PSY1022 WEEK 5 ABNORM 1

Question 1

DEMONIC MODEL

Answer 1

View of mental illness in which odd behaviour, hearing voices, or talking to oneself was attributed to evil spirits infesting the body.

Question 2

MEDICAL MODEL

Answer 2

View of mental illness as due to a physical disorder requiring treatment.

Question 3

ASYLUM

Answer 3

Institution for people with mental illnesses created in the 15th century.
“Bedlam” comes from Bethlehem, the name of an insane asylum in London in the Middle Ages.

Question 4

MORAL TREATMENT

Answer 4

Approach to mental illness calling for dignity, kindness, and respect for those with mental illness. 
Dorothea Dix (America) and Phillippe Pinel (France)

Question 5

DE INSTITUTIONALIZATION

Answer 5

1960s and 1970s government policy that focused on releasing hospital psychiatric patients into the community and closing mental hospitals.
Both good and bad. Many people then had no care at all. Homeless.

Question 6

PSYCHOPATHOLOGY

Answer 6

Mental illness.

Often studied using a failure analysis approach. Examining breakdowns to understand healthy functioning.

Question 7

MENTAL DISORDER CRITERIA (WHAT IS ABNORMAL?)

Answer 7

• Statistical rarity - but not all uncommon things are bad and not all mental illness is uncommon.
• Subjective distress - often bad, but sometimes feel good (like manic phase of bipolar)
• Impairment - Most interfere with people’s ability to function. But other things that aren’t mental illness also interfere (like laziness)
• Societal disapproval - can be a factor. But not everything we disapprove of is a mental disorder (like racism)
• Biological dysfunction - some yes (schizophrenia), some no (phobias)

Question 8

FAMILY RESEMBLANCE VIEW

Answer 8

According to this view mental disorders don’t all have one thing in common. They are similar, but there are differences (like in a family).

Question 9

CHLORPROMAZINE

Answer 9

One of the first drugs used in mental hospitals. Provided some relief from symptoms of schizophrenia and other disorders marked by a loss of contact with reality.

Question 10

PSYCHIATRIC DIAGNOSES ACROSS CULTURES

Answer 10

Certain conditions are culture bound, or specific to one or more societies.
Koro - parts of Asia. Patients believe their penis is retreating into their abdomen.
Amok - parts of Asia and Africa. Intense sadness followed by uncontrolled behaivour and unprovoked attacks on people and animals. “Running amok”

Question 11

CULTURAL UNIVERSALITY

Answer 11

Many mental disorders, especially those that are severe, appear to exist in most and perhaps all cultures.

Question 12

MISCONCEPTION: PSYCHIATRIC DIAGNOSIS IS JUST PIGEONHOLING.

Answer 12

We deprive people of their uniqueness, and imply that all people in the same category are alike in all important respects.
No - a diagnosis implies they are alike in at least one important respect. People are very different. Can also make communication easier, especially between mental health professionals.

Question 13

MISCONCEPTION: PSYCHIATRIC DIAGNOSES ARE UNRELIABLE.

Answer 13

Interrater reliability is usually high. But lower for personality disorders.

Question 14

MISCONCEPTION: PSYCHIATRIC DIAGNOSES ARE INVALID

Answer 14

Don’t provide us with any new information. Just labels for behaviour we don’t like.
No - can predict behaviour and performance. Though some pop psychology labels are just that.

Question 15

MISCONCEPTION: PSYCHIATRIC DIAGNOSES STIGMATISE PEOPLE

Answer 15

Psychiatric diagnoses exert powerful negative effects on people’s perceptions and behaviour.
No - there is some stigma, but the effect of the labels only lasts so long.

Question 16

LABELING THEORISTS

Answer 16

Scholars who argue that psychiatric diagnoses exert powerful negative effects on people’s perceptions and behaviours.

Question 17

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM)

Answer 17

Diagnostic system containing the American Psychiatric Association (APA) criteria for mental disorders.
Book says DSM-IV (2000), but DSM-V is out now.
Problems: comorbitity, categorical model.
Biosocialpyscho approach.
Designed to improve communication. 1844.
DSM-IV 17 major categories, 200 subcategories. DSM-V has 21.

Question 18

PREVALENCE

Answer 18

Percentage of people within a population who have a specific mental disorder.

Question 19

AXIS

Answer 19

Dimension of functioning.
- life stressors, associated mental conditions, etc.
1 - major disorders (depression, etc.) Diagnosis of a category.
2- personality disorders and mental retardation
3 - medical conditions
4 - pyschosocial stressors
5 - global assessment (referral, hospitalisation, etc)
In DSM-V 1 to 3 are combined.

Question 20

COMORBIDITY

Answer 20

Co-occurance of two or more diagnoses within the same person (eg. depression and anxiety)

Question 21

CATEGORICAL MODEL

Answer 21

Model in which a mental disorder differs from normal functioning in kind rather than degree. Eg. someone has major depression, or they don’t.

Question 22

DIMENSIONAL MODEL

Answer 22

Model in which a mental disorder differs from normal functioning in degree rather than kind. People fall on a continuum. Eg. different degrees of depression.

Question 23

MENTAL ILLNESS AND VIOLENCE

Answer 23

Myth that people with mental illness are at a greatly heightened risk of violence.
Fact is that overwhelming majority are not physically aggressive.
But people with substance abuse ARE.

Question 24

INSANITY DEFENSE

Answer 24

Legal defense proposing that people shouldn’t be held legally responsible for their actions if they weren’t of “sound mind” when committing them.

Question 25

INVOLUNTARY COMMITMENT

Answer 25

Procedure of placing some people with mental illnesses in a psychiatric hospital or other facility based on their potential danger to themselves or others, or their inability to care for themselves.

Question 26

MAJOR DEPRESSIVE EPISODE

Answer 26

State in which a person experiences a lingering depressed mood or diminished interest in pleasurable activities, along with symptoms that include weight loss and sleep difficulties. Retarded or agitated motor function. Self blame.
2 weeks.

Question 27

MAJOR DEPRESSIVE DISORDER

Answer 27

Chronic or recurrent state in which a person experiences a lingering depressed mood or diminished interest in pleasurable activities, along with symptoms that include weight loss and sleep difficulties.
16% of people experience this. Women are twice as likely as men. Recurrent. Average person with major depression has 5 to 6 episodes in a lifetime.
Unipolar.

Question 28

MANIC EPISODE

Answer 28

Markedly inflated self-esteem or grandiosity, greatly decreased need for sleep, much more talkative than usual, racing thoughts, distractability, increased activity level or agitation,
and excessive involvement in pleasurable activities that can cause problems (like reckless driving or excessive spending).
Positive and negative symptoms.

Question 29

BIPOLAR DISORDER I

Answer 29

Presence of one or more manic episodes. Formerly called manic-depressive disorder.
Equal in men and women.
90% of people who have had one manic episode will have another.
More than half the time a major depressive episode preceeds a manic episode.
Most genetically influenced of all mental disorders. Heritability may be as high as 85%.
Stress can trigger a switch between states. Some suggestion of biological link. Sometimes triggered by positive events.

Question 30

BIPOLAR DISORDER II

Answer 30

Patients must experience at least one episode of major depression and one hypomanic episode.

Question 31

DYSTHYMIC DISORDER

Answer 31

Low-level depression of at least two years’ duration; feelings of inadequacy, sadness, low energy, poor appetite, decreased pleasure and productivity, and hopelessness.

Question 32

HYPOMANIC EPISODE

Answer 32

A less intense and disruptive version of a manic episode; feelings of elation, grouchiness or irritability, distractability, and talkativeness.

Question 33

CYCLOTHYMIC DISORDER

Answer 33

Moods alternate between numerous periods of hypomanic symptoms and numerous periods of depressive symptoms. Cycles up and down. Increases the risk of developing bipolar disorder.

Question 34

POSTPARTUM DEPRESSION

Answer 34

A depressive episode that occurs within a month after childbirth. As many as 15% of women develop postpartum depression. A much more serious condition is post partum psychosis. One or two in 1000. Hallucinations to kill the infant, or delusions it is possessed by an evil spirit.

Question 35

SEASONAL AFFECTIVE DISORDER

Answer 35

Depressive episodes that display a seasonal pattern, most commonly beginning in autumn or winter and improving in spring. There must be two consecutive years in which the episode appears on a seasonal basis. Symptoms often include weight gain, lack of energy, carbohydrate craving, and excessive sleep.

Question 36

COGNITIVE MODEL OF DEPRESSION

Answer 36

Theory that depression is caused by negative beliefs and expectations.
Aaron Beck.

Question 37

BEHAVIORAL MODEL OF DEPRESSION

Answer 37

Proposes that depression results from a low rate of response-contingent positive reinforcement.
Cognitive triad: negative views of oneself, the world, and the future. Negative schemas. Originate in early experiences of loss, failure, and rejection.
Cognitive distortions.

Question 38

DEPRESSIVE REALISM

Answer 38

Individuals with mild depression actually have a more accurate view of circumstances.
But depressed people are also less attentive to reality.

Question 39

LEARNED HELPLESSNESS

Answer 39

Tendency to feel helpless in the face of events we can’t control.
Martin Seligman, experiments with dogs.
People with depression attribute failure to internal factors, and success to external factors.

Question 40

BIOLOGY IN DEPRESSION?

Answer 40

Twin studies suggest genes exert a moderate effect on the risk of major depression.
Stress-sensitive gene? More research needed.
Low level of norepinephrine and diminshed neurogenesis.
Many patients have problems with the brain’s reward and stress-response systems. Decreased dopamine.

Question 41

SUICIDE

Answer 41

Major depression and bipolar disorder at higher risk of suicide than most other disorders.
Bipolar 15 times more likely than general population.
Also some anxiety disorders and substance abuse.
People are only acutely suicidal for a short window of time, so intervention is critical.
12 to 13 people out of 100, 000 commit suicide.
3 times as many man as women.

Question 42

MAJOR SUICIDE RISK FACTORS

Answer 42

Depression
Hopelessness
Substance abuse
Schizophrenia
Homosexuality (social stigma)
Unemployment
Chronic, painful, or disfiguring illness
Recent loss of a loved one (death or divorce)
Family history of suicide
Personality disorders
Anxiety disorders
Old age, especially in men
Recent discharge from a hospital.

Question 43

SCHIZOPHRENIA

Answer 43

Severe disorder of thought and emotion associated with a loss of contact with reality.
NOT always multiple personalities, rather one personality that is shattered.
Delusions. Hallucinations, usually auditory. Disorganised speech.
Twice as likely to relapse if relatives display highly expressed emotion (criticism, etc).

Question 44

DELUSIONS

Answer 44

Strongly held, fixed belief that has no basis in reality. Commonly involve the theme of persecution.

Question 45

PSYCHOTIC SYMPTOM

Answer 45

Psychological problem reflecting serious distortions in reality.

Question 46

HALLUCINATIONS

Answer 46

Sensory perception that occurs in the absence of an external stimulus. Can be auditory, olfactory, gustatory, tactile, or visual.
Visual hallucinations, especially in the absence of auditory hallucinations, are usually signs of organic (medical) disorder or substance abuse.

Question 47

DISORGANISED SPEECH

Answer 47

Symptom of schizophrenia. Results from thought disorder. Usual associations between two words, such as mother-child, are weakened or highly unusual in schizophrenics.
Can become so bad it is called “word salad”

Question 48

PARANOID TYPE OF SCHIZOPHRENIA

Answer 48

Prominent delusions or auditory hallucinations. Generally persecutory or grandiose, but often combined and organised around a central theme.
Ability to think, reason, and express feelings (outside of the delusion) may not be impaired.
Function at a higher level than other types of schizophrenia.

Question 49

DISORGANISED TYPE OF SCHIZOPHRENIA

Answer 49

Disorganised speech and behaviour, as well as flat or inappropriate affect, such as unpredictable giggling. Delusions and hallucinations, if present, are not well organised into a single theme and are often short-lived.

Question 50

CATATONIC TYPE OF SCHIZOPHRENIA

Answer 50

One or more catatonic symptoms. Can harm themselves or others when they are in a stupor and are immobile or when they are extremely excited and agitated. Malnutrition, exhaustion, and self inflicted injuries are possible.

Question 51

CATATONIC SYMPTOM

Answer 51

Motor problem, including extreme resistance to complying with simple suggestions, holding the body in bizarre or rigid postures, or curling up in a fetal position.

Question 52

BIOLOGICAL CAUSES OF SCHIZOPHRENIA

Answer 52

• Brain abnormalities. Typically central ventricles are enlarged. Suggests brain deterioration. Grey matter loss.
• Increased size of sulci.
• Decreased size of temporal lobes, activation of the amygdala and hippocampus, basal ganglia, and symmetry of the brain’s hemispheres.
• Hypofrontality. Front lobes less active when engaged in demanding mental tasks.
• Dopamine pathways.
• Genetic links.

Question 53

DIATHESIS-STRESS MODEL

Answer 53

Perspective proposing that mental disorders are a joint product of genetic vulnerability, called a diathesis, and stressors that trigger this vulnerability.
Idea that 10% of people are predisposed to schizophrenia. Have schizotypal personality disorder.
- social withdrawal, thought and movement abnormalities, learning and memory deficits, elevated neuroticism, temporal lobe abnormalities, impaired attention, eye movement disturbances when tracking moving objects.
But most people with a vulnerability do not develop schizophrenia.

Question 54

POSITIVE SYMPTOMS OF SCHIZOPHRENIA

Answer 54

Symptoms ADDED to what normal people experience. Delusions, hallucinations, disordered thoughts and speech, etc.

Question 55

NEGATIVE SYMPTOMS OF SCHIZOPHRENIA

Answer 55

Symptoms SUBTRACTED from what normal people experience. Deficits of emotional or thought responses, lack of motivation, inability to experience pleasure, etc.

Question 56

SYMPTOM

Answer 56

Any characteristic of a person’s actions, thoughts, or feelings that could be a potential indicator of a mental disorder.

Question 57

SYNDROME

Answer 57

A constellation of interrelated symptoms manifested by a given individual.

• must involve distress or impaired functioning
• the source must be located within the person
• can’t be purely explained as an effect of poverty, prejudice, or social forces.

Question 58

MULTIPLE CAUSATION

Answer 58

Predisposing causes
Precipitating causes
Maintaining causes

Question 59

PREDISPOSING CAUSES

Answer 59

Those well in place before the onset of the disorder that make the person susceptible to the disorder.

Question 60

PRECIPITATING CAUSES

Answer 60

Immediate events in one’s life that bring on the disorder.

Question 61

MAINTAINING CAUSES

Answer 61

The consequences of a disorder that help to keep it going once it begins.

Question 62

MOOD

Answer 62

A prolonged state that alters a person’s thoughts and behaviours.
Two main categories of mood disorders in DSM-IV:
- major depressive
- bi polar
DSM-V has many more.

Question 63

TWO MAJOR DISTINCTIONS BETWEEN DEPRESSION AND ANXIETY

Answer 63

• Anxiety tends to be coupled with physiological arousal and hyper vigilance.
• Depression tends to entail an absence of pleasure and sense of hopelessness.