Psychological Disorders

Question 1

Defining Abnormality

Answer 1

Psychological disorders – meet at least two of criteria below 
Unusualness
Deviance from the social norm
Significant distress
Maladaptive
Danger to self or others

Question 2

Major Depressive Disorder

Answer 2

Depressed mood
Loss of interest or pleasure in activities
>5% weight loss/gain or decrease/increase in appetite
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or inappropriate guilt
Diminished concentration or indecisiveness
Recurrent thoughts of death or suicide

Question 3

Trephination

Answer 3

boring a hole into the skull to release the demons responsible for abnormal behaviour

Question 4

Hippocrates

Answer 4

The health of the body and mind depends upon the balance of the four humors / vital fluids
Phlegm
Black bile
Yellow bile 
Blood

Question 5

biological model of abnormality

Answer 5

Genetic predisposition
Neurotransmitters
Brain structure abnormalities

Question 6

Psychological model of abnormality

Answer 6

Unconscious conflicts / repression
Behaviourism (learning theories)
Cognitions / thoughts
Personality traits

Question 7

social model of abnormality

Answer 7

Family
Social group
Society
Culture

Question 8

Anxiety definition

Answer 8

Future-oriented mood state accompanied by strong affect

Free-floating anxiety: anxiety that is unrelated to any realistic and specific known factor

Question 9

Emotional symptoms of anxiety

Answer 9

Restlessness
Irritability
Sense of dread
Terror

Question 10

Cognitive symptoms of anxiety

Answer 10

Worry
Poor concentration
Anticipating harm
Fear of losing control or dying
Hypervigilance

Question 11

Somatic symptoms of anxiety

Answer 11

Increased heart rate
Sweating
Rapid breathing
Muscle tension
Dilated pupils

Question 12

Behavioural symptoms of anxiety

Answer 12

Freezing up
Escape (flight)
Aggression (fight)
Avoidance 
Decreased appetite

Question 13

classifying anxiety

Answer 13

Out of proportion to the threat posed
A state that the individual constantly finds themselves in
A cause of distress that disrupts normal day-to-day functioning

Question 14

types of anxiety disorders

Answer 14

Social anxiety disorder
Specific phobia (phobic disorder)
Panic disorder
Generalised anxiety disorder
Obsessive-Compulsive Disorder
PTSD

Question 15

Social Anxiety Disorder

Answer 15

Fear or anxiety about social situations in which the individual is exposed to possible scrutiny by others
The person fears negative evaluation
Social situations almost always provoke fear or anxiety
Social situations are avoided or endured with intense fear or anxiety
Fear/anxiety/avoidance is persistent (> 6 months)
Causes significant distress or impairs functioning

Question 16

most frequent social triggers

Answer 16

Initiating conversation

Taking part in small groups

Dating

Interacting with authority figures

Attending parties

Public speaking

Eating or drinking in public

Question 17

specific Phobias

Answer 17

Fear or anxiety about a specific object or situation (e.g. flying, heights, animals, injections, seeing blood)
Phobic object or situation almost always provokes immediate fear or anxiety
The phobic object is avoided or endured with intense anxiety
The fear or anxiety is out of proportion to actual danger posed
The fear/anxiety/avoidance is persistent (> 6 months)
Causes significant distress or impairs functioning

Question 18

Panic disorder

Answer 18

Recurrent unexpected panic attacks
Four panic attack symptoms e.g. heart palpitations, sweating, shaking, shortness of breath, chest pain, nausea, dizziness, fear of losing control, fear of dying
One month of persistent worry about additional panic attacks or their consequences and/or a significant maladaptive change in behavior related to the attacks e.g. avoidance of situations where the panic attack occurs

Question 19

Generalised Anxiety Disorder

Answer 19

Excessive anxiety and worry, occurring most days, about several events or activities for at least 6 months
The individual finds it difficult to control the worry
Three (or more) of the following symptoms:
Restlessness or being on edge
Easily fatigued
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance
Symptoms cause significant distress or impairment

Question 20

Obsessive-Compulsive Disorder (OCD)

Obsessions:

Answer 20

Presence of obsessions, compulsions, or both

Recurrent and persistent thoughts, urges, or images that are intrusive and unwanted and cause anxiety or distress
The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralise them with some other thought or action (a compulsion)

Question 21

Obsessive-Compulsive Disorder (OCD)

Compulsions

Answer 21

Repetitive behaviours (e.g. hand washing, checking) or mental acts (counting, repeating words silently) that the individual feels driven to perform in response to an obsession
The behaviours or mental acts aim to prevent or reduce anxiety, distress or a dreaded event or situation
The obsessions or compulsions are time-consuming (> 1 hour per day) or cause significant distress or impairment

Question 22

Aetiology of Anxiety Disorders

biological explanation

Answer 22

Genetic predisposition
Imbalances in the neurotransmitters norepinephrine and serotonin
Amygdala – more active; excessive conditioning and exaggerated responses to stimuli

Question 23

Aetiology of Anxiety Disorders

Behavioural explanations

Answer 23

Anxious behavioural responses are learned
Classical conditioning – pairing of an object or situation with a fear-producing stimulus (origin of the disorder)
Operant conditioning – avoidance behaviours are negatively reinforced (maintains the disorder)
Observational learning

Question 24

Aetiology of Anxiety Disorders

Cognitive explanations

Answer 24

Anxiety disorders are caused by illogical, irrational thought processes
Cognitive distortions – magnification, minimisation, overgeneralisation, all-or-nothing thinking
Social anxiety disorder – negative beliefs and cognitive biases by which social situations and the self are evaluated
Panic disorder – paying close attention to physical sensations, negative interpretation of physical sensations and catastrophic thinking

Question 25

Aetiology of Anxiety Disorders | Social Factors

Answer 25

``` Environmental factors (in South Africa) may lead to high levels of anxiety Feelings of exclusion High crime rates High unemployment Economic instability ```

Question 26

Normal Sadness

Answer 26

Context-specific response Proportionate to the situation Recedes once the situation changes

Question 27

Depression

Answer 27

Pervasive and persistent Impairs functioning May occur in the absence of precipitating events May be out of proportion to circumstances ‘Feel strange’ or difficult to describe

Question 28

Manic Episode definition

Answer 28

An elevated, expansive, or irritable mood and increased goal-directed activity or energy Lasting at least one week Impairment or hospitalisation or psychotic features Three (or more) symptoms are present and represent a noticeable change from usual behaviour

Question 29

Manic Episode symptoms

Answer 29

Inflated self-esteem or grandiosity Decreased need for sleep More talkative than usual or pressure to keep talking Flight of ideas or feels like thoughts are racing Distractibility Increased goal-directed activity or psychomotor agitation Excessive involvement in activities that have a high potential for painful consequences

Question 30

Hypomanic Episode

Answer 30

3 or more symptoms Same symptoms as for a manic episode BUT Lasting at least 4 days Not severe enough to cause impairment in functioning or hospitalisation.

Question 31

Bipolar I Disorder

Answer 31

Person meets the criteria for at least one manic episode The manic episode may be preceded or followed by major depressive episodes Causes marked impairment in functioning or hospitalisation or psychotic features

Question 32

Bipolar II Disorder

Answer 32

Person meets the criteria for a current or past hypomanic episode and a current or past major depressive episode Person has never met the criteria for a manic episode Not severe enough to cause impairment in functioning or hospitalisation Depressive episode causes distress or impairment

Question 33

Aetiology of Depression – Biological

Answer 33

``` Genetic predisposition – 30% to 40% concordance rates Brain abnormalities Hippocampus: Deficits in hippocampus function Dissociates affective response from context Sadness occurs independently of context Amygdala Increased activation Attention to stimuli Prioritise threatening information Interpret it negatively ```

Question 34

Aetiology of Depression – Behavioural

Answer 34

Seligman’s Learned Helplessness Theory | Uncontrollable negative life events -> Perceived lack of control -> Generalised helpless behaviour

Question 35

Aetiology of Depression - Social

Answer 35

``` Gender differences – higher prevalence rates of depression in women (up to 3 times higher) Hormonal structure Emotional display rules Social roles Oppression Exposure to trauma ```

Question 36

Anorexia Nervosa

Answer 36

Restriction of energy intake relative to requirements, leading to a significantly low body weight (BMI < 17) Intense fear of gaining weight or persistent behavior that interferes with weight gain Disturbance in the way in which one’s body weight or shape is experienced Undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight Restricting type: dieting, fasting or excessive exercise Binge-eating/purging type: binge-eating and purging

Question 37

Anorexia Nervosa severity

Answer 37

Mild: BMI ≥ 17 kg/m2 Moderate: BMI 16–16.99 kg/m2 Severe: BMI 15–15.99 kg/m2 Extreme: BMI < 15 kg/m2

Question 38

Anorexia Nervosa medical complications

Answer 38

``` Abnormal hormonal secretion (thyroid and adrenal glands) Weak heart muscles or altered heart rhythms Diarrhoea Loss of muscle tissue Difficulty sleeping Low blood sugar Amenorrhea (menstruation stops) Dry, cracked skin Lanugo (fine, downy hair) ```

Question 39

Bulimia Nervosa

Answer 39

Recurrent episodes of binge eating which is: Eating a large amount of food within two hours Lack of control over eating during the episode Inappropriate compensatory behaviors to prevent weight gain (vomiting, laxatives, fasting, excessive exercise) Self-evaluation is unduly influenced by body shape and weight Binge-eating and purging occurs least once a week for 3 months

Question 40

Bulimia Nervosa medical complications

Answer 40

``` Tooth decay Erosion of the lining of the oesophagus Enlarged salivary glands (puffy face) Imbalances in sodium, calcium and potassium Heart problems Fatigue Seizures Rupture of the stomach ```

Question 41

Binge-Eating Disorder diagnosis

Answer 41

Recurrent episodes of binge eating which is: Eating a large amount of food within two hours Lack of control over eating during the episode At least three of the following symptoms Eating much faster than normal Eating until feeling uncomfortably full Eating large amounts when not hungry Eating alone due to embarrassment Feeling disgusted, depressed or guilty afterwards

Question 42

Aetiology of Eating Disorders biological explanations

Answer 42

Genetic predisposition – 40% to 60% concordance rates Low levels of serotonin Diminished endocrine functioning

Question 43

Aetiology of anorexia psychological explanations

Answer 43

``` Perfectionism Shyness Depression Low Self-Esteem Negative Body Image Dietary Restraint ```

Question 44

Aetiology of Bulimia and Binge-Eating disorder psychological explanations

Answer 44

``` 1. Preoccupation with food Uncontrollable hunger 2. Binge-Eating 3. Disappointment Self-criticism Sense of loss of control Guilt and shame Body dissatisfaction Social anxiety 4. Efforts to Control Diet ```

Question 45

Aetiology of Eating Disorders Social factors (Anorexia Nervosa and family dynamics)

Answer 45

May be linked to troubled family relationships Struggle for control Desperate sense of having no control Family members may be too close (enmeshed) and overly involved in each other’s lives Enmeshment Hypothesis - the only thing the person can control in their intrusive families is their eating (Minuchin et al., 1978)

Question 46

Aetiology of Eating Disorders Social factors – Standards of Beauty

Answer 46

Changing standards of beauty may explain surge in eating disorders BMI of women on magazine covers decreased dramatically over time Media exposure to images of super-thin women increases body dissatisfaction in girls and young women May explain the large variation in prevalence between men and women Women - thinness is essential to good looks Young men – pressure to be strong and muscular Dolls and action figures

Question 47

Schizophrenia

Answer 47

A long-lasting psychotic disorder, in which there is an inability to distinguish what is real from what is not real Disturbances in thinking, emotions, behaviour and perception Usually arises in late teens or early twenties

Question 48

Schizophrenia – DSM-5 criteria

Answer 48

Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3): Delusions Hallucinations Disorganised speech (e.g., frequent derailment or incoherence) Grossly disorganised or catatonic behavior Negative symptoms (i.e., diminished emotional expression or avolition)

Question 49

The nature of psychotic symptoms - Schizophrenia

Answer 49

Positive symptoms – excess of normal functions Delusions Hallucinations Negative symptoms – decrease in normal functions Poor attention Flat affect Poor speech production Avolition (decrease in goal-directed activities) Catatonia (lack of movement)

Question 50

Delusions

Answer 50

False beliefs the person has about the world Remain fixed even in the face of evidence that disproves them Persecution reference influence grandeur

Question 51

persecution

Answer 51

Other people are trying to hurt them

Question 52

Reference

Answer 52

Others (people, characters in a book/TV) are talking to them specifically

Question 53

influence

Answer 53

They are being controlled by external forces

Question 54

grandeur

Answer 54

Convinced that they are powerful and have a special mission

Question 55

Hallucinations

Answer 55

Sensory perceptions experienced in the absence of external stimuli that get confused with reality auditory hallucinations = most common

Question 56

Disorganised thinking (speech)

Answer 56

Difficulty linking and expressing thoughts in a logical way Word salad – jumbled mixture of words and phrases Clanging – stringing words together on basis of sounds

Question 57

Emotional disturbances | schitzophrenia

Answer 57

Flat affect – the person shows little or no emotion Excessive emotion Inappropriate emotion

Question 58

Aetiology of Schizophrenia biological

Answer 58

– Dopamine Hypothesis Excessive activity of the neurotransmitter dopamine Antipsychotic drugs that alleviate psychotic symptoms block the brain’s dopamine receptor sites Amphetamine psychosis resembles psychosis and is related to excess dopamine MRI scans and post-mortem studies suggest sufferers exhibit more dopamine receptors in the brain

Question 59

Aetiology of Schizophrenia Biological explanations – brain structure

Answer 59

Smaller brain size Enlarged ventricles, reduction in cortical grey matter Less myelin coating on the cingulum bundle (linking the frontal lobe and temporal lobe)

Question 60

Aetiology of Schizophrenia Environmental factors influencing brain development

Answer 60

Viral infections during pregnancy | Birth complications

Question 61

Aetiology of Schizophrenia Psychological explanations – cognitive biases

Answer 61

Attentional biases – prioritising threatening information and information related to the delusions Attributional biases – attributing negative life events to external causes Reasoning bias – jumping to conclusions about the meaning of events in the absence of evidence Interpretational bias – interpreting cognitive intrusions (e.g. hallucinations) in a negative way

Question 62

Aetiology of Schizophrenia Social explanations – Family Factors

Answer 62

High levels of expressed emotion (EE) A pattern of responding to the family member in a hostile, critical, unsupportive way High EE families tend to have an attributional style that blames the sufferer for his/her condition (Weisman et al., 2000) EE is a robust predictor of relapse (Kavanagh, 1992) Interventions to moderate EE in a family can have beneficial effects on symptoms (Hogarty et al., 1986)