Psych Unit 8

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