM more
rapidly, generally in less than 45 minutes (regularly
takes 90 minutes). They also tend to awaken
frequently during the night.
Most people feel slightly better during the summer (when the sun is out
most of the day) than during the winter (when there are fewer hours of
sunlight). People with seasonal affective disorder (SAD) feel good in the
summer and seriously depressed in the winter (or good in the winter and
depressed in the summer). Seasonal affective disorder is commonest in far
northern locations such as Scandinavia, where the summer days are very
long and bright and the winter days are very short and dark. The disorder is
unheard-of in tropical locations such as Hawaii, where the amount of
sunlight per day varies only slightly between summer and winter.
SAD Seasonal Affective
Disorder
Subtype of depression that recurs
One hypothesis as to why this happens
is that shorter periods of less direct
sunlight during winter disturbs both
mood and sleep/ wake schedules,
causing depression
 Bipolar Disorder
Manic episode: an episode
marked by a hyperactive, wildly
optimistic state.
Bipolar disorder: a mood disorder
in which the person alternates
between the hopelessness &
lethargy of depression and the
overexcited state of mania
The 2 poles of emotion
 Bipolar Disorder
During the manic state in the bipolar disorder, the
person becomes highly talkative, overactive and
may engage in reckless activities (unsafe sex,
spending sprees, investments) with dangerously
soaring self-esteem.
However, milder forms of mania can help
creativity:
George Frideric Handel, who was believed to have
suffered from bipolar disorder, composed the four-
hour-long Messiah for symphony orchestra during
the three weeks of his manic episode.
 Bipolar Disorder

Bipolar
disorder is much less common than
major depression
occurs in about 1% of the population
afflicts both men and women equally
Newer drug treatments, have been
successful in managing symptoms for
many individuals
Explaining Mood
Disorders
Freuds psychoanalytic theory (importance of
early childhood experiences and unconscious
impulses) suggests that depression occurs when
significant losses evoke feelings associated with
losses experienced in childhood

Todays bio-psycho-social perspective is

replacing Freudian explanations with biological &
cognitive explanations
Explaining Mood Disorders
Biological Perspective

Genetic influences:
mood disorders run in families
risk of major depression & bipolar
disorder increases if you have a
depressed parent or sibling
even if identical twins are raised in
different environments, they have
greater similarities for depressive
tendencies
Explaining Mood Disorders
Biological Perspective
Depressed brain
norepinephrine (a neurotransmitter
that increases arousal and boosts
mood) is overabundant during mania
and scarce during depression
serotonin is scarce during depression
repetitive physical exercise reduces
depression
(it increases serotonin)
 PETscans show that brain energy
consumption rises and falls with emotional
swings of bipolar disorder

Depressed state Manic state Depressed state

 Explaining Mood
Disorders
Biological Perspective
Depressed brain
neurological signs of depression
many recent studies have found the brains of
depressed people to be less active
left frontal lobe (active during positive emotions) is
likely to be inactive in depressed states
MRIscans have shown frontal lobes to be 7%
smaller in severely depressed people
hippocampus (memory processing center linked
with brains emotional circuitry) can be affected by
stress-related damage
Explaining Mood Disorders:
The Social-Cognitive
Perspective
Self-defeating beliefs feed depressions
vicious cycle.
Self-defeating beliefs may arise from
learned helplessness through
uncontrollable painful events.
Women are more often abused or made
to feel helpless than men, and they may
respond more strongly to stress.
Explaining Mood Disorders
The Social-Cognitive
Perspective

Negative thoughts feed negative moods; negative moods feed

negative thoughts (cycle)
Depressed people tend to explain bad events in terms that are
Stable (its going to last forever)
Global (Its going to affect everything I do)
Internal (its all my fault)
Result of these pessimistic, over generalized, self blaming
attributions is a depressing sense of hopelessness.
 Social-Cognitive
Around The World

Depression is common among young people in

the Western world because of epidemic
hopelessness stemming from the rise of
individualism and decline of commitment to
religion and family.
Self-focused individuals take on personal
responsibility for problems and have nothing to
fall back on for hope
Non-western cultures encourage close-knit
relationships and cooperation depression is
less common and less tied to self-blame.
Depressions Vicious
Cycle
A recipe for severe depression is preexisting pessimism
encountering failure Martin Seligman.
Depression can be brought on by stressful experiences
(losing a job, getting divorced, suffering physical traumas,
etc.) that disrupt your sense of who you are and why you
are a worthy human being.
Depression: Women vs
Men
Woman often have
more vivid memories
for both wonderful
and horrid
experiences than
men.
Woman may fret and
act anxious or
depressed, while a
man may distract
himself by drinking,
acting out, delving
into work, or
watching sports.
 Depressions Vicious
Cycle
When bad things happen,
those who are pessimistic
are more at risk for
depression.

Ifyou are optimistic, failure

or stress is unlikely to
provoke depression. Even if
you do fall into depression,
you are more likely to
recover quickly!
Depressions Vicious
Cycle
Lauren Alloy and her collaborators
monitored Temple University and
University of Wisconsin students. Among
those identified as having optimistic
thinking styles as they began college, only
1% had a first episode of major depression,
compared to 17% of those who began
college with pessimistic views.
Students who show optimism as they
begin college develop more social support
lowered risk of depression.
Depressions Vicious
Cycle
1. Stressful
Experiences
(Divorce, job loss,
etc)

4. Cognitive 2. Negative
and Explanatory
Behavioral Style
Changes (Pessimism,
(Hopeless self-blaming)
Attitude,
Fatigue) 3. Depressed
Mood
End of class pick me up
happy - Minions
https://www.youtube.com/watch?v=MOWDb2TB
YDg