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Psych Disorders > Lecture 9 - Madness > Flashcards

Lecture 9 - Madness Flashcards

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1
Q

Outline prejoratives

A

Describing someone who is not-healthy minded has been a phenomena for a long time
- for instance, words like lunatyke has been seen as far back as 1290AD

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2
Q

What’s the difference between mental disorders and learning disabilities

A
  1. Mental Disorders
    - disordered thoughts and feelings
    - usually acquired
  2. Learning Disabilities
    - Slow/ limited learning, e.g. poor memory
    - Can also cause some affective/ personality issues
    - Incidences of mental disorders are just as prevelant in this population as wider population
    - Some organic causes to them
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3
Q

What did Emil Kraeplin do?

A

Introduced us the language of the medial model

  • He said we should think about mental disorders the same way as physical disorders
  • E.g. if someone came into your clinic, said i have a rash, you wouldn’t immediately diagnose with Measles, you would look at what else is going, such as temperature
  • He said that we need to look at constellations of symptoms before diagnosing, these became known as syndromes
  • He argued we should do the same thing with Psychiatry and mental illness - look at multiple symptoms before concluding
  • however, he recognised that the underlying cause may not be that obvious
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4
Q

Outline what is meant by a syndrome

A

Kraeplin came up with this
- A syndrome = a pattern of multiple symptoms all with an underlying cause

For instance: exceptional thirst + dry mouth + frequent urination etc = Indicates Type 1 diabetes, no one symptom on their own indicates this.
- Underlying cause = insulin deficiency

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5
Q

What is the principle of the medical model?

A

The principle of the medical model is that we should look at x, y and z = this indicates a syndrome
- with an underlying cause - e.g. type 1 diabetes

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6
Q

What are the 2 Diagnostic Manuals and who made them

A
  1. International Classifications of Disease - World Health Organisation - more commonly used in Europe and rest of world
  2. Diagnostic and Statistical Manual - American Psychiatric Association - used in USA
    - currently on DSM 5 (2014)
    - lots of changes throughout the 20 and 21 - has the brain’s physiology changed very much in this time? Can question?
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7
Q

What were the changes made to the DSM 5?

A
  1. Some OLD conditions have been REMOVED
    - e.g. Sexual Aversion Disorder
    - Aspberger’s Syndrome - is now a part of ASD
  2. Some NEW Conditions have been ADDED
    - 15 new conditions have been added
    •Hoarding Disorder
    •Binge eating Disorder (now its own classifcation)
    •PTSD and OCD now their own things, not classified as an anxiety disorder
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8
Q

Outline Positive and negative symptoms of Sz

A
  1. Positive
    - Hallucinations
    - Disordered Thought
    - Delusions
  2. Negative
    - low affect
    - lethargy
    - Withdrawal
    - might get worse with medication
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9
Q

What is the difference between hallucinations and delusions?

A

Hallucinations are sensory/perceptual experiences that are not real
- seeing, hearing things even smelling things

Delusions - fixed and false beliefs
- If you have delusions you are delusive
- common ones include:
• Grandiosity
• Persecution
•aliens have abducted me and my body is being controlled
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10
Q

What is the difference between incidence and prevelance

A
  1. Incidence = Frequency of onsets per year
    - If you are going to get it what age is most likely
  2. Prevelance = how many are living with it at that given time
P=  how likely will you get it
I = when are you most likely to get it if so
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11
Q

Outline Incidence of Schizophrenia - age is most likely?

A

Onset risk peaks in early 20s

- common at universities as lots of people of this age are there

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12
Q

Outline prevelance of Sz

A

4-5 per 1000
- 1 in 100 chance in your lifetime

In Uk: c250,000
- more common for BAME (Black, asion, Minority ethnic)

Worldwide: 0.25 per 100 with it

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13
Q

What are the 2 biological theories behind Sz?

A
  1. Genetics - inheriting predisposition

2. Neural - NT disfunction- problem at synapse

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14
Q

What is the genetic evidence for Sz

**

A
  1. If you have a sibling with Sz:
    - .10 probability. Much more likely compared to stranger, due to 50% of shared genes
  2. If you have one parent with Sz
    - .15
  3. If you have 2 parents with Sz
    - .45 - because it is 100% of your gene pool
  4. Dz twins
    - .20 - more likely than just a sibling
  5. Mz twins
    - .40-.50 - more likely than parents
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15
Q

What is evidence against genetic factors (3 things)

A
  1. No one has been able to identify a single Sz gene - you have an eye colour gene and a red hair gene, but no one has found a Sz gene
  2. If it is caused by genetics, why arent Mz twins at 100?
    - clearly something else influences
  3. Diagnoses between ethnicities is highly variables
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16
Q

Outline evidence for neuronall Causes for Sz?

- DA Hypothesis

A

Not lesions/ atrophy - this is a matter of Neuronal pathways and mechanisms

Dopamine Hypothesis in Sz

  • argues that those with symptoms of Sz have TOO MUCH DOPAMINE - EXCESS DA - something has caused this
  • either because they are producing too much, or it is just bouncing back and forth

SOLUTION: Block receptors on the post-synaptic dendrite - prevent Dopamine from being received

E.g. using the drug: Chlopromazine

17
Q

What are the evaluations for the Neural explanation (DA) for Sz
*****

A

Evidence that DA system IS involved in Sz
√ - Increasing DA symptoms, i.e. via Amphetamines, causing Sz symptoms
√ - Scans of Sz patients show high active DA pathways
√ - Inhibiting DA via these drugs relieves these symptoms

Evidence that DA is NOT involved in Sz
X - Amphetamines do loads of other stuff, so can’t pinpoint them to DA
X - Pathways are not exclusive to DA
X - Drugs do not have an immediate effect, they take weeks - might be something else going on here
X - Other drugs that are not effective on DA can still relieve symptoms

18
Q

Outline social factors as an evaluation of genetic factors for Sz

A

Hard to isolate genetics from social factors like upbringing
- might contribute a psychological cause to this

There may be a genetic or a neuronal cause to this, but no area (lesion) or gene has been identified, so maybe there is more of a psychological/ emotional cause we need to find

Sz might actually just be a constellation of multiple other problems - like emotional issues or behavioural problems etc

19
Q

When would a Sz or a depression person be sectioned

A

If you are a danger to yourselve or to others

20
Q

What are 6 symptoms of depression

A
  1. Dejected mood
  2. lethargy
  3. Loss of appetite
  4. Weakness
  5. Early-morning waking
  6. Suicidal thoughts
  • Unclear what the underlying cause of all of these area
21
Q

Outline the incidence and prevelance of depression

A

Incidence:
- 10-15 in 100 chance over lifetime

Prevelance

  • 500,000 males, 750,000 females with depression in UK
  • World wide: 1.7 males, 2.5 females per 100
22
Q

What are the 2 Biological theories associated with depression?

A
  1. Neuronal Transmission Problems

2. Genetic predisposition

23
Q

Outline Neuronal transmission problems as a biological theory associated with depression

A

Lots of NT’s are associated with depression: DA, Serotonin, Acetylcholine, Noradrenaline

SEROTONIN DEFICIENCY (most popular model)
- opposite to Sz as you have too much of something (DA) in this model, you dont have enough

Medical model suggests it would be neurons here as the underlying cause - Serotonin in particular

24
Q

Outline genetic predispositions as a theory behind depression

A

There is strong evidence here for Bipolar, but not much for other ones

25
Q

Outline SSRI’s

A

Works at the synapse

  1. Keeps the little Serotonin molecules in play for longer, as depressives dont have much
  2. Ups the production of Serotonin

Common SSRI’s:

  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
26
Q

What are the fors and againsts of SSRI’s?

A

√ - THEY WORK - gives relief to symptoms

X - not immediate relief - takes a while, something else might be implicated
X - doesnt work for all symptoms
X - Side effects - Prozac can cause suicide
X - Dependency - easily addicted to them

27
Q

What are the 3 non-medical models for mental illness?

A
  1. Psychoanalytic Theory
  2. Cognitive/ Learning Maladaption
  3. Social Construction
28
Q

Outline the Psychoanalytic theory as a non-medical model of mental illness
- the other two are Social construction and Cognitive/ learning maladptation

A

This theory argues that signs and symptoms of something are indicative of their background causes
- they aren’t mad/ behaving strangely for no reason - it was caused, perhaps something from childhood

•Drug therapies will only resolve superficial issues - what we need to do is target underlying causes/ deep-rooted issues
- Deep-seated unconscious conflicts

Nothing in DSM talks about the persons life psychologically

29
Q

Outline Cognitive/ learning maladaption as a non-medical model of mental illness

A

Argues: Mental illness is caused by maladaptive patterns of thinking - you’ve developed certain biases in the way you think that aren’t seen as typical in this world

This is where Cognitive Behavioural Therapy comes in

  • Change your thoughts, and this will change your feelings
  • Stresses personal agency

Successful in treating anxiety and phobias

30
Q

Outline Social Construction as a non-medical model

A

Social construction refers to the way in which society views stuff like mental illnesses

There have been lots of changes made to the DSM, but our brains havent changed in 50 years
- could be used as evidence to suggests that social constructs and Zeitgeists are influential in the diagnosis of mental health

FOR INSTANCE HOMOSEXUALITY WAS DROPPED FROM DSM IN 1974
ADHD DIDNT APPEAR UNTIL 1987 - before which you were just a bit hyper

In current DSM 5

  • Hoarding disorder has been added - previously might have just been seen as eccentric
  • Avoidant PD - might have just been seen as shy

Clearly The way society views things influences how we see them as mental illnesses

Psych Disorders (10 decks)

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