INDIVIDUAL DIFFERENCES

1. INDIVIDUAL DIFFERENCES Psychopathology.

2. The symptoms can be broken down into two categories, positive and negative. Positive: Reflect an excess of normal functioning. Negative: Reflect a loss of normal/typical functioning. Positive: Delusions – Seem real but are not. Experiences of control – E.G. Under the control of some alien force. Auditory hallucinations – Hearing forces. Negative: Alogia – Lessening of speech. Avolition– Inability to initiate goal assisted behaviour. Affective Flattening: - Reduction in emotional displays of expression i.e. What are the characteristics of someone with schizophrenia?

3. Depression is classified as a mood disorder, this means the disorder is affecting their emotional state. Recall unipolar and bipolar. What is the main difference? Formal diagnosis requires the presence of at least 5 symptoms, and last at least 2 weeks. Sad, depressed mood. Loss of interest and pleasure in most activities. Sleeping disturbances Poor appetite. Loss of energy and increased fatigue. Concentration problems Recurrent thoughts What are the characteristics of someone with Depression?

4. OCD is an anxiety disorder. The behaviours are ritualistic, (hand washing, constant checking) and is therefore is the source of great anxiety. Interestingly the disorder is equally common in both men and women and the onset of the behaviour is usually in young adult life. Again you could think of the disorder as having two components Obsessions. Compulsions. Obsessions – recurrent, intrusive thoughts or impulses that are perceived as inappropriate, grotesque or forbidden (DSM-IVR). The obsessions generally cause anxiety as they are unlike the sufferers typical thoughts. These thoughts are believed to be uncontrollable, the sufferer feels as though they may lose control and act upon these obsessions. The most common obsessions take the form of DOUBTS IMPULSES IMAGES. Compulsions – Repetitive acts that work to reduce anxiety of the sufferer by preventing some dreaded event happening (DSM-IVR). These behaviours can be ‘hidden’ i.e. mental acts or overt i.e. hand washing. The vast majority of sufferers realise their behaviour is irrational but feel compelled to perform the given behaviour for fear of something terrible occurring, thus the behaviour also create anxiety. What are the characteristics of someone with Obsessive-compulsive disorder (OCD)?

5. What are the characteristics of someone with Obsessive-compulsive disorder (OCD)? • A diagnosis is given if the sufferer fits the following criteria: • Recurrent persistent thoughts, impulses or images that feel intrusive and inappropriate, and cause excessive anxiety or distress. • The sufferer partakes in regular repetitive behaviour ( hand washing). The behaviour must not be related in anyway to what they are designed to prevent. • The individual recognises the behaviour is excessive and product of their own mind.

6. Before we move on…….. • It is likely you’ll only be asked to describe the characteristics so it’s worth being able to describe in enough depth and breadth the characteristics…do not focus your energies upon evaluation. • Remember: Answer the question stated not your own question, take a minute to think about it first!!!!

7. Genetic Factors. Family studies- Gottesman (1991) Schizophrenia is more common in biological relatives, the more closely related, the higher the risk. The concordance rate among identical twins is 48%, fraternal twins is 17%. Adoption studies- Kety et al (1988) found 14% of biological relatives of adoptees were classified as schizophrenic whereas only 2.7% of adoptive relatives were found to be schizophrenic. Biochemical Factors. Dopamine Hypothesis: Abnormally high levels of D2 receptors on their receiving neurons resulting in more binding and thus more neurons firing. These neurons are especially important to attention thus????? Evidence: Antipsychotic drugs they work on Phenothiazines- these block transmission of nerve impulses and bind to the D2 receptors, thus reducing attention deficit in sufferers. Brain Dysfunction. Enlarged Ventricles: The ventricles of a sufferer are approx 15% larger than normal. Sufferers with this dysfunction tend to display more positive symptoms and have more cognitive disturbances. Specific Brain Abnormalities: pre-frontal cortex demonstrated reduced activation when working on a working memory task. At the same time dopamine levels were raised suggesting the dopamine levels and brain dysfunction are linked. Meyer-Lindenberg et al (2002). Viral Infection. A virus before/at birth may be present but dormant in the body and become activated by hormonal changes in puberty Gheradelli et al (2002). Evidence: Sufferer by and large born in the winter months Mothers more likely exposed to flu during pregnancy Fingerprint abnormalities- More/less ridges compared with non-schizophrenic twins. Fingerprints develop in the 2nd trimester (13-27 weeks) when the foetus is most at risk from viruses. Biological explanations of schizophrenia.

8. Psychological explanations of schizophrenia. • Psychodynamic Explanations-Freud believed schizophrenia was linked to - • Regression to pre-ego state-Delusions of grandeur. • Attempts to re-establish ego control- auditory hallucinations Schizophrenia was looked upon as an infantile state, a place where the child was safe from the realities and harshness of the real world. • Behavioural Explanations-Consequences of faulty learning, the Childs disinterested parent gave little/no social reinforcement thus the child sought cues from inappropriate and irrelevant environmental cues (sounds of words-not meaning). Thus the responses of the child appears to outside world as odd, the responses to the behaviour (usually avoidance or inconsistent) inadvertently reinforce the behaviour and lead to a psychotic state. • Cognitive Explanations-Initially linked to biological factors but claims later features occur out of attempting to understand their disorder. The validation sought from others that they are not crazy (as they may report hearing voices) leads to schizophrenics believing those around them are against them, they may feel manipulated and/or persecuted as their loved ones do not confirm what they are experiencing.

9. Psychological explanations of schizophrenia. Socio-cultural Factors. Life events-A great deal of stress has been found to be a possible factor involved in the onset of schizophrenia, due to the elevated physiological arousal associated with the neurotransmitter changes. Retrospective studies-50% of people suffered a major life event 3 weeks prior to the onset of an episode compared to 12% reported in 9 weeks prior to that. A control group reported low unchanging levels over same period thus suggesting life events may have triggered the episode (Brown & Birley ,1968). Prospective Studies- 71 patients over a 48 week period. Life events made significant cumulative contribution in 12 mths preceding to relapse. Hirsch et al (1996) Family relationships- Bateson double blind theory(1965) Contradictory parenting may encourage the onset of schizophrenia. Prolonged exposure to inconsistent parenting will result in the development of an internally incoherent construction of reality, this may manifest itself as schizophrenia in the future. Social Labelling- (Scheff 1999)Social groups create the concept of psychiatric deviance by constructing rules for groups to follow. The symptoms of schizophrenia seen as ‘deviation from norm’, the label schizophrenic may be applied and it becomes a self fulfilling prophecy (Comer 2003)

10. Genetic Family studies – Risk increased when relative is closer i.e. parent. Twin studies- Monozygotic twins (identical) share the same genes, Dizygotic twins (non identical) share 50%, concordance rates for the former is approx 46% the latter 20%. Genes diatheses- Environment may affect genetic predisposition differently from those without it. Biological Neurotransmitter dysfunction- Norepinephrine is found to be deficient in sufferers of depression. Serotonin- Low levels and depression, especially those with suicidal thoughts. Anti depressants such as the popular Prozac work to block serotonin reuptake thus reduce the affect of depression upon the individual. Cortisol Hypersecretion- Elevated levels of cortisol have been found in studies of depression sufferers. When dexamethasone is administered the drug is able to suppress cortisol secretion in typical individuals, this is not the case with depressed individuals, thus suggesting the HPA axis is a characteristic of the depressed state. Biological explanations of depression.

11. Psychological Explanations of Depression. • Psychodynamic Explanations- Freud believed depression was linked to - • Mourning – When we suffer loss there is a period of mourning, for some life does not return to normal and mourning appears to last for some time after. • Melancholia – A pathological illness, we tend to harbour negative feelings toward those we love, when we lose loved ones we turn this feeling onto ourselves. • Cognitive Explanations- Becks theory of depression (1967) depressed individuals feel as they do as they are negative thinkers They acquire this from childhood schemas, these schemas are learned and subject to over generalisation. These negative schemas and biases result in the Negative triad, the individual has a negative view of themselves, the world and the future. • Learned Helplessness: Try but fail to control unpleasant experiences thus resulting in a sense of being unable to exercise control over their lives, and become depressed. • Hopelessness:A hopeless individual expects bad things to happen and does not believe they have the resources to change that situation.

12. Genetic Factors Family/Twin Studies- Nestadt et al (2000) 80 patients with OCD & 343 of near relatives compared with 73 control patients without relatives & 300 of their relatives. Strong link with near family (5x). COMT gene COMT helps to terminate the action of neurotransmitters. Researchers collected DNA samples from 148 who did not have a mental disorder. The gene occurred in neraly half of the men whereas 1in 10 women and 1in 6 of the men and women who displayed good mental health displayed the same genetic trait. Biochemical Factors Serotonin– Lower levels of serotonin found in OCD sufferers Some receptors appear to block the serotonin from entering the cell. Drugs that increase serotonin (SSRI) show a reduction of OCD, opposed to less potent serotonin inhibitors. Dopamine40% of OCD sufferers do not respond to SSRIs, thus suggesting other neurotransmitters are involved in OCD. Increased levels of dopamine in animals demonstrate OCD type behaviours. Brain Dysfunction Basal Ganglia –abnormalities in prefrontal cortex where thinking and judgement takes place is present in OCD sufferers. Biological explanations of OCD.

13. Psychological explanations of OCD. • Psychodynamic Conflicts within the Id when wishes and impulses are repressed thus provoking anxiety. The use of ego defence mechanisms reduce the anxiety. The 3 most common defences are isolation( isolate ,disown undesirable wishes) Undoing ( When isolation fails undoing produces compulsive acts-washing away unacceptable impulses) Reaction Formation (taking on traits that are opposite to the unacceptable impulses-being when you feel aggressive.) (Adler's inferiority complex is a more contemporary version of Freud's interpretation.) • Behavioural Classical conditioning Association with stimuli over time through avoidance leads to positive outcomes and is therefore reinforced. Operant conditioning Any action that enables the individual to avoid a negative event is negative reinforcement. Thus the compulsive behaviour becomes a way of establishing control and as a result the behaviour is reinforced. • Cognitive Irrational thoughts cannot be ignored and feel overwhelming they act as a cue for self blame and the expectation of negative events to occur. The thoughts continue until the sufferer carries out the behaviour.