Psychological Disorders

point prevalence

the percentage of people in a given population who have a given psychological disorder at a particular point in time

lifetime prevalence

the percentage of people in a certain population who will have a given psychological disorder at any point in their lives

clinical assessment

a procedure for gathering the information that is needed to evaluate an individuals psychological functioning and determine whether a clinical diagnosis is warranted

clinical interview

interview in which clinician asks patient to describe their problems or concerns

self report measures

standardized clinical assessment that consists of a fixed set of questions the patient answers

projective tests

a form of clinical assessment in which a person responds to unstructured or ambiguous stimuli; it is thought that responses reveal unconscious wishes and conflicts

benefits of diagnostic labels for psychological disorders

improves treatment, improves research and reduces confusion

costs of diagnostic labels

can create sigma and affect how someone is perceived by others, encourage researchers think of disorder as fixed and enduring diagnosis, creates framework that reduces understanding of the real overlap between disorders

diathesis stress model

model of clinical disorders suggesting that genes provide a susceptibility for a disorder that will manifest as symptoms only under certain levels of stress

etiology

the cause or set of causes for a disease

specific phobia

a marked fear of or anxiety about a particular object or situation

treating phobias

exposure techniques - repeated approach toward feared stimulus to remove anxiety connection, systematic desensitization - gradual exposure to feared stimulus in a controlled way: image/object

generalized anxiety disorder

an anxiety disorder charactered by continuous, pervasive and difficult to control anxiety

cognitive symptoms of GAD

feelings of inadequacy, difficulty in concentrating and decision making, sleep disturbances

bodily symptoms

muscle tension, elevated heart rate, diarrhea, breathing difficulty

treatments of GAD

cognitive behavioral therapy (CBT), mindfulness-based therapies, medications

cognitive behavioral therapies (CBT)

teaches coping strategies, identifies challenges and excessive worries and catastrophic thinking, exposure to worry triggers and relaxation training

mindfulness based therapies

reduce rumination and increase present moment awareness, often integrated with CBT

medications

benzodiazepines, SSRIs and SNRIs

cognitive behavioral therapy is the gold standard

focuses on connection between thoughts emotions and behaviors

benzodiazepine

a common type of drug used to treat anxiety disorders, diazepam, lorazepam, alprazolam, fast acting but only provides relief for acute anxiety symptoms, high risk dependence

anxiolytic

type of drug that alleviates symptoms of anxiety by targeting neurotransmitters (GABA) to increase inhibition

general risk factors

make someone vulnerable to more than one anxiety disorder

general risk factors are

concordance rate shows moderate heritability: 30-40%, female sex certain personality traits, early trauma or chronic stress, cognitive styles tendency to catastrophize and avoid

specific risk factors of anxiety related disorders

panic disorders, social anxiety disorder and specific phobia

major depressive disorder or “depression”

a mood disorder characterized by feelings of sadness, emptiness and anhedonia

anhedonia

diminished interest or pleasure in nearly all of the activities that usually provide pleasure, such as eating, exercising or spending time with friends

rumination

the process of repetitively turning emotional difficulties over and over in the mind

diagnosis requires

depressed mood and or marked diminished interested most of the day, nearly everyday for at least two weeks along with other symptoms

depression prevalence

very common 7-15% men and 20-25% women, partially heritable: 37-46% concordance

relative balance of 3 neurotransmitters

norepinephrine, dopamine, serotonin

norepinephrine

mobilizes the brain for action, related to concentration, mood

dopamine

related to motivation and reward

serotonin

stabilizes mood, feelings of wellbeing, important for signals related to hunger and sleep

atypical antidepressant

medication that works in various ways on serotonin, norepinephrine, and dopamine systems

atypical antidepressant: Wellbutrin

operates less on serotonin and more on dopamine and norepinephrine systems

limitations of antidepressants

must take for at least a month before benefits, uncertainty abt how much benefit, necessary trial period for balance, reduced benefit after prolonged use, side effects

other treatments: deep brain stimulation (dbs)

stimulating specific parts of the brain with implanted electrodes, disrupt abnormal patterns of brain activity and normalize it

repetitive transcranial magnetic stimulation (rTMS) and TDCS

applying rapid pulses of magnetic stimulation to the brain from a coil head near the scalp

other treatments for depression

cognitve behavioral therapy and mindfulness based cognitive therapy

negative cognitive schema

a mental framework in which a person consistently interprets events negatively

explanatory style

how a person explains why bad things happen to him or her

bipolar disorder

a mood related disorder characterized by both manic (excited and energetic) episodes and depressive, with normal periods interspersed

bipolar heritability

4% lifetime prevalence; about 40-70% concordance

treating bipolar: medication

mood stabilizers like lithium or valproate are most effective, antidepressants used with mood stabilizers, atypical antipsychotics are sometimes used and can be affective for both mania and depression

treating bipolar: adjunctive treatments

CBT, psychoeducation and lifestyle/self management strategies

schizophrenia

psychological disorder characterized by loss of contact with reality and breakdown of the normal function of the mind, leading to bizarre perceptions

schizophrenia prevalence

not very common, high heritability 35-65% concordance, onset commonly during late adolescence and early adulthood; earlier and more severe in men than women

schizophrenia positive symptoms

strange behavior, added behaviors that arent typical in healthy individuals; hallucinations, delusions, disorganized speech and behavior

schizophrenia negative symptoms

absence of normal behavior; flat affect lacking emotion, alogia reduced speech, anhedonia reduced anticipation of pleasure, avolition lack of emotion, social withdrawal

cognitive symptoms

impairments in thinking and processing, attention trouble focusing, impaired episodic memory, reduced cognitive control problems with planning decision making and organizing, sensory processing defects

causes of schizophrenia: prenatal

maternal ill health during pregnancy: infection, flu, malnutrition; birth complications: oxygen deprivation

schizophrenia causes: psychosocial

low socioeconomic status, higher social stress, location of birth/early growth

treatments for schizophrenia

antipsychotic medications, psychosocial interventions, cognitive remediation

antipsychotic medications

typical (first generation) effective for positive symptoms (hallucinations and delusions) atypical (second generation) also help with negative symptoms

psychosocial interventions

CBT helps manage delusions and hallucinations; social skills training and rehabilitation: improves functioning and coping

cognitive remediation

targets cognitive symptoms like attention memory and executive function

autism spectrum disorder

characterized by difficulties in social communication and interaction along with restricted repetitive patterns of behavior or interests

ASD prevalence

lifetime 3%, very high concordance 60-90%, occurs four times more often in boys than girls, usually diagnosed before child is three

core symptoms of ASD

social communication and interaction, restricted and repetitive behaviors and sensory sensitivity

social communication and interaction

difficulty with social reciprocity, eye contact, understanding nonverbal cues

restricted repetitive behaviors

repetitive movements, strict routines, intense interests

sensory sensitivities

over or under reactivity to sounds lights textures

asd genetic factors

heritability within families

environmental factors ASD

prenatal maternal health: infection, diabetes, autoimmune conditions; birth complications, parental age

treating ASD

behavioral interventions: ABA social skill training, relationship development intervention, CBT; speech and OT: improve communication and daily functioning; educational support IEPS; medications: for co occurring issues