Psychological Disorders (Ch. 13) Flashcards

1
Q

what are psychological disorders?

A

Behavioral or psychological syndromes or patterns that lead to clinically significant distress or disability.

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2
Q

point prevalence

A

% of people in a given population who have a given psychological disorder at one point in time.

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3
Q

lifetime prevalence

A

% of people in a given population who have a given psychological disorder at any point in their lives.

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4
Q

what are the impacts of psychological disorders on death rates?

A

psychological disorders represent 5/10 leading causes of disability and premature death worldwide

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5
Q

what is a clinical assessment?

A

a procedure used to evaluate a client’s psychological functioning and determine whether a psychological disorder is present

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6
Q

clinical interviews

A

designed to systematically explore a client’s current mental state, life circumstances, and history
- asks them to describe their problems
- open-ended or structural (can ask questions pertinent to diagnostic criteria)
- can gather insights from looking at hand gestures, facial expressions, etc.

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7
Q

what can therapists use to eval clients besides clinical interviews?

A

self-report measures and projective tests

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8
Q

self-report measures

A

fixed set of questions for patient to answer

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9
Q

projective tests

A

client asked to respond to unstructured/ ambiguous stimuli (usually pictures) requires them to impose their own structure
(ex. Thematic Apperception Test [TAT], client has to make up a story about what is happening)
(ex. Rorschach Inkblot Test, client has to describe what they see in set of inkblots)

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10
Q

are projective tests useful?

A

general consensus is that the popularity > usefulness

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11
Q

what do we use to diagnose disorders?

A

Diagnostic and Statistical Manual of Mental Disorders (DSM). It has been revised many times, now at version DSM-5. It is updated to reflect current scientific evidence.

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12
Q

who publishes the DSM?

A

the American Psychiatric Association

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13
Q

how does the DSM reflect culture-specific disorders?

A

in addition to the 20 categories of disorders, there is an appendix of some culture-specific ones (however still some specific to only W culture, ex. bulimia nervosa, that is concluded in the overall manual)

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14
Q

how can we make our language more inclusive around people with mental illnesses?

A

distinguishing between the person and the illness (ex. “people with schizophrenia,” as opposed to “schizophrenics”)

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15
Q

the biopsychosocial model

A

analysis of psychological functioning is incomplete unless it considers biological, psychological, and social dimensions

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16
Q

panic disorder

A

anticipation and experience of unexpected panic attacks (sudden episodes of terrifying bodily symptoms – labored breathing, choking, sweating, heart palpitations – and sense of losing control)

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17
Q

are panic attacks specific to panic disorder?

A

No, they occur in almost all anxiety disorders, but in panic disorders, they are recurrent and unexpected

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18
Q

what is the relationship between panic disorder and agoraphobia?

A

panic disorders are usually accompanied by agoraphobia (fear of being in situations where help may not be available or escape would be embarrassing/ difficult)

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19
Q

why are panic disorder and agoraphobia usually concurrent?

A

because people with panic disorders usually fear having an attack in a public place (so stay in side)

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20
Q

worry and generalized anxiety disorder

A

one common feature of GAD is worry, which some clinicians believe is a cognitive form of avoidance to decrease anxiety responses

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21
Q

OCD (obsessive-compulsive disorder)

A

obsessions (recurrent unwanted disturbing thoughts) and compulsions (ritualistic actions to control the obsessions)

sometimes people have just one or both

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22
Q

is OCD voluntary?

A

people usually know the obsessions are irrational but unable to stop and control the compulsions
(ex. an obsession with cleanliness may lead to a compulsion to keep washing their hands)

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23
Q

mental rituals

A

form of compulsions in an attempt to manage obsessions

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24
Q

trauma and stress-related disorders

A

psychological disorders triggered by an event involving death (or the threat of), serious injury, sexual violation, etc.

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25
Q

process of trauma and stress-related disorders

A
  1. period of numbness/ disassociation (feels alienated, socially unresponsive, oddly unaffected)
  2. intrusive symptoms emerge (recurrent nightmares/ flashbacks), arousal symptoms (maintaining high states of readiness), avoidance symptoms
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26
Q

acute stress disorder

A

trauma and stress-related disorders that last less than a month

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27
Q

post-traumatic stress disorder (PTSD)

A

if acute stress disorder symptoms last longer than one month, it is considered PTSD

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28
Q

why do some people who experience trauma not develop a stress disorder?

A

unclear, only 1 in 10 individuals who experience highly traumatic events go on to experience PTSD

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29
Q

comorbidity

A

having one anxiety disorder increases the likelihood of having another at the same time

30
Q

biological risk factors (diatheses)

A

genetic profile, propensity to active brain regions (esp those associated with fear learning)

31
Q

psychological risk factors (stressors)

A

fear learning (ex. mental associations because of phobia stimulus or vicarious learning – learning from others)

32
Q

brain regions associated with various disorders

A

phobias: active amygdala and insula
PTSD: lower activation in the prefrontal regions associated with emotional regulation
panic disorder: instability in autonomic nervous system
OCD: overactivity in anterior cingulate cortex, insula, caudate, putamen

33
Q

bipolar disorder

A

manic (excited/ energetic) and depressive episodes with normal time interspaced

34
Q

hypomania

A

(mild level of mania) can often feel pleasurable, high-sprits, happiness, nervous energy
but often develops into full-blown mania which can be terrifying and destructive

35
Q

who does bipolar disorder occur in?

A

children and adults

36
Q

what is the lading cause of death worldwide?

A

suicide, in the US the person at highest risk for death by suicide is male, non-Hispanic White or Native American, adolescent or older adult

37
Q

men and women and suicide rates?

A

across most all cultures, women are more likely to attempt suicide (use less lethal things) but men are more likely to die by suicide

38
Q

is there an association between psychological disorders and suicide?

A

the overwhelming majority of individuals who commit suicide are thought to have psychological disorders
people who die by suicide have low levels of serotonin (NT) in the prefrontal cortex

39
Q

bipolar disorder and suicide risk?

A

most at risk during leave from hospital and period immediately after discharge

40
Q

what is an effective way to reduce suicide rates?

A

at the societal level, interventions that focus on educating children about suicide via school-based awareness programs

41
Q

biological risk factors for mood-related disorders?

A
  • genetic profile
  • abnormalities in 3 NT (norepinephrine, dopamine, serotonin)
  • dysregulation in emotion-generative brain regions (more activation in limbic system region (subgenual cinglate cortex), associated with MDD). (less activation in PFC, more activation in the amygdala, associated with BPD)
42
Q

psychological risk factors for mood-related disorders

A
  • dysfunctional patterns of thinking (negative cognitive schema or negative explanatory style, high levels of interpersonal stress)
43
Q

social risk factors for mood-related disorders

A
  • interpersonal stress
  • having a depressed cartetaker
44
Q

dopamine hypothesis

A

early theory on cause of schizophrenia
- believed that elevated levels of dopamine is associated with schizophrenia
+ found that imbalance in dopamine is a more likely cause

45
Q

what evidence was used to justify the dopamine hypothesis?

A

classical antipsychotics blocks dopamine receptors and was effective in relieving schizophrenia

46
Q

(explaining schizophrenia) dysfunction in glutamate transmission

A

increasing glutamate (NT) activity has lowered the impact of schizophrenia

47
Q

(explaining schizophrenia) abnormalities in frontal/ temporal lobes

A
  • loss of grey matter in prefrontal cortex
  • enlarged ventricles
48
Q

causes of schizophrenia

A
  1. genetics (twin & adoption studies suggest genetic basis)
  2. prenatal risk factors (diatheses): poor maternal health during pregnancy (malnutrition, etc.) and birth complications
  3. low SES (particularly poverty)
49
Q

schizophrenia as a neurodevelopmental disorder

A

now viewed as a neurodevelopmental order (meaning it stems from early brain abnormalities)

50
Q

civil commitment laws

A

people can be hospitalized against their will due to mental limitations associated with a psychological disorder
1. individual must have a mental illness (definition varies by state, but someone close to them usually initiates proceedings and client is able to defend themselves)
2. danger to themselves or others or unable to care for themselves

51
Q

stigma around mental illness

A

stigma that they are violent because of a mental illness

52
Q

not guilty by reason of insanity

A

not responsible for their criminal behavior, if at the time of the event they had a psychological disorder, they were unable to
1. understand their actions were wrong
2. behave as they know they should

53
Q

autism spectrum disorder

A
  1. persistent deficits in social communication and interaction
  2. restricted/ repetitive patterns of interest or behavior
54
Q

what does “spectrum” mean for autism

A

there are variations in the degree of impairment

55
Q

prevalence of autism spectrum disorder

A
  • it is 4x more likely in boys
  • usually diagnosed in childhood
  • increased in prevalence in the last two years –> some controversy
56
Q

why have autism diagnoses increased in the past few years?

A

expanded criteria, increased awareness, diagnostic substitution (misdiagnosing as intellectual disorder)

57
Q

some deficits of children with autism

A
  • some children don’t speak or produce high-pitched noises
  • trouble with pronouns (identifying themselves as “I”)
  • can’t hold “joint attention” (attention shared with someone)
  • less motivation to socially interact and less empathy
58
Q

why does autism occur?

A

difficulties with theory of mind (diminished motivation to engage in social interaction), brain abnormalities

59
Q

ADHD (attention-deficit/ hyperactivity disorder)

A

children with ADHD are impulsive and hyperactive, have difficulting shifting their focus to where it needs to be (fidget)
most common psychological disorder in childhood

60
Q

who is most likely to have ADHD

A
  • boys 2x more likely to have it
  • often doesn’t occur in adulthood
61
Q

ADHD treatment

A
  • Adderall (amphetamine and dextroamphetamine) and Ritalin (methylphenidate) are stimulants that enhance the release of dopamine and norepinephrine –> activate inhibitory circuits and help symptoms of ADHD
62
Q

controversy in ADHD diagnosis

A
  • is it just a label for kids who don’t adapt well to a crowded classroom?
  • great prevalence rate in different US states (bc diff methods)
63
Q

Disassociative Identity Disorder (DID)

A

(used to be called multiple personality disorder)
presence of two or more distinct personality states/ identities within a single person (each with own style, habits, beliefs, and memories)

64
Q

why the massive increase in diagnosis of DID?

A

could be because therapists encouraged suggestible clients, and they developed signs/ symptoms of the syndrome
hard to make a conclusion bc
1. little is known about the disorder (thought memory partitioning- interidentity amnesia- but no evidence of that)
2. double over well-documented cases (“Sybil,” ex. a therapist wrote a book on her and her DID, but transcripts show the therapist suggested DID and Sybil was in love with her therapist)

65
Q

how does DID arise?

A

ongoing controversy, unclear whether to cope with serious trauma or bc of therapists’ suggestion

66
Q

personality disorder

A

enduring pattern of inner experience and behavior that
1. largely deviates from cultural norms and expectations
2. inflexible and pervasive across a broad range of personal and social situations
3. leads to “clinically significant distress/ impairment in functioning”

67
Q

personality disorders recognized by the DSM-5

A

A: odd or eccentric behavior (paranoid, schizoid, schizotypal)
B: dramatic or emotional behavior (antisocial borderline, histrionic, narcissistic)
C: anxious or fearful behavior (avoidant, dependent, obsessive-compulsive)

68
Q

difficulties in diagnosis

A
  • no “pure” form of a personality disorder
  • overlapping symptoms
  • comorbid (likely to have 2 personality disorders in the same person)
  • hard to define threshold of when it becomes a personality disorder and not just eccentric personality trait
69
Q

antisocial personality disorder

A

lack of empathy: pervasive patter of disregard for and violation of the rights of others (diagnosed in someone at least 18 years)
(at least 3 of the things below)
1. repeated action, could be arrested
2. deceit (for pleasure or profit)
3. impulsivity/ lack of planning
4. repeated physical fights/ assaults
5. disregard for own/ others’ safety
6. irresponsibility and repeated failure to honor work and financial obligation
7. lack of empathy and response for harming others

70
Q

future of people with antisocial personality disorder?

A
  • overrepresented in prison populations but depends on IQ (range of incarceration to stress depending on life circumstances and IQ)
71
Q

what does antisocial personality disorder look like cognitively?

A

low in prefrontal gray matter volume and structural abnormalities in amygdala