W1.1
ARTICLE BY TEN HAVE ET AL. (2023) – PREVALENCE AND TRENDS OF
COMMON MENTAL DISORDERS FROM 2007-2009 TO 2019-2022: RESULTS
FROM THE NETHERLANDS MENTAL HEALTH SURVEY AND INCIDENCE
STUDIES (NEMESIS), INCLUDING COMPARISON OF PREVALENCE RATES
BEFORE VS. DURING THE COVID-19 PANDEMIC
NEMESIS: A prospective study among Dutch-speaking subjects aged 18-64 years from the
general Dutch population
Limitations to existing trend studies:
- Most focused solely on major depressive episodes, while trends in anxiety and
substance use disorders were explored far less
- Did not always use fully structured diagnostic interviews to assess mental disorders –
Relied on abbreviated versions
- Hardly any study investigated socio-demographic differences in time trends
Limitations to COVID-era studies:
- Only three studies used diagnostic interviews
- Two of these studies indicated stable levels of depression and mental disorders during
the pandemic compared to pre-pandemic levels, while another suggested a large
increase in the prevalence of mental disorders
- Different method to collect data before vs. during the pandemic
NEMESIS-2: Performed from November 2007 to July 2009
NEMESIS-3: Performed from November 2019 to March 2022
NEMESIS-3 assessed the following conditions: mood disorders, anxiety disorders, substance
use disorders and ADHD – Assessed using the CIDI 3,0
Prevalences of mental health disorders:
- Any lifetime disorder → 48.4%
- Mood disorders → 27,6%
- MDD → 24,9%
- Anxiety disorders → 28,6%
- SAD → 13,1%
- Specific phobia → 11,8%
- Substance use disorders → 16,7%
- ADHD → 3,6%
The prevalence rate of any DSM-5 disorder in the past 12 months assessed before vs. during
the COVID-19 pandemic did not differ significantly → After adjusting for socio-demographic
differences, there was a significant decrease in the prevalence of DSM-5 disorders during the
pandemic compared to before
Significant differences that were found:
- Increase in mental health problems from the NEMESIS-2 to NEMESIS-3
, - General medical and specialised mental health care significantly and substantially
increased between NEMESIS-2 and NEMESIS-3
- The percentage of those with two or more mental disorders significantly increased
between NEMESIS-2 and NEMESIS-3
Proposed reasons for the increase in mental health problems:
- Individualisation
- Social media
- Increased pressure to succeed
- Housing problems
- More recognition/acceptance of mental disorders – Less stigma
- More recognition of mental disorders
LECTURE W1.1 (INTRODUCTION)
Diathesis-stress model: The theory that mental and physical disorders develop from a genetic
or biological predisposition for that illness (= diathesis) combined with stressful conditions
that play a precipitating or facilitating role
- Genotype: An individual’s inherited
genetic makeup
- Phenotype: The interaction of an
individual’s inherited genetic
makeup and environmental
influences to create the physical
appearance and behaviour (= G × E)
Theory: Bodies of knowledge that aim to
explain phenomena (= stable, recurrent and
general features of the world) – Practical –
Predict and control the environment through
strategic interventions and technologies
Model: Instantiation of theories – Narrower in scope and more concrete
Toothbrush problem: Psychologists treat other peoples’ theories like toothbrushes; no self-
respecting person wants to use anyone else’s (Mischel) – No shortage of theories, but a lack
of coordination → Need for formalised theories
Two kinds of theories:
1. Formal theories: Very precise, deductive and mathematical – High degree of precision
and unambiguous representation – Expressed using mathematical symbols and syntax,
which provide clear and concise expressions
2. Verbal theories: Less rigid than formal theories, as they often deal with complex
phenomena that may not be easily measurable – Expressed using natural language –
Provide a flexible and accessible means of communication, allowing for nuanced
descriptions and interpretations
Box: ‘All models are wrong, but some models are useful’
Medical model: Symptoms are independently caused by the underlying condition
,Risk factors for mental health disorders:
- Younger age
- Gender (i.e. female)
- Living alone
- Being unemployed
- Low education/low income
- Higher degree of urbanisation
Mood and anxiety disorders → Internalising disorders
- High comorbidity
- Similar transdiagnostic processes → Genetics; neurotransmitters; cognitive emotional
learning; thinking (E.g.: intrusive thoughts); youth; interpersonal processes
Network model: A conceptual or mathematical representation of the relationships between
different elements or components within a system – Used to understand and analyse the
interactions and connections between these elements – Symptoms influence each other
, W1.2
FROM CHAPTER 4 (POWER & DALGLEISH) – COGNITIVE THEORIES OF
EMOTIONAL DISORDER
Cognitive theories of ‘disordered’ emotions: Focus on a specific disorder such as depression
or anxiety rather than attempting broader accounts of a range of emotional disorders → The
carving up of the emotional disorders can lead to a false sense of disjointedness between the
emotions
- Criticism: How do theories account for normal emotions?
Cognitive theories of ‘normal’ emotions: More over-arching theories
- Benefits:
1. Success in one domain may extend to other areas
2. The integration of cognitive and clinical psychology could lead to more
general theories of emotional disorders
- Criticisms:
- Often provide inadequate accounts of how emotional disorders might be
explained within their frameworks
Freud: Suggested that significant losses are experienced both in normal mourning and in
melancholia, but in melancholia vulnerable individuals in addition turn their anger against the
self – May be a possible mechanism that would lead to low self-esteem
LEARNED HELPLESSNESS
Learned helplessness: A psychological phenomenon where an individual perceives a lack of
control over a situation, leading to feelings of helplessness and resignation (Seligman)
- Perceived non-contingency: The belief that there is no correlation or relationship
between one’s actions and the outcomes experienced
Researchers attempted to replicate the phenomenon in humans, but the students in these
studies did not consistently demonstrate learned helplessness + There were features of
depression for which the original theory provided no account (E.g.: receiving unexpected
positive events, like money through the letterbox, does not necessarily lead to depression)
↓
Reformulated learned helplessness: Added Weiner’s attribution theory – Focused on how
individuals attribute the causes of success and failure
- Suggested that the perception of uncontrollability leads to helplessness, but the
subsequent effects depend on the type and importance of the event, as well as the
individual’s explanation for the cause of the event – Focused on three dimensions:
1. Internal-external locus: Where individuals attribute the cause of an event (E.g.:
if someone fails a test, they might attribute the failure internally (‘I'm not smart
enough’) or externally (‘The test was too difficult’))
2. Stable-unstable: Whether the cause of the event is perceived as constant or
changeable over time (E.g.: if someone fails a test and attributes it to lack of
intelligence (stable), they might feel helpless because they believe their
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