Abnormal psychology/ disorders Flashcards
DSM-5
Based on atheoretical descriptions of symptoms of various disorders; organized into 18 classifications of disorders
Neurodevelopmental disorders
those linked to the development of the nervous system (e.g. AD/HD, Autism spectrum, Tourette’s)
ADHD
inattentive, easily distracted, can’t maintain focus on task, daydreams, difficulty following instructions. hyperactive, fidgets, squirms, dashes around, always in motion, talks nonstop;
characterized by developmentally atypical inattention and/or impulsivity and hyperactivity. Short attention span, difficulty staying on task or organizing tasks, unable to follow instructions or requests.. hyperactivity in running, fidgeting, and restlessness. Impulsivity in inability to delay gratification, impatience, and frequently interrupting others.
Autism Spectrum
a range of neurodevelopmental disorders characterized by impairment of social skill and communication skills as well as repetitive behaviors. includes autism, Asperger’s syndrome, and pervasive developmental disorder not otherwise specified (PDD-NOS); children with autism may not cuddle, make eye contact, and may display little or no facial expressions, impairment in language skills, both receptive and expressive, also tend to be oversensitive to sensory stimuli.
Tourette’s disorder
characterized by multiple motor tics (e.g. eye-blinking, skipping, deep knee bends) or one or more vocal tics (e.g. grunts, barks, sniffs, snorts, coughs, utterance of obscenities). Tics are sudden, recurrent, and stereotyped. Duration of disorder is life long, but periods of remission may occur.
Schizophrenia
relatively recent term (1911 by Bleuler). characterized by gross distortions of reality and disturbances in the content and form of thought, perception, and affect. Could have delusions, hallucinations, disorganized thought, inappropriate affect, and catatonic behavior
Symptoms of schizophrenia
divided into positive and negative types. Positive: behaviors, thoughts, or affects added to normal behavior (e.g. delusions and hallucinations, disorganized speech, and disorganized or catatonic behavior). These are either on the psychotic dimension or the disorganized dimension. Negative symptoms are those that involve the absence of normal or desired behavior (e.e.g flat affect, blunted emotional expression)
delusions (and types)
false beliefs, discordant with reality, that are maintained in spite of strong evidence to the contrary , e.g. delusions of reference, persecution, or grandeur. Delusions of reference may involve an individuals belief that others are talking about them, that common elements in the environment are direction at them.Delusions of persecution involve the belief that the person is being deliberately interfered with, discriminated against, plotted against, or threatened. Delusions of grandeur involve the believe that they are a remarkable person, like an inventor, historical figure, etc. Or involve thought broadcasting, which is belief that one’s thoughts are broadcast directly from one’s head to the external world, and thought insertion, that thoughts are inserted into one’s head
Hallucinations
perceptions that are not due to external stimuli but have a compelling sense of reality.
disorganized thought
characterized by the loosening of associations (e.g. speech in which ideas shift from one subject to another unrelated subject in a way that a listener wouldn’t be able to follow the train of thought, or word salad).
catatonic motor behavior
various extreme behaviors characterized by reduced movement/activity or maintaining a rigid posture, refusing to be moved. Sometimes, catatonic behavior may include useless and bizarre movements not caused by any external stimuli
Epidemiology
study of the distribution of disorders in a population; prevalence (proportion of active cases of a disorder), incidence (occurrence of new cases of a disorder).
Norepinephrine
anxiety disorders
Serotonin and dopamine
Depression and schizophrenia
GABA
anxiety
Anxiety
Apprehension about a future threat, involves physiological arousal (fight or flight) and increases preparedness.
Anxiety disorders in DSM-5
Most common psychiatric disorders: specific phobias, social phobias, panic disorder (with and without agoraphobia), generalized anxiety disorder
Anxiety risk factors
Genetic (twin studies suggest heritability for phobias, GAD, PTSD and panic disorder); Neurobiological (overactive fear circuit, neurotransmitters serotonin, GABA, norepinephrine); Personality (behavioral inhibition, temperament, neuroticism); Cognitive (perceived control, attention to threat); Social (negative life events that often precede disorder onset)
Anxiety common treatment
Emphasize exposure- face the situation or object that triggers anxiety; medications (anxiolytics, benzodiazepenes (e.g. valium, xanax), antidepressants (e.g. SSRIs))
Phobic disorders
phobia- persistent and disproportionate fear of some specific object or situation that presents little or no actual danger; Marked by anxiety, avoidance, persistence (6 mo. or more), distress/ impairment. 16% of women and 7% of men; Causal factors: traumatic conditioning of fear, cognitive biases, evolutionary origins, genetic and temperamental factors.
Panic Disorder + agoraphobia
characterized by the occurrence of unexpected panic attacks, marked by brevity and intensity, worry and avoidance of situations in which a panic attack may occur; Marked by presence of recurrent PAs followed by at least one month of persistent worry of having further attacks or significant behavioral change related to the attacks; with agoraphobia- avoidance of situations in which escape would be difficult or embarrassing (e.g. being outside the home alone, in a plane, etc.)
Social Anxiety Disorders
Disabling fears of one or more discrete social situations in which a person fears that they may be exposed to the scrutiny or potential negative evaluation of others
Generalized anxiety disorder
involves chronic, excessive worrying (other symptoms: restlessness, poor concentration, irritability, muscle tension, easily fatigued); possible biological factors (neuroticism-common genetic predisposition for GAD and MDD), neurotransmitters GABA, serotonin and norephinephrine, HPA axis.
OCD and Related Disorders
OCD, Body Dysmorphic Disorder, Hoarding Disorder, Trichotillomania, Excoriation (Skin-Picking)
Obsessive-Compulsive Disorder
Traditionally conceptualized as an anxiety disorder, characterized by anxiety/fear and attempts at controlling and escaping from anxiety/fear. Recurrent obsession and compulsions: obsessions are unwanted and intrusive thoughts or images that are irrational or uncontrollable and compulsions are repetitive behavior or mental actions designed to neutralized obsessions, provide relief and prevent feared event. Obsessions tend to be ego-dystonic, themes are cross-culturally consistent. Effects both genders equally. Serotonin strongly implicated, maybe brain abnormalities in caudate nucleus and orbitofrontal-subcortical hyperactivity.
Hoarding Disorder
Persistent difficulty discarding or parting with possessions, fear of losing something important or need to keep all items; unlike OCD, thought is not intrusive.
Trichotillomania
Recurrent pulling out hair, efforts to stop/control fail, theoretically an anxiety disorder (controls, abates feelings of anxiety; but motivations appear to vary)
Excoriation (skin picking)
Recurrent picking or scratching at skin or scabs, behavior is quite routine and perhaps without intrusive thought.
Body Dysmorphic Disorder
Preoccupation with and extreme distress over imagined or exaggerated defect in appearance. Constant examination of self in mirror (or avoids mirror entirely), some people become housebound or have plastic surgery.
Trauma and stress-related disorders
New category in DSM-5: Reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, adjustment disorders
PTSD
Repeated reexperiencing/ intrusions, avoidance, negative cognitions and mood (e.g. inability to remember important aspects of trauma, persistent negative beliefs about ones self or others or the world, distorted cognitions about cause or consequence of trauma that lead to blame, negative emotional state, etc.), arousal and reactivity (hypervigilence, startled response, problems with concentration, etc.)
Acute Stress Disorder (ASD)
Similar symptoms to PTSD, have more emphasis on dissociation. Duration varies (short term reactions, symptoms can occur between 3 days and 1 month after trauma). Often a precursor to PTSD (66%).
Etiology of PTSD
Nature of trauma, neurobiological (smaller hippocampal volume, increased receptor sensitivity to cortisol), behavioral, psychological (perception of control, avoidance coping, dissociation, memory suppression), nature of and proximity to stressor, psychosocial factors (appraisal of stressor, personality, cognitive ability), sociocultural factors (social support, stigma, readjustment), biological (HPA axis, locus coeruleus, norepinephrine-sympathetic-system)
Depressive Disorders + Bipolar and Related Disorders
Major Depressive Disorder, Persistent Depressive Disorder (Dysthymia) + Bipolar I, Bipolar II, Cyclothymia
MDE
Dysphoria, sadness, anhedonia (loss of interest or pleasure), other symptoms.
Persistent Depressive Disorder (Dysthymia)
Depressed mood for most of the day , for more days than not, for at least two years; similar symptoms to depression
Premenstrual Dysphoric Disorder
very severe form of PMS, about 3-5% of women would meet criteria for this,
Beck’s Negative Triad (Depression)
Negative view of world, negative view of self, negative view of future leads to: Depressed mood, paralysis of will, avoidance, suicidal wishes, increased dependency
Risks for MDE onset/ relapse
Multiple prior MDEs, double depression (MDD and dysthymia), long duration of individual MDEs, family history of affective disorder, residual symptoms, comorbid anxiety or substance abuse, female, never married or divorced, unemployment or disability, poverty
Bipolar related disorders
three building blocks: Major depressive episode, manic episode, hypomanic episode
Manic episode
elevated or irritable mood and increased goal-directed activity, grandiosity, decreased need for sleep, more talkative, racing thoughts, distractibility, excessive involvement in activities with high risk for consequences + impairment or hospitalization
Hypomanic episode
same symptoms as mania, change in functioning, shorter duration, no clinically-significant impairment or hospitalization of psychotic features
Bipolar I
has manic episode
Bipolar II
Hypomanic episode, MDE, no history of full mania
Cyclothymia
symptoms of hypomania and depressive symptoms, no history of depressive, manic, or hypomanic episode, distress or impairment is present
Neurotransmitters in BP
dopamine enhanced during mania (dopamine agonists and precursors trigger manic symptoms e.g. amphetamines/ L-dopa); serotonin/ glutamate
Suicide and Psychopathology
90% of suicides related to mental illness; depression most strongly linked to ideation; anxiety impulse-control and substance disorders linked to plans and attempts
Suicide risk factors
previous suicidal behavior, precipitant stressors, impulsivity, hopelessness, aspects of current suicidality
Joiner’s Theory of Suicidality
Social-interpersonal theory: thwarted belongingness, perceived burdensomness create desire for suicide + capacity for suicide can = an attempt
Somatic symptom disorder
involves physical symptoms and complaints suggesting the presence of medical condition, contain no evidence of physical pathology; not intentionally produced or under voluntary control; individuals seek medical, not psychological treatment; excessive thoughts, feelings, or behaviors related to somatic symptoms or related health concerns: disproportionate and persistent thoughts about seriousness, high levels of anxiety, excessive time/energy devoted
Illness Anxiety Disorder
preoccupation with having/ acquiring a serious illness, somatic symptoms may or may not be present, high level of anxiety about health, excessive health-related behaviors or maladaptive avoidance
Factitious disorder
“Previously Munchausen’s” falsification of physical of psychological signs or symptoms, or induction of injury or disease, associated with identified deception; presents themselves to others as ill, impaired, or injured; deceptive behavior is evident even int eh absence of obvious external rewards, can be by proxy
David Southall
Filmed suspected cases waiting to be seen (his patients), parents suffocated, poisoned, or attempted to break bones. 33 parents prosecuted, 23 diagnosed with factitious disorder by proxy
Dissociative disorders
sudden disruption in the continuity of consciousness, memory, identity
Dissociative amnesia
inability to recall important personal information: usually about a traumatic experience, not ordinary forgetting, not due to physical trauma, may last hours or years; usually remits spontaneously and memory returns in bits and pieces
Dissociative Fugue
amnesia plus flight; sudden, unexpected travel with inability to recall one’s past: assume new identity (may involve new name, job, personality characteristics), more often of brief duration, remits spontaneously
Depersonalization/ derealization disorder
Perception of self is altered- feelings of detachment or disconnection: watching self from outside, emotional numbing. unusual sensory experiences: limbs feel deformed or enlarged, voice sounds different or distant
Dissociative identity disorder (DID)
Two or more distinct and fully developed personalities (alters), each with unique behaviors, memories, and friendships. Memory gaps common for periods of time when alters are in control. rare disorder (diagnosis is controversial). other symptoms: headaches, hallucinations, self harm, suicide attempts
Etiology of DID, two theories
Posttraumatic model: DID results from severe psychological and/or sexual abuse from childhood
sociocognitive model: DID a form of role-play in suggestible individuals, occurs in response to prompting by therapists or media, no conscious deception
eating disorders
anorexia nervosa, bulimia nervosa, binge-eating disorder
Anorexia nervosa
restriction of energy intake: unable to maintain 85% of expected weight for frame, height. extreme weight loss or failure to gain weight during period of growth, restricted diet. intense fear of weight gain: increases as weight diminishes. Disturbance in the way in which one’s body shape or weight is experienced, undue influence on self-evaluation, or denial of seriousness of current low weight. Restricting and purging subtypes
Bulimia nervosa
Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self induced vomiting etc. Self evaluation unduly influenced by body shape and weight. Recurrence of bingeing and purging Weight is usually normal, easy to conceal
Binge Eating Disorder
same as BN but without purging; impaired control, stress. Binges: more rapidly, uncomfortably full, eating when not hungry, eating alone, disgusted, depressed, guilty
Eating disorders neurotransmitters
serotonin (plays role in satiation, regulation of mood and impulsivity, esp. in BN) and norepinephrine (diminished, maybe due to malnutrition, but could play a role in maintenance), SSRIs used in treatment.
Personality disorders
long-standing patterns of thought, behavior, and emotions that are maladaptive for the individual or for people around him/her
Personality disorders diagnostic difficulties
not sharply defined, diagnostic criteria less precise, inferred traits rather than behavior, low reliability and validity, categories not mutually exclusive, substantial comorbidity, little prospective research, little research on etiology, categorical vs. dimensional approach
Personality disorder clusters
Cluster A seem odd or eccentric: paranoid, schizoid, schizotypal
Cluster B seem dramatic, emotional, or erratic: antisocial, borderline, histrionic, narcissistic
Cluster C appear anxious or fearful: avoidant, dependent, obsessive-compulsive
Five factor model to personality
neuroticism, extraversion, openness to experience, agreeableness, conscientiousness
Paranoid Personality Disorder (cluster A)
Pervasive and unjustified mistrust and suspicion. causes are unclear (may result from early learning that people and the world is dangerous).
Schizoid personality disorder (cluster A)
Pervasive pattern of detachment from social relationships, very limited range of emotions in interpersonal situations, causes unclear.
Schizotypal personality disorder
behavior and dress is odd and unusual, most are socially isolated and may be highly suspicious of others, magical thinking, ideas of reference, and illusions are common. risk of developing schizophrenia is high in this group. (maybe it is a phenotype of a schizophrenia genotype?)
Avoidant personality disorder (cluster c)
extremely sensitive to opinions of others, highly avoidant of most interpersonal relationships, are interpersonally anxious and fearful of rejection. causes unclear (but maybe early development- a difficult temperament produces early rejection).
Dependent personality disorder (cluster c)
excessive reliance on others to make major and minor life decisions, unreasonable fear of abandonment, tendency to be clingy and submissive in interpersonal relationships. Causes unclear but linked to early disruptions in learning independence.
Obsessive-compulsive personality disorder (cluster c)
excessive and rigid fixation on doing things the right way. tend to be highly perfectionistic, orderly, and emotionally shallow. obsessions and compulsions are rare.
Borderline personality disorder (cluster b)
patterns of unstable moods and relationships. impulsivity, fear of abandonment, coupled with poor self-image. Self-mutilation and suicidal gestures are not uncommon. Causes: runs in families, may be related to early trauma and abuse
Histrionic Personality disorder (cluster b)
patterns of behavior that are overly dramatic, sensational, and sexually provocative. often impulsive and need to be the center of attention. thinking and emotions are perceived as shallow. causes unknown
(maybe a sex-typed variant of antisocial personality?)
Narcissistic Personality Disorder (cluster b)
exaggerated and unreasonable sense of self-importance, preoccupation with receiving attention, lack sensitivity and compassion for other people, highly sensitive to criticism, tend to be envious and arrogant. causes unknown.
Antisocial personality disorder (cluster b)
Have to be 18 y.o. before it can be diagnosed; predatory attitude toward other people, chronic indifference to and violation of the rights of one’s fellow human beings, history of illegal or socially disapproved activity beginning before age 15 and continuing into adulthood, failure to show constancy and responsibility in work, sexual relationships, parenthood, or financial obligations. irritability and aggressiveness, reckless and impulsive behavior, disregard for the truth. (causes: maybe genetics, low serotonin, individual differences, modeling, etc.)
psychopathy
deeds are not motivated by any understandable purpose, shallow emotions, poor judgement and failure to learn from experience, ability to maintain a pleasant and convincing exterior, inadequate conscience development, irresponsible and impulsive behavior, rejection of authority, ability to impress and exploit others, inability to maintain good relationships.
substance abuse disorders
problems related to the use and abuse of psychoactive substances; produce wide-ranging physiological, psychological, and behavioral effects.
substance abuse
failure to fulfill major obligations, exposure to physical dangers, legal problems brought on by drug use, persistent social or interpersonal problems.
substance dependence
tolerance to drug action occurs, withdraw symptoms occur with cessation, person recognizes excessive use of the drug, much of their time is spent getting the drug or recovering from its effects, substance use continues despite physical or psychological problems caused by it.
Five main categories of substances
depressants (result in behavioral sedation e.g. alcohol, sedative, anxioltyic drugs), stimulants (increase alertness and elevate mood e.g. cocaine, nicotine, caffeine), opiates (primarily produce analgesia and euphoria e.g. heroin, morphine, codeine), hallucinogens (alter sensory perception e.g. marijuana, LSD), other drugs of abuse include inhalants, anabolic steroids, medications.
physical v behavioral dependence
physical dependence easy to treat, behavioral dependence when drugs become central reinforcement of life, life revolves around use of drug (e.g. social life, etc.), state-dependent learning
behavioral addictive disorders
gambling, internet, shopping, sex (hypersexual disorder), etc.
Alcohol Use Disorder
problematic pattern of alcohol use leading to impairment/distress as manifested by at least two symptoms: alcohol taken in larger amounts or over a longer period of time than was intended, persistent desire or unsuccessful efforts to control, time spent in activities necessary to obtain alcohol, use it or recover from it, craving, recurrent use resulting in failure to fulfill major role obligations, continued use despite having persistent and recurrent social and interpersonal problems caused by it, important social, occupational, or recreational activities given up, recurrent use in situations in which it is physically dangerous, use is continued despite knowledge of having persistent and recurrent physical or psychological problems caused or exacerbated by its use, tolerance, withdrawal.
Paraphilia, gender dysphoria, sexual dysfunctions
paraphilias- recurrent, intense, sexually arousing fantasies, urges, or behaviors that involve nonhuman objects, suffering or humiliation of oneself or partner, children or non-consenting person. (fetishistic, transvestic, voyeuristic, exhibitionistic, etc.)
gender dysphoria- people who believe they are of the opposite sex and suffer from it, controversial diagnostic category, pathologizes natural variation in human behavior and carries stigma.
sexual dysfunction- disruption in sexual functioning
psychosis
the hallmark of schizophrenia, a significant loss of contact with reality
Disruptive mood dysregulation disorder
childhood disorder: over-diagnosis of bipolar disorder in children, new diagnosis with restrictive criteria might diminish the over-diagnosis.
Conduct disorder
four groups of features: aggression to people/ animals, destruction of property, deceitfulness or theft, serious violations of rules. 15 year or younger, subtype callous-unemotional. 40% meet ASPD as adults.
Oppositional defiant disorder (ODD)
argumentative/ defiant, angry/irritable, vindictive. 25% later meet criteria for conduct disorder, begins by age 8.
Neurodevelopmental disorders
intellectual disability, autism spectrum, communication, ADHD, learning disorders, motor disorders.
asberger’s
much more highly functioning, lack of severe self-injury or isolated repetitive behaviors, employed but socially isolated, awkward, and peculiar, mild variant of autism spectrum.
conversion disorder
unexplained symptoms affecting voluntary motor or sensory function. include paralysis when there is no neurobiological damage or even blindness when there is no evidence of damage to the visual system or brain.
