Session One (What is Abnormal Psychology?)

Question 1

Describe Bipolar Disorder

Answer 1

• Episodes of mania followed by episodes of low mood

- Shifts in mood, energy and activity levels

Question 2

Describe OCD

Answer 2

• Obsessions (repetitive, intrusive thoughts) mixed with

- Compulsions (actions that temporarily relieve obsessions)

Question 3

Describe PTSD

Answer 3

• The re-experiencing of trauma through intrusive images, flashbacks and nightmares
• Often see emotional numbing and avoidance behaviour

Question 4

Describe Schizophrenia

Answer 4

• Hallucinations
• Delusions
• Negative symptoms

Question 5

Describe Social Anxiety Disorder

Answer 5

• Fear of evaluation and humiliation by peers

- Avoidance of social situations

Question 6

Describe ADHD

Answer 6

Classic triad of

• Poor sustained attention
• Hyperactivity
• Impulsivity

Question 7

Describe Depression

Answer 7

Classic triad of

• Low mood
• Low energy
• Anhedonia

But also see significant effects on eating, sleeping, energy levels, sociability and cognition.

Question 8

Describe Eating Disorders

Answer 8

• Distorted perception of body weight and shaped with concurrent..
• Efforts to control this, normally through purging or starvation

Question 9

Why is the study of psychiatry important to medicine generally?

Answer 9

1) Scale of mental health (1/4 people in UK affected)
2) Substantial financial burden (105 billion pounds a year)
3) Presence of mental illness in all departments of medicine (but especially GP, Dermatology, Obs and Gynae, Oncology and Neurology)
4) Mental states can influence onset of symptoms (stress weakens the immune system) and the progression of a disease (the development of chronic pain)

Question 10

What is the Fear-Avoidance model of pain?

Answer 10

A theory proposed by Lethem et al that suggests that a patient’s pain related fear can cause avoidance behaviour and attentional processes that can eventually lead to the development of chronic MSK pain. Essentially, lack of pain due to pain avoidance creates a positive feedback loop that long term leads to chronic pain and disability.

Question 11

What is the effect of chronic stress on the immune system?

Answer 11

• Chronic stress disrupts HPA functioning and its regulation of the inflammatory responses to infections.
• Cohen et al (2011): Exposed patients with varying levels of stressful life events to a virus. Those who had experienced more stressful life events were more likely to show cold symptoms.

Question 12

How can stress affect the heart?

Answer 12

• Direct physiological effects; cortisol makes blood vessels less able to dilate, SNS overstimulation increases blood glucose and speeds up plaque buildup
• Secondary effects; Stress leads to health risk behaviours that increase the risk of heart disease such as smoking, drinking, eating fatty foods.

Question 13

What is the gut-brain connection?

Answer 13

Unclear, but it appears different levels of gut flora can affect cognition, including having a direct influence on a person’s mental health.

Question 14

How can we define abnormal psychology?

Answer 14

• As a deviation from a STATISTICAL norm (i.e. high number of sad thoughts = depression)
• As a deviation from SOCIETAL norm (problematic though, homosexuality was ruled a mental illness for this reason)
• Personal distress (again issues, some psych conditions don’t cause mental distress e.g. Antisocial personality disorder)

Question 15

What are the benefits of classifying psychiatric conditions?

Answer 15

• Fundamental scientific benefit; allows us to understand diseases and their underlying laws.
• Medical benefit to the patient; allows for better communication about clinical diagnoses and treatment amongst healthcare practitioners.

Question 16

What are the limitations of classifying psychiatric conditions?

Answer 16

• Assumes psych disorders exist as categorically different rather than on a continuum. Many different conditions share similar symptoms and behaviours.
• How do we decide when a symptom becomes clinically relevant? Many disorders are preceded by sub-clinical symptoms, the relatives of disordered individuals often show sub-clinical symptoms and sub-clinical and clinical symptoms often have the same risk factors.
• There is significant co-morbidity within psych disorders, which suggest inter-relation which makes categorisation difficult.
• Many of these symptoms are naturally evolved processes we all experience (e.g. anxiety). At what point are they abnormal?

Question 17

What are the evolutionary bases behind symptoms like Anxiety, Depression, OCD and Psychosis?

Answer 17

• Anxiety: Flight or Fight response
• Depression: Believed that the grieving process evolved to encourage us to seek comfort in others after losing someone (safety in numbers)
• OCD: Obsessions exist to protect us (theoretically), OCD is these same protective impulses going out of whack.
• Psychosis: Supposedly linked to creativity?

Question 18

Why are psychiatrists attempting to identify biomarkers for psychiatric disorders?

Answer 18

• Essentially born out of all the difficulties in classifying psych disorders.
• Improves the precision of psych diagnoses.
• Improves treatment.
• Helps us look across and between disorders for similar mechanisms, rather than treating them all as distinct and unrelated.

Question 19

What are ‘Trans-Diagnostic Markers’ of psychiatric disorders?

Answer 19

Gross similarities between seemingly distinct disorders that allow us to form new categories. Often genetic or biochemical. For example disorders can be organised into:

• Altered reward function (eating disorders, ADHD, substance abuse, depression) or
• Altered threat responses (depression, anxiety, psychosis)

Question 20

What are the limitations of using Trans-Diagnostic Markers?

Answer 20

We do still need categories. Diagnoses provide:

• Ease of treatment, intervention, access to resources
• Relief to the patient and their family
• Help in raising awareness and reducing stigma of specific conditions

Question 21

What are the different levels of analysis used in psych disorders?

Answer 21

• Biological Perspective (genes, abnormalities in brain structure/function/resting state/networks, neurotransmitters, ANS or HPA dysfunction)
• Sociocultural Perspective (proximal social factors and greater environmental/cultural factors can both contribute to or protect from psych problems)
• Cognitive-Behaviour Perspective (maladaptive behaviours are learned through conditioning and reinforcement. Bares in mind conscious, voluntary mental processes as well as more automatic, involuntary information processing factors)