14 - Psychological Disorders Flashcards
Psychopathology
- the scientific study of mental disorders
- sickness or disorder of the mind
- psychological disorder
- reflects dysfunction of the body, particularly of the brain
- environment and biology interact to produce psychological disorders
Etiology
- factors that contribute to the development of a disorder
- how psychologists understand disorders
society
What are the 4 considerations of abnormal behaviour?
(4)
- do they act in a way that deviates from cultural norms?
- is their behaviour maladaptive? does it interfere with a person’s ability to respond appropriately in some situations?
- is their behaviour self-destructive, does it cause them distress, or threaten others?
- does the behaviour cause discomfort and concern to others? (impairing social relationships)
What are the main purposes of the DSM-5?
- description of disorders based on similarity of symptoms
- provide a shared language and classification
- allow care providers to bill health insurance companies (many times they need a DSM diagnosis first)
What are some problems with the DSM-5?
- categorical approach = someone either has a psychological disorder or they don’t (doesn’t take different levels of severity into account)
dimensional approach
- considers psychological disorders on a continuum
- people vary in degree
- a spectrum
- domains of functioning instead of observable symptoms (ex. cognitive systems, social processes, arousal and regulatory systems, etc.)
Research Domain Criteria (RDoC)
- a method that defines basic domains of functioning (such as attention, social communication, anxiety) and considers them across multiple levels of analysis, from genes to brain systems to behaviour
- guide research rather than classify disorders for treatment
Comorbidity
- people don’t often fit neatly into a category
- psychological disorders commonly overlap (ex. persisitent depressive disorder usually has a strong overlab with substance abuse and vice versa)
- which do you treat?
Assessment
What is the primary goal?
- in psychology, examination of a person’s cognitive, behavioural, or emotional functioning to diagnose possible psychological disorders
- make a diagnosis so that appropriate treatment can be provided
Evidence-based assessment
- assessment based on research into evaluation of psychopathology, selection of tests, and neuropsychological methods
Diathesis-stress model
- a way of thinking about the interaction between environment and person in the onset of psychopathology
- diagnostic model proposing that a disorder may develop when an underlying vulnerability is coupled with a precipitating event
- diathesis: underlying vulnerability
Family systems model
- a diagnostic model that considers problems within an individual as indicating problems within the family
Sociocultural model
- a diagnostic model that views psychopathology as the result of the interaction between individuals and their cultures
- ex. (dramatic) one person has schizophrenia the other is a quaker
Cognitive-behavioural approach
- a diagnostic model that views psychopathology as the result of learned, maladaptive thoughts and beliefs
- many types of abnormal behaviour are learned
2 major types of psychopathology
Internalizing disorders
- characterized by negative emotions
- divided into broad categories that reflect emotions of distress and fear
- more common in women
2 major types of psychopathology
Externalizing disorders
- characterized by impulsive behaviour
- more common in men
Anxiety disorders
- psychological disorders characterized by excessive fear and anxiety in the absence of true danger
- continually arousing the autonomic nervous system
- involve fear or nervousness that is excessive, irrational, and maladaptive
- part of fight or flight response
Generalized anxiety disorder (GAD)
- state of constant anxiety not associated with any specific object or event
- ex. Reginald is feeling very worried and has been for months, but he can’t figure out why. It seems like he’s anxious about everything
Social anxiety disorder
- fear of being negatively evaluated by others
- the more social fears someone has, the more likely they are to develop other disorders (ex. substance abuse, depression, etc.)
- comorbid with many other things
Agoraphobia
- intense fear of having a panic attack in public
- try to avoid certain situations
- fear they won’t have a way to get out/escape
- causes panic attacks
Panic disorder
- sudden attacks of overwhelming terror
Phobia
- fear of a specific object or situation
Panic attacks (3 reactions)
- emotional reaction: intense fear, apprehension, and terror
- physical reaction: racing heart, trembling, dizziness
- cognitive reaction: think they’re having a heart attack, going crazy, losing control
What are some factors that the behavioural manifestations of anxiety disorders share?
- biased thinking - anxious individuals tend to perceive neutral situations as threatening and they focus on that
- learning - developing fears from observing others that have those fears
- biological basis
Q: How does the cause of anxiety differ in specific phobias and in GAD?
- specific phobias have a specific object or event that causes fear
- GAD is worry with no specific threat
What is a common feature of all depressive disorders?
- presence of sad, empty, or irritable mood
- bodily symptoms
- cognitive problems that interfere with everyday life
Major depressive disorder
critera of diagnosis
- a disorder characterized by severe negative moods or lack of interest in normally pleasurable activities
- to be diagnosed they have to experience a major depressive episode for at least two weeks along with other symptoms (appetite, sleep, etc.)
Persistent depressive disorder
- a form of depression that is not severe enough to be diagnosed as major depressive disorder but lasts longer (can last 2-20 years)
Aaron Beck
Cognitive Triad
causes of depression
- people suffering from depression perceive themselves, situaions, and the future negatively
- they influence one another and contribute to the disorder
Learned helplessness
- a cognitive model of depression in which people feel unable to control events in their lives
Manic episodes
- last at least one week
- abnormally and persistently elevated mood
- increased activity
- diminished need for sleep
- grandiose ideas
- racing thoughts
- extreme distractibility
- often lead to excessive involvement in activities that make someone happy but may not be positive in the long run (behaviour they may regret later)
- may have severe thought disturbances and hallucinations
Bipolar 1 disorder
- more manic episodes than depression
- frequent depressive episodes as well (but they wouldnt be severe enough for the DSM5)
- manic episodes cause significant impairment in daily living and may result in hospitalization
- doesn’t require a major depressive episode for diagnosis
Bioplar 2 disorder
hypomania
- alternating periods of extremely depressed and mildly elevated moods
- experience hypomania: heightened creativity and productivity. Somewhat disruptive but not enough for hospitalization
- at least one major depressive episode required for diagnosis
What is the strongest and most consistent risk factor for bipolar disorders?
- family history of bipolar disorders
Q: What characteristic usually differentiates people who do and do not act on suicidal ideation?
- an aquired cpacity of willingness to harm themselves
Psychosis
- a break from reality in which a person has difficulty distinguishing real perceptions from imaginary ones
- split or disconnection from reality
Schizophrenia
- “splitting of the mind”
- characterized by alterations in thoughts, perceptions, or in consciousness, resulting in psychosis
- must experience symptoms for at least 6 months to be diagnosed
Positive symptoms of schizophrenia
- presence of maladaptive behaviour
- features that are present in schizophrenia but not in typical behaviour
- ex: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour
Negative symptoms of schizophrenia
- absence of normal behaviour
- symptoms of schizophrenia that are marked by deficits in functioning
- characteristics missing in schizophrenia that are typically part of daily functioning
- ex: diminished emotional response, lack of motivation, slowed speech and movement, apathy
- resistant to medications unlike positive symptoms
positive symptoms of schizophrenia
Delusions
- false beliefs based on incorrect inferences about reality
- persist in their beliefs even though there is evidence that it isn’t real
Positive symptoms of schizophrenia
Hallucinations
- false sensory perceptions that are experienced without an external source
- vivid, clear, seem real
- commonly auditory but can also be visual, olfactory, or somatosensory
- may be caused by the difficulty distinguishing inner speech with external stimuli
positive symptoms of schizophrenia
Disorganized speech
- incoherent speech patterns that involve frequently changing topics and saying strange or inappropriate things
- “word salad”
positive symptoms of schizophrenia
Disorganized behaviour
- acting in strange or unusual ways, including strange movement of limbs, bizarre speech, and inappropriate self-care, such as failing to dress properly or bathe
5 factors that predict the onset of psychotic disorders
1) a family history of schizophrenia
2) greater social impairment
3) higher levels of suspicion/paranoia
4) a history of substance abuse
5) greater frequency of unusual thoughts
Q: How does schizophrenia fit the diathesis-stress model of psychopathy?
People who both have a diathesis and who experience environmental stress are most likely to develop schizophrenia
Obsessive-compulsive disorder
- a disorder characterized by frequent intrusive thoughts and compulsive actions
- people are aware that their obsessions and compulsions are irrational but they are unable to stop them
Obsessions
- recurrent, intrusive, and unwanted thoughts, ideas or mental images that increase anxiety
- worry, doubting, aggressive thoughts
Compulsions
- particular acts that people with OCD feel driven to perform over and over to reduce anxiety
- counting (way to distract themselves from obsessive thoughts), hand washing, silently repeating words
What are some causes of OCD?
Conditioning: anxiety is paired with a specific event (classical conditioning), the person engages in behaviour that reduces the anxiety and is reinforced (operant conditioning)
Genetics: runs in families
Environment: random virus
Anorexia Nervosa
- excessive fear of getting fat
- severely restricting food and energy intake
- controls how they view themselves and the world
Bulimia Nervosa
- alternate between dieting, binge eating, and purging (puking)
- may abuse laxitives or over exercise
- caught in a cycle
Binge-eating disorder
- engage in binge eating at least once a week
- causes significant distress
- may feel guilt or embarassment
Addiction
- substance use that persists despite its negative consequences
Prognosis
- the probable outcome
- typical success of treatments
What effects do genes have on the brain that may contribute to biological explanations of psychological disorders?
- affects neurotransmitter levels
- affects brain structure and connectivity
Environmental effects on biology that may contribute to psychological disorders
- teratogens
- toxins, stress, malnutrition
- epigenetic reactions (a certain gene was turned on)
Causes of depression (biological)
- strong genetic link
- neurotransmitter imbalances - dopamine, serotonin
Cyclothymic disorder
- cyclic disorder that causes brief episodes of hypomania and depression
what brain regions are involved in addiction
prefrontal cortex, amygdala, thalamus, hippocampus, insula
What are the stages of addiction?
- euphoria from trying it for the first time - looks forward to using it on some occassions
- builds a tolerance - needs more to feel the effects - stops being as pleasurable
- desire to use it more often to cure the negative feelings of withdrawal
Q: What is the current understanding of the influences of genes on alcohol addiction?
No single gene is responsible for alcohol addiction, but certain inherited characteristics, such as sensitivity to reward and and impulsivity, can increase vulnerability to addiction
Trauma
- a prolonged psychological and physiological response to a distressing event, often one that profoundly violates the person’s beliefs about the world
- defined by the subjective response to an event and not the event itself
Posttraumatic stress disorder (PTSD)
- a disorder that involves frequent nightmares, intrusive thoughts, and flashbacks related to an earlier trauma
Dissociative disorders
- disorders that involve disruptions of identity, of memory, or of conscious awareness
- may be a functional response to an extremely distressing or traumatic event
Dissociative amnesia
- a person forgets that an event happened or loses awareness of a substantial block of time
Dissociative fugue
- extreme dissociative amnesia
- loss of identity
- usually involves moving somewhere new and assuming a new identity but not remembering any of it
Dissociative identity disorder DID (multiple personality disorder)
- diagnosis occurs when a person has difficulty accounting for large chunks of the day
Borderline Personality Disorder
- a personality disorder characterized by disturbances in identity, in affect, and in impulse control
- often associated with interpersonal trauma in childhood
- instability in several domains: sense of self, interpersonal relationships, goals, emotions, and behaviours
- cannot tolerate being alone and have an intense fear of abandonment
- emotionally unstable/manipulative
- impulsive
- suicidal or self harming tendencies
- suddenly ending relationships
Personality disorders
Cluster A: odd or eccentric behaviour
- paranoid, schizoid, schizotypal
- often reclusive and suspicious
- difficulty forming personal relationships because of their strange behaviour and aloofness
- some similarities to schizophrenia but symptoms are less severe
Personality disorders
Cluster B: dramatic, emotional, or erratic behaviour
- histrionic, narcissistic, borderline, antisocial
Personality disorders
Cluster C: anxious or fearful behaviour
- ## avoidant, dependent, obsessive-compulsive
What is the difference between OCD and obsessive compulsive personality disorder
OCD: self-reinforcing cycle of compulsive behaviours that reduce anciety
OC personality disorder: broader pattern of behaviours
- all-encompassing rigidity, orderliness, perfectionism
Antisocial personality disorder
- a personality disorder in which people engage in socially undesirable behaviours, are hedonistic and impulsive, and lack empathy
- lack of concern for others
- used to be considered a psychopath
Autism spectrum disorder
- a developmental disorder characterized by impaired communication, restricted interests, and deficits in social interaction
- restrictive or repetitive behaviours, interests, or activities
Q: What are the atypical characteristics of brain development in autism spectrum disorder?
- unusually rapid brain growth
- abnormal connections between brain regions
ADHD
- a disorder characterized by restlessness, inattentiveness, and impulsivity
Catatonia
- a movement disorder in which an individual does not move and rigidly remains in a pose for a lengthy period
- idea that it’s based on dopamine
Schizovirus hypothesis
- a prenatal virus works with genetic predisposition
- schizophrenics are more likely to be born in the winter months (flu season)
What causes eating disorders?
- stress and psychological vulnerability
- feel like it’s the only thing they have control over in their life
- perfectionism
- depression
- peer/social/media influence
Personality disorders
- unusual patterns of behaviour
- maladaptive, distressing to oneself or others, and resistant to change
- long term which is why it’s considered part of their personality
- often can be traced back to childhood