Psychological Disorders Flashcards
Mental disorder is
- Persistent disturbance or dysfunction in behaviour, thoughts, or emotions that causes significant distress or impairment
- Problems with perception, memory, learning, emotion, motivation, thinking and social processes
Who is involved in the diagnosis of mental illness?
- Psychologists: no medication, therapeutic techniques
- Psychiatrists: physicians (i.e. medication), therapeutic techniques
How were mental disorders conceptualized historically?
- Thought to be caused by religious or supernatural forces
- People with psychological disorders have been feared, ridiculed, treated as criminals
Conceptualization of mental illness with medical model
Conceptualized as illnesses with biological and environmental causes, defined symptoms, and possible cures
Implications of medical models
More scientifically accurate + treats people like human beings (doesn’t condemn them for things outside their control)
Medical model
- Diagnosis: Clinicians determine the nature of the mental disorder by looking at signs/symptoms
- Signs: Objectively observed indicators of a disorder
- Symptoms: Subjectively reported behaviours, thoughts, and emotions that suggest illness
Disorder
Common set of signs/symptoms
Disease
Pathological process affecting the body
Diagnosis
Determination if disorder or disease is present
Comorbidity
Co-occurrence of two or more disorders in a single individual
Criticisms of medical model
- Client’s self-report to diagnose symptoms
- Medicalizes normal human behaviour - concern of overlabeling and diagnosis (e.g. super shy as social anxiety disorder)
DSM (Diagnostic and Statistical Manual of Mental Disorders)
- Describes the symptoms used to diagnose each recognized mental disorder
- Indicates how disorders can be distinguished from other similar problems
- Each disorder is named and classified as a distinct illness
History of DSM
- Early volumes = descriptions were vague
- Recent volumes = diagnostic criteria and lists
- DSM-5: 22 categories containing more than 200 mental disorders
Epidemiology
Study of distribution and causes of health and disease
Mental health issues are reported at different rates BUT….
- Depression and anxiety = most common
- Impulse-control and substance-use disorders = 2nd most common
What is culture’s role in mental health?
- Culture can influence how mental disorders are experienced, described, assessed and treated
- Use of “Cultural Formulation Interview” (CFI) in DSM
Cultural effects
Box on page 593
Cultural syndrome
Groups of symptoms that cluster together in specific cultures
Cultural idioms of distress
Ways of talking about or expressing distress that differ across cultures
Cultural explanations
Culturally recognized descriptions of what causes the symptoms, distress, or disorder
Etiology
Specifiable pattern of cause
Prognosis
Course over time and susceptibility to treatment and cure
Prevalence
Proportionate of the population found to have the condition
Biopsychosocial perspective
Mental disorders result from interaction of biological, psychological, and social factors
- Includes biological, psychological and social factors
Best way to understand what factors cause mental disorders
- Biopsychosocial perspective
- Diathesis-stress model
(Figure 15.2)
Diathesis-stress model
Disorders have both internal (bio/psych) and external (environmental) causes; person may be predisposed for a psychological disorder that stress brings on
- Diathesis = internal predisposition
- Stress = external trigger
Biological factors
- Genetic/epigenetic influences
- Biochemical imbalances
- Abnormalities in brain structure/function
Psychological factors
- Maladaptive learning/coping
- Cognitive biases/dysfunctional attitudes
- Interpersonal problems
Social factors
- Poor socialization
- Stressful life experiences
- Cultural/social inequalities
Research Domain Criteria Project (RDoC)
- Guides the classification and understanding of mental disorders by revealing the basic processes that give rise to them
- Not a replacement for DSM, just aid in revising it
Goal of RDoC
Better understand what abnormalities cause different disorders and to classify based on causes rather than symptoms
Dangers of labelling
- Concern of negative stereotypes/stigma (60% of people with disorders do not seek treatment)
- Expectations can compromise judgment of professionals = once you have the label, it sticks
- Myth of the need to institutionalize
- Labelling effects how individuals view themselves (e.g. person with schizophrenia vs. a schizophrenic)
Anxiety disorders
- NOT referring to situational anxiety, but long-lasting
- Class of disorders in which anxiety is the predominate feature
- Common to experience more than one type
- Often comorbid with depressio
- Types: phobic, panic and generalized
Phobic disorders
- Marked, persistent and excessive fear and avoidance of specific objects, activities, or situations
- Recognize fear is irrational but can’t stop it from interfering with everyday functioning
Specific phobia
Five categories
- Animals
- Natural environments (e.g. heights, storms, water)
- Situations (e.g. bridges, elevators, enclosed spaces)
- Blood, injections, and injury
- Other (e.g. choking, loud noises, costumed characters)
Social phobia
- Irrational fear of being publicly humiliated or embarrassed
- e.g. public speaking, eating in public, using a public bathroom
Preparedness theory
People are instinctively predisposed toward certain fears from evolutionary perspective
Why are phobias so common?
- Preparedness theory
- Heritability
- Temperament
- Neurobiological factors (abnormalities in serotonin and dopamine; activity of amygdala)
- Role of environment (learned emotional experiences)
Panic disorder
Sudden occurrence of multiple psychological and physiological symptoms that contribute to feeling of terror
Acute symptoms of panic disorder
- Shortness of breath
- Heart palpitations
- Sweating
- Dizziness
- Depersonalization (detached from body) and derealization (world around you doesn’t feel real)
- Fear of going crazy or dying
Agoraphobia
A specific phobia involving a fear of having a panic attack in public places - feeling of being trapped
- Usually during period of intense stress
- Need to report worry about another attack for diagnosis
Why is it called “generalized” anxiety disorder?
- Worries are not focused on any particular threat; exaggerated and irrational
- Can’t pinpoint cause, anxiety becomes global, breaks down confidence -> basic tasks become stressful
Generalized anxiety disorder
Chronic, excessive worry accompanied by three or more of the following:
- Restlessness
- Fatigue
- Concentration problems
- Irritability
- Muscle tension
- Sleep disturbance
Cause of generalized anxiety disorder
- COMPLICATED! Likely a neurotransmitter imbbalance (e.g. GABA)
- Influence of stressful life events
Obsessive-Compulsive Disorder
Repetitive, intrusive thoughts (obsessions) and ritualistic behaviours (compulsions) designed to fend off those thoughts; significantly interferes with an individual’s functioning
Role of anxiety in OCD
Obsessive thoughts cause anxiety and compulsions are performed to reduce it
Why is suppression of thoughts not effective for OCD?
Often leads to increase in frequency or intensity of thoughts
Why is OCD classified separate from anxiety disorders?
Because it has distinct cause and neural circuitry
What kinds of obsessions and compulsions?
- Checking (most common)
- Ordering
- Moral concerns
- Contamination
Why do people with OCD have obsessions?
Role of preparedness theory - obsessions over things that pose a real threat (e.g. house on fire from unwatched stove)
How long and intense are the rituals?
Vary in length and intensity
Causes of OCD
- Moderate genetic heritability for OCD (though not an actual CAUSE)
- Heightened neural activity in the caudate nucleus of the region
- Drugs that increase activity of serotonin help to inhibit activity of caudate nucleus (so usually treated with SSRIs)
PTSD
Chronic physiological arousal, recurrent unwanted thoughts or images to the trauma, and avoidance of things that bring traumatic event to mind
- Many sources, most commonly war
- One of the hardest disorders to treatMir
How do people differ in sensitivity to trauma?
- Increased activity in amygdala (evaluating threat); interprets environment as more threatening
- Decreased activity in medial prefrontal cortex (extinction of fear conditioning)
- Smaller hippocampus (memory)
Mood disorders
Mental disorders with mood disturbance as their predominant feature
- Depression (unipolar mania)
- Bipolar disorder (extreme depression to extreme mania)
Unipolar depression
Severely depressed mood and/or inability to experience pleasure that lasts 2 or more weeks; is accompanied by feelings of worthlessness, lethargy, and sleep and appetite disturbances
Persistent depressive disorder
Same cognitive and bodily problems, but less severe and last longer, for at least 2 years
Double depression
- When both unipolar depression and persistent depressive disorder occur
- Moderately depressed mood that persists for 2 years and punctuated by periods of major depression
Seasonal affective disorder
Recurrent depressive episodes in a seasonal pattern; related to lack of light
Causes of depression
- SES status (low income/poverty linked to depression)
- Hormones (estrogen, androgen and progesterone)
- 33-45% heritability, vary in severity
Treatments for depression
- Mixed! Some drugs that increase levels of NEP and serotonin are effective; others that decrease are effective
- Hard to treat - many different biological system interactions
