Post on 02-Jan-2016
Personality
Stability vs. Situation?
Personality• Traits vs. States vs. Types• 18,000 personality terms to 32 traits to- • Big five:
– Extraversion (outgoing, sociable, positive)– Neuroticism (prone to negative emotions)– Conscientiousness (organized, efficient, disciplined)– Openness to experience (non-conventional,
curious)– Agreeableness (trusting & easygoing with others)
40 to 60% heritable
Situationism• Low correlations across situations
– Strong vs. weak situations– But-brain differences and heritability
• Introverts more sensitive to external stimuli• More reactive central nervous system• Low pain tolerance• Underactive Nor-epi system• Sensation seeking extraverts
Heritability: Big five correlations
• Identical twins vs. fraternal twins :
Identical Fraternal
• Reared together- .51 .23
• Reared apart- .50 .21
Personality Theories• Psychoanalytic
– Childhood experience, ucs influence, dynamics, conflict, defenses, development and identification
• Humanistic– Focus on self & self-actualization, existential
approach, flow & happiness
• Social-Cognitive Theory– Beliefs, thoughts & personal constructs shape
behavior
• Behavioral Theory– Learning history, self-perception theory, self-control
Defining Abnormality
• Medical approach
• Statistical approach
• Functional approach
These reflect two basic views of disorders
--brain based
--behavior/experience/situation based
The “two worlds” of psychiatry
DSM-IV• Axis 1: Syndromes (Scz, Depress, etc.)
• Axis 2: Retardation & Personality Disorders
• Axis 3: General Medical Condition
• Axis 4: Social/Environmental Problems
• Axis 5: Global Assessment & Coping
• Older classification (primarily of Axis 1 & 2) dichotomized: Neuroses & Psychoses
• Mood (Dep. Bipolar) vs. Thought (Scz) Disrdr
• Now replaced by highly elaborated DSM-V
Heritability of Psychosis: Schizophrenia
Scz incidence & poverty/residential area
Prevalence of Neurotic Disorders by Age
Prevalence of Neurosis by Age & Social Class
Prevalence of Psychosis by Age & Gender
Some Interim Conclusions
• Psychoses (focus on SCZ) is a disorder of heredity and/or prenatal environment
• But it’s also a disorder of poverty (and that may be bidirectional)!
• Another view of prevalence and recent dramatic changes in prevalence
Incidence & Prevalence
• Schizophrenia: approx. 1%
• Bipolar Disorder: approx. 1%
• Depression: approx. M 13% F 21%
Different Therapies for Different Conditions
• Medical: Brain targeted drug interventions examples: --SCZ: Dopamine receptor blockers (the better the block the more effective it is)
--Other neurotransmitters involved as well--Depression: ex. Norepinephrine uptake or release+, Serotonin release+, & a host of other neurotransmitter controls involved
-- Electro-convulsive shock therapy!
Psychological Therapies
• Psychoanalytic
• Behavioral
• Client-centered
• Cognitive-behavioral
• Existential
• Eclectic
• Situational
Commonalities• Just as there are some common underlying
aspects of disorders (chemical imbalance, brain disease, stress, social disconnection) there are commonalities of psychotherapy.
• Correcting the neurological imbalance can correct our thinking and so can working directly on our thinking and behavior.
• A two-pronged approach may be best.
One More Outcome Study
• In a recent meta-analysis comparing drug with psychotherapy approaches to treating depression, drugs resulted in a 55% improvement, psychotherapy 52% and a combination of the two 85%!! (New England J. of Medicine, 5-18-’00.)
• Mind and body interact, we shouldn’t be surprised!
Some Over-arching Issues
• Therapy works!
• Comparative studies
• It’s the therapist as much as the theory
• Meta analyses
• Cost is driving the system now!
What to do?• Keep wits about you & get recommendations from
knowledgeable people• Don’t try to tough it out--it’s not weakness!• Make sure therapist listens and understands• Realize that there are setbacks along the way and
that it takes time• Remember that heredity vs. environment isn’t
“either-or” but a set of interactions--so changing situations is important in any case
• Finally, remember that most people get better!