Stages of Adult Stages of Adult DevelopmentDevelopmentChapter 14, Mental Disorders: Failure to cope: Steven Mendoza, Ph.D. Adjunct Assistant Professor Lvx Et Veritas

Psychopathology: Psychopathology: Age & Gender Age & Gender DifferencesDifferences• Age

– Schizophrenia usually occurs in young adulthood and continues throughout life

– Anxiety disorders more common in young adults– Mental retardation is usually diagnosed early in

life– Alcoholism peaks in early midlife– Personality disorders decrease

• May be an artifact of measures and coping skills

Psychopathology: Psychopathology: Age & Gender Age & Gender DifferencesDifferences

• Gender– Differences emerge early in life– Indications of differences may be due to

expectations• Women higher in

– Schizophrenia, Depression, Neurosis, Late-life- depression

• Men higher in– Alcoholism, Drug addiction

– Mental disorders higher in married women– Mental disorders lower in married men

Psychopathology: Psychopathology: Stress & Stress & helplessnesshelplessness• Environmental stress is primary in most mental

disorders• Powerlessness

– Women– Lower social classes

• Mental disorders are 10 X higher in lower compared with upper classes

• Functional impairment faster for poor and less educated– Social drift hypothesis

• Mentally disordered people are in the lower classes due to the fact that they can not function in ways to move to the upper classes

• Learned helplessness– Who most likely perceives themselves as not having control?

• Women, lower socio-economic classes, minority members, older adults

– This perception may or may not be accurate

Depression & SuicideDepression & Suicide• Symptoms of Depression

– Painful sadness, lack of interest in life, inactivity, pessimism, low-self esteem, difficulty in making even simple decisions, dreams of being lost with no one to help

• Does incidence increase with age?– Rises over age 70, but linked to physical

limitations

• Depression often masked by hypochondriasis– Physical complaint with no discernable cause

Depression & SuicideDepression & Suicide• Therapy for depression

– Behavior modification• Causation of depression-not enough

reinforcement

– Cognitive therapy• Depression results from negative thought

patterns– Thoughts, beliefs, assumptions & attitudes

Depression & SuicideDepression & Suicide• Suicide is related to age, sex & race

– Males have highest rate• White males rates peak in adolescence, drops until 50, then rises

to highest levels until very old• Non-white males do not rise after adulthood except for Asian

males– Rates are 4 X higher for males than females– Why?

• More successful at attempts– Women make more unsuccessful attempts (4:1)

– Young adults attempts to death (7:1)– Older adults are usually successful in their attempts

• Why?– Are they more “serious” about dying rather than a “cry for help?”– Do they have less social support so it is less likely that someone will

intervene?

Brain DisordersBrain Disorders• Acute

– Sudden onset such as heart attack or stroke– Often treated successfully

• Chronic– Often develop gradually, mild symptoms– Progressively become more severe with loss of

abilities or dementia– Two types: senile dementia (Alzheimer's) &

multi-infarct dementia

Brain DisordersBrain Disorders• Senile dementia (Alzheimer's)

– Average age of onset for Alzheimer's is 75– Symptoms

• Intellectual deterioration & emotional behavioral irregularities• Brain atrophy, plaques and neurofibrillary tangles• Estimated incidence

– 5% at 65– 20% 85– 40% 90

– Risk factors• Lack of education & lower occupational attainment

– Increased education and demands of higher occupation may create a reserve capacity that delays expression of brain disease

• Genetic risk- gene increase productivity of plaques– Hope for future- pharmaceuticals

Alcoholism and Drug Alcoholism and Drug MisuseMisuse• Alcoholism less common in elderly than

younger– Drinking decreases after 50

– After 66, only 5% of males & 1% of females are heavy drinkers

– Of the older adults who have drinking problems• Most had life long problems• Started drinking in 20s

Alcoholism and Drug Alcoholism and Drug MisuseMisuse• Psychoactive drugs used in mental hospitals

– 90% of those under 65– 55% over 65 years

• Most prescribed drugs for those over 65 have sedating effect which can exacerbate concerns about aging

• Drug metabolism is less effective in elderly leading to more pronounced effect

• Elderly more likely to fail to comply with doctors orders when taking medication– In 70s (2X) more likely to not comply than in 40s

Psychotherapy across life-Psychotherapy across life-spanspan• Youth

– Focus on identity and intimacies issues

• Elderly– Less likely to receive psychotherapy more likely

to receive drugs– Elderly may not seek treatment because they see

their symptoms as typical aging– Therapists, in general, prefer to treat younger

patients whom are judged to be more “treatable”