Chapter 15: Psychological Disorders Flashcards
Emil Kraepelin (1856-1926)
§ Considered the father of
_________
modern psychiatry
________: views
psychological conditions as
sets of symptoms, causes,
and outcomes, with
treatments aimed at
changing physiological
processes
Medical model
______: A more holistic
view of mental
health that
recognizes that
physiological
processes interact
with psychological
and social factors
biopsychosocial model
who developed the medical model?
Emil Kraepelin
______ behaviour: Causes distress to self or
others
§ Impairs ability to function
in daily activities
§ Increases risk of injury,
death, legal infractions
maladaptive
what counts as abnormal?
maladaptive behaviour
______:
establishes criteria for
the diagnosis of mental
disorders
Diagnostic and
Statistical Manual for
Mental Disorders (DSM)
what three things does the DSM contain for each mental disorder?
- Set of symptoms
- Etiology (causes) of
symptoms - Prognosis of how
symptoms change
over time
T/F: there’s a spectrum to maladaptive behaviour
true, there’s “normal” amounts of each maladaptive behaviour… depends on strength and longevity of behaviour!
why is the DSM so important?
standardizes it! allows people to talk about disorders with consistent framework
what are some critics of the DSM?
Subjective component
from clinician- clinician has personal bias
Lack of objective
diagnostic methods
(genetics, brain imaging)
pharmaceutical industry might have had too much influence in creating it
Arbitrary diagnostic criteria, need to have 6/10 symptoms… but cutoff number should be fluid!
Promoting overdiagnosis
(e.g., ADHD) vs diagnostic
inconsistency
_____: Standardized language and
hope of treatments, makes things consistent! can help patients if they know what’s happening to them
labels
______: negative views
of and biases towards the
mentally ill, getting a label can lead to a loss of self-esteem
§ Self-fulfilling prophecies
Stigmatization
where does mental illness stigma come from?
ignorance
education can solve many of these issues!
what was David Rosenhan’s experiment?
being sane in insane places
he pretended to have a mental breakdown, got admitted to psychiatric hospitals, then acted totally sane… took up to weeks-months to be released
once they got the label of a diagnosis, the doctors/nurses viewed all their behaviour through this lens…
T/F: Labels alter the lens
through which we
view people
true!! ex: David Rosenhan’s experiment
T/F: insanity is a diagnosis
false, its a legal term NOT a diagnosis
________ Defense:
a legal claim that a
defendant was unable to
differentiate between right
and wrong when the
criminal act was
committed
Mental Disorder
if someone wins with a mental disorder defense, what happens?
held not criminally responsible, go to a psychiatric hospital instead of prison
what is the myth of violence?
that whenever a violent act occurs, people ask about mental illness
T/F: Violence associated
with substance abuse,
regardless of mental
illness
true!! its the substance abuse that causes this increase in violence
how does the availability heuristic relate to our perceptions of mental illness and violence?
we’re much more likely to remeber these weird, gruesome crimes committed by people with mental illness
so its at the front of our mind, affecting our personal biases!
_______: Unusual patterns of behaviour for one’s culture that are
maladaptive and resistant to change
personality disorders
______ Disorders
§ Odd or eccentric
behaviour
Cluster A
_______ Disorders
§ Dramatic, emotional,
and erratic behaviour
Cluster B
______ Disorders
§ Anxious, fearful, and
inhibited behaviour
Cluster C
T/F: personality disorders are examined in a culture-specific way
true!! shift and change based on environment, examined differently!
________: pervasive
distrust of others,
overly sensitive to
perceived slights, impaired social life
Paranoid personality
disorder
Paranoid personality
disorder is a….
Cluster A personality disorder
______: detached
and aloof, lacks
desire for social
relationships;
indifferent to social
norms (can come across as rude or arrogant)
Schizoid personality
disorder
Schizoid personality
disorder is a….
Cluster A personality disorder
_______:
odd appearance,
mannerisms, and
beliefs; prone to
unusual perceptual
experiences (think everything happens because of them); believe
others are harmful
Schizotypal
personality disorder
Schizotypal
personality disorder is a…
Cluster A personality disorder
_______: intense
extremes between
positive and negative
emotions, an unstable
sense of self,
impulsivity, and
difficult, unstable
social relationships
Borderline personality
disorder
high risk of suicidal tendencies, lots of risky behaviour (sexual, social etc.)
Borderline personality
disorder is a…
Cluster B personality disorder
_______: inflated sense of
self-importance and an
intense need for attention
and admiration, as well as
intense self-doubt and
fear of abandonment
Narcissistic personality
disorder
Narcissistic personality
disorder is a…
Cluster B personality disorder
______: excessive
attention seeking and
dramatic behaviour, immature, differentiated from narcissistic personality disorder by overdramatic behaviour
Histrionic personality
disorder
Histrionic personality
disorder is a…
Cluster B personality disorder
_______:
a habitual pattern of willingly
violating others’ personal
rights, with very little sign of
empathy or remorse, don’t consider other people’s perceptions… can be helpful in life! ex: corporate world, lots of people in prison have _____ (def overrepresented)
Antisocial Personality Disorder
Antisocial Personality Disorder is a…
Cluster B personality disorder
_______: characterized by a belief
that one is socially inept, fear of rejection, and
restraint in personal relationships, reclusive and isolated, kind of get stuck in a self-actualization cycle
Avoidant personality disorder
_______: extreme lack
of confidence, excessive
need to be looked after,
fear of abandonment
Dependent personality
disorder
Avoidant personality disorder is a…
Cluster C personality disorder
Dependent personality
disorder is a…
Cluster C personality disorder
________: preoccupation
with details, rules, and
achieving perfection
Obsessive-compulsive
(anankastic) personality
disorder
Obsessive-compulsive
(anankastic) personality
disorder is a…
Cluster C personality disorder
_______:
characterized by a split
between conscious awareness
from feeling, cognition, memory,
and identity
Dissociative disorders
_______: a
person claims that their identity
has split into one of more
distinct personalities or ‘alters’
§ Likely therapist-induced- was sensationalized in the media and number of cases skyrocketed (cluster of same therapists using hypnosis for psychiatric treatment)
Dissociative identity disorder
(controversially diagnosed as Multiple Personality Disorder in the past)
T/F: we all experience dissociation
true! we all can lose track of our surroundings, like when driving or reading a good book
T/F: there are cultural differneces within the presentation of dissociative identity disorders
true! people had cultural expectations of how they should be behaving
NA patients would flip “alters” multiple times a day, suddenly (like shown in our media)
Indian patients would only switch at night, and spend a whole day as their alter (like shown in their media)
_______: A category of disorders involving fear of nervousness that is
excessive, irrational, and maladaptive
anxiety disorders
_________: involves frequently
elevated levels of anxiety that are not directed at or limited
to any particular situation
Generalized anxiety disorder (GAD)
_______: Marked by repeated
episodes of sudden,
very intense fear (i.e.,
panic attacks)
panic disorder
_______: an
intense fear of having
a panic attack or lower-
level panic symptoms
in public
Agoraphobia
______: A severe, irrational
fear of a very specific
object or situation
phobia
______ phobias:
involve an intense
fear of an object,
activity, or organism
Specific
T/F: we’re more likely to develop phobias of things that it makes sense to be scared of, i.e. preparedness!
true, makes sense for our evolutionary ancestors to be scared of
what is Parasitic processing?
phobias can be conditioned, and learned! self-destructive feedback loop
________: an
irrational fear of being
observed, evaluated, or
embarrassed in public
Social anxiety disorder
T/F: Individuals with social anxiety disorder structure
their lives to avoid anxiety
true! very extreme cases of social anxiety
T/F: Anxiety is independent
of the individual’s
personality
true, not the same as avoidant personality disorder
_______: Characterized by
unwanted, inappropriate,
and persistent thoughts
(obsessions); repetitive
stereotyped behaviours
(compulsions); or a
combination of the two
obsessive-compulsive disorder (OCD)
_____: Prolonged periods of
sadness, feelings of
worthlessness and
hopelessness, social
withdrawal, and cognitive
and physical sluggishness
§ Depressed cognition
§ Lethargic and sleepy,
yet insomnia
§ Appetite change and
digestive problems
major depression
________: self-damaging mental habits of
internalizing, stabilizing, and globalizing
Pessimistic explanatory style
Pessimistic explanatory style is a…
self-defeating mental habit
T/F: women experience major depression more often than males
true!
“I’m so stupid! It’s my fault, I’m a bad person” is an example of…
internalizing, internal locus of control
“It’s always going to be this way, things will never change” is an example of…
stabilizing
“And this applies to everything, not just the current situation” is an example of…
globalizing (similar to catastrophizing)
people with depression show
cell loss in _____, _______, and ______
frontal lobes,
hippocampus, and amygdala
T/F: in depression, Amygdala becomes
dysregulated and
overstimulates HPA axis,
which is no longer effectively
inhibited by frontal lobes and
hippocampus
true! dysregulates out emotional responses!
what happens when the HPA axis is activated (overstimulated) by the amygdala during depression?
increased cortisol, further damages the hippocampus, and impairs neurogenesis
________: reduced
ability to feel
pleasure, loss of
interest in usually
enjoyed activities
Anhedonia
don’t feel reward and pleasure from nucleus accumbens
_______: dwelling
on negative thoughts
even as they become
self-damaging
Rumination
losing executive function from prefrontal cortex
T/F: Substantial overlap between
brain structures implicated in
anxiety and mood disorders
true!!! many people with depression have anxiety and vice versa
what are the slight differences between anxiety and depression (brain structure and function)
anxiety is abnormal brain activity
mood disorders (like depression) cause atrophy in the brain
T/F: Twin studies indicate an underlying genetic
risk for developing major depression
true!!
monozygotic twins (both same sex always) show more concordance to rates of depression
T/F: Socioeconomic status associated with higher risk of mental
illness, including depression
true!!
________ model: Some people inherit a diathesis (genetic susceptibility), which is
incapable of initiating disorder
in absence of stress
diathesis-stress model
need the interaction (genetics and environment) to have disorder (i.e. need to have genetic vulnerability with a stressful environment)
_______: Characterized by extreme
highs and lows in mood,
motivation, and energy
§ Episodes vary in
length and duration
§ Mania can take
several forms but
include problems
with inhibition,
planning, and risk-
taking
bipolar disorder
_______: Significant breaks from
reality, a lack of integration
of thoughts and emotions,
and serious problems with
attention and memory
hallucinations, delusions, confused thoughts and speech
schizophrenia
_______: false perceptions
Hallucinations (usually auditory but also visual)
_______: false beliefs
Delusions
can be delusions of grandeur (belief that you’re more important than you are)
or persecutory delusions (someone is coming to harm you)
how do we classify schizophrenic symptoms?
negative or positive symptoms
_______: involve the
absence of adaptive behaviour
§ Flat affect
§ Poverty of speech
§ Lack of motivation
Negative symptoms
_______: behaviours
that are present that should
not be occurring
§ Hallucinations/Delusions
§ Confused thoughts and
speech
§ Inappropriate affect
Positive symptoms
what are the 3 phases of schizophrenia
prodromal, active, residual
______ phase: confusion, loss of interest, social withdrawal (early warning signs)
______ phase: hallucinations, delusions, disorganized thoughts,
emotions, behaviours (in complete psychotic episode)
_______ phase: period of reduced symptoms; may continue to
be withdrawn, have difficulty concentrating, and lack motivation (slight recovery)
Prodromal
Active
Residual
T/F: with every schizophrenic episode, people lose more and more function
true! they don’t fully recover to the same level as when they started the episode, one of the main goals of treatment is to prevent as many episodes as possible to keep as much function possible
Decreased frontal lobe
activation
Enlarged ventricles due to
widespread loss of brain matter (atrophies)
§ Likely stress related
Progressive deterioration over
repeat brain scans
these are all aspects of…
schizophrenia and its effect on the brain
what happens to our neurotransmitters when we have schizophrenia?
Overactive dopamine
associated with positive
symptoms of schizophrenia (illusions and delusions)
Glutamate-blocking drugs
produce negative
symptoms that mimic
those in schizophrenia (disorganized thought patterns)- so people with schizophrenia are lacking in glutamate
T/F: if one identical twin has
schizophrenia, the other
twin has a 25-50%
chance of also
developing it
true! not 100%
monozygotic twins have higher rates of concordance
Estimated that _____% of
the population has a
gene sequence that
puts them at risk for schizophrenia
10
what are some environmental influences for the development of schizophrenia?
Maternal exposure to
influenza virus (winter babies have more chance, first trimester is super important for brain development! don’t want to be sick then)
Fetal exposure to stress (ex: famine)
Marijuana use (need susceptibility)
Head injuries (before the age of 10, but only people who have underlying risk factors)
Stressful rearing
environments
_______ protects
against relapse of schizophrenia
Supportive family
environment
________ hypothesis: Emergence of schizophrenia in early adulthood due to
outgrowth of neurological systems previously disrupted
the neurodevelopmental hypothesis
we don’t DEVELOP schizophrenia, we GROW into it
what is the prognosis of schizophrenia?
Despite common
perception, prognosis
is not entirely poor
Early treatment and
proper social support
vastly improves
prognosis (supplemented with supportive social environment)
Relapses common,
though most people
make functional
recoveries
