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PSY240 > PSY240 1. Intro > Flashcards

PSY240 1. Intro Flashcards

1
Q

Definitions of “Abnormal”

A
  1. Statistical Definition 2. Personal Distress

3. Personal Dysfunction 4. Violation of Norms

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2
Q

Definitions of “Abnormal”

A
  1. Comparing to avg
  2. Is it causing someone to be upset? Is it causing other people distress?
  3. Does it get in the way of functioning as a productive member of society?
  4. Taking context into consideration. Depending on culture, some acts are acceptable, others are not
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3
Q

Definitions of “Abnormal”

A

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4
Q

Definitions of “Abnormal”

A

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5
Q
  1. Statistical Definition
A

Deviation from average – Is the behaviour rare?
• Problems:
– Not all deviations are abnormal – Where is the cut-off

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6
Q
  1. Statistical Definition
A

Is the response rare?

But not everything rare is not pathological or abnormal
e.g. High IQ, not problematic
at the low end, it becomes problematic
e.g. athleticism
Where is the cutoff between normal and abnormal?
Doesn’t capture every factor of describing abnormality

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7
Q
  1. Statistical Definition
A

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8
Q
  1. Statistical Definition
A

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9
Q
  1. Personal Distress
A

• Behaviour is only abnormal if:
– The individual suffers as a result, and
– The individual wishes to be rid of the behavior
• Advantage: many disorders are distressing!

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10
Q
  1. Personal Distress
A

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11
Q
  1. Personal Distress
A

Problems
• “Normal”distress
• Some disorders don’t involve suffering
• Maynotcareaboutdiscomfortofothers • Poor insight

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12
Q
  1. Personal Distress
A

e.g. Manic Episode
Might have lots of energy and inflated sense of self-esteem so they may not feel like it’s an impairment, but the succeeding depressive episode might
e.g. Schizophrenia - Poor Insight
Idea of reality testing - when intact, you can challenge their hallucinations
Psychosis: cannot argue with them about hallucinations
Forms of Distress completely normal
e.g. bereavement - culturally sanctioned form of distress, thus not considered pathological

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13
Q
  1. Personal Distress
A

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14
Q
  1. Personal Distress
A

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15
Q
  1. Personal Distress
A

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16
Q
  1. Personal Dysfunction
A

• AKA: Harmful dysfunction
• Disorder causes “functional” impairment – Occupational
– Academic – Social

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17
Q
  1. Personal Dysfunction
A

Occupational: e.g. depressed - can’t get out of bed
Academic: anxiety - can’t write tests
Social: anti-social personality - can’t make friends

Typically judged by others and professionals, they may not see it as an impairment

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18
Q
  1. Personal Dysfunction
A

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19
Q
  1. Personal Dysfunction
A

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20
Q
  1. Personal Dysfunction
A

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21
Q
  1. Violation of Norms
A
  • AKA Societal / Cultural Relativism
  • Norm violation
  • No universal standards or rules
  • Ab/normality is relative to cultural norms
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22
Q
  1. Violation of Norms
A

Relative to culture
What might hold in 1 society, doesn’t hold in another
Problematic in pinning down definition when it culturally varies
e.g. Gender Roles: Masculine + Feminine Expectations
These are culturally sanctioned
e.g. Nudity - frowned upon in North America
In some African Tribes - normal to wear less clothing

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23
Q
  1. Violation of Norms
A

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24
Q
  1. Violation of Norms
A

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25
Q

Problems with Societal Definition

A
  • Emphasizes conformity • Cultural specificity
  • Temporal specificity
  • Potential for abuse
  • Some societies endorse bad things
  • Society’s implicit rules are hard to break
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26
Q

Problems with Societal Definition

A

Everyone should be the same

Specific to a culture

How come abnormality changes across the world and time

Potential for powerful people to abuse these definitions

Hard to defy social norms once in place

Risk being alienated or worse - consequences for deviating

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27
Q

Problems with Societal Definition

A

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28
Q

Problems with Societal Definition

A

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29
Q

DSM-5

A

• Section I: Basics
• Section II: Diagnostic
Criteria & Codes
• Section III: Emerging Measures & Models

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30
Q

DSM-5

A

3 Sections
Basic: caution, purpose

Diagnostic:
Chapters divided into the different types of disorders
Broken down into the specific listing of symptoms needed in order to qualify for a diagnosis

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31
Q

DSM-5

A

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32
Q

DSM Basics

A
  • A mental disorder is a behavioral or psychological dysfunction associated with…Personal distress
  • Impairment in work, home, school, or social activities
  • “Significantly increased risk of suffering death, pain, disability, or an important loss of freedom”
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33
Q

DSM Basics

A

Death - Increased risk for suicide

Loss of Freedom - going to jail

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34
Q

DSM Basics

A

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35
Q

DSM Definition

A

• Mental disorders are not:
– An expected or appropriate response to an event – Statistically deviant behavior of minority groups – A conflict between one individual and society

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36
Q

DSM Definition

A

e.g. bereavement: expected to be sad
causing severe impairment or lasting a long time not normal in bereavement - considered for clinical attention

Required to be culturally sensitive
Keep in mind the patients context of what’s normal and abnormal

e.g. Ghandi - not pathological

Clinicians are ethically trained and specialize in diagnosis

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37
Q

DSM Definition

A

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38
Q

DSM Definition

A

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39
Q

DSM Example: Major Depressive Episode (MDE)

A

5+ of the following symptoms nearly every day (2+ weeks):

  1. Depressed Mood
  2. Anhedonia
  3. Weight/Appetite Change
  4. Sleep Change
  5. Change in Psychomotor Activity
  6. Loss of Energy
  7. Guilt/Worthlessness
  8. Impaired Concentration
  9. Suicidality
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40
Q

DSM Example: Major Depressive Episode (MDE)

A

Symptom criteria where is a threshold for amount needed to diagnosis
Need either Depressed Mood or Anhedonia (inability to take pleasure in anything)

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41
Q

DSM Example: Major Depressive Episode (MDE)

A

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42
Q

DSM Example: Major Depressive Episode (MDE)

A

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43
Q

DSM Example: Major Depressive Episode (MDE)

A

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44
Q

Differing Opinions

A

•“As long as the research community takes the DSM to be a bible, we’ll never make progress. People think that everything has to match DSM criteria, but you know what? Biology never read that book.” – Dr. Thomas Insel
“A classification system is like a map. And just as any map is only provisional, ready to be changed as the landscape changes, so does classification.” – Dr. Sir Simon Wessely

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45
Q

Differing Opinions

A

Some people are not fond of DSM-V
It is not the bible - it changes constantly
It is not the absolute truth
To think otherwise impairs the ability to see the truth

Wessely: Take it with a grain of salt
It’s a work in progress, but it’s all we got

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46
Q

Differing Opinions

A

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47
Q

Differing Opinions

A

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48
Q

Differing Opinions

A

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49
Q

DSM Classification

A

Advantages
• Increasesscientificcommunication
• Used in forensic situations
• Necessitated by 3rd party payers Disadvantages
• Loseindividualinformation
• Stigma and stereotyping
• Subject to political and social influences

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50
Q

DSM Classification

A

Advantages:
Better communication between professionals
e.g. communicating symptoms and treatment when switching clinicians
often
Used in criminal court
e.g. Diagnostic label - qualified for insurance claims
Psychotherapy not covered by OHIP

Disadvantages:
Once labeled, they assume things about them that might not be true
They may live up to the label
Reasons for including homosexuality in early versions of DSM

51
Q

DSM Classification

A

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52
Q

DSM Classification

A

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53
Q

DSM Classification

A

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54
Q

DSM Classification

A

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55
Q

Historical Perspectives

A
  1. Supernaturaltradition
  2. Biologicaltradition
  3. Psychologicaltradition
56
Q

Historical Perspectives

A
  1. It’s ghosts, curses, demonic possession, witches
  2. breakdown of a system in the body
  3. result of some trauma
57
Q

Historical Perspectives

A

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58
Q

Historical Perspectives

A

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59
Q

Ancient Stone Age Theories

A

Demonological or supernatural model – Spirit possession
Potential Treatments – Exorcism
– Trephination

60
Q

Ancient Stone Age Theories

A

comes from archaeological findings - e.g. skulls, inscriptions

Trephination: releasing demons by drilling hole in skull
Other treatments: magic or prayer

61
Q

Ancient Stone Age Theories

A

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62
Q

Ancient Stone Age Theories

A

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63
Q

Ancient Egypt, Greece and Rome

A
  • Origins of the medical model • Primarily “natural” theories
  • Still included supernatural/religious views –e.g., wandering uterus (hysteria)
  • Treatment: Marriage
64
Q

Ancient Egypt, Greece and Rome

A

more scientific views
e.g hysteria: understood as a wandering uterus
Hippocrates: various humours across the bodies

Treatment: marriage or sweet smelling flowers

65
Q

Ancient Egypt, Greece and Rome

A

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66
Q

Ancient Egypt, Greece and Rome

A

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67
Q

Hippocrates

A

• Father of modern medicine
• Biological view of psychopathology
• Four basic humours (~400 BC)
1. Choleric: easily angered, bad tempered
2. Phlegmatic:calm,unemotional
3. Sanguine:courageous,hopeful,amorous
4. Melancholic:despondent,sleepless,irritable

68
Q

Hippocrates

A

imbalance of humours: bodily fluids
temperments and behaviour decided by levels of humours
emphasis on natural causes for mental illness

69
Q

Hippocrates

A

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70
Q

Hippocrates

A

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71
Q

Middle Ages / Medieval theories

A

Late 400s ‐1800s
• Rise of Christianity
• Return to supernatural model – Demonology/Witchcraft
– Psychic epidemics – Animalism

72
Q

Middle Ages / Medieval theories

A

rejection of scientific ways of thinking - great influence of religion
clergy responsible for dealing with mentally ill
people identified as witches - tortured and killed
Mentally ill were treated like animals - abnormal, lived terrible conditions

73
Q

Middle Ages / Medieval theories

A

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74
Q

Middle Ages / Medieval theories

A

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75
Q

Middle Ages / Medieval theories

A

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76
Q

Renaissance Era

A

• The growth of asylums (“storage”) • Treatment often inhumane
to keep them away from everyone else
inhumane treatment

Bedlam: first institution dedicated to mental illness

77
Q

Renaissance Era

A

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78
Q

Renaissance Era

A

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79
Q

Renaissance Era

A

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80
Q

Age of Reason and Enlightenment

A

1700s to 1800s
• Greisinger (1817‐1868): abnormality rooted in brain
• Kraepelin(1856–1926): – Medical model
– Classification of disorders – Discovered cause of syphilis

81
Q

Age of Reason and Enlightenment

A

Kraepelin:
medical model: biologically based
classification: at the time he only had schizophrenia and bipolar disorder

82
Q

Age of Reason and Enlightenment

A

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83
Q

Age of Reason and Enlightenment

A

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84
Q

Moral Treatment of the 18th Century

A

• Movement toward a more humane treatment
• Incorporated a psychological view:
– People become mad when separated from nature
– Succumb to stresses imposed by rapid social changes
Treatment focus on rest and relaxation (Pinel, Dix)

85
Q

Moral Treatment of the 18th Century

A

Rise of moral therapy
humane treatment
removal of chains, exercise, sunny rooms instead of darkness
Penel and Dix

86
Q

Moral Treatment of the 18th Century

A

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87
Q

Moral Treatment of the 18th Century

A

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88
Q

Moral Treatment of the 18th Century

A

• First Canadian asylum in Beauport, QC (1845) • By 1914, all Canadian provinces had an asylum • Conditions deteriorated with overcrowding

89
Q

Moral Treatment of the 18th Century

A

Gains achieved by moral treatment lost when there was overcrowding

90
Q

Moral Treatment of the 18th Century

A

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91
Q

Moral Treatment of the 18th Century

A

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92
Q

Modern Health Care

A

• Discoveryofantipsychoticmedications(HeinzLehman)
• Transformedpsychiatriccare:
1. Patients could be treated in the community
2. Recognition of psychobiological factors

93
Q

Modern Health Care

A
  1. they can return to live in the community

not isolated

94
Q

Modern Health Care

A

-

95
Q

Deinstitutionalization

A

Patients’ Rights Movement
• Re-integration into the community
• Community-basedtreatmentfacilities
• Promote autonomy and enhance quality of life
• Problems: Homelessness and incarceration

96
Q

Deinstitutionalization

A

advocate for better recovery

discharged into community

97
Q

Deinstitutionalization

A

Biological Approach
• Psychological Approach
• Social Approach

98
Q

Contemporary Approaches

A

Genetic vulnerability, injury

way we think affects how we feel
childhood trauma

relationships with people
social influences such as poverty

99
Q

Contemporary Approaches

A

-

100
Q

Biological Approaches

A
  • StructuralTheories
  • BiochemicalTheories
  • GeneticTheories
101
Q

Biological Approaches

A
  1. abnormality arises from brain damages
  2. imbalance in neurotransmitters or hormones
  3. disorders run in families
    genes that might influence transmission of disorders

they all influence one another

102
Q

Biological Approaches

A

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103
Q

Biological Approaches

A

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104
Q

Structural Abnormalities

A

Caused damage to frontal cortex - ability to plan and reason, the site of personality
Drastic change to personality
Could not modulate social behaviour, inhibit
Gage was no longer Gage

105
Q

Structural Abnormalities

A

Phineas Gage

106
Q

Structural Abnormalities

A

Key Structures – Hypothalamus – Limbic system
• Structural abnormalities may result from – Brain trauma
– Deterioration or atrophy

107
Q

Structural Abnormalities

A

Lesions to
Hypothalamus: the four Fs and certain aspects of emotion
Limbic system: emotion

trauma: e.g. car accident

108
Q

Structural Abnormalities

A

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109
Q

Biochemical Theories

A

• Neurotransmitter (NT) function & imbalances • Hormones & neuroendocrine function

110
Q

Biochemical Theories

A

excess or deficiency in neurotransmitter can affect emotion

111
Q

Biochemical Theories

A

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112
Q

Basics of Neurotransmission

A

chemical and electrical in nature
communication between cells
released into the synapse
receptors receive incoming neurotransmitters
transmission affected by type of neurotransmitter, amount of neurotransmitter, duration in synapse affected by reuptake or speed of degradation (speed broken down)
neurotransmitters and amount can affect emotion

113
Q

Basics of Neurotransmission

A

-

114
Q

Biochemical Bases of Abnormality: NT Theories of Disorders

A

• Too little or too much NT
• Drug therapies designed to affect neurotransmission
– e.g., Selective Serotonin Reuptake Inhibitors

115
Q

Biochemical Bases of Abnormality: NT Theories of Disorders

A

developing treatments of different disorders
SSRIS - low levels of serotonin in depressed people
increase serotonin by blocking reuptake - more time for receiving neuron to get them
designed to affect amount available by influencing reuptake or degradation

116
Q

Biochemical Bases of Abnormality: NT Theories of Disorders

A 
Serotonin (5-HT)
Norepinephrine (NE)
Dopamine (DA)
Gamma-aminobutyric acid (GABA)
• Emotion regulation
• Depression, Anxiety, Sleep, and Eating
stress related disorders
• Too much over-stimulation • Too little depression
• Eating Disorders
implicated in Mood disorders
• Reward systems
• Muscle symptoms
• Psychosis & Parkinson’s Disease
Parkinsons: affect on motion
Inability to inhibit drive toward reward - e.g. substance abuse
• Inhibitory effect
• Tranquilizing effect • Anxiety
reduces symptoms of anxiety
tranquilizers
deficiency causes anxiety
117
Q

Biochemical Bases of Abnormality: Four Common NTs

A

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118
Q

Biochemical Bases of Abnormality: Four Common NTs

A

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119
Q

Biochemical Bases of Abnormality: Four Common NTs

A

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120
Q

Biochemical Bases of Abnormality: Four Common NTs

A

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121
Q

Biochemical Bases of Abnormality: Four Common NTs

A

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122
Q

Biochemical Bases of Abnormality: Four Common NTs

A

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123
Q

Biochemical Bases of Abnormality: Four Common NTs

A

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PSY240 (5 decks)

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