Abnormal Psychology (L12)

Question 1

How are mental illnesses diagnosed?

Answer 1

• US used the Diagnostic and Statistical Manual of mental disorders (DSM)
• Europe used the ICD-10 classification

Question 2

Major depressive disorder: what is the DSM IV criteria?

Answer 2

• Feeling sad and helpless every day for weeks at a time
• Feeling suicidal, have sleep problems, feel worthless, have low energy, problems with concentration, can’t imagine being happy again

Question 3

Major depressive disorder

Answer 3

• Peters et al. proposed that absence of happiness was a more reliable symptom than an increase in sadness
• Rottenberg et al. showed that depressed patients react normally to sad or distressing images but rarely smile at comical ones
• Childhood depression rates are equal for boys and girls until age 14, when depression becomes more prevalent in the female population
• It is more common to have episodes of depression separated by periods of normal mood than to have long-term episodes (Klein)
• The more often you experience an episode the easier it is to have another one (Post + Silberstein)

Question 4

Major depressive disorder: genetics

Answer 4

• 33-45% heritability
• No one gene shows a strong link to depression
• Genetic link may be masked by different onset types
• Early onset: high probability (40-50%) of other relatives with depression and other mood disorders
• Late onset: high probability of relatives with circulatory problems

Question 5

Major depressive disorder: serotonin uptake transporter gene

Answer 5

• Regulates ability of axons to reabsorb serotonin
• Individuals with short form of gene showed marked environmental effect on the probability of developing depression
• BUT same gene increases emotional activity across a range of positive and negative emotions (not specific to depression)

Question 6

Major depressive disorder: Borna disease

Answer 6

• A viral infection in farm animals that produces periods of frantic activity as well as lethargy (similar to bipolar disorder)
• Borna disease has been found in 5% of the normal population but depression is present in about 1/3rd of cases
• Viruses might be predisposing factor in the development of depression

Question 7

Major depressive disorder: hormones

Answer 7

• Cortisol linked to stress which is in turn linked to depression
• Some women experience depression after giving birth (due to change in ovarian hormones)
• Decline in testosterone in older men also lined to increased probability of depression

Question 8

Major depressive disorder: hemispheric factors

Answer 8

• Depressed people have decreased activity in left and increased activity in right prefrontal cortex
• May be biological predisposition rather than a predictive factor

Question 9

Seasonal affective disorder

Answer 9

• Form of depression where episodes occur in winter due to reduced levels of light
• Treated with a bright light
• Possible link with vitamin D deficiency

Question 10

Name the 4 main types of antidepressant drugs?

Answer 10

1. Tricyclics
2. Selective serotonin reuptake inhibitors
3. Monoamine oxidase inhibitors
4. Atypical antidepressants

Question 11

Antidepressant treatments: tricyclics

Answer 11

• Block transporter proteins that reuptake serotonin, dopamine and noradrenaline
• Prolongs the presence of neurotransmitters in the synaptic cleft
• Also block histamine and acetylcholine receptors and some sodium channels
• Cause side effects such as drowsiness, dry mouth and heart irregularities respectively so are not suitable for long-term use

Question 12

Antidepressant treatments: selective serotonin reuptake inhibitors

Answer 12

• Similar to tricyclics but specific to serotonin
• Milder side effects to tricyclics but similar treatment outcomes
• Newer versions block reuptake of serotonin and noradrenaline

Question 13

Antidepressant treatments: monoamine oxidase inhibitors

Answer 13

• Block the enzyme monoamine oxidase which metabolizes catecholamines and serotonin to render them inactive
• By blocking this enzyme there is more of the neurotransmitter available for release

Question 14

Antidepressant treatments: atypical antidepressants

Answer 14

• Dopamine and noradrenaline reuptake inhibitors

- St John’s Wort is a non-prescription drug has been argued to have similar effect to antidepressant prescription drugs

Question 15

Antidepressant treatments: electroconvulsive therapy

Answer 15

• Electrically induced seizures
• Used in cases of severe depression where drug treatments have failed
• Side effects include transient memory loss (reduced if confined to the right hemisphere)
• Alters the expression of more than 100 genes in the hippocampus and frontal lobes

Question 16

Antidepressant treatments: exercise

Answer 16

• Exercise can have antidepressant effects, especially in older adults
• Best effects when combined with other treatments/dietary changes

Question 17

Bipolar disorder

Answer 17

• Individuals vary between two poles: mania and depression
• Mania is periods of restless activity, excitement, laughter, self-confidence and loss of inhibition
• Bipolar I disorder: people with full blown episodes of mania
• Bipolar II disorder: people with milder episodes of mania
• People also have attention problems, poor self-control and problems with verbal memory

Question 18

Bipolar disorder: genetics

Answer 18

• Highest rate of heritability among mental disorders
• Two genes identified that appear to increase the probability of bipolar II
• Genetic link between major depression and bipolar disorder (Lui et al.)

Question 19

Bipolar disorder: treatments

Answer 19

• Lithium salts, valproate and carbamazepine
• Appear to reduce the number of AMPA glutamate receptors in the hippocampus (linked with mania)
• Block the synthesis of arachidonic acid that is produced when the brain is inflamed
• Bipolar patients show increased gene expression associated with inflammation
• Arachidonic acid is countered by omega-3 fatty acids found in seafood = eating seafood decreases risk of bipolar disorder
• The intensity of mood swings can be reduced by encouraging a healthy sleep cycle in a quiet, dark room

Question 20

Schizophrenia

Answer 20

• ‘Split-mind’ between emotion and cognition
• 1% of the world suffer with schizophrenia at some point in their lives
• More severe and earlier onset in men

Question 21

Schizophrenia: symptoms

Answer 21

• Positive symptoms are behaviours that are present but should be absent: delusions, hallucinations, disorganised speech and grossly disorganised behaviour
• Negative symptoms are behaviours that are absent but should be present: emotional and social withdrawal, apathy and poverty of speech

Question 22

Schizophrenia: genetics

Answer 22

• As the genetic link increases so does the probability of developing schizophrenia
• Schizophrenia is more common in their biological family than their adopted one for adopted schizophrenic children
• Higher incidence of schizophrenia in adopted children whose biological parents have schizophrenia (genetic) and have a disordered adoptive family (environmental)

Question 23

Schizophrenia: prenatal and neonatal environment

Answer 23

• Risk is elevated by poor nutritional intake by mother, premature birth, low birth weight, exposure of mother to extreme stress and head injuries during childhood
• 5-8% more likely to develop schizophrenia if born in winter due to nutrition, viral infection

Question 24

Schizophrenia: toxoplasma gondii

Answer 24

• Infants infected with toxoplasma gondii have impaired brain development (impairs memory, leads to hallucinations and delusions)
• Adults with a diagnosis of schizophrenia are more likely to have had a pet cat in childhood
• Blood tests also show higher concentration of toxoplasma antibodies in schizophrenics than in the general population

Question 25

Schizophrenia: brain abnormalities

Answer 25

• Schizophrenia is associated with larger than average brain ventricles and less than average grey matter and white matter in the brain
• Weaker connections between prefrontal cortex and other brain areas
• May be caused by excess of dopamine activity

Question 26

Schizophrenia: treatments

Answer 26

• Antipsychotic and neuroleptic drugs are used to treat schizophrenia
• Block dopamine synapses (elevated dopamine is a key symptom in first episodes)
• Narcotics such as PCP inhibit glutamate receptors and in high doses mirror schizophrenic symptoms (lower release of glutamate and fewer number of receptors in prefrontal and hippocampus seen in schizophrenia)

Question 27

The medical model

Answer 27

The conceptualisation of psychological abnormalities as diseases that have symptoms, causes and possible cures

Question 28

Physiognomy

Answer 28

The theory that mental disorders could be diagnosed by facial features

Question 29

Neurosis

Answer 29

A condition that involves anxiety but in which the person is still in touch with reality

Question 30

Psychosis

Answer 30

A condition in which the person experiences serious distortions of perception and thought that weaken their grasp on reality

Question 31

The biopsychosocial model

Answer 31

• Incorporates biological, psychological and environmental factors
• Biological: genetic influences, biochemical imbalances, structural abnormalities of the brain
• Psychological: maladaptive learning and coping, cognitive biases, dysfunctional attitudes and interpersonal problems
• Environmental: poor socialisation, stressful life circumstance and cultural and social inequities

Question 32

The diathesis-stress model

Answer 32

• Suggests that a person may be predisposed to a mental disorder that remains unexpressed until triggered by stress

Question 33

Consequences of labelling

Answer 33

• Psychiatric labelling conjures bias in the general public
• A labelled person views themselves self negatively and may develop defeatist attitudes which may reduce their effort to work towards their recovery

Question 34

Generalised anxiety disorder

Answer 34

• A disorder characterised by chronic excessive worry accompanied by 3 or more of the following symptoms…
• Restlessness, fatigue, concentration problems, irritability, muscle tension and sleep disturbance
• Occurs more frequently in lower socioeconomic groups and is twice as common women
• Stressful experiences play a role
• Treated using benzodiazepines (class of sedative drugs that stimulate GABA)

Question 35

Phobic disorders

Answer 35

• Anxiety is evoked only in a certain well-defined situation
• Social disorder: an irrational fear of scrutiny by other people leading to avoidance of social situations
• Specific phobias: animals, situations, natural environments, situations blood and injury
• Some heritability
• Abnormalities in serotonin and dopamine
• Abnormally high levels of activity in the amygdala
• Can be classically conditioned

Question 36

Panic disorder

Answer 36

• Characterised by recurrent attacks of severe anxiety (panic) which are not restricted to any particular situation and are therefore unpredictable
• Symptoms: shortness of breath, heart palpitations, sweating, dizziness, depersonalisation, derealisation and a fear that one is going crazy/about to die
• Panic attacks may be traceable to the fear of fear itself

Question 37

Obsessive-compulsive disorder

Answer 37

• Obsessive thoughts produce anxiety, and the compulsive behaviours are performed to reduce it
• The compulsions are intense, frequent and experiences as irrational and excessive
• Attempt to supress these actions can increase the frequency and intensity of the obsessive thoughts
• The most common obsessions involve contamination, aggression, death, sex, disease, orderliness and disfigurement
• Heightened neural activity in the caudate nucleus (involved in the initiation of intentional actions)

Question 38

Post traumatic stress disorder

Answer 38

• Appears after a person lives through an experience so threatening and uncontrollable that they are left with feelings of terror and helplessness
• Characterised by recurrent reliving of the trauma as intrusive memories or flashbacks

Question 39

Dissociative identity disorder

Answer 39

• ‘Multiple personality disorder’
• The presence within an individual of two or more distinct identities that at different times take control of the individual’s behaviour
• The host personality is usually unaware of the alters
• More prevalent in women and individuals with a history of severe childhood abuse and trauma

Question 40

Dissociative amnesia

Answer 40

The sudden loss of memory for significant personal information

Question 41

Dissociative fugue

Answer 41

The sudden loss of memory for one’s personal history, accompanied by an abrupt departure from home and the assumption of a new identity

Question 42

Dysthymia

Answer 42

A disorder that involves the symptoms of depression only less severe and longer lasting

Question 43

Major depressive disorder: psychological factors

Answer 43

• Helplessness theory: individuals who are prone to depression automatically attribute negative experiences to causes that are internal (their own fault), stable (unlikely to change) and global (widespread)
• Depressed individuals’ judgements and memories are negatively biased
• The Werther effect: increase of suicide rates following the publication of a suicide story (copycat suicide)
• Depression realism theory: non-depressed individuals insulate themselves against negativity by adopting a positive attributional style, whereas people with depression are more realistic

Question 44

Schizophrenia: psychological factors

Answer 44

• Development of and recovery is dependent on the family environment
• Relapse is more likely with emotional intrusiveness and excessive criticism directed towards the patient by their family

Question 45

Antisocial personality disorder

Answer 45

• A pervasive pattern of disregard for and violation of the rights of others
• Diagnostic signs include illegal behaviour, deception, impulsivity, physical aggression, recklessness, irresponsibility and a lack of remorse for wrongdoing
• times more likely in men than women
• The terms sociopath and psychopath describe people with APD who are especially cold hearted, manipulative and ruthless
• Psychopaths who are shown negative emotional words show less activity in the amygdala and hippocampus than non-criminals (they are less sensitive to fear)