Psychological Disorders Flashcards
Biomedical Approach
Takes into account only the physical and medical causes of a psychological disorder
Biopsychosocial approach
Considers the relative contributions of biological, psychological, and social components to an individual’s disorder. Goal is often to provide direct therapy (treatment that acts directly on the individual) and indirect therapy (aims to increase social support by empowering family/friends)
What does DSM stand for
Diagnostic and Statistical Manual of Mental Disorders –> current version is DSM-5
What is the DSM
Categorizes mental disorders based on symptom patterns. Psychological disorders, especially anxiety, depressive, and substance use disorders, are very common
Scizophrenia
The prototypical psychotic disorder, characterized by both positive and negative symptoms. Associated with genetic factors, birth trauma, and family history. Involves high levels of dopaminergic transmission
Positive symptoms
The addition of something to behaviour/cognition, and includes delusions, hallucinations, disorganized speech/thought, and disorganized behaviour, such as perhaps catatonia, echolalia, or echopraxia
Negative symptoms
The loss of something from behaviour, cognition, or affect and include disturbance of affect (inappropriate variability of facial expression etc) and avolition (decreases engagement in purposeful, goal-directed actions)
Depressive Disorders
Major depressive disorder and persistent depressive disorder
Major depressive disorder
Contains at least one major depressive episode (2+ weeks), plus at least 5 other symptoms from the following:
Weight loss/gain or increase/ decrease in appetite
insomnia/hypersomnia
loss of interest in formerly enjoyable activities (anhedonia)
Psychomotor agitation/retardation
fatigue/loss of energy
Feelings of worthlessness or excessive guilt
indecisiveness , or reduced ability to think or concentrate
Recurrent thoughts of death/suicide, a suicide attempt, or a plan
Mnemonic: SIG E. CAPS
Sleep, Interest, Guilt, Energy, Concentration, Appetite, psychomotor symptoms, suicidal thoughts
Persistent depressive disorder
Dysthymia (persistent mild depression) for at least 2 years
Seasonal Affective disorder
Colloquial name for major depressive disorder with seasonal onset, with depression occurring during winter months
What are typical hormonal patterns accompanying depression?
High levels of glucocorticoids and low levels of norepinephrine, serotonin, and dopamine
Bipolar and related disorders
Have manic or hypomanic episodes, and includes bipolar I disorder, bipolar II disorder, and cyclothymic disorder.
Bipolar disorders are accompanied by high levels of norepinephrine and serotonin, and are also highly heritable
Bipolar I disorder
Contains at least one manic episode with or without major depressive disorders
Bipolar II disorder
Contains at least one hypomanic episode and at least one major depressive episode
Cyclothymic disorder
Contains hypomanic episodes with periods of dysthymia
Anxiety disorders
Include generalized anxiety disorder, specific phobias, social anxiety disorder, agoraphobia, and panic disorder
Generalized anxiety disorder
Disproportionate and persistent worry about many different things for at least 6 months
Specific phobias
Irrational fears of specific objects or situations
Social anxiety disorder
Anxiety that embarrassment may occur due to social or performance situations
Panic disorder
Marked by recurrent panic attacks: intense, overwhelming fear and sympathetic nervous system activity with no clear stimulus. Often accompanied by agoraphobia:
Obsessive-compulsive disorder
Characterized by obsessions and compulsions
Obsessions
Persistent, intrusive thoughts and impulses which produce tension
Compulsions
Repetitive tasks that relieve tension but cause significant impairment in a person’s life
Body Dysmorphic Disorder
Characterized by an unrealistic negative evaluation of one’s appearance or a specific body part. Individual often takes extreme measures to correct the perceived imperfection
Posttraumatic stress disorder (PTSD)
Characterized by intrusion symptoms (reliving the event, flashbacks, nightmares), avoidance symptoms (avoidance of people, places, objects associated with trauma), negative cognitive symptoms (amnesia, negative mood and emotions), and arousal symptoms (increased startle response, irritability, anxiety). To be PTSD, certain number of these symptoms must be present for at least 1 month.
Dissociative disorders
Person avoids stress by escaping from their identity. Includes dissociative amnesia, dissociative identity disorder, and depersonalization/derealization disorder
Dissociative amnesia
An inability to recall past experience; not associated with an underlying neurological disorder, but rather trauma. May involve dissociation fugue
Dissociation fugue
A sudden change in location that may involve the assumption of a new identity
Dissociative identity disorder
The occurrence of 2 or more personalities that take control of a person’s behaviour; usually, the patient has suffered severe physical or sexual abuse as a young child
Depersonalization/Derealization disorder
Involves feelings of detachment from their mind and body (depersonalization) or from their environment/surroundings (derealization).
Somatic symptom and related disorders
Involves significant bodily symptoms, includes somatic symptom disorder, illness anxiety disorder, and conversion disorder
Somatic symptom disorder
Involves at least one somatic symptom, which may or may not be linked to an underlying medical condition, that causes disproportionate concern
Illness anxiety disorder
A preoccupation with thoughts about having, or coming down with, a serious medical condition
Conversion disorder
Involves unexplained symptoms affecting motor or sensory function and is associated with prior trauma
Personality disorders (PD)
Patterns of inflexible, maladaptive behaviour that cause distress or impaired functioning in at least two of the following: cognition, emotions, interpersonal functioning, or impulse control. They occur in 3 clusters: A (odd, eccentric), B (dramatic, emotional, erratic), and C (anxious, fearful).
Cluster A
Odd, eccentric; includes paranoid PD, Schizotypal PD, and Schizoid PD
Paranoid PD
Pervasive distrust and suspicion of others
Schizotypal PD
Ideas of reference, magical thinking, and eccentricity
Schizoid PD
Detachment from social relationships and limited emotion
Cluster B
Dramatic, emotional, erratic; includes Antisocial, Borderline, Histrionic, and Narcissistic PDs
Antisocial PD
Disregard for and violation of the rights of others ( 3x more common in males than females)
Borderline PD
(2x more common in females than males) Instability in relationships, mood, and self-image, splitting (having difficulty holding opposing thoughts) is characteristic, as well as recurrent suicide attempts
Histrionic PD
Constant attention-seeking behaviour
Narcissistic PD
Grandiose sense of self-importance, need for admiration
Cluster C
Anxious, fearful; includes Avoidant PD, Dependent PD, and Obsessive-Compulsive PD
Avoidant PD
Extreme shyness and fear of rejection
Dependent PD
Continuous need for reassurance
Obsessive-Compulsive PD
Perfectionism, inflexibility, preoccupation with rules
Biological Markers of Alzheimer’s Disease
- Diffuse atrophy of the brain on CT/MRI
- Flattened sulci in cerebral cortex
- Enlarged cerebral ventricles
- Deficient blood flow in parietal lobes, which is correlated with cognitive decline
- Reduction in levels of acetylcholine
- Reduction in choline acetyltransferase (ChAT), enzyme that produces acetylcholine
- Reduced metabolism in temporal and parietal lobes
- Senile plaques of Beta-amyloid
- Neurofibrillary tangles of hyperphosphorylated tau protein
Parkinsons’ Disease (biological)
Associated with bradykinesia, resting tremor, pill-rolling tremor, masklike facies, cogwheel rigidity, and a shuffling gait. There is decreased dopamine production by cells in the substantia nigra. Depression and dementia are also common.
Bradykinesia
Slowness of movement; one of the cardinal symptoms of Parkinson’s
Resting tremor
Most common form of tremors associated with Parkinson’s; occurs when muscles are relaxed and still
Pill-rolling tremor
Looks like you are trying to roll a pill or other object between thumb and index finger
Masklike facies
Loss of facial expressions commonly associated with Parkinson’s
Cogwheel rigidity
Rigidity in which the muscles respond with cogwheel-like jerks to the use of force in bending the limb, as occurs in Parkinson’s disease.
What is a psychological disorder
Characteristic set of thoughts, feelings, or actions that cause noticeable distress to the sufferer, cause maladaptive functioning in society, or are considered deviant by the individual’s culture.
What causes diagnosis of schizophrenia
Must show continuous signs of disturbance for at least 6 months, and this 6-month period must include at least one month of “active symptoms” (delusions, hallucinations, disorganized speech)
Catatonia
Refers to certain motor behaviours characteristic of some people with schizophrenia
Echolalia
Repeating another’s words
Echopraxia
Imitating another’s actions
Prodomal phase
A phase a patient often goes through before schizophrenia is diagnosed: exemplified by clear evidence of deterioration, social withdrawal, role functioning impairment, peculiar behaviour, inappropriate effect, and unusual experiences.
Manic episode
Characterized by abnormal and persistently elevated mood lasting at least one week with at least 3 of the following: DIG FAST Distractible Insomnia Grandiosity Flight of ideas (racing thoughts) Agitation Speech (pressured) Thoughtlessness (risky behaviour)
Agoraphobia
Anxiety disorder characterized by a fear of being in places or in situations where it might be hard for an individual to escape
Biological Markers of Depression
- Abnormally high glucose metabolism in the amygdala
- Hippocampal atrophy after a long duration of illness
- Abnormally high levels of glucocorticoids (cortisol)
- Decreased norepinephrine, serotonin, and dopamine (monoamine theory of depression)
Biological markers for Bipolar Disorders
- Increased norepinephrine and serotonin (monoamine theory)
- Higher risk if parent has bipolar disorder
- Higher risk for people with multiple sclerosis.
