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
schizoaffective disorder
combination of both a cognitive disorder and a mood disorder
Diagnostic: uninterrupted period of at least one month of major-depressive, manic, or mixed-episode mood disorder concurrent w/ symptoms which include delusions for at least 2 weeks
dopamine hypothesis
the main cause of schizophrenia is an abnormally high level of brain activity in the brain circuits to sensitive to the neurotransmitter dopamine
- not too much dopamine being released from neuron A to B, but rather too high a sensitivity of the dopamine receptors on Neuron B to what is released
classical antipsychotics
block the dopamine receptors on Neuron B from being activated by dopamine producing relief from many of schizophrenia’s symptoms
What are the cognitive defects of schizophrenia?
1) ability to reason or to plan
2) hold a goal in mind while working on a problem
3) inhibit a habitual thought or response
Sigmund Freud
- most notable deceased psychologist
- founder of psychoanalysis
- studied patients suffering from hysteria
hysteria (conversion disorder)
an older term for a group of presumably psychogenic disorders that included a wide variety of physical and mental symptoms
Psychoanalytic Theory
proposed that childhood sexuality and unconscious motivations influence personality
What are the psychogenic symptoms of hysteria (conversion disorder)
helter-skelter physical and mental complaints such as partial blindness or deafness, paralysis, or anesthesia of various parts of the body, uncontrollable trembling
repression
a mechanism of defense by means of which thoughts, impulses, or memories that give rise to anxiety are pushed out of consciousness
ie- Lashea cannot remember her father’s fatal heart attack although she was present
psychoanalysis
Freud’s theory based on assertions about unconscious conflict and early psychosexual development
ID
- totally unconscious (pleasure principle)
- the most primitive reactions of human personality, consisting of blind striving for immediate biological satisfaction
Ego
- personality executive (middle man
- operates both unconsciously and consciously (reality principle)
- tries to satisfy the id (to gain pleasure) but does so pragmatically, finding strategies that work but also accord with the demands of the real world
Superego
- operates both unconsciously and consciously (internalized code of conduct)
- reaction patterns that emerge from within the ego, represent the internalized rules of society & come to control the ego by punishment with guilt
- voice of conscience
- forces ego to consider not only the real but the ideal
displacement
redirection of an impulse from a channel that is blocked into another, more available outlet
ie– child who is disciplined by parent vents her anger by punching/kicking her doll
reaction formation
a forbidden impulse is turned into its opposite
ie– a young boy who hates his sister and is punished for calling her names may protect himself by bombarding her with exaggerated love and tenderness
Rationalization
unacceptable thoughts or impulses are reinterpreted in more acceptable and thus, less anxiety-arousing terms
ie- a cruel father beats his child mercilessly but is sure to so do “for the child’s own good”
Projection
various forbidden thoughts and impulses are attributed to another person, rather than the self
ie– “i desire you” becomes “you desire me”
“i hate you” –> “you hate me”
Regression
Returning to coping strategies for less mature stages of development
ie– After failing to pass his doctoral examinations, Giorgio spends days in bed cuddling his favorite childhood toy
oral stage
- preoccupations with the mouth sucking, swallowing etc
- superego develops
anal stage
-preoccupations with the anus-withholding or expelling faeces
Phallic stage
penis or clitoris -masturbation
-superego develops
genital stage
-the penis or vagina (sexual intercourse)
Diathesis-Stress Model
- a conception of psychopathology that distinguishes factors that creates a risk of illness (the diathesis) from the factors that turn the risk into a problem (the stress)
- a disorder results when a person has BOTH a predisposition (diathesis) for a disorder and a high level of stress
Minnesota Multiphasic Personality Inventory (MMPI)
-comparison between two diagnostic groups
-if all groups tended to respond to a particular question the same way, that question was deemed uninformative and was removed from the test
-questions were kept on the test only if one of the diagnostic groups tended to answer it differently from the other groups
ie– someone w/ depression answered differently than someone with anxiety
Anxiety Disorders
group of disorders distinguished by feelings of intense distress and worry, and in many cases, disruptive and unsuccessful attempts to deal with these feelings (maladaptive behaviors)
classical conditioning
i was once bitten by a raccoon and as a result developed a fear of all raccoons
- -> anxiety around raccoons and all things related (extended phobia of garbage cans, anxiety at sight of photographs or on tv, etx)
- -> maladaptive behaviors (actively avoiding raccoons, not going near trash cans, not going out at night
PTSD
chronic lifelong disorder following a traumatic experience
Symptoms:
- Re-experiencing symptoms: nightmares, recalling the event, flashbacks
- Arousal symptoms: difficulty concentrating, problems falling asllep, extreme responses to being startled
- Avoidance Symptoms:Avoidance of people, places, or objects that are linked to the trauma
Aaron Beck & negative cognitive schema
- predisposition for depression
- core cognitive component of depression is one’s negative cognitive schema (automatic negative interpretations of himself, his future and the world)
- -> the beliefs some people hold that they are worthless, that their future is bleak, that anything that happens around them is sure to turn out for the worst
Peterson & Seligman and Explanatory (Attributional Style)
- Negative Explanatory Styles: beliefs about why particular events happened to an individual and they are attributions to internal characteristics of the self that are also stable and global
- each of us has our own way of thinking about what happens to us
chemical model of depression and its major LIMITATION
antidepressant medications improve the functioning of a number of different neurotransmitters
–> Limitation: effects don’t actually start to take place until 4-6 weeks later (may be too late for some)
What song is this? Her dreams went out the door When she turned twenty four Only been with one man What happened to her plan?
Bowling for Soup
Prevalence of Schizophrenia and which two possible phenomena it points to?
- highest in poorest and most dilapidated areas fo the city, and lower in the higher status social region suggesting:
- environmental stress is implicated in the cause of schizophrenia (homelessness causes schizophrenia)
- schizophrenics are lower in social class BECAUSE of their schizophrenia (schizophrenia causes homelessness)
Mary and her Schizophrenia
20 years old, she began to exhibit mild paranoia, then one day, she began to hear voices, urging her to kill herself, telling her she was useless and no good
- would watch a tv show and mimic the behavior of a character on the show the next day.
- stopped bathing, chose to wear the same sweats and a pair of underwear
- lost track of the passage of time: a day would pass and she would think it was an hour
DSM & Shizophrenia
Negative symptoms: attributes that are are characterized as less than normal
- social withdrawal
- flat affect (blunted emotional responses)
- anhedonia
- reduced motivation and poor focus on tasks (avolitia)
- alogia (reduced speech)
- catatonia (reduced movement
Positive Symptoms: “add-on: attributes that normal ppl DONT show:
- Hallucinations (most often auditory)
- Delusions of grandeur, persecution, etc.
- Disordered thought processes
- Bizarre behavior
Dopamine Hypothesis and Schizophrenia
- oversensitive to the neurotransmitter Dopamine
- Schizophrenia: abnormally high level of activity in the brain circuits that are sensitive to dopamine
- classical antipsychotics (such as Thorazine and Haldol) –>block Dopamine receptors, reducing the amount of dopamine in the brain and seem to treat many POSITIVE symptoms of Schizophrenia
amphetamines & schizophrenia
- agonists to dopamine
- stimulants whose effects include increasing levels of Dopamine in brain, and when taken in large enough doses these drugs produce temporary psychosis
The Glutamate Hypothesis
dysfunction in Glutamate transmission in their brains, either b/c they have INSUFFICIENT GLUTAMATE or b/c they are relatively INSENSITIVE to it (receptor hypersensitivity)
- Evidence: drug Phencyclidine (PCP) (antagonist for glutamate) blocks glutamate receptors and induces symptoms similar to those seen in schizophrenia (receptor insensitivity)–> increases in dopamine: as in the brains of Schizos and in amphetamine useres leading to POSITIVE symptoms of Schizo (where amphetamines are AGONISTS for dopamine)
- -> while decreases in glutamate; as in the brains of Schizos and in PCP users also leads to POSITIVE symptoms (where PCP acts as an ANTAGONIST FOR GLUTAMATE
Schizophrenia and Brain Structure
- have enlarged ventricles (fluid filled cavities in the brain) B/C there is not enough brain to fill the skull–> indicating there is either a dramatic loss of brain tissue or a deficiency that has existed from the start
- tend to have loss of gray matter in PREFRONTAL regions (support working memory)
- -> degree of tissue loss is correlated with severity of symptoms
- also tend to have cellular abnormalities
Antipsychotic Medications
- tend to be more effective in treating positive symptoms than negative
- need to be taken regularly because they only relieve symptoms while being taken
Side effects:
- sedation
- weight gain
- Tardive Dyskinesia (repetitive involuntary movements, twitches)
- Akathisia (distressing sense of inner restlessness
- headaches, dizziness, anxiety
Dissociation
- various way in which people try to distance themselves psychologically from ongoing events
- conscious awareness becomes separated from previous memories, thoughts, and feelings
- are more easily hypnotized than others
- usually triggered by a major stressor/ distressing event in a person’s life (psychogenic amnesia: lasts less than a week) & psychogenic fugue: severely amnesis, wanders from home, )
- in almost all known cases of DID, patients had experienced physical and/or sexual abuse as children
Autism
- diagnosed in young children
- characterized by a wide range of developmental problems, including language and motor problems (usually given before the age of 3)
- more prevalent in boys
Amy and GAD
- constantly tense and has difficulty concentrating, frequently suffers from insomnia and rapid heartbeat
- Meds: Anxiolytics (Valium, Xanax, etc)
Dr. Kestenbaum Lecture
- Mind:
- -> thoughts + feelings
- -> consious + unconscious
- Laws of Mind:
1) Control
2) Unconscious does not know time
3) job of unconscious is to protect (from feeling out of control) - Process of Psychotherapy (= process of Human Growth(
4) Working alliance
5) Uncovering
Correlations and Correlations Coefficient
-measures of the extent to which 2 factors vary together, and thus of how well either factor predicts the other
- correlation does not equal causation: no matter how strong a relationship, correlation does not prove anything
ie– amount of ice cream people eat increases during the summer as does the number of shark attacks
–> positive correation
–> there is a hidden reason that is the cause of both (third factor: warm weather & in the summer, more people eat ice cream because it’s warmer, and more people go swimming, so more shark attacks occur
- correlation coefficient: statistical index of the relationship between two things
Scatterplots
graphed cluster of dots, each of which reps the values of 2w variables
- slope: direction of the relationship btwn the 2 variables
- amount of scatter => strength (little scatter= high correlation)
Scientific Method
describes the practices of gathering knowledge that involve some extent of control and measurements (explanations of how things work)
- look for cause-effect relationships
Theory: explanation using an integrated set of principles that organizes observations and predicts behaviors or events
Hypothesis: testable prediction, often implied by a theory
Experimentation
“happy are they, who have been able to perceive cases of things” -roman poet Virgil
-research method in which an investigator manipulates on or more factors (independent variable) to over the effect on some behavior or mental process (dependent variable
independent variable
experimental factor that is manipulated;the variable whose effect is being studied
ie– wine consumption (what we are manipulating)
dependent variable
outcome factor the variable that may change in response to manipulations of the independent variable (*is dependent on the independent variable)
ie– calories burned (what we are measuring)
Random Assignment
assigning participants to experimental and control groups by chance, thus minimizing preexisting differences btwn those assigned to diff groups
Experimental (treatement group)
group that is exposed to the treatment (to one version of the independent variable)
ie– participants who drank the wine
Control (comparison) group
group that is not exposed to the treatment
ie– participants who dont drink wine
Normal Curve
symmetrical, bell-shaped curve that describes the distribution of many types of date
standard deviation
computed measure of how much scores vary around the mean score
When is an observed difference reliable?
1) Representative samples are better than biased samples
2) Less-variable observations are more reliable than those that are more variable
3) More cases are better than fewer
When is a difference significant ?
statistical significance: a statistical statement of how likely it is that an obtained result occurred by chance
(when sample averages are reliable and when the difference between them is relatively large)
case study
an intensive study of one person
demand characteristics
cues in a study that might tell a research participant what behaviors are expected or desirable in that setting
Double-blind design
technique of assigning participants to experimental conditions while keeping both the participants and the researchers unaware of who is assigned to which group
Random Sampling
every member of the population has an equal chance of being picked to participate in a study
Descriptive Stats
mathematical procedures that allow a researcher to characterize a date pattern; include measures of central tendency and variability
inferential stats
mathematical procedures that allow a researcher to draw further claims from a data pattern, including claims about whether the pattern observed in the sample is likely to be observed in other samples
reliability
degree of consistency with which a test measures a trait or attribute
validity
extent to which a method or procedure measures what its supposed to measure
effect size
the magitude of diff betwn groups in a study often computed by subtracting the mean of one group’s scores from the mean of others’ scores
quasi-experiment
a comparison that relies on already-existing groups (groups the experimenter didnt create)
correlational studies & Third-Variable Prolem
- studies in which the investigator analyzes the relationships among variables that were in place before the study (w/o manipulation)
- the possibility that two correlated variables may be changing together only due to the operation of a third variable
Within-subjects comparisons
within a study, comparing the data about each participant in one situation to data about the same participant in another situation
between-subjects comparisons
within a study, comparing one group of individuals to a different group
internal validity
the characteristics of a study that allows us to conclude that the manipulation of the independent variable caused the observed changes in the dependent variable
Meta-analysis
statistical technique for combining the results of many studies on a particular topic, even when the studies used diff data collection methods
empirical claims
claims that can be true or false depending on the facts
physiological/somatic model
mind disturbances are caused by body disturbances
psychodynamic therapy
is a form of depth psychology to reveal the unconscious content of a client’s psyche in an effort to alleviate psychic tension (similar to psychoanalysis)
somatoform disorders
form of mental illness that causes one or more bodily symptoms, including pain
Antisocial personality disorder
- pervasive pattern of disregard for and violation of, the rights of others that begins in childhood or early adolescence
- must be 18 or older for diagnosis and have a history of some symptoms of conduct disorder before the age of 15
What are the causes of Sociopathy?
1) Failure to anticipate the negative consequences of an action
2) dominance of an anticipation of reward in controlling behavior
3) underaroused (irregular signaling activities in the orbitofrontal and dorsolateral prefrontal cortex
Biomedical model
organic underlying cause + somatic therapy
Psychodynamic model
unconscious conflicts + various defenses against anxiety
Treatment: “talk therapy” gain insight into inner conflicts
The Learning Model
maladaptive learning of faulty thinking habits
Treatment: behavior/cognitive therapy
