Chapter 14 Flashcards
The Troubled Mind: Psychological Disorders
1
Q
mental health resources at UTSC
A
- the Health & Wellness Centre
- personal counselling
- SCSU benefits
2
Q
why surface behaviour isn’t enough to describe psychological disorders
A
atypical behaviours don’t always equate to psychological disorders, especially if there’s another reason (e.g. crying a lot for hours on end may not equate to depression, especially if someone has recently lost a loved one)
3
Q
mental disorders
A
persistent disturbance or dysfunction in behaviour, thoughts, or emotions that causes significant distress or impairment
4
Q
two models for psychological disorders
A
- medical model: psychological disorders are illnesses with biological causes
- biopsychosocial model: psychological disorders are illnesses with biological (internal), psychological (external), and social (relational) causes
5
Q
psychopathology
A
the scientific study of mental disorders
6
Q
overpathologizing
A
attributing diverse or atypical behaviours or thoughts to psychological disorders, particularly when diagnostic criteria isn’t met (e.g. thinking that someone who’s super anal has OCD)
7
Q
diagnostic criteria
A
a set of symptoms, behaviours, or characteristics that must be present in order to diagnose an individual with a disorder
8
Q
instruments clinicians can use to diagnose psychological disorders
A
- questionnaires and interviews
- observation of behaviour
- patient history
- neuroimaging
9
Q
the DSM-5
A
- the Diagnostic and Statistical Manual of Mental Disorders (in its 5th edition)
- published by the American Psychiatric Association; used predominantly in North America
- uses a biopsychosocial model
- used by clinicians to diagnose psychological disorders
10
Q
the five pieces of information about each disorder that the DSM-5 includes
A
- diagnostic criteria: symptoms
- onset: the age/period when symptoms first appear
- prognosis: the likely trajectory of a disorder (i.e. fixed period vs. lifelong)
- risk factors/etiology: risk factors increase the likelihood of having the disorder (often known), and etiology causes the disorder (often not known)
- comorbidities: other disorders that are likely to co-occur
11
Q
the three diagnostic criteria most DSM-5 disorders have in common
A
- causes significant distress/affects functioning
- cannot be attributed to substance use or another medical condition
- cannot be better described by another DSM diagnosis
12
Q
the diathesis-stress model
A
the risk of a disorder, personality of a person, and life circumstances combine to lead to the disorder
13
Q
criticisms of the DSM-5
A
- can lead to overpathologizing
- follows a binary system (either you have the disorder or not), but many disorders have spectrums
14
Q
fear vs. anxiety
A
- fear is a response to a specific, present stressor; it’s often adaptive, increasing fitness
- anxiety is the fear of a potential stressor (fear of fear); it’s often maladaptive, decreasing fitness
15
Q
Fear and anxiety are both ________, but anxiety that interferes with normal functioning is ________.
A
adaptive, maladaptive
16
Q
________% of Canadians will experience anxiety, but only ________% are ever diagnosed.
A
30%, 5%
17
Q
generalized anxiety disorder (GAD)
A
an anxiety disorder in which worries are not focused on any specific threat
18
Q
diagnostic criteria of generalized anxiety disorder
A
- Excessive anxiety and worry, occuring more often than not for at least 6 months, about more than one stressor
- Difficult to control the worry
- Three or more of these symptoms:
- restlessness
- fatigue
- concentration deficiency
- irritability
- muscle tension (i.e. headaches)
- sleep disturbance
- Causes significant distress/affects functioning
- Cannot be attributed to substance use or another condition
- Cannot be better described by another DSM diagnosis
19
Q
onset of generalized anxiety disorder
A
- often diagnosed around 30 years old
- constant anxiety throughout the lifespan (doesn’t increase/decrease with age); content of worries change
20
Q
prognosis of generalized anxiety disorder
A
- severity of symptoms waxes and wanes across a lifespan
- full remission is rare
21
Q
phobic disorders
A
- a specific type of anxiety disorder characterized by an excessive fear of specific objects or situations
- the irrationality of the fear is often recognized, but uncontrollable (e.g. you know a spider can’t hurt you, but you’re still scared of it)
22
Q
specific types of phobias
A
- animals (e.g. spiders, snakes)
- natural environments (e.g. earthquakes, darkness)
- situations (e.g. elevators, enclosed spaces)
- medical events (e.g. blood, injections)
- costumed characters (e.g. clowns, dolls)
- loud noises
- choking
23
Q
social anxiety disorder
A
- a maladaptive fear of public humiliation
- may have a “performance-only” specifier (i.e. stage fright, but can engage with others)
24
Q
why phobic disorders are so common
A
- preparedness theory: evolutionarily adaptive to fear certain stimuli
- overdevelopment of said fears in individuals leads to phobic disorders
25
evidence of the preparedness theory
* it's difficult to eradicate primates' fears of snake
* it's difficult to condition fear of other objects, even if dangerous (e.g. electrical outlets)
26
panic attack
the experience of intense fear and autonomic arousal in the absence of real threat
27
panic disorder
a disorder characterized by **repeated** panic attacks and fear of future attacks (a singular panic attack doesn't mean a panic disorder)
28
mood
emotional states that are long-lasting and non-specific
29
mood disorders
psychological disorders that have mood disturbances as their prominent feature
30
two main types of DSM-5 mood disorders
depressive disorders and bipolar disorders
31
five differences within depressive disorders
* **gender differences:** women are diagnosed with depression more than men
* **hormonal and biological differences**
* **severity of diagnoses:** the more severe, the more likely to receive treatment
* **different coping strategies:** including sharing and co-rumination
* **differences in childhood adversity**
32
major depressive disorder (MDD)
* the most well-known depressive disorder
* sometimes called unipolar depression
* consists of 1+ episodes of depression lasting two weeks or longer
33
diagnostic criteria of major depressive disorder
1. Five or more of the following symptoms present most of the day, nearly every day, during the same 2-week period, and representing a change in previous functioning (**including at least one of the bolded symptoms**):
* **depressed mood**
* **anheodia (loss of pleasure)**
* significant weight loss/gain
* insomnia or hypersomnia
* psychomotor agitation (speeding up) or retardation (slowing down)
* fatigue
* feelings of excessive worthlessness/guilt
* diminished concentration/decisiveness
* recurrent thoughts of death/suicide
2. Not better explained by a schizophrenic disorder
3. No evidence of mania
4. Causes significant distress/affects functioning
5. Cannot be attributed to substance use or another condition
6. Cannot be better described by another DSM diagnosis
34
onset of major depressive disorder
appears at any age, but three times more likely for 18-29 year olds
35
prognosis of major depressive disorder
* remission is rare; many years of remission can occur between episodes
* most people recover within a year
* chronicity (frequent episodes) is linked to personalities and the presence of other disorders
36
risk factors of major depressive disorder
* **temperamental factors:** high levels of neuroticism
* **environmental factors:** adverse childhood experiences, stressful life events
* **genetic factors:** about 40% heritability
* **psychological factors:** the way people think
37
comorbidities of major depressive disorder
* substance-related disorders
* panic disorders
* OCD
* anorexia nervosa
* bulimia nervosa
38
Major depressive disorder cannot be comorbid with...
bipolar disorder
39
attribution theory
the way a person thinks about failure makes them more/less likely to be depressed (e.g. "I can learn from this." vs. "I will always be alone.")
40
persistent depressive disorder (PDD)
moderate depressive symptoms that last for more than two years
41
double depression
* when persistent depressive disorder and major depressive disorder co-occur
* constant moderate depressive symptoms (PDD) with occasional, stronger episodes (MDD)
42
serious mental illnesses (SMIs)
characterized by significant disturbances in thinking, emotional regulation, or behaviour; leading to significant distress and/or impairment in social, education, or occupational functioning
43
three examples of serious mental illnesses
* schizophrenia
* bipolar disorder
* major depressive disorder
44
All serious mental illnesses (SMIs) can involve...
psychosis
45
psychosis
* an experience in which a person's perceptions, thoughts, mood, and behaviour are significantly altered
* characterized by a loss of contact with reality
46
Everyone with schizophrenia experiences...
psychosis
47
Disorders on the Schizophrenia Spectrum differ by...
* individual symptoms
* length of symptoms
* whether symptoms are drug-induced
* whether the disorder co-occurs with mood symptoms
48
DSM-5 disorders on the Schizophrenia Spectrum
* **schizophrenia:** a chronic disorder with persistent psychotic symptoms (e.g. delusions, hallucinations, cluttered thinking and behaviour) lasting 6+ months
* **schizophreniform disorder:** similar to schizophrenia, but only lasts 1-6 months
* **brief psychotic disorder:** a sudden onset of psychotic symptoms, lasting 1 day to 1 month
* **schizoaffective disorder:** a combination of schizophrenia and mood disorder symptoms
* **delusional disorder:** persisten delusions without other major schizophrenic symptoms
* **substance/medication-induced psychotic disorder:** a disorder where psychotic symptoms are directly caused by the use and/or withdrawal of substance or medication
49
diagnostic criteria of schizophrenia
1. Two or more of the following core symptoms present (**including at least one of the bolded symptoms**):
* **delusions**
* **hallucinations**
* **disorganized speech**
* grossly disorganized/catatonic behaviour and speech
* negative symptoms
2. Continuous signs of disturbance for at least 6 months (1 month active)
3. Must have hallucinations/delusions if autism/communication disorder present
4. Causes significant distress/affects functioning
5. Cannot be attributed to substance use or another condition
6. Cannot be better described by another DSM diagnosis
50
positive vs. negative symptoms, with schizophrenia as an example
* **positive symptoms** involve an addition of problematic symptoms (e.g. delusions, hallucinations, disorganized behaviour)
* **negative symptoms** involve a reduction of function (e.g. reduced emotion, lack of motivation, decreased speech)
51
types of hallucinations
false senses
* **auditory** (hearing voices/noises; can give commands)
* **visual**
* **olfactory** (smells)
* **tactile** (feelings)
* **gustatory** (tastes)
52
four types of delusions
* **persecutory (paranoia):** e.g. "Someone poisoned my food."
* **grandiose:** e.g. "I am chose to save humanity."
* **referential:** something has importance to specifically them, e.g. "That song is trying to send me a message."
* **thought control:** e.g. "The FBI is placing thoughts in my mind."
53
the three phases of schizophrenia
**prodromal period:**
* initial deterioration in functioning
* problems with cognition
* noticeable by others and affects daily life (e.g. relationships, employment)
* can be misdiagnosed (e.g. as depression)
**active/acute phase:**
* core psychotic symptoms are most prominent and severe
* both positive and negative symptoms are present
* significant distress/impairment in daily life
* usually requires intensive treatment
**residual phase:**
* occurs after symptom improvement
* reduced symptoms, increased cognition
* individuals may cycle between acute episodes and phases of remission
54
comorbidities of schizophrenia
* depression
* social anxiety disorder
* PTSD
* autism spectrum disorder
* cardiovascular disease (e.g. obesity, diabetes)
55
the Forensic Mental Healthcare System (FMHS)
* integrates the mental health system and the criminal justice system
* rehabilitates symptoms of mental illnesses and reduces the risk of reoffenses for clients in the system, before they are released
* focuses majorly on people with serious mental illnesses (SMIs) who are **unfit to stand trial**
56
mental health professionals within the Forensic Mental Healthcare System
* **clinical psychologists:** conduct specialized assessments to know if someone is faking
* **psychiatrists:** lead forensic assessments and prescribe medications
* **nurses:** look after daily needs of clients
* **recreational therapists:** help clients participate in recreational activities for physical/mental wellbeing
* **social workers:** assist with transitioning back into the community, giving finanical and community support
* **occupational therapists:** assist with improving daily functioning (e.g. cooking, taking medication, employment)
57
four things a clinical-forensic psychologist does
* therapy with clients to reduce symptoms
* clinical meetings to collaborate on patient care
* complete forensic assessments
* write psychological assessments and testify in court
