Chapter 15 Flashcards
Abnormal Psychology
Psychological study of mental illness
Does a person have maladaptive thoughts, feelings or behaviours?
Maladaptive
Causing distress to oneself or others
Impairing day-to-day functioning
Increasing the risk of injury or harm to oneself or others
Medical Model of Psychiatry(1800s)
Considers psychological issues as being similar to physical conditions(a set of symptoms, causes and outcomes)
Treatments aimed at changing physiological processes in order to alleviate symptoms
(Psychological issues like depression, anxiety or autism approaches like diabetes or cancer)
The Diagnostic and Statistical Manual (DSM)
Standardized manual to diagnose psychological disorders
Created by American Psychiatric Association in WW2
Current version: DSM-5-TR (2022)
Divides mental illnesses into 19 categories
Current version defines disorders on a continuum/scale
Challenges with Classifying Behaviour
How can we determine who has a mental disorder?
Is a disorder something someone has?
Normal behaviour vs symptom?
Diagnoses still largely influenced by clinician
Personality Disorders
Unusual patterns of behaviour that are
-maladaptive
-distressing to oneself or others
-resistant to change
Relative to individual’s cultural context
Present for long time (since adolescence/childhood)
Distinct from other psychological disorders, mental conditions or substances
Cluster A Personality Disorders
-Odd and Eccentric Behaviours
-Individuals perceive and interpret world in inaccurate way
-Thoughts expressed in manner that makes close relationships difficult
Paranoid Personality Disorder (PDP)
-Preoccupied by belief that other people are trying to harm/deceive them
-Often react with anger to imagined threats and are suspicious and guarded around others
-Demonstrate faster neural response to auditory stimuli, larger level of stress hormones (vigilance for threats)
Schizoid Personality Disorder (SPD)
-Socially detaches, do not desire close relationships, do not find most activities enjoyable
-may appear indifferent, cold, emotionless
-results in intentional self-isolation
Schizotypal Personality Disorder
-Uncomfortable with close relationships, develop unusual or eccentric thoughts and behaviours
-tend to be suspicious and superstitious, determine imaginary connections between thoughts and events, express thoughts using strange abstract phrasing
Schizotypal Causes
-smaller left Superior Temporal Gyrus (auditory cortex and language processes)
-particular form of ‘COMT’ gene:related to dopamine/epinephrine neurotransmitters
-problems during prenatal development (males)
-psychological trauma and chronic stress
Cluster B Personality Disorders
-Dramatic and Erratic Behaviours
-Emotional intensity and emotional outbursts that impair social functioning
-Dramatic, erratic behaviour
Borderline Personality Disorder (BPD)
Switch between extreme positive and negative emotions
Unstable sense of self, impulsivity, difficulty maintaining social relationships
Relationships may involve strong feelings of attachment, fear of abandonment and manipulation
BPD causes
-Medial frontal lobes (regulation of attention and emotional responses) smaller in BPD individuals than healthy controls
-May be related to deep feelings of insecurity and severe emotional experiences early in life
-Dangerous self destructive behaviour(substance abuse, indiscriminate sex, self injury, suicide)may reflect individual’s difficulty coping with extreme negative emotions
Narcissistic Personality Disorder
-Inflated sense of self importance and excessive need for attention and admiration AND intense self doubt and fear of abandonment
-May be related to disruption of frontal lobe circuit involved with feelings of empathy
Histrionic Personality Disorder (HPD)
-Excessive attention seeking and dramatic behaviour
-Makes individuals seem excessively comfortable in social situations
-Engagement in risky and indulgent behaviours, sensitive to criticism, manipulative in relationships
-more flamboyant and exhibitionistic than other disorders
Antisocial Personality Disorder (APD)
-Lack of empathy and emotional connection with others
-Disregard for others’ rights or feelings, tendency to impose own desires onto others regardless of consequences
-No remorse so rarely motivated to change/accept treatment
-Difficulty learning tasks that require decision making and following complex rules
APD causes
-Troubled upbringing, trauma, abuse
-self-defence against extreme negative emotions may affect ability to feel empathy, leading to cruel behaviour towards others
-Conduct Disorders: Precursor to APD, demonstrate reduced activity in frontal lobes
APD and Psycopathy
-15-20% of people with APD with psychopathy
-Hare Psychopathy Checklist-Revised
>20 item checklist, 2 main factors
–1.Interpersonal/Emotional
–2.Social Deviance (people with APD but not psychopathy score high on this factor)
Associations for Psychopathy
-Reduced amygdala and frontal lobe activation in response to aversive stimuli
-Less connections between frontal lobes and amygdala
-Demonstrate frontal lobe activity (planning) during perspective-taking tasks instead of empathy related area activity
Cluster C Personality Disorders
Anxious and Fearful Behaviours
-feelings of anxiety, nervousness that affect observable behaviour
-inhibited behaviour
Avoidant Personality Disorder (AvPD)
-Avoid social interactions, including school and work, because of feeling inadequate and fear of rejection
-Avoid new experiences due to fear of embarrassment, criticism
-Increased amygdala activity when judging emotional content of negative stimuli-increased activity positively correlated with self-reported anxiety
Dependent Personality Disorder
-Excessive need to be cared for
-Require frequent assurance from others and help with everyday decision making
-Fear of abandonment and lack of confidence
Obsessive-Compulsive Personality Disorder (OCPD)
-Unusually focused on perfection, details, organization, productivity
-avoid spending money or disposing of old, worthless objects
-have trouble delegating, receiving help from others
-high in Parkinson’s patience (dopamine related?)
Dissociative Experiences
Sense of separation/dissociation between person and surroundings
(daydreaming, intense focus on one task)
Dissociative Disorder
Split between a person’s conscious awareness and their feelings, cognitions, memory and identity
Can be caused by brain damage, psychological trauma, or extreme stress
Victims of extreme stress or psychological trauma cope by shifting consciousness to different perspective (experience event or trauma as an observer)
Dissociative Identity Disorder
<1% of population
Split in identity, feeling different aspects of themselves as if separated from each other
Can be severe enough to construct entirely separate personalities that switch being in control
Some evidence that some learning and memory doesn’t transfer
More diagnoses over time now
Anxiety Disorders
1/8 population
Often co-occur with other disorders like depression, OCD, substance abuse
Repeated activation of fight or flight (sympathetic nervous system)
More intense, long, not connected to current circumstance
Generalized Anxiety Disorder (GAD)
Frequently elevated levels of anxiety in response to normal challenges and daily stresses
Difficulty sleeping, breathing, concentrating
Hard to identify specific cause/source of anxiety
Right amygdala is larger (more sensitive to stressors)
Panic Disorder
Occasional episodes of sudden intense fear
Shorter intervals of SEVERE anxiety (compared to GAD)
Panic Attacks: Brief (<10 min) moments of extreme anxiety, rush of physical arousal and frightening thoughts
>agoraphobia: fear of panic attack in public
Phobias
Severe, irrational fear of specific object/situation
Specific Phobias: Fear of specific object, activity or organism
Social Phobias: Fear of interpersonal situations/relationships
Social Anxiety Disorder
Very strong fear of being judged, embarrassed or humiliated
Managed by developing familiar routines, controlled exits, limiting social activities
Obsessive-Compulsive Disorder (OCD)
Obsessions: Unwanted inappropriate persistent thoughts
Compulsions: Engagement in repetitive ritualistic behaviours
OCD and the brain
Orbitofrontal loop:
-orbitofrontal cortex: Decision making
-basal ganglia: Movement and reward
-thalamus: receiving sensory information
Dorsolateral prefrontal cortex: Attentional control and problem solving
Anterior cingulate cortex: Attention and emotion
Major Depression
Prolonged periods of:
-sadness
-worthlessness/hopelessness
-social withdrawl
-cognitive and physical sluggishness
Development of pessimistic explanatory style:
-critical personal, stable and global attributions
Genetic vulnerability to Depression
Twin studies suggest genetic risk
Risk increases with degree of stress person experiences
Diathesis-Stress Model: An interaction between genetic predisposition for a disorder and amount of stress will influence risk for developing that disorder
Depressed vs Non-Depressed Brain
See diagram
Long term effects
Sensitive to stressful events triggering more depressive episodes
Damage to hippocampus: reduce neurogenesis (neuronal cell growth), reduction in new learning and flexible thinking
Most antidepressants target seratonin
Dysfunctional Brain Areas with Depression
Nucleus accumbens : Anhedonia>reduced ability to feel pleasure
Medial prefrontal cortex: Overactivation causes ruminating on negative events
Bipolar Disorder
Swings in emotion between depression and mania
Mania: Extreme energy, positivity, speaking quickly, impulsive/spontaneous decision making, high risk behaviours
-frequency varies
Rates of suicide higher than Major Depression
(increase in energy from manic episode)
Schizophrenia
Significant breaks from reality, lack of integration of thoughts and emotions, problems with attention and memory
<1% of adults worldwide
Can develop gradually or rapidly
Schizophrenia Stages
- Prodromal Phase
-confusion/difficulty organizing thoughts
-loss of interest and withdrawal from friends, family, seek isolation
-general loss of motivation
2.Active phase
-delusional thoughts, hallucinations (more pronounced)
-disorganized patterns of thoughts, emotions, behaviour
3.Residual Phase
-most symptoms disappear/lessen
-withdraw from social contact, trouble concentrating, lack of motivation
Schizophrenia Positive Symptoms
Presence of maladaptive behaviours
-Confused, paranoid thinking
-Inappropriate emotional reactions
-Hallucinations: Alterations in perception like sensing something that doesn’t exist
-Delusions: Beliefs not based on/integrated with reality (ex delusions of grandeur)
-Disorganized Behaviour: Difficulty completing everyday tasks (ex cooking cleaning..)
Negative Symptoms Schizophrenia
Absence of adaptive behaviours
-flat emotional reactions
-lack of interaction with others, lack of motivation, working memory deficits
-catatonia: movement disorder where individual is unresponsive/does not move for long periods of time
(dopamine likely plays role in catatonic states)
Schizophrenia Genetics
25-50% concordance in identical twins
108 genes associated with schizophrenia
(many are also with other disorders)
Schizophrenia the Brain
Larger ventricles in brain due to loss of brain matter
-more loss in amygdala and hippocampus
Lowered activity in frontal lobes
-may explain attentional difficulties and organizing info within logical narrative
Increased dopamine levels
-related to positive symptoms of schizophrenia (hallucinations, delusions)
Decreased glutamate levels
-related to negative symptoms
