Psychology Disorders & Treatment

Question 1

Misconceptions & Controversies: The medical model

Answer 1

focus on bio causes, views abnormal behaviour as disease •problems + limitations
•Still maybe most dominant model
•Relied on supernatural explanations
•Medical model helped ppl get treated better
•Stigma seems to be getting worse
•Doesn’t take into considerations the other factors

Question 2

Stereotypes of Psychological Disorders

Answer 2

–Psychological disorders incurable
–violent + dangerous
–behave in bizarre ways + very different from normal ppl
•Once diagnosed – always gonna have label
•Vast majority can be successfully treated + a lot of the time temporary
•most extreme cases of mental illness: we use availability heuristic
•Incredibly small minority engage in criminal acts
•Touches everyone: most of the time you have no idea

Question 3

criteria do psychologists use to determine whether someone’s behaviour is normal/abnormal?

Answer 3

–Deviance: in terms of norms for that culture
•Deviant in 1 culture, normal in another
–Maladaptive behaviour: harmful for person
–Personal distress: behaviour must interfere with at least one aspect of the person’s life (relationship, emotional well-being, workplace)
•Our understanding of abnormal behaviour + mental illness is also constantly evolving: Homosexuality was a disorder until 1974 + Drake domania
•Hard to tell whether its normal/abnormal
•Hysteria –exclusive to W

Question 4

Diathesis-Stress Model

Answer 4

Diagnostic model proposes disorder may develop when underlying vulnerability + precipitating event
•Diathesis: vulnerability, genetic predisposistion
•Doesn’t have to be biological: can be childhood trauma
•Stress: hard time, stressful circumstances

Question 5

Family systems model

Answer 5

emphasis on social context (family)

how relationships contributing

Question 6

Socio-cultural model

Answer 6

emphasis on interaction between individual + culture
–anorexia nervosa
certain disorders more likely to occur in certain socioeconomic status, subcultural you grow up in

Question 7

Cognitive-behavioural approach

Answer 7

emphasis on maladaptive thoughts + beliefs that the individual has learned
–#1 treatment, focus on cognitive (thoughts) + behaviours
•replace those behaviours with functional ones

Question 8

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV): Multiaxial system

Answer 8

–Axis I: Clinical disorders - come + go, easier to treat - schizophrenia, childhood disorders, depression
–Axis II: Personality disorders & mental retardation - lasting longer - antisocial personality disorder
–Axis III: General medical conditions - Alzheimer’s, obesity

Question 9

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV): Multiaxial system

Answer 9

–Axis IV: Psychosocial/environ problems - what’s going in person’s life - unemployment, divorce, poverty
–Axis V: Global assessment of functioning - how are they doing in general - Scale from 1 to 100
DSM-5 dropped the multiaxial system: Intellectual disorders looked at together

Question 10

Assessment

Answer 10

examining mental state to diagnose + treat possible psychological disorders
•Evaluating them

Question 11

evidence-based assessment

Answer 11

use research rather than gut feeling
•probability, what research says, what treatment is most effective
comorbidity: if you have 1 there’s an increased likelihood you have another one as well
•Are they suffering from these other mental disorders

Question 12

Psychotherapy

Answer 12

formal psychological treatment
–Always involve interactions between practitioner + client: importance of finding the right therapist - trust, believe it’s gonna work

Question 13

Treatment

Answer 13

Increased understanding of the causes of a mental disorder does not necessarily lead to more effective treatment strategies
•Can’t assign a catch all treatment to whole disorder = Need to consider personal circumstances

Question 14

Psychodynamic therapy (Freud)

Answer 14

–Psychoanalysis
–Insight: Increase patient’s understanding of own psychological processes/where conflict coming from
–less common
•Unconscious conflict gives rise to symptoms
•Free association: whatever comes to mind
•dream analysis: Meaning from dreams
•Minimize role of therapist

Question 15

Client-centered therapy (Rogers):

Answer 15

–Safe + comfortable setting, empathy, reflective
listening
–Encouragement of personal growth through self- understanding
•Client being listened to, accepted, not judged
•Reflective listening: repeating so they know you’re listening

Question 16

Cognitive therapy

Answer 16

–Attempts to modify thought patterns in order to eliminate maladaptive behaviours + emotion
–Cognitive restructuring

Question 17

Behavioural therapy

Answer 17

–maladaptive behaviours learned conditioning + can be ‘unlearned’ in same way
–Behaviour modification: effective for autism
•Reinforce positive + ignore/punish negative

Question 18

Psychotropic medication

Answer 18

Drugs that affect mental processes
–Anti-anxiety drugs: Short-term treatment of anxiety - increase GABA activity
tranquilizers – negative side effects

Question 19

Psychotropic medication

Answer 19

–Antidepressants: SSRI - increase serotonin levels

–Antipsychotics (neuroleptics): Block dopamine, reduce positive symptoms of schizophrenia

Question 20

Anxiety Disorders

Answer 20

• excessive anxiety in absence of true danger
• Very common: 1/4 ppl
• Common symptoms: autonomic system arousal, worry/anxiety/tenseness, restlessness, excessive startle response

Question 21

Phobic disorder

Answer 21

–Specific phobias: specific object/scenarios
–Social phobia
–Agoraphobia can have panic attacks
•Illogical level

Question 22

Generalized anxiety disorder (GAD)

Answer 22

–Hypervigilance
•Chronic sense of anxiety
•High alert
•Excessive anxiety

Question 23

Panic disorder

Answer 23

–fear of having panic attacks
•All associated with autonomic nervous system
•blood injury injection phobia: sympathetic nervous, take blood, bp drops after get raised

Question 24

Obsessive-compulsive disorder (OCD)

Answer 24

–Obsessions vs. compulsions
-OCD no longer grouped with the anxiety disorders
Obsessions: thoughts
•Compulsions: things done to deal with thoughts

Question 25

Causes: Cognitive factors

Answer 25

–Attention to + perception of threat •Ambiguous stimuli (At the meeting contribution elicits reactions •Can contribute, not necessarily does •Cognitive: seeing threat

Question 26

Causes: Situational/Environmental factors

Answer 26

–Learning (OCD): Learn to do compulsions | –Streptococcal infection (OCD): present symptoms similar to OCD

Question 27

Causes: Biological factors

Answer 27

–Inhibited temperamental style: tends to lead to shyness in adulthood can lead to anxiety disorder •Threat detector overactive – increased amygdala response –Genetics (OCD runs in families) –Abnormal brain activity: Caudate – basal ganglia – smaller + react abnormaly in OCD – impulse control

Question 28

Treatment: Phobic disorder

Answer 28

Behavioural techniques treatment of choice for specific phobias –Systematic desensitization therapy: Fear hierarchy, relaxation training, exposure therapy •Hier – list diff scenario + order

Question 29

Treatment: Anxiety Disorders

Answer 29

Cognitive-Behavioural Therapy (CBT): –correct faulty thinking + change maladaptive behaviours • Cognitive restructuring, exposure & response prevention (ERP) •Exposure therapy

Question 30

Mood Disorders: Dysthymia

Answer 30

–“Depressed mood most of the day, more days | than not, for at least two years”

Question 31

Mood Disorders: Major Depression

Answer 31

–Common cold of mental disorders | so common particularly in W

Question 32

Mood Disorders: Bipolar disorder

Answer 32

–Alternating periods of depression + mania –Manic episodes: elevated mood, increased activity, diminished need for sleep, grandiose ideas, racing thoughts, + extreme distractibility

Question 33

Causes: Cognitive factors

Answer 33

–cognitive triad: selves, situation, future –Learned helplessness model: just give up, learning nothing you do has consequences so you just give up •Low effecacy

Question 34

Causes: Situational/Environmental factors

Answer 34

–Life stressors, particularly interpersonal loss

Question 35

Causes: Biological factors

Answer 35

–Genetics –Monoamine deficiency (serotonin) –Biological rhythms: circadian rhythms – SAD

Question 36

Treatment: Depression

Answer 36

–no “best” way, many effective approaches available • Antidepressants: help alleviate pain • Cognitive-behavioural therapy: for long term

Question 37

Treatment: Depression

Answer 37

–Alternative treatments include phototherapy, exercise, electroconvulsive therapy, transcranial magnetic stimulation, + deep brain stimulation •Best treatment is medication + CBT

Question 38

Treatment: Bipolar Disorder

Answer 38

–Lithium (mania): not understood, they want to feel high, don’t wanna take medication, lot of artists suffer from bipolar, most creative

Question 39

Electroconvulsive therapy (ECT)

Answer 39

administering strong electrical current to brain | •ECT last resort, not responding to CBT, medication

Question 40

Transcranial magnetic stimulation (TMS)

Answer 40

electrical current in the brain region directly below coil | left prefrontal – less active

Question 41

Deep Brain Stimulation (DBS)

Answer 41

implanting electrodes within certain parts of the brain | pace maker – everynow + then sends stimulation, shown to be successful, also used for OCD

Question 42

Schizophrenia

Answer 42

alterations in perceptions, emotions, thoughts/consciousness DSM-5: Subtypes have been removed: Useless subtypes •Psychotic – abnormal thought patterns

Question 43

Schizophrenia: subtypes

Answer 43

``` –Paranoid type –Disorganized type –Catatonic type –Undifferentiated type –Residual type ```

Question 44

Schizophrenia: Positive symptoms

Answer 44

Excesses in behaviour –Delusions: False personal beliefs based on incorrect inferences about reality –Hallucinations: False sensory experiences

Question 45

Schizophrenia: Positive symptoms

Answer 45

–Loosening of associations: Speech pattern in which thoughts are disorganized/meaningless – gibberish –Disorganized behaviour: Acting in strange ways – deviant behaviour

Question 46

Schizophrenia: Negative symptoms

Answer 46

``` Deficits in functioning; includes behaviours such as: –Isolation, withdrawal –Apathy –Blunted emotion –Slowed, monotonous speech + movement ```

Question 47

Schizophrenia: Negative symptoms

Answer 47

•more difficult to treat than positive symptoms; different underlying causes no emotion, weird speech + movement •Positive respond to treatment easier

Question 48

Schizophrenia: Causes

Answer 48

* Genetic component: brain disorder: enlarged ventricles - Lack of brain matter * Missing white matter: brain matter responsible sensory perceptions, motor control * Environmental stress: cultural frequently in lower socioeconomic classes * Most often from cities

Question 49

Schizophrenia: Treatment

Answer 49

•Pharmacological treatments most effective –Antipsychotics haloperidol + chlorpromazine revolutionized the treatment of schizophrenia: get rid of positive symptoms •Little to no effect on negative symptoms •Significant side effects: tardive dyskinesia - no cure, motor impairment – ticking

Question 50

Schizophrenia: Treatment

Answer 50

–Clozapine: Acts on numerous neurotransmitter receptors + treats negative symptoms, no signs of motor impairment, – -Social skills training, intensive form of CBT – learning social interactions

Question 51

Dissociative Identity Disorder

Answer 51

•Controversial disorder part of a broader group of dissociative disorders –Some suggest it should be included as a type of PTSD

Question 52

Dissociative Identity Disorder

Answer 52

* Dissociative: breakdown of memory/awareness * Extreme personality shifts * Stanford prison experiment: see how ppl were treated * We’re capable of extreme shifts in personality given circumstances

Question 53

Personality Disorders

Answer 53

* interacting with the world in maladaptive + inflexible ways, for long time, resulting in social/work problems + personal distress * Usually last throughout lifespan with no expectation of significant change (Axis II)

Question 54

Personality Disorders: three groups

Answer 54

–Odd/Eccentric Behaviour: like positive symptoms of schizo –Dramatic/Emotional/Erratic Behaviour: borderline, antisocial –Anxious/Fearful Behaviour: similar to anxiety disorder •Harder to treat, doesn’t mean incurrable

Question 55

Borderline personality disorder

Answer 55

disturbances in identity, affect + impulse control •Identity: Lack a strong sense of self, fear abandonment, can be very manipulative in attempts to control relationships •More common in W

Question 56

Borderline personality disorder

Answer 56

* Affect: Profound emotional instability * Impulsivity: Self-mutilation most common, also sexual promiscuity, physical fighting, binge eating + purging * Need at least 5 symptoms * Borderline: borderline betw normal + psychotic behaviour

Question 57

Borderline personality disorder – Causes

Answer 57

* Biological factors: Genetics, serotonin | * Environmental factors: Abuse, trauma, relationship with caregivers

Question 58

Anti-social personality disorder (APD)

Answer 58

``` –lack of empathy + remorse –More common in M –Psychopaths: most extreme version of APD - superficially charming + rational, insincere, unsocial, incapable of love, lacking insight, shameless •Common in prison •Hedonistic ```

Question 59

Anti-social personality disorder (APD) – Causes

Answer 59

Biological factors:lower levels of arousal, lack of fear/anxiety, amygdala abnormalities, deficits in frontal lobe functioning = lack of foresight –Genetics more important for psychopathy

Question 60

Anti-social personality disorder (APD) – Causes

Answer 60

Situational/Environmental factors: low socio- economic status, dysfunctional families, childhood abuse

Question 61

Treatment: Borderline personality disorder

Answer 61

notoriously difficult to treat –Dialectical behaviour therapy (DBT) -psychodynamic, cognitive + behavioural component •1st stage: change behaviour •2nd: psychodynamic – understand background, insight •3rd: addressing maladaptive thoughts

Question 62

Treatment: Anti-social personality disorder

Answer 62

–Problems with treatment: no desire to get treatment, just manipulate •superficially charming –Prognosis: subsides with age

Question 63

Childhood Disorders

Answer 63

usually first diagnosed in infancy, childhood/adolescence –Very wide-ranging –Need to be considered within the context of normal childhood development – Assessment can be challenging DSM-5: No longer a separate chapter •might persist into adulthood •selective mutism

Question 64

Autism/Autism Spectrum Disorder

Answer 64

DSM-5: Now Autism spectrum disorder -developmental disorder involving deficits in social interaction, impaired communication + restricted interests •nothing suggests it’s more frequent •more likely to be diagnosed, more likely to recognize symptoms

Question 65

Asperger’s syndrome

Answer 65

form in which children have deficits in social interaction + theory of mind, but don’t show the same impairments in linguistic/cognitive development + normal IQ DSM-5: No longer a distinct diagnosis, instead falls under autism spectrum disorder

Question 66

Autism Spectrum Disorder: Core symptoms

Answer 66

1)Unaware of others: lack of eye contact, smiling 2)Deficits in communication: echolalia, pronoun reversal 3)Restricted activities + interests: repetitive play + behaviour, interested in nonsocial objects •Any changes to routine/settings extremely upsetting

Question 67

Autism Spectrum Disorder: Causes

Answer 67

–Primarily biological; hereditary component –Pre-natal/neo-natal events may result in brain dysfunction: breathing probs, heart probs, overgrowth/undergrowth pattern of brain development •2-5 grows large then stops growing –Promising new research: oxytocin research

Question 68

Autism Spectrum Disorder: Treatment

Answer 68

–Applied behavioural analysis (ABA): intensive treatment based on the principles of operant conditioning •40 hours/week: Huge time commitment, financially + emotionally draining •when done right, can have big results •Not something all parents can do •Reward positive behaviour

Question 69

Attention Deficit Hyperactivity Disorder (ADHD)

Answer 69

•restless, inattentive + impulsive behaviours | –Behavioural profiles vary greatly, causes may vary greatly as well

Question 70

Attention Deficit Hyperactivity Disorder (ADHD)

Answer 70

Biological factors: connection between frontal lobe + limbic system, abnormal activation of prefrontal regions, basal ganglia •30-80% of children diagnosed with ADHD continue to show symptoms in adulthood: may lead to academic + employment struggles

Question 71

ADHD: Treatment

Answer 71

Ritalin (methylphenidate): stimulant without them having to engage in hyperactivity –Decreases overactivity + increases attention •Side-effects: sleep problems, loss of appetite, etc. •Limbic system: subcortical •Overdiagnosed •Extra issues of kids on drugs

Question 72

Summary

Answer 72

* Importance of taking a holistic perspective, examining + treating the person within context * Importance of evidence-based assessment + treatment * Importance of patient beliefs + trust in the treatment provider (i.e., therapist)