Characteristics of disorders

Question 1

Frequency of phobias in the UK

Answer 1

2% of people in the UK suffer from phobia (Mental Health Foundation 2014)

Question 2

What is a phobia?

Answer 2

A phobia is an anxiety disorder that interferes with daily living. It is an irrational, excessive fear that produces a conscious avoidance of the feared object or situation.

Question 3

Behavioural characteristics of phobias

Answer 3

1. Panic- may involve a range of behaviours including crying, screaming, running away but children react slightly differently eg. clinging.
2. Avoidance- tend to go to effort to avoid coming into contact with the phobic stimulus, which can make it hard to go about daily life.
3. Endurance- Opposite of avoidance. When a sufferer remains in the presence of the phobic stimulus but continues to experience high levels of anxiety, which may be unavoidable in some situations.

Question 4

Emotional characteristics of phobias

Answer 4

1. Extreme anxiety- unpleasant state of high arousal which prevents the sufferer from relaxing and makes it difficult to experience positive emotion. This can be long term.
2. Unreasonable- emotional responses go beyond that which is reasonable, usually wildly disproportionate to any real danger posed.

Question 5

Cognitive characteristics of phobias

Answer 5

1. Selective attention- becomes hard for a sufferer to look away from the phobic stimulus, in order to give the best quick reaction to potential danger- this is not so useful when it is irrational.
2. Irrational belief- An example would be social phobias, which could involve beliefs such as ‘if i blush people will think I’m weak’. This belief increases the pressure on the sufferer to perform well in social situations.
3. Cognitive distortions- perceptions of phobic stimulus may be distorted, eg. seeing a belly button as ugly or disgusting.

Question 6

Frequency of depression in the Uk

Answer 6

3.3% of people in the UK suffer from depression- Mental Health Foundation, 2014
3.5% of women, 3% of men (stigma may reduce registered diagnosis however)

Question 7

Depression

Answer 7

Umbrella term for a series of depressive disorders, all characterised by a change in mood.

Question 8

DSM-5 recognised categories for depression

Answer 8

The DSM-5 recognises 4 categories of depressive disorders:
- Major depressive disorder
- Persistent depressive disorder
- Disruptive mood dysregulation disorder
- Premenstrual dysphoric disorder

Question 9

How do the characteristics of depression and phobias differ?

Answer 9

• Emotional-
  D: mood disorder, low mood, potentially leading to self harm
  P: anxiety disorder, anxiety, unreasonable emotional characteristics
• Behavioural-
  D: greater disturbances of daily life, like disruption of sleep and eating
  P: reactive behaviour such as panic or endurance
• Cognitive-
  D: ‘black and white thinking’, situations perceived negatively
  P: cognitive distortions and irrational beliefs, warping reality according to phobia

Question 10

Behavioural characteristics of depression

Answer 10

1. Disruption of sleep and eating: changes to sleeping behaviour. May experience reduced sleep (insomnia)- including premature waking, or increased need for sleep (hypersomnia). Appetite may increase or decrease (weight gain or loss). Behaviours are disrupted.
2. Change in activity levels: reduced levels of energy- making them lethargic. Can have knock on effect- withdrawal from work, education and social life. can be so severe that sufferer cannot get out of bed. sometimes can have opposite effect- psychomotor agitation (struggle to relax, may end up pacing)
3. Aggression: often irritable, some cases can become verbally or physically aggressive. Serious knock on effects- eg. verbal aggression through ending a relationship, or quitting a job. Physical aggression against the self- self-harm, through cutting or suicide attempts.

Question 11

Emotional characteristics of depression

Answer 11

1. Anger: experience of negative emotion extends further than sadness- sometimes extreme anger. Can be directed to the self and others. Emotions can lead to aggressive or self-harming behaviour.
2. Low mood: defining emotional element of depression- more pronounced than everyday experience of lethargy and sadness. Patients often describe themselves as ‘worthless’ and ‘empty’
3. Low self esteem: emotional experience of how much we like ourselves. Tend to report reduced self esteem, liking themselves less than usual. Can be extreme, with some describing self loathing.

Question 12

Cognitive characteristics of depression

Answer 12

1. Poor concentration: may find themselves unable to stick with a task as usual, or might find it hard to make decisions that are usually straightforward. Likely to interfere with work.
2. Black and white thinking: absolutism. Tends to think things are all-bad. This means when a situation is unfortunate they tend to see it as an absolute disaster.
3. Dwelling on the negative: Inclined to pay more attention to negative aspects of a situation. Glass half empty- ignores the positives. Bias towards recalling unhappy events rather than happy ones- opposite bias when not depressed.

Question 13

How is OCD defined?

Answer 13

Obsessive compulsive disorder is a condition characterised by obsessions and/ or compulsive behaviour.
Obsession (internal)- recurring thoughts or images
Compulsions (external)- repetitive behaviours or rituals that must be completed.

Question 14

Frequency of OCD in the UK

Answer 14

1.5% of women in the UK, 1% of men (Mental Health Foundation 2014)

Question 15

Examples of types of OCD

Answer 15

Intrusive/ obsessive thoughts
Contamination OCD
Symmetry OCD
Particular avoidance
Tapping OCD

Question 16

Behavioural characteristics of OCD

Answer 16

1. Compulsions
   - Repetitive: feeling compelled to repeat a behaviour eg. hand washing, counting, praying, tidying, ordering groups of objects (collections or containers)
   - Anxiety reduction: 10% show compulsions without obsessions, but for many compulsions are carried out to reduce anxiety from obsessions eg. compulsive hand washing carried out a response to obsessive fear of germs
2. Avoidance
   - attempt to reduce anxiety- keeping away from situations that trigger it- helps to manage anxiety levels eg. may avoid contact with germs.
   - can lead to avoiding ordinary situations such as emptying their bins which can interfere with life.

Question 17

Emotional characteristics of OCD

Answer 17

1. Anxiety and distress
   Unpleasant emotional experience due to powerful anxiety that accompanies obsessions and compulsions (can be frightening and overwhelming).
   Urge to repeat behaviour causes anxiety.
2. Accompanying depression
   Anxiety can be accompanied by low mood and lack of enjoyment in activities.
   Compulsions tend to bring only temporary relief from anxiety.
3. Guilt and disgust
   Irrational guilt eg. over minor moral issues, or disgust which may be directed against something external like dirt or towards the self.

Question 18

Cognitive characteristics of OCD

Answer 18

1. Obsessive thoughts
   For 90% of sufferers. Thoughts that recur over and over again. These vary but are always unpleasant eg. worries of being contaminated by germs
2. Cognitive strategies to deal with obsessions
   Religious person tormented by obsessive guilt may respond by praying or meditating. May help manage anxiety but can make a person appear abnormal to others and can distract from everyday tasks.
3. Insight into excessive anxiety
   Aware that behaviour is irrational- necessary for diagnosis. Experience catastrophic thoughts about worst case scenarios that might result if anxieties were justified.
   Hypervigilant- maintain alertness and keep attention on potential hazards.