1. Virginia Union University Introduction to Psychology

2.  A prolonged and disturbed emotional state that affects almost all of the person’s thoughts, feelings & behaviors  3 of the most common Major depressive disorder Bipolar I disorder Dysthymic disorder

3.  Major Depressive Disorders About 16% of US adults report at least one episode of depression  Women outnumbering men, 2 to 1 Marked by at least 2 weeks of continually being in a bad mood, having no interest in anything, and getting no pleasure from activities. Person must have at least 4 of the following symptoms:  Problems with  Eating  Sleeping  Thinking  Concentrating  Making decisions  Lacking energy  Thinking about suicide  Feeling worthless or guilty

4.  Bipolar I Disorder About 1.3% of the population suffer from bipolar I disorder  1.6% suffer from only manic episodes Marked by fluctuations between episodes of depression and mania A manic episode goes on for at least a week, during which a person is unusually euphoric, cheerful, and high and has at least 3 of the following symptoms:  Has great self-esteem  Has little need for sleep  Speaks rapidly and frequently  Has racing thoughts  Is easily distracted  Pursues pleasurable activities

5.  Dysthymic Disorder Affects about 6% of the population; less serious than major depression  Feeling “down in the dumps” Characterized by being chronically but not continuously depressed for a period of two years While depressed, a person experiences at least 2 of the following symptoms:  Poor appetite  Insomnia  Fatigue  Low self-esteem  Poor concentration  Feelings of hopelessness

6.  SAD (Seasonal Affective Disorder) Depression as a result of a decrease in the number of sunny days Occurs in fall and winter months, recovery in the summer months

7.  Causes Biological Factors – genetic, neurological, chemical & physiological components that may predispose or put someone at risk for developing a mood disorder

8.  Causes Biological Factors  Genetic factor  40-60% of susceptibility to depression is genetic  Not a single gene, but a combination of genes  Deficits in specific genes affect sensitivity to stress  Genes involved in regulating the brain’s neurotransmitters or chemical systems used in communication

9.  Causes Biological Factors  Neurological factors  Chemical imbalance in the brain  Group of neurotransmitters called monoamines (serotonin, norepinephrine, dopamine) involved in mood problems  Continued stress alters the brain & body’s stress management system, altering hormonal & neurotransmitter levels & can trigger depression

10.  Causes Biological Factors  Brain scans  Brain area called the anterior cingulate cortex shown to be overactive in depressed patients  Depression treated by stimulating (and reducing activity) in this brain region

11.  Causes Psychosocial Factors – such as personality traits, cognitive styles, social supports, and the ability to deal with stressors, interact with predisposing biological factors to put one at risk for developing a mood disorder

12.  Causes Psychosocial Factors  Stressful live events  Strongly related to the onset of mood disorders

13.  Causes Psychosocial Factors  Negative cognitive style(Negative way of thinking)  Depression may result from one’s perceiving the world in a negative way, which in turn leads to feeling depressed

14.  Causes Psychosocial Factors  Personality factors  Individuals who are especially sensitive to and overreact to negative events with feelings of fear, anxiety, guilt, sadness, and anger are at risk for developing a mood disorder  Socially dependent people or individuals who make their self worth contingent on what others say or think have increased risk of depression  Need for control also influences depression risk when uncontrollable stress encountered

15.  Causes Psychosocial Factors  Depressed mothers  Mother’s depression influences child’s susceptibility for depression, even if the child is adopted  Mother’s treatment produces positive outcomes for the child too

16.  Treatment Major depression & dysthymic disorder  Antidepressants – act by increasing the levels of a specific group of neurotransmitters (monoamines – serotonin, norepinephrine, and dopamine) that are involved in the regulation of emotions and moods  SSRIs (Selective Serotonin Reuptake Inhibitors)  80% of antidepressants are SSRIs, raise the level of the neurotransmitter serotonin  Antidepressants – most commonly prescribed medication in the US, used by 10% of the population  Effectiveness of antidepressants  May take up to 8 weeks to work, symptoms for only 1/3 will go away  Some antidepressants work better than others, depends on the individual

17.  Treatment Major depression & dysthymic disorder  Psychotherapy  Less severe depression – psychotherapy as effective as antidepressants  More severe depression – combo of psychotherapy & antidepressants most effective  Relapse  70% of patients relapsed 18 months after treatment, required additional treatment  Depression viewed as a chronic disease or long-term disease  30% maintained recovery – patients treated with psychotherapy less likely to relapse

18.  Treatment Bipolar I disorder  Drugs  Mood stabilizer lithium combined with other drugs  Lithium thought to prevent manic episodes by preventing neurons from being overstimulated  50% of patients who stop taking lithium experience a manic episode  Only 50% of patients are helped by the drug combo (30% partially helped, 20% little to no help)  Relapse  10-30% of patients receive no help from current drugs  30-70% initially improve but later relapse  Researchers continue to look for new ways to treat mood disorders  Electroconvulsive Therapy (ECT) – treatment of last resort

19.  Involves placing electrodes on the skull and administering a mild electric current that passes through the brain and causes a seizure.  Usual treatment consists of a series of 10 to 12 ECT sessions, at the rate of about 3 per week  Used as a last resort for the 40% of patients whose depression doesn’t decrease from the use of antidepressants  In the US, ECT is currently used for 100,000 patients/year

20.  ECT as last resort Risks: may cause varying degrees of memory loss Gradual improvement in memory after ECT, for most memory returns to normal  ECT effective in reducing depressive symptoms in 70-90% of patients  Avg. relapse rate after ECT exceeds 50%, patients may need antidepressants after ECT or additional ECT treatments for depression  No evidence to suggest that ECT causes brain damage

21.  New treatment option for treatment- resistant depression Transcranial Magnetic Stimulation (TMS)  Noninvasive technique that activates neurons by sending pulses of magnetic energy in the brain  Depressed patients who did not respond to antidepressants experienced improvement after 40 mins of TMS daily for 4 weeks  Side effects may occur (headache, lightheadness, scalp discomfort), less severe than ECT (unlikely to cause seizures & doesn’t require anesthesia)

22.  Consists of inflexible, long-standing, maladaptive traits that cause significantly impaired functioning or great distress in one’s personal & social life  Found in about 9% of the population  Affect men & women equally, gender influences which personality disorder develops

23.  Seven most common personality disorders 1. Paranoid personality disorder  Pattern of distrust & suspiciousness & perceiving others as having evil motives (0.5-2.5% of the pop.) 2. Schizotypal personality disorder  Acute discomfort in close relationships, distortions in thinking & eccentric behavior (3-5% of the pop.) 3. Histrionic personality disorder  Excessive emotionality & attention seeking (2% of the pop.)

24.  Seven most common personality disorders 4. Obsessive-compulsive personality disorder  Intense interest in being orderly, achieving perfection & having control (4% of the pop.) 5. Dependent personality disorder  Pattern of being submissive & clingy because of an excessive need to be taken care of (2% of the pop.) 6. Borderline personality disorder  Pattern of instability in personal relationships, self-image & emotions as well as impulsive behavior (2% of the pop.) 7. Antisocial personality disorder  Pattern of disregarding or violating the rights of others without feeling guilt or remorse (3% of pop., predominantly male)

25.  Borderline Personality Disorder Intense, unpredictable emotional outbursts & lack impulse control causing them to express inappropriate anger & engage in dangerous behaviors Emotionally erratic – express love & rage simultaneously, emotionally volatile, unable to maintain stable relationships 75% hurt themselves through self-mutilation 10% eventually commit suicide

26.  Borderline Personality Disorder Causes  Environmental & genetic causes  Experienced trauma in childhood  Overactive amygdala (emotional center of brain)  Underactive area of brain that controls emotional responses  Impulsivity & aggression are heritable Treatment  Dialectical behavior therapy most effective  A type of cognitive-behavioral therapy that helps patient identify thoughts, beliefs & assumptions that make their life challenging & teaches them different ways to think & react

27.  Antisocial Personality Disorder Killers from ‘Most Evil’ 50-80% of prisoners meet criteria for antisocial personality disorder Not all are alike, diagnostic symptoms vary along a continuum  One end: delinquents, bullies, lawbreakers  Other end: serial killers

28.  Antisocial Personality Disorder Causes  Psychosocial factors  Aggressive & antisocial children who are difficult to control  Early appearance of behavioral problems (temper tantrums, bullying, torturing animals, habitual lying)  Children who experience physical or sexual abuse

29.  Antisocial Personality Disorder Causes  Biological factors  Genetic factors  Genetics contribute 30-50% to the development of antisocial personality disorder  Neurological factors  Prefrontal cortex damage/impairment  Involved in important executive functioning, such as making decisions & planning

30.  Antisocial Personality Disorder Treatment  Psychotherapy not shown to be effective, patient does not see their behaviors as wrong  Drugs tried that raise brain serotonin levels  Serotonin may underline impulsive & aggressive behaviors  For 69% of patients, antisocial personality disorder is an ongoing & long-term problem