INDIVIDUAL DIFFERENCES

1
INDIVIDUAL DIFFERENCES

• Psychopathology.

2
What are the characteristics of someone with
schizophrenia?

• 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.

3
What are the characteristics of someone with
Depression?

• 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

4
What are the characteristics of someone with
Obsessive-compulsive disorder (OCD)?

• 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.

• 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.

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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.

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Before we move on..

• It is likely youll only be asked to describe the
  characteristics so its worth being able to
  describe in enough depth and breadth the
  characteristicsdo not focus your energies upon
  evaluation.
• Remember Answer the question stated not your own
  question, take a minute to think about it
  first!!!!

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Biological explanations of schizophrenia.

• 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.

• 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.

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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.

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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)

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Biological explanations of depression.

• 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.

• 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.

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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.

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Biological explanations of OCD.

• 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.
• Dopamine 40 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.

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.