Psych 105 - Psychological Disorders

Psychological Disorders

• Definition: Persistent disturbance or dysfunction in behavior, thoughts, or emotions that causes significant distress or impairment.

• Larger Concept: Conceptualized within the medical model as an illness with biological and environmental causes, symptoms, and potential cures, moving away from pseudoscience explanations.

• Brain Part (General): The brain is the biological basis for all psychological processes, and dysfunctions in various regions and neural circuits are implicated in psychological disorders. The diathesis-stress model highlights the interaction between pre-existing vulnerabilities (potentially involving brain structure, hormones, genes) and environmental stressors.

Three D's of Psychopathology

• Definition: Distressing to oneself or others, Dysfunctional for the person or society, and Deviant (violates social norms). These are used as a judgment of abnormality.

• Larger Concept: These criteria help determine what might be considered a psychological disorder, as there are no clear-cut biological markers.

• Brain Part: Not explicitly mentioned in the notes as a specific brain region for the "Three D's." This is a framework for judging abnormality based on observable behavior and subjective experience, rather than a specific neurological phenomenon.

The Medical Model

• Definition: Approach that conceptualizes abnormal psychological experience as illness that, like physical illnesses, have biological and environmental causes, defined symptoms, and possible cures.

• Larger Concept: Provided a framework for diagnosis through signs and symptoms and helped to destigmatize mental illness by rooting the cause in natural processes rather than pseudoscience.

• Brain Part: Implicitly suggests that biological causes may involve the brain and neurochemistry, although no specific regions are detailed in this section.

The Diagnostic and Statistical Manual of Medical Disorders (DSM)

• Definition: Classification system that describes the symptoms present within each recognized psychological disorder and indicates how the disorder can be distinguished from other, similar problems.

• Larger Concept: Used to create consistency within diagnostics and insurance billing, allowing for a standardized way to list and record psychological disorders. It categorizes various types of disorders (anxiety, depressive, etc.).

• Brain Part: Not directly linked to a specific brain region in the notes. The DSM is a classification system based on observable symptoms and diagnostic criteria, not directly on neurobiological findings, although it aims to categorize conditions that have underlying neurological components.

Disorders and Culture

• Definition: The understanding, experience, assessment, and treatment of psychological disorders can be influenced by cultural factors.

• Larger Concept: Highlights that what is considered a disorder, how it's experienced (e.g., different symptoms in China and Japan for depression/anxiety), and the preferred treatments (e.g., religious-based treatments in religious cultures) are culture-informed.

• Brain Part: Not directly linked to specific brain regions. This concept emphasizes the socio-cultural context rather than specific neurobiological mechanisms. However, culture can influence stress levels and experiences, which can interact with biological predispositions.

Biopsychosocial Perspective

• Definition: Considers biological (genes, brain structure, hormones), psychological (learning, perceptions, memory), and social (environment, support, culture) factors in the causation of psychological disorders.

• Larger Concept: Emphasizes multicausation in the development of psychological disorders, moving beyond purely biological or psychological explanations.

• Brain Part: Implicitly includes the brain as a key component of the "biological" factors influencing the development of disorders.

Diathesis-Stress Model

• Definition: Psychological disorders develop when an existing predisposition or vulnerability (diathesis - e.g., brain structure, genes, early learning) is triggered by stressful life events (stress - e.g., abuse, trauma, loss).

• Larger Concept: Explains how vulnerability factors (genetic, biological, psychological, social) interact with stressors to lead to the manifestation of psychological disorders.

• Brain Part: The "diathesis" component can include pre-existing differences in brain structure, neurochemistry, or other biological factors that make an individual more susceptible to developing a disorder when faced with stress.

Dangers of Labelling

• Definition: Diagnostic labels can lead to individuals being described and interpreted solely through the lens of their diagnosis, potentially overlooking situational factors and normal behaviors.

• Larger Concept: Highlights the potential for stigma and misinterpretation associated with diagnostic labels, as demonstrated by the Rosenhan (1973) study where normal behavior was pathologized within the context of a schizophrenia diagnosis.

• Brain Part: Not directly linked to a specific brain region. This concept focuses on the social and cognitive consequences of applying diagnostic categories.

Anxiety Disorders

• Definition: A category of psychological disorders where the primary feature is the presence of excessive anxiety. Includes phobias, panic disorder, social anxiety, and generalized anxiety.

• Larger Concept: Represents a broad group of disorders characterized by a common underlying experience of anxiety, which manifests in different ways.

• Brain Part: The amygdala (emotional processing center, especially for fear) is often implicated in anxiety disorders, showing heightened activity in some cases. Neurotransmitters like serotonin and dopamine are also thought to play a role in regulating anxiety responses.

Phobic Disorders (Phobias)

• Definition: Irrational or disproportionate fear of a specific object, activity, or situation, with recognition of the irrationality of the fear.

• Larger Concept: Illustrates how learning through classical conditioning (associating a stimulus with a negative experience) and preparedness theory (predisposition to certain fears) can contribute to the development of specific anxiety disorders.

• Brain Part: The amygdala is easily activated in response to the phobic stimulus. A shortage of serotonin and dopamine may impair the regulation of this fear response.

Social Phobia (Social Anxiety Disorder)

• Definition: Irrational fear of being publicly humiliated or embarrassed.

• Larger Concept: A specific type of phobia focused on social evaluation and scrutiny, often with an onset in adolescence or early adulthood.

• Brain Part: Similar to other anxiety disorders, the amygdala likely plays a role in the fear response in social situations. Areas involved in social processing and self-awareness might also be implicated, although not specifically mentioned in your notes.

Panic Disorder

• Definition: Sudden occurrence of multiple psychological and physiological symptoms that contribute to intense terror (feeling of impending death or doom). May be unpredictable.

• Larger Concept: Characterized by acute episodes of anxiety that can lead to significant distress and avoidance behaviors (like agoraphobia) due to fear of future attacks.

• Brain Part: While not explicitly stated in your notes for panic disorder specifically, the amygdala's role in processing fear suggests its involvement. Hypersensitivity to physiological signs of anxiety might also involve interoceptive pathways in the brain.

Agoraphobia

• Definition: A specific fear of open public spaces, often developing as a consequence of panic attacks occurring in those places.

• Larger Concept: Demonstrates how classical conditioning can lead to avoidance behaviors in anxiety disorders, where the association of panic attacks with certain locations triggers fear and avoidance.

• Brain Part: The brain regions involved in fear (amygdala) and spatial awareness and memory (hippocampus) are likely involved in the development and maintenance of agoraphobia. The fear response becomes associated with specific environments.

Generalized Anxiety Disorder (GAD)

• Definition: Chronic excessive worry accompanied by three or more of the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, ¹ sleep disturbance. ² Often described as "free floating" anxiety.  

• Larger Concept: Represents a persistent state of anxiety that can interfere with various cognitive processes (decision making, working memory) due to the constant worry.

• Brain Part: Lower levels of the inhibitory neurotransmitter GABA are associated with GAD. The heritability suggests a genetic influence on brain structure and function related to anxiety regulation.

Obsessive-Compulsive Disorder (OCD)

• Definition: Repetitive intrusive thoughts (obsessions) and ritualistic behaviours (compulsions) designed to fend off those thoughts that interfere significantly with an individual's functioning.

• Larger Concept: Illustrates how intrusive thoughts can lead to significant anxiety and how ritualistic behaviors are developed as a maladaptive coping mechanism to reduce this anxiety.

• Brain Part: While not explicitly detailed in your notes, OCD is often linked to abnormalities in circuits connecting the basal ganglia, orbitofrontal cortex, and anterior cingulate cortex, which are involved in habit formation, error detection, and impulse control.

PTSD (Post-Traumatic Stress Disorder)

• Definition: Chronic physiological arousal, recurrent unwanted thoughts or images of the trauma causing arousal, and avoidance of things related to the traumatic event.

• Larger Concept: Demonstrates how exposure to traumatic events can lead to long-lasting changes in psychological and physiological functioning.

• Brain Part: Heightened activity in the amygdala (emotional processing), reduced activity in the medial prefrontal cortex (executive functioning), and smaller hippocampal volume (memory processing and fear unlearning) are associated with PTSD.

Term: Brain Changes in PTSD
Definition: Includes heightened amygdala activity, reduced medial prefrontal cortex activity, and smaller hippocampal volume, which impairs memory processing and fear extinction.

Mood Disorders

• Definition: A category of psychological disorders where mood disturbances are the predominant feature. Includes depressive disorders and bipolar disorder.

• Larger Concept: Encompasses disorders characterized by significant and persistent disruptions in emotional state, affecting thoughts, behavior, and physical functioning.

• Brain Part: Mood disorders are associated with imbalances in neurotransmitters, particularly norepinephrine and serotonin, although the exact mechanisms are complex and not fully understood. Brain regions involved in mood regulation, such as the prefrontal cortex, amygdala, and hippocampus, are also implicated.

Depressive Disorders (Unipolar Depression)

• Definition: Characterized by symptoms such as persistent sadness, hopelessness, anxiety, misery, inability to enjoy, negative cognitions, loss of interest, lack of drive, and somatic symptoms (appetite/sleep changes, fatigue).

• Larger Concept: Includes Major Depressive Disorder (severe, acute episodes) and Persistent Depressive Disorder (less severe, chronic). The cognitive model highlights the role of negative thinking patterns (negative self-talk, helplessness theory, negative schema).

• Brain Part: While your notes mention that the role of norepinephrine and serotonin is unclear, imbalances in these neurotransmitters are often implicated. The prefrontal cortex (cognition, mood regulation), amygdala (emotion), and hippocampus (memory, learning) are also involved.

Bipolar Disorder

• Definition: Characterized by cycles of abnormal, persistent high mood (mania) and low mood (depression).

• Larger Concept: Involves significant shifts in mood and energy levels, with mania potentially leading to impulsive and risky behaviors. Includes Bipolar I (manic and depressive episodes) and Bipolar II (hypomanic and depressive episodes).

• Brain Part: Similar to depressive disorders, neurotransmitter imbalances are suspected, although the specific mechanisms are complex. Brain regions involved in mood regulation, such as the prefrontal cortex and amygdala, are also implicated in the cycling of moods.

Schizophrenia

• Definition: A psychotic disorder characterized by a profound disruption of basic psychological processes (break from experience and reality).

• Larger Concept: Manifests with positive symptoms (hallucinations, delusions), negative symptoms (withdrawal, apathy, flat affect), disorganized symptoms (speech, behavior, catatonia), and cognitive symptoms (deficits in executive functioning, attention, working memory). The diathesis-stress model is relevant due to incomplete concordance rates in identical twins.

• Brain Part: The dopamine hypothesis suggests an excess of dopamine, although this is not fully supported. The enlarged ventricles hypothesis and tissue loss in the parietal lobe are also noted.

Personality Disorders

• Definition: Enduring patterns of thinking, feeling, relating to others, or controlling impulses that deviate from cultural expectations and cause distress or impaired functioning, beginning in adolescence/early adulthood and stable over time.

• Larger Concept: Represent inflexible and maladaptive personality traits that cause significant problems in social and occupational functioning. Categorized into three clusters: A (odd/eccentric), B (dramatic/erratic), and C (anxious/inhibited).

• Brain Part: While the notes don't provide a general brain region for all personality disorders, specific disorders within this category have some neurological associations (e.g., lower amygdala and prefrontal cortex activity in Antisocial Personality Disorder).

Antisocial Personality Disorder (ASPD)

• Definition: Characterized by a pervasive pattern of disregard for and violation of the rights of others, beginning in early childhood/adolescence and continuing into adulthood.

• Larger Concept: Often associated with terms like "psychopath" or "sociopath" (though these are not formal diagnoses). Features include illegal behavior, deception, impulsivity, aggression, recklessness, irresponsibility, and lack of remorse. May be linked to preconventional morality.

• Brain Part: Lower activity in the amygdala (emotional processing, fear response) and lower regulation of impulses due to lower activity in the prefrontal cortex (impulse control) are noted.

Borderline Personality Disorder

• Definition: Characterized by unstable moods and intense, stormy personal relationships, frequent mood changes and anger, unpredictable impulses, and self-mutilation. Often involves "splitting" (seeing others as all good or all bad).

• Under Cluster B Disorder

• Larger Concept: Associated with a high suicide rate (though often not intended to be successful). Can be very challenging to treat.

• Brain Part: While not explicitly detailed in your notes, BPD is often linked to dysregulation in the limbic system(involved in emotion processing) and reduced connectivity between the limbic system and the prefrontal cortex(involved in emotional regulation).

Sex Differences in Psychological Disorders

• Definition: Some psychological disorders are diagnosed at different rates in men and women (e.g., women higher for anxiety/depression, men higher for intermittent explosive disorder/ASPD).

• Larger Concept: These differences may be due to variations in reporting or suppressing distress, clinicians' expectations (diagnostic bias), and differing social roles and experiences (e.g., job roles, responsibilities, exposure to certain stressors). Also linked to internalizing (women) vs. externalizing (men) responses to distress.

• Brain Part: While not directly specified, hormonal differences and potential variations in brain structure and function between sexes could contribute to these differing rates, interacting with social and psychological factors.

Common OCD Compulsions

Include checking, ordering, moral concerns, and contamination. Each is a repetitive behaviour aimed at reducing anxiety.

Checking (Compulsion)
Definition: Repeatedly ensuring something is left a certain way to prevent a feared consequence.

Term: Ordering (Compulsion)
Definition: Placing items in a particular or precise order to relieve distress.

Term: Moral Concerns (Compulsion)
Definition: Obsessions related to morality, often involving excessive guilt or fear of being immoral.

Term: Scrupulosity
Definition: A moral or religious form of OCD where the person believes they have committed a sin or immoral act. Compulsions include excessive prayer or self-punishment.

Term: Contamination (Compulsion)
Definition: The belief that one is prone to disease or contamination, leading to excessive washing or avoidance.

Emotional Symptoms of Depression

Sadness, hopelessness, anxiety, misery, and a blunted affect—muting of all emotions.

Paranoid Personality Disorder

Distrust in others and suspicion that others are out to get you. Lack of loyalty, even among close friends.

Cluster A

Schizoid Personality Disorder

Extreme introversion, withdrawal from relationships, and no desire for social interaction.

Cluster A

Schizotypal Personality Disorder

Peculiar, eccentric behaviors and beliefs, such as telepathy or conspiracy theories; difficulty forming relationships. Associated with schizophrenia but without hallucinations or delusions.

Cluster A

Antisocial Personality Disorder (ASPD)

A pervasive pattern of disregard for and violation of others' rights, beginning in childhood or adolescence and continuing into adulthood.

Common Traits of ASPD

Illegal behavior, deception, impulsivity, aggression, recklessness, irresponsibility, and lack of remorse.

Must be at least 18 years old and have shown conduct disorder before age 15. Includes aggression toward people/animals, dishonesty, and impulsivity.

Brain Differences in ASPD

Lower amygdala activity (less fear/startle response) and reduced prefrontal cortex activity (less impulse control), contributing to moral disregard.

Cluster b

Histrionic Personality Disorder

Characterized by excessive attention-seeking, theatrical or exaggerated behavior, and flirtatiousness.

Cluster b

Narcissistic Personality Disorder

Involves an inflated sense of self-importance, exaggeration of achievements, charm that wears thin, and fantasies of success and superiority.

Cluster b

Avoidant Personality Disorder

Social anxiety and discomfort unless certain of being liked. Desires social interaction but fears criticism and embarrassment.

Dependent Personality Disorder

Submissive and needy for approval, reassurance, and advice. Fearful of abandonment and potentially suicidal after relationship loss.

Gender and Disorder Prevalence

Women are twice as likely to experience anxiety and depression; men are 3–4 times more likely to be diagnosed with intermittent explosive disorder and ASPD.

Reporting Bias

Men may suppress reporting anxiety and depression, while more readily report disorders like ASPD. Diagnostic biases may also reflect clinicians’ expectations.

Gendered Social Roles and Experience

Women often face added stressors like low-paying jobs and fear of sexual violence, contributing to anxiety and depression.

Emotional Response Differences

• Women: Tend to internalize emotions (e.g., depression, anxiety)

• Men: More likely to externalize emotions (e.g., substance abuse, risky behaviour)

Cluster A – Odd or Eccentric Disorders

Characterized by social awkwardness and withdrawal, along with unusual thinking or behavior. These individuals may seem strange or peculiar, and their symptoms are somewhat similar to—but not as extreme as—schizophrenia.

1. Paranoid

2. Schizoid

3. Schizotypal

Cluster B – Dramatic, Emotional, or Erratic Disorders

nvolves intense emotional reactions, unpredictable behavior, and difficulty in maintaining relationships. These disorders are associated with impulsivity, unstable moods, and attention-seeking or manipulative behaviors.

1. ASPD

2. Narcissistic

3. Histrionic

4. Borderline

Cluster C – Anxious or Fearful Disorders

Marked by excessive fear, anxiety, or avoidance. These individuals are often very self-conscious, perfectionistic, or clingy in relationships due to deep insecurities and fears of rejection or disapproval.

1. Avoidant

2. Dependent

3. OCD

Somatic Symptoms of Depression

1. Somatic Symptoms: reduced funtions of appetite, energy, sleeping, physiological manifestations of depressions 

   1. Loss of appetite 

   2. Lack of energy 

   3. Sleep difficulties 

   4. Weight loss/gain

Cognitive Symptoms of Depression

1. Cognitive Symptoms: negative self talk about self (meaningless, actions are futile) the world (that it is cruel and unjust) and the future (that your actions are irrelevant to the future and any change, that things will simply not matter then) 

   1. Negative cognitions about the self, world, and future 

   2. Motivational Symptoms: amotivation to do anything, regardless of interests, even simple tasks such as getting out of bed, furthering the entrenchment into depression. 

   3. Loss of interest 

   4. Lack of drive 

   5. Difficulty starting anything