Chapter 14 Flashcards
mental disorder
a persistent disturbance or dysfunction in behavior, thoughts, or emotions that causes significant distress or impairment. People have problems with their perception, memory, learning, emotion, motivation, thinking, and social processes.
medical model
abnormal psychological experiences are conceptualized as illnesses that, like physical illnesses, have biological and environmental causes, defined symptoms, and possible cures.
diagnosis
a determination as to whether a disorder or disease is present. clinicians seek to determine the nature of a person’s mental disorder by assessing signs (objectively observed indicators of a disorder) and symptoms (subjectively reported behaviors, thoughts, and emotions) that suggest an underlying illness.
disorder
refers to a common set of signs and symptoms.
disease
a known pathological process affecting the body.
knowing that a disorder is present
doesn’t necessarily mean that we know what the underlying disease process in the body that gives rise to the signs and symptoms of the disorder.
criticisms of the medical model
some psychologists argue that it is inappropriate to use clients’ subjective self report, rather than physical tests of pathology to determine the underlying illness. Others argue that the model often “medicalizes” or “pathologizes” normal human behavior.
Diagnostic and Statistical Manual of Mental Disorders (DSM)
a classification system that describes the features used to diagnose each recognized mental disorder and indicates how the disorder can be distinguished from other, similar problems.
diagnostic criteria
detailed lists of symptoms.
DSM-5
released by the American Psychiatric Association in May 2013; describes 22 major categories containing more than 200 different mental disorders, along with the specific criteria that must be met in order for a person to be diagnosed with that disorder. Also a section devoted to cultural considerations in diagnosing mental disorders. NIMH will not provide funding to experiments using this guide.
comorbidity
the co-occurrence of two or more disorders in a single individual.
etiology
specifiable pattern of causes.
prognosis
typical course over time and susceptibility to treatment and cure.
medical model of mental disorder
etiology may exist for different psychological disorders and also suggests that each category of mental disorder is likely to have a common prognosis. Usually an oversimplification: it is rarely useful to focus on a single cause this is internal to the person and that suggest a single cure.
biopyschosocial perspective
explains mental disorders as the result of interactions among biological, psychological, and social factors.
biological perspective (biopsychosocial perspective)
focus is on genetic and epigenetic influences, biochemical imbalances, and abnormalities in brain structure and function. The complexity of causation suggests that individuals can experience a similar mental disorder (e.g. depression) for different reasons.
Psychological perspective (biopsychosocial perspective)
focuses on maladaptive learning and copying, cognitive biases, dysfunctional attitudes, and interpersonal problems.
Social factors (biopsychosocial perspective)
include poor socialization, stressful life experiences, and cultural and social inequities.
Diathesis-stress model
È suggests that a person may be predisposed for a psychological disorder that remains unexpressed until triggered by stress. The diathesis is the internal predisposition and the stress is the external trigger.
Research Domain Criteria Project (RDoC)
created by the National Institutes of Mental Health (NIMH); a new initiative that aims to guide the classification and understanding of mental disorders by revealing the basic processes that give rise to them. Not intended to replace DSM, but to inform future revisions to it. Focus on biological domains, such as arousal, sleep patterns; psychological domains such as learning, attention, and memory; and social domains such as attachment and self-perception. Each domain can be approached by studying “units of analysis” – from genes, cells, behavior.
RDoC approach
NIMH would like to shift researchers away from studying currently defined DSM categories and toward the study of the dimensional biopsychosocial processes believed, at the extreme end of the continuum, to lead to mental disorders. Goal to better understand what abnormalities cause different disorders, and to classify disorders based on those underlying causes, rather than on observed symptoms. Aims to shift the focus away from surface symptoms and toward an understanding of the processes that give rise to disordered behavior.
DRD2
variations in this gene that codes for dopamine receptors are associated with abnormalities in connectivity between parts of the frontal lobe and the striatum. The lack of connectivity is related to impulsiveness and responsiveness to rewards associated with a range of addictive behavior disorders.
the focus of the RDoC approach
overall emphasis on neuroscience, with specific focuses on abnormalities in emotional and motivation systems, cognitive systems such as memory, learning, language, and cognition, social processes, and stress and arousal.
Stigma associated with mental disorders
may explain why most people with diagnosable psychological disorders (~60%) do not seek treatment.
labeling
can compromise the judgment of mental health professionals. Also affect how labeled people view themselves, may come to view themselves as hopeless or worthless, which can cause them to fail to work towards their recovery.
anxiety disorder
the class of mental disorder in which anxiety is the predominant feature. characterized by excessive apprehension and anxiety. Includes phobic disorders, panic disorder, and generalized anxiety disorder.
phobic disorders
disorders characterized by marked, persistent, and excessive fear and avoidance of specific objects, activities, or situations.
specific phobia
a disorder that involves an irrational fear of a particular object or situation that markedly interferes with an individual’s ability to function. Fall into 5 categories: 1) animals, 2) natural environments, 3) situations, 4) blood, injections, and injury, 5) other phobias including vomiting and choking.
social phobia
a disorder that involves an irrational fear of being publicly humiliated or embarrassed. Can develop in childhood, but usually emerges between early adolescence and early adulthood. Probably due to subjective experience, same level of arousal as everyone else.
preparedness theory of phobias
the idea that people are instinctively predisposed toward certain fears. Easily to condition anger and fear response towards non-neutral stimuli.
neurological factors for phobias
abnormalities in the neurotransmitters serotonin and dopamine are more common in individuals who report phobias than among people who didn’t. sometimes show abnormally high levels of activity in the amygdala.
panic disorder
a disorder characterized by the sudden occurrence of multiple psychological and physiological symptoms that contribute to a feeling of stark terror. Acute symptoms, including shortness of breath, heart palpitations, sweating, dizziness, depersonalization, or de-realization, and a feeling of dying, last only a few minutes.
agoraphobia
a specific phobia involving a fear of public places where escape is difficult or help is difficult to receive; common complication of panic disorder.
those who have panic attacks
may be hypersensitive to physiological signs of anxiety, which they interpret as having disastrous consequences for their well being.
generalized anxiety disorder (GAD)
disorder characterized by chronic excessive worry accompanied by three or more of the following symptoms for 6+ months: restlessness, fatigue, concentration problems, irritability, muscle tension, and sleep disturbance. Uncontrollable worry produces a sense of loss of control that can erode self-confidence. Neurotransmitter imbalances may play a role. source of anxiety is unidentifiable. autonomic arousal.
Benzodiazepines
sedative; appears to stimulate the neurotransmitter GABA and can sometimes reduce the symptoms of GAD.
Psychological explanations for GAD
focus on anxiety provoking situations that produce high levels of GAD. Prevalent among people who have low incomes, living in large city, or unpredictable environments.
risk of GAD
unpredictable traumatic experiences in childhood increase development of GAD. Also increases following the experience of a loss.
Obsessive compulsive disorder (OCD)
disorder in which repetitive, intrusive thoughts (obsessions) and ritualistic behaviors (compulsions) designed to fend off those thoughts interfere significantly with an individual’s functioning. Obsessive thoughts typically produce anxiety and the compulsions are performed to reduce it.
cause of OCD
may be from heightened neural activity in the caudate nucleus of the brain, a portion of the basal ganglia known to be involved in the initiation of intentional actions. May not be the cause, may be an effect.
Posttraumatic stress disorder (PTSD)
a disorder characterized by chronic physiological arousal, recurrent unwanted thoughts or images of the trauma, and avoidance of things that call the traumatic event to mind. Show heightened activity in the amygdala, decreased activity in the medial prefrontal cortex, and a smaller sized hippocampus.
mood disorders
mental disorders that have mood disturbance as their predominant feature and take two main forms: depression (also called unipolar depression) and bipolar disorder.
major depressive disorder (unipolar depression)
disorder characterized by a severely depressed mood and/or inability to experience pleasure that lasts 2 or more weeks and is accompanied by feelings of worthlessness, lethargy, and sleep and appetite disturbance. Abnormalities in parts of the brain involved in attention and memory, especially when presented with negative info.
seasonal affective disorder (SAD)
recurrent depressive episodes in a seasonal pattern. occurs with shifts into autumn-winter or spring-summer.
causes of depression
socioeconomic standing and poverty. Estrogen, androgen, and progesterone influence depression; some women experience postpartum depression (following childbirth) due to changing hormone balances.
reduce depression
by increasing the neurotransmitters norepinephrine and serotonin. Although, some studies have found increases in norepinephrine activity among depressed individuals. Takes 2 weeks to relieve symptoms and not effective in most cases.
Cognitive model of depression
developed by Beck; states that biases in how info is attended to, processed, and remembered lead to and maintain depression.
Helplessness theory
part of the cognitive model of depression; the idea that individuals who are prone to depression automatically attribute negative experiences to causes that are internal, stable, and global.
bipolar disorder
a condition characterized by cycles of abnormal, persistent high mood (mania), and low mood (depression). In the manic phase (1 week+), mood can be elevated, expansive, or irritable. Other symptoms include grandiosity, decreased need for sleep, talkativeness, racing thoughts, distractibility, and reckless behavior. Hallucinations and delusions may be present, so the disorder may be misdiagnosed as schizophrenia. Risk doesn’t differ between men and women.
rapid cycling bipolar disorder
10% of people of have bipolar; characterized by at least four mood episodes every year. More common in women and sometimes precipitated by taking certain kinds of antidepressant drugs.
Psychotic and mood (especially bipolar) disorders
have higher creativity and intellectual ability.
cause of bipolar disorder
most likely polygenic, arising from the interaction of multiple genes that combine to create the symptoms observed in those with this disorder. Genes have been difficult to identify though. There is also evidence that common genetic risk factors are associated with bipolar disorder and schizophrenia, as well with major depression, autism spectrum disorder, and attention-deficit/hyperactivity disorder. Share symptoms including problems with mood regulation, cognitive impairments, and social withdrawal.
increases in bipolar symptoms
personality characteristics such as neuroticism and conscientiousness increase it.
expressed emotion
a measure of how much hostility, criticism, and emotional over-involvement are used when speaking about a family member with a mental disorder.
schizophrenia
a psychotic disorder (psychosis is a break from reality) characterized by the profound disruption of basic psychological processes; a distorted perception of reality; altered or blunted emotion; and disturbances in thought, motivation, and behavior. Two or more symptoms must emerge in a period of at least 1 month and signs persisting for at least 6 months. Symptoms are separated into positive, negative, and cognitive symptoms. 1% of pop and more common in men slightly.
positive symptoms
thoughts and behaviors not seen in those without the disorder.
hallucinations (positive)
false perceptual experiences that have a compelling sense of being real despite the absence of external stimulation. 65% report hearing voices.
delusions (positive)
patently false beliefs, often bizarre and grandiose, that are maintained in spite of their irrationality.
disorganized speech (positive)
severe disruption of verbal communication in which ideas shift rapidly and incoherently among unrelated topics.
grossly disorganized behavior
behavior that is inappropriate for the situation or ineffective in attaining goals, often with specific motor disturbances.
catatonic behavior (positive)
marked decrease in all movement or an increase in muscular rigidity and over activity.
catatonia
actively resist movement.
catatonic stupor
become completely unresponsive and unaware of their surroundings.
medication-induced movement disorder
identifies motor disturbances arising from the use of medication of the sort commonly used to treat schizophrenia.
negative symptoms
deficits or disruptions to normal emotions and behaviors. Include emotional and social withdrawal; apathy; poverty of speech; and other indications of the absence or insufficiency of normal behavior, motivation, and emotion.
cognitive symptoms
deficits in cognitive abilities, specifically in executive functioning, attention, and working memory. Most difficult to notice, but they play a large role in terms of preventing people from achieving a high level of functioning, such as maintaining friendships and a job.
closer genetic relatedness to a person with schizophrenia
the greater the likelihood of developing the disorder.
dopamine hypothesis
idea that schizophrenia involves an excess of dopamine activity. Explains why amphetamines often exacerbate symptoms of schizophrenia, but they take weeks to show beneficial response. May be a complex interaction among a host of different biochemicals instead. linked w/ positive symptoms.
brain abnormalities in schizophrenia
MRI scans detect progressive tissue loss beginning in the parietal lobe and eventually encompassing much of the brain.
psychological factors of schizophrenia
among children whose biological mothers had schizophrenia, the disturbed environment increased the likelihood of schizophrenia – an outcome that was not found among children who were reared in disturbed families but whose biological mothers not have schizophrenia.
neurodevelopmental disorders
always begin in childhood or adolescence. Include autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disability, learning disorders, communication disorders, and motor skill disorders.
autism spectrum disorder (ASD)
a condition beginning in early childhood in which a person shows persistent communication deficits as well as restricted and repetitive patterns of behaviors, interests, or activities. Includes autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder. Boys have higher rate, 4:1.
one model of ASD suggests
can be understood as an impaired capacity for empathizing, knowing the mental states of others, combined with superior ability for systematizing, understanding the rules that organize the structure and function of objects. Decreased activity in regions associated with understanding the minds of others and greater activation in regions related to basic object perception. Some people have remarkable abilities to perceive or remember details or to master symbol systems like math or music.
Attention-deficit/hyperactivity disorder (ADHD)
a persistent pattern of severe problems with inattention and/or hyperactivity or impulsiveness that cause significant impairments in functioning. Must have symptoms of inattention and hyperactivity-impulsiveness for at least 6 months in 2 different environments. 10% of boys, 4% of girls.
cause of ADHD
suggest strong genetic influence. Smaller brain volumes as well as structural and functional abnormalities in brain networks associated with attention and behavioral inhibition.
conduct disorder
a persistent pattern of deviant behavior involving aggression against people or animals, destruction of property, deceitfulness or theft, or serious rule violations. Must have 3 out of 15 symptoms.
personality disorders
enduring patterns of thinking, feeling, or relating to others or controlling impulses that deviate from cultural expectations and cause distress and impaired functioning. Fall into 3 clusters: odd/eccentric, dramatic/erratic, and anxious/inhibited.
Antisocial personality disorder (APD)
a pervasive pattern of disregard for and violation for the rights of others that begins in childhood or early adolescence and continues into adulthood. Terms sociopath and psychopath describe people with APD who are especially coldhearted, manipulative, and ruthless. Usually have a history of conduct disorder before age 15. Less activity in the amygdala and hippocampus when shown negative emotional words.
diagnosis of APD
given to individuals who show three or more of 7 signs: illegal behavior, deception, impulsivity, physical aggression, recklessness, irresponsibility, and lack of remorse for wrongdoing.
suicide
intentional self-inflicted death. 80% occur among men and 90% among white people. 90% of people who die have at least 1 mental disorder; significant negative life events during childhood/adulthood, and severe medical problems.
suicide attempt
self-inflicted injury from which a person has at least some intention of dying. Women experience suicidal thoughts and nonfatal suicide attempts at significantly higher rates than men.
nonsuicidal self-injury (NSSI)
direct, deliberate destruction of body tissue in the absence of any intent to die. Rates even between genders and ethnicities. Strong emotion and physiological responses to negative events, that they perceive this response an intolerable, and that NSSI serves to diminish the intensity of this response. May engage to communicate distress or elicit help from others.
glutamate hypothesis
faulty glutamate receptors linked to negative symptoms of schizophrenia; thought disorder. vapid corticol loss during adolescence (we all experience it, but those w/ schizophrenia lose a lot more)
antianxiety drugs
GABA agonist; increase inhibition of CNS.
antidepressant drugs
serotonin agonist; increases serotonin and norepinephrine.
prevalence
collected from people who seek treatment. women are more likely to seek treatment.
