Ch 15 Psychological Disorders

Question 1

How should we draw the line between normality and disorder?

Answer 1

Clinical disturbance in cognition, emotion regulation, or behavior. These dysfunctional, or maladaptive thoughts/behaviors interfere with daily life.

Question 2

How doe the medical model and biosocial approach influence our understanding of psychological disorders?

Answer 2

The medical model assumes disorders have physical causes that can be treated.

The Biopsychosocial model perspective assumes disordered behavior comes from the interaction of biological characteristics, psychological dynamics, and social-cultural influences.

Question 3

How and why do Clinicians classify psychological disorders, and why do some psychologists criticize diagnostic labels?

Answer 3

The DMS5-TR contains labels and descriptions in order to provide a common language for communication and research. It’s critics believe it casts too wide a net.

The US National Institute of Mental Health’s Research Domain Criteria (RDoC) project, instead organizes disorders according to behaviors and brain activity across several dimensions.

Classification attempts can lead to preconceptions which bias perceptions of a person’s past and behavior.

Question 4

What factors increase the risk of suicide, and what do we know about
nonsuicidal self-injury?

Answer 4

Suicide rates differ by nation, race, gender, age group, income, religious involvement, marital status, and other factors. In most countries, suicide rates have been increasing.
Those lacking social support, such as many gay, transgender, and gender
nonconforming youth, are at increased risk, as are people who have been anxious or depressed.

Nonsuicidal self-injury (NSSI) does not usually lead to suicide but may escalate to suicidal thoughts and acts if untreated. People who engage in NSSI do not tolerate stress well and tend to be self-critical and impulsive.

Question 5

Do psychological disorders predict violent behavior?

Answer 5

Mental disorders seldom lead to violence, and clinicians cannot predict who is likely to harm others. Most people with disorders are nonviolent and are more likely to be victims than attackers. Better predictors of violence are alcohol or drug use, previous
violence, gun availability, and brain damage.

Question 6

How many people have, or have had, a psychological disorder? What are some
of the risk factors?

Answer 6

Psychological disorder rates vary, depending on the time and place of the survey. In one multinational survey, the lowest rate of reported mental disorders was in Nigeria, and the highest rate in the United States. Poverty is a risk factor. But some disorders, such as schizophrenia, can also drive people into poverty. Immigrants to the United
States may average better mental health than their U.S. counterparts with the same ethnic heritage (a phenomenon known as the immigrant paradox).

Question 7

How do generalized anxiety disorder, panic disorder, and specific phobias
differ?

Answer 7

Anxiety disorders are psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety.
People with generalized anxiety disorder feel persistently and uncontrollably tense and apprehensive, for no apparent reason. In the more extreme panic disorder, anxiety escalates into periodic episodes of intense dread. Those with a specific phobia may be irrationally afraid of some object,
activity, or situation.

Question 8

What is OCD?

Answer 8

Persistent and repetitive thoughts (obsessions), actions (compulsions), or both characterize obsessive-compulsive disorder (OCD)

Question 9

What is PTSD?

Answer 9

Symptoms of posttraumatic stress disorder (PTSD) include four or more weeks of haunting memories, nightmares, hypervigilance, avoidance of trauma-related stimuli, social withdrawal, jumpy anxiety, numbness of feeling, and/or sleep problems following some traumatic experience.

Question 10

What are somatic symptom and related disorders?

Answer 10

In somatic symptom and related disorders, including illness anxiety disorder, symptoms take a somatic (bodily) form without apparent physical cause.

Question 11

How do conditioning, cognition, and biology contribute to the feelings and
thoughts that mark anxiety-related disorders?

Answer 11

The learning perspective views anxiety-related disorders as products of fear
conditioning, stimulus generalization, fearful-behavior reinforcement, and
observational learning of others’ fears and cognitions. The biological perspective considers genetic predispositions for high levels of emotional reactivity and neurotransmitter production; abnormal responses in the brain’s fear circuits; and the role that fears of life threatening dangers played in natural selection and evolution.

Question 12

How do depressive disorders and bipolar disorders differ?

Answer 12

A person with major depressive disorder experiences at least five symptoms of
depression (including either depressed mood or loss of interest or pleasure) for two or more weeks.
Persistent depressive disorder includes a long-lasting mildly depressed mood. A person with a bipolar disorder experiences not only depression but also mania—episodes of hyperactive and wildly optimistic, impulsive behavior.

Question 13

How can the biological and social-cognitive perspectives help us understand depressive disorders and bipolar disorders?

Answer 13

The biological perspective on depressive disorders and bipolar disorders focuses on genetic predispositions, abnormalities in brain structures and function (including those found in neurotransmitter systems), and nutritional (and drug) effects. The
social-cognitive perspective views depression as an ongoing cycle of stressful experiences (interpreted through negative beliefs, attributions, and memories, often with relentless rumination) leading to negative moods, thoughts, and actions, thereby
fueling new stressful experiences.

Question 14

What patterns of perceiving, thinking, and feeling characterize schizophrenia?

Answer 14

Schizophrenia is a psychotic disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression.
Hallucinations are sensory experiences without sensory stimulation; delusions are false beliefs. Schizophrenia symptoms may be positive (the presence of inappropriate
behaviors) or negative (the absence of appropriate behaviors).

Question 15

How do chronic schizophrenia and acute schizophrenia differ?

Answer 15

Schizophrenia typically strikes during late adolescence, affects males slightly more often, and occurs in all cultures. In chronic (or process) schizophrenia, development is gradual and recovery is doubtful. In acute (or reactive) schizophrenia, onset is sudden— in reaction to stress—and prospects for recovery are brighter.

Question 16

What brain abnormalities are associated with schizophrenia?

Answer 16

People with schizophrenia have an excess number of dopamine receptors, which may intensify brain signals, creating positive symptoms such as hallucinations and paranoia. Brain scans have revealed abnormal activity in the frontal lobes, thalamus, and amygdala, as well as a loss of neural connections across the brain network. Brain abnormalities associated with schizophrenia include enlarged, fluid-filled areas and corresponding shrinkage and thinning of cerebral tissue. Smaller-than-normal areas may include the cortex, the hippocampus, the corpus callosum, and the thalamus.

Question 17

What prenatal events are associated with increased risk of developing
schizophrenia?

Answer 17

Possible contributing factors include maternal diabetes, older paternal age, viral infections or famine conditions during the mother’s pregnancy, and low weight or oxygen deprivation at birth.

Question 18

How do genes influence schizophrenia? What factors may be early warningsigns of schizophrenia in children?

Answer 18

Twin and adoption studies indicate that the predisposition to schizophrenia is
inherited. Multiple genes interact to produce schizophrenia. No environmental causes invariably produce schizophrenia, but environmental events (such as prenatal viruses or maternal stress) may “turn on” genes in those who are predisposed to this disorder.
Possible early warning signs include social withdrawal; a mother with severe and long-lasting schizophrenia; birth complications; separation from parents; short attention span; poor muscle coordination; emotional unpredictability; poor peer relations and solo play; separation from parents; and childhood abuse.

Question 19

What are dissociative disorders, and why are they controversial?

Answer 19

Dissociative disorders are controversial, rare conditions in which conscious awareness seems to become separated from previous memories, thoughts, and feelings. Skeptics note that dissociative identity disorder (DID) increased dramatically in the late twentieth century; is rarely found outside North America; and may reflect role playing by people vulnerable to therapists’ suggestions. Others view DID as a manifestation of feelings of anxiety, or as a response learned when behaviors are reinforced by anxiety-reduction.

Question 20

What are the three clusters of personality disorders? What behaviors and brain activity characterize antisocial personality disorder?

Answer 20

Personality disorders are inflexible and enduring behavior patterns that impair social functioning. The ten DSM-5 disorders tend to form three clusters, characterized by (1) anxiety, (2) eccentric or odd behaviors, and (3) dramatic or impulsive behaviors.

Antisocial personality disorder (one of those in the third cluster) is characterized by a lack of conscience and, sometimes, by aggressive and fearless behavior. The amygdala is often smaller and the frontal lobes less active in people with this disorder, leading to impaired frontal lobe cognitive functions and decreased responsiveness to others’ distress. Genetic predispositions may interact with the environment to produce these characteristics.

Question 21

What are the three main eating disorders, and how do biological,
psychological, and social-cultural influences make people more vulnerable to them?

Answer 21

In those with eating disorders (most often women or gay men), psychological factors overwhelm the body’s tendency to maintain a normal weight. Despite being significantly underweight, people with anorexia nervosa (usually adolescent females) maintain a starvation diet, sometimes exercising excessively, and have an inaccurate self-perception. Those with bulimia nervosa (usually women in their late teens and early twenties) binge and then compensate by purging, fasting, or excessively exercising.
Those with binge-eating disorder binge but do not follow with purging, fasting, and exercising. Cultural pressures, low self-esteem, and negative emotions interact with stressful life experiences and genetics to produce eating disorders.

Question 22

NEURODEVELOPMENTAL DISORDERS

Answer 22

Neurodevelopmental disorders are central nervous system abnormalities (usually in the brain) that start in childhood and alter thinking and behavior (as in intellectual limitations or a psychological disorder).

Question 23

What is autism spectrum disorder?

Answer 23

Autism spectrum disorder appears in childhood and is marked by significant limitations in communication and social interaction, as well as rigidly fixated interests and repetitive behaviors

Question 24

Why is there controversy over attention-deficit/hyperactivity disorder?

Answer 24

A child (or, less commonly, an adult) who displays extreme inattention and/or
hyperactivity and impulsivity may be diagnosed with attention-deficit/hyperactivity disorder (ADHD). Controversies center on whether the growing number of ADHD cases
reflect overdiagnosis or increased awareness of the disorder, and on the long-term effects of stimulant-drug treatment.

Question 25

Psychological Disorder

Answer 25

a syndrome marked by a clinically significant disturbance in an individual’s cognitions, emotion regulation, or behavior.

Question 26

Medical Model

Answer 26

the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and, in most cases, cured, often through treatment in a hospital.

Question 27

Epigenetics

Answer 27

“above” or “in addition to” (epi) genetics; the study of the molecular mechanisms by which environments can influence

Question 28

DSM-5

Answer 28

the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; a widely used system for classifying psychological disorders