PSY100 - Ch 14 The Troubled Mind: Psychological disorders

Psychological disorders

a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning

biopsychosocial model

emphasizes the interconnection between biological, psychological and socio-environmental factors.

evidence-based practice

combines the personal experience of the clinician, the best scientific evidence, and a consideration of patient values and expectations to tailor scientifically valid treatments to the individual

comorbidity

Two or more disorders in the same individual

abnormal behaviour

The study of psychological disorders

diathesis-stress model

A model that suggests that the experience of stress interacts with an individual’s pre-existing vulnerability to produce a psychological disorder

psychoanalytic/psychodynamic therapy

• Focus on bringing unconscious struggles into consciousness (free association, dream analysis)

• Insight: increase patient’s understanding of their own psychological processes

Person/Client centered therapy

• Encouragement of personal growth through self-understanding → congruence

• Safe and comfortable setting, empathy, reflective listening

• unconditional positive regard

cognitive behavioural therapy

• Incorporates techniques from both cognitive therapy and behavioral therapy to correct faulty thinking and change maladaptive behaviors

• treats mood disorders like depression

Psychotropic medication/pharmacotherapy

therapy using psychotropic medication (drugs affecting mental processes)

anxiolytics

increases GABA activity for anxiety treatment (benzodiazepines)

antidepressants

 increases serotonin levels (SSRIs)

Antipsychotics

blocks dopamine, reduces positive symptoms of schizophrenia (hallucinations, delusions, etc)

Neurodevelopmental disorders

• disorders typically diagnosed in childhood, yet often continue throughout one’s lifespan

• ADHD, Schizophrenia, autism, etc

autism spectrum disorder (ASD)

characterized by deficits in social relatedness and communication skills that are often accompanied by repetitive, ritualistic behaviour

ASD symptoms

• Little to no eye contact

• Failure to develop a normal theory of mind

• No language abilities or delayed acquisition of language  to normal skills

• Difficulty maintaining conversations with others because of their social skills deficits

• High levels of repetitive, routine behaviour

• Extremely limited and focused preoccupations

• Unusually increased or decreased sensitivity to stimuli

ASD causes

• Strong evidence for genetic connection

• Environmental factors interacting with genetic factors associated with ASD during sensitive periods of brain development

• Parental age

attention deficit hyperactivity disorder (ADHD)

characterized by either unusual inattentiveness, hyperactivity with impulsivity, or both

ADHD symptoms

• The inability to maintain sustained attention or on-task behaviour for an age-appropriate length of time (problems completing and organizing work, following instructions)

• Engaging in structural activities is challenging (waiting in line), behaviour is noisy, active, and appear to take action without thinking

ADHD is 2 times more common in … than …

men, women

ADHD causes

• Genetics play a significant role in the development of ADHD

• Environmental factors: lead contamination, low birth weight, and prenatal exposure to tobacco, alcohol, and other drugs

• Underactive frontal lobes or smaller amygdala, basal ganglia, and hippocampus

Schizophrenia spectrum

A disorder characterized by hallucinations, delusions, disorganized thought and speech, disorders of movement, restricted affect, and avolition or asociality

Schizophrenia: Positive symptoms

excess in behaviour

• Delusions: false personal beliefs based on incorrect inferences about reality

• Hallucinations: false sensory experiences

• Disorganized Speech: loosening of associations; speech pattern in which thoughts are disorganized or meaningless

• Disorganized Behaviour: disorganized or abnormal motor behaviour, e.g., catatonia

Schizophrenia: Negative symptoms

deficits in functioning, harder to treat

• Isolation, withdrawal

• Apathy

• Blunted emotion

• Slowed, monotonous speech

Schizophrenia: Treatment

• Pharmacological: antipsychotics are very effective

• Side effects: tardive dyskinesia (results in uncontrollable sudden erratic motor behaviors

• Second-gen meds: clozapine (lower risk of tardive dyskinesia)

• No effect on negative symptoms

mood disorders

your general emotional state or mood is distorted or inconsistent with your circumstances and interferes with your ability to function.

common mood disorders

major depression, dysthymia (dysthymic disorder), bipolar disorder, mood disorder due to a general medical condition, and substance-induced mood disorder.

depressive attributional style

attributes failures to internal, global, stable causes

Beck’s Cognitive Triad

 negative views about oneself → negative views about the world → negative views about the future → repeat

bipolar disorder

a mental illness that causes unusual shifts in a person's mood, energy, activity levels, concentration, and ability to carry out day-to-day tasks

manic episodes

elevated mood, increased activity, diminished need for sleep, grandiose ideas, racing thoughts, and extreme distractibility

BPD: Type 1

* extreme highs (manic episodes, irritable to invincible, more frequent with lack of treatment) and low

BPD: Type 2

* not as extreme

BPD: treatment

• lithium, used for treatment

• Patients tend to refuse treatment as it will dampen their ability to emote

major depressive disorder

• characterized by lengthy periods of depressed mood, loss of pleasure in normal activities, disturbances in sleep and appetite, difficulty concentrating, feelings of hopelessness, and possible thoughts of suicide

• presence of depressive mood and anhedonia

anhedonia

loss of the ability to feel pleasure

electroconvulsive therapy

treats depression

procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure

deep brain stimulation

involves implanting electrodes within certain areas of the brain to regulate abnormal impulses

anxiety disorders

* characterized by excessive anxiety in the absence of true danger

generalized anxiety disorder

characterized by excessive anxiety and worry that is not correlated with particular objects or situations

GAD: symptoms

Hypervigilance → fatigue, irritability, headaches, etc.

specific phobias

fears of specific objects

social anxiety disorder

* characterized by an unrealistic fear of being scrutinized and criticized by others

agoraphobia

• unrealistic fear of open spaces, being outside the home alone, or being in a crowd

• often claustrophobic

Panic Disorders

* characterized by repeated panic attacks and fear of future attacks

Panic Attack

* the experience of intense fear and autonomic arousal in the absence of real threat 

anxiety disorders: symptoms

• Autonomic system arousal

• Worry/anxiety/tenseness

• Restlessness

• Excessive startle response

anxiety disorders: causes

• Cognitive Factors

• attention to and perception of threat

• Ambiguous stimuli

• interpretation of bodily sensations (panic disorder)

anxiety disorders: biological factors

• Genetics; inhibited temperamental style

• Fear circuitry dysfunction (amygdala, prefrontal cortex)

• Problems with the hypothalamic-pituitary-adrenal (HPA) axis → the system responsible for the release of cortisol into the bloodstream during periods of stress

anxiety disorders: treatment

• Anxiolytics: xanax → increase GABA

• Cognitive-Behavioural Therapy

• Exposure Therapy (phobias)

obsessive compulsive disorders

* associated with intrusive obsessions and compulsions; anticipates catastrophe and loss of control

obsession

* recurrent, intrusive, and unwanted thoughts or ideas or mental images; often include fear of contamination, of accidents, or of one’s own aggression

compulsions

* repetitive, ritualistic behaviour associated with high anxiety, particular acts that one feels driven to perform over and over again

OCD: causes

• Strong genetic vulnerability, childhood trauma

• Classical (anxiety paired to some event, originally linked to one thing grows to many other things)  and operant conditioning (behaviours linked with relief)

learned helplessness

A state in which experiencing random or uncontrolled consequences leads to feelings of helplessness and possibly depression

narcissistic personality disorder (NPD)

A disorder characterized by grandiosity, need for admiration, and low empathy

post-traumatic-stress-disorder (PTSD)

A disorder caused by the experience of trauma, which leads to flashbacks, dreams, hypervigilance, and avoidance of stimuli associated with the traumatic event

* recently added DSM-5 (Trauma and stressor-related disorders

dissociative disorder (ex: DID)

A disorder characterized by disruptions in a person’s identity, memory, or consciousness

schizophrenia: biological + environmental causes

• Genetic component

• Structural and functional differences in the brain → frontal lobe dysfunction, enlarged ventricles

• Environmental stress → socioeconomic status, prenatal environment

• Drug use (THC)