1. AFFECTIVE FACTORS IMPACTING ON ACADEMIC FUNCTIONING Student Development Services: Faculty of Commerce

2. Overview of presentation  Stats for the year  What students presented with  Diagnostic clusters  How these difficulties impact on their functioning primarily in academic ways  How we work with these difficulties  Significant questions we want to answer

3. Presenting Problems

4. Possible Diagnoses  Depression  Anxiety  Psychotic disorders  V-Codes  Academic difficulties, learning difficulties  Relationship problems  Family problems

5. Mood disorders  Depression: Five (or more) of the following symptoms have been present during a 2 week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. 1. Depressed mood most of the day, nearly every day as indicated by either subjective report or observation made by others 2. Markedly diminished interest or pleasure in all, or almost all activities most of the day, nearly every day 3. Significant weight loss or weight gain 4. Insomnia or hypersomnia nearly every day 5. Psychomotor retardation nearly every day – feelings of restlessness or being slowed down 6. Fatique or loss of energy nearly every day 7. Feelings of worthlessness or excessive or inappropriate guilt 8. Diminished ability to think or concentrate or indecisiveness 9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, suicide attempt or a specific plan for committing suicide.

6. Dysthymia  Depressed mood for most of the day, as indicated by subjective account of observation by others for at least 2 years.  While depressed 2 or more of the following must be present 1. Poor appetite or overeating 2. Insomnia or hypersomnia 3. Low energy or fatigue 4. Low self esteem 5. Poor concentration or difficulty making decisions 6. Feelings of hopelessness  During the 2-year period, the person has never been without the symptoms in Criteria A or B for more than 2 months at a time  The symptoms are not due to the direct physiological effects of a substance or medical condition  The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning

7. Manic episode  A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week  During the period of mood disturbance, 3 or more of the following have persisted 1. inflated self-esteem or grandiosity 2. Decreased need for sleep 3. More talkative than usual or pressure to deep talking 4. flight of ideas or subjective experience that thoughts are racing 5. distractability 6. Increase in goal directed activity (socially, at work or sexually) or psychomotor agitation 7. Excessive involvement in pleasurable activities that have a high potential for painful consequences  Bi-polar disorder: Currently in a Manic or Depressed mood with history of a mood disorder, The presentation is not better accounted for by personality disorders Bereavement

8. Psychotic disorders  Diagnostic criteria for Brief Psychotic Disorder  Presence of 1 or more of the following symptoms 1. Delusions 2. Hallucinations 3. Disorganised speech eg: frequent derailment or incoherence 4. Grossly disorganised or catatonic behaviour B. Duration of an episode of the disturbance is at least 1 day but less than 1 month with eventual return to premorbid level of functioning. C. The disturbance is not better accounted for by a Mood Disorder with Psychotic Features

9. Anxiety Disorders  Normal vs Pathological Anxiety  Panic disorder and agoraphobia (includes panic attacks)  Social and simple phobias  Obsessive-compulsive disorder  Post traumatic stress disorder  Generalised anxiety disorder

10. Impact on academic functioning of anxiety conditions  Anxiety produces confusion, distortion of perceptions, of time and space as well as of people and meaning of events.  PTSD  Hypervigilance  Feeling unsafe  Social Anxiety  Difficulty interacting with peers/groups  Difficulty asking questions of lecturers/ tutors  Difficulty asking for help  Generalised Anxiety Disorder  Lack of concentration  Poor working memory  Panic attacks/disorder  With agoraphobia

11. Adjustment disorders  With anxious mood Impact on academic functioning  Difficulty in coping a new environment  Inability to use resources available to them  Loss of use of internal resources

12. V-codes  Academic difficulties Impact on academic functioning  Adjustment to academic demands on campus  Learning difficulties  Family problems Impact on academic functioning  Distracted by thoughts of difficulties at home  Lack of support from home  Hostile relations with people at home

13. Interventions focus on restoring functioning (active model)  Individual therapy: Brief model  6 – 8 sessions  Eclectic approach (range of modalities)  Assessment and referral  Building relationship, establishing rapport, health model (build on their resilience)  Emergencies seen at Student Wellness Service  Group therapy :  20 weeks – term time only  Brief psychodynamic group  Workshops  Skills for Commerce

14. Future directions  How can we effectively identify “at-risk” students?  RAC?  How can we offer services to students who do not present themselves for therapy?  How do we evaluate the effectiveness of our service on students’ wellbeing and academic functioning?

15. Contact details  Jean Luyt  Rm 2.13.2  650 2224  Jean.luyt@uct.ac.za Jean.luyt@uct.ac.za  Wiedaad Dollie  Rm 2.4  650 2075  Wiedaad.dollie@uct.ac.za Wiedaad.dollie@uct.ac.za