The scope and nature of psychological disorders and Children Flashcards
- At any given point one in ___ Canadians suffer from a diagnosable mental disorder
- _________ ________ are the second leading cause of disability, exceeding physical illnesses and accidents
- Medications used to treat ______ and _______ are among the most frequently prescribed drugs in North America
- One adolescent commits suicide every ______ in North America
- Each year more than a ________ students withdraw from universities in North America because of Emotional problems
- five
- Psychological disorders
- Anxiety and Depression
- 90 seconds
- a million
What are 6 things that make is difficult to diagnose psychological disorders?
- The personal values of a given diagnostician
- The expectation of the culture in which a person currently lives
- The expectation of the person’s culture of origin
- The general assumption about human nature
- Statistical deviation from the norm
- Harmfulness, suffering and impairment
What are the three Ds that typically underlie judgements that behaviour is abnormal?
Distressing (to self and others)
Dysfunctional (for person or society)
Deviant (violates social norms)
Define abnormal behaviour
behaviour that is personally distressful, personally dysfunctional, and/or so culturally deviant that other people judge it to be inappropriate or maladaptive
What are the major diagnostic categories in the DSM-5?
- Anxiety Disorder
- Mood (affective) disorders
- Somatic symptoms disorder
- Dissociative disorders
- Schizophrenic and other psychotic disorders
- Substance-rekated and addictive disorders
- Neurodevelopment disorders
- Eating disorders
- Personality disorders
What are the major diagnosis characteristic categories for somatic symptom disorder?
Physical symptoms, such as blindness, paralysis or pain that have no physical basis and are assumed to be caused by psychological factors
What are the major diagnosis characteristic categories for personality disorder?
Rigid, stable and maladaptive personality patters, such as antisocial, borderline and narcissistic disorders
What are the major diagnosis characteristic categories for eating disorder?
Includes anorexia nervosa (self- starvation) and bulimia nervosa (patterns of bingeing and purging)
What are the major diagnosis characteristic categories for neurodevelopmental disorder?
disorders that begin in childhood such as autism spectrum disorder and attention-deficit/ hyperactivity disorder
What are the major diagnosis characteristic categories for substance related and additive disorder?
Personal and social problems associated with the use of psychoactive substances, such as alcohol, heroin or other drugs. Also includes behavioural dependencies such as gambling disorder
What are the major diagnosis characteristic categories for schizophrenic and other psychotic disorder?
Severe disorders of thinking, perception and emotion that involves loss of contact with reality and disordered behaviours
What are the major diagnosis characteristic categories for dissociative disorder?
psychologically caused problems of consciousness and self-identification, including amnesia and multiple personalities (dissociative identity disorder)
What are the major diagnosis characteristic categories for mood (affective) disorder?
Marked disturbances of mood, including depression and mania (extreme elation and excitement)
What are the major diagnosis characteristic categories for anxiety disorder?
intense, frequent or inappropriate anxiety, but no loss of reality contact; includes phobias, generalized anxiety reactions and panic disorders
What ancient treatment used to be used for abnormal behaviour?
trephination
a hole was chiselled through the skull to release the evil spirit thought to be causing the abnormal behaviour
•Many people died from this operation
Describe the demonological perspective on abnormal behaviour and its implications for dealing with deviant behaviour?
Disturbed people either were possessed involuntarily by the devil poor had voluntarily made a pact with the forces of darkness
•People who had psychological disorders were considered witches and hunted
What was the historical importance of discovering the cause of general paresis?
A disorder caused by syphilis that causes mental deterioration and bizarre behaviour due to massive brain deterioration
The first demonstration that a psychological disorder was caused by an underlying physical malady
Vulnerability–Stress model
AKA diathesis-stress model
a model that explains behaviour disorders as resulting from predisposing biological or psychological vulnerability factors that are triggered by a stressor
What are the vulnerability factors that could lead to psychological disorders?
- Genetic factors
- Biological characteristics
- Psychological traits
- Previous maladaptive learning
- Low social supper
What are the stressors that can lead to psychological disorders?
- Economic adversity
- Environmental trauma
- Interpersonal stresses or losses
- Occupational setbacks or demands
Reliability
Clinicians using the system should show a high level of agreement with diagnostic decisions
Validity
The diagnostic categories should accurately capture the essential features of the various disorders
What is the most widely used classification system for psychological disorders?
DSM-5 (the DSM-IV-TR prior to May 2013, International classification of diseases for Europe)
•has more than 350 diagnostic categories
•Contains detailed lists of observable behaviours that must be present in order for a diagnosis to be made
•Gives severity
• A dimensional system
What were some problems with DSM-IV-TR?
A categorical system
The criteria was so specific that 50 % of people didn’t fit neatly in one category
People who were diagnosed with the same disorder may look very different
Did not find a way to capture the severity of the person’s disorder
Does not capture symptoms that are adaptively important
What are the six basic personality trait dimensions in the DSM-5?
- Negative emotionality (distress, anxiety, depression)
- Schizotypy (odd, unusual thinking)
- Disinhibition (Impulsivity, irresponsibility, acting out)
- Introversion (social withdrawal, intimacy avoidance)
- Antagonism (callousness, manipulation, hostility/aggression)
- Compulsivity
What are the 2 types of personality disorders in the DSM-5?
- Borderline type (high negative emotion, schizotypy and disinhibition)
- Antisocial/ Psychopathic Type (high disinhibition/ antagonism)
What are some social and personal implications of diagnostic labelling?
- Sometimes labels are accepted as descriptions of the individual rather than the behaviour
- Affects how people interact with that person
- Behaviours viewed as consistent with this label
- Develop the expected roll and outline with disorder
- Might be good to evoke sympathy, understanding and support from others
Insanity
a legal decision that a defendant was so severely impaired at the time a crime was committed that he or she was incapable of appreciating the wrongfulness of the act or of controlling his or her behaviour
Competency
a legal decision that a defendant is mentally capable of understanding the nature of criminal charges, participating meaningfully in a trial, and consulting with a lawyer
What does guilty but mentally ill mean ?
Same sentence
but defendant gets sent to mental hospital for treatment
If they recover from being in the hospital before sentence is up they go to jail
•A new Criminal Insanity Bill makes it difficult for high-risk offenders to leave
Anxiety disorders
a group of behaviour disorders in which anxiety and associated maladaptive behaviours are the core of the disturbance
What are the 4 components of anxiety?
1. A subjective emotional component • Feelings of tension • Apprehension 2. Cognitive Symptoms •A subjective feeling of apprehension, • a sense of impeding danger (work), •a feeling of the inability to cope 3. Physiological responses •Increased heart rate and blood pressure • Muscle tension •rapid breathing, nausea, dry mouth, diarrhea, frequent urination 4. Behavioural Resposes •Avoidance of feared situation •decreased task performance • increased startle response
Phobias
strong and irrational fears of particular objects or circumstances
•People know they are irrational but feel helpless to deal with these fears
•Once they develop they seldom go away
Agoraphobia
a phobia centred around open spaces and public places
Social Anxiety Disorder
an excessive and inappropriate fear of social situations in which a person might be evaluated and possibly embarrassed; formerly known as social phobia
Specific Phobia
irrational and excessive fear of specific objects or situations that pose little or no actual threat
What are the three major types of phobias?
- Agoraphobia
- Social anxiety disorder
- Specific phobia
Generalized anxiety and worry disorder
a chronic state of diffuse, or “free-floating,” anxiety that is not attached to specific situations or objects, it is almost continuously present, onset occurs in childhood and adolescence
Panic disorder
an anxiety disorder characterized by unpredictable panic attacks and a pervasive fear that another will occur; may also include a resulting agoraphobia
When do panic attacks usually develop?
Late adolescence or early adulthood
Obsessive-Compulsive Disorder (OCD)
an anxiety disorder characterized by persistent and unwanted thoughts and compulsive behaviours
Obsessions
an unwanted and disturbing thought or image that invades consciousness and is very difficult to control
Compulsions
a repetitive act that the person feels compelled to carry out, often in response to an obsessive thought or image
What are 3 specific types of OCD?
Hoarding disorder,
Hair pulling disorder (trichorillomania )
Skin picking disorder (exoriation)
When is typical onset of OCD?
20s
Incidence
The number of new cases that occur during a given period
Prevalence
The number of people who have a disorder during a specified period of time (both new and previously existing cases)
True or false
All anxiety disorders tend to occur more frequently in females than in males
TRUE
Believed to be due both to environment and biologically
What 3 levels of anxiety can be factors?
Biological
Psychological
Environmental
What brain pathways are compulsions involved in?
prefrontal-caudate-thalamus circuit
What brain pathway generates obsessions?
Orbitofrontal-cingulate pathway
What is some evidence that genetics may play a role in predisposed anxiety disorders?
- Autonomic nervous system that overreacts to perceived threat, creates high level of physiological arousal
- The amygdala plays a threat-detecting role in phobias
- Overreactivity of neurotransmitter systems involved in emotional responses
Which neurotransmitters have been linked to anxiety disorders?
GABA
•Inhibiter of the amygdala and other structures that cause arousal (anxious people have low levels)
Serotonin
Neurotic Anxiety
in psychoanalytic theory, a state of anxiety that arises when impulses from the id threaten to break through into behaviour
•Occurs when unacceptable impulses threaten to overwhelm the ego’s defences and explode into action
According to Freud, what is obsessions symbolically linked to?
Obsession is symbolically related to, but less terrifying than the underlying impulse
According to Freud, what is compulsions symbolically linked to?
A way of taking back or undoing one’s unacceptable urges
According to Freud, when do generalized anxiety and panic attacks occur?
When one’s defences are not strong enough to control or contain anxiety but are strong enough to hide the underlying conflict
What can make anxiety-disordered people feel powerless to cope effectively?
they catastrophize demands and magnify them into threats
anticipate the worst will happen and feel powerless to cope effectively
What are panic attacks triggered by?
Exaggerated misinterpretation of normal anxiety symptoms
Culture-Bound disorders
behaviour disorders whose specific forms are restricted to one particular cultural context
Koro
An example of a culture-bound disorder where men in southeast asia are fearful of their penis retracting into the abdomen and killing him
Taijin Kyofushu
A cultural bound disorder that people in japan are fearful of offending others by emitting offensive odours, blushing, staring inappropriately, or having a blemish or improper expression
Windigo
Anxiety disorder in North American Aboriginals
fear of being possessed by monsters who will turn them into homicidal cannibals
Anorexia nervosa
A culture-bound disorder with a strong phobic component of getting fat
• an eating disorder involving a severe and sometimes fatal restriction of food intake
Bulimia Nervosa
a disorder involving the bingeing and purging of food, usually by vomiting or laxative use, because of a concern with becoming fat
•Most are normal weight
What is more common anorexia or bulimia?
Bulimia 1-3 % of North American women
0.5% of North American women have anorexia
What personality factors are associated with anorexics?
Perfectionists: high achievers who often strive to live up to loft self-standards, including distorted standards concerning an acceptably thin body
•Parents are disapproving and as setting abnormally high achievement standards
•View losing weight as a battle for success and control (me vs food)
What personality factors are associated with Bulimics?
Low impulse control
lack a stable sense of personal identity and self-sufficiency
What biological characteristic is commonly found in people with eating disorders?
abnormal activity of serotonin
What are some bodily responses to people with eating disorders and perpetuate eating and digestive irregularities?
Anorexia:
•The amount of leptin circulating in their bloodstream is abnormally low
Bulimia: Stomach acids expelled in mouth causes loss of taste sensitivity which makes vomiting more tolerable
Attention deficit/ hyperactivity disorder (ADHD)
disorder in which problems may take the form of attentional difficulties, hyperactivity-impulsivity, or a combination of the two that results in impaired functioning
What percentage of american children meet the DSM-5 criteria for the most common childhood disorder ?
What is the most frequently diagnosed childhood disorder?
Is this disorder more common in girls or boyd?
7– 10 %
ADHD
Boys (4X as likely to have it)
What are the problems with not treating children psychological disorders?
Needless distress for children
Disorders tend to continue into adulthood
What is the likelyhood of continuation into adolescence? and adulthood?
50 – 80 %
30 – 50 %
Why has it been hard to find consistent differences in neurotransmitters and brain structures between people with ADHD and control groups?
ADHD is a multifaceted disorders with several subcategories of biological patterns
Autistic Spectrum disorder
- Identified by Leo Kanner
- long-term disorder characterized by extreme unresponsiveness to others, poor communication skills, and highly repetitive and rigid behaviour patterns
What are the early signs of autism? When do signs begin to be visible?
In what percentage does this tend to be a life long disorder?
Form of unresponsiveness and lack of interest in others (no eye contact). Frustration with broken routine and sameness.
Before age 3
70 %
What are some problems for all people with autism ?
Problems in communication
Restricted interests and activities
Difficulty relating to others
Many autistic children have trouble developing language. Some engage in echolalia. What is echolalia?
The exact echoing of phrases spoken by others
What is a common savant skill of autistic people?
Calendar calculation (tell you what day of the week your birthday will be on in 2076)
What are some biological factors determining autism?
5 to 10 % larger brain size at 18 months to 4 years
•Accelerated pruning of neural connections during early life
•Abnormal development of cerebellum (involved in shifting attention) and pre-frontal cortex
What are some genetic factors determining autism?
4 to 6 major genes and 20 to 30 minor genes that contribute to autism
•Different genes involved for girls and boy
•Siblings of autistic children are 200 times more likely to have autism
In autistic people, what impairs language and social development ?
Lack of theory of mind
Dementia
the gradual loss of cognitive abilities that accompanies brain deterioration and interferes with normal functioning
What are the 4 most common types of dementia?
Alzheimer’s Disease
Parkinson’s disease
Huntington’s disease
Creutzfeldt-Jakob disease
When can dementia occur?
When is it considered senile dementia?
at any point in the lifespan
After age 65 (8% of population gets it. 2 female: 1 male)
What are some symptoms of dementia?
Memory impairment, poor judgement, confusion, language problems, disorientation
can appear gradually or sporadically
What is associated with over half of the cases of senile dementia?
Depression, anxiety, aggregation, paranoid reaction or disordered thinking that may resemble schizophrenia
Alzheimer’s disease
a brain disorder that is the leading cause of dementia in the elderly, accounting for about 60 percent of senile dementias. Caused by deterioration in the frontal and temporal lobes of the brain, including the hippocampus, a subcortical structure involved in memory
What characterize Alzheimer’s disease?
Plague in the brain
Destruction of cells that produces ACh (neurotransmitter in memory)
