Psych Unit 8

anxiety disorders

anxiety disorders

marked by feelings of apprehension and anxiety

Generalized Anxiety Disorder

marked by chronic, high levels of anxiety that is not tied to any specific threat

1. Specific Phobia (general definition)

excessive fear of a specific object or situation

1. Social Phobia (Social Anxiety Disorder)*

fear of social or performance situations where they are being scrutinized (evaluated) by others. (spotlight effect)

3. Agoraphobia

fear of going out to public places; fear of open spaces or leaving a safe place

C. Panic Disorder

recurrent attacks of overwhelming anxiety that occur suddenly and unexpectedly

1. Obsessive-Compulsive Disorder (OCD), obsession

unwanted thoughts that are intrusive and will not go away

1. Obsessive-Compulsive Disorder (OCD), compuslion

ritualistic/repetitive behavior a person engages in to manage anxiety caused by the thoughts. (Compulsive behavior is driven by obsessions)

Hoarding

difficulty discarding or parting with possessions regardless of their actual value

C. Body Dysmorphic Disorder*

preoccupation with one or more perceived flaws/defects in physical appearance that is not observable to others or appears slight

1. Concordance rate

% of twin pairs or other pairs of relatives who exhibit the same disorder

neurotransmitter imbalance

disturbances in neural circuits using GABA; high levels of norepinephrine (anxiety); serotonin & glutamate (OCD)

conditioning and learning (behavioral approach)

Phobias: acquired thru CC & maintained through OC

OCD: maintained thru OC

Many of the disorders can be influenced by OL

3. Cognitive Factors, ocd and anxiety

misinterpret harmless situations as threatening;

excessive attention on perceived threats; selectively recall

info that seems threatening; low self-efficacy or self-concept

1. Post-traumatic Stress Disorder (PTSD)

involuntary recollections of trauma/flashbacks, nightmares, intense/prolonged distress, persistent negative emotions, avoidance behaviors, dissociative symptoms.

B. Etiology Ptsd

Significant/severe trauma or life stressors

V. Somatic Symptom & Related Disorders*

physical symptoms with no physical cause

conversion disorder

temporary functional impairment (e.g. blind, deaf, paralyzed) with no physical cause

B. Somatic Symptom Disorder (AKA Illness Anxiety Disorder; formerly Hypochondriasis)*

preoccupied with concern they have a serious disease; may believe that minor complaints are signs of very serious medical problems

etiology, somatic symptom disorder

too much attention to bodily sensations, minor symptoms = catastrophic, unrealistic def. of healthy

etiology somatic symptom disorder

learning: reinforced for being sick

VI. Depressive Disorders (Affective/Mood Disorders) Definition

emotional disturbances of various kinds that disrupt physical, perceptual, social, and thought processes

1. Major Depressive Disorder (MDD)

persistent feelings of sadness, despair, loss of interest, etc.

that impairs everyday adaptive behavior for more than 2 wks

- suicidal tendencies

anhedonia

diminished ability to experience pleasure

B. Persistent Depressive Disorder (PDD)*

"mild depression" - symptoms of depression that come & go over a period of years, often with changing intensity

VII. Bipolar Disorders

formerly known as "manic-depression"; characterized by experience of one or more manic episodes as well as periods of depression

mania

euphoric, elated state characterized by impulsiveness, racing thoughts (flight of ideas), delusions of grandeur, little sleep, & spending $

bipolar 1

intense mania & intense depression

1. Bipolar II*

mild mania & intense depression

1. Cyclothymic Disorder*

mild mania & mild depression

1. Genetic Vulnerability

concordance rates: identical twins = 65%; fraternal twins = 14%

biological (nuerochemical and nueroanatomical)

abnormal levels of serotonin & norepinephrine

Ex: low levels of serotonin = depression;  fluctuation = bipolar

hormonal factors

-overactivity among the HPA axis in response to stress

-elevated cortisol levels

4. Cognitive Factors, bipolar

-learned helplessness (Seligman)

-ruminating, irrational thinking, pessimistic viewpoint

-globalized low self-efficacy; negative self-concept

5. Interpersonal Roots

inadequate social skills, lack of social support, lack of reinforcers

1. Anorexia Nervosa

intense fear of gaining weight, disturbed body image, refusal to maintain normal weight, and use of dangerous measures to lose weight

1. Bulimia Nervosa

habitually engaging in out-of-control overeating followed by unhealthy compensatory efforts (purging, laxatives, excessive exercise)

etiology of eating disorders

*Genetic Vulnerability - not much research

*Personality (need for control & perfection)

*Cultural Values (sociocultural perspective)

*Critical mothers

IX. Personality Disorders

Defn: marked by extreme, inflexible personality traits that cause subjective distress or impaired social and occupational functioning

1. Medical Model

abnormal behavior is a treatable disease

1. Diagnosis

distinguishing one illness from another; “labeling” a disorder

1. Etiology

cause of an illness

1. Prognosis

forecast about the probable course of an illness

Deviance

Behavior that deviates from what society considers acceptable

1. Maladaptive behavior

Behavior that interferes with daily life activities***

1. Personal Distress

Aversive, self-focused emotional reaction**

C. Psychodiagnosis: The Classification of Disorders

Defining mental illness (According to the APA): A syndrome marked by a clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior.

3. Comorbidity

coexistence of two or more disorders

1. Epidemiology

the study of the distribution of mental or physical disorders in a population

prevalence

the percentage of a population that exhibit a disorder during a specific time period

*Diathesis-Stress Model

a person's genetic or biological vulnerability to a mental illness (diathesis)+ stress from life experiences

E. Explaining Psychological Disorders from the different perspectives*, humanistic

failure to strive to ones potential or being out of touch with ones feelings

E. Explaining Psychological Disorders from the different perspectives* behavioral

reinforcement history, the environment

E. Explaining Psychological Disorders from the different perspectives* cognitive

irrational, dysfunctional thoughts or ways of thinking

E. Explaining Psychological Disorders from the different perspectives*

dysfunctional society, societal expectations

E. Explaining Psychological Disorders from the different perspectives* biomedical

organic problems, biochemical imbalances, genetic predispositions

Insanity

legal status (not medical) indicating that a person cannot be held legally responsible for his/her actions because of mental illness

involuntary commitment

Legal system’s ability to hospitalize people in psychiatric facilities against their will. Used to help a person who may be mentally ill and harmful to self or others and refuses to seek treatment or whose judgment is so impaired they do not understand their need for treatment. (Commitment usually has a max. time)

1. Dissociative Amnesia

sudden loss of memory for important personal info (too extensive to be due to normal forgetting & NOT due to  physical damage to the brain)

dissociative fugue

loss of memory of entire life/identity; often found in a new location

B. Dissociative Identity Disorder (DID)

Formerly known as "Multiple Personalities"

-coexistence in one person of two or more different personalities

(each identity has own name, memories, traits, & physical mannerisms)

C. Etiology of Dissociative Disorders

• excessive stress (ALL)

• severe emotional trauma in childhood  (DID, specifically)

• severe repression -- psychoanalytic approach

• Lack of coping mechanisms

XI. Schizophrenic & Psychotic Disorders

psychotic disorders: a group of disorders marked by irrational ideas, distorted perceptions, deterioration of adaptive behavior & a general loss of contact with reality

schizophrenia and general symptoms

a disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression (affect).

1. Delusions & Irrational Thoughts

false beliefs that are maintained even though they clearly are out of touch with reality

ideas of a reference

the belief that innocuous events have highly personal significance (usually in a negative or hostile manner)

delusions of granduer

the belief that one possesses superior qualities such as genius, fame, omnipotence, or wealth

1. Thought broadcasting, Thought blocking/withdrawal, &/or Thought insertion*

beliefs that others can either hear your thoughts, can prevent you from having thoughts, or put thoughts into your head (= paranoia)

2. Hallucinations

sensory perceptions that occur in the absence of real, external stimuli or are gross distortions of perceptual input

deterioration of adaptive behavior

deterioration of routine functioning in work, social relations, and personal care

disturbed emotion

little emotional responsiveness (blunted/flat affect) or inappropriate emotional responses

1. Neologisms*

making up words

loose associations

response does not relate to the question asked; sentence is not logically related to those before/after it

1. Clang associations*

association of words based on sounds rather than concepts (rhyming)

1. Word Salad*

mix of real words/phrases that don't make sense when put together

B. Etiology of Schizophrenia, Genetic Vulnerability

concordance rate: identical twins = 48%,

fraternal twins = 17%

two schizophrenic parents = child w/ 46% prob.

B. Etiology of Schizophrenia, neurochemical factors

excess dopamine activity

(abnormal/excessive synaptic pruning)

(high frequency/high potency marijuana use causing episodes of psychosis)

3. Structural Abnormalities in the Brain (bio.)

*enlarged brain ventricles

*reductions in gray and white matter

nuerodevelopmental hypnosis

Issues during prenatal development (disruptions in normal maturational process of the brain before or at birth)

5. Diathesis Stress, schizophrenia

*Stress = key role in triggering

*High stress can trigger relapses

intellectual disabilty

deficits in general mental abilities, impairments of adaptive functioning

autism spectrum

lacking theory of mind; persistent deficits in social communication and social interaction across multiple contexts; Restricted, repetitive patterns of behavior, interests, or activities & inflexibility

ADD/ADHD

persistent pattern of inattention and/or hyperactivity/impulsivity

A. Diagnostic Problems, Add/ADHD

Too much overlap with other disorders/each other

ETiology ADD/ADHD

• Concordance rate: identical twins 67%, fraternal twins 31%

• Antisocial - lack inhibitions

• Dysfunctional Family Systems

insight therapies

talk therapy to gain increased insight and sort through possible solutions; individual or group

behavior therapies

therapist makes a direct effort to alter problematic responses and maladaptive habits; want to change client's behavior; uses principles of learning (OC, CC, OL)

biomedical therapies

interventions into a person's biological functioning; drug therapy and other treatments of structural or chemical abnormalities

Psychologists, Ph.D PsyD, Ed.D

*specialize in diagnosis and treatment of psychological disorders (clinical) and everyday behavioral problems (counseling)

*Use insight or behavioral approaches

1. Psychiatrists

*diagnosis and treatment of psychological disorders

-Focus more on severe disorders (schizophrenia, depressive disorders, bipolar)

*Use insight, behavioral, and biomedical approaches

*Clinical Social Workers:

MS, work w/patients + their families to ease patient back into the community

Psychiatric Nurses: BS or MS,

hospitals + inpatient treatment

*Counselors: MA,

schools, colleges, or community agencies

*Marriage and family therapists: MA,

couples and families

II. Insight Therapies

Talking to enhance self-knowledge and to promote healthy changes in personality and behavior

1. Psychoanalysis

Emphasizes the recovery of unconscious conflicts, motives, and defenses through techniques such as free association and transference

1. Free association

spontaneously expressing their thoughts and feelings exactly as they occur, with as little censorship as possible

1. Dream analysis (review of manifest vs. latent content)

therapist interprets the symbolic meaning (latent content) of the client's dreams

hypnosis

a trance-like mental state in which people experience increased attention, concentration, and suggestibility

Resistance

largely unconscious defensive maneuvers intended to hinder the progress of therapy