Chapter 16: Psychological Disorders - 18 marks Flashcards by Unknown Unknown

Distressing
Dysfunctional
Deviant

What is Abnormal?-Social Construct 3 D’s

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Abnormal behaviour = result of supernatural forces
Possessed by a spirit

Demenological View-Deviant Behaviour

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Historical Perspectives On Deviant Behaviour-Treatment

Trephination - ‘hole in the skull’

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Mental illnesses are diseases like physical illness that effect the brain (Hippocrates, 5th Century B.C.)

Historical Perspectives On Deviant Behaviour-Early biological views

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General paresis - caused by syphilis
Disorders linked to physical causes
Current - physiological & psychological

Historical Perspectives On Deviant Behaviour-Breakthrough

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Each of us has some degree (range) of vulnerability for developing a psychological disorder, given sufficient stress

The Vulnerability-Stress Model-The Diathesis-Stress Model

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Means that clinicians using the system should show high levels of agreement in their diagnostic decisions.

Diagnosing Psychological Disorders-Reliability

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Means that the diagnostic categories should accurately capture the essential features of the various disorders

Diagnosing Psychological Disorders-Validity

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The DSM-5: Integrating Categorical and Dimensional Approaches
Detailed behaviour must be present for diagnosis
Five axes / dimensions
Assess both person & life situation

The DSM-5: Integrating Categorical and Dimensional Approaches

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Diagnosis (e.g., depression, schizophrenia, social phobia)

Diagnosis (e.g., depression, schizophrenia, social phobia) Dimensions-Axis I: Clinical Symptoms

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E.g., autism, mental retardation (typically first evident in childhood )
Personality disorders
Long lasting & encompass way of interacting with the world
E.g., Paranoid, Antisocial, Borderline Personality Disorders

Dimensions-Axis II: Developmental & Personality Disorders

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E.g., brain injury or HIV/AIDS that can result in symptoms of mental illness

Dimensions-Axis III: Physical Conditions

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Dimensions-Axis IV: Severity of Psychosocial Stressors E.g., death of a loved one, starting a new job, college, unemployment, marriage

Dimensions-Axis IV: Severity of Psychosocial Stressors

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Dimensions-Axis V: Highest Level of Functioning Level of functioning both at present time & highest level within previous year

Dimensions-Axis V: Highest Level of Functioning

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Critical Issues in Diagnostic Labelling-Social & Personal Becomes too easy to accept label as description of the individual
May accept the new identity implied by the label
May develop the expected role and outlook

Critical Issues in Diagnostic Labelling-Social & Personal

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Involuntary commitment
Loss of civil rights
Indefinite detainment

Critical Issues in Diagnostic Labelling-Legal Consequences

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Competency
State of mind at time of a judicial hearing
Insanity
State of mind at time crime was committed

Critical Issues in Diagnostic Labelling-Legal Consequences

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Is not feeling apprehensive about some real threat

Definition
Frequency & intensity of responses are out of proportion to situations
Interferes with daily life
E.g., Phobias, generalized anxiety disorder, obsessive-compulsive

Anxiety Disorders

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Most develop during childhood, adolescence, young adulthood

Phobic Disorder-Strong, irrational fears of objects or situations

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Can intensify over time

Phobic Disorder-Seldom go away on their own

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Depends on how often condition is encountered

Phobic Disorder-Degree of impairment

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Most Common in Western Society
Agoraphobia

Fear of open spaces, public places
Social phobias

Fear of certain situations
Specific phobias

Fear of specific objects such as animals or situations

Phobic Disorder

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State of diffuse, ‘free-floating’ anxiety
Not tied to specific situation; condition
Feeling of something is going to happen; don’t know what
5% of population between 15-45 years

Generalized Anxiety Disorder

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Occur suddenly, unpredictably, intense
May occur with or without agoraphobia
Fear of future attacks
3.5% of population

Panic Disorder

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Obsessions = cognitive component Repetitive & unwelcome thoughts Compulsions = behavioural component Repetitive behavioural responses 2.5% of population

Obsessive-Compulsive Disorder (OCD)

Problem with impulse control and behavioural inhibition Involvement of prefrontal cortex, caudate nucleus

Neuroscience of OCD-Executive dysfunction model

Dysfunction in orbitofrontal cortex and associated areas

Neuroscience of OCD- Modulatory control model

Genetics MZ twins more similar than DZ twins GABA Low levels may cause highly reactive nervous systems

Causal Factors in Anxiety Disorders and OCD-Biological Factors

Females exhibit more anxiety disorders than males Differences emerge as early as seven years old Possible explanations Sex-linked biological disposition Less power & personal control for women

Causal Factors in Anxiety Disorders and OCD-Gender Differences

Unacceptable impulses threaten to overwhelm ego’s defenses Cognitive Explanations Maladaptive thoughts & beliefs Things appraised ‘catastrophically’

Causal Factors in Anxiety Disorders and OCD Psychodynamic Explanations Neurotic Anxiety

Classical conditioning: Associating an object or situation with pain and trauma Modeling Learning by watching others

Causal Factors in Anxiety Disorders and OCD-Learning Explanations

Culture defines what is important Some disorders are ‘culturally bound’ Fear of offending someone; fear of being fat

Causal Factors in Anxiety Disorders and OCD-Sociocultural Factors

Intense fear of being fat Severely restrict food intake 90% are female A potentially life-threatening disorder

Eating Disorders-Anorexia Nervosa

Binge and purge 90% are female

Eating Disorders-Bulimia Nervosa

Environmental, psychological, biological Common in industrialized cultures (beauty equated with thinness) Objectification theory Cultural emphasis on viewing one’s body as object

Causes of Anorexia and Bulimia

Anorexics - Abnormally high achievement standards Bulimics - Depressed, anxious

Causes of Anorexia and Bulimia-Personality factors

Higher concordance rate among identical twins

Causes of Anorexia and Bulimia-Genetics

Is not a ‘case of the blues’ or ‘having a bad day’ Clinical depression = frequency, intensity, duration of symptoms is out of proportion to situation

Mood (Affective) Disorders-Depression

Unable to function effectively

Mood (Affective) Disorders-Major depression

Chronic disruption of mood

Mood (Affective) Disorders-Dysthymia

Negative mood state

Mood (Affective) Disorders-Emotional

Difficulty concentrating; feelings of inferiority & failure, pessimism

Mood (Affective) Disorders-Cognitive

Loss of interest & drive

Mood (Affective) Disorders-Motivational

Appetite loss, compulsive eating, sleep disturbances

Mood (Affective) Disorders-Somatic

Depression alternates with mania Manic state Euphoric mood, grandiose cognitions Rapid speech

Bipolar Disorder

Data from numerous studies indicates Depression is on the rise in young groups The onset of depression increasing in 15- to 19-year-olds and in the 18 -25 age range People born after 1960 are Ten times more likely to experience depression than are their grandparents Even though their grandparents have lived much longer

Prevalence and Course of Mood Disorders

Women twice as likely to suffer from unipolar depression Women are most likely to suffer their first episode of depression in their 20s, men in their 40s No differences for bipolar disorder

Prevalence and Course of Mood Disorders-Gender Differences

Genetic factors Biochemical differences Underactivity of norepinephrine, dopamine, seratonin

Causal Factors in Mood Disorders-Biological Factors Depression

Stronger genetic component than unipolar depression 50% have relative with disorder Concordance rate is 5 times higher among identical twins compared to fraternal twins Manic disorders - overactivity of neurotransmitters?

Biological Explanations-Bipolar disorder

Early traumatic losses / rejections create vulnerability

Causal Factors in Mood Disorders-Psychological Factors Personality-based vulnerability Psychodynamic View

Define self-worth in terms of individual attainment React more strongly to failures; due to inadequacies Experience of meaninglessness

Psychological Factors-Humanistic View

Negative thoughts concerning: The world Oneself The future Cannot suppress negative thoughts Recall more failures vs. successes

Cognitive Processes-Depressive Cognitive Triad

Success = factors outside self Negative outcomes = personal factors

Cognitive Processes-Depressive Attributional Pattern

People expect bad events will occur and they can’t cope with them

Cognitive Processes-Learned Helplessness

Loss of reinforcement Depression occurs Causes loss of social support Deeper depression

Learning & Environmental Factors-Learning

Poor parenting Many stressful experiences Failure to develop good coping skills Failure to develop positive self-concept

Learning & Environmental Factors-Environmental

Prevalence of depressive disorders Less in Hong Kong & Taiwan than in the West Feelings of guilt & inadequacy Highest in North America & Western Europe Gender difference not found in developing countries

Sociocultural Factors-Cultural Variation

The World Health Organization estimates that nearly 500 000 people worldwide commit suicide annually, about 1.4 per minute 4000 per year in Canada For indigenous peoples, the rate is at least double 2nd most frequent cause of death among 15-24 year olds

Applications-Understanding And Preventing Suicide Willful taking of one’s life

No known biological cause Hypochondriasis Unduly alarmed Pain disorder Out of proportion Conversion disorder Sudden neurological problems

Somatic Symptom Disorders

Selective memory loss following trauma

Dissociative Disorders-Psychogenic amnesia

Loss of all personal identity

Dissociative Disorders-Psychogenic fugue

2 or more separate personalities

Dissociative Disorders-Dissociative identity disorder

Own set of memories, ideas, thoughts One identity may be protector; another a child

Dissociative Identity Disorder (DID)-Each identity is unique

DID generally results from severe traumatic experience during early childhood

Dissociative Identity Disorder (DID)-What Causes Dissociative Identity Disorder? Trauma-dissociation Theory

Schizophrenia = ‘split-mind’ Characteristics of Schizophrenia Severe disturbances in Thinking Delusions = false beliefs Speech Disorganized; strange words

Schizophrenia

Hallucinations = false perceptions

Schizophrenia-Perception

Blunted affect; inappropriate affect Behaviour

Schizophrenia-Emotion

Delusions of persecution; grandeur

Subtypes of Schizophrenia-Paranoid

Confusion; incoherence

Subtypes of Schizophrenia-Disorganized

Severe motor disturbances

Subtypes of Schizophrenia-Catatonic

Not easily classified as one of above

Subtypes of Schizophrenia-Undifferentiated

Predominance of positive symptoms Pathological extremes Delusions, hallucinations, disordered speech & thought

Subtypes of Schizophrenia-Type I

Predominance of negative symptoms Absence of normal reactions Lack of emotion, expression, motivation

Subtypes of Schizophrenia-Type II

Long history of poor functioning Poor recovery

Subtypes of Schizophrenia-Negative symptoms

History of good functioning; better prognosis

Subtypes of Schizophrenia-Positive symptoms

Twins - higher concordance rate

Schizophrenia: Biological Factors-Genetics

Twins - higher concordance rate

Schizophrenia: Biological Factors-Genetics

Neurodegenerative Hypothesis Atrophy & Destruction of neural tissue

Schizophrenia: Biological Factors-Brain

Overactivity of dopamine system Regulate emotion, motivation, cognitive functioning Antipsychotic drugs used for schizophrenia reduce dopamine activity

Schizophrenia: Biochemical Factors-Dopamine hypothesis

Extreme use of defence mechanism regression (retreat to an earlier, more secure stage in life) Not generally accepted but life stress is a factor Cognitive Defect in ability to filter

Schizophrenia: Psychological Factors-Freud

Stressful life events Family dynamics Vulnerability factor & negative reactions from others

Schizophrenia: Environmental-Factors

High levels of criticism High levels of hostility Overinvolvement in person’s life

Schizophrenia: Environmental-High in expressed emotion

Higher levels of stress among low-income

Schizophrenia: Sociocultural Factors-Social Causation Hypothesis

As functioning deteriorates- drift down socio-economic ladder

Schizophrenia: Sociocultural Factors-Social Drift Hypothesis

Exhibit stable, ingrained, inflexible, and maladaptive ways of thinking, feeling, and behaving 10 to 15 percent of adults in the United States, Canada, and European countries may have personality disorders

Personality Disorders

Anti-Social Personality Disorder Narcissistic personality disorder Borderline personality disorder Avoidant personality disorder Obsessive-compulsive personality disorder Schizotypal personality disorder

Six personality disorders in the DSM-5

The most destructive to society Exhibit little anxiety or guilt Tend to be impulsive Unable to delay gratification of their needs Actual antisocial behaviour occurs in only a portion of psychopathic individuals

Antisocial Personality Disorder

Genetic predisposition Dysfunction in brain structures that govern self-control and emotional arousal? MRI - differences in prefrontal lobes Weaker limbic input to frontal cortex

Antisocial Personality Disorder- Causal Factors-Biological factors

Lack of a superego

Antisocial Personality Disorder -Psychodynamic view-Causal Factors

No conditioned fear responses when punished Modeling of aggression Inattention to children’s needs Exposure to deviant peers

Antisocial Personality Disorder-Causal Factors-Learning explanations

Consistent failure to think about or anticipate long-term negative consequences of acts

Antisocial Personality Disorder-Causal Factors-Cognitive

Instability in behaviour, emotion, identity Emotional dysregulation Inability to control negative emotions Intense and unstable personal relationships Anger, loneliness, emptiness Impulsive behaviour Running away, promiscuity, drug abuse

Borderline Personality Disorder

View others as less than helpful Parents – abusive, rejecting, non-affirming

Borderline Personality Disorder: Causal Factors-Chaotic personal histories Treated malevolently

Over 20% of children aged 2-5 diagnosed with a DSM disorder 2 receiving particular attention: Attention Deficit/Hyperactivity Disorder Autism

Disorders Of Childhood And Old Age

Attentional difficulties Hyperactivity-impulsivity 7-10% of North American children Genetic predispositions Brain scans = no consistent differences with normals Why? Multifaceted disorder and interplay of environmental factors

Childhood Disorders-Attention Deficit/Hyperactivity Disorder

Extreme unresponsiveness to others Poor communication skills Lack of social responsiveness Repetitive and stereotyped behaviours Some exhibit savant abilities

Childhood Disorders-Autistic Spectrum Disorder

In 2000, it was estimated that autism affects about one in every 2000 children, About 80 percent of them boys

Childhood Disorders-Autistic Spectrum Disorder

Brains – larger by 5-10% (age 18 months – 4 yrs) Abnormal development in cerebellum

Autistic Spectrum Disorder: Causal Factors-Biological basis

May be 4-6 major genes 20-30 others involved No scientific evidence of link to vaccines

Autistic Spectrum Disorder: Causal Factors-Genetic factors

May be 4-6 major genes 20-30 others involved No scientific evidence of link to vaccines

Autistic Spectrum Disorder: Causal Factors-Genetic factors

E.g., Alzheimer’s, Parkinson’s, Huntington’s, Creutzfeldt-Jakob Diseases

Dementia in Old Age-Gradual loss of cognitive abilities Accompanies brain deterioration

Dementia that begins after age 65 2:1 female-male ratio Onset is typically gradual

Dementia in Old Age-Senile Dementia

60% of dementias Deterioration in frontal, temporal lobes Plaques in brain Destruction of acetylcholine

Dementia in Old Age-Alzheimer’s Disease

Molecule of DNA Contains many genes

Chromosomes and Genes-Chromosome

Contain genetic blueprint

Chromosomes and Genes-Genes

Exception: egg and sperm 23 chromosomes Form new cell with 46 chromosomes

Chromosomes and Genes-Every Cell Has 46 Chromosomes (23 pairs

Chapter 16: Psychological Disorders - 18 marks Flashcards

(106 cards)