Psychology Chapter 14

Psychopathology

Is the study of psychological disorders including their symptoms, etiology (IE: their causes), and treatment.

Psychologists

work to distinguish psychological disorders from inner experiences and behaviours that are merely situational, ideasyncratic,or unconventional. Consenus can be difficult

Definition of a psychological disorder

Label behaviours, thoughts, and inner experiences that are atypical distressful, dysfunctional, and sometimes even dangerous, as signs of a disorder.

However, just because something is atypical, however, does not necessarily mean it is disordered

Some disorders, although not exactly typical, are from atypical, and the rates in which they appear in the population are surprisingly high

Violating Cultural Expectations

____ is not, in and of itself, a satisfactory means of identifying the presence of a psychological disorder. Since behaviour varies from one culture to another, what may be expected and considered appropriate in one culture may not be viewed as such in other cultures

Hallucinations

(Seeing or hearing things that are not physically present) in Western Societies is a violation of cultural expectations, and a person who reports such inner experiences is readily labeled as psychologically disordered. In other cultures, visions that, for example, pertain to future events may be regarded as normal experiences that are positively valued

Harmful Dysfunction

If none of the criteria (hallucinations,atypical and violating Cultural expectations) is adequate by itself to define the presence of a psychological disorder, how can a disorder be conceptualized? Many efforts have been made to identify the specific dimensions of psychological disorders, yet none is entirely satisfactory. No universal definition of psychological disorder exists that can apply to all situations in which a disorder is thought to be present. However, one of the more influential conceptualizations was proposed by Wakefield, who defined psychological disorder as ____

How Dysfunction Occurs

When an internal mechanisms breaks down and can no longer perform its normal function. The presence of a dysfunction by itself down not determine a disorder. The dysfunction must be harmful in that it leads to negative consequences for the individual or for others, as judged by the standard’s of the individual’s culture. The harm may include significant internal anguish (eg: high levels of anxiety or depression) or problems in day-to-day living (eg: in one’s social or work life)

Many Features of the Harmful Dysfunction Model

___are incorporated in a formal definition of psychological disorder developed by the American Psychiatric Association (APA). According to the APA, a psychological disorder is a condition that is said to consist the following….

APA psychological disorder conditions

There are significant disturbances in thoughts, feelings and behaviours.

The disturbances reflect some kind of biological, psychological, or developmental dysfunction

The disturbances lead to significant distress or disability in one’s life.

The disturbances do not reflect expected or culturally approved responses to certain events

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Each disorder is described in detail, including an overview of the disorder (diagnostic features), in specific symptoms required for diagnosis (diagnosis criteria), prevalence information (what percent of the population is thought to be afflicted with the disorder), and risk factors associated with the disorder

Also provides information about comorbidity

Comorbidity

The co-occurence of two disorders

The International Classification of Diseases (ICD)

Is also widely recognized. Published by the World Health Organization (WHO)

The ___ is used for clinical purposes and used to examine the general health of populations and to monitor the prevalence of diseases and other health problems internationally

The Commpassionate view of Psychological Disorders

Psychological disorders represent extremes of inner experience and behaviour. Each of us experiences episodes of sadness, anxiety, and preoccupation with certain thoughts-times when we do not quite feel ourselves. These episodes should not be considered problematic unless the accompanying thoughts and behaviours became extreme and have a disruptive effect on one’s life

Psychological disorder nots

People with psychological disorders are far more than just embodiments of their disorders. We do not use terms such as schizophrenics, depressives, or phobias because they are labels that objectify people who suffer from these conditions, thus promoting biased and disparaging assumptions about them.

A psychological disorders is not what a person is; it is something that a person experiences-through no fault of his or her own

Supernatural

For centuries, psychological disorders were viewed from a ___ perspective: Attributed to a force beyond scientific understanding (IE: possessed by spirits)

Biological

Views psychological disorders as linked to ___ phenomena, such as genetic factors, chemical imbalances, and brain abnormalities

Psychosocial

Emphasizes the importance of learning, stress, faulty and self-defeating thinking patterns, and environmental factors

Diathesis Stress Model

Integreates biological and psychological factors to predict the likelihood of a disorder. This ___suggests that people with an underlying predisposition for a disorder (IE:a diathesis) are more likely than others to develop a disorder when faced with adverse environmental or psychological events (IE: Stress), such as childhood maltreatment, negative life events, trauma, and so on. A is not always a biological vulnerability to an illness: some __ may be psychological (EG: a tendency to think about life events in a pessimistic, self-defeating way)

The Key Assumption of the Diathesis

Stress model is that both factors, diathesis and stress, are necessary in the development of a disorder

Attention Deficit/Hyperactivity Disorder (ADHD)

Shows a constant pattern of inattention and/or hyperactivity and impulsive behaviour that interferes with normal functioning

Attention Deficit/Hyperactivity Disorder (ADHD) Signs

___ of inattention include great difficulty with and avoidance of tasks that require sustained attention (such as conversations or readings), failure to follow instructions (often resulting in failure to complete school work and other duties), disorganization (difficulty keeping things in order, poor time management, sloppy and messy work), lack of attention to detail, becoming easily distracted and forgetfulness

Hyperactivity

___is characterized by excessive movement, and includes fidgeting or squirming, leaving one’s seat in situations when remaining seated is expected, having trouble sitting still (eg, in a restaurant), running about and climbing on things, blurting out responses before another person’s question or statement has been completed, difficulty waiting one’s turn for something, and interrupting and intruding on others

Attention Deficit/Hyperactivity Disorder (ADHD) Causes

Genetics

Abnormalities in frontal lobes

Studying link with maternal smoking

Autism Spectrum Disorder

Show signs of significant disturbances in three main areas:

A-Deficits in social interaction

B-Deficits in communicating and..

C-Repetitive patterns of behaviour or interests

Autism Spectrum Disorder Causes

The exact ____ remain unknown despite massive research efforts over the last two decades

Autism Spectrum Disorder Genetics

Many different gene and gene mutations have been implicated In __

A number of environmental factors are also thought to be associated with increased risk for __, at least in part, because they contribute to new mutations. Those factors include exposure to pollutants, such as plant emissions and mercury, Urban versus rural residence, and vitamin D deficiency

Schizophrenia

Considered a psychotic disorder, or one in which the person’s thoughts, perceptions, and behaviours are impaired to the point where she is not able to function normally in life

Schizophrenia Symptoms

Hallucinations, delusions, disorganized think, disorganized or abnormal motor behaviour, and negative symptoms

Schizophrenia Causes

Genetics, Distrurbed family environment,

Supports a diathesis-stress interpretation of -both genetic vulnerability and environmental stress are necessary for ___ to develop, genes alone do not show the complete picture,

Neurotransmitters (IE:Dopamine), Brain Anatomy (IE: Complications during birth, exposure to influenza during first trimester, emotional stress during pregnancy), cannabis use-casual role in the development of ___

Hallucinations

A perceptual experience that occurs in the absence of external stimulation. Auditory is the most common

Delusions

Beliefs that are contrary to reality and are firmly held even in the face of contradictory evidence

Disorganized Thinking

Refers to disjointed and incoherent thought processes-usually detected by what a person says

Disorganzied or Abnormal Motor Behaviour

Refers to unusual behaviours and movements:becoming unusually active, exhibiting silly child-like behaviours (giggling and self absorbed smiling)

Negative Symptoms

Reflect noticeable decreases and absences in certain behaviours, emotions, or drives. A person who exhibits diminished emotional expression shows no emotion in his facial expressions

Mood Disorders

Characterized by severe disturbances in mood and emotions-most often depression, but also mania and elation

Major Depression Disorder

According to the DSM-5, the defining symptoms of ____include “depressed mood most of the day, nearly everyday” (feeling sad, empty, hopeless or appearing tearful to others), and loss of interests and pleasure in usual activities

Recieving Diagnosis for Major Depressive Disorder

To ____, one must experience a total of five symptoms for at least a two week period; these symptoms must cause significant distress or impair normal functioning, and they must not be caused by substances or a medical condition. At least one of the two symptoms mentioned above must be present, plus any combination of other symptoms

Major Depresive Disorder Symptoms

Considered episodic-its symptoms are typically present a their full magnitude for a certain period of time and then gradually abate

Significant weight loss (when not dicting) or weight gain and/or significant decrease or increase in appetite

Difficulty of falling asleep or sleeping too much

Psychomotor agitation

Fatigue or loss of energy

Feelings of worthlessness or guilt

Difficulty concentrating and indecisiveness

Suicidal idealation

Psychomotor agitation

(the person is noticeably fidgety and jittery, demonstrated by behaviours like the inability to sit, pacing, hand-wringing, pulling or rubbing of the skin, clothing or other objects)

Suicidal Idealation

Thoughts of death (not just fear of dying), thinking about or planning suicide, or making an actual suicide attempt

Subtypes of Depression

The DSM-5 lists several different ___. These subtypes-what the DSM-5 refer to as specificers-are not specific disorders; rather, they are labels used to indicate specific patterns of symptoms or to specify patterns of symptoms or to specify certain periods of time in which the symptoms may be present.

Season pattern, Peripartum Onset, and Persistent Depression Disorder

Seasonal Pattern

Applies to situations in which a person experiences the symptoms of major depressive disorders only during a particular time of year (IE:Winter)

Peripartum Onset

(Commonly referred to as postpartum depression), applies to people who experience major depression during pregnancy or in the four weeks following the birth of their child

Persistent Depression Disorder

(Previously known as dysthymia) experience depressed moods most of the day nearly everyday for at least two years, as well as at least two of the other symptoms of major depressive disorder

Bipolar Disorder

Experiences mood states that vacillate between depression and mania; that is, the person’s mood is said to alternate from one emotional extreme to the other (in contrast to unipolar, which indicates a persistently sad moods)

Bipolar Disorder Diagnosis

To be ____, a person must have experienced a manic episode at least once in their life; although major depressive episodes are common in ___, they are not required for a diagnosis. According to the DSM-5, a manic episode is characterized as a “distinct period of abnormally and persistently increased activity or energy lasting at least one week”, that lasts most of time each day

Biological Basis of Mood Disorders

Have a strong genetic and biological basis

People with mood disorders often have Imbalances in certain neurotransmittors

Depression is linked to abnormal activity in several regions of the brain

Depressed individuals have abnormal levels or cortisol, a stress hormones released into the blood by the neuroendocrine system during times of stress

Diathesis Stress Model and Major Depressive Disorder

Stressful life events can trigger depression, and research has consistently supported the conclusion

Exit Events

Instances in which an important person departs (eg; death, divorce, or separation, or a family member leaving home)-often occur prior to an episode

Individuals with Traumatic Stress During Childhood

___who are exposed to ___-such as separation from a parent, family turmoil, and maltreatment (physical or sexual abuse)-are at a heightened risk

Not everyone who experiences stressful life events or childhood adversities succumbs to depression-indeed, most do not. Clearly, a diathesis-stress interpretation of major depressive disorder, in which certain predispositions or vulnerability factors influence one’s reaction to stress, would seem logical

Cognitive Theories of Depression

Take the view that depression is triggered by negative thoughts, interpretations, self evalutions, and expectations

These diathesis-stress models propose that depression is triggered by a ‘cognitive vulnerability” (negative and maladaptive thinking) and by precipitating stressful life events

Aaron Beck

Theorized that depression-prone people possess depressive schemas, or mental predispositions to think about most things in a negative way

Depressive schemas prompt dysfunctional and pessimistic thoughts about the self, the world, and the future.

Cognitive therapies for depression, aimed at changing a depressed person’s negative thinking were developed as an explanation of this theory

Helplessness Theory

Postulates that a particular style of negative thinking leads to a sense of ___, which then leads to depression.

____is an expectation that unpleasant outcomes will occur or that desired outcomes will not occur, and there is nothing one can do to prevent such outcomes

Key Assumption about Helplessness Theory

That helplessness stems from a tendency to perceive negative life events as having stable (“its never going to change”) and global (“its going to affect my whole life”) causes, in contrast to unstable (“its fixable”) and specific (“it applies only to this particular situation”) causes

Theory Focused on Rumination

Focuses how people’s thoughts about their distressed moods-depressed symptoms in particular-can increase the risk and duration of depression

Rumination

Is the repetitive and passive focus on the fact that one is depressed and dwelling and dwelling on depressed symptoms, rather that distracting one’s self from the symptoms or attempting to address them in an active, problem-solving manner

When people __, they have thoughts such as “why am I so unmotivated? I just can’t get going. I’m never going to get my work done feeling this way”

Anxiety Disorder

Characterized by excessive and Persistent fear and anxiety, and by related disturbances in behaviour

Specific Phobia

(Formerly known as simple phobia) experiences excessive distressing, and persistent fear or anxiety about a __object or situation (such as animals, enclosed spaces, elevators, or flying)

How do people acquire a phobia

Classical conditioning

Vicarious Learning Modelling

Verbal Transmission

Social Anxiety Disorder

(Formally called social phobia) is characterized by extreme and persistent fear or anxiety and avoidance of social situations in which the person could potentially be evaluated negatively by others)

Panic Disorder

Experience recurrent (more than one) and unexpected panic attacks, along with at least one month of persistent concern about additional panic attacks, worry over the consequences of the attackers, or self-defeating changes in behaviour related to the attacks (eg; avoidance of exercise or unfamiliar situations)

Generalized Anxiety Disorder

A relatively continuous state of excessive, uncontrollable, and pointless worry and apprehension. people with generalized anxiety disorder often worry about routine, everyday things, even though their concerns are unjustified

Obsessive Compulsive Related Disorders

Group of overlapping disorders that generally involve intrusive, unpleasant thoughts and repetitive behaviours

Obsessive-compulsive disorder (OCD), Body dismorphic disorders, Hoarding Disorder

The preoccupation with imagined physical flaws drives the person to engage in repetition and ritualistic behavioural and mental acts such as constantly looking in the mirror, trying to hide the offending body parts, companions with others, and, in some extreme cases, cosmetic surgery

Obsessive-Compulsive Disorder (OCD)

Experience thoughts and urges that are intrusive and unwanted (obsessions) and/or the need to engage in repetitive behaviours or mental acts (compulsions)

Body Dysmorphic Disorder

Is preoccupied with a percieved flaw in physical appearance that is either nonexistent or barely noticeable to other people

Hoarding Disorder

Traditionally considered to be a symptom of OCD< considerable evidence suggests that hoarding represents an entirely different disorders

People who suffer from this disorder have great difficulty parting with items because they believe the items might be of some later use, or because they form a sentimental attachment to the items. Importantly, a diagnosis of ___is made only if the is not caused by another medical condition and if the _ is not a symptom of another disorder (IE; schizophrenia)

Causes of OCD

Moderate genetic component

Studies have implicated about two dozen potential genes that may be involved in OCD; these genes regulate the function of three neurotransmitters

A brain region that is believed to play a critical role in OCD is the orbitofrontal cortex (area of the frontal lobe)

The symptoms of OCD have been theorized to be learned reponses, acquired and sustained as the result of a combination of two forms of learning; classical conditioning and operant conditioning

Post Traumatic Stress Disorder (PTSD)

Used to describe a set of fear and arousal-related symptoms tied to a specific traumatic event or events

Diagnosed when an individual who had a traumatic experience develops a set of fear and arousal relayed symptoms that lasts at least a month. The individual may have been present for the traumatic event as a victim or a witness, or they may have second hand exposure to the event from someone who was present

The Symptoms of PTSD categories

Intrusion, avoidance, alterations in cognitions and mood, and alternations in arousal and reactivity

Intrusion

Symptoms occur when the traumatic event is re-experienced through memories, nightmares, flashbacks, and emotional or physical Reactivity after exposure to stimuli associated with the trauma

Avoidance

Occurs when the individual avoids stimuli or thoughts and feelings associated with the trauma

Alterations in Cognitions and Mood

Involve pervasive negative mood, feelings of isolation, extreme negative beliefs about the self or the world, and problems with memory, often specific to trauma related memories

Alterations in Arousal and Reactivity

Include irritability or aggression, increased risk-taking, hyper-vigilance, jumpiness, and difficulty with concentration or sleep

Complex PTSD (C-PTSD)

Is a variant of PTSD. D generally results from prolonged or repeated instances of trauma from which escape is difficult or impossible, like childhood neglect or domestic abuse. Diagnosis of ___ requires the presence of intrusions, avoidance, and alternatives in Arousal and hyperactivity (three core features of PTSD), as well as extreme emotional dysregulation, persistent interpresonal difficulties, and negative self-concept

Differences Between People with C-PTSD

As a result of the differences of PTSD, people with C-PTSD may often be misdiagnosed as having Borderline Personality Disorder (BPD). There is a high rate of comorbodily between C-PTSD, however, research has supported the validity of C-PTSD as a distant construct and different treatment courses are indicated

Risk Factors for PTSD

Not everyone who experiences a traumatic event will go onto develop PTSD. Trauma is complex, and a variety of factors have been identified as increasing one’s risk for developing PTSD

Some of the risk factors for PTSD can be considered individual risk factors, involving the coping strategies and resources an individual has to deal with trauma. For example, people who experience trauma

maybe

individual factors like genetics and coping strategies are important in assessing risk for PTSD, but also interact with environmental factors, which affect everyone in a shared environment

Support for Sufferers of PTSD

Research has shown that social support following a traumatic event can reduce the likelihood of PTSD

There are also a number of promising clinical treatments/psychotherapeutic strategies for PTSD including Exposure Therapy, cognitive behavioural therapy (CBT), eye movement desenitization and reprocessing (EMDR), and psychedelic Therapies

Dissociative DIsorders

Characterized by an individual becoming split off, or dissociated, from her core sense of self. Memory and identity become disturbed; these disturbances have a psychological rather than physical cause

Dissociative Amnesia

Unable to recall important personal information, usually following an extremely stressful or traumatic experiences such as combat, natural disasters, or being the victim of violence. The memory impairments are not caused by ordinary forgetting. Some individuals with ___ will also experience dissociative fugure

Dissociative Fugue

(From the word “to flee” in French), whereby people with dissociative amnesia suddenly wander away from their home, experience confusion about their identity and sometimes even adopt a new identity

Depersonalization/Derealization Disorders

Is characterized by recurring episodes of _____,___ or both

Depersonalization

Is defined as feelings of “unreality or detachment from, or unfamiliarity with, one’s whole self or from aspects of self”. Individuals who experience __might believe their thoughts and feelings are not their own; they may feel robotic as thought they lack control over their movements and speech; they may experience a distorted sense of time, and in extremely cases, they may sense an “out of body” experience in which they see from themselves vantage point of another person

Derealization

Is conceptualized as a sense of “unreality or detachment from, or unfamiliarity with, the world, be it individuals, inaimate objects, or all surroundings”

Dissociative Identity Disorder

Exhibit two or more separate personalities or identities, each well-defined and distinct from one another. They also experience memory gaps for the time during which another identity is in charge (eg; one might find unfamiliar items in her shopping bags or among her possessions), and in some cases may report hearing voices, such as a child’s voice or the sound of somebody crying

Personality

Refers loosely to one’s stable, consistent, and distinctive way of thinking about, feeling, acting, and relating to the world

People with personality Disorders

Exhibit a personality style that differs markedly from the expectations of their culture, is pervasive and inflexible, begins in adolescence or early adulthood and causes distress or impairment

Maladaptive Personality Disorder

___styles frequently bring them into conflict with others, disrupt their ability to develop and maintain social relationships, and prevent them from accomplishing realistic life goals

The DSM-5 recognizes 10 personality disorders, organized into 3 different clusters, A, B and C.

Cluster A disorders

Include paranoid personality disorders, schizoid personality disorder, and schizotypal personality disorder. People with these disorders display a personality style that is odd or eccentric

Cluster B Disorders

Include antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and borderline personality disorder. People with these disorders usually are impulsive, overly dramatic, highly emotional, and erratic

Cluster C Disorders

Include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder (which is not the same thing as obsessive-compulsive disorder). People with these disorders often appear to be nervous and fearful

Paranoid DSM-5 Personality Disorder

Description: Harbours a pervasive and unjustifiable suspiciousness and mistrust of others; reluctant to confide in or become close to othersl reads hidden demeaning or threathening meaning into benign remarks or events; takes offence easily and bears grudges; not due to schizophrenia or others psychotic disorders

Cluster: A

Schizoid DSM-5 Personality Disorder

Description:Lacks interest and desire to form relationships with others; aloof and shows emotional coldness and detachment; indifferent to approval or criticism of others; lacks close friends or confidants; not due to schizophrenia or other psychotic disorders, not an autism spectrum disorder

Cluster: A

Schizotypal DSM-5 Personality Disorder

Description: Exhibits eccentricities in thought, perception, emption, speech and behavioural; shows suspiciousness or paranoia, has unusual perceptual experiences; speech is often idiosyncratic; displays inappropriate emotions; lacks friends or confidants; not due to schizophrenia or other psychotic disorder, or to autism spectrum disorder

Cluser: A

Antisocial DSM-5 Personality Disorder

Description: Continously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds

Cluster: B

Histrionic DSM-5 Personality Disorder

Description: Excessive overdramatic, emotional, and theatrical, feelings uncomfortable when not the center of others’ attention; behaviour is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; many alienate friends with demands for constant attention

Cluster: B

Narcissistic DSM-5 Personality Disorder

Description: Overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; believes he is entitled to special treatment from others; shows arrogant attitudes and behaviours; takes advantage of others; lacks empathy

Cluster: B

Borderline DSM-5 Personality Disorder

Description: Unstable in self-image, mood and behaviour; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behaviour is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestues

Cluster: B

Avoidant DSM-5 Personality Disorder

Description: Socially inhibited and oversensitive to negative evaluation avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing, unwilling to take risks or engage in new activities if they may prove embarrassing

Cluster: C

Dependent DSM-5 Personality Disorder

Description: Allows others to take over and run her life; is submissive, clingy, and fears separation; cannot make decisions without advice and reasurance from others; lacks self-confidence, cannot do things on her own; feels uncomfortable or helpless when alone

Cluster: C

Obsessive-Compulsive DSM-5 Personality Disorder

Description:Pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubbornly insists things be done his way; miserly with money

Cluster: C