Abnormal Psychology Flashcards
1
Q
What is the definition of psychological disorders?
A
Patterns of thoughts, feelings, or behaviour that are deviant, distressful, and dysfunctional
2
Q
When does a psychological disorder occur?
A
When there is a lack of control over symptoms that:
- Deviate from sociocultural norms (normal)
- Eg. not having hallucinations in Canada is not normal, in other cultures hallucinations are seen as normal and cannot be used as a symptom of psychological disorders there - Cause dysfunctional or dangerous actions
- When people start losing control, often it starts affecting their life due to modification of behaviour - Cause (emotional) distress
- When you can’t do what you want, and when symptoms start impacting your life negatively, you feel distress
3
Q
What are the different ways of describing “normal”?
A
- What most people do/think/feel? (averages)
- Can backfire because the average in a group can be bad (have a substance use abuse problem)
- What everyone is doing does not mean it is the healthy thing to do - What most people should do/think/feel? (values, morals)
- Eg. science (value) says that everyone should exercise, gives you a different perspective even if not everyone does it - What most people would expect you to do/think/feel? (expectations)
- Typically used in context of treating one specific client experiencing specific symptoms
- What do their parents/friends think they should do?
- What pressures is on the client?
4
Q
Discuss the situation’s influence on what is seen as normal.
A
- Whether a behaviour varies from normality depends on the situation in which behaviour occurs
- Context depends on the society’s norms
- Variations across culture groups
- Most parents in Canada encourage kids to be outside
- Most parents in Japan never encourage you to play outside (pollution)
- Playing outside in Canada tells you something different from playing outside in Japan - Changes over time
- Overnight, homosexuality was not a psychological disorder anymore in this society
- Changes in values in society change how that culture understands mental health
5
Q
What is the legal definition of psychological disorders?
A
- No person is criminally responsible for an act committed while suffering from a mental disorder that rendered the person incapable of appreciating the nature and quality of the act or knowing that it was wrong
- It is hard for people to decide whether someone in an event was in control of what was going on or was not (judgement call)
- Usually done by psychiatrists, not psychologists
6
Q
How are psychological disorders distinguished?
A
- Patterns of dysfunctional behaviours and/or thoughts that create distress and deviate from the norm
- Some patterns tend to go together
- Eg. when people find it difficult to control their worry, they are often also restless and have trouble sleeping
- These grouping of symptoms are the basis of distinguishing one disorder from another (labels)
7
Q
What is the Diagnostic and Statistical manual? What are the criteria?
A
- DSM-IV-TR (used the longest) or DSM-V (2013, controversial) by the Amemrican Psychiatric Association
Uses 3 main criteria in which to base classification/groupings:
- Type and number of symptoms
- Aetiology (causes) of the symptoms
- Prognosis (what is the likely outcome of treatment?)
NOT severity of symptoms
8
Q
Why should we classify disorders?
A
- Increases reliability (consistency) between psychologists’ assessments
- Before, psychologists had different diagnosis for the same set of symptoms - Diagnoses create a verbal shorthand for referring to a list of associated symptoms
- Doctors do not have to list all the symptoms everytime they talk about the disorder, just say the name - Diagnoses allow to statistically keep track of cases occurring over time and study many similar cases which helps improve practice
- Allows funding in society to increase if mental health problems need it (rising numbers) - Diagnoses help guide treatment choices; learning to predict outcomes of treatment
- The DSM is used to justify payment for treatment
- Mainly true in the USA, insurance companies will only pay if you have a specific diagnosis
9
Q
What are the general criticisms of the DSM?
A
- The border between disorder and normal is often blurry; the book makes the problem seems very straight forward but in reality isn’t
- The border between diagnoses is also often blurry (is it generalized anxiety or social anxiety?); particularly when considering co-morbidities (multiple disorders, disorders that occur together like anxiety & depression) when figuring out which came first
- Decisions about what is a disorder or abnormal include value judgements shaped by prevailing cultural norms
- Eg. is it normal to engage in sexual relations with someone of the same sex? - Diagnostic labels direct how patient view themselves and how others view them
- Liberating (“now I know what’s going on in my life”)
- Stigma (individuals see themselves as a label/diagnosis/treatment; people’s symptoms will become amplified because they took the label as their identity)
10
Q
What are the specific criticisms of the DSM-V?
A
- Pharmaceutical companies had input in the creation of the book at a level never observed before
- Creating disorders to match their medications = more profit
- Pharmaceutical companies have a different interest from doctors trying to help people - Adding new disorders that end up pathologizing otherwise challenging but normal behaviour and thought patterns
- Turning events that until recently was considered normal human behaviour that do not need to be diagnosed with a disorder
- Eg. disruptive mood dysregulation disorder (kid throwing a tantrum); bereavement (depression linked to the loss of somebody, part of normal experience to feel sad when you lose someone close to you, takes this normal process into a disorder that needs to be treated) - Combining diagnoses criteria that might be better off separate; clustering separate things
- Eg. initial substance abuse vs long-time abusers
- Person that has been addicted to a drug for decades have different styles/patterns of thinking/situation than someone who just started
- The treatment between the 2 will be different so why are they being combined for the a same treatment? - Vague criteria that fail to reach consensus among clinicians (interrater reliability = different clinicians look at symptoms and agree how they are treated)
- Way higher disagreement than in previous versions
11
Q
Why should we diagnose disorders?
A
- Psychological disorders are typically seen as pathologies with a cause
- Treatment is possible
2 Diagnosis aims to identify the most probable aetiology (cause) of the symptoms of disorder
- Often exclusionary diagnoses (per exclusionem); if you are diagnosing properly, you are ruling out different things and the one you are left is the one you use to diagnose someone
- Aetiology guides the choice of treatment (psychotherapy and/or psychopharmacology)
- Treatment targets the aetiology with the goal of restoring mental health can be provided
- Focus is often on addressing the dysfunctional patterns of behaviour and thoughts
12
Q
What are the 5 axes of the DSM-IV-R and what is the importance?
A
Rule out simpler explanations before a diagnosis of a psychological disorder.
Axis I: all diagnostic categories except mental retardation and personality disorder
- Typically shorter term prognosis
- Can probably address with psychotherapy treatment and medication treatment combination
Axis II: is a personality disorder or mental retardation present?
- After all the other factors are rules out, look at genetic/life long psychological disorders
- The treatment is life-long management of disorder
Axis III: is a general medical condition also present?
- If you rule out social problems, look at physical conditions
- Diagnosis of depression in a 15 minutes process without a physical exam is not done properly - shouldn’t be done in a single consultation
- Eg. a girl diagnosed with ADHD and was actually low blood iron level due to her period
Axis IV: are psychosocial or environmental problems also present?
- Depending on functionality, look at social/physical environment
- Eg. someone with depression in an abusive work environment; treatment of this client will be to fix the environment
Axis V: what is the global assessment of this person’s function?
- Can this person look after themselves and other people?
- Is this person experiencing dysfunctionality?
- Starting point
13
Q
Discuss psychological disorders worldwide.
A
- Most likely underestimate, because of challenges to assess, particularly in developing countries (we know very little about mental health outside of Western countries)
- Some disorders seem to be universal (eg. depression, schizophrenia)
- Some seem to be culture specific (eg. bulimia tends to be in Western industrialized countries)
- Impacts psychological well being (eg. sadness) and physiological wellbeing (eg. high blood pressure)
14
Q
What are anxiety disorders?
A
Characterized by a permanent and irrational (no objective reason) fear that typically brings people to avoid certain situations, people, and/or objects
15
Q
What are the factors for anxiety disorders?
A
- Conditioning and learning (while you cannot delete memories, you can modify anything that has been learned)
- Classical conditioning: acquiring anxious responses, result is phobia or generalized anxiety
- Eg. Little Albert study; took an orphan and put a white rat in front of him and he was not afraid; conditioned a fearful response to rat by hitting a metal frying pan and hammer together; Albert started to generalize the response to anything that was white and fluffy
- Operant anxiety: negative reinforcement motivating anxious-avoidant responses (coping with responses to anxious disorders, explains how these disorders are maintained)
- The result is an increase in anxious thoughts and behaviours
- Maintain anxious responses
- Eg. anxious dog running away and hiding from thunder, stress about thunder goes away which reinforces action - Cognitive appraisal
- Cognitive processes include anxiety-provoking thoughts, such as mistaken appraisals (you are not objectively assessing the situation) and rumination (worried thoughts)
- In anxiety disorders, such types of cognitions appear repeatedly and often automatically (due to practicing; everytime you ruminate you get better at activating those thoughts)
- Eg. you’ve got a headache, you automatically think you have brain cancer
- Acquired through direct and observational learning
- Eg. fear of calling customer service because as a child would constantly see parent throw a tantrum calling customer service because it was a stressful experience
- She had never had a bad experience with customer service but her mother would always throw an anxious show - Personality (eg. neuroticism)
- Doesn’t consider interactions with social environment
- Leaves little room for solutions if we assume it’s all genetics (not a hopeful perspective)
16
Q
What is generalized anxiety disorder?
A
- Apprehension and agitation persistent and uncontrollable
- Inability to identify the cause(s) of the anxiety (free-floating fear; scared of many triggers)
- Started off probably as a specific response but got generalized to a wide range of things
- Activation of the autonomic system to a generalized wide range of stimuli
17
Q
What are phobias?
A
- A phobia is more than just a strong fear or dislike
- A specific phobia is diagnosed when there is an uncontrollable, irrational, intense desire to avoid certain situations, people, or object
- The rates of fear change depending on the stimuli whereas the rate of phobia is stable
- Usually very specific to one stimuli
- Responds the best to psychological principles (conditioning)
18
Q
What are obsessive compulsive disorders? When is it really OCD?
A
- Obsessions: intense, unwanted worries, ideas, and images that repeatedly pop up in the mind
- Compulsion: repeatedly strong feeling of needing (lack of control) to carry out an action (even though it doesn’t feel like it makes sense)
When is it a disorder?
- Dysfunction: when the time and mental energy spent on these thoughts and behaviours interfere with everyday life
- Distress: when you are deeply frustrated with not being able to control the behaviours
19
Q
What are mood disorders?
A
Cluster of disorders for which a disturbance of the person’s mood is assumed to be the underlying cause
20
Q
What are the explanations for mood disorders?
A
- Biological aspects and explanations: brain cell communication (neurotransmitters)
- Less norepinephrine (arousal) during depressive episodes
- Major depression can come with difficulties focusing
- Norepinephrine focuses on helping concentrating to help the person change how patients think (cognition) of the situation they are in
- Reduced serotonin activity with presence of depression symptoms (eg. Prozac) - Social-cognitive aspects and explanations
- Depressive explanatory style
- Stressful event = temporary = specific = externalize (if you think more clearly about the situation, you can think about good things and other options, not blaming only yourself) = avoid depressive thoughts = resilience
- Stressful event = stable = global = internalized = depression
- When you think poorly and internalize the situation, you practice these thoughts and get good at them (automatic)
- Viscous social cognitive cycle of depression (if you use the second option)
- Stressful experience = negative explanatory style = depressed mood = cognitive and behavioural changes = stressful experience
- Practicing the same muscle over and over again
21
Q
Discuss major depression disorder.
A
- Yearly estimates: 6% of men and 10% of women
- Symptoms: depressed mood, loss of interest in things that were pleasurable
- Most of the time, most days, during the same 2 weeks
- Will sometimes also manifest more in terms of somatic (physical) symptoms (sleep issues, loss of appetite) but less common in the West
- Subjective report or observation made by others
- Major depression episodes are actually painful for the person; adding to the disorder with stigma (“faking it”) doesn’t help the person
- The feeling of ostracism triggers the same neurological structures that are associated with physical pain
- It will not motivate them to “get better quicker”; they are fully aware that they are not functioning properly
- The concept of depression passes on its own is necessarily true
- It depends on the cause and the trigger
- Some cases look like it passed on its own without therapy if the cause was resolved
22
Q
What are substance use disorders?
A
Disorders in which the need for obtaining a substance and/or its frequent use creates dysfunction
23
Q
When is it a substance use disorder? Talk about normalization in society.
A
- In most societies, moderate use of some psychoactive substances (eg. coffee, alcohol) is considered normal
- When moderate substance use is normal in a given environment it may hamper people from noticing they have a problem
- Eg. Big Bang Theory; Penny has a drinking problem but everyone laughs about it
When is it a disorder?
- Loss of control over the use of the substance (you can’t easily cut it out)
- Impairment in daily functioning and continued use of substance despite adverse consequences
- Physical or emotional adaptation to the presence of the drug, such as in the development of tolerance (compulsion)
- You can’t be happy without the presence of the substance
- Note that acknowledging the problem is not part of the list
24
Q
Discuss prescription opioids for substance use disorders.
A
- Prescription opioids (OxyNeo; Percocet; Dilaudid) can be addicting
- Prescription habits of doctors; believe that they are not addictive but can harm patients
- Make sure to ask your doctor about nonaddictive or less addictive options (be sure to try these options first)
- If you get a prescription of opioid, ask your doctor to make the prescription short (CDC results suggest no more than 5 days)
25
Q
Discuss the explanations for substance use disorders.
A
- For psychoactive substances to have an effect on you, it must be able to cross the blood-brain barrier
- Psychoactive substances typically affect areas of the brain tied to the neurotransmitter dopamine (among others)
- Neuroadaptation: with time the brain adapts to the repeated/continuous presence of the substance, which leads to a greater tolerance (eg. stops producing enough dopamine)
- Facilitated by biological factors (eg. genetics), psychological factors (eg. expectations) and social factors (eg. peer group, watching Penny on TV)
Opponent process theory: competition between 2 different processes (colours in perception)
- Early on, the substance produces a hedonic state (affective pleasure)
- Positive reinforcement motivates the search for that experience again (acquisition; substance abuse)
- You will be chasing it for the rest of your life if you have a substance abuse problem, but you will never get the first buzz ever again (and you cannot unlearn it)
- Opponent processes will start to change body to adjust to the presence of the substance = build tolerance
- With repeated exposure, this first hedonic state will decrease in its value, higher dose is needed for same “buzz”
- Eventually when substance is not taken the body experience a tense unpleasurable state (withdrawal; agitation, jitteryness, convulsions, hallucinations from alcohol; misunderstand who’s around you)
- Negative reinforcement sets in and motivates the search for the substance (maintenance, substance dependence)
- The arousal state of withdrawal motivates you to seek out the substance
- Some substances make your body adjust so much (alcohol) that if you stop it quickly, it can be fatal (needs to be under medical supervision)
