L12: Disorders & Treatment Flashcards
Deviance
Behaviours, thoughts, and feelings that are not in line with normal or usually accepted standards
Definition of disorder
Syndromes, or clusters of symptoms, that tend to occur simultaneously. Comprised of deviance, distress, dysfunction, and danger.
Dysfunction
Behaviours, thoughts, and feelings that are disruptive to one’s regular routine interference with day-to-day functioning
Danger
Behaviours, thoughts, and feelings that may lead to harm or injury to self or others
Biopsychosocial Model
Interactions of a person’s biological makeup, psychological experiences and social environment determine their risk for a psychological disorder
DSM-5
Diagnostic & Statistical Manual of Mental Disorders (5th edition - 2013)
- American manual that provides a list of symptoms, with a decision rule on the number of symptoms present for diagnosis
- Acknowledges the biopsychosocial approach
- Organized with a lifetime development scheme
Problems with classification systems
- subjective
- fosters overdiagnosis
- ignores stigmatization
- creates illusion of objectivity
- over-emphasis on separation between disorders
Stigma
Disapproval, poor treatment or isolation due to being different. Fueled by lack of information, fear, and discomfort
Anxiety Disorders
Characterized by excessive fear and/or worrying
Includes panic disorder, phobias, social anxiety disorder, generalized anxiety disorder
Panic disorder
- unexpected panic attacks
- followed by worry about additional attacks and avoidance
- sudden onset of symptoms that reaches a peak within 5-10 mins, then resolves itself quickly
- if persists longer, anxiety attack
Phobias
- unrealistic fears of a specific situation
- avoidance
Social Anxiety Disorder
- worry about negative evaluation in social situations
- fears of speaking in public, eating in public, having to perform for an audience
Generalized Anxiety Disorder
- Continuous chronic anxiety and worry that is hard to control and interferes with daily functioning
- Believe in the benefits of worry
OCD
characterized by obsessions and compulsions, although one can be present without the other
Obsessions
recurrent, unwished for thoughts or images (internal)
Compulsions
Repetitions, ritualized behaviours, a person feels unable to control (external)
PTSD
- intrusive symptoms
- avoidance of internal feelings & external reminders
- negative alterations in mood and cognitions
- alterations in arousal and reactivity
- minority of people who experience a traumatic experience will develop PTSD
PTSD risk factors
- general vulnerability/ resistance
- historical of psychological problems
- lack of social & cognitive resources
Depressive Disorders
characterized by persistent depressed mood and/or lack of interest/pleasure in activities
Vulnerability Stress Model of Depression
- interactions between individual and vulnerabilities and stress experiences
Cognitive Habits in Depression
Rumination: focusing repetitively on the symptoms of distress, possible causes, and consequences of distress
Internal & Global Attribution: Blaming negative events on oneself and believing they will affect everything in one’s life
Attribution Theory of Depression
People with depression experience internal, stable global styles: Blaming negative events on oneself and believing they will affect everything in one’s life
Schizophrenia
characterized by delusions, hallucinations, disorganized thinking, avolition (loss of motivation to take care of oneself), flat affect, and alogia (reduction in speech).
Positive psychotic symptoms
new symptoms not present before the disorder
Schizophrenia possible causes
- abnormalities in the thalamus
- deficits in Broca/ Wernickle’s areas
- enlarged ventricles
- neurotransmitter abnormalities (dopamine & serotonin)
Bipolar disorder
- characterized by mania/ hypomania
- abnormally elated or irritable mood
- inflated self-esteem
- racing thoughts, distractibility
- divided into bipolar l and ll
Negative psychotic symptoms
behaviours lost after the disorder
Psychotherapy
process where a professionally-trained therapist uses techniques from psychological principles to relieve another person’s psychological distress and promote growth
Pharmacotherapy
treating illness with medication. can go hand in hand with psychotherapy
evidence-based approach
- explicit use of the best available research evidence to inform each stage of clinical decision- making
- studied using randomized controlled trials (RCTs)
Randomized control trials (RCTs)
- Studies to determine how beneficial a type of therapy is
- 3 elements:
- Homogenous population (little variation)
- exclusion criteria
- only one intervention at a time
Issues with RCTs
- waitlist control
- highly controlled treatment
- patients are uncomplicated
cognitive behavioural therapy (CBT)
changing emotions through thoughts and behaviour. employs cognitive and behavioural techniques. 3 different waves
Cognitive Distortions
polarized thinking mental filtering overgeneralization jumping to conclusions castrophizing personalization blaming labelling always being right should statemnts emotional reasoning control fallacies
polarized thinking
- when one has black and white thinking patterns/ all or nothing attitude
mental filtering
consists of two types of distortions that occur when one focuses solely on the negative aspects of an experience
overgeneralization
occurs when a person focuses on a single event that occurred and makes a conclusion based on this single piece of negative evidence
jumping to conclusions
making assumptions that are not based on any actual evidence
castrophizing
the magnitude of an event is exaggerated or diminished
personalization
individual takes this personally, causing a direct and personal reaction to everything others say and do, even if it was unrelated to them
blaming
person directs blame externally for their problems
labelling
an extreme form of overgeneralization, when one assigns judgment to oneself and others based on one negative occurrence or incident
always being right
a person internalizes their opinions as facts and puts others on trial to prove that their own opinions are the correct ones
should statements
generalizations of things that a person, including oneself, should. must or shouldn’t do
emotional reasoning
one’s emotion is accepted as a fact and all logical reasoning is blocked out
control fallacies
cognitive distortion defined by external and internal control fallacies (assuming an inaccurate amount of control)
Cognitive Restructuring
- Restructuring thoughts by providing evidence for and against and replacing original thoughts with an alternative thought
- CBT’s C component
CBT’s B component
Activation (for depression):
increase engagement in adaptive activities, while decreasing engagement in activities that maintain symptoms
Exposure (for anxiety & OCD)
real life exposure to avoid engaging in safety behaviour
Psychopathology
Individual’s efforts to escape unpleasant feelings
ACT
- acceptance and commitment therapy
- holding negative thoughts and feelings in mind with acceptance, without clutching onto thoughts
Critique of CBT
- too mechanistic
- too focused on symptom change
Critique of ACT
- it’s the same
- restructuring is incompatible with thought suppression
Common factors b/n all types of therapies
- client characteristics: + expectancies
- treatment structure: techniques to explore the inner world. adheres to theory
- therapist qualities: warm & cultivates hope
- relationship elements: development of an alliance
- change processes: acquisition & practice of new behaviours through therapeutic rational
Therapeutic Alliance
- Bordin: this shall be embedded in all psychotherapies
1) consensus on tasks
2) agreement on goals
3) bond b/n client & therapist
Arguments for specific therapies
Certain therapists are better than others for particular disorders.
OCD: CBT or ACT
Panic Disorder: CBT
SAD: CBT
GAD: CBT
Eating Disorders: CBT & family-based therapy
PTSD: cognitive reprocessing theory
Normal vs. Abnormal
Difficult to define.
In psych: Failure of adaptation = abnormal
Distress
Behaviours, thoughts, and feelings that are upsetting and cause pain, suffering and/or sorrow
4 Ds
Deviance, Distress, Dysfunction, Dangerous
Epigenetics
how environmental factors can can affect gene expression
Agoraphobia
Fear of using public transportation, being outside of the home alone and escape not being possible
Bipolar l vs. Bipolar ll
Bipolar l:
- Depressive episode not required
- Extremely high energy levels
- Manic episodes lasting multiple weeks/ months
Bipolar ll:
- Depressive episode required
- Higher energy levels than normal
- Hypomanic episodes typically lasting one week
Possible Schizophrenia Causes
- abnormalities in the thalamus
- deficits in Broca/Wernickle’s areas (involved in language)
- enlarged ventricles
- neurotransmitter abnormalities
Specific vs. Global Attribution Styles
Specific: this negative event will affect one aspect of my life
Global: this negative event with affect everything in my life
Psychodynamic Therapy
analyzing unconscious processes through different methods. the goal is to create harmony b/n the 3 components (id, superego & ego)
included the analysis of resistance, free association, interpretation, and transference
Person-centred/ Humanistic Therapy
- Goal of therapy: increase the insight of the patient
- Eliminates the hierarchy b/n the therapist & client
- 3 key ideas:
- unconditional positive regard
- empathy
- congruence
3 waves of CBT
1) behaviour therapy: behaviour modifications based on conditioning
2) CBT: identify & challenge dysfunctional cognitions
3) ACT: metacognitive shifts
Clinical formation
looks at the nature of the client’s issues and create a hypothesis for further analysis
Aspects of ACT
- acceptance
- cognitive defusion
- self as context
- being present
- values
- committed action
Types of Therapies
- individual therapy
- group therapy
- couples therapy
- family therapy
- self-help
Resistance
Avoiding certain ideas. Component of psychodynamic therapy
Behavioural Activation
Governs the general tendency towards approach over avoidance
Systematic Desensitization
Periods of relaxation between exposures to feared stimuli
Dodo Bird Effect
all forms of psychological therapy are equally effective
