Chapter 10 - Psychological Disorders Flashcards
What are multidisciplinary contributions?
Psychology, biology, biochemistry & neuroscience
Clinical, experimental & practical
Genetics, environment & interactions
How are behavioural classified?
What are some potential causes?
Social, psychological, psychiatric, or neurological
Reflect on assessment/treatment roles
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Genetic abnormalities/mutations
Abnormalities in nervous system development
Environmental/epigenetic effects —> modulate genetic and developmental expression
How do we diagnose behavioural disorders?
Classification systems:
ICD-10
DSM
RDoC (research domain criteria)
What are the sections of the DSM-5?
Section 1:
- history of revisions and changes
Section 2:
- criteria for main diagnosis
- list disorders and symptoms
Section 3:
- assessment measures, criteria for disorders that need further research
- focus on sociocultural reasons
What are some criticisms of the DSM-5?
Concerns w/ validity -
Describing symptoms not disorders
Some diagnostic criteria based on RESEARCH, some based on committee determinations
High COMORBIDITY b/w diagnosis (lot of symptoms common)
Relies heavily on CATERGORIZATION rather than DIMENSION models for many diagnosis
What do we focus on when treating behavioural disorders?
Focus on key ENVIRONMENTAL FACTORS that influence actions
Also effects the BRAIN, can be considered biological intervention
Compare behaviour modification, cognitive therapy, and neuropsychological therapy & emotional therapy…
Behaviour modification:
- applies principles of learning
Ex) systematic sensitization
Cognitive therapy:
- addresses thoughts that AFFECT EMOTIONS & EVALUATION before action
Ex) identity and replace self-defeating patterns
Neropsychological therapy:
- RETRAIN individuals to use LOST processes, STRENGTHEN existing ones
Emotional therapy:
- gain INSIGHT into emotional states and the EFFECTS they have
Ex) talk therapy, psychotherapy
What are psychiatric disorders?
Assumed to be due to ATYPICAL brain activity or fxn
3 major categories:
1. Anxiety disorders
2. Mood disorders
3. Psychoses
What are schizophrenias (+) and (-) symptoms?
(+):
- EXCESS of something
- delusions: beliefs distort reality
- hallucinations: distorted perceptions
- disorganized speech: incoherent statements
- disorganized behaviour or excessive agitation
(-):
- ABSENCE of some normal response
- blunted emotions, loss interest/drive
- catatonic behaviour (freeze, no movement)
What is type I VS type II schizophrenia
Type I:
- predominance of (+) symptoms
- pathological EXTREMES
- delusions, hallucinations, disordered speech/thought
- no intellectual impairment
- POSSIBLE CAUSE: increased D2 receptors
= ***RESPOND TO ANTIDOPAMINERGIC DRUGS GOOD
- potentially reversible
Type II:
- predominance of (-) symptoms
- ABSENCE of normal reactions
- lack of emotion, expression & motivation
- intellectual impairment sometimes present
- POSSIBLE CAUSE: cell loss in temporal lobes
= ***RESPONSE TO ANTIDOPAMINERGIC DRUGS POOR
- irreversible?
How often is schizophrenia diagnosed?
Concordance of 0.80 in identical twins
- strong genetic role = enviro factors play a role
About 300 diff MUTATIONS on 10 diff genes PREDISPOSE an individual to schizophrenia
- tend to be genes = linked brain development
- but NOT all genes found in all populations
Often diagnosed EARY in life = link to development
What brain areas show changes with schizophrenia diagnosis?
ENLARGED VENTRICLES (more space = more lost neurons) and a THINNER CORTEX
^ especially in medial temporal regions & frontal cortex
= suggest CELL LOSS in these areas
Direction of HIPPOCAMPAL NEURONS in their brain is HAPHAZARD (disorganized)
- associated w/ alternations in the temporal region & frontal cortex
Less light activation in MRI in frontal lobe
What are some reasons (hypothesis) why schizophrenia is diagnosed?
(4 theories)
- Dopamine hypothesis linked FIRST
- theory that schizophrenia involves HIGH dopamine activity
- however dopamine drug therapy ineffective in many? - Aberrant salience hypothesis:
- heightened levels of dopamine increase ATTENTIONAL/MOTIVATIONAL circuits to make ordinary enviro features seem SIGNIFICANT - Glutamate theory:
- hypofxn of NMDA receptors —> increase in GLUTAMATE —> increase in DOPAMINE
- produce (+) and (-) symptoms of schizophrenia - Neurochemical abnormalities
***STILL COMPLICATED = DRIVEN BY DIFF SOURCES?
How do you treat schizophrenia?
Antipsychotic drugs:
- decrease ACTION of dopamine
- reduce (+) symptoms of schizophrenia (delusions/hallucinations)
- LITTLE EFFECT on (-) symptoms
Electroconvulsive therapy:
- began w/ observation that schizophrenia and epilepsy rarely occur together
- encouraging certain pathways to make connection
- useful in treating severe depression
- effects can be immediate
- 60 -70% improve
What is tardive dyskinesia?
Severe movement disorder
Due to 1st generation psychotics treating schizophrenia
Risk of these^^
Define stress, stressors and stress responses…
Stress:
- range of concepts from EXTERNAL environment stimuli to internal experiences and bodily responses
Stressors:
- external stimuli and events that represent a perceived potential for HARM, LOSS, DAMAGE, CHALLENGE or other deviations from a balanced state
Stress responses:
- internal psychological (cognitive) and biological responses to STRESSORS that work to RESTORE a balanced state
What is the diathesis-stress model?
Theory that mental and physical disorders develop from a GENETIC/BIOLOGICAL PREDISPOSITION for that ILLNESS (diathesis)
Combined w/ STRESSFUL COND that play a precipitating/facilitating role
What is the hypothalamic-pituitary-adrenal axis?
Controls production and release of HORMONES related to STRESS
When stressed, secrete CORTICOTROPIN-RELEASING HORMONE, which stimulates the pituitary to produce ADRENOCORTICOTROPIC HORMONE —> RELEASE CORTISOL
What happens when we have excessive stress?
Excessive CORTISOL can (-) influence BRAIN if stress is intense
Damages FEEDBACK LOOPS the brain uses to TURN OFF the stress response
What is major depressive disorder?
What is chronic depressive disorder?
Major depressive disorder:
- prolonged feelings of guilt, worthlessness, disruption normal eating habits, sleep disturbances, a general slowing of behaviour and thoughts of suicide
Lasts for WEEKS, MONTHS or years
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Chronic depressive disorder:
- far less intense
What is bipolar disorder?
Characterized by periods of DEPRESSION w/ normal periods and periods of INTENSE EXCITATION or MANIA
What is bipolar I disorder VS bipolar II disorder?
Bipolar I disorder:
- periods of depression ALTERNATE w/ mania
- manic state (opposite to depressive state)
- singe manic episode is sufficient for diagnosis
Bipolar II disorder:
- periods of depression ALTERNATE w/ hypomania (very good mood)
- hypomania is NOT quite as bad as a full manic episode
What is seasonal affective disorder (SAD)?
What is phototherapy?
Pattern of depression that RISES and FALLS with the seasons
Circannual rhythm
Leads to EXCESSIVE sleep and INCREASED appetites
Shorter days and reduced daylight appear to be important in winter depression
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Patient sits in front of HIGH-INTENSITY lights for a couple of hours a day
What some factors involved in mood disorders?
- Biological factors:
- monozygotic twins more similar than dizygotic twins (more extreme for bipolar disorder)
- underactivity of norepinephrine, dopamine, serotonin for depression
- overactivity of neurotransmitters for mania? - Psychological factors:
- personality-based vulnerability
- negative thought patterns, self-perceptions - Cognitive factors:
- depressive cognitive triad (negative thoughts concerning world, oneself and future)
- cannot suppress negative thoughts
- depressive attributional pattern (success = factors outside self, negative outcomes = personal factors)
