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PSYC 100A > In-Class: Psychological Disorders > Flashcards

In-Class: Psychological Disorders Flashcards

1
Q

What is the intern syndrome/medical student syndrome?

A

When learning about psychological disorders for the first time, students wonder about their influences on friends, family, and themselves. Students often overdiagnose the disorder in question. Recognizing the symptoms in others.

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2
Q

Why does the intern syndrome occur?

A
  • Confirmation bias: Ignore contradictory evidence, confirm our pre-disposition
  • Overconfidence
  • Self-serving bias
  • Availability heuristic: What easily comes to our mind

= Awareness
= Add friction

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3
Q

What is the 4 Ds?

A

Experiencing a symptom once or twice is not enough for a diagnosis!

Consider the 4 Ds - No single D is sufficient:

Deviant: Recurring behaviours, thoughts, emotions that deviate from the typical expectations of a society
**Context

Distress: The behaviour causes distress to oneself or other

Dysfunction: The behaviour interferes with daily functioning

Danger: The behaviour is harmful to oneself or others

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4
Q

Why are we interested in psychological disorders?

A
  • Personal benefit of increased understanding
  • Prevalence and impact of psychological disorders in society
  • Curiosity about the brain and human nature
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5
Q

Definition: Psychological Disorders

A

A syndrome marked by a clinically significant disturbance in an individual’s cognition, emotion regulation, and/or behaviour.

Clinical significance – Refer to the 4 D’s

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6
Q

What is a disorder?

A

A state of mental/behavioural ill-health.

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7
Q

What are patterns?

A

A COLLECTION of symptoms rather than a single one.

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8
Q

Symptoms of psychological disorders are…

A

Deviant: Differing from the norm/developmental pathway/expectation, given the cultural context.

Maladaptive and dysfunctional: Sufficiently severe to interfere with one’s daily life and well-being.

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9
Q

What are culture-bound syndromes?

A

Disorders unique to certain cultures, demonstrating how culture can play a role in both CAUSING and DEFINING a disorder.

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10
Q

What are some considerations to take when diagnosing a psychological disorder?

A

“MORE DAYS THAN NOT”

  • Informal standard used to establish whether a RELIABLE pattern exists
  • Over some period, the number of days during which an individual displays symptoms is counted
  • For psychopathology, symptom-present days > symptom-absent days

JUSTIFICATION
-Context is crucial! Is there a good reason for the pattern? Have you considered cultural/religious values?

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11
Q

Why is it important to understand the nature of psychological disorders?

A
  • Diagnoses aid in decisions about treatment: How to approach, treat?
  • For successful treatments to be available, we must understand the nature and cause of the symptoms
  • Allows for learning. In earlier times, treatments were cruel, ineffective, harsh therapies
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12
Q

What was Pinel’s approach to psychological disorders?

A

He proposed that mental disorders are NOT caused by demonic possession, but rather by ENVIRONMENTAL factors, such as stress and inhumane conditions.

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13
Q

How did Pinel treat his patients?

A

“Moral treatments”

  • Improvement in the environment
  • Holding patient dances
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14
Q

How was the Medical Model discovered?

A

Syphilis breakthrough, in which mental symptoms infecting the brain led to the Medical Model for mental illness.

Connection between symptoms and brain infection

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15
Q

What is the Medical Model?

A

Sees psychological disorders as psychopathology, an ILLNESS of the mind.

The disorders can be DIAGNOSED: Labeled as a collection of symptoms that tend to go together.

People with disorders can be TREATED, with the goal of restoring mental HEALTH.

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16
Q

What is the biopsychosocial approach?

A

Considers…

BIOLOGICAL INFLUENCES

  • Evolution
  • Individual genes, predispositions
  • Brain structure and chemistry

PSYCHOLOGICAL INFLUENCES, including inner psychological dynamics

  • Stress
  • Trauma
  • Learned helplessness
  • Mood-related perceptions and memories

SOCIAL-CULTURAL INFLUENCES

  • Roles
  • Expectations
  • Definitions of normality and disorder
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17
Q

What is the DSM?

A

Classifying psychological disorders and evaluating how often they occur.

Published by the American Psychiatric Association, the Diagnostic and Statistical Manual of Mental Disorders is a system of CLASSIFICATION used in the US and Canada.

Criteria and codes.

**Resembles the ICD, tracking worldwide trends.

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18
Q

Why is classification useful? What is the purpose of classification systems?

A
  • Verbal shorthand for referring to a list of associated symptoms.
  • Allows for us to study many similar cases, learning to predict outcomes.
  • Diagnoses can guide treatment choices.
  • Stimulates research into cause/origin.
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19
Q

What are the disadvantages and criticisms of the DSM?

A
  • Pathologizing normal human experience: Labelling!
  • Arbitrary cutoffs, between diagnoses and “normal” human experience.
  • Lack of sensitivity towards cultural diversity.
  • Diagnostic LABELS that provide a lens through which we may view and interpret behaviour/mental states as disordered = We can seek confirmation bias; self-fulfilling prophecy.
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20
Q

What are the problems with labelling?

A

Brings preconceptions, that bias our interpretations, memories
-Self-confirming evidence, which inevitably seems consistent with the diagnosis

If you say you have a certain issue, the doctor will be LOOKING for a problem

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21
Q

What are the rates of psychological disorders?

A

Worldwide, the rates vary by nation and disorder type.

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22
Q

What is the immigrant paradox?

A

In the US, Mexican-Americans are at greater risk of mental disorder, compared to those born in Mexico who immigrate.

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23
Q

What is subjective experience?

A

It is important to consider the individual first, rather than simply relying on the symptoms!

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24
Q

What is anxiety?

A

Negative mood state characterized by physical tension and apprehension, worry about the future.

MIGHT happen.

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25
Q

What is fear?

A

Immediate emotional reaction to danger.

IS happening.

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26
Q

What are the pros of anxiety?

A

Anxiety can keep us alert, prepare us for danger, motivate us

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27
Q

What happens when anxiety becomes excessive?

A

It becomes an anxiety disorder!

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28
Q

What are the characteristics of anxiety disorders?

A
  • Pervasive, persistent anxiety
  • Excessive avoidance/attempts to escape
  • Significant distress/impairment associated with the anxiety
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29
Q

What are specific phobias?

A

Extreme, irrational fear causing distress. Leads to extreme avoidance?

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30
Q

What are the four main types of specific phobias?

A
  • Animal type
  • Natural environment type
  • Situational type
  • Blood-injection-injury type

An excessive fear. The individual will go to great lengths to avoid

31
Q

What are panic attacks

A

Abrupt experience of intense fear/discomfort, accompanied by physical symptoms.

Usually lasting a few minutes, can seem forever. Can be stimulus-driven or situational, or unexpected.

32
Q

What are panic disorders?

A

Recurrent and unexpected panic attacks, with persistent anxiety/concern about having more panic attacks and the implications of their panic attacks.

They may show a significant change in their behaviour, upon the onset of their panic attacks.

Fear of experiencing the physical symptoms of panic attacks.

33
Q

What are the biological predispositions of panic attacks?

A

Vulnerability due to poor regulation to fight-or-flight response = Physiological alarm response, to an unreal threat.
Reacting as if there is danger, though there isn’t! A false alarm system that won’t shut off.

34
Q

What generates the ‘physiological alarm’ of a panic attack, and what does this perpetuate?

A

Both a stress event and biological vulnerability can trigger a physiological alarm.

This leads to catastrophic thoughts, assumptions that change future behaviours.

People will be safety-seeking and become hypervigilent, super sensitive to minor changes in the body. They always believe they are having a panic attack, even though this may not be true!

The hypervigilence will see symptoms as signs of an impeding panic attack.

35
Q

What is a social anxiety disorder?

A

Fear of being humiliated or embarrassed. This distress, avoidance of the situation disrupts the individual’s function.

36
Q

What are the vulnerabilities of social anxiety disorder?

A

Biological: Shyness

Cognitive:

  • Misinterpretation of cues
  • Perfectionistic standards

Social/Learning:

  • Rejection by peers
  • Overcontrolling, critical parents
  • Prepared conditioning: Emotional reasoning that says ‘If I’m feeling this way, it must be going terribly’
37
Q

The episodes of fear and panic in panic disorder and phobias are…

A

Acute.

38
Q

What is generalized anxiety disorder (GAD)?

A

Persistent, pervasive, excessive anxiety or worry.

The basic anxiety disorder, because it is founded on intense, unfocused anxiety = All the time!

The anxiety is unreasonable, involving both minor and major events.

39
Q

How is GAD different from typical worry?

A

The worry feels out of the individual’s control, and is accompanied by three other symptoms:

Irritability, difficulty concentrating, sleeping; muscle tension; edginess, restlessness; chronic fatigue
= Distress, impediment in your life

40
Q

What are the vulnerabilities to GAD?

A

Biological:
-Greater reactivity to threat, emotional stimuli: Amygdala, elevated sympathetic nervous system

Cognitive:

  • Hypervigilance to threat = On guard for threat all the time!
  • Intolerance of uncertainty
  • Core beliefs about the world being dangerous –> Expect the worst, constant preparation for danger, due to trauma experienced.

Social/Learning:
Uncontrollable adverse events

41
Q

What is obsessive-compulsive disorder (OCD)?

A

A battle of trying to suppress thoughts related to worry.
The more they try to suppress these thoughts, impulses, and images, the more difficult it becomes to get rid of them.

Obsessions: Attempts to ignore or suppress them (often, non-sensible, non-threatening)
Compulsions: Attempts to reduce anxiety = In response to the obsession, responding to obsessions.

These interfere with their daily life and causes distress.

The danger is internal, not external - things generated by your own mind!

The obsessions and compulsions must be TIME-CONSUMING.

42
Q

What are the subtypes of obsessions/compulsions?

A

Symmetry, exactness, “just right”

  • Needing things to be symmetrical, “just so”
  • Continuously arranging things

Cleaning, contamination

  • Fear of germs, contamination
  • Repetitive/excessive washing, use of barriers
43
Q

What is the biological predisposition to OCD?

A

Hyperactivity in the orbital frontal cortex, the caudate nucleus, thalamus, the structures that form a circuit that processes information.

OFC receives stimuli –> CN filters impulses –> Thalamus: Think and act on the impulses, automatic behaviours

In OCD patients, the circuit isn’t working as it should! The individual pays attention to stimuli they should be ignoring.

44
Q

What are the cognitive-behavioural vulnerabilities of OCD?

A
  • How thoughts are interpreted –> Drives OCD
  • People have rigid, moralistic judgments of their thoughts, deeming their thoughts as unacceptable
  • Intolerance of uncertainty and doubt, generating distress
  • Unrealistic belief that they have a personal responsibility for events that occur

As such, the compulsions become negative reinforcers!

45
Q

Emotion is __________.

A

Useful!

46
Q

What did Clark and Teasdale’s study of memory associations conclude?

A

-We tend to remember things that are consistent with our current state = State-dependent memory

47
Q

What behavioural and cognitive changes accompany depression?

A

Increased recall of negative information
Inactivity, lack of motivation
The expectation of negative outcomes

48
Q

Depression is ________/

A

Widespread! More than 350M people suffer from depression worldwide.

49
Q

What are the gender differences in depression?

A

Women are more susceptible (2x more vulnerable);

Women may experience situations that may feed into depression.

50
Q

Most major depressive episodes ___________.

A

Self-terminate! They return to normal without professional help.

51
Q

What precedes depression?

A

Stressful events related to work, marriage, close relationships. Response to past and current loss, trauma.

52
Q

WIth each new generation, depression is striking _____ and affecting ______ people.

A

Earlier; more

53
Q

What is the biological perspective of depressive and bipolar disorders?

A
  • Genetic predispositions: Heritability, these disorders run in family
  • Brain activity
  • Biochemical imbalances: Neurotransmitter systems
    • Norepinephrine: Increases arousal, boosts mood = Scarce during the depression, overabundant during mania
    • Serotonin: Affects mood, hunger, sleep, arousal = Scarce during the depression
  • Nutrition

Stressed individuals are more likely to suffer depression if they carry a variation of the serotonin-controlling gene

54
Q

How can we prevent, reduce depression?

A
  • Adjust neurotransmitters with medication: Increase norepinephrine/serotonin supplies, by blocking their reuptake
  • Increase serotonin levels with repetitive physical exercise
55
Q

What is the social cognitive perspective of depressive and bipolar disorders?

A

This explores the role of thinking and acting.

Sees depression as arising from self-defeating beliefs and negative explanatory styles.
Women’s higher risk of depression may also be related to rumination, a tendency to overthink.

56
Q

What are the styles of causal explanations?

A

Attributions: External vs Internal Cause
Stable vs Unstable Cause
Global Cause vs Specific Cause

Internal, stable and global explanations are most associated with depression!

57
Q

_________ style feeds into depression.

A

Explanatory style!

The problem assumed is STABLE, GLOBAL, INTERNAL. These are the ways you cope with an undesirable event.

58
Q

What is depression’s vicious cycle?

A
  1. Negative stressful events
  2. Pessimistic explanatory style
  3. Hopeless depressed state
  4. Cognitive and behavioural changes: Hamper the way the individual thinks and acts, fueling personal rejection.
59
Q

What is a major depressive disorder?

A

A presence of at least five of the following symptoms, over a two-week period:

  • Depressed mood most of the time
  • Dramatically reduced interest or enjoyment in most activities, most of the time
  • Significant challenges in regulating appetite and weight
  • Significant challenges in regulating sleep
  • Physical agitation, lethargy
  • Feeling listless, with much less energy
  • Feeling worthless; unwarranted guilt
  • Problems in thinking, concentrating, decision-making
  • Thinking repetitively of death and suicide
60
Q

What is a persistent depressive disorder?

A

A mildly depressed mood lasting for two years or more, with at least two of the following symptoms:

  • Difficulty with decision-making, concentration
  • Feeling hopeless
  • Poor self-esteem
  • Reduced energy levels
  • Problems regulating sleep
  • Problems regulating appetite
61
Q

What is bipolar disorder?

A

Characterized by a person alternating between the despondency and lethargy of depression, and a state of extreme euphoria, excitement, physical energy, wild optimism, rapid thoughts and speech (mania)

62
Q

What is the former name for bipolar disorder?

A

Manic-depressive disorder

63
Q

What is the ‘depressed mood’ aspect of bipolar disorder?

A

Feeling down:

  • Exaggerated pessimism
  • Social withdrawal
  • Lack of felt pleasure
  • Inactivity, lack of initiative
  • Difficulty focusing
  • Fatigue, excessive desire to sleep
64
Q

What is the ‘mania’ aspect of bipolar disorder?

A
  • Exaggerated optimism
  • Hypersociality and sexuality
  • Delight in everything
  • Impulsivity, overactivity
  • Racing thoughts, the mind won’t settle down
  • Little desire to sleep
65
Q

What is schizophrenia?

A

“Split mind”: The mind is split from reality, a splinter of functions governing thinking, perception, personality, memory, emotions.

A split from one’s own thoughts so that they appear as hallucinations.

66
Q

What is psychosis?

A

A mental split from reality and rationality.

67
Q

What are the two types of symptoms of schizophrenia?

A

Positive symptoms: The presence of inappropriate behaviours

  • Hallucinations
  • Disorganized, delusional talking

Negative symptoms: Absence of normally found behaviours
-Toneless voice
-Expressionless faces
=Mute, rigid bodies

68
Q

What are the symptoms of schizophrenia?

A

DISORGANIZED THINKING: Expressing fragmented and bizarre thoughts, often marked by DELUSIONS - an odd belief that does not match reality

**Breakdown of selective attention: Every stimuli, memory, idea comes at you with the same intensity.

DISTURBED PERCEPTIONS: Experiencing hallucinations, in seeing, feeling, tasting, smelling unpresent things

DIMINISHED AND INAPPROPRIATE EMOTIONS: Exhibiting unexplainable laughter, tears, rage, lacking any emotional expression when some might be expected

**Impaired Theory of Mind: Difficulty understanding others’ mental states

69
Q

How does schizophrenia develop?

A

Prevalence? It appears in all cultures, affecting men and women. It can be more severe for men.

Course (Development over time)? Typically begins in adolescence.

Prognosis (What kind of outcome can we eventually expect)?

  • ACUTE schizophrenia: Symptoms start suddenly, and are more likely to subside = Higher rates of recovery
  • CHRONIC schizophrenia: Symptoms emerge gradually, with poorer prospects for full recovery.
70
Q

What are the differences between chronic and acute schizophrenia?

A

Chronic/Process:

  • Slow to develop
  • Poor recovery
  • Display of negative symptoms

Acute/Reactive:

  • Rapid to develop
  • Better recovery
  • Display of positive symptoms
71
Q

Where is schizophrenia manifested?

A

It is a disease of the mind, manifesting itself in the brain!

72
Q

Brain difference in schizophrenia: Dopamine overactivity

A

Excess of receptors for dopamine.

High levels = Intensified brain signals, creating positive symptoms –> Hallucinations, paranoia

May underlie patients’ overreactions to irrelevant external and internal stimuli

**We need to try to bring down these dopamine levels!

73
Q

Brain difference in schizophrenia: Brain activity

A

In the frontal lobe: Reasoning, planning, problem solving = Low brain activity, less synchronization of neural firings

In the thalamus: Filtering incoming sensory signals, transmitting them to the cortex = High activity

In the amygdala: Fear-processing center, which acts up in psychosis

PSYC 100A (7 decks)

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