Psychological Disorders (Ch. 13)

Question 1

what are psychological disorders?

Answer 1

Behavioral or psychological syndromes or patterns that lead to clinically significant distress or disability.

Question 2

point prevalence

Answer 2

% of people in a given population who have a given psychological disorder at one point in time.

Question 3

lifetime prevalence

Answer 3

% of people in a given population who have a given psychological disorder at any point in their lives.

Question 4

what are the impacts of psychological disorders on death rates?

Answer 4

psychological disorders represent 5/10 leading causes of disability and premature death worldwide

Question 5

what is a clinical assessment?

Answer 5

a procedure used to evaluate a client’s psychological functioning and determine whether a psychological disorder is present

Question 6

clinical interviews

Answer 6

designed to systematically explore a client’s current mental state, life circumstances, and history
- asks them to describe their problems
- open-ended or structural (can ask questions pertinent to diagnostic criteria)
- can gather insights from looking at hand gestures, facial expressions, etc.

Question 7

what can therapists use to eval clients besides clinical interviews?

Answer 7

self-report measures and projective tests

Question 8

self-report measures

Answer 8

fixed set of questions for patient to answer

Question 9

projective tests

Answer 9

client asked to respond to unstructured/ ambiguous stimuli (usually pictures) requires them to impose their own structure
(ex. Thematic Apperception Test [TAT], client has to make up a story about what is happening)
(ex. Rorschach Inkblot Test, client has to describe what they see in set of inkblots)

Question 10

are projective tests useful?

Answer 10

general consensus is that the popularity > usefulness

Question 11

what do we use to diagnose disorders?

Answer 11

Diagnostic and Statistical Manual of Mental Disorders (DSM). It has been revised many times, now at version DSM-5. It is updated to reflect current scientific evidence.

Question 12

who publishes the DSM?

Answer 12

the American Psychiatric Association

Question 13

how does the DSM reflect culture-specific disorders?

Answer 13

in addition to the 20 categories of disorders, there is an appendix of some culture-specific ones (however still some specific to only W culture, ex. bulimia nervosa, that is concluded in the overall manual)

Question 14

how can we make our language more inclusive around people with mental illnesses?

Answer 14

distinguishing between the person and the illness (ex. “people with schizophrenia,” as opposed to “schizophrenics”)

Question 15

the biopsychosocial model

Answer 15

analysis of psychological functioning is incomplete unless it considers biological, psychological, and social dimensions

Question 16

panic disorder

Answer 16

anticipation and experience of unexpected panic attacks (sudden episodes of terrifying bodily symptoms – labored breathing, choking, sweating, heart palpitations – and sense of losing control)

Question 17

are panic attacks specific to panic disorder?

Answer 17

No, they occur in almost all anxiety disorders, but in panic disorders, they are recurrent and unexpected

Question 18

what is the relationship between panic disorder and agoraphobia?

Answer 18

panic disorders are usually accompanied by agoraphobia (fear of being in situations where help may not be available or escape would be embarrassing/ difficult)

Question 19

why are panic disorder and agoraphobia usually concurrent?

Answer 19

because people with panic disorders usually fear having an attack in a public place (so stay in side)

Question 20

worry and generalized anxiety disorder

Answer 20

one common feature of GAD is worry, which some clinicians believe is a cognitive form of avoidance to decrease anxiety responses

Question 21

OCD (obsessive-compulsive disorder)

Answer 21

obsessions (recurrent unwanted disturbing thoughts) and compulsions (ritualistic actions to control the obsessions)

sometimes people have just one or both

Question 22

is OCD voluntary?

Answer 22

people usually know the obsessions are irrational but unable to stop and control the compulsions
(ex. an obsession with cleanliness may lead to a compulsion to keep washing their hands)

Question 23

mental rituals

Answer 23

form of compulsions in an attempt to manage obsessions

Question 24

trauma and stress-related disorders

Answer 24

psychological disorders triggered by an event involving death (or the threat of), serious injury, sexual violation, etc.

Question 25

process of trauma and stress-related disorders

Answer 25

1. period of numbness/ disassociation (feels alienated, socially unresponsive, oddly unaffected) 2. intrusive symptoms emerge (recurrent nightmares/ flashbacks), arousal symptoms (maintaining high states of readiness), avoidance symptoms

Question 26

acute stress disorder

Answer 26

trauma and stress-related disorders that last less than a month

Question 27

post-traumatic stress disorder (PTSD)

Answer 27

if acute stress disorder symptoms last longer than one month, it is considered PTSD

Question 28

why do some people who experience trauma not develop a stress disorder?

Answer 28

unclear, only 1 in 10 individuals who experience highly traumatic events go on to experience PTSD

Question 29

comorbidity

Answer 29

having one anxiety disorder increases the likelihood of having another at the same time

Question 30

biological risk factors (diatheses)

Answer 30

genetic profile, propensity to active brain regions (esp those associated with fear learning)

Question 31

psychological risk factors (stressors)

Answer 31

fear learning (ex. mental associations because of phobia stimulus or vicarious learning -- learning from others)

Question 32

brain regions associated with various disorders

Answer 32

phobias: active amygdala and insula PTSD: lower activation in the prefrontal regions associated with emotional regulation panic disorder: instability in autonomic nervous system OCD: overactivity in anterior cingulate cortex, insula, caudate, putamen

Question 33

bipolar disorder

Answer 33

manic (excited/ energetic) and depressive episodes with normal time interspaced

Question 34

hypomania

Answer 34

(mild level of mania) can often feel pleasurable, high-sprits, happiness, nervous energy but often develops into full-blown mania which can be terrifying and destructive

Question 35

who does bipolar disorder occur in?

Answer 35

children and adults

Question 36

what is the lading cause of death worldwide?

Answer 36

suicide, in the US the person at highest risk for death by suicide is male, non-Hispanic White or Native American, adolescent or older adult

Question 37

men and women and suicide rates?

Answer 37

across most all cultures, women are more likely to attempt suicide (use less lethal things) but men are more likely to die by suicide

Question 38

is there an association between psychological disorders and suicide?

Answer 38

the overwhelming majority of individuals who commit suicide are thought to have psychological disorders people who die by suicide have low levels of serotonin (NT) in the prefrontal cortex

Question 39

bipolar disorder and suicide risk?

Answer 39

most at risk during leave from hospital and period immediately after discharge

Question 40

what is an effective way to reduce suicide rates?

Answer 40

at the societal level, interventions that focus on educating children about suicide via school-based awareness programs

Question 41

biological risk factors for mood-related disorders?

Answer 41

- genetic profile - abnormalities in 3 NT (norepinephrine, dopamine, serotonin) - dysregulation in emotion-generative brain regions (more activation in limbic system region (subgenual cinglate cortex), associated with MDD). (less activation in PFC, more activation in the amygdala, associated with BPD)

Question 42

psychological risk factors for mood-related disorders

Answer 42

- dysfunctional patterns of thinking (negative cognitive schema or negative explanatory style, high levels of interpersonal stress)

Question 43

social risk factors for mood-related disorders

Answer 43

- interpersonal stress - having a depressed cartetaker

Question 44

dopamine hypothesis

Answer 44

early theory on cause of schizophrenia - believed that elevated levels of dopamine is associated with schizophrenia + found that imbalance in dopamine is a more likely cause

Question 45

what evidence was used to justify the dopamine hypothesis?

Answer 45

classical antipsychotics blocks dopamine receptors and was effective in relieving schizophrenia

Question 46

(explaining schizophrenia) dysfunction in glutamate transmission

Answer 46

increasing glutamate (NT) activity has lowered the impact of schizophrenia

Question 47

(explaining schizophrenia) abnormalities in frontal/ temporal lobes

Answer 47

- loss of grey matter in prefrontal cortex - enlarged ventricles

Question 48

causes of schizophrenia

Answer 48

1. genetics (twin & adoption studies suggest genetic basis) 2. prenatal risk factors (diatheses): poor maternal health during pregnancy (malnutrition, etc.) and birth complications 3. low SES (particularly poverty)

Question 49

schizophrenia as a neurodevelopmental disorder

Answer 49

now viewed as a neurodevelopmental order (meaning it stems from early brain abnormalities)

Question 50

civil commitment laws

Answer 50

people can be hospitalized against their will due to mental limitations associated with a psychological disorder 1. individual must have a mental illness (definition varies by state, but someone close to them usually initiates proceedings and client is able to defend themselves) 2. danger to themselves or others or unable to care for themselves

Question 51

stigma around mental illness

Answer 51

stigma that they are violent because of a mental illness

Question 52

not guilty by reason of insanity

Answer 52

not responsible for their criminal behavior, if at the time of the event they had a psychological disorder, they were unable to 1. understand their actions were wrong 2. behave as they know they should

Question 53

autism spectrum disorder

Answer 53

1. persistent deficits in social communication and interaction 2. restricted/ repetitive patterns of interest or behavior

Question 54

what does "spectrum" mean for autism

Answer 54

there are variations in the degree of impairment

Question 55

prevalence of autism spectrum disorder

Answer 55

- it is 4x more likely in boys - usually diagnosed in childhood - increased in prevalence in the last two years --> some controversy

Question 56

why have autism diagnoses increased in the past few years?

Answer 56

expanded criteria, increased awareness, diagnostic substitution (misdiagnosing as intellectual disorder)

Question 57

some deficits of children with autism

Answer 57

- some children don't speak or produce high-pitched noises - trouble with pronouns (identifying themselves as "I") - can't hold "joint attention" (attention shared with someone) - less motivation to socially interact and less empathy

Question 58

why does autism occur?

Answer 58

difficulties with theory of mind (diminished motivation to engage in social interaction), brain abnormalities

Question 59

ADHD (attention-deficit/ hyperactivity disorder)

Answer 59

children with ADHD are impulsive and hyperactive, have difficulting shifting their focus to where it needs to be (fidget) most common psychological disorder in childhood

Question 60

who is most likely to have ADHD

Answer 60

- boys 2x more likely to have it - often doesn't occur in adulthood

Question 61

ADHD treatment

Answer 61

- Adderall (amphetamine and dextroamphetamine) and Ritalin (methylphenidate) are stimulants that enhance the release of dopamine and norepinephrine --> activate inhibitory circuits and help symptoms of ADHD

Question 62

controversy in ADHD diagnosis

Answer 62

- is it just a label for kids who don't adapt well to a crowded classroom? - great prevalence rate in different US states (bc diff methods)

Question 63

Disassociative Identity Disorder (DID)

Answer 63

(used to be called multiple personality disorder) presence of two or more distinct personality states/ identities within a single person (each with own style, habits, beliefs, and memories)

Question 64

why the massive increase in diagnosis of DID?

Answer 64

could be because therapists encouraged suggestible clients, and they developed signs/ symptoms of the syndrome hard to make a conclusion bc 1. little is known about the disorder (thought memory partitioning- interidentity amnesia- but no evidence of that) 2. double over well-documented cases ("Sybil," ex. a therapist wrote a book on her and her DID, but transcripts show the therapist suggested DID and Sybil was in love with her therapist)

Question 65

how does DID arise?

Answer 65

ongoing controversy, unclear whether to cope with serious trauma or bc of therapists' suggestion

Question 66

personality disorder

Answer 66

enduring pattern of inner experience and behavior that 1. largely deviates from cultural norms and expectations 2. inflexible and pervasive across a broad range of personal and social situations 3. leads to "clinically significant distress/ impairment in functioning"

Question 67

personality disorders recognized by the DSM-5

Answer 67

A: odd or eccentric behavior (paranoid, schizoid, schizotypal) B: dramatic or emotional behavior (antisocial borderline, histrionic, narcissistic) C: anxious or fearful behavior (avoidant, dependent, obsessive-compulsive)

Question 68

difficulties in diagnosis

Answer 68

- no "pure" form of a personality disorder - overlapping symptoms - comorbid (likely to have 2 personality disorders in the same person) - hard to define threshold of when it becomes a personality disorder and not just eccentric personality trait

Question 69

antisocial personality disorder

Answer 69

lack of empathy: pervasive patter of disregard for and violation of the rights of others (diagnosed in someone at least 18 years) (at least 3 of the things below) 1. repeated action, could be arrested 2. deceit (for pleasure or profit) 3. impulsivity/ lack of planning 4. repeated physical fights/ assaults 5. disregard for own/ others' safety 6. irresponsibility and repeated failure to honor work and financial obligation 7. lack of empathy and response for harming others

Question 70

future of people with antisocial personality disorder?

Answer 70

- overrepresented in prison populations but depends on IQ (range of incarceration to stress depending on life circumstances and IQ)

Question 71

what does antisocial personality disorder look like cognitively?

Answer 71

low in prefrontal gray matter volume and structural abnormalities in amygdala