PSYC-1104 Ch. 15

Psychological Disorders

abnormal psychology

scientific study of psychological disorders.

Four Ds:

• Deviance- behavior, thoughts, or emotions are unusual

• Distress- unhappiness to the person or close others

• Dysfunction- interference with daily activities

• Danger- most people with disorders are not a danger to themselves or others, but people who put themselves or others at risk may have a disorder.

International Classification of Diseases (ICD-11)

system used by most countries to classify psychological disorders; published by the World Health Organization and currently in its eleventh edition

Diagnostic and Statistical Manual of Mental Disorders (DSM-V)

manual used to diagnose mental disorders in North America. Provides a categorical list of symptoms for mental disorders.

Diagnosis

identifying a disorder by its symptoms and other evidence

comorbidity

two or more disorders are present

Classification of disorders Table 15-1

• neurodevelopmental disorders

• neurocognitive disorders

• substance-related and addictive disorders

• schizophrenia-spectrum and other psychotic disorders

• depressive disorders

• bipolar and related disorders

• anxiety disorders

• obsessive-compulsive and related disorders

• trauma and stressor-related disorders

• somatic symptoms and related disorders

• dissociative disorders

• feeding and eating disorders

• sexual dysfunctions

• gender dysphoria

• paraphilic disorders

• sleep-wake disorders

• disruptive, impulse control, and conduct disorders

• personality disorders

the neuroscience model

genetic inheritance (no single gene). Too few or too many neurotransmitters. Viral infection— effects on brain development. Hormones. Brain structure abnormalities. Does not take into account additional factors such as stress, experiences.

the cognitive-behavioral model

disorders are the result of maladaptive learned behaviors and problematic thinking. Behavior and thinking interact and influence each other. Acknowledge that emotions and biological factors also interact with behavior and cognition. Behavioral perspective— based on learning principles from classical conditioning, operant conditioning, and modelling.

selective perception

see only the negative features of an event

magnification

exaggerating the importance of undesirable events

overgeneralization

drawing broad negative conclusions on the basis of a single insignificant event

the psychodynamic model

underlying, perhaps unconscious psychological forces cause conflict. Rooted in Freudian theory.

fixation

being trapped at an early stage of development due to traumatic childhood experiences.

the socio-cultural model

a society’s characteristics create stressors for some of its members. Widespread social change. Socio-economic class. Cultural factors. Social networks and supports. Family systems.

the Developmental Psychopathology model

study how behaviors evolve as a function of a person’s genes and early experiences and how these early issues affect the person at later life stages.

• risk factors: biological and environmental factors that contribute to problem outcomes

• equifinality: the idea that different children can start from different points and wind up at the same outcome

• multifinality: the idea that children can start from the same point and wind up at any number of different outcomes.

• resilience: the ability to recover from or avoid the serious effects of negative circumstances

depression

mood disorder.

low, sad state in which people feel overwhelmed. Most people with a mood disorder suffer only from depression. Major depressive disorder is more severe that dysthymic disorder.

mania

mood disorder.

elation and frenzied energy. People with bipolar disorder or the less severe cyclothymic disorder also experience mania.

major depressive disorder

mood disorder.

a disorder characterized by a depressed mood that is significantly disabling and is not caused by such factors as drugs or a general medical condition.

symptoms:

• emotional- depressed mood

• motivational- loss of desire to do usual activities, lack of drive

• behavioral- less active and productive, may move and speak slowly or seem physically agitated

• cognitive- negative self-evaluation, self-blame, pessimism, guilt, indecisiveness, difficulty concentrating, thoughts of death or suicide.

• physical- headaches, indigestion, constipation, dizzy spells, pain, sleep and eating disturbance, fatigue.

explanations for major depressive disorder

• neuroscientists: genetic predisposition. Low norepinephrine and serotonin. High cortisol.

• socio-cultural theorists: social support. Stressors.

• cognitive-behavioral theorists: learned helplessness. Attribution-helplessness theory- global, stable, internal, vs. specific, temporary, external. Negative thinking/dysfunctional attitudes- illogical thinking processes, automatic thoughts, the cognitive triad.

bipolar disorder

mood disorder.

periods of mania alternate with periods of depressions.

symptoms (alternating with depressive symptoms):

• emotional: powerful highs and lows.

• motivational: seek excitement and companionship

• behavioral: may move and speak quickly

• cognitive: poor judgement and planning, optimism, grandiosity

• physical: energetic, require little sleep.

explanations for bipolar disorder

• neuroscientists: gene abnormalities, highly heritable. Irregularities in ions that allow neurons to communicate.

• other causes: stress plus biological predisposition. life events— stiving, failures.

anxiety disorders

most common group disorders in Canada (12%). Disabling levels of fear or anxiety that are frequent, severe, persistent, or easily triggered. Most people with one anxiety disorder experience another one as well.

generalized anxiety disorder

anxiety under most life-circumstances; diffuse worry. Restlessness, edginess, easily tired. Difficulty concentrating. Sleep problems.

explanations for generalized anxiety disorder

• cognitive-behavioral theorists: dysfunctional assumptions (assumption that one is in danger). Intolerance of uncertainty theory (unwilling to accept negative events)

• neuroscientists: malfunctioning GABA feedback system (neurons don’t stop firing). Malfunctioning emotional brain circuit (prefrontal cortex, anterior cingulate, and amygdala)

social anxiety disorder

more women than men, more poor people than wealthier people. 12% of population develop this at some time in their life. Often begins in late childhood or adolescence.

• severe, persistent fear of embarrassment in social situations

• fear of talking in public

• general fear of functioning poorly in front of others

explanations for social anxiety disorder

• cognitive-behavioral theorists: dysfunctional cognitions about social situations. Unrealistically high social standards. View oneself as socially unattractive. View oneself as socially unskilled. Belief that one is in danger of behaving clumsily. Expect negative consequences for clumsy behavior. Belief that one has no control over anxious feelings.

phobias

7.7% of people in Canada suffer from at least one specific phobia in any year. Persistent, irrational fear of a specific object, activity, or situation.

explanations for phobias

classically conditioned fear. Avoidance behaviors are reinforced through operant conditioning (negative reinforcement). Modelling of fearful behavior.

10 most common phobias

1. spiders- arachnophobia

2. heights- acrophobia

3. public, social spaces- agoraphobia

4. social situations- social phobia

5. flying- aerophobia

6. enclosed spaces- claustrophobia

7. thunder- brontophobia

8. germs- mysophobia

9. cancer- carcinophobia

10. death- necrophobia

panic attacks

sudden bouts of panic. 4% of Canadians over 15 years old have suffered from a panic attack at some point.

panic disorder

panic attack plus changes in thinking or behavior. May misinterpret panic as a sign of medical emergency. often accompanied by agoraphobia.

explanations for panic disorder

malfunctioning brain circuit and excess norepinephrine. Misinterpretation of bodily sensations.

obsessive-compulsive disorder

obsessions: persistent unwanted thoughts.

compulsions: repetitive, rigid behaviors or mental acts. Often responses to obsessive thoughts, performed to reduce or prevent anxiety.

diagnosed when obsession or compulsions are sever, viewed by the person as excessive or unreasonable, cause great distress, consume considerable time, or interfere with daily functions.

explanations for obsessive-compulsive disorder

• neuroscientists: low serotonin activity. Overactive orbitofrontal cortex and caudate nuclei (eruption of troublesome thoughts and actions). Cingulate cortex, thalamus, and amygdala may activate the OCD impulses (amygdala drives the fear and anxiety components of the OCD response)

• cognitive-behavioral theorists: learning that compulsive behavior relieves distress

acute stress disorder (ASD)

lasts less than a month and begins within four weeks of the event

posttraumatic stress disorder

persistent depression, anxiety after a traumatic event. lasts more than a month, may begin shortly after or years after the event. Hyperalertness, easily startled, sleep disturbance, guilt, anxiety, depression, difficulty with concentration

explanations for PTSD

9.2% of Canadians experience PTSD in their lifetime. Twice as common in women than men.

• biological factors: increased cortisol and norepinephrine. Damaged hippocampus, amygdala

• personality: view negative events as outside one’s control.

• childhood experiences: poverty, parents separate…

• social and family support

psychosis

loss of contact with reality

schizophrenia

a mental disorder characterized by disorganized thoughts, lack of contact with reality, and sometimes hallucinations

positive schizophrenia symptoms

pathological excesses

• delusions: false beliefs

• hallucinations: false sensory perceptions

• disorganized thinking and speech, loose associations or derailment

• inappropriate affect

negative schizophrenia symptoms

pathological deficits.

• poverty of speech

• flat affect

• loss of volition

• social withdrawal

psychomotor schizophrenia symptoms

• strange movements

• catatonia: extreme psychomotor symptoms

• stupor: stop responding to environment- remain motionless

• rigidity: upright posture, resisting to be moved

• posturing: awkward bizarre positions (squatting)

• waxy flexibility: maintain postures into which they have been placed

explanations for schizophrenia

• neuroscientists: genetic predisposition (identical twins have a 48% concordance rate, fraternal twins have a 17% concordance rate). Biochemical abnormalities (excessive dopamine activity). Brain structure (enlarged ventricles, small temporal lobes and frontal lobes, structural abnormalities of the hippocampus, amygdala, and thalamus).

• Diathesis-stress model: biological predisposition plus negative event

somatic (physical) symptom and related disorders

excessive thoughts, feelings, and behaviors related to somatic symptoms.

somatic symptom disorder

symptoms cause distress and significant disruption in life. Excessive health-related anxiety. Concern has lasted over 6 months. Frequently no medical explanation is available.

illness anxiety disorder

preoccupied with having a illness despite a lack of symptoms. Engage in excessive care-seeking for over 6 months. Engage in excessive illness behaviors.

factitious disorder

deliberately assume physical or psychological symptoms to adopt the patient role. May lie about symptoms or deliberately make themselves ill.

dissociative disorders

major disruptions in memory.

• dissociative amnesia: unable to remember important information about a traumatic event; wartime, natural disaster.

• derealization disorder: person feels detached from their body

• dissociative identity disorder: two or more distinct personalities

explanations for dissociative disorders

• psychodynamic theorists: repression

• neuroscience: smaller hippocampus and amygdala, changes in the level of activity in the sensory cortex

personality disorders

rigid patterns of experience and behavior causing distress or difficulty

antisocial personality disorder

disregards and violates the rights of others, impulsive, reckless, self-centered; linked to criminal behavior.

explanations for antisocial personality disorder

modelling, operant conditioning; low serotonin activity, deficient functioning in the frontal lobes, lower arousal to stress and less anxiety.

borderline personality disorder

unstable mood, self-image, high volatility

explanation for borderline personality disorder

biosocial theory: child has difficulty identifying and controlling emotions, and the emotions are punished or disregarded.