Psych Chapter 13-14

psychological disorder

psychological disorder

a collection of symptoms (syndrome) marked by a clinically significant disturbance in cognitions, emotion regulation, or behavior; determine if one or more present - distress, dysfunction, deviance

medical model

belief that psychological disorders are like physical diseases; disease with predictable symptoms, has an underlying cause that should be treated

biopsychological approach

emphasizes interaction of biological, psychological and social/sociocultural factors in psychological disorders

diagnosis

a form of classification: determining whether something is abnormal and how it is abnormal

stigma

labels and negative attitudes toward people because of particular attribute

self-stigma

negative attitudes, including internalized shame, that people with mental illness have about their own condition; Undermines self-worth and self-efficacy; Hinders recovery

anxiety

anticipation of future threat; Includes muscle tension, worry and vigilance, cautious or avoidant behaviors, and physiological reactivity

anxiety disorders

Distressing, persistent anxiety, Or maladaptive behaviors to reduce anxiety; includes GAD, panic disorder, social anxiety, phobias

generalized anxiety disorder

Constant, difficult to control, high levels of anxiety and worry; Develops gradually; Aspects of worrying: Cope with stressful events or situations, Constantly generate solutions to "what if" scenarios, Worry about worry

panic disorder

Recurrent, unexpected panic attacks, Combined with worry about future panic attacks or avoidance of situations that might cause panic attacks; panic attacks include sudden onset of palpitations, sweating, fear of dying, etc.

social anxiety disorder/social phobia

Intense fear of being scrutinized or doing something embarrassing or humiliating in the presence of others; Can involve avoiding most or all social activities - E.g. parties, presentations, eating in public

phobia

Extreme fear of a specific object or situation; ex. blood, living creatures (Spiders) or environmental conditions (heights)

obsessive-compulsive disorder (OCD)

Obsessive thoughts (Unwanted and repetitive anxiety producing thoughts or images) and Compulsive behaviors (Repetitive responses to these thoughts) in an attempt to counteract anxiety or prevent dreaded events

post-traumatic stress disorder (PTSD)

response to trauma: Recurring memories or nightmares of the event, Numbness and social withdrawal, Anxiety, depression, loss of interest, Hypervigilance, jumpiness, difficulty sleeping

trauma

exposure to actual or threatened death, serious injury, or sexual violence

approaches to understanding anxiety disorders (PTSD, OCD)

classical conditioning (associate stimulus with reflexive reaction, stimulus generalization), operant conditioning and negative reinforcement (ex. lower anxiety is reinforcing, so OCD-like behaviors will continue to be repeated); generally looking for/pay more attention to more anxiety-provoking situations; biology

substance use disorder

using a substance to alter your mental state without moderation or responsibility: diminished control, diminished social functioning, hazardous use, psychological changes (tolerance or withdrawal)

tolerance

brain adapts to continued use of a substance, so that it takes larger and larger doses to experience the same effect

withdrawal

discomfort, distress, and other physiological symptoms that result from stopping the use of a substance

depressants

Lower (depress) neural activity and slow body functions, E.g. alcohol, opiates (heroin, morphine, Oxycontin), barbiturates (tranquilizers)/benzodiazepines; Lead to relaxation, pleasure, sleepiness; Can be life-threatening: impacting our judgment, stopping breathing

barbituates

depressant drugs that have a sedative effect; tranquilizers, benzodiazephines

opiates

opium and its derivatives, such as morphine and heroin, oxycontin; they depress neural activity, temporarily lessening pain and anxiety

stimulants

Excite neural activity and speed up body functions; e.g Nicotine, cocaine, methamphetamine, ecstasy (also a mild hallucinogen); they Increase energy, alertness, and self-confidence, decrease appetite, may produce euphoria; Side effects include depressive symptoms, health problems (including death), lifestyle changes due to addiction

nicotine

stimulants, that provides energy and relaxation

cocaine

gives energy and euphoria, CNS stimulant

amphetamines

CNS stimulant, energy, euphoria, enhanced attention

methamphetamine

CNS stimulant, with speeded-up body functions and associated energy and mood changes; over time, appears to reduce baseline dopamine levels

Ectasy (MDMA)

energy, sensory distortions, feelings of connection; CNS stimulant that's also a mild hallucinogen

Hallucinogens

alter perceptions, thoughts, and feelings; including hallucinogens; also called psychedelics

LSD

(lysergic acid diethylamide, or acid); altered perceptions, sensory distortions

THC/marijuana

the major active ingredient in marijuana, triggers a variety of effects, including mild hallucinations; used medicinally for decreasing chronic pain and nausea, with downsides (impaired perception/can lead to dependence)

approaches to understanding substance use disorders

biologic: genetics, impact on dopamine production

psychological: cope with stress/emotional symptoms; behavioral control

Social factors: lack f parenting, peer pressure, college (esp. alcohol)

depression

intense sadness and/or loss of interest in normally enjoyed activities; also involves pessimism, suicidal thoughts, low energy, sleep problems, appetite change...

major depressive disorder

involves feeling many different (depressive) symptoms for at least two weeks

bipolar disorder

Involves alternation between episodes of depression and episodes of mania

mania

a state of hyperactivity, extreme optimism, and euphoria (or irritability); can include poor judgement and risky behaviors; strongly linked to genetic factors

suicide

the intentional, direct, and conscious of taking one's own life; no single cause, is 5x more likely with depression

schizophrenia

involves a split from reality, and includes: Changes in perception and beliefs, Disorganized thinking and speech, Diminished or inappropriate emotional expression

psychosis

loss of contact with reality

positive symptms

behaviors or experiences not present in the general population (positive = additional); hallucinations and delusions

negative symptoms

the absence of typical behaviors or experiences (negative = subtracted); ex. flat affect (limited emotional expression) and impaired theory of mind

delusion

unusual or incorrect beliefs; can involve paranoia: feeling of being threatened or persecuted by others

hallucination

perceiving something that is not perceived by others; usually auditory, but it can involve other senses

approaches to understanding schizophreia

possibility of excess dopamine in certain brain areas, lower activity in frontal lobes; genetics; environmental - trauma, perinatal influences, etc.

psychotherapy

use of psychological techniques to help someone overcome difficulties and achieve goals. Includes many different techniques and theories

biomedical therapy

uses medications or other biomedical treatments to alleviate symptoms by acting directly on a person's physiology

psychoanalysis

Helping people to access unknown (and often unwanted) thoughts and feelings could relieve symptoms; Psychiatric symptoms are often related to conflicts between the ego, id, and superego; sessions may be multiple time per week for years

free assooication

encouraging client to say whatever comes to mind; provides access to important thoughts and feelings that are screened out or repressed (technique of psychoanalysis)

resistance

use of defense mechanisms to interfere with change; Can indicate sensitive but important topics and feelings (technique of psychoanalysis)

interpretation

used to understand patterns of behavior and the relationship between current problems and personal history

transference

projecting feelings toward significant others onto therapist

psychodynamic therapy

derived from Freudian psychoanalysis, that emphasizes understanding current symptoms by looking at themes across relationships; Goal is to explore and gain perspective on defended-against ("unacceptable") thoughts and feelings

insight therapies/humanistic therapies

a variety of therapies that aim to boost self-fulfillment by awareness and acceptance; responsibility for feelings and actions (more conscious driven) in the present and future rather than past

person-centered therapy

The more responsibility clients take for their own healing, the more effective therapy will be; nondirective therapist

active listening

echo, restate, and clarify what client is expressing

unconditional positive regard

acceptance; basic acceptance regardless of what the client says or does, helps client feel freer and more open to change

behavior therapy

applies learning principles to the elimination of unwanted behaviors; pathological behaviors develop through the same laws of learning other behaviors (classical and operant conditioning, observational learning)

exposure therapies

Change responses by repeatedly exposing people to feared events; you gradually adapt and learn how to respond with less anxiety (like extinction in classical conditioning)

systematic desensitization

creating a hierarchy on anxiety provoking situations and start at the lowest, present item repeatedly until no longer elicits anxiety and then move to next item in hierarchy

progressive relaxation

Involves tensing and releasing various muscle groups and focusing on sensations of relaxation that follow

exposure and response prevention

expose to feared situation but prevent any maladaptive response; client notices that nothing bad happens and anxiety gradually disappears (especially with OCD)

behavioral activation

lack of rewarding behaviors leads to lack of rewards in life; patients schedule and complete rewarding behaviors, which improves mood; ues principles of operant conditioning

aversive conditioning

Associates unwanted behavior with painful and unpleasant stimuli to decrease likelihood of unwanted behaviors (uses principles of operant conditioning - punishment); used for drug use, overeating, smoking, etc.

cognitive therapy

help clients to recognize when their maladaptive thoughts are affecting their behavior and experience. They address and change their actions and thoughts that lead to changes in emotions (to more realistic)

cognitive-behavioral therapy (CBT)

a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior); good for anxiety, PTSD, and depression

group therapy

a meeting with a group of clients that allows for seeing/changing interpersonal problems and interaction patterns in real time, receive feedback from group members

family therapy

Symptoms may be in an individual (identified patient), but the problem belongs to the group; changes family dynamics; opposes problem origination within the individual, rather dysfunctional family interactions/communication

dodo bird effect

A common finding that all therapy techniques are equally effective

therapeutic alliance

a bond of trust and mutual understanding between a therapist and client; empathetic and caring relationship

antipsychotic drugs

reduces the intensity of symptoms (more effective with positive than negative symptoms)

Thorazine

first generation antipsychotics that was used to treat schizophrenia

side effects of antipsychotic drugs

parkinsonism (muscle tremors, shakiness, and immobility), tardive dyskinesia (involuntary ad rhythmic tongue movement); dystonia (involuntary muscle contractions in limbs and tongue), akathisia (motor restlessness); metabolic syndrome (obesity, diabetes, high cholesterol, hypertension)

antianxiety drugs

anxiolytics; work by depressing the nervous system (so they are dangerous to use with alcohol); include Xanax, Ativan, Valium

mood stabilizers

treatment for bipolar disorder; Lithium and anticonvulsant drugs (Depakote, Lamictal) are used; antidepressants are used to deal with depressive symptoms, but they may exacerbate manic symptoms; side effects include weight gain, memory problems, poor concentration

electroconvulsive therapy (ECT)

used as a treatment for severe depression; today Uses general anesthetic and lower voltage (30-60V), in briefer pulses; memory loss for treatment period

repetitive transcranial magnetic stimulation (rTMS)

Used to treat depression; sends repeated magnetic impulses to specific parts of the brain; small antidepressant benefit

deep brain stimulation

Can be used to treat depression; Involves electrodes implanted in the brain that inhibit activity in that area; can improve mood

psychosurgery

Removes or destroys brain tissue to change symptoms; irreversible and rarely used today; microsurgery is used occasionally (in seizures and OCD)

lobotomy

Disconnected frontal lobes from rest of brain; common in mid-20th century; used to calm violent patients, but leaves people feeling listless, uncreative, motivates

preventing psychological disorders

systematic contributors (Poverty, Exploitative work conditions, Unemployment, Racism, Gender, discrimination); we can teach parenting skills to reduce childhood behavior disorders, Create a positive school climate to reduce bullying, Provide early education enrichment programs to increase literacy and education achievement

antidepressants

used to treat depression, occasionally in anxiety disorders; typically increase norepinephrine or serotonin avalability (SSRI); Prozac, Zoloft, Paxil