lecture 10

• Specific Phobia

  • Unreasonable fear of a specific object/situation that interferes with daily functioning
• subtypes of specific phobias 1. Animal phobia 2. Natural environment phobia 3. Blood injury injection phobia 4. Situational phobia

  Other phobias (i.e.,illness phobia)***
• Specific Phobia: Clinical Description

  • Most have multiple types of phobias

  • Causes: True alarm (I.e., being bitten by a dog), Vicarious experience (I.e., seeing someone else getting bitten by a dog), Informational transmission( I.e., being told about someone getting bitten by a dog), False alarm (I.e., phobia of driving due to having a panic attack, not an accident)

  • Anxiety over the possibility of another traumatic event
• Blood, injury, injection phobia:

  • Unreasonable fear & avoidance of exposure to blood , injury or injection • Physiological reaction experienced is different• Age of onset: ~ 9 years old
• Situational phobia:

  • Anxieties involving enclosed places (Claustrophobia) Onset: ~ 20-25 years old (Oldest age of onset )
• Natural environment phobia:

  • Extreme fear of situations in nature, Fear must be persistent & interfere with functioning (Onset: ~ 7 years old)
• Animal phobia:

  • Fear of animals & insects • Onset: ~ 7 years old
• Neurodevelopmental Disorders

  • Neurologically based

  • Revealed during a child’s developing years

  • Lifelong disorders

  • Sequential process of development:• Disruption in the development of early skills will disrupt the development of later skills

  • Early identification and intervention are crucial
• ADHD: Causes Genetics play a role:

  • ADHD is more common in families who have other individuals with ADHD (high heritability)

  • Multiple genes may be involved

  • ADHD is associated with Dopamine• i.e. Ritalin increases the amount of dopamine
• ADHD: Causes

  Environmental risk factors:

  • Maternal smoking during pregnancy (more consistent findings)
  • Maternal stress during pregnancy
  • Maternal alcohol use during pregnancy
  • Low Birth weight
• ASD: Autism Spectrum Disorder

  • Impairments in social interaction & communication AND repetitive & restricted behaviours and interests
• ASD: Social Communication & Interactions

  1.social 2. Nonverbal 3.Initiating & maintaining reciprocity communication social relationships

  • All 3 subparts must be present for a child to be diagnosed with ASD
  • ASD can be diagnosed as early as 18 months
• ASD: Social Communication & Interactions

  • Problems with social reciprocity in ASD, may involve inability to engage in Joint attention:

  • When an individual is interested to share his/her interest towards an object with another individual

  • Children with ASD do not engage in social spontaneous or pretend play or imitative
• ASD Ranges on a Spectrum

  • Some may never develop speech proficiency• Some with speech may display unusual communication • IQ measures are used to determine prognosis
• ASD: Repetitive & Restricted Behaviours & Interests: Consists of 2 distinct dimensions:1)Maintenance of sameness 2) Stereotype & ritualistic behaviours
• ASD: Causes

  • Complex genetic component  highly heterogenous disorder
  • Families with a child with ASD are more likely to have another child with ASD
  • Increased risk of having a child with ASD among older parents
  • Our knowledge from neuroimaging findings are limited to high-functioning individuals with ASD
• Mood disorders  severe & enduring disturbances in emotions ranging from feelings of elation to severe depression
• Major Depressive Disorder (MDD)

  • The most common form of depression

  • Depressed mood lasts at least 2 yrs & includes:

  • Cognitive symptoms: feelings of worthlessness & indecisiveness

  • Disturbance on physical functions : change in sleeping patterns, appetite, weight, loss of energy (somatic symptoms)

  • Typically, also includes:• General loss of interest• Inability to experience pleasure (anhedonia)
• Mania

  • Period of exaggerated elation , joy or euphoria
  • Feeling extreme pleasure in every activity, hyperactive, need little sleep &development of grandiose plans
  • Incoherent & rapid speech
  • Feelings of irritability, anxiety & depression are common
  • A duration of 1 week of the manic episode required (DSM-5)
• • Hypomanic episode:less sever; doesn’t cause impairment in functioning ; needs to last at least 4 days
• Unipolar disorder

  • Experiencing either mood state, Unipolar mania is rare
• Major Depressive Disorder:

  • Presence of depression & the absence of manic / hypomanic before or during the depressive episode
  • Experiencing only one depressive episode is very rare
  • Chronic condition
  • Median lifetime number of major depressive disorders: 4-7
  • Median duration of recurrent major depressive episodes: 4-5 months
• • Recurrent major depressive disorder: 2 or more major depressive episodes, separated by 2 months (during which the individual is not depressed)
• Persistent Depressive Disorder:

  • Dysthymia”
  • Depressed mood that continues for at least 2 years, during which the patient cannot symptom free for more than 2 months months at a time• Even though they may not experience all the symptoms of MDD• More severe than MDD because: • More chronic course• Higher rates of comorbidity• Less responsive to treatments• Slower rates of improvement over time • More likely to attempt suicide
• Peripartum: Depression occurring right before or right after childbirth
• “Baby blues” : minor reactions in adjustments after childbirth • Majority of new mothers experience this
• Postpartum: depression that occurs after childbirth Mothers have harmed themselves or their newborns
• Seasonal affective disorder

  • Depressive episodes that occur in certain seasons (I.e., Winter depression)

  • Depressive episodes must have occurred for at least 2 years, with no evidence of nonseasonal major depressive episode during this time

  • Excessive sleep, increased appetite, weight gain
• Etiology of Mood Disorders

  Biological Dimensions

  • Family studies & twin studies demonstrate high heritability

  Psychological dimensions

  • Stressful life events precede almost all types of depression

  • Must identify the meaning of events for individuals, rather than attempting to identify the nature of the stressful life events

  • Learn helplessness theory of depression: depression may result from believing one has no control over stress in one’s life

  • Once a person feels helpless (believe they lack control ) & hopeless of ever regaining control , depression may develop
• Cognitive triad (Aaron T. Beck) - negative views about the world/oneself/future
• Social Dimensions

  • Mood disorder are strongly influenced by interpersonal stress (I.e., martial depression)

  • Social support influences depression:

  • Higher risk of depression in those living alone

  • Higher risk of depression in those without close supportive relationships
• Bipolar Disorders

  • Alternating between manic & major depressive episodes

  • Bipolar I disorder : alternating between major depressive & funk manic episodes ( Minority progress into bipolar I disorder)

  • Bipolar II disorder: alternating between major depressive & hypomanic episodes 
• During a manic/hypomanic episode: • Deny having any problems

  • Pleasurable feeling
• Attention-Deficit Hyperactivity Disorder (ADHD): Clinical Description. 3 subtypes:

  1. Inattentive subtype:Inattention 2. Hyperactive/impulsive subtype:Hyperactivity & impulsivity 3. Combined subtype:Inattention, hyperactivity & impulsivity