Sonia

When I first met Sonia, she struck me as the most extroverted and welcoming person in the office. She knew every person in the company, chatted with everyone and seemed to have a special type of relationship with most of our co-workers.

She soon complimented my skills and job experience in private. She also appointed herself as the unofficial leader of our small team. She enjoyed leading our meetings and having people report to her. However, she was not very interested in who was doing what or actual productivity.

Sonia spent most of her day in meeting rooms or hanging out in the breakroom. She also put a lot of effort into organizing get-togethers and parties outside of work.

histrionic personality disorder

After a couple of months, I grew tired of Sonia’s intense nature. Every little work issue was blown out of proportion, every matter was about her. I also started noticing how she insisted male co-workers join for after-work drinks while most female colleagues were deliberately left out of her plans.

It was only during our first meeting with some senior managers that I observed she was flirtatious in professional settings too. It took me some time to realize that Sonia was not trying to get ahead, she just yearned for the attention.

In reality, Sonia was quite a lonely person. She was about to turn forty and had lived in the same city for years, yet -who she considered- her closest friends, were people she had only recently met.

She had strong opinions about everyone. People Sonia liked were usually described as ‘the most loyal, good-hearted, amazing friend’ she could ask for. People she didn’t like -or paid her little attention- were considered ‘toxic, double-faced or insincere’.

After a series of organizational changes, we were left under the supervision of a boss she could not charm. He was more experienced and demanding than previous bosses. He also refused her advances quite clearly.

Sonia told everyone she was being bullied and decided to hand in her resignation. She claimed she already had several job offers lined up. The perks of having such good friends in the industry, she said.

Three months into unemployment she went to see a therapist who eventually diagnosed her with histrionic personality disorder.

 


Prevalence in the general population: >1%–2.0% *
Comorbid with: Narcissistic (13.2%), Dependent (9.5%), Schizotypal (9.4%) *
No gender differences
Course: Chronic

*Sources: Lenzenweger et al. (2007)
Torgersen, Kringlen, and Cramer (2001)
Zimmerman, M., Rothschild, L., & Chelminski, I. (2005)

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Introduction to Personality disorders

After my last entry on personality and the five-factor model, I wanted to start a series discussing personality disorders. Personality is defined as the characteristic way in which an individual thinks and behaves. When these patterns of thought and behavior are problematic and cause a big deal of anxiety and hindrance, we can consider a personality disorder.

There are ten, well-defined personality disorders. Personality disorders are usually classified into three clusters: cluster A – the odd, cluster B – the dramatic and cluster C – the anxious. The DSM-IV-TR also considers the possibility of personality disorders that don’t fit the diagnostic criteria of any of these. It is important to note that some personality disorders have a high comorbidity with each other. In other words, some individuals might meet diagnostic criteria for more than one personality disorder.

Since this is quite a broad topic, today I will only do a recap of the ten personality disorders. I will discuss them, one by one, in the following posts. This time I plan on doing something different. I will describe someone’s case instead of presenting the diagnostic criteria and general knowledge we have. I think it is a better way to paint a realistic and comprehensible portrayal of these disorders.

But first, a quick summary that will serve as a guide:

personalitydisorders

 

Understanding the Big Five

If you are into Psychology, you might already have heard about the Big Five. The Big Five model attempts to classify personality traits into five dimensions; openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism.

Psychologists have been trying to create a comprehensive classification of human personality for decades. The five-factor model, also known as Big Five is the prevailing personality model nowadays. Before I discuss the model and the five factors I’d like to explain how it came about.

the big five

Personality psychology studies the individual differences in our characteristic patterns of thinking and behaving. The notion of personality should not be confused with a set of behaviors or emotional states. Personality is a concept, a perception that results from the fact that individuals have different identities and different personality traits. Personality is a construct that is inferred from our actions and feelings.

We find the origins of most personality models in the lexical hypothesis. The lexical hypothesis or lexical approach states that the most important personality characteristics will eventually become a part of people’s language. It also states that these very important personality traits are likely to be encoded into a language as a single word.

Decades of research and psycholexical classification produced lists with thousands of terms that would later get classified into smaller categories. Making use of factor analysis [1], these terms were finally grouped into five dimensions. These five factors are the Big Five.

Conscientiousness: this dimension refers to our ability to be organized and to show self-discipline. To be able to work dutifully towards our goals.

Agreeableness: a tendency to be in a good disposition for social interaction. A natural inclination to be compassionate and empathic rather than antagonistic or combative.

Neuroticism: this dimension refers to our emotional adjustment. How often and how deeply we let unpleasant emotions overtake us.

Openness to experience: this dimension refers to the search and appreciation for new experiences. It shows a degree of curiosity and interest. A preference for novelty.

Extraversion: it refers to the amount and intensity of interpersonal interaction we enjoy. How social and outgoing a person is.

These are the big five categories of personality. It is important to note that these dimensions exist on a continuum rather than being a discrete attribute that a person does or does not have. For each trait, we are all situated somewhere along their continuum – from low to high.

I hope you enjoyed my explanation of the conception of the five factors model. I plan on writing in more in detail about each dimension soon.

 

[1] Factor analysis: a statistical technique that describes the variability of observed, correlated variables. It looks for joint variations that could be the result of a latent variable or factor. Grouping together these variables helps to reduce the number of observed variables in a given dataset.

How to beat winter blues

In my previous post, I talked about winter blues and how it differs from a seasonal affective disorder or winter depression. Because it is common to feel a bit down during the first quarter of the year, I wanted to give you some tips to overcome the winter blues.Keep your body active

Keep your body active

Extensive research seems to indicate that exercise not only improves physical health but also mental health [1]. It is not quite clear if there is a physiological mechanism responsible for this improvement. The positive effects could also come from a feeling of self-efficiency, distraction and -in some cases- the social interaction it promotes. Whatever the case may be, fitting in some exercise into your day, will have a positive impact on how you are feeling.

Socialize

Interacting with people you like it’s a great way to overcome this gloomy season. It might seem hard but you should make an effort to accept invitations -even if you just stay for a while- as well as call up and set up dates with people you have been wanting to see for a while.

Don’t put too much on your plate

You need to incorporate all these new activities within reason. It is easy to feel overwhelmed by the New Year’s resolutions and goals you set for yourself for 2017. Try to find ways to keep yourself active by doing things you enjoy and that you really want to do. There is no need to sign up for spinning classes or have a dinner date every weeknight. Build up your routines gradually.

These were my three, very simple but effective tips to beat winter blues. I encourage you to put them into practice this week to start feeling better.

 

Sources:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/

(This post was originally published on http://www.ourplasticbrains.com on January 22nd, 2017)

Is winter blues “a thing”?

Once the holiday season is over and we are faced with the beginning of a new year, it is common to feel down or generally unhappy. Daylight plunges, vacation days are scarce during Q1 and we are often confronted with the many demands of our New Year’s resolutions. It is no wonder we feel off and distressed. This feeling is very common and normal. Today I’d like to write about how this temporary state of general unhappiness differs from a full-fledged mood disorder also known as Seasonal affective disorder (SAD) or Seasonal Depression.

winter blues
Source: 9gag

 

The psychopathology of seasonal depression

Seasonal affective disorder, first described in 1984 by Norman E. Rosenthal, has been considered both a unique mood disorder and a modifier -or specifier- of a recurrent depressive disorder that occurs with a seasonal pattern. In short, there are two lines of thinking about seasonal depression; those who consider it an independent disorder and those who prefer to think of it as a modifier -a special characteristic- of a major depressive disorder.

The proponents of SAD as a unique entity, support their claims with biological studies. Patients affected by a depressive disorder with seasonal pattern, have problems processing visual light, usually, develop their symptoms when adequate light is not present and respond favorably to light therapy.

Those who prefer the SAD to remain as a major depressive disorder with seasonal pattern, claim that patients diagnosed with winter depression suffer recurrent episodes of major depression. Their symptoms seem to increase during the fall and winter and decrease with the coming of spring and summer.

Diagnosis of a depressive disorder

At this point, I would like to talk about the criteria for the diagnosis of a depressive disorder. The DSM-V (The Diagnostic and Statistical Manual of Mental Disorders) indicates that 5 or more of the following symptoms need to have been present during a same 2-week period. At least one of the symptoms has to be number 1 or 2.

  1. Depressed mood most of the day, nearly every day (self-reported or observation made by others).
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the
    day, nearly every day (as indicated by either subjective account or observation).
  3. Significant weight loss when not dieting or weight gain (e.g., a change of more than
    5% of body weight in a month), or decrease or increase in appetite nearly every day.
  4. Insomnia or hypersomnia nearly every day.
  5. Psychomotor agitation or retardation nearly every day (observable by others, not
    merely subjective feelings of restlessness).
  6. Fatigue or loss of energy nearly every day.
  7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  8. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

These symptoms cannot be attributed to another medical condition and cause significant stress as well as social and occupational impairment. If in the last 2-year period, two episodes of major depression have occurred and remitted in specific times of the year, we can speak about seasonal depression.

As you can see, the actual diagnosis of winter depression, it’s more complex than what many articles written these days would lead you to believe. I encourage anyone who recognizes the preceding symptoms in themselves to seek professional help. If you are just feeling down or overwhelmed these days, I will offer some tips about how to overcome the winter blues in my next post.


Sources:
Article about seasonal disorders
DSM-V

(This post was originally published on http://www.ourplasticbrains.com on January 10th, 2017)

Why are dementia rates going down?

A recently published, observational study [1] led by Dr. Kenneth Langa shows that the prevalence of dementia in the US has declined significantly from 2000 to 2012.

Making use of the Health and Retirement Study (HRS), a source of nationally representative, longitudinal surveyed data, they compared the dementia rates of the 2000 (n = 10 546) and the 2012 (n = 10 511) waves. Their findings show that dementia prevalence declined from 11.6% in 2000 to 8.8% in 2012.

Another study published in 2016 [2] of participants in the Framingham Heart Study showed that the incidence of dementia in the last three decades had been declining.

Although an increase in total years of education was associated with a lower risk of developing dementia in the first study, many other social and medical factors associated with the onset of the disease are still uncertain.

At this point, we can only speculate about the role that physical activity, leisure time and intellectual stimulation play in these results. What I find very interesting is that this decrease in dementia rates have occurred while the prevalence of hypertension and obesity increases. I would like to see more research done about whether these conditions are protective factors in themselves or the medication prescribed for these conditions -cholesterol-lowering drugs (statins) and antihypertensive drugs- are lowering the rates of dementia in the aging population as some studies have started to suggest. [3] [4]

———-

Sources:
[1] A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012
Kenneth M. Langa, MD, PhD; Eric B. Larson, MD; Eileen M. Crimmins, PhD; et al

[2] Incidence of Dementia over Three Decades in the Framingham Heart Study
Claudia L. Satizabal, Ph.D., Alexa S. Beiser, Ph.D., Vincent Chouraki, M.D., Ph.D., Geneviève Chêne, M.D., Ph.D., Carole Dufouil, Ph.D., and Sudha Seshadri, M.D.

[3] The age-dependent relation of blood pressure to cognitive function and dementia.

[4] Do Statins Reduce Risk of Incident Dementia and Alzheimer Disease?

(This post was originally published on http://www.ourplasticbrains.com on January 7th, 2017)

Cognitive biases

I decided to write my first post about a very popular Psychology phenomena: Cognitive biases.

Cognitive biases are systematic patterns in which we deviate from rational thinking. When pressed to make a decision with limited information, we make use of heuristics -simple and efficient rules- to do so in a faster manner. We make use of these shortcuts because of cognitive limitations or motivational factors. Sometimes these processes don’t work as expected and lead us to errors. Those errors are the cognitive biases.

First identified by Daniel Kahneman and Amos Tversky in the early 70s [1], the concept has been widely reported and applied in the fields of Economics and Marketing. Nowadays, we can easily find multiple sources that list from 15 to over 250 different types of cognitive biases. In many cases, it is a matter of using different names to describe the same occurrence.

For now, I am going to start discussing cognitive biases that have been highly documented and that do not correlate with cognitive ability. These are the ones that we all succumb to and seem to be universally present.

Anchoring is a very popular type of decision-making bias. It occurs when the piece of information that first appears anchors the judgments and guesses that would come later. This effect has been substantially demonstrated in tasks involving numerical variables.

An example of this is the study in which subjects are asked to guess how many African countries belong to the UN. Before being asked this, an experimenter spins a wheel that would point to a number -15 in the first condition, 65 in the second. After this, the subjects in the first condition underestimated the number of African countries. The subjects in the second condition -the ones who saw the wheel point to number 65- overestimated the number. In case you were wondering, there are 54 African member states in the UN.

The Escalation of commitment bias is the tendency to continue to invest additional resources -including time and money- on a failing course of action. This pattern is explained by the importance we give to the sunk costs -what has already been spent and cannot be recovered.

I find very interesting that this type of irrational thinking has been observed universally and seems to be independent of cognitive ability. Apart from being observed in experimental studies, the building of the Concord and the continuation of the Vietnam War are also cited as examples of the effect of this type of bias.

I will also like to comment on some types of cognitive biases for which the empirical evidence is inconclusive. As I mentioned earlier, resources found online usually list many of these.

Loss aversion is the tendency to prefer to avoid losses than to obtain similar gains. The idea is that loss has a stronger psychological impact than gain. Most people would prefer not to lose €20 rather than to stumble upon a €20 bill.

Loss aversion has been questioned in the last years, as it seems that not everyone is affected by it. Also, the effect on people who are indeed affected seems to be smaller than first reported.

The probability neglect bias is defined as the tendency to disregard probability when making a decision. In particular, people seem to disregard probability when there is a very small risk of negative outcome. It seems that this cognitive bias is not universally present and correlates with cognitive ability.

We are still trying to correctly identify cognitive biases that operate as single entities [2]. There is also a lot to be said about their universality. [3] The study of human decision-making processes is a thriving one in Psychology, in part due to the immediate applications in more lucrative fields like Marketing. It is safe to say that we will see new developments in this topic in the upcoming 2017.

References:

1 http://people.hss.caltech.edu/~camerer/Ec101/JudgementUncertainty.pdf
2 http://psycnet.apa.org/psycinfo/2011-27261-001
3 http://www.keithstanovich.com/Site/Research_on_Reasoning_files/JPSP08.pdf

(This post was originally published on http://www.ourplasticbrains.com on December 28th, 2016)