Affective factors impacting on academic functioning

1. Affective factors impacting on academic functioning Student Development Services: Faculty of Commerce

2. Overview of presentation • Stats for the year • What students presented with • Diagnostic clusters • How these difficulties impact on their functioning primarily in academic ways • How we work with these difficulties • Significant questions we want to answer

3. Presenting Problems

4. Possible Diagnoses • Depression • Anxiety • Psychotic disorders • V-Codes • Academic difficulties, learning difficulties • Relationship problems • Family problems

5. Mood disorders • Depression: Five (or more) of the following symptoms have been present during a 2 week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. • Depressed mood most of the day, nearly every day as indicated by either subjective report or observation made by others • Markedly diminished interest or pleasure in all, or almost all activities most of the day, nearly every day • Significant weight loss or weight gain • Insomnia or hypersomnia nearly every day • Psychomotor retardation nearly every day – feelings of restlessness or being slowed down • Fatique or loss of energy nearly every day • Feelings of worthlessness or excessive or inappropriate guilt • Diminished ability to think or concentrate or indecisiveness • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, suicide attempt or a specific plan for committing suicide.

6. Dysthymia • Depressed mood for most of the day, as indicated by subjective account of observation by others for at least 2 years. • While depressed 2 or more of the following must be present • Poor appetite or overeating • Insomnia or hypersomnia • Low energy or fatigue • Low self esteem • Poor concentration or difficulty making decisions • Feelings of hopelessness • During the 2-year period, the person has never been without the symptoms in Criteria A or B for more than 2 months at a time • The symptoms are not due to the direct physiological effects of a substance or medical condition • The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning

7. Manic episode • A distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting at least 1 week • During the period of mood disturbance, 3 or more of the following have persisted • inflated self-esteem or grandiosity • Decreased need for sleep • More talkative than usual or pressure to deep talking • flight of ideas or subjective experience that thoughts are racing • distractability • Increase in goal directed activity (socially, at work or sexually) or psychomotor agitation • Excessive involvement in pleasurable activities that have a high potential for painful consequences • Bi-polar disorder: Currently in a Manic or Depressed mood with history of a mood disorder, The presentation is not better accounted for by personality disorders Bereavement

8. Psychotic disorders • Diagnostic criteria for Brief Psychotic Disorder • Presence of 1 or more of the following symptoms • Delusions • Hallucinations • Disorganised speech eg: frequent derailment or incoherence • Grossly disorganised or catatonic behaviour B. Duration of an episode of the disturbance is at least 1 day but less than 1 month with eventual return to premorbid level of functioning. C. The disturbance is not better accounted for by a Mood Disorder with Psychotic Features

9. Anxiety Disorders • Normal vs Pathological Anxiety • Panic disorder and agoraphobia (includes panic attacks) • Social and simple phobias • Obsessive-compulsive disorder • Post traumatic stress disorder • Generalised anxiety disorder

10. Impact on academic functioning of anxiety conditions • Anxiety produces confusion, distortion of perceptions , of time and space as well as of people and meaning of events. • PTSD • Hypervigilance • Feeling unsafe • Social Anxiety • Difficulty interacting with peers/groups • Difficulty asking questions of lecturers/ tutors • Difficulty asking for help • Generalised Anxiety Disorder • Lack of concentration • Poor working memory • Panic attacks/disorder • With agoraphobia

11. Adjustment disorders • With anxious mood Impact on academic functioning • Difficulty in coping a new environment • Inability to use resources available to them • Loss of use of internal resources

12. V-codes • Academic difficulties Impact on academic functioning • Adjustment to academic demands on campus • Learning difficulties • Family problems Impact on academic functioning • Distracted by thoughts of difficulties at home • Lack of support from home • Hostile relations with people at home

13. Interventions focus on restoring functioning (active model) • Individual therapy: Brief model • 6 – 8 sessions • Eclectic approach (range of modalities) • Assessment and referral • Building relationship, establishing rapport, health model (build on their resilience) • Emergencies seen at Student Wellness Service • Group therapy : • 20 weeks – term time only • Brief psychodynamic group • Workshops • Skills for Commerce

14. Future directions • How can we effectively identify “at-risk” students? • RAC? • How can we offer services to students who do not present themselves for therapy? • How do we evaluate the effectiveness of our service on students’ wellbeing and academic functioning?

15. Contact details • Jean Luyt • Rm 2.13.2 • 650 2224 • Jean.luyt@uct.ac.za • Wiedaad Dollie • Rm 2.4 • 650 2075 • Wiedaad.dollie@uct.ac.za