Lecture 1: introduction Flashcards
students disease =
temporary hypochondria
trigger warnings are ….
not helpful, sometimes actually harmful
learning objectives
- Understand the pro’s and con’s of working with models in clinical psychology
- Describe the prevalence and course of the disorders as discussed in the lecture.
- Explain what transdiagnostic processes are and identify them in the course material.
- Reflect on the difference between normal emotional experiences and emotional disorders
- Understand the basics of the network perspective of mental disorders
general model of psychopathology
pre-dispositional vulnerability <-> (early) learning experiences
leiden tot
vulnerable phenotype
beinvloedt door protective factors & stressors
uiteindelijk
emotional disorders
theories are…
- bodies of knowledge that aim to explain phenomena: stable recurrent and general features of the world
- deeply practical
models are…
instantiations of theories, narrower in scope and often more concrete
wat willen we met theorieen
ze zouden ons moeten helpen met: pridicting and controlling our environment through strategic interventions and technologies
toothbrush problem:
you should never use another persons theory (you always want to create your own)
there is no shortage in theories, but….
a lack of coordination
what do we need more of?
formalized theories
theories in psychology are…
verbal, not mathematical (maar steeds meer mathematical ook!)
relation between theory, data and phenomenon: figuur
verbal theory - ? - phenomenon
verbal theory (theoretical anchor) - formal model (production) - statistical pattern (empirical anchor) - phenomenon
‘all models are wrong, but some are useful’
oke
Chronological Assessment of Suicidal Episodes: wat was hiermee?
niet helemaal bedoeld voor assessing suicidal attempts, maar werd wel zo gebruiktt
nemesis =
NEtherlands MEntal health Survey and Incidence Study
welke populatie van nemesis
dutch population based sample, 18+
methode van nemesis
DSM IV ánd V diagnoses assessed with Composite international diagnostic interview (CIDI)
wat voor sampling procedure
Multistage, stratified random sampling procedure.
- First, a random sample of municipalities was drawn
- A random sample of individuals aged 18
75 years was drawn from the Dutch population register
lifetime prevalence van anxiety or mood disorder in NL
48%
dus 48% van de nederlanders heeft een angst- of stemmingsstoornis op een punt in hun leven
12 months prevalence of any disorder in NL
1 van de 4 respondenten voldoet aan de criteria voor een van de syndromen, in de 12 maanden voor het interview
lifetime prevalentie van stemmingssyndromen/mood disorders=
27.6%
lifetime prevalentie van anxiety syndromen =
28.6%
lifetime prevalentie van substance use disorders =
16.7%
lifetime prevalentie van adhd=
3.6%
lifetime prevalentie van mdd=
24.9%
lifetime prevalentie social phobia=
13.1%
lifetime prevalentie van specific phobia=
11.8%
lifetime prevalentie van alcohol use disorder=
12.8%
dus specifieke disorders op een rijtje van veelvoorkomend naar minder:
major depressive disorder
social phobia
alcohol use disorder
specific phobia
en broad disorder categories op een rijtje
anxiety (iets meer dan mood)
mood
substance use disorders
adhd
wat was de meest prevalente disorder categorie in 12 maanden
ook anxiety
12 maanden prevalentie van anxiety disorders
15.2%
12 maanden prevalentie van mood disorders
9.8%
12 maanden prevalentie van substance use disorders =
7.1%
12 maanden prevalentie van adhd
3.2%
wat zijn de risico factors voor 12 month dsm 5 disorder
- Younger age
- Female gender
- Living alone
- Being unemployed
- Low education
- Lower income
- Higher degree of urbanization
wat was de belangrijkste bevinding van de studie
significante increase van prevalence rates of 12 month dsm 5 disorders, van mood, anxiety, substance en any mental disorder
wat was de increase in life time prevalence van anxiety/mood disorders
2007: 20%
2020: 48%
wat was de 12 month prevalence increase van any disorder
2007: 17%
2020: 24%
kwam dit door corona
nee, geen significant verschil tussen pre-pandemic en during pandemic
proposed reasons for increase mental health problems:
- Individualisation
- Social media
- Increased pressure to succeed
- Housing
- More recognition/acceptance of mental disorders/less stigma
vulnerability paradox=
at the level of the country there are a lot of mental health resources, but at the individual level mental health problems arise
Today, psychiatrist Christiaan Vinkers stated in the Volkskrant: is all this attention to mental health really healthy? Our answer: absolutely!
The question is not whether we should pay attention to mental health issues, but in what way. Openness ensures that people with complaints, especially young people who often feel more reluctance, can be directed to help sooner. Unfortunately, the stigma surrounding mental health issues is still significant. By informing people effectively, they are also better able to assess the severity of their complaints. And they have a better understanding of whether, how, and when intervention is necessary. Attention and reliable information are crucial. Making people aware without imposing it on them.
oke
suicidal thoughts: lifetime & 12 month prevalence
lifetime = 8.3%
12 month = 1.1%
suicidal plans prevalence lifetime & 12 month:
lifetime = 3%
12 months = 0.4%
suicide attempt lifetime & 12 month:
lifetime = 2.2%
12 months = 0.1%
wat is een mythe over zelfmoord
- Most people who have suicidal thoughts do not want to die
- They want to escape from their situation
prevalenties van psychose
- 8% has psychotic experiences
- 4% psychotic symtpoms
- 2-3% psychotic disorder
- 0.6-0.7% diagnoses schizophrenia
hoe worden mood and anxiety disorders ook wel genoemd
internalising disorders of emotional disorders
wat is er met mood and anxiety disorders
- High comorbidity!
- Comorbidity was the rule in over three quarter of subjects with depressive and/or anxiety disorders, most often preceded by an anxiety disorder.
- Response to the same treatments
- Many transdiagnostic processes
transdiagnostisch=
De laatste tijd zien we echter een ontwikkeling waarin niet zozeer een specifieke diagnose, maar meer de onderliggende symptomen als uitgangspunt worden genomen. Deze ontwikkeling wordt onder andere ingegeven door het feit dat diverse stoornissen overeenkomstige symptomen vertonen of tegelijkertijd voorkomen. Angstgevoelens en slaapproblemen komen bijvoorbeeld zowel bij depressie, psychotische stoornissen als angststoornissen voor.
Hierdoor is de gedachte ontstaan dat er achter verschillende stoornissen een aantal gemeenschappelijke psychopathologische processen of factoren schuil gaan. Omdat fenomenen als een negatief zelfbeeld of piekeren niet gebonden zijn aan één specifieke stoornis, maar een rol spelen bij verschillende psychiatrische aandoeningen worden dit ook wel transdiagnostische factoren genoemd.
dus dingen die overlappen tussen syndromen
voorbeelden van transdiagnostisch
- Genetics
- Brain, neurotransmitters
- Cognitive emotional learning
- Thinking (e.g., negative repetitive, intrusive)
- Youth and upbringing
- Interpersonal processes
normal versus abnormal emotions
depressive symptoms dont have to be pathological; they can be normal reactions, in response to a stressor (bv loss)
dus lastig: when is something pathological?
wat zijn overeenkomsten tussen generalized anxiety disorder en major depressive disorder
- sleep disturbances
- restlessness vs psychomotor agitation
- fatigue
- irritability
wat zegt het medical model
states that there is an overlapping latent variable that causes these symptoms.
symptoms are all caused by the underlying condition.
wat zegt het network model
maybe there isnt a latent variable, but it is the symptoms that interact with themselves
symptoms cause each other! (sleep issues can lead to more worrying)
you cant have depression without the symptoms, but you can have HIV without the symptoms
oke; laat dus medical vs network model zien
figuur van comorbidity under the network approach
disorder A - bridge symptoms - disorder B
kijken in schrift
transdiagnostic process=
A transdiagnostic process is a proposed psychological mechanism underlying and connecting a group of mental disorders.