Psychopathy Weeks 19-20 Flashcards
three general theories of the etiology of mental illness
1 -Supernatural: possession by evil/demonic spirits, displeasure of gods, eclipses, planetary gravitation, curses, sin.
2- Somatogenic: disturbances in physical function from illness, genetic inheritance, brain damage/imbalance
3 - Psychogenic: traumatic/stressful experiences, maladaptive learned associations/cognitions or distorted perceptions.
History of Medical Illnesses - Related Terms
● Trephination: drilling of a hole in the skull, presumably via treating psychological disorders (lobotomy?)
● Hysteria: term used by the ancient Greeks and Egyptians to describe a disorder believed to be caused by a woman’s uterus wandering
throughout the body and interfering with other organs
● Humourism: belief from ancient Greek & Roman physicians that an excess/deficiency in body fluids - blood, black bile, yellow bile,
phlegm - directly affected their health and temperament.
● Animism: the belief that everyone and everything had a “soul” and that mental illness was due to animistic causes, for example, evil
spirits controlling an individual and their behavior.
Anxiety Disorder
Anxiety is motivational but can also be debilitating.
● Anxiety is a disorder if it interferes in a person’s life in a significant way
Anxiety and “Triple Vulnerabilities” - all must be present for anxiety disorder
Biological vulnerabilities
- specific genetic/neurobiological factors; can predispose anxiety.
genes can make us more susceptible, influence how our brains react to stress.
Psychological vulnerabilities
- influences of our early experiences on how we view the world (unpredictable stressors/trauma at young age)
Specific vulnerabilities
- how our experiences lead us to focus/channel our anxiety.
Generalized Anxiety Disorder
excessive worry about everyday things, at a level out of proportion to the cause of worry.
symptoms like muscle tension, fatigue, agitation/restlessness, irritability, sleep difficulties, concentration difficulties.
- 6 months, ongoing, on more days than not, for good proportion of the day
● Those with GAD are more sensitive/vigilant towards possible threats.
○ Maybe they worry as a way to gain control over unpredictable experiences (arose from early stressful experiences so they
view world as unpredictable) or to avoid feeling distress
○ Going through “What If?” scenarios may allow them to feel somewhat prepared.
● But many of the catastrophic what if? scenarios don’t happen, so worrying gets reinforced (when the GAD person links the desired outcome with worry).
Panic Disorder (PD)
a condition marked by regular, strong (unexpected) panic attacks (fight-or-flight response), may include significant worry about
future attacks.
● DSM Criteria: must have unexpected panic attacks but also ongoing, intense anxiety/avoidance related to the attack for at least a month, causing
distress to interfere in lives.
● Domino effect as PD people interpret normal physical sensations in catastrophic way = triggers more anxiety = triggers more physical sensation
○ Results in interoceptive avoidance (avoidance of situations/activities that cause sensations of physical arousal similar to those during a
panic attack/intense fear response).
● Internal bodily/somatic cues are physical sensations that serve as triggers for anxiety or as reminders of past traumatic events.
● External cues are stimuli in outside world that are triggers for anxiety/reminders of past trauma.
Agoraphobia
when someone feels a place is uncomfortable or they may be unsafe because it is significantly open/crowded (maybe feels like escape isn’t possible)
● DSM Criteria: develops in the absence of panic attacks, separate disorder but often accompanies panic disorder
Phobias
DSM Criteria: must be irrational fear of specific object/situation that substantially interferes with person’s function.
● Four major types are blood-injury-injection (BII)**, situational (e.g.; planes/elevators/enclosed spaces), natural environment (e.g.; heights, storms,
water), and animal.
○ Fifth category is “other” - e.g.; fear of choking, vomiting, contracting illness.
● Most phobic reactions cause surge of activity in sympathetic nervous system and increased heart rate and blood pressure (maybe even a panic
attack).
**drop in heart rate/blood pressure, may even faint, always differ in physiological reaction from people with other phobias, tuns in families more strongly than any other known phobic disorders.
● Most people who suffer from phobias tend to have multiple phobias of several types.
Social Anxiety Disorder (Social Phobia) (SAD)
Acute fear of social situations (any type) which lead to worry and diminished day-to-day functioning.
● DSM Criteria: fear/anxiety associated with social situations is so strong the person avoids them entirely or endures them with great deal of
distress if unavoidable.
○ Fear/avoidance of social situations interfere in person’s daily life (limit academic/occupational functioning).
Cause could be by social trauma (bullying) or reinforcement of dangers of social behaviour when growing up.
● Someone can react strongly to anxiety of social situation to the point where they have unexpected panic attack, which then becomes conditioned response.
Posttraumatic Stress Disorder (PTSD)
Sense of intense fear (triggered by memories of past trauma) that another traumatic event might occur.
○ May include feelings of isolation/emotional numbing.
● DSM Criteria: must have been exposed to event involving actual/threatened death, serious injury, sexual violence (experience, witness, learning from a close relative/friend, or repeated exposure
● PTSD person re-experiences the event through intrusive memories/nightmares (flashbacks)
● They may avoid anything that reminds them of event (conversations, places, types of people).
● They may not be able to remember certain aspects of what happened during the event and feel sense of foreshortened future or be jumpy/easily startled and quick to anger.
● Involves sensitivity to both internal and external cues that serve as reminders of trauma.
Obsessive-Compulsive Disorder (OCD)
Desire and urge to engage in behaviours excessively/compulsively in hopes of reducing anxiety (includes behaviours like cleaning, opening/closing doors, hoarding, obsessing), can be intense and cause significant anxiety
● may feel compelled to repeat the behaviour until they’re satisfied.
● DSM Criteria: must experience obsessive thoughts/compulsions that seem irrational/nonsensical but keep coming into their mind - repetitive
and excessive (e.g.; doubting, contamination, aggression).
○ Compulsions can be carried out to neutralize thoughts and provide temporary relief or can be non-sensible in and of themselves.
Treatments for Anxiety & Related Disorders
1- Medications (anti-anxiety drugs/antidepressants) were found to help in non-phobia disorders, but relapse rates are high once medications are
stopped.
● Some classes of medications (minor tranquilizers or benzodiazepines) can be habit forming.
2 - Exposure-based cognitive behavioral therapies (CBT) are effective psychosocial treatments for anxiety disorders, and many show greater treatment effects than medication in the long term.
○ In CBT, patients are taught skills to help identify/change problematic thought processes, beliefs, behaviours that worsen symptoms of
anxiety.
■ Involves practice in applying skills to real-life situations via exposure exercises.
■ Learn how automatic appraisals/thoughts they have about a situation affect how they feel and how they behave.
■ Learn how engaging in certain behaviours strengthens the belief the situation is something to be feared rather than normal
circumstances.
● Typically, 50% to 80% of patients receiving drugs or CBT will show a good initial response and effect of CBT is more durable.
● Newer developments in treatment of anxiety disorders focus on novel interventions, (e.g.; combining medications with CBT) and transdiagnostic
treatments to targeting underlying vulnerabilities.
Mood episodes
brief periods of sadness, irritability, or euphoria.
Major Depressive Episode (MDE)
symptoms that co-occur for at least 2 weeks and cause significant
distress/impairment in functioning.
● Core symptoms: anhedonia - loss of interest or pleasure in activities one previously found
enjoyable or rewarding.
● MDE requires 5+ of the following symptoms:
(1) depressed mood
(2) diminished interest/pleasure in activities
(3) weight loss/gain,
(4) insomnia/hypersomnia
(5) psychomotor agitation/retardation: a slowing of physical activities in which routine activities (e.g., eating, brushing teeth) are performed in an
unusually slow manner
(6) fatigue/loss of energy
(7) feeling worthless/inappropriate
guilt
(8) diminished ability to concentrate, (9) suicidal ideation
Manic/Hypomanic Episode
distinct period of abnormally and persistently euphoric, expansive, or irritable
mood and persistently increased goal-directed activity or energy.
● Mood disturbance must be present for 1 week longer in mania, or 4+ days in hypomania.
● At least 3+ of the following symptoms in the context of euphoric mood (or 4 in the context of
irritable mood):
1- Grandiosity - inflated self-esteem or an exaggerated sense of self-importance and self
worth (e.g., believing one has special powers or superior abilities)
2 - increased motor activity
associated with restlessness, including physical actions (e.g., fidgeting, pacing, feet tapping, handwringing)
3 - Reduced need for sleep.
4 - Racing thoughts.
5 - Distractibility.
6 - Increased talkativeness.
7- Excessive involvement in risky behaviours
Etiology
The causal description of all of the factors that contribute to the development of a disorder or illness.
interoceptive avoidance
Avoidance of situations or activities that produce sensations of physical arousal similar to those occurring during a panic attack or intense fear response.
Fusion
The tendency to overestimate the relationship between a thought and an action, such that one mistakenly believes a “bad” thought is the equivalent of a “bad” action.
major depressive disorder
defined by one or more MDEs, but no history of manic or hypomanic episodes
persistent depressive disorder (PDD; dysthymia)
most days for at least two years; at least two of the following: poor appetite or overeating
insomnia or hypersomnia
low energy or fatigue
low self-esteem
poor concentration or difficulty making decisions
feelings of hopelessness
Bipolar I Disorder (BD I)
previously known as manic-depression, is characterized by a single (or recurrent) manic episode
Bipolar II Disorder
characterized by single (or recurrent) hypomanic episodes and depressive episodes
cyclothymic disorder
characterized by numerous and alternating periods of hypomania and depression, lasting at least two years
person must experience symptoms at least half the time with no more than two consecutive symptom-free months
Treatment for Depressive Disorders
1: antidepressant medications are available, all of which target one or more of the neurotransmitters implicated in depression
- (MAOIs): inhibit monoamine oxidase, an enzyme involved in deactivating dopamine, norepinephrine, and serotonin
- Tricyclics: block the reabsorption of norepinephrine, serotonin, or dopamine at synapses, resulting in their increased availability - for vegetative/somatic
- SSRIs (most common) block the reabsorption of serotonin, whereas SNRIs block the reabsorption of serotonin and norepinephrine.
2: electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and deep brain stimulation
3: behavior therapy, cognitive therapy, and interpersonal therapy
4: Short-Term Psychodynamic Therapy for Depression - more involved therapist
