Week11/12- Unit 8/9 Flashcards
Define: Psychological Disorders
Persistent disturbances in thinking, behaviour & emotions.
For it to be clinically significant, it must be distressing AND lead to dysfunctional behaviour.
BASED ON ‘Diagnostic and Statistical Manual of Mental Disorders, Ed 5’
(DSM-5) -describes roughly 300 specific disorders of about 20 major categories.
1 of the 20 categories of disorders:
1st: Mood Disorders :
Group of psychological disorders in which the main symptom is a dramatic and persistent shift in a person’s mood and energy level
Comes in 2 forms:
-
Depressive Disorders (downward mood swing) -
Ex: Major Depressive Disorder - period of weeks or months of deeply depressed mood, with feelings of worthlessness and diminished interest in life
Ex: Dysthymia - more persistent, but usually milder depression. -
Bipolar and Related Disorders (mood swings in both directions) -
Ex: Bipolar Disorder - experience a few weeks of extreme optimism and high energy (mania) followed by months of deep depression
Ex: Cyclothymia - a milder but more persistent form of bipolar disorder
1 of the 20 categories of disorders
2nd : Anxiety Disorders :
Group of psychological disorders involving persistent anxiety and fearfulness, often accompanied by maladaptive behaviours that attempt to reduce the anxiety
This anxiety is out of proportion to the actual danger or threat that is posed.
Affects 3% of the population. Heritability in families at about 30%. More in women than men. Reduces as you get older, so disappearing by about age 50 but could instead be replaced with physical symptoms.
Then why have anxiety?
Evolutionary reasons: more alert, sensitive to changes in surroundings, escape predators. Leads to rumination (why did that person say that? Did I remember to turn off the stove? Lock the door – leads to prep in dealing with a potential problem. BUT if too extreme and long, becomes maladaptive
Ex: a phobia - a persistant, irrational fear of a specific object or situation (fear lasts more than 6 mos, not associated with another mental disorder, separation anxiety, etc) – 4 types are Animal Type(dogs, spiders), Natural Environment Type (heights, storms, water), Blood-Injection-Injury Type (blood, receiving injection, any medical procedure), Situational Type (plane, elevator, driving, enclosed places), Other Types (avoidance due to other things like fear of choking or illness, avoidance of loud sounds like balloons or clowns)
Ex: Social Anxiety Disorder - a persistent fear of one or more social or performance situations in which person is exposed to unfamiliar people or to possible scrutiny by others. A fear by patient is that they will act in an embarrassing or humiliating way. Exposure to the situation may lead to a panic attack. Patient realizes that the fear is unreasonable and excessive. The situations are avoided or endured but under intense anxiety or distress. Lasts at least 6 mos. Not due to physiological effects of a drug or a general medical condition or another mental disorder. High heritability @ 25-50%. Affects 7% of population. Generally, patients earn less, have less friends, less likely to marry, more likely to divorce, less likely to have children, avoid jobs that require any public appearances/speaking.
Ex: Generalized Anxiety Disorder- constantly tense and in a state of automomic nervous system arousal for no apparent reason (experiencing ‘free-floating’ anxiety)
Ex: Panic Disorder – frequent panic attacks, each one a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, sweating, palpitations, shaking, nausea, abdominal distres, dizzy, chills or heat sensations, paresthesias (numbness or tingling), derealization (feelings of unreality) or depersonalization (being detached from oneself), feeling going ‘crazy’, fear of dying.
THEN: after a panic attack, the following month or more is:
1. Persistent concern or worry about additional panic attacks or the consequences
2. Significant maladaptive change in behaviour related to the attacks (behaviours designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations)
3. Disturbance is not attributable to the physiological effects of a substance or another medical condition.
4. Disturbance not explained by another mental disorder.
Obsessive-Compulsive Disorder (OCD)?
Separate from Anxiety Disorders now
- presence of recurrent or persistent thoughts, urges, or impulses that are experienced at some time during the disturbance. Intrusive and unwanted, and cause anxiety and distress.
- repeptitive motions, behaviours, mental acts.
- acts are done to reduce anxiety or distress, or prevent some dreaded event or situation.
- cause patient to contnually do them so that it is time-consuming each day (takes up an hour or more each day)
- not caused by any physiological effects of drugs or other medical condition
Compulsions (rep. behaviours) different from Obsessions (rep. thoughts)
Post-traumatic Stress Disorder (PTSD)?
- exposure to real threat or real death, serious injury, or sexual violence
- experiences directly, witnesses the event, experiences it many times (police offices, EMS personnel, exposed to details of child abuse)
Obsessive Compulsive Disorder (OCD)?
Post-traumatic Stress Disorder (PTSD)?
DMS-5 used to have these 2 orders under ‘Anxiety Disorders’ but has moved them out of there and given them their own category.
-
OCD - high levels of anxiety with unwanted, repetitive thoughts (obsessions) and/or actions (compulsions)
(symptoms include ‘Cleaning, Hoarding, Obsession with Symmetry & Order, & Checking behaviours) Cognitive Behavioural Therapy can help with this disorder. - PTSD - constantly tense and apprehensive, startles easily, frequent haunting memories (flashbacks) & insomnia with frequent nightmares.
1 of the 20 categories of disorders
3rd : Personality Disorders :
Group of psychological disorders involving persistent, inflexible patterns of thinking and behaviour that disrupt a person’s social relationships, generally without anxiety, depression, or delusions. Often more distressing to family and friends, than to the individual.
Ex: Antisocial personality disorder – ruthless and aggressive disregard for the welfare, rights, and well-being of others and a lack of remorse for wrongdoing, more common in males.
Ex: Avoidant Personality Disorder – high levels of anxiety and pervasive feelings of social inadequacy, leading them to withdraw from contact with others
Ex: Narcissistic Personality Disorder– involves inflated self perceptions and self-focused behaviour coupled with a lack of interest and empathy toward others
Ex: Borderline Personality Disorder – unstable & unpredictable, due to abrupt mood swings and impulsive behaviour
1 of the 20 categories of disorders
4th : Dissociative Disorders :
Group of psychological disorders involving a splitting (dissociation) of current conscious awareness from past memories (including memories of past events) and emotions
Ex: Dissociative Amnesia - selective memory loss, typically memories of stressful or traumatic experiences
Ex: Dissociative Identity Disorder - more extreme, involving temporary loss of one’s identity and personality traits, as the person shifts from one personality to another (formerly known as ‘multiple personality disorder’)
1 of the 20 categories of disorders
5th : Eating Disorders :
Psychological disorders characterized by a persistent, distressing disturbance in appetite or food consumption
- more common in female
- usually has an anxiety component
Ex: Anorexia nervosa
Ex: Bulimia nervosa – binging than purging cycles
Ex: Bing-eating Disorder – excessive eating followed by remorse, but no attempts to ‘purge’
1 of the 20 categories of disorders
6th : Schizophrenia :
Psychological disorder characterized by disturbed, irrational thinking and inappropriate emotional behavior, break from reality(considered the most serious of the psychological disorders)
May exhibit ‘positive’ symptoms (pereceptual distortions, irrational beliefs, disturbances in thinking and speech) and ‘negative’ symptoms (social withdrawal, lack of appropriate emotions).
Ex: Chronic Schizophrenia - mainly negative symptoms beings in the teen years and gradually worsen
Ex: Acute Reactive Schizophrenia - a well-adjusted person suddenly develops mainly positive symptoms in response to traumatic experiences. Recovery is more likely.
Related to epigenetics. Overactive dopamine and glutamate system is believed to linked to ‘positive symptoms’ of schizophrenia. Also, the thalamus has been found to be thinner than usual. Environmental factors include viral infections or the flu during pregnancy and nutritional deficiencies (famine) or even a temporary loss of oxygen during birthing. Genetic factors include schizophrenia running in families
Biopsychosocial Approach
Biopsychosocial Model:
the role this model has with mood disorders?
- Biological Influences: genetic influences
- Psychological Influences: negative explananatory style, learned helplessness & emotional responses
- Social-Cultural Influences: traumatic negative events, cultural expectations, reactions from others
Psychological Disorder?
A syndrome marked by clinically significant disturbances in an individual’s :
* Cognition
* Emotional Regulation
* Behaviour
4 Criteria used to assess for a psychological disorder?
- Distress (a way that brings considerable discomfort and pain)
- Danger(to themselves or others)
- Deviance (being different from most other peeople in one’s culture)
- Dysfunction (a way of being that is maladaptive & that interferes with normal day-to-day functioning)
Before this man starting in1793, mentally ill people were thought to be animals
Philippe Pinel
He thought the mentally ill could be ‘cured’
He was saved from a mob by one of his first patients who was ‘cured’. He was a simple family doctor who took it upon himself to help hundreds.
- He thought that most patients will get better on their own
- Just need to provide appropriate conditions to help nurture
- Medications are a last resort
Biopsychosocial & Stress-vulnerability approach?
This model holds that GENETIC & BIOLOGICAL factors predispose people to psychological disorders….but depends on various psychological and social factors.
Simply because someone is labelled with a psychological disorder, doesn’t mean they are ‘dangerous’.
1. Most violent criminals are not mentally ill and most mentally ill people are not violent(Fazel & Grann, 2006, Skeem et al, 2016)
2. Those who do commit violent acts are individuals who experience threatening delusions or hallucinations, suffered loss of finances, loss of a relationship, have substance abuse issues.
3. Best predictors of violence: alcohol, drug use, previous violence, gun availability, being male (Douglas et al, 2009, Elbogen et al., 2016, Fazel et al., 2009,2010)
4. People with psych. disorders more likely to be victims rather than the perpetrators (Marley & Bulia, 2001).
Stats of psych. disorders:
- Rates of psych disorders vary across countries and ethnic groups. The WHO’s stats: highest rates are in the USA. Lowest rates are in Nigeria.
- Recent immigrants to the USA average better in mental health than those born in the USA, with similar heritage
- 1 in 5 Americans have a mental, behavioural, emotional disorder compared with 1 in 10 people around the world.
- MEN: more externalizing disorders (antisocial personality disorder, substance use disorder) WOMEN: more internalizing disorders (anxiety disorder, major depressive disorder)D
Risks/Protectors for mental health:
Best predictor of mental disorders (across gender AND ethnic lines) is poverty, with psych. disorders being 2.5 x higher when below the poverty line.
Also reciprocal and correlated:
psych disorders —-> poverty
poverty —-> psych disorders
Onset of psyc disorders?
Between 14 and 24 yrs.
For antisocial personality disorder, it’s 8yrs old.
For phobias, it’s 10 years old.
For alcohol use disorder, OCD, Bipolar, Schizophrenia, 20 yrs+
For major depressive disorder, 25 years old+
Remember, there is no ONE gene for any psych disorder. Psychopathology is a spectrum with only the extreme cases being more problematic for the individual.
