L12.1 - Disorders

Question 1

Normal vs Abnormal

Answer 1

• Hard to define abnormality
• Psychologists and psychiastrists use specific system to classify abnormality
• Topic of controversy

Question 2

Definition of Disorder

Answer 2

1. Deviance

• Behaviours, thoughts, an feeling that are not in line with the normal or usually accepted standards

2. Distress

• Behaviours, thoughts and feelings that are upsetting and cause pain suffering and sorrow

3. Dysfunction

• Thoughts, behviours & feelings that are disruptive to one’s regular routine or interfere with day-to-day functioning

4. Danger

• Thoughts, behavior, and feelings may lead to harm or injure to self or others

Question 3

Biopsychosocial model

Answer 3

Psychological disorders result from an interaction btw:

• Psychological factors
• Psychological experiences
• Social Env

Question 4

DSM-5

Answer 4

• Diagnostic and statistical manual of mental disorders 5th edition in 2013, revision in 2022
• First published 1952
• Lists symptoms and criteria for disorders
• 247 disorders
• 19 categories

Question 5

DSM Classification (Part 1)

Answer 5

1. Neurodevelopmental disorders
2. Schizophrenia spectrum and other psychotic disorders
3. Bipolar & related disorders
4. Depressive disorders
5. Anxiety disorders
6. OCD & related disorders
7. Trauma and stressor related disorders
8. Dissociative disorders
9. Somatic symptom & related disorders
10. Feeding/eating disorders

Question 6

DSM Classification (Part 2)

Answer 6

11. Elimination disorders
12. Sleep-wake disorders
13. Sexual dysfunctions
14. Gender dysphoria
15. Disruptive, impulse control and conduct disorders
16. Substance and addictive related disorders
17. Neurocognitive disorders
18. Personality Disorders
19. Paraphillic Disorders

Question 7

DSM gives list of symptoms and information about

Answer 7

• Age of onset & course of the disorder (evolution and persistence of symptoms)
• Predisposing and risk factors
• Prevalence rates
• Gender differences
• Cultural considerations for diagnosis
• Differential diagnosis

Question 8

DSM Classification for Major Depressive Disorder

Answer 8

• Presentations are heterogeneous
• Symptoms cause clinically significant distress or impairment in social, occupational & other
  important areas of functioning
• The episode isn’t bc of physiological effects of a substance or other medical condition
• 12 month prevalence

Question 9

DSM Classification - Risk and Prognostic Factors

Answer 9

1. Temperamental

• Neuroticism (negative affectivity) is a risk factor for Major Depressive Disorder

2. Environmental

• Adverse childhood events and stressful life events is a risk factor major depressive disorder

3. Genetic and physiological

• First-degree family members of individuals with Major Depressive Disorder have a risk of the disorder

Question 10

DSM Classification - Differential Diagnosis

Answer 10

• Manic episodes with irritable mood or mixed episodes
• Mood disorder due to another medical condition (ex. consequence of multiple sclerosis)
• Substance/medication-induced depressive or bipolar disorder
• Attention-deficit/hyperactivity disorder (ADHD)

Question 11

Problems with the DSM

Answer 11

• Diagnosis of mental disorders is a subjective process + relies on self-report
• No biomarkers for mental disorders exist
• Overdiagnosis
  -> Consider everyday problems of living as serious mental disorder
• Uses Categorical approach (symptom overlap)

Question 12

Problem with the DSM in terms of Comorbidity

Answer 12

• Does not appropriately account for comorbidity
• Comorbidity is often a rule
• Sequential comorbidity (1 disorder gives rise to the other)

Question 13

Ethical Issues with the DSM

Answer 13

• Gender Identity Disorder renamed to Gender Dysphoria in the DSM-5
• Maintained in the DSM to allow transgender individuals to be financially covered for the services they need
• Subjectivity in the inclusion or exclusion of a condition

Question 14

Stigma & Destigmatization

Answer 14

• Ppl w psychological disorders viewed negatively (sometimes reinforced by media portrayals of ppl with disorders as criminals)
• Therapy stigma causes ethnic diff in seeking therapy
• Person-first language destigmatizes (someone suffering from depression)

Question 15

Stigma and Labels

Answer 15

• Labels can have bad effect on how ppl like clinicians & researchers perceive someone
• Labels prevent consideration of overlap of disorder
• Labels can also provide a measure of relief

Question 16

Stigma and the Law

Answer 16

• Mental health professionals fight the stigma that ppl with psyc disorders are dangerous by emphasizing they aren’t more likely to commit violent acts
• Truth is somewhere in the middle (modest increase)
• Schizophrenia and substance abuse = most violent
• Law: Not guilty by reason of insanity

Question 17

Anxiety Disorders

Answer 17

1. Specific Phobia
2. Social Anxiety Disorder

• fear of public speaking, eating in public, performing, negative evaluation (avoidance response)

3. Agoraphobia

• fear of using public transportation, open spaces, standing in line, being in a crowd
• fear of not being able to escape or get help in event of panic
• avoidance of situations

Question 18

Generalized Anxiety Disorder (GAD) & Symptoms

Answer 18

• Excessive anxiety related to a number of events or activities (continuous, passive)
• Pervasive worrying could be cognitive type of avoidance

Symptoms:

• Difficulty concentrating
• Sleep disturbance

NOTE: 2x as common in women

Question 19

Panic Disorder

Answer 19

• Recurring unexpected panic attacks lead to problems (think they r having a heart attack, dying)
• Feelings of unreality, terror, impending doom
• Often accompanied by agoraphobia

Question 20

PTSD

Answer 20

• Immediately numbness or dissociation
• Intrusive symptoms and memories
• Avoidance of external reminders
• Negative alterations in mood and cognitions (exaggerated beliefs about others)
• Altered arousal and reactivity (hyper vigilance, irritability)

Question 21

Risk Factors of PTSD

Answer 21

• Genetic vulnerability
• History of psychological problems
• Tendency to avoid unwanted thoughts
• Lack of social and cognitive resources

Question 22

OCD

Answer 22

• Recurrent unwanted thoughts/images (obsessions)
• Thought-action fusion
• Repetitive ritualized behaviours (compulsions) that person cant control (handwashing, checking the door)
• Magical thinking
• Behavioural/cognitive rigidity related to abnormalities in PREFRONTAL CORTEX
• AMYGDALA also active (fear & threat)

Question 23

Bipolar Disorder

Answer 23

BP 1: at least one manic episode, no major depressive episode required
BP 2: at least one hypomanic episode and one major depressive episode is required

Question 24

Mania

Answer 24

Abnormally elevated/irritable mood accompanied by increased activity or energy:

• Inflate self-esteem
• No sleep
• Psychotic symptoms (sometimes)
• Racing thoughts, distracted
• Increase goal-directed acitvity
• Increased risk-taking
• Increased talkativeness

Question 25

Depressive disorders

Answer 25

Persistant depressed mood/Anhedonia (lack of pleasure/interest) paired with: - Change in sleep and apetite - Change in movement (irritation/slow) - Loss of energy - Problems concentrating - Indecisiveness - Thoughts of death, worthlessness, guilt - Stress or impairment in functioning More common in women due to increased rumination

Question 26

Vulnerability-Stress model of depression

Answer 26

The interactions btw individual vulnerabilities and stressful experiences - Genetic components - Stressful life events - Serotonin studies inconclusive bs findings not well replicated

Question 27

Cognitive vulnerability factors of depression

Answer 27

Attributional theory: negative events attributed to causes that are - Internal/external - Stable/temporary - Global/specific Rumination: focusing repetitively/passively on distress (symptoms, causes, and consequences) Negative Feedback Seeking (NFS), Excessive Reassurance Seeking (ERS)

Question 28

Schizophrenia: Positive Symptoms

Answer 28

Behaviours that were NOT PRESENT prior to beginning of disorder - Delusions - Hallucinations - Disorganized thinking - Abnormal motor behaviours (catatonic behaviour)

Question 29

Schizophrenia: Negative Symptoms

Answer 29

Behaviours that were LOST since onset of disorder - Avolition: Loss of motivation to take care of yourself - Flat or blunted effect - Agolia: reduced speech prodcution - Asociality

Question 30

Origins of Schizophrenia

Answer 30

- Childhood or past trauma - Brain abnormalities -> Enlarged ventricals -> Neurotransmitter abnormalities -> Abnormalities in the thalamus -> Deficiencies in the auditory cortex (auditory hallucinations) -> Hyperactivity of dopamine is subcortical & prefrontal regions

Question 31

Genetic contributions to Schizophrenia

Answer 31

- Genetic predispositions - Prenatal problems or birth complications - Environmental stressors that interact with genetic predisposition

Question 32

Origins of Schizophrenia - Biological contributions

Answer 32

- Enlarged ventricles in the brain (can be seen in identical twins) - Reduction in gray matter density in adoescents with schizophrenia over 5 years ON BRAIN SCAN: - Greatest tissue loss are in red and magenta - Schizophrenic brain = blue