Psychology Disorders & Treatment Flashcards
Misconceptions & Controversies: The medical model
focus on bio causes, views abnormal behaviour as disease •problems + limitations
•Still maybe most dominant model
•Relied on supernatural explanations
•Medical model helped ppl get treated better
•Stigma seems to be getting worse
•Doesn’t take into considerations the other factors
Stereotypes of Psychological Disorders
–Psychological disorders incurable
–violent + dangerous
–behave in bizarre ways + very different from normal ppl
•Once diagnosed – always gonna have label
•Vast majority can be successfully treated + a lot of the time temporary
•most extreme cases of mental illness: we use availability heuristic
•Incredibly small minority engage in criminal acts
•Touches everyone: most of the time you have no idea
criteria do psychologists use to determine whether someone’s behaviour is normal/abnormal?
–Deviance: in terms of norms for that culture
•Deviant in 1 culture, normal in another
–Maladaptive behaviour: harmful for person
–Personal distress: behaviour must interfere with at least one aspect of the person’s life (relationship, emotional well-being, workplace)
•Our understanding of abnormal behaviour + mental illness is also constantly evolving: Homosexuality was a disorder until 1974 + Drake domania
•Hard to tell whether its normal/abnormal
•Hysteria –exclusive to W
Diathesis-Stress Model
Diagnostic model proposes disorder may develop when underlying vulnerability + precipitating event
•Diathesis: vulnerability, genetic predisposistion
•Doesn’t have to be biological: can be childhood trauma
•Stress: hard time, stressful circumstances
Family systems model
emphasis on social context (family)
how relationships contributing
Socio-cultural model
emphasis on interaction between individual + culture
–anorexia nervosa
certain disorders more likely to occur in certain socioeconomic status, subcultural you grow up in
Cognitive-behavioural approach
emphasis on maladaptive thoughts + beliefs that the individual has learned
–#1 treatment, focus on cognitive (thoughts) + behaviours
•replace those behaviours with functional ones
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV): Multiaxial system
–Axis I: Clinical disorders - come + go, easier to treat - schizophrenia, childhood disorders, depression
–Axis II: Personality disorders & mental retardation - lasting longer - antisocial personality disorder
–Axis III: General medical conditions - Alzheimer’s, obesity
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV): Multiaxial system
–Axis IV: Psychosocial/environ problems - what’s going in person’s life - unemployment, divorce, poverty
–Axis V: Global assessment of functioning - how are they doing in general - Scale from 1 to 100
DSM-5 dropped the multiaxial system: Intellectual disorders looked at together
Assessment
examining mental state to diagnose + treat possible psychological disorders
•Evaluating them
evidence-based assessment
use research rather than gut feeling
•probability, what research says, what treatment is most effective
comorbidity: if you have 1 there’s an increased likelihood you have another one as well
•Are they suffering from these other mental disorders
Psychotherapy
formal psychological treatment
–Always involve interactions between practitioner + client: importance of finding the right therapist - trust, believe it’s gonna work
Treatment
Increased understanding of the causes of a mental disorder does not necessarily lead to more effective treatment strategies
•Can’t assign a catch all treatment to whole disorder = Need to consider personal circumstances
Psychodynamic therapy (Freud)
–Psychoanalysis
–Insight: Increase patient’s understanding of own psychological processes/where conflict coming from
–less common
•Unconscious conflict gives rise to symptoms
•Free association: whatever comes to mind
•dream analysis: Meaning from dreams
•Minimize role of therapist
Client-centered therapy (Rogers):
–Safe + comfortable setting, empathy, reflective
listening
–Encouragement of personal growth through self- understanding
•Client being listened to, accepted, not judged
•Reflective listening: repeating so they know you’re listening
Cognitive therapy
–Attempts to modify thought patterns in order to eliminate maladaptive behaviours + emotion
–Cognitive restructuring
Behavioural therapy
–maladaptive behaviours learned conditioning + can be ‘unlearned’ in same way
–Behaviour modification: effective for autism
•Reinforce positive + ignore/punish negative
Psychotropic medication
Drugs that affect mental processes
–Anti-anxiety drugs: Short-term treatment of anxiety - increase GABA activity
tranquilizers – negative side effects
Psychotropic medication
–Antidepressants: SSRI - increase serotonin levels
–Antipsychotics (neuroleptics): Block dopamine, reduce positive symptoms of schizophrenia
Anxiety Disorders
- excessive anxiety in absence of true danger
- Very common: 1/4 ppl
- Common symptoms: autonomic system arousal, worry/anxiety/tenseness, restlessness, excessive startle response
Phobic disorder
–Specific phobias: specific object/scenarios
–Social phobia
–Agoraphobia can have panic attacks
•Illogical level
Generalized anxiety disorder (GAD)
–Hypervigilance
•Chronic sense of anxiety
•High alert
•Excessive anxiety
Panic disorder
–fear of having panic attacks
•All associated with autonomic nervous system
•blood injury injection phobia: sympathetic nervous, take blood, bp drops after get raised
Obsessive-compulsive disorder (OCD)
–Obsessions vs. compulsions
-OCD no longer grouped with the anxiety disorders
Obsessions: thoughts
•Compulsions: things done to deal with thoughts
Causes: Cognitive factors
–Attention to + perception of threat
•Ambiguous stimuli (At the meeting contribution elicits reactions
•Can contribute, not necessarily does
•Cognitive: seeing threat
Causes: Situational/Environmental factors
–Learning (OCD): Learn to do compulsions
–Streptococcal infection (OCD): present symptoms similar to OCD
Causes: Biological factors
–Inhibited temperamental style: tends to lead to shyness in adulthood can lead to anxiety disorder
•Threat detector overactive – increased amygdala response
–Genetics (OCD runs in families)
–Abnormal brain activity: Caudate – basal ganglia – smaller + react abnormaly in OCD – impulse control
Treatment: Phobic disorder
Behavioural techniques treatment of choice for specific phobias
–Systematic desensitization therapy: Fear hierarchy, relaxation training, exposure therapy
•Hier – list diff scenario + order
Treatment: Anxiety Disorders
Cognitive-Behavioural Therapy (CBT):
–correct faulty thinking + change maladaptive behaviours
• Cognitive restructuring, exposure & response prevention (ERP)
•Exposure therapy
Mood Disorders: Dysthymia
–“Depressed mood most of the day, more days
than not, for at least two years”
Mood Disorders: Major Depression
–Common cold of mental disorders
so common particularly in W
Mood Disorders: Bipolar disorder
–Alternating periods of depression + mania
–Manic episodes: elevated mood, increased activity, diminished need for sleep, grandiose ideas, racing thoughts, + extreme distractibility
Causes: Cognitive factors
–cognitive triad: selves, situation, future
–Learned helplessness model: just give up, learning nothing you do has consequences so you just give up
•Low effecacy
Causes: Situational/Environmental factors
–Life stressors, particularly interpersonal loss
Causes: Biological factors
–Genetics
–Monoamine deficiency (serotonin)
–Biological rhythms: circadian rhythms – SAD
Treatment: Depression
–no “best” way, many effective approaches available
• Antidepressants: help alleviate pain
• Cognitive-behavioural therapy: for long term
Treatment: Depression
–Alternative treatments include phototherapy, exercise, electroconvulsive therapy, transcranial magnetic stimulation, + deep brain stimulation
•Best treatment is medication + CBT
Treatment: Bipolar Disorder
–Lithium (mania): not understood, they want to feel high, don’t wanna take medication, lot of artists suffer from bipolar, most creative
Electroconvulsive therapy (ECT)
administering strong electrical current to brain
•ECT last resort, not responding to CBT, medication
Transcranial magnetic stimulation (TMS)
electrical current in the brain region directly below coil
left prefrontal – less active
Deep Brain Stimulation (DBS)
implanting electrodes within certain parts of the brain
pace maker – everynow + then sends stimulation, shown to be successful, also used for OCD
Schizophrenia
alterations in perceptions, emotions, thoughts/consciousness
DSM-5: Subtypes have been removed: Useless subtypes
•Psychotic – abnormal thought patterns
Schizophrenia: subtypes
–Paranoid type –Disorganized type –Catatonic type –Undifferentiated type –Residual type
Schizophrenia: Positive symptoms
Excesses in behaviour
–Delusions: False personal beliefs based on incorrect inferences about reality
–Hallucinations: False sensory experiences
Schizophrenia: Positive symptoms
–Loosening of associations: Speech pattern in which thoughts are disorganized/meaningless – gibberish
–Disorganized behaviour: Acting in strange ways – deviant behaviour
Schizophrenia: Negative symptoms
Deficits in functioning; includes behaviours such as: –Isolation, withdrawal –Apathy –Blunted emotion –Slowed, monotonous speech + movement
Schizophrenia: Negative symptoms
•more difficult to treat than positive symptoms; different underlying causes
no emotion, weird speech + movement
•Positive respond to treatment easier
Schizophrenia: Causes
- Genetic component: brain disorder: enlarged ventricles - Lack of brain matter
- Missing white matter: brain matter responsible sensory perceptions, motor control
- Environmental stress: cultural frequently in lower socioeconomic classes
- Most often from cities
Schizophrenia: Treatment
•Pharmacological treatments most effective
–Antipsychotics haloperidol + chlorpromazine revolutionized the treatment of schizophrenia: get rid of positive symptoms
•Little to no effect on negative symptoms
•Significant side effects: tardive dyskinesia - no cure, motor impairment – ticking
Schizophrenia: Treatment
–Clozapine: Acts on numerous neurotransmitter receptors + treats negative symptoms, no signs of motor impairment, – -Social skills training, intensive form of CBT – learning social interactions
Dissociative Identity Disorder
•Controversial disorder part of a broader group of dissociative disorders
–Some suggest it should be included as a type of PTSD
Dissociative Identity Disorder
- Dissociative: breakdown of memory/awareness
- Extreme personality shifts
- Stanford prison experiment: see how ppl were treated
- We’re capable of extreme shifts in personality given circumstances
Personality Disorders
- interacting with the world in maladaptive + inflexible ways, for long time, resulting in social/work problems + personal distress
- Usually last throughout lifespan with no expectation of significant change (Axis II)
Personality Disorders: three groups
–Odd/Eccentric Behaviour: like positive symptoms of schizo
–Dramatic/Emotional/Erratic Behaviour: borderline, antisocial
–Anxious/Fearful Behaviour: similar to anxiety disorder
•Harder to treat, doesn’t mean incurrable
Borderline personality disorder
disturbances in identity, affect + impulse control
•Identity: Lack a strong sense of self, fear abandonment, can be very manipulative in attempts to control relationships
•More common in W
Borderline personality disorder
- Affect: Profound emotional instability
- Impulsivity: Self-mutilation most common, also sexual promiscuity, physical fighting, binge eating + purging
- Need at least 5 symptoms
- Borderline: borderline betw normal + psychotic behaviour
Borderline personality disorder – Causes
- Biological factors: Genetics, serotonin
* Environmental factors: Abuse, trauma, relationship with caregivers
Anti-social personality disorder (APD)
–lack of empathy + remorse –More common in M –Psychopaths: most extreme version of APD - superficially charming + rational, insincere, unsocial, incapable of love, lacking insight, shameless •Common in prison •Hedonistic
Anti-social personality disorder (APD) – Causes
Biological factors:lower levels of arousal, lack of fear/anxiety, amygdala abnormalities, deficits in frontal lobe functioning = lack of foresight
–Genetics more important for psychopathy
Anti-social personality disorder (APD) – Causes
Situational/Environmental factors: low socio- economic status, dysfunctional families, childhood abuse
Treatment: Borderline personality disorder
notoriously difficult to treat
–Dialectical behaviour therapy (DBT)
-psychodynamic, cognitive + behavioural component
•1st stage: change behaviour
•2nd: psychodynamic – understand background, insight
•3rd: addressing maladaptive thoughts
Treatment: Anti-social personality disorder
–Problems with treatment: no desire to get treatment, just manipulate
•superficially charming
–Prognosis: subsides with age
Childhood Disorders
usually first diagnosed in infancy, childhood/adolescence
–Very wide-ranging
–Need to be considered within the context of
normal childhood development – Assessment can be challenging
DSM-5: No longer a separate chapter
•might persist into adulthood
•selective mutism
Autism/Autism Spectrum Disorder
DSM-5: Now Autism spectrum disorder
-developmental disorder involving deficits in social interaction, impaired communication + restricted interests
•nothing suggests it’s more frequent
•more likely to be diagnosed, more likely to recognize symptoms
Asperger’s syndrome
form in which children have deficits in social interaction + theory of mind, but don’t show the same impairments in linguistic/cognitive development + normal IQ
DSM-5: No longer a distinct diagnosis, instead falls under autism spectrum disorder
Autism Spectrum Disorder: Core symptoms
1)Unaware of others: lack of eye contact, smiling
2)Deficits in communication: echolalia, pronoun reversal
3)Restricted activities + interests: repetitive play + behaviour, interested in nonsocial objects
•Any changes to routine/settings extremely upsetting
Autism Spectrum Disorder: Causes
–Primarily biological; hereditary component
–Pre-natal/neo-natal events may result in brain dysfunction: breathing probs, heart probs, overgrowth/undergrowth pattern of brain development
•2-5 grows large then stops growing
–Promising new research: oxytocin research
Autism Spectrum Disorder: Treatment
–Applied behavioural analysis (ABA): intensive treatment based on the principles of operant conditioning
•40 hours/week: Huge time commitment, financially + emotionally draining
•when done right, can have big results
•Not something all parents can do
•Reward positive behaviour
Attention Deficit Hyperactivity Disorder (ADHD)
•restless, inattentive + impulsive behaviours
–Behavioural profiles vary greatly, causes may vary greatly as well
Attention Deficit Hyperactivity Disorder (ADHD)
Biological factors: connection between frontal lobe + limbic system, abnormal activation of prefrontal regions, basal ganglia
•30-80% of children diagnosed with ADHD continue to show symptoms in adulthood: may lead to academic + employment struggles
ADHD: Treatment
Ritalin (methylphenidate): stimulant without them having to engage in hyperactivity
–Decreases overactivity + increases attention
•Side-effects: sleep problems, loss of appetite, etc.
•Limbic system: subcortical
•Overdiagnosed
•Extra issues of kids on drugs
Summary
- Importance of taking a holistic perspective, examining + treating the person within context
- Importance of evidence-based assessment + treatment
- Importance of patient beliefs + trust in the treatment provider (i.e., therapist)
