The scope and nature of psychological disorders and Children

Question 1

1. At any given point one in ___ Canadians suffer from a diagnosable mental disorder
2. _________ ________ are the second leading cause of disability, exceeding physical illnesses and accidents
3. Medications used to treat ______ and _______ are among the most frequently prescribed drugs in North America
4. One adolescent commits suicide every ______ in North America
5. Each year more than a ________ students withdraw from universities in North America because of Emotional problems

Answer 1

1. five
2. Psychological disorders
3. Anxiety and Depression
4. 90 seconds
5. a million

Question 2

What are 6 things that make is difficult to diagnose psychological disorders?

Answer 2

1. The personal values of a given diagnostician
2. The expectation of the culture in which a person currently lives
3. The expectation of the person’s culture of origin
4. The general assumption about human nature
5. Statistical deviation from the norm
6. Harmfulness, suffering and impairment

Question 3

What are the three Ds that typically underlie judgements that behaviour is abnormal?

Answer 3

Distressing (to self and others)
Dysfunctional (for person or society)
Deviant (violates social norms)

Question 4

Define abnormal behaviour

Answer 4

behaviour that is personally distressful, personally dysfunctional, and/or so culturally deviant that other people judge it to be inappropriate or maladaptive

Question 5

What are the major diagnostic categories in the DSM-5?

Answer 5

1. Anxiety Disorder
2. Mood (affective) disorders
3. Somatic symptoms disorder
4. Dissociative disorders
5. Schizophrenic and other psychotic disorders
6. Substance-rekated and addictive disorders
7. Neurodevelopment disorders
8. Eating disorders
9. Personality disorders

Question 6

What are the major diagnosis characteristic categories for somatic symptom disorder?

Answer 6

Physical symptoms, such as blindness, paralysis or pain that have no physical basis and are assumed to be caused by psychological factors

Question 7

What are the major diagnosis characteristic categories for personality disorder?

Answer 7

Rigid, stable and maladaptive personality patters, such as antisocial, borderline and narcissistic disorders

Question 8

What are the major diagnosis characteristic categories for eating disorder?

Answer 8

Includes anorexia nervosa (self- starvation) and bulimia nervosa (patterns of bingeing and purging)

Question 9

What are the major diagnosis characteristic categories for neurodevelopmental disorder?

Answer 9

disorders that begin in childhood such as autism spectrum disorder and attention-deficit/ hyperactivity disorder

Question 10

What are the major diagnosis characteristic categories for substance related and additive disorder?

Answer 10

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

Question 11

What are the major diagnosis characteristic categories for schizophrenic and other psychotic disorder?

Answer 11

Severe disorders of thinking, perception and emotion that involves loss of contact with reality and disordered behaviours

Question 12

What are the major diagnosis characteristic categories for dissociative disorder?

Answer 12

psychologically caused problems of consciousness and self-identification, including amnesia and multiple personalities (dissociative identity disorder)

Question 13

What are the major diagnosis characteristic categories for mood (affective) disorder?

Answer 13

Marked disturbances of mood, including depression and mania (extreme elation and excitement)

Question 14

What are the major diagnosis characteristic categories for anxiety disorder?

Answer 14

intense, frequent or inappropriate anxiety, but no loss of reality contact; includes phobias, generalized anxiety reactions and panic disorders

Question 15

What ancient treatment used to be used for abnormal behaviour?

Answer 15

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

Question 16

Describe the demonological perspective on abnormal behaviour and its implications for dealing with deviant behaviour?

Answer 16

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

Question 17

What was the historical importance of discovering the cause of general paresis?

Answer 17

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

Question 18

Vulnerability–Stress model

Answer 18

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

Question 19

What are the vulnerability factors that could lead to psychological disorders?

Answer 19

• Genetic factors
• Biological characteristics
• Psychological traits
• Previous maladaptive learning
• Low social supper

Question 20

What are the stressors that can lead to psychological disorders?

Answer 20

• Economic adversity
• Environmental trauma
• Interpersonal stresses or losses
• Occupational setbacks or demands

Question 21

Reliability

Answer 21

Clinicians using the system should show a high level of agreement with diagnostic decisions

Question 22

Validity

Answer 22

The diagnostic categories should accurately capture the essential features of the various disorders

Question 23

What is the most widely used classification system for psychological disorders?

Answer 23

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

Question 24

What were some problems with DSM-IV-TR?

Answer 24

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

Question 25

What are the six basic personality trait dimensions in the DSM-5?

Answer 25

1. Negative emotionality (distress, anxiety, depression) 2. Schizotypy (odd, unusual thinking) 3. Disinhibition (Impulsivity, irresponsibility, acting out) 4. Introversion (social withdrawal, intimacy avoidance) 5. Antagonism (callousness, manipulation, hostility/aggression) 6. Compulsivity

Question 26

What are the 2 types of personality disorders in the DSM-5?

Answer 26

1. Borderline type (high negative emotion, schizotypy and disinhibition) 2. Antisocial/ Psychopathic Type (high disinhibition/ antagonism)

Question 27

What are some social and personal implications of diagnostic labelling?

Answer 27

* 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

Question 28

Insanity

Answer 28

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

Question 29

Competency

Answer 29

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

Question 30

What does guilty but mentally ill mean ?

Answer 30

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

Question 31

Anxiety disorders

Answer 31

a group of behaviour disorders in which anxiety and associated maladaptive behaviours are the core of the disturbance

Question 32

What are the 4 components of anxiety?

Answer 32

``` 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 ```

Question 33

Phobias

Answer 33

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

Question 34

Agoraphobia

Answer 34

a phobia centred around open spaces and public places

Question 35

Social Anxiety Disorder

Answer 35

an excessive and inappropriate fear of social situations in which a person might be evaluated and possibly embarrassed; formerly known as social phobia

Question 36

Specific Phobia

Answer 36

irrational and excessive fear of specific objects or situations that pose little or no actual threat

Question 37

What are the three major types of phobias?

Answer 37

1. Agoraphobia 2. Social anxiety disorder 3. Specific phobia

Question 38

Generalized anxiety and worry disorder

Answer 38

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

Question 39

Panic disorder

Answer 39

an anxiety disorder characterized by unpredictable panic attacks and a pervasive fear that another will occur; may also include a resulting agoraphobia

Question 40

When do panic attacks usually develop?

Answer 40

Late adolescence or early adulthood

Question 41

Obsessive-Compulsive Disorder (OCD)

Answer 41

an anxiety disorder characterized by persistent and unwanted thoughts and compulsive behaviours

Question 42

Obsessions

Answer 42

an unwanted and disturbing thought or image that invades consciousness and is very difficult to control

Question 43

Compulsions

Answer 43

a repetitive act that the person feels compelled to carry out, often in response to an obsessive thought or image

Question 44

What are 3 specific types of OCD?

Answer 44

Hoarding disorder, Hair pulling disorder (trichorillomania ) Skin picking disorder (exoriation)

Question 45

When is typical onset of OCD?

Answer 45

20s

Question 46

Incidence

Answer 46

The number of new cases that occur during a given period

Question 47

Prevalence

Answer 47

The number of people who have a disorder during a specified period of time (both new and previously existing cases)

Question 48

True or false | All anxiety disorders tend to occur more frequently in females than in males

Answer 48

TRUE | Believed to be due both to environment and biologically

Question 49

What 3 levels of anxiety can be factors?

Answer 49

Biological Psychological Environmental

Question 50

What brain pathways are compulsions involved in?

Answer 50

prefrontal-caudate-thalamus circuit

Question 51

What brain pathway generates obsessions?

Answer 51

Orbitofrontal-cingulate pathway

Question 52

What is some evidence that genetics may play a role in predisposed anxiety disorders?

Answer 52

* 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

Question 53

Which neurotransmitters have been linked to anxiety disorders?

Answer 53

GABA •Inhibiter of the amygdala and other structures that cause arousal (anxious people have low levels) Serotonin

Question 54

Neurotic Anxiety

Answer 54

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

Question 55

According to Freud, what is obsessions symbolically linked to?

Answer 55

Obsession is symbolically related to, but less terrifying than the underlying impulse

Question 56

According to Freud, what is compulsions symbolically linked to?

Answer 56

A way of taking back or undoing one's unacceptable urges

Question 57

According to Freud, when do generalized anxiety and panic attacks occur?

Answer 57

When one's defences are not strong enough to control or contain anxiety but are strong enough to hide the underlying conflict

Question 58

What can make anxiety-disordered people feel powerless to cope effectively?

Answer 58

they catastrophize demands and magnify them into threats | anticipate the worst will happen and feel powerless to cope effectively

Question 59

What are panic attacks triggered by?

Answer 59

Exaggerated misinterpretation of normal anxiety symptoms

Question 60

Culture-Bound disorders

Answer 60

behaviour disorders whose specific forms are restricted to one particular cultural context

Question 61

Koro

Answer 61

An example of a culture-bound disorder where men in southeast asia are fearful of their penis retracting into the abdomen and killing him

Question 62

Taijin Kyofushu

Answer 62

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

Question 63

Windigo

Answer 63

Anxiety disorder in North American Aboriginals | fear of being possessed by monsters who will turn them into homicidal cannibals

Question 64

Anorexia nervosa

Answer 64

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

Question 65

Bulimia Nervosa

Answer 65

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

Question 66

What is more common anorexia or bulimia?

Answer 66

Bulimia 1-3 % of North American women | 0.5% of North American women have anorexia

Question 67

What personality factors are associated with anorexics?

Answer 67

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)

Question 68

What personality factors are associated with Bulimics?

Answer 68

Low impulse control | lack a stable sense of personal identity and self-sufficiency

Question 69

What biological characteristic is commonly found in people with eating disorders?

Answer 69

abnormal activity of serotonin

Question 70

What are some bodily responses to people with eating disorders and perpetuate eating and digestive irregularities?

Answer 70

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

Question 71

Attention deficit/ hyperactivity disorder (ADHD)

Answer 71

disorder in which problems may take the form of attentional difficulties, hyperactivity-impulsivity, or a combination of the two that results in impaired functioning

Question 72

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?

Answer 72

7– 10 % ADHD Boys (4X as likely to have it)

Question 73

What are the problems with not treating children psychological disorders?

Answer 73

Needless distress for children | Disorders tend to continue into adulthood

Question 74

What is the likelyhood of continuation into adolescence? and adulthood?

Answer 74

50 – 80 % 30 – 50 %

Question 75

Why has it been hard to find consistent differences in neurotransmitters and brain structures between people with ADHD and control groups?

Answer 75

ADHD is a multifaceted disorders with several subcategories of biological patterns

Question 76

Autistic Spectrum disorder

Answer 76

* Identified by Leo Kanner * long-term disorder characterized by extreme unresponsiveness to others, poor communication skills, and highly repetitive and rigid behaviour patterns

Question 77

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?

Answer 77

Form of unresponsiveness and lack of interest in others (no eye contact). Frustration with broken routine and sameness. Before age 3 70 %

Question 78

What are some problems for all people with autism ?

Answer 78

Problems in communication Restricted interests and activities Difficulty relating to others

Question 79

Many autistic children have trouble developing language. Some engage in echolalia. What is echolalia?

Answer 79

The exact echoing of phrases spoken by others

Question 80

What is a common savant skill of autistic people?

Answer 80

Calendar calculation (tell you what day of the week your birthday will be on in 2076)

Question 81

What are some biological factors determining autism?

Answer 81

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

Question 82

What are some genetic factors determining autism?

Answer 82

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

Question 83

In autistic people, what impairs language and social development ?

Answer 83

Lack of theory of mind

Question 84

Dementia

Answer 84

the gradual loss of cognitive abilities that accompanies brain deterioration and interferes with normal functioning

Question 85

What are the 4 most common types of dementia?

Answer 85

Alzheimer's Disease Parkinson's disease Huntington's disease Creutzfeldt-Jakob disease

Question 86

When can dementia occur? | When is it considered senile dementia?

Answer 86

at any point in the lifespan | After age 65 (8% of population gets it. 2 female: 1 male)

Question 87

What are some symptoms of dementia?

Answer 87

Memory impairment, poor judgement, confusion, language problems, disorientation can appear gradually or sporadically

Question 88

What is associated with over half of the cases of senile dementia?

Answer 88

Depression, anxiety, aggregation, paranoid reaction or disordered thinking that may resemble schizophrenia

Question 89

Alzheimer's disease

Answer 89

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

Question 90

What characterize Alzheimer's disease?

Answer 90

Plague in the brain | Destruction of cells that produces ACh (neurotransmitter in memory)