Chapter 13 - Psychosocial Problems Flashcards

1
Q

What is the most common psychological disturbance among adolescents?

A

depression

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2
Q

What is the difference between depressed mood and major depressive disorder?

A

depressed mood

  • feeling down, sad, empty, frustrated, stressed, unmotivated
  • but passes

depressive disorders

  • much more serious, can be disabling
  • involve serious disturbances in mood
  • extreme sadness/irritability
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3
Q

What are the 3 main areas of disturbance in depression?

A

affect/emotion
cognition
behaviour/functioning

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4
Q

How is emotion/affect disturbed in depression?

A

feelings of sadness, lowered mood, worthlessness, guilt

anhedonia - without pleasure

  • decreased interest in previously enjoyed activities
  • nothing feels good anymore
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5
Q

How is cognition disturbed in depression?

A

negative thoughts involving self-criticism, self-blame, expectations of negative outcomes

decreased concentration, slowed thinking

thoughts of death or suicide

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6
Q

How is behaviour/functioning disturbed in depression?

A
fatigue
aches and pains
change in sleep, appetite, weight
behavioural slowing
agitation
loss of sexual desire/performance
reduced participation in activities
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7
Q

How is adolescent depression typically displayed?

A

irritable mood

misinterpreted as annoying and argumentative

undetected and undiagnosed

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8
Q

What are some notable depressive symptoms in adolescence?

A

withdrawal from family
co-occurring substance misuse
NSSI

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9
Q

What is smiling depression?

A

non-clinical term describing people who mask their symptoms of depression

work hard to disguise symptoms

adolescents frequently hide depression

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10
Q

Why do youth keep their depression a secret?

A

fear of burdening others
- don’t want to stress family/friends

embarrassment over appearing weak or imperfect

denial

fear of peer disapproval

guilt and shame

  • “shouldn’t be depressed”
  • feel they must be doing something wrong

unrealistic views of happiness

  • influenced by social media
  • believe they are the only ones struggling
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11
Q

What are some signs to look for in youth to determine depression?

A

neuro-vegetative symptoms

change in habits, fatigue, loss of interest

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12
Q

What are the 3 main DSM-5 depressive disorders?

A

major depressive disorder (MDD)

persistent depressive disorder (dysthymia)
- chronic

premenstrual dysphoric disorder (PMDD)

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13
Q

What is premenstrual dysphoric disorder?

A

intense emotional and physical symptoms in the weeks prior to menstruation

markedly depressed mood, intense mood swings, increased sensitivity to rejection, anxiety, panic attacks, anhedonia

similar to PMS but so severe it impairs functioning in social activities, work, and relationships

typically starts in adolescence

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14
Q

What is major depressive disorder?

A

recurrent, discrete episodes of at least 2 weeks with clear changes in affect, cognition, and physical functions

inter-episode remissions

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15
Q

What are the DSM-5 criteria for MDD?

A

a) many symptoms, at least one of which is depressed mood or loss of interest/pleasure
- weight loss/gain
- appetite change
- insomnia or hypersomnia
- feeling worthless or guilty nearly everyday
- recurrent thoughts of death

b) symptoms cause significant distress or impairment in multiple areas of functioning
c) episode not attributable to physiological effects of a substance or other medical condition
d) episode can’t be explained by another psychological disorder
e) never been a manic episode

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16
Q

What is dysthymia?

A

ongoing, low-level depression

at least 2 years

same symptoms as MDD but less intense and continuous

“a veil of sadness”, chronic depressed mood

symptoms hard to spot, mild enough to hide easily and function daily

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17
Q

What happens when dysthymia starts in adolescence or earlier?

A

youth come to believe that depression is part of their personality

don’t remember what it feels like not to be depressed

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18
Q

What is double depression?

A

MDD and PDD at the same time

often PDD experience worsening symptoms resulting in onset of MDD
- often triggered by trauma

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19
Q

What is the difference between sadness and depression?

A

sadness

  • caused by specific trigger
  • temporary, distractible
  • can sleep, eat, remain motivated
  • a normal emotion!

depression

  • no trigger needed
  • all consuming
  • serious disruption of eating, sleeping, motivation
  • pervasive sense of worthlessness and guilt
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20
Q

How prevalent are depressive disorders in adolescence?

A

17% of 12-19 year olds have experienced a major depressive episode

15-24 year olds have highest rates of mood and anxiety disorders
- and increasing, though treatment rates are not changing

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21
Q

What are the biological factors contributing to depression?

A

genetics
NT imbalance
brain structure and processing difference
cortisol release

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22
Q

What is the diathesis stress model?

A

some people have a diathesis (vulnerability/predisposition) to depression

some people experience a stressor (negative circumstance/event)

combination of diathesis and stress = depression

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23
Q

What are some potential stressors for youth depression?

A

normative events
- puberty, grade transition

non-normative events
- divorce, moving

living in neighbourhoods with low collective efficacy

poor peer relationships

romantic relationship issues

cognitive factors

response style

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24
Q

How can peer relationships cause depression?

A

bullying/exclusion

strained relationships compounded by alienating behaviours that lead to avoidance by peers
- cycle of rejection and depression

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25
What are the cognitive factors that can lead to depression?
3 attribution styles - internal (something about me) - global (not just this situation, all situations always) - stable (will go on forever) learned helplessness
26
How can response style lead to depression?
rumination - dwelling on negative thoughts/feelings/events - amplifies negative mood and depressive symptoms - more common in females distraction - more common in males - sports, video games, drinking
27
What are some treatments for depression?
anti-depressants - effect delay, trail and error, side effects, withdrawal, increased risk of suicidal behaviours psychotherapy mindfulness relaxation therapy lifestyle changes (diet/exercise) most effect is medication and psychotherapy in combinatino
28
How had COVID-19 affected Canadians mentally?
fewer Canadians report excellent or very good mental health youth (15-24) report greatest declines those with poor mental health prior to the pandemic impacted even more - increased difficulty accessing resources - loneliness and social isolation - fear of illness for self and others - job loss/financial stress
29
What is the "second wave of brain growth"?
beginning in adolescence in prefrontal cortex (thinking) and limbic system (emotion and motivation) critical to intelligence and performance in all areas brain blossoms with new brain cells and neural connections - connections not used are pruned, connections that are used are hardwired for life brain you have when you enter your teen years is not the one you have when you grow out of them
30
Why are teens that use drugs particularly susceptible to lifetime addiction?
brain is still developing - pathways used are hardwired adolescence period of increased risk-taking - increased sensation seeking, decreased decision-making higher risk of developing addiction - teen limbic system very sensitive to dopamine, released in high quantities during drug use immature nucleus accumbens - leads to motivation deficit: prone to engaging in behaviours with high excitement or low effort (or both: eating, drinking, smoking)
31
Why are teens hardwired to take risks?
evolved out of the need for offspring to leave the safety of the nest and take risks to find a life of their own
32
Why do teens experiment with drugs/alcohol?
peer pressure attraction to novelty desire to loosen sexual inhibitions primarily due to changes in dopamine-rich areas
33
What are the 4 key changes in the brain that lead to heightened susceptibility to addiction?
active wiring while under construction changes associated with risk taking dopamine abundance/sensitivity motivational deficit
34
What is the primary cause of schizophrenia?
levels of dopamine surge and overstimulate receptors, affect ability of the brain to stimulate accurate signals many malfunctioning parts throughout the brain, orchestrated by prefrontal cortex misfiring of the brain produces symptoms (ex. sounds that aren't there)
35
How is addiction developed using NT?
addictive drugs alter levels of NT mimic NT (usually dopamine) and clog dopamine vacuums so it can't be reabsorbed, causes dopamine high tricks your brain into feeling happy, makes you feel like you can't be happy without it
36
What are the general principles of psychosocial problems?
most problems reflect transitory experimentation not all problems begin in adolescence most problems do not persist into adulthood problems during adolescence are not caused BY adolescence
37
What is substance abuse?
misuse of alcohol or other drugs to a degree that causes problems in the individual's life co-morbid with internalizing and externalizing disorders
38
What are externalizing disorders?
those in which young person's problems are turned outwards and manifested in behavioural problems "acting out" delinquency, antisocial aggression, truancy
39
What are internalizing disorders?
those in which young person's problems are turned inwards and manifested in emotional and cognitive distress depression, anxiety, disordered eating
40
In what order are internalizing and externalizing problems developed?
in girls, internalizing problems precede conduct problems reverse for boys
41
What is problem behaviour syndrome?
underlying trait of unconventionality results in covariation amongst various types of externalizing behaviours unconventionality in both adolescent's personality and social environment - individual: tolerant of deviance, not highly connected to educational or religious institutions - environments: large number of individuals share same attitudes individuals in these environments are more likely to engage in wide variety of risk taking behaviour biological or social origins
42
What are problem clusters?
different types of deviance have different origins but involvement in one type may lead to involvement in another cluster together not because of common underlying traits but because of chain reactions in involvement
43
What is social control theory?
theory of delinquency that links deviance with the absence of bonds to society's main institutions school, family, workplace underlying weakness in the individuals attachment to society leads to development of unconventional attitude, membership in unconventional peer group, or involvement in problem behaviours
44
Why is there high comorbidity among internalizing problems?
common subjective state of distress can be thought of as different manifestations of a common underlying factor of negative emotionality those with high negative emotionality become distressed easily, at greater risk of anxiety those with low positive emotionality prone to depression underlying trait may also be cognitive in nature (self-criticism, rumination, etc.)
45
How are the signals towards substance use and abuse mixed towards adolescents?
told how bad it is but advertising is directed towards them
46
What are the most common drugs of choice?
alcohol marijuana tobacco
47
What is binge drinking?
consuming 5+ drinks on one occasion, indicator of alcohol abuse
48
When does drug use peak?
increases during adolescence, peak during early 20's, and then decline
49
Has drug use changed over time?
not dramatically only new concern is number of teenagers who report vaping
50
What are the 6 distinct types of alcohol users?
``` non-users experimenters low escalators early starters late starters high escalators ```
51
What are the risk factors for substance abuse?
psychological - anger, impulsivity, inattentiveness, sensation seeking family - distant, hostile, conflict - overly permissive, uninvolved, neglectful - other members use drugs friends - use and tolerate drugs social - context makes drug use easier - community norms, drug law enforcement, drug presentation in the media
52
What are some protective factors for substance abuse?
``` positive mental health high academic achievement engagement in school close family relationships involvement in religious activities ```
53
What is conduct disorder?
repetitive pattern of antisocial behaviour that results in problems at school or work or in relationships with others
54
What is oppositional defiant disorder?
disorder of childhood and adolescence characterized by excessive anger, spite, and stubbornness
55
What is antisocial personality disorder?
disorder of adulthood characterized by antisocial behaviour and consistent disregard for the rules of society and rights of others
56
What are callous unemotional traits?
cluster of traits characteristic of psychopathic individuals which includes a lack of empathy and indifference towards the feelings of others
57
What are status offences?
violations of the law that pertain to minors but not adults
58
What is the age crime curve?
relationship between age and offending, showing prevalence of offending peaks in late adolescence
59
What is overt vs. covert antisocial behaviour?
overt = aggression towards others covert = misdeeds that are not always detected by others (lying, stealing)
60
What is juvenile offending?
externalizing problem including delinquency and criminal behaviour
61
Compare school shootings and street shootings.
school shootings are: - more rare - concentrated in rural/suburbs - mostly white middle class - guns legally obtained street shootings are: - less rare - concentrated in inner cities - mostly low income - non-white offenders overrepresented - gun usually obtained illegally
62
Why are adolescent crime rates inaccurate?
underreported and selectively reported almost all adolescents have engaged in delinquent behaviour at one time or another ethnic differences smaller than reported
63
What are the 2 major types of offenders?
life course persistent offenders: demonstrate antisocial behaviour during childhood and continue through adolescence and into adulthood - typically come from disorganized or neglectful homes adolescence limited offenders: antisocial adolescents whose delinquent/violent behaviour begins and ends in adolescence - greater than average sensation seeking - poor parenting, unsupervised time - affiliation with antisocial peers
64
What is hostile attribution bias?
tendency to interpret ambiguous interactions with others as deliberately hostile
65
Why do more females have depression?
adolescence more stressful for girls - bodily changes (especially early) more stressful for girls - experience more stressors more likely to internalize oxytocin hormone makes females want to invest more in close relationships, make them more vulnerable to adverse consequences of relational difficulties
66
What is suicide contagion?
process through which learning about others' suicide can lead to people trying to take their own lives
67
What are primary and secondary control strategies?
primary = attempts to change the stressor secondary = attempts to adapt the stressor