FE (4) Psychological Disorders II Flashcards
What Is Mental Illness?
- Often seen as a failure of adaptation to the environment
1) Failure analysis approach: Trying to understand mental illness by
examining breakdowns in functioning
a) Clinically significant disturbance in cognition, emotion regulation, or
behaviour
b) Dysfunction in the biological, psychological, or developmental
processes underlying mental functioning
Criteria for defining mental illness,
1) Statistical rarity
2) Subjective distress
3) Impairment
4) Societal disapproval
5) Biological dysfunction
Whats Statistical rarity
first criteria in defining mental inllness
- Many mental disorders such as schizophrenia are uncommon. Yet we can’t rely on statistical rarity to define mental disorder because not all infrequent conditions—such as extraordinary creativity—are pathological or indicative of mental illness, and many mental disorders—such as mild depression—are quite common
Whats SUBJECTIVE DISTRESS.
2nd criteria in defining mental illness
- Most mental disorders produce emotional pain for individuals afflicted with them, but not all of them do. For example, during the manic phases of bipo- lar disorder, people frequently feel better than normal and perceive nothing wrong with their behaviors. Similarly, many adults with antisocial personality disorder experience less distress than the typical person.
WHats IMPAIRMENT.
3rd criteria in defining a mental illness Most mental disorders interfere with people’s ability to function in every- day life. These disorders can destroy marriages, friendships, and jobs. Yet the presence of impairment by itself can’t define mental illness because some conditions, such as laziness, can produce impairment but aren’t mental disorders.
Whats SOCIETAL DISAPPROVAL
4th criteria in defining mental illlness
- Nearly 50 years ago, Thomas Szasz (1960) argued famously that “mental illness is a myth” and that “mental disorders” are nothing more than condi- tions that society dislikes. He even proposed that psychologists and psychiatrists use diag- noses as weapons of control; by attaching negative labels to people whose behaviors they find objectionable, they’re putting these people “in their place.” Szasz was both right and wrong. He was right that our negative attitudes toward those with serious mental illnesses are often deep-seated and widespread. Szasz was also right that societal attitudes shape our views of abnormality.
Indeed, psychiatric diagnoses have often mirrored the views of the times. For centuries, some psychiatrists invoked the diagnosis of masturbational insanity to describe individuals whose compulsive masturbation supposedly drove them mad (Hare, 1962). Homosexuality was classified as a mental illness until members of the American Psychiatric Association voted to remove it from their list of disorders in 1973 (Bayer, 1981; see Chapter 11). As society became more accepting of homosexuality, mental health professionals came to reject the view that such behavior is pathological.
But Szasz was wrong that society regards all disapproved conditions as mental disor- ders (Wakefield, 1992). For example, racism is justifiably deplored by society, but isn’t con- sidered a mental disorder (Yamey & Shaw, 2002). Neither is messiness nor rudeness, even
though they’re both considered undesirable by society.
Whats BIOLOGICAL DYSFUNCTION.
last and 5th criteria in defining mental illness
- Many mental disorders probably result from break- downs or failures of physiological systems. For example, we’ll learn that schizophrenia is often marked by an underactivity in the brain’s frontal lobes. In contrast, some men- tal disorders, such as specific phobias, which are intense and irrational fears, appear to be acquired largely through learning experiences and often require only a weak genetic predisposition to trigger them.
WHat are the three main Historical Conceptions of mental illness
1) Middle ages:
Demonic model
- Mental illness was
due to evil spirits
infesting the body
- Trephination,
exorcism
2) Renaissance:
Medical model
- Mental illness was
due to physical disease
that can be cured
- Moral treatment
3) Modern era
- Medication (1950s:
Chlorpromazine for
schizophrenia)
- Deinstitutionalization
(1960-70s): mixed results
Historical Diagnosis of Psychological Disorders
The Rosenhan Experiment: Are psychiatric diagnoses in
1970s reliable and valid?
* Healthy individuals faked auditory hallucinations to gain admission
to a psychiatric hospital…
* Pseudo-patients..
Whats The DSM-5
Diagnostic and Statistical Manual of Mental Disorders
(DSM)
* Currently on 5th edition, with text revision: DSM-5-TR
- Diagnostic criteria and decision rules for each condition
- Thinking organic
- Information on prevalence
What does The DSM-5 help to do
- make treatment decisions
- communicate among clinicians
- inform research
What are some critisms of The DSM-5
- Not all disorders have criteria
validity - High level of the possibilty of having one or more mental illness/disorders at once
- Reliance on categorical model
of psychopathology - Tendency to “medicalize
normalcy”
In terms of Mental Illness how does it afftect the Law
1) Insanity / mental disorder defense
* aka not criminally responsible by reason of mental disorder
- Not aware of what they were doing at time of crime
- Did not know what they were doing was wrong
* Less than 1% of criminal cases use this ground successfully.
2) Incompetence to stand trial
What Is Anxiety?
Unpleasant feeling of fear and apprehension
* Most anxieties are transient and can be adaptive.
* They can also become excessive and impair normal functioning
What are the four componnets of anxiety
1) Psycholgical ( includes physical symptoms and sensations)
2) Cognitive ( involves what if questions like “what if I fail”
3) Emotional ( emotions associated with stress such as fear, dread and panic
4) Behavioural ( examples include reduced performance, avoidance)
What are Anxiety Disorders
- The most prevalent psychological disorders
- DSM-5: 11 anxiety disorders (~7.3% globally with one of
these disorders)
- e.g., specific phobia, social anxiety disorder (social phobia), panic
disorder, agoraphobia, generalized anxiety disorder, other specified
disorders (e.g., somatic symptom and related disorders) - Explanations
What is What Is a Phobia?
Intense fear of an object or situation that is greatly out of
proportion to its actual threat
* Most common anxiety disorder (11%)
* Comes in 3 different forms
What are the three differncet forms of Phobia, explain
1) Specific Phobia( ex: claustrophobia)
2) Soical Phobia ( Marked fear of public appearances or social interactions in
which embarrassment or humiliation is possible)
3) Agoraphobia
* Fear of being in a place or situation from which escape is
difficult or embarrassing
* Arises in the mid-teens
* Seems to differ across cultures
- Kayak angst
WHats a Panic Disorder
- Repeated, unexpected episodes of intense fear with
physical symptoms, along with either:- Persistent concerns about future attacks
- A change in personal behaviour in an attempt to avoid them
- Can be associated with specific situation or come “out of
the blue” - Onset between adolescence & the mid-30s
Whats Generalized Anxiety Disorder
Chronic, uncontrollable worry about all manners of things
* Free-floating anxiety
* Lasting over 6 months
* Interferes with daily functioning
* May also experience panic disorder or phobias
What are some facts about generalized anxiety disorder
About 3% of the population
* One third: following a major stressor or life change.
* More prevalent in females and Caucasians
Whats a Somatic symptom disorder
also known as somatoform disorder
* Condition marked by physical symptoms that suggest an underlying
medical illness, but are actually psychological in origin
* Excessive worry about the symptoms
* Recurring somatic complaints for at least 6 months
Whats an Illness Anxiety Disorder
- Long-lasting preoccupation with the notion that one has a
serious illness - Based on misinterpretation of normal body reactions
What are the 3 Explanations for Anxiety Disorders
1) Biological influences
* Genetically influenced (e.g., genes affect levels of neuroticism)
2) Social-cultural influences
* Significant life events
* Learning models ( classical conditioning, operant conditioning, social
learning)
3) Psychological Influences
* Catastrophic thinking: Predicting terrible events despite their low
probability
* Anxiety sensitivity: High levels of anxiety or concern about anxiety-related
sensations
What two forms do
Mood Disorders come in
- Depression
- Mania
Whats Depression
- Mood disorder
- A low, miserable, unhappy mood
- Feelings of worthlessness, and
pessimism - Altered sleep and appetite
- Inability to experience pleasure
Whats Mania
- Mood disorder
- Extremely high / agitated mood
- Excessively and unrealistically
positive - Feelings of elation and a strong
sense of pleasure - Grandiose ideas
- Hyperactive
What symptoms involve Major Depressive Disorder (MDD)
Five or more of these symptoms for at least 2 weeks:
* Depressed mood for most of the day
* Loss of interest in normal daily activities
* Difficulties in sleeping
* Change in activity level
* Poor appetite/weight loss or increased appetite/weight gain
* Daily fatigue or loss of energy
* Negative self-concept (worthlessness; excessive guilt)
* Trouble concentrating or making decisions
* Recurrent thoughts of death or suicide
What are some Biological, socio cultural and psychological influences on MDD
1) Biological influences
* Genes (moderate influence)
* Neurotransmitter imbalances (e.g., low levels of serotonin)
2) Social-cultural influences
* Significant life events
* Interpersonal model: Seek excessive reassurance à rejection or
dislike
3) Psychological influences
* Maladaptive attributions: (Internal, stable, global attributions for
negative experiences may contribute to depression)
* Learned helplessness: ( tendency to feel helpless in the face of events we can’t control)
Descride the study of Seligman & Maier (1967) learned helplessness
Seligman & Maier (1967): Three groups of dogs with
harnesses on
* Group 1: Kept in regular harnesses and then let loose (control group)
* Group 2: Administered painful shocks that could be stopped by
pressing a lever
* Group 3: Administered the same shocks that could not be stopped
(ineffective lever) – These dogs became very passive and depressed
What were the results of the study of Seligman & Maier (1967) learned helplessness
Results
* Groups 1 & 2: Quickly
jumped over the barrier
to escape the painful
situation
* Group 3: No attempt to
jump or escape
How does leanred helplessness develop
1) Uncontrollable bad events
2) Perceived LAck of control
3) Generalized helpless behaviour
Personality Disorders should only be diagnosed when
1) Personality traits first appear by adolescence
2) Traits are inflexible, stable, and expressed in a wide variety
of situations
3) Traits lead to distress or impairment
What are the Causes of Psychopathic Personality
- Possible deficit in fear
- Possible deficit in arousal
- Neurological basis?
Whats a Psychopathic Personality
Condition marked by superficial charm, dishonesty,
manipulativeness, self-centeredness, lack of empathy/guilt,
and risk taking
* Overlaps with antisocial personality disorder
* Primarily males, about 25% of the prison population
qualifies
What are Dissociative Disorders
Conditions involving disruptions in consciousness, memory,
identity, or perception
1) Depersonalization/derealization disorder
2) Dissociative amnesia
3) Dissociative fugue
4) Dissociative identity disorder (DID)
Whats Dissociative identity disorder (DID)
*Individual alternates between two or more distinct
identities
- Multiple personality disorder
- Host personality vs. alters
* Recognized by DSM, but not all clinicians believe in it
Explanations for DID
- Posttraumatic model
- Severe abuse in childhood?
*Socio-cognitive model - Expectancies and beliefs from psychotherapy
- Cultural influences
- Severe abuse in childhood?
Whats Schizophrenia
- Severe disorder of thought and emotion associated with a loss of
contact with reality - Involves fundamental disturbances in thinking, language,
emotion, and relationships
What are Positive symptoms in Schizophrenia
Observable expression of abnormal
behaviours
* Delusions ( strongly held fixed belief that has no basis in reality.)
* Hallucinations ( sensory perception that occurs in the absence of an external stimulus.
* Disorganized speech
* Catatonia ( motor problem, including holding the body in bizarre or rigid postures, curling up in a fetal position, and resisting simple suggestions to move.)
What are Negative symptoms in Schizophrenia
Elimination or reduction of
normal behaviours
* Flat affect: Little or no emotional reaction to events
* Impaired social skills
* Social withdrawal
Explainstions of Schizophrenia
1) Biological influences
* Neurotransmitter imbalances
* Dopamine excess involved in schizophrenia
2) Brain abnormalities
* Enlarged ventricles and sulci
* Decreased hemispherical asymmetry (L > R asymmetry for right-
handed individuals) à disorganized speech
* Decreased activation of the amygdala, hippocampus, and frontal
lobe
3) Genetic vulnerability
* Highly genetic
* Greater genetic similarity, greater the risk
Whats the Diathesis-Stress Model
That Schizophrenia is caused by a genetic vulnerability
(diathesis) coupled with stressors
* Early warning signs of schizophrenia vulnerability
* Social withdrawal
* Thought and movement problems
* Lack of emotions, decreased eye contact
