Behaviour Disorders (BDOs) Flashcards
1
Q
What are the 4 Conceptions of ABNORMALITY?
A
1) Statistical frequency
2) Deviation from social norms of acceptable behaviour (changes w/ culture and time)
3) Maladaptiveness to behaviour - Dysfunctional (does it affect the well-being of those affected or of people with whom they interact? - Anorexia, suicidal)
4) Personal Distress - people w/ BDOs, especially left untreated, re often miserable. Subjective sense of distress may be only symptom of abnormality - otherwise they seem fine.
All criteria should be assessed to determine abnormality
2
Q
Schizophrenia diagnoses steps?
A
> Person presents w/ symptoms similar to others w/ the DO
Shows itself in late teens
Meds must be taken consistently
3
Q
Normal?
A
General Well-being
4
Q
Steps of Psychodiagnoses?
A
> Describe DO and its symptomology
Give a prognosis (will DO get better or worse)
Suggest appropriate treatment
Stimulate Etiological Research and facilitate communication b/w professionals
5
Q
Etiology meaning?
A
Where from/ what causes
6
Q
What is Institutionalization?
A
Major problem for those in mental hospitals
- Once they get out they relapse extremely quickly (60% w/in a week) and end up back inside, sometimes on purpose (the institution becomes all they know.
7
Q
What is the DSM and what info does it provide?
A
Diagnostic and Statistical Manual of Mental Disorders (DSM-5 = 5th edition)
> has specific categories for different DOs
> 350 DOs in manual
> Categories of DOs
- Schizophrenia spectrum
- Phobias and General Anxiety DOs (GADs)
- OCD/ related DOs
8
Q
Why an increase in DOs?
A
- More research to better understand and define DOs
- Increased strength of lobbying groups (big Pharma companies) - want more BDOs to be recognized (for $)
9
Q
Issues w/ the DSM-5?
A
- Unreliability in psychodiagnoses
- DO definitions and diagnostic criteria can fail to represent empirical findings
- Major overlap b/w DOs - hard to differentiate
- Does not tell you how to treat the DO
10
Q
ADHD Diagnoses?
A
- Dramatic increases
- boys are 3x more likely to be diagnosed
- Can be just general behaviour problems from being in new situations
11
Q
What is Comorbidity?
A
> when 2 or more DOs are present at once (anxiety and depression)
Rule of 50% - half of people who meet criteria for 1 DO will meet criteria fro another (half will meet criteria for a third)
12
Q
Best steps for using the DSM-5
A
> After extensive evaluation, clinician diagnoses DO
DSM provides specific diagnoses
DSM provides known info about DO (facts, vulnerabilities, commonality)
13
Q
Personality and DOs?
A
- Neuroticism is a risk factor for many DOs
- Low agreeableness is associated w/ PDOs
14
Q
Psych DO facts?
A
- Mental health illness affects 1 in 5 Canadians
- Nearly 50% of North Americans between 15 and 54 will experience a psych DO in lifetime
- Anti - Anxiety/ depression drugs are some of the most commonly prescribed
15
Q
DSM DO Categories?
A
> Anxiety DOs
Mood DOs
SOmatic symptom DOs
Dissociative DOs
Schizophrenic DOs
16
Q
What is Trephination?
A
The cutting of holes in the skull to release an evil spirit that caused abnormal behaviour
17
Q
Vulnerability - Stress Model?
A
Everyone has a degree of vulnerability towards developing a Psych DO given sufficient stress
- Vulnerabilities = genetics, biologic factors, low social support
- Stressors = economic adversity, environmental trauma, interpersonal stresses/ losses
18
Q
Reliability vs Validity?
A
R = clinicians using the system should show high levels of agreement in diagnostic decisions
V = Diagnostic categories accurately capture the essential features of the various DOs
19
Q
European classification system?
A
International Statistical Classification of Diseases (ICD)
20
Q
6 Dimensions of disordered personality?
A
> Negative emotionality
Schizotypy
Disinhibition
Introversion
Antagonism
Compulsivity
21
Q
Issues w/ Diagnostic Labelling?
A
- Those w/ labels are stigmatized
- People male assumptions - less likely t be able to rent apartment or find job
- 20% of Canadians will receive a label
- Label begins to describe the person not the behaviour.
- Rosenhan study found it very hard for people to accurately label people as sane or insane
- Mental status based on Competency and Insanity (C = state of mind at judicial hearing… I = state of mind at time of crime)
22
Q
4 Components/ Responses of Anxiety DOs?
A
1) Subjective-Emotional > feelings of tension/ apprehension
2) Cognitive > worry, feel an inability to cope
3) Physiological > High HR/ BP/ BR, msc tension, nausea,
4) Behavioural > avoidance of feared situations, impaired task performance
23
Q
DOs included under Anxiety DOs according to the DSM-5?
A
-Phobic DOs, GADs, Panic DOs, PTSD, Social anxiety
24
Q
Most prevalent (new and previously existing cases) psych DO?
A
Anxiety DOs
- 18.6% of NAs
- 34% for indigenous people
- 16% for women (in Canada)
- 9% for men in Canada
- 34% of performers have have performance anxiety
25
Normal Anxiety vs ADOs?
Normal = get over it pretty quickly
ADOs = don't get over it - persistent, intense, distressing
- also ADOs have physiological correlation
26
What is Social Anxiety Disorder (SAD)?
- Most common social phobia
- Fear of social interaction
- los social skills
- Exaggerated fear of embarrassing self in public
- Prevalent in 8% of people
- Start in late adolescents
- Become chronic if not treated
27
3 main Phobic DOs?
- Simple phobias (specific to objects or situations)
- Agoraphobia (fear of open/ public spaces)
- Social Phobias - most common is Social Anxiety Disorder (SAD)
28
What is General Anxiety Disorder (GAD)
> Slow/ steady IV drip of worry
> General/ Free Floating anxiety not caused by one particular thing/ situation
> Anxious about many/ most things
> Often high in neuroticism
> Uptight, nervous
> Anticipate the worst
> Shows phys signs of anxiety/ stress
29
What are Panic DOs?
> Often in response to specific situation
> Intense and minutes long
> Anxiety and its physiological symptoms are present
> So unpredictable/ scary that many avoid all situations where they might occur
30
Describe Obsessive Compulsive Dosorder (OCD)?
> Persistent/ intrusive thoughts that you can't control
> Extremely anxiety provoking leading to compulsion
> Compulsion = near irresistible urge to do something in order to reduce anxiety
> Anxiety is only reduced temporarily
> Usually in late teens/ early 20s
> Prevalence = 2-4%
> Howie Mandell, Leonardo Dicaprio
> High activity in frontal lobe = more stimulation noticed and considered threatening
31
Difference b/w Anxiety and Depression?
Anxiety > More likely to have intense physiological arousal
Depression > Characterized more by a sense of hopelessness and an absence of pleasure
32
Etiology of Anxiety DOs?
> Huge biological factors
- Twin studies show some genetic predisposition to ADOs
> Biological sensitivity - greater awareness of anxiety reactions > linked to over arousal of brain areas involved w/ impulse control and habitual behaviour, focusing and directing attention
> Those high in neuroticism over-interpret stimuli as anxiety provaoking
33
Drugs that help with ADOs/ OCD?
Drugs that inhibit the release of Serotonin tend to be effective in decreasing ADOs
34
What are Mood DOs?
- 2nd most common psych DO
- High comorbidity w/ anxiety DOs
- Don't get over moments of low moods
- Some are episodic (short time)
- Periods of feeling ok are overwhelmed by feelings of depression
35
2 Types of Mood DOs?
Depressive DOs
Bipolar DOs (manic depression)
36
Bipolar DO?
Alternating periods of extreme elation and serious depression
- Prevalence = 1-7%
37
4 Symptoms that Characterize Depression?
1) EMOTIONAL > overwhelming sadness/ despair, hopeless outlook, loss of pleasure
2) COGNITIVE > Suuuper negative self evaluation, think the people feel the same towards them, poor concentration/ memory
3) MOTIVATIONAL > Struggle to push themselves to do things, not very excited about anything
4) PHYSICAL > Changes in sleep/ appetite, general fatigue, random ches/ pains
38
Requirements for clinical diagnoses of Depression?
- Don't need all 4 factors but the more they have/ the more intense they are = more likely they are clinically depressed
- Symptoms continue for more than 2 weeks
- Symptoms are constant
- Affects day to day functioning
39
2 Depression Diagnostic Methods?
MMIP >
Beck Depression Inventory > correlation of .60 - .90 w/ depression
40
Vulnerabilities and prevalence of depression?
> 2-3x more likely to be diagnosed in women
> Major D tends to begin in adulthood
- w/ age comes experience of world (good and bad)
- W/ age, predisposed psych factors (personality - neuroticism, cynical outlook) become more engrained in us
> Lifetime prevalence = 7-17%
41
Best way to treat depression?
Cognitive Behavioural Therapy
42
What are the Biological Factors of Depression?
> Twin studies - fraternal = 11-17% both have depression, Identical = 40-67%
> Biochemical abnormality - Issues w/ neurotransmitter (norepinephrine & serotonin) receptors being under or over sensitive
> Under active prefrontal cortex (not great at processing + stimuli)
> Communication breakdown b/w Amygdala (threat/ danger signals) and the Prefrontal Cortex (should send amygdala signals when danger is passed). If PFC doesn't send signals, leads to continued warning signals and lots of fear/ depression
43
COGNITIVE FACTORS (Distortions) of DEPRESSION?
> Involves Distorted interpretation/ attributional tendencies
> Beck - The COGNITIVE TRIAD = Negative beliefs about - Self, Present Experience, and the Future
> Cognitive distortions are the opposite of defence mechanisms - make life harder to deal with
> Beck - negative view of self formed quite early through interpersonal relationships involving rejection, criticism, tragedy
> Negative views/ experiences tend to be reactivated by similar experiences
44
4 Components of Cognitive Distortions?
Magnification > small mishaps are seen as a really big deal
Minimization > minimize/ discredit the importance of a positive event
Overgeneralization > make a sweeping conclusion based on one event
Self-Perpetuating > negative self-evaluation, what happens is distorted to fit inside negative self-view
45
What is a Schema?
> An organized knowledge structure about an entity
46
How does Depression affect schemas?
- Those diagnosed have depressive self-schemas > negative qualities (no good, failure, useless)
- Info from intrapersonal world is distorted to fit schemas (others thoughts towards them)
47
How do Pessimistic Cognitive STYLES affect Depression (Seligman et al.)?
- They make internal, self-defeating attributions
- This style makes people more vulnerable to depression and those with depression tend to have this style.
- Negative cognitive style predicts depression (1st year students w/ negative cog style more likely to become depressed by 3rd/ 4th year)
47
Effects of Depression on memory and recall?
> Have better memories for negative things rather than positive things
> Have a harder time recalling positive themes from stories
> Recall more bad memories faster
48
Characteristics of Personality DOs?
> Longstanding/ deeply imbedded personality traits
> Maladaptive ways of thinking, feeling, behaving
> Hard to change b/c personality is relatively stable in normal and abnormal personalities
> Inflexible and extreme levels of the Big 5 personalities
E.g. > PDO w/ extraversion = off the charts extraversion, always want to be centre of attention, not situationally flexible, overdramatic, self-centred
49
Prevalence of PDOs?
7-15%
4x more likely in women
50
Borderline PDO characteristics?
- History of instability and impulsivity in relationships
- identity instability
- verbally aggressive
- Don't see self a having problem
51
2 potential Treatments for BPDOs?
People are very resistant to treatment
> Anti-depressant drugs - serotonin related
> DIALECTICAL TREATMENT - Improve interpersonal skills, stress tolerance, and emotional regulation
52
Affects of inhibitory GABA on anxiety?
Low levels of inhibitory GABA in arousal areas may cause people to have highly reactive NSs that produce anxiety responses quickly
53
What is Freud's Neurotic Anxiety?
Occurs when unacceptable impulses threaten to overwhelm the Ego's defences and explode into action
53
Causes of anorexia and bulimia?
> Cultural factors - thin = beautiful
> Personality factors - perfectionists
> Family pressures
> Low impulse control
> Reduce depression/ anxiety
> Genetic predisposition
> Low leptin from decreased fat mass
> Insensitivity to stomach acid after a while
54
What is Chronic Depressive DO?
Has less dramatic effects on personal/ occupational functioning than major depression but can last a long time
55
3 Possibilities after suffering major depression?
50% - depression will recur
40% - depression will never recur after recovery
10% - no recovery - Chronic Depression
56
What is the BAS?
Behaviour Activating System
- extraversion
- reward oriented by cues that predict future pleasure
- Low BAS can = depression
57
What is BIS?
Behaviour Inhibition System
- neuroticism
- pain avoidant, generates fear/ anxiety
- high sensitivity can = depression
58
Theory on how neurotransmitters affect motivation?
> Considers Depression as a disorder of motivation caused by under activity in some NTs (dopamine, norepinephrine, serotonin).
> These NTs are involved w/ the BAS and play role in reward/ pleasure so low levels can lead to decreased pleasure/ motivation = depression
59
How can traumatic losses/ rejection cause depression
Can lead to vulnerability to depression by triggering a grieving/ rage process that become part of ones personality
60
What is Learned Helplessness Theory?
Depression occurs when people expect bad events to occur and believe there is nothing they can do to stop them/ cope
61
What is a Depressive Attributional Pattern?
Taking no credit for success and blaming oneself for all failures increases/ maintains low self-esteem/ worthlessness
62
Pain disorders?
People experience intense pain that is out of proportion for their condition or for which no cause can be found
63
What are Somatic Symptom DOs?
Physical complaints or disabilities that suggest a medical problem but have no known biological cause
64
What is Functional Neurological Symptom DO (conversion DO)?
Serious neurological symptoms paralysis, blindness, loss of sensation) occur with no known cause.
65
Dissociative DOs?
Involve a breakdown of normal memory integration resulting in significant alterations to memory or identity
66
What is Dissociative Fugue?
Person loses all sense of personal identity and gives up normal life, moves away and creates new identity
Triggered by trauma
67
What is Dissociative Amnesia?
Person responds to a stressful event in their life with extensive but selective memory loss
68
What is Dissociative Identity DO (DID)?
Multiple personality DO
- 2 or more separate personalities coexist in the same person
- develop in response to severe stress/ abuse in early childhood
69
Characteristics of Schizophrenia disorder and its meaning?
> Severe disturbances in thinking, speaking, perception, emotion, behaviour
> Misinterpretation of reality
> Low interaction w/ others
> Communication is strange/ inappropriate
> DELUSIONS
> Hallucinations
> Movement issues
> Means Split Mind (a split/ break from reality)
70
Prevalence of Schizophrenia?
- About 1% of Canadians
- Onset bw 15-35 y/o
- Requires hospitalization for months or years
- People w/ this take up half the beds in mental hospitals
71
What are delusions?
False beliefs that are sustained in the face of evidence that would normally be sufficient to destroy them
- Delusion of persecution vs delusion of grandeur
72
What are Hallucinations?
False perceptions that have a compelling sense of reality
73
3 affects of Schizophrenia?
Blunt effect (very little emotion)
Flat affect (no emotion)
Inappropriate affect (backwards emotions)
74
What is Catatonic Schizophrenia?
Striking motor disturbances from muscular rigidity, random/ repetitive movements, or extreme flexibility
75
Type 1 Schizophrenia?
Characterized by positive symptoms (added pathological extremes)
- delusions, hallucinations, disordered speech/ thinking
- Less successful outcomes after treatment
76
Type 2 Schizophrenia?
Characterized by negative symptoms
- Absence of normal reactions
- lack emotional expression
- loss of motivation
- loss of normal speech
- More positive outcomes following treatment
77
Genetic Predispositions to Schizophrenia?
- Identical twins are 48% risk if the other has it
-
78
Brain abnormalities leading to schizophrenia?
- Destruction of neural tissue
- Brain atrophy in regions responsible for cognition and emotion
- Thalamus abnormalities
-
79
Biochemical factors leading to schizophrenia?
- Dopamine hypothesis > overactivity of Dopamine system that control emotion, motivation, cognition
- have more dopamine receptors than normal and they are overreactive
- Antipsychotic drugs help b/c they reduce dopamine activity
80
Psych factors leading to schizophrenia?
> Freud believed it is an extreme example of the coping mechanism REGRESSION
> A retreat from an interpersonal world that has become too stressful
> Increased distractibility due to disfunctioning of attentional mechanisms.
81
Environment and Sociocultural factors leading to schizophrenia?
- Stressful life events
- Family struggles
- Early childhood trauma
- Family environments that are high in EXPRESSED EMOTION (Criticism, hostility, over involvement)
- Higher in low socioeconomic populations
- Culture free DO
82
What is Antisocial PDO?
Psychopaths
- Seem to lack a conscience
- exhibit very little guilt for their actions
- Jeffery Dahmer
83
Biological Factors of Antisocial PDO?
Genetics
- Heritability b/w 40-50%
84
Psych Factors of APDO?
- Lack conscience b/c they have not developed the Super EGO which would control the impulses of the Id.
- Caused by lack of adult role models on life.
- Need to cognitive control to think of the consequences before acting impulsively
85
ADHD?
7-10% of kids
-
86
Autism Spectrum DO?
Unresponsiveness
Poor communication skills
REpetitive/ rigid mvms
1/44 kids
- Larger brain, abnormal cerebellum development
87
Dementia?
The gradual loss of cognitive abilities that accompanies brain deterioration and affects normal functioning
88
Alzheimer's Disease?
Leading form of Dementia
- deterioration of the frontal/ temporal lobes (the hippocampus)
-
