Week 9 Flashcards

1
Q

Psychological Disorders - Middle Ages

A

Middle ages
► Possession by demons
► Exorcism of evil spirits thought responsible for mental illness
► Trephination: drilling holes into skull to let out demons

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2
Q

Psychological Disorders - Bedlam

A

Bedlam
► St Mary of Bethlehem Priory, England, founded in 1247
► Operated for five centuries as institution for mentally ill
► Gentry would pay to admission to watch the antics of the mad

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3
Q

Psychological Disorders - Changing Views

A

Changing views…
► an illness, but mental rather than physical
► People like Phillipe Pinel and William Tuke ushered in a more humane approach to the treatment of the mentally ill

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4
Q

Process of Diagnosis

A
The clinical interview
► Current symptoms
► History of symptoms
► Impact of symptoms on functioning
► Hypothesis testing
Collateral information
► Family members, friends, GPs, teachers, etc.
Psychometric assessment (e.g., Beck’s Depression Inventory, Alcohol Use Disorders Identification Test, Depression, Anxiety, and Stress Scale)
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5
Q

Mental Disorder

A

A syndrome (group of associated features) that is characterized by clinically significant disturbance in an individual’s cognitions, emotion, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning

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6
Q

Not mental disorders

A

It is not:
► An expectable or culturally approved response to a common stressor
► Socially deviant behaviour or conflicts that are primarily between the individual and society (e.g. criminality), unless the deviance/conflict results from a dysfunction in the individual

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7
Q

Why classify abnormal behaviour ?

A
  • Assists communication
  • Assists research
  • Assists understanding of causality
  • Assists treatment selection
  • Facilitates comparisons across time and geographic areas
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8
Q

Disorders classified by

A

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM)
► DSM (1952) | DSM-II (1968) | DSM-III (1980) | DSM-III-R (1987) | DSM-IV (1994) | DSM-IV-TR (2000) | DSM-5 (2013)
World Health Organization: International Classification of Diseases (ICD)

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9
Q

Diagnostic Categories

A

Anxiety disorders | Mood disorders | Schizophrenia | Obsessive-compulsive disorders | Personality disorders | Dissociative disorders | Eating disorders | Trauma-related disorders | Conduct disorders | Substance-related disorders | Somatic symptom disorders

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10
Q

Criticism of classifying behaviour

A
Categories versus dimensions
► DSM-5 has introduced a dimensional approach that allows clinicians to rate disorders along a continuum of severity
- Pejorative labels/terminology
- Danger of self-fulfilment
- Reliability
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11
Q

Prevalence

A

Proportion of people in a defined population who have the condition at a specified point in time (or during a period of time)
► e.g., How many Australian adults would currently meet criteria for a Major Depressive Disorder?

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12
Q

Incidence

A

Frequency of new cases identified during a specified period of time
► e.g., The number of new cases of Major Depressive Disorder diagnosed in Australian adults in 2015

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13
Q

Comorbidity

A

Co-occurrence of disorders

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14
Q

Anxiety Disorders

A

Characterised by feelings of excessive fear, anxiety, and related behavioural disturbances
► Out of proportion to environmental threats

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15
Q

Generalised Anxiety Disorders (GAD)

A
  • Persistent and excessive anxiety and worry about a number of events or activities (for at least 6 months)
  • Perseverative, negative thinking about things that can go wrong
  • Accompanied by symptoms such as restlessness, difficulty concentrating, muscle tension, irritability
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16
Q

Panic Disorders - Anxiety

A
  • Recurrent attacks of overwhelming anxiety and intense fear that usually occur suddenly and unexpectedly
  • Often leads to avoidance of precipitating conditions
    Can develop agoraphobia
    ► Fear of being in places from which escape might be difficult or help might not be available in the event of embarrassing or incapacitating symptoms
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17
Q

Panic Attacks - Anxiety

A

Panic attack: abrupt surge of intense fear or intense discomfort that reaches a peak within minutes
► Heart palpitations, pounding heart, or accelerated heart rate
► Trembling or shaking
► Feelings of choking
► Nausea or abdominal distress
► Feeling dizzy, unsteady, lightheaded, or faint
► Chill or heat sensations
► Fear of losing control, “going crazy”, or dying

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18
Q

Specific Phobia - Anxiety

A
  • Persistent irrational fear or anxiety about a specific object, activity, or situation (e.g. spiders, heights, flying, receiving an injection)
  • Avoidance of situations
  • Treated with exposure therapy
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19
Q

Social Anxiety Disorder

A

► Marked fear or anxiety about social situations (fear of possible scrutiny or negative evaluation)
► Frequently concerned about others noticing anxiety symptoms
- Treated with exposure therapy

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20
Q

Anxiety Aetiology - Biological

A
BIOLOGICAL
- Biological preparedness (evolutionary)
- Neurochemistry
► Low levels of GABA (gamma-Aminobutyric acid)
► Low levels of serotonin
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21
Q

Anxiety Twin Studies - Biological

A

Twin studies and family studies show moderate genetic predisposition to anxiety disorders
► MZ twins: If one twin has an anxiety disorder, 35% chance other twin will have an anxiety disorder
► DZ twins: If one twin has an anxiety disorder, 15% chance other twin will have an anxiety disorder

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22
Q

Anxiety Aetiology - Environmental

A

ENVIRONMENTAL

  • Diathesis-stress hypothesis
  • Genetic factors place an individual at risk…BUT… environmental stress factors must impinge in order for the potential risk to manifest itself
  • Severe stressors
  • Negative life events
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23
Q

Anxiety Aetiology - Cognitive

A

COGNITIVE
Overestimate likelihood or nature of threat
► Perceive ambiguous situations as threatening, and focus excessive attention on perceived threats
- Underestimate ability to cope with threat
- Selective recall of threat information
‘Vicious Cycle’ of Anxiety
►Trigger –>
Cognition | Behaviours | Physical Symptoms

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24
Q

Mood Disorders

A

Characterised by disturbance in emotion or mood

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25
Q

Major Depressive Disorder - Mood Disorders

A
  • Persistent depressed mood and anhedonia
  • Other symptoms: disturbances in appetite, sleep, energy level, concentration, feelings of worthlessness, suicidal thoughts/attempts
  • Symptoms present most of the day, nearly every day, for a minimum of 2 weeks
  • Major depressive episodes are often recurrent
26
Q

Persistent Depressive Disorder - Mood Disorders

A
  • Also known as dysthymia

- Chronically depressed mood that occurs for most of the day, more days than not, for at least 2 years

27
Q

Seasonal Affective Disorder - Mood Disorders

A
  • A depressive syndrome that occurs during a particular season
  • Characterised by mood and behaviour changes with regular seasonal climatic variation
28
Q

Bipolar Disorder - Mood Disorders

A
  • Experience both emotional “poles” of depression and mania
    Manic episode:
    Abnormally elevated or expansive mood, excessive happiness and euphoria in combination with several additional symptoms: grandiosity, decreased sleep, racing thoughts, constant need to speak, psychomotor agitation, excessive involvement in pleasurable activities
29
Q

Mood Disorder Aetiology - Biological

A

BIOLOGICAL
Neurochemistry
► Serotonin (low -> depression, high -> mania)
► Noradrenaline (low -> depression, high -> mania)

30
Q

Mood Disorders Twin Studies - Biological

A

Twin studies
► MZ twins: if one twin has an mood disorder, 65% chance other twin will have an mood disorder
► DZ twins: if one twin has an mood disorder, 15% chance other twin will have an mood disorder

31
Q

Mood Disorders Aetiology - Cognitive

A

Negative triad: Negative views about self, world, and future
Cognitive distortions:
► Automatic/implicit processing of positive and neutral information in negative way
► Memory bias for sad events
- Learned helplessness, pessimistic attribution style
- Rumination

32
Q

Mood Disorders Aetiology - Environmental

A

ENVIRONMENTAL

  • Diathesis-stress hypothesis
  • Severe stressors
  • Negative life events
  • Early childhood and family environment– disruptive, hostile, negative
  • Social isolation, lack of intimate relationships
33
Q

Schizophrenia

A

Schizophrenia involves disturbances in nearly every dimension of human psychology – thought, perception, behaviour, language, communication, emotion

34
Q

Schizophrenia - Positive Symptoms

A

Excesses, presence of abnormal features
► Hallucinations, delusions
► Loosening of associations, disordered thought/speech
► Inappropriate emotions, bizarre behaviour

35
Q

Schizophrenia - Negative Symptoms

A
Deficits, absence of normal features
► Flat/blunted affect
► Lack of motivation, apathy
► Social withdrawal
► Intellectual impairment (e.g., impoverished thought)
36
Q

Schizophrenia - Hallucinations

A

► Perceptual experiences (e.g., visual, auditory, tactile)
► Either gross distortion of perceptual input OR Occur in absence of real, external stimulus
► Auditory hallucinations (e.g., hearing voices) – most common

37
Q

Schizophrenia - Delusions

A

False beliefs that are maintained even though they clearly are out of touch with reality

38
Q

Schizophrenia - Delusions associated belief

A
Persecution
Reference
Grandeur
Identity
Guilt
Control
39
Q

Persecution - Schizophrenia

A

Belief that others are persecuting, spying on, or trying to harm them

40
Q

Reference - Schizophrenia

A

Belief that objects, events, or other people have particular significance to them

41
Q

Grandeur - Schizophrenia

A

Belief that they have great power, knowledge, or talent

42
Q

Identity - Schizophrenia

A

Belief that they are someone else
(e.g., Jesus Christ, the Queen)

43
Q

Guilt - Schizophrenia

A

Belief that they have committed a terrible sin

44
Q

Control - Schizophrenia

A

Belief that their thoughts and behaviours are being controlled by external forces

45
Q

Loosening of Associations - Schizophrenia

A

Tendency for conscious thought to move along associative lines rather than to be controlled, logical, and purposeful
► Reflected in speech
Disorganised speech:
► Loosening of associations
► Word salad
Deterioration of adaptive behaviour e.g. social, occupational, personal hygiene

46
Q

Schizophrenia Aetiology - Biological

A

BIOLOGICAL
Neurochemistry
► Excessive dopamine

47
Q

Schizophrenia Twin Studies - Biological

A

Twin studies
► MZ twins: if one twin has schizophrenia, 48% chance other twin will have schizophrenia
► DZ twins: if one twin has schizophrenia, 17% chance other twin will have schizophrenia

48
Q

Schizophrenia Aetiology - Environmental

A

ENVIRONMENTAL
- Diathesis-stress hypothesis
- Birth complications, viruses, malnutrition
- Stressful life events (in combination with emotional reactivity)
- Expressed emotion within family
► Highly critical/hostile attitudes
► Emotionally over-involved/intrusive family members
- Child abuse
*look up image

49
Q

Obsessive Compulsive Disorders

A

Obsessions:
Intrusive, repeated, distressing thoughts, ideas or urges
Compulsions:
Repetitive behaviours or mental acts the person feels forced to carry out (usually to reduce anxiety associated with obsessions)

50
Q

OCD main types

A

► Checking
► Contamination
► Hoarding
► Intrusive thoughts

51
Q

Personality Disorders

A
  • An enduring maladaptive pattern of thought, feeling, and behaviour
  • The pattern is inflexible & stable, pervasive across situations
  • The pattern causes clinically significant disturbance / impairment in social, occupational, or other important areas of functioning
  • The pattern is traceable back at least to adolescence or early adulthood
52
Q

Paranoid PD

A

suspicious, mistrusts loyalties, reluctant to confide, bears grudges, perceives attacks on reputation

53
Q

Borderline PD

A

instability in relationships, poor sense of identity,poor affect regulation; impulsivity; recurrent suicidal/self-harm

54
Q

Antisocial PD

A

disregard for rights of others; deceitfulness; lack of remorse/empathy; reckless disregard for safety; law violations

55
Q

Narcissistic PD

A

grandiose, self-important, arrogant, entitled, lacks empathy/interest in others, envious, interpersonally exploitative

56
Q

Dependent PD

A

submissive, clingy, excessive need to be taken care of, feels helpless when alone, desperately seeks relationships

57
Q

Dissociative Disorders

A
  • Characterised by disruptions in consciousness, memory, sense of identity, or perception
  • Associated with amnesia
58
Q

Dissociative Identity Disorder

A
  • Colloquially known as multiple personality disorder
  • At least two distinct personalities exist within same person
  • Generally reflect history of trauma/abuse
59
Q

Anorexia Nervosa

A
  • Refusal to maintain body weight at minimally normal weight for age & height (< 85% expected weight)
  • Intense fear of gaining weight, even though underweight
  • Distorted body image
  • Food restriction, excessive exercise, vomiting
  • Health implications (e.g., brittle bones, heart attack, death)
60
Q

Bulimia Nervosa

A

Binge-and-purge syndrome