Phobias What is a phobia? Do you have a phobia? If so, why do you think you have that particular phobia? What do you think are the most common phobias? 1

Learning Objectives E-D explain what is meant by a phobia C-B outline the emotional, behavioural and cognitive characteristics of phobias A-A* consider the implications a phobia will have on an individual’s quality of life

Mental Disorders Depression, phobias and obsessive-compulsive disorder (OCD) are three of the most common mental disorders. In 2009 in the UK: Phobias = 2.6% Depression = 2.6% OCD = 1.3%

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

DSM-V marked and persistent fear of a specific object or situation exposure to the phobic stimulus nearly always produces a rapid anxiety response fear of the phobic object or situation is excessive the phobic stimulus is either avoided or responded to with great anxiety the phobic reactions interfere significantly with the individual’s working or social life, or he/she is very distressed about the phobia 6 months

Which phobias are most common? Arachnophobia Social Phobia Aerophobia (Flying) Agoraphobia Claustrophobia Acrophobia (Heights) Emetophobia Carcinophobia Brontophobia Necrophobia Aquaphobia Hemophobia https://www.youtube.com/watch?v=BzNSYw7xwpU&index=1&list=PLBC166F83ACE852E8

What are the characteristics of phobias? Emotional Behavioural Cognitive What do you THINK about your feared object? How do you FEEL when you see your feared object? How do you BEHAVE when you see your feared object?

Exam Questions Outline the emotional characteristics of phobias. (3 marks) Outline the behavioural characteristics of phobias. (3 marks) Outline the cognitive characteristics of phobias. (3 marks)

Depression Depression What is depression? How does this make someone feel? How can you tell if someone is depressed? Depression 9

Take notes from video clip to address previous slides questions https://youtu.be/NYPTl4-gwNE

Learning Objectives E-D explain what is meant by depression C-B outline the emotional, behavioural and cognitive characteristics of depression A-A* consider the implications depression will have on an individual’s quality of life

Mental Disorders Depression- A mental disorder characterised Depression, phobias and obsessive-compulsive disorder (OCD) are three of the most common mental disorders. In 2009 in the UK: Phobias = 2.6% Depression = 2.6% OCD = 1.3% Depression- A mental disorder characterised By low mood and low energy levels

DSM-V All forms of depression are characterised by changes in the mood The DSM-V has recognised the following categories of depression and depressive disorders: Major depressive disorder- severe but often short-term depression Persistent depressive disorder- long-term or recurring depression, including sustained major depression and what used to be called dysthymia Disruptive mood dysregulation disorder- Childhood temper tantrums Premenstrual dysphoric disorder- disruption to mood prior to and/or during menstruation

What are the characteristics of Depression? Emotional Behavioural Cognitive What do you THINK when you are depressed? How do you FEEL when you suffer with depression? How do you BEHAVE when you suffer with depression?

Behavioural characteristics of depression Behaviour changes when we suffer an episode of depression. Activity levels- Generally suffers of depression have reduced levels of energy, this can make the individual lethargic which can make them withdrawn from work, education and also social life. Severe cases of this can led to the sufferer not being able to get out of bed. Some sufferers can have the opposite effects, known as psychomotor agitation. Agitated individuals struggle to relax and may end up pacing around. Disruption to sleep and eating behaviour- Behaviours such as sleep and appetite can be affected by depression. Both can either increase or decrease. For example, one sufferer may struggle to sleep where another may sleep more than usual and the same with eating behaviour. Aggression and self-harm- Becoming irritable is a common behaviour change in individuals with depression, this can lead to both verbal and physical aggression towards others. Physical aggression can also be directed at themselves, for example self harm or suicide attempts.

Emotional characteristics of depression Lowered mood- Depression is often described as having a low or lowered mood or feeling sad/miserable. Lowered mood is a defining emotional element of depression. This is more obvious in sufferers than other emotional characteristics such as feeling lethargic and sad. Sufferers often feel worthless and empty. Anger- Negative emotions are more common than positive emotions during depression but it is not just limited to sadness. An emotional response can also be anger and extreme anger. This can be focused at others or the actual sufferer. This can lead to self harming, much like the behavioural characteristics of the depression. Lowered self-esteem- Self esteem is an emotional experience of how much we like ourselves. Depression sufferers may have a reduced self esteem and not like themselves and sometimes hate themselves.

Cognitive characteristics of depression Cognitive aspect focuses on how the sufferers process information. Sufferers of depression process information of several aspects of the world differently to the ‘normal’ way that individuals that do not suffer from depression. Poor concentration- Sufferers of depression often experience a change in concentration levels. They may find it difficult to focus and loose concentration easily. This may also interfere with the individuals ability to make a decision. Both concentration levels and the ability to make a decision can affect an individuals daily life and work life. Attending to and dwelling on the negative- Instead of a glass half full, sufferers will see a glass half empty- always focus on the negative aspects of a situation and ignore the positives. Sufferers also remember unhappy events over happy events during depressive episodes. Absolutist thinking- Even though things are not all bad a sufferer may think that way. Known as ‘black and white thinking’, they see an unfortunate event as an absolute disaster.

Apply it Some doctors consider weight change as a result of depression to be significant when the sufferer gains or loses 5% of their body weight. Oona normally weighs 10 stone exactly. Her current weight is nine stone six pounds. Approximately what percentage of her body weight has Oona lost? (1mark) Is this weight change likely to be seen as clinically significant? Explain your answer. (2 marks)

Mini whiteboards Sufferers of depression may experience which of following behavioural characteristics? Changes to activity level Changes to sleeping patterns Changes to eating patterns All of the above Answer: D

Mini whiteboards Patients with a diagnosis of depression are likely to have? Lowered mood Anger Low self esteem All of the above Answer: D

Mini whiteboards Which of the following is a cognitive characteristic of depression? Focusing on the negative aspects of a situation Low self esteem Anger All of the above Answer: A

Exam Questions Outline the emotional characteristics of depression. (3 marks) Outline the behavioural characteristics of depression. Outline the cognitive characteristics of depression.

Obsessive-compulsive disorder

What is OCD? On a mini-whiteboard, write down what you know about OCD.

Definition A condition characterised by obsessions (recurring thoughts, images etc.) and/or compulsive behaviour. An obsession is a cognition – it takes place in the mind. A compulsion is a behaviour - something you do.

Definition A condition characterised by obsessions (recurring thoughts, images etc.) and/or compulsive behaviour. An obsession is a cognition – it takes place in the mind. A compulsion is a behaviour - something you do. Lots of people have strange thoughts/behaviours that they carry out – why aren’t they diagnosed with OCD?

You need to know… Behavioural characteristics Emotional characteristics Cognitive characteristics

Behavioural Characteristics: Compulsions They are repetitive: e.g. hand washing, counting, praying, tidying/ordering They reduce anxiety: for most people, compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions. E.g. compulsive hand washing is carried out as a response to an obsessive fear of germs. Compulsive checking is carried out as a response to the obsessive thought that ?

Emotional Characteristics Anxiety of the obsessions and compulsions can be overwhelming. OCD is often accompanied by depression Sometimes people feel irrational guilt or disgust.

Cognitive Characteristics Obsessions are recurrent and persistent thoughts ‘intrusive thoughts’ Common themes: germ contamination, sexual images The person recognises that the thoughts are a product of their own mind (rather than the thoughts being inserted into their own mind which is common in schizophrenics) The thoughts can be embarrassing/frightening so the person may not want to talk about them with friends At some point they recognise that the obsessions and compulsions are excessive and unreasonable.

The OCD Cycle Emily suffers from OCD; she describes her condition as follows. ‘I am constantly anxious about throwing things away. I can’t put something in the bin without thinking that I need it for something or feel like I have lost something personal to me. My house is starting to become full of stuff and I should throw it away but the thought of throwing it away makes me feel extremely anxious.’ Apply the scenario to the OCD cycle. What are her obsessive thoughts? Why do they produce anxiety? What compulsive behaviour does she carry out? How does it relieve anxiety?

A monster in my mind BBC Horizon documentary https://www.youtube.com/watch?v=KG3TB6AoRKM