Psychopathology Flashcards
general paresis & Richard von Krafft- Ebing
- disorder characterized by a broad decline in physical and psychological functions
- co-occuring set of physical and mental dementia symptoms were recognized as constituting a defined medical disease
- personality aberrations such as grandiose delusions (i am the king of england)
- profound hypochondriacal depressions (my heart has stopped beating)
- von Krafft- Ebing discovered that this disorder was actually a result of syphilis
syndrome
patterns of signs and symptoms that tend to go together
etiology
possible causes of the symptoms
Diagnostic and Statistical Manual DSM-III
- manual that provided specific guidance on how to diagnose each of the nearly 200 psychological disorders
- tend to begin with a clinical interview (clinician asks the patient to describe their problems and concerns)
- emphasized the specific signs and symptoms required for each diagnosis, holding theory to the side as much as possible
DSM-IV
split diagnostic categories into smaller, more sharply defined ones. Some terms (“neurosis” and “hysteria”) have been largely abandoned as not meaningful
tackled the crucial problem for clinicians–> how severe a set of symptoms has to be before it merits a diagnosis
acknowledges that the presentation and frequency of various disorders depend on the cultural setting and that some syndromes seem to appear only in some cultures
DSM-IV: Axis I
describes syndromes such as schizophrenia, depression and drug dependency
DSM-IV: Axis II
describes mental retardation and personality disorders (antisocial personality disorder and OCD)
DSM-IV: Axis IIII
describes general medical conditions that may contribute to a person’s psychological functioning (such as constant pain from some continuing medical problem)
DSM-IV: Axis IV
assessing social or environmental problems (family or legal difficulties)
DSM-IV: Axis V
provides global assessment of functioning (how well a person is coping with her overall situation)
anxiety disorder
person is chronically apprehensive, always fears the worst, must guard vigilantly against anticipated disaster (over 20 million people each year in the US)
phobia ( see Coon’s phobia of taxi cabs)
- intense and irrational fear, coupled with great efforts to avoid the feared object/situation
- produced via classical conditioning
–> an individual encounters an originally neutral object or situation (dog or lake) and has a negative experience with that stimulus (getting bitten or near-drowning experience)
vicarious conditioning
- preparedness to become phobic that can be triggered into actuality by seeing someone else show a fear reaction to one of these stimuli
- makes sense evolutionarily: evolution should favor organisms with advantageous genes that predispose them to fear things that are inherently dangerous to them, such as spiders, snake, heights, etc.
panic attack
sudden over-awareness of their own bodily signs leading to feelings of horror/impending doom induce fight-or-flight symptoms (5% of women and 2% of men)
agoraphobia
fear of being out in the open/ where other people are able to see them
generalized anxiety disorder
-fear and anxiety experienced is “free-floating,” that is, generalized to all stimuli so that it is continuous and all-pervasive
-abnormalities in the neurotransmitter symptoms involving norepinephrine, serotonin, and gamma-aminobutyric acid)
-symptoms of GAD include:
● Feeling inadequate
● Constantly tense
● Difficulty concentrating
● Insomnia
OCD (obsessive-compulsive disorder)
- defense against anxiety
- obsessions (recurrent unwanted and disturbing thoughts) and a series of compulsive behaviors intended in large part to deal with the obsessions (continual hand washing)
- begins before age 10, and if untreated, worsens over time
- afflicts 2-3% of population sometime in lives
Which brain areas is OCD linked to?
- orbitofrontal cortex
- the caudate nucleus
- anterior cingulate
–> although it is unclear whether this activity is the cause of the disease of one of its consequences
What are the two kinds of stress disorderes
acute stress disorder and if the acute phases persists for over a month, post traumatic stress disorder (PTSD)
cortisol
- substance secreted by adrenal gland (marker of both early adversity and later vulnerability)
- PTSD sufferers show abnormally low levels
depression
- feelings of sadness, hopelessness, and broad apathy about life; loss of interest in eating, hobbies, sex, and, for that matter, almost everything
- if feelings of sadness have lasted for a least 2 weeks and are accompanied by other symptoms such as insomnia + feelings of worthlessness
- low levels of seratonin
- mood disorder characterized by disabling sadness, hopelessness, and apathy: a loss of energy, pleasure and motivation: and disturbances of sleep, diet and other bodily functions
- lose interest in most hobbies (eating and sex)
what are the accompaniments of clinical depression?
1) considerable anxiety
2) some signs of psychosis ( loss of contact with reality: delusions and hallucinations of worthlessness)
3) disruptions of attentions and working memory
4) various physical manifestations or reduced sensitivity to basic protection, replication, and renewal needs
bipolar disorder
-patient endures alternating episodes at manic and depressive extremes (with normal periods interspersed)
-may cycle every few hours or may take several
months from peak to peak
-.5-1% of the populations
-concordance rate is almost 2x higher in identical twins than in fraternal: if someone’s identical twin has BD, 60% chance they too will have the disorder
major depression
- mood extreme is of one kind only
- 13% of men; 23% of all women
- have certain genes that make them deficient in certain neurotransmitters: seratonin, dopamine and norepinephrine
- -> antidepressant medications seem to work by increasing levels of neurotransmitters in brain
mixed states
the seemingly opposite states of mania and depression co-occur (tearfulness and pessimism combined with grandiosity and racing thoughts)
Hypomania
infectiously happy, utterly self-confident, and indefatigable moods; jumping from plan to plan, restlessness, responses to even small frustrations by quick shifts from elation to irritation
mania
1) extreme energy and enthusiasms for projects
2) little need for sleep
3) racing thoughts (endless streams of talk that run from one topic to another and know no inhibition of social and personal propriety
4) sense of utter invincibility
Where does the cause to bipolar disorder lie?
EITHER in some dysfunction in neuronal membranes such that they mismanage fluctuations in the level of various neurotransmitters OR to lie in a mitochondrial dysfunction involving cellular energy production
What is the major therapeutic agent for treating bipolar?
lithium chloride, an agent that stabilizes the cycling through actions reducing the manic phase
What does lithium chloride act on?
various genes that control
1) glutamate production
2) mitochondrial action
3) enzyme helping to regulate diurnal cycles in the body so as to reset them
negative cognitive schema
triad of negative irrational and pessimistic beliefs
1) worthlessness= control locus is viewed as internal & bad (has a negative internal locus of control)
2) everything is wrong=situation is viewed as global & bad
3) the future is bleak=situation is viewed as stable & bad (person feels she will always mess up)
learned helplessness theory
Martin Seligman’s research with dogs (221)
explanatory style
- the reason not every human becomes depressed who has experienced a series of failures as did Seligman’s dogs
- style a person has for looking at and interpreting the world (pessimistic –> depression)
Why is major depression more common in women?
1) susceptibility genes (lie on X Chromosome
2) hormonal menstrual cycle, postpartum, and menopausal changes
3) women amplify problems by ruminating on them
schizophrenia
- psychosis: loss of contact with reality
- split-mind
- group of severe mental disorders characterized by at least some of the following: marked disturbance of thought, withdrawal, inappropriate or flat emotions, delusions and hallucinations
- typically occurs in late adolescence and early adulthood
- sooner/more severely men than for women
- very rare (1% of the population(rate varies from country to country: prevalence rates are very high in Croatia, but low in Papua New Guinea))
- substantial genetic risk: biological parents–> child has an 8% chance
Diathesis-Stress Models (Emil Kraepelin)
purpose: to list diagnoses and symptoms so that psychologists and others can help diagnose psychological disorders
1) symptoms & syndromes
2) immediate causes in terms of
a: psychological mediators
b: physiological mediators
2) remote or underlying causes in terms of
a: diathesis (predisposition)
b: stress (set of discomforting environmental conditions)
Positive Symptoms of Schizophrenia
- Delusions: incorrect beliefs that are rigidly maintained despite the absence of any evidence for the belief and in many cases, despite contradictory evidence
- Hallucinations: sensory experiences in the absence of any actual input (auditory, tactile, visual)
Disorganized Behavior: unusual behaviors such as dressing peculiarly, becoming frenzied, running haphazardly, shouting nonsensically, acting violently
Negative (deficit) symptoms of Schizophrenia
- absence of behaviors usually evident in healthy people
- diminution or loss of normal functions
a) affective flattening
b) alogia (poverty of speech)
c) avolition (lack of motivation)
d) catatonic behavior: standing or sitting “frozen” in one position for hours on end, even in uncomfortable postures
e) anhedonia: loss of interest in activities that we would ordinarily expect to be pleasurable
f) withdrawal from people: may not have many childhood friends, excessively private
affective flattening
- blunted ability to express affect and emotion
- express little emotion, say little, may be unable to persist in activities, may stare vacantly into space, speak in monotone
alogia
poverty of speech
lack of motivation
lack of motivation
anhedonia
inability to experience affect and emotion
delusions
- grandiosity/ persecution/reference
- incorrect beliefs that are rigidly maintained despite the absence of any supporting evidence (90% of schizophrenics)
Hebephrenia
- childlike silliness to unpredictable agitation
- difficulties in performing activities of daily living (organizing meals or maintaining hygiene)
Catatonic Type
- stand/sit “frozen in stupor” in some posture
- may be rigidly resistant to instructions to move or attempts to be moved
- become frenzied, running haphazardly, shouting nonsenically and acting violently
- echolalia/echopraxia
positive symptoms of schizophrenia
characteristics that schizophrenics do show that nons don’t show
simple schizophrenia
- insidious progressive development of prominent negative symptoms often from early childhood with no history of psychotic episodes
- in other cases characterized by admixtures with positive symptoms the withdrawal still typically develops but slowly
What are the prominent subtypes of schizophrenia?
paranoid type, disorganized type=hebophrenic, catatonic type, simple schizophrenia, schizoaffective disorder
paranoid type
preoccupation with one or more delusions or frequent auditory hallucinations but disorganized behavior, or, flat or inappropriate affect are present
disorganized type
- disorganized speech
- disorganized behavior
- flat or innappropriate behavior
catatonic type
1) motoric immobility (stupor or waxy flexibility)
2) excessive, purposeless motor activity
3) extreme negativism/mutism
4) peculiarities of voluntary movement, stereotyped movements, prominent mannerisms
5) echolalia or echopraxia
simple schizophrenia
- affective flattening
- alogia
- avolition