Clinical Psychology: Psychological disorders (CH14) Flashcards
Medical model
Conceptualization of psychological disorders as diseases that, like physical diseases, have biological causes, defined symptoms and possible cures
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Classification system that describes the features used to diagnose each recognized mental disorder and indicates how the disorder can be distinguished from others, similar problems
Comorbidity
Co-occurrence of two or more disorders in a single individual
Global assessment of functioning
Rating of the person from 0 to 100; one with more severe disorders is indicated by lower numbers and more effective functioning by higher numbers
Diathesis-stress model
A person may be predisposed for a psychological disorder that remains unexpressed until triggered by stress
- Diathesis: internal predisposition, which could be genetic
- Stress: external trigger/environment
Intervention-causation fallacy
Involves the assumption that if a treatment is effective, it must address the cause of the problem
Anxiety disorder
The class of mental disorder in which anxiety is the predominant factor
Generalized anxiety disorder (GAD)
A disorder characterized by chronic excessive worry accompanied by 3 or more of the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension and sleep disturbance
*non-specific anxiety
Phobic disorders
Marked, persistent and excessive fear and avoidance of specific objects, activities or situations
Specific disorders
Disorder that involves an irrational fear of a particular object of situation that markedly interferes with an individual’s ability to function
5 categories:
1. Animals (dogs, cats, rats, snakes, spiders, etc.)
2. Natural environments (heights, darkness, water, storms, etc.)
3. Situations (bridges, elevators, tunnels, enclosed places, etc.)
4. Blood, injections, injury
5. Other phobias (illness, death, etc.)
Social phobia
Disorder that involves an irrational fear of being publicly humiliated or embarrassed
Preparedness theory
People are instinctively predisposed toward certain fears (ex. snakes, spiders but not flowers or toy bunnies)
Panic disorder
Disorder characterized by the sudden occurrence of multiple psychological and physiological symptoms that contribute to a feeling of stark terror
- Feel that you’re going to die
- False interpretation of bodily state (arousal) *2 factor theory
Agoraphobia
An extreme fear of venturing into public places
Obsessive-compulsive disorder (OCD)
Disorder in which repetitive, intrusive thoughts (obsessions) and ritualistic behaviours (compulsions) designed to fend off those thoughts interfere significantly with an individual’s functioning
Mood disorders
Mental disorders that have mood disturbance as their predominant feature
Major depressive disorder
Onset mid-20’s
Disorder characterized by severely depressed mood that lasts 2 weeks or more and is accompanied by feelings of:
- Sadness (profound/deep)
- Anhedonia (no longer pursue enjoyable activities)
- Change in sleep (far more/less)
- Change in appetite (far more/less)
- Psychomotor agitation/retardation (feel antsy/weak/lethargic)
- Fatigue and loss of E.: cannot power up
- Worthlessness, guilt (feel far less value, take ownership in things that are not their fault)
- Decreased ability to concentrate (cannot focus, reframe, not productive)
- Suicidal
Dysthymia
Early, insidious, chronic
Same cognitive and bodily problems as in depression are present but they are less severe and last longer (persisting for at least 2 years)
Double depression
Moderately depressed mood that persists for at least 2 years and is punctuated by periods of major depression
Seasonal affective disorder (SAD)
Recurrent depressive episodes in a seasonal pattern
Postpartum depression
Depression in women following childbirth due to changing hormone balances
Helplessness theory
Individuals who are prone to depression automatically attribute negative experiences to causes that are internal (their own fault), stable (unlikely to change) and global (widespread, all of future)
Symbolic loss (Freud)
States that the “worst” possible situation is loss of parents; an individual with depression equates all negative situations to the “worst” situation thus making their experience of depression even worse
Biological underpinnings of depression
Neurotransmitters
-Catecholamine & Indoleamine theory: low levels of NE and serotonin
Brain dysfunction
-Left frontal: less active than expected
-Right frontal: more active than expected thus causing rumination (think the same negative thoughts over and over)
Bipolar disorder
Onset 20’s but childhood BPD may have different symptoms due to comorbidity
An unstable emotional condition characterized by cycles of abnormal, persistent high mode (mania) and low mood (depression)
- BPD-I (mania):
- inflated self-esteem, grandiosity
- decreased need for sleep
- flight of ideas, racing thoughts
- distractibility
- increase in goal-directed behaviour
- excessive involvement in pleasurable activities
Biological underpinnings of bipolar disorder
Neurotransmitters
-High levels of NE (mental arousal)
Permissive theory: Serotonin levels are low thus dysfunctional for NE thus, NE swings from high to low for mania to depression
Cyclothymia
Onset adolescence, may or many nor develop into full bipolar disorder
Same cognitive and bodily problems as in bipolar disorder are present but they are less severe and last longer (persisting for at least 2 or more years)
Dissociative disorder
Condition in which normal cognitive processes are severely disjointed and creating significant disruptions in memory, awareness, or personality that can vary in length from a matter of minutes to many years
Dissociative identity disorder (DID)
Presence within an individual of 2 or more distinct identities that at different times take control of the individual’s behaviour
-Most DID patients have experienced tough physical and/or psychological trauma earlier in life; the only way to manage the stress was to create 2/+ personalities that were better able to cope with the situation (Freud)
Schizophrenia
Profound disruption of basic psychological processes; a distorted perception of reality; altered or blunted emotion; disturbances in though, motivation and behaviour
DSM: at least 6 months
-delusion, hallucination, disorganized speech, grossly disorganized behaviour or catatonic behaviour and negative symptoms
Delusion
Patently false belief system, often bizarre and grandiose, that is maintained in spite of its irrationality
ex. may think he/she is Jesus Christ, Napoleon, Joan of Arc, etc.
ex. think CIA, demons, ET’s, etc. are conspiring to harm them or control his or her mind
Hallucination
False perceptual experience that has compelling sense of being real despite the absence of external stimulation
ex. hearing, seeing, smelling things that are not there or having tactile sensations in absence of relevant sensory stimulation
Disorganized speech
Sever disruption of verbal communication in which ideas shift rapidly and incoherently from one to another unrelated topics
Grossly disorganized behaviour
Behaviour that is inappropriate for the situation or ineffective in attaining goals, often with specific motor disturbances
ex. improper sexual behaviour, loud shouting/swearing, constant childlike silliness
Catatonic behaviour
Marked decrease in all movements or an increase in muscular rigidity and overactivity
Negative symptoms
Emotional and social withdrawal; apathy; poverty of speech; other indications of absence or insufficiency of normal behaviour, motivation and emotion
-Symptoms that are missing in people with schizophrenia that appear more in people WITH schizophrenia than other people
Positive symptoms
Symptoms that you expect to find in people with schizophrenia and not in others
Types of schizophrenia
- Paranoid: prominent delusions, hallucinations
- Disorganized: speech, behaviour and/or affect
- Catatonic: marked psychomotor disturbance
- Undifferentiated: residual, do not fall cleanly into first 3
Schizophrenia onset & course
Onset
- more common in males
- early onset is less frequent
- rarely childhood onset
- may/may not have prodromal phase (transitional stage, warning stage before full schizophrenia)
Course (quarter system)
- 25% complete recovery
- 25% much improved, relatively independent (some help for daily functions), still on therapy and medication
- 25% improved but require extensive support network
- 15% unimproved, hospitalized
- 10% dead (mostly suicide)
Biological underpinnings in schizophrenia
Heritability estimates
-not wholly heritable though, environment also contribute
Biochemical factors
-dopamine hypothesis: idea that schizophrenia involves an excess of dopamine activity (aggravates symptoms)
Neuroanatomy
-extensive neuronal loss
-larger ventricles (hollow areas filled with CSF deep within the core of the brain)
Psychological underpinnings
Development in a stressful environment
ex. Individual starts to show odd symptoms -others start to treat individual differently -increase stress -individual start to treat others differently -socially isolated -increase more stress
