Disorders and therapy Flashcards
Psychological Causes: Learned Helplessness
- Efforts of controlling certain life events repeatedly fail
- May stop attempting to control those situations
- And, if this happens often enough, may generalize lack of power/control and not try even when you could have an effect
- Learned helplessness: expectation that you cannot control outcomes, so you become apathetic and depressed
Depressive Explanatory style
Attribute negative events to internal, stable, and global factors
Internal, stable, global
Internal: “It’s my fault”
Stable: “It will never change”
Global: “It’s going to ruin my life” (versus well, its just this one thing and its not going to affect everything else in my life)
Explanatory Style and Depression
- Measured explanatory styles among first-year college students
- Two years later, those with negative style were more likely to experience a major or minor depressive disorder
Depressive Cognition: Negative Biases
- Overgeneralizing
- Selective Abstraction
- Personalization
- Magnification and minimization
- Arbitrary inference
- Dichotomous thinking
Overgeneralizing
Drawing global conclusions on basis of single fact
Selective Abstraction
Focusing on some insignificant (negative) detail while ignoring more important aspects
Personalization
Incorrectly taking responsibility for bad events in the world
Magnification and minimization
Small bad events are exaggerated and good events minimized
Arbitrary inference
Draw conclusions without evidence
Dichotomous thinking
Seeing everything in extremes, black and white
The vicious cycle of depression
Depression can lead to behaviors that cause social rejection, which worsens depression
- Biological causes –> depression–> social rejection–> negative life experiences–> depression again
Bipolar Disorder (Manic-depresive)
- Extreme moods: Manic episodes and extreme depression mixed with normal mood
- Mania involves delusional levels of optimism, euphoria and energy. equally common in both sexes
- Sufferers make poor decisions while manic, withdraw when depressed. Dangers in both states.
Two types of bipolar disorder
Bipolar I: More extreme manic state–sometimes with delusions or hallucinations
Bipolar II: Hypomania, no delusions
Manic behavior
Emotional characteristics: Elation, euphoria, extreme sociability, expansiveness, impatience
Cognitive characteristics: Distractibility, desire for action, impulsiveness, talkativeness, grandiosity, inflated self-esteem
Motor characteristics: Hyperactivity, decreased for sleep, sexual indiscretion, fluctuating appetite
Depressive behavior
Emotional characteristics: Gloominess, hopelessness, social withdrawal, irritability, indecisiveness
Cognitive characteristics: Slowness of thought, obsessive worrying about death, negative self-image, delusions of guilt, difficulty in concentrating
Motor characteristics: Decreased motor activity, fatigue, difficulty in sleeping, decreased in sex drive, decreased appetite
True or false: Minor depression responds to same treatments as major depression
True
Nine criteria for Major Depression (need 5)
- Depressed mood most of the day, nearly every day
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day
- Significant weight loss when not dieting or weight gain
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or lethargy
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt
- diminished ability to think or concentrate, or indecisiveness, nearly every day
- Recurrent thoughts of death, recurrent social ideation
Dysthymia
- More chronic, low intensity mood disorder
- By definition, symptoms must be present>2 years consecutively
- It is characterized by anhedonia, low self-esteem and low energy
- It tends to respond to medication and psychotherapy
- Long-term psychotherapy is frequently able to bring about lasting change in dysthymic individuals
Seasonal Affective Disorder
- Results from changes in the season. Most cases begin in the fall or winter, or when there is a decrease in sunlight
- Pattern of onset at the same time each year
- Full remissions occur at a characteristic time of year
Suicide Facts
- Major risk in depression. The majority of suicide victims are suffering from depression
- 10-14% of those who attempt suicide will eventually succeed in a later attempt
- Suicide rates are highest among the elderly (health problems)
- Most suicidal people leave clues of their intentions
- Most suicidal people have not made a definite decision to die
- Suicide is less frequent for married people and women with children
Schizophrenia
- “Split-brain/split-mind”
- Found in all cultures
- Affects men and women (almost) equally)
- About 1% of Americans affected in lifetime
- Age of onset:
19-25 men
24-25 women
Burden of Schizophrenia: Disability and premature death
- 8th leading cause of disability-adjusted life years worldwide
- Reduces a person’s life span by 10 years
- 30% of schizophrenia attempt suicide at least once in their lifetime
- About 10% of patients die by suicide
Burden of Schizophrenia: cost
- Psychotic disorders: most expensive mental illnesses in terms of costs of care/patient
- 1.5% (UK), 2% (the Netherlands, France), and 2.5% (USA) of national health expenditures
Major Schizophrenia Symptoms
Incoherent thinking: rambling from one topic to another
Delusions: false beliefs
Hallucinations: Sensory Experiences in the absence of actual stimulation
Disturbance of Affect: emotion/facial expressions
Bizarre Behavior
Common delusions
- Mind is controlled by evil forces
- Thoughts being broadcast out loud and other people can hear what you are thinking
- Delusions of grandeur
- Delusions of persecution
Hallucinations
- Often auditory (report hearing voices)
- Can be other senses as well
Disturbance of Affect
- Emotion, mood, facial expressions
- “Flat” affect, show no emotion, blank expression
- Exaggerated or inappropriate emotions
Bizarre behaviors
- Talk to themselves
- Frozen in place (catatonic state)
- Walk in circles
Positive symptoms
Cognitive, emotional, and behavioral excesses
Example of positive symptoms
- Hallucinations (69%)
- Delusions (84%)
- Though disorders (43%)
- Bizarre behaviors (26%)
Negative symptoms
Cognitive, emotional, and behavioral deficits
Examples of negative symptoms
- Apathy (90%)
- Flattened Affect (88%)
- Social withdrawal (88%)
- Inattention (66%)
- Slowed speech or no speech (53%)
Paranoid Schizophrenia Types
- Delusions and auditory hallucinations
- Delusions of grandeur or of persecution
- Suspicion and hostility
- Usually harmless, but may become violent if threatened
Catatonic Schizophrenia
- Periods of frenzied activity alternating with periods of immobility
- May stay in odd positions for hours
Disorganized Schizophrenia
- Inappropriate affect and actions
- Incoherent verbal behavior
- Illogical thinking
Undifferentiated Schizophrenia
Used to characterize cases with mixed or unusual symptoms
Residual schizophrenia
Prior episodes not currently experiencing symptoms
Causes of Schizophrenia
- Genetics
- Neurotransmitter and Brain abnormalities
- Diathesis-Stress model (Vulnerability Stress Model)
Childhood Data on Schizophrenia
- Studies have looked at childhood of people who were later diagnosed with schizophrenia
- Walker 1994, studied home movies of infancy to adulthood. Found more involuntary movements, such as writhing, involuntary movements of tongue, lip, or arm. Also were unhappier than unaffected siblings
- Cannon, 1999, school records. Okay academically, but worse at sports and craft activities (motor problem?)
- Psychology grad students were shown home movies of affected children and unaffected siblings, 78% guessed correctly
Causes: Dopamine Hypothesis (Schizophrenia)
- Brain circuits sensitive to dopamine have abnormally high levels of activity. Cause could be excess of dopamine, over-sensitivity of dopamine receptors, etc.
Evidence of a Dopamine hypothesis
- Antipsychotic drugs, block dopamine receptors
- Increasing dopamine makes symptoms worse (Davis, 1974)
- Overdose of amphetamines: causes paranoid schizophrenia-like symptoms
Brain abnormalities and schizophrenia
Some schizophrenics have:
1. Low frontal activity
2. Undersize hippocampus, amygdala, or thalamus
3. Larger than normal ventricles
Schizophrenia: A brain disorder
- Pairs of identical twins, discordant (one schizophrenic and the other normal)
- Schizophrenics had enlarged ventricles compared to normal sibling
The Vulnerability-Stress View of Schizophrenia
Genetic abnormalities lead to biochemical abnormalities, which can result in a physiological predisposition towards schizophrenia. In such a situation, environmental stressors can trigger the behavior patterns of schizophrenia
Personality Disorders
- Disorder in which person has highly inflexible and maladaptive personality
- 10% of population. Self-defeating patterns of behavior
- Controversy: Are some labels just “pathologizing” variations of personality
Schizoid personality
Socially isolated, emotional detached
Paranoid personality
overly sensitive and suspicious
Histrionic personality
melodramatic and attention seeking
Narcissistic personality
Self-centered and ego inflated
Obsessive-compulsive personality
perfectionist (not same as having OCD)
Avoidant personality
Fears rejection so much that he/she does not start new relationships
Cluster A Personality Disorders
Paranoid, schizoid and schizotypal personality disorders. Individuals with these disorders often appear odd or eccentric
Cluster B Personality Disorders
Antisocial, borderline, histrionic, and narcissistic personality disorders. Individuals with these disorders often appear dramatic, emotional, or erratic
Cluster C personality
Avoidant, dependent, obsessive compulsive personality disorders. Appear anxious and fearful