Psych 1010: Chapter 12

Define Abnormality

1. Abnormality by seeing rare or infrequent behaviors (clipping your toenails on the TTC)

2. Deviation from the ideal cultural or societal standard (talking loudly in public)

3. Abnormality by producing personal distress, guilt or anxiety, OR is harmful to someone else

Abnormality (2)

1. Cannot function properly (interact, hold a job, do certain tasks(

2. Legal or not (insanity.. or perfectly fine)

What is the Demonic… supernatural model (middle ages)

If you were talking to yourself or hear voices, they believe you were infested… with DEMONS! So, to get them out they torture you, how thoughtful!

Define (however you say this aloud) Trephination

drilling or scraping a hole into the human skull to release the demons (strangers things core ish)

What did Hippocrates argue?

That behaviors that characterize our mental illness was because of imbalances of the four essential body fluids (blood, phlegm, bile and black bile).

2) You should treat it like a physical illness, Use emetics, laxatives and leeches to remove them.

What’s the modern (somatogenic) model

Mental illness has biological causes and we cannot control them.

What place was created to put these people there, and who else were there?

Asylums. But they were overcrowded as unemployed, unhoused poor and criminal people were also there.

Did people question these? If so who, and what did they say?

DUH! Pinel (France), and Dix (USA) wanted these people to be treated fairly with kindness and respect.

Also FREE them from the physical restrains, let the interact with others and go outside and touch grass

In the early 1950… what happend?

1. The drug chlorpromazine (Thorazine) was introduced)

2. It decreased the symptons of schizophrenia

3. Helped empty out asylums

4. Medications came after and helped with deinstitulionalization

Deinstitutionalization … describe

1. Made by government in 1960-1970

2. Released thousand of patients from asylums

True or false: Deinstitutionalization was good

• In theory, but not in practice

• While some return to normal lives, thousands had no follow up care and ended up in jail or homeless

• The clinics had to pick up the pieces

True or false: from the medical perspective, our entire vocabulary is rooted in this perspective

True, for instance: “symptoms, illness or diagnosis

True or false: there are many abnormal behaviour for which there is a biological cause that has been identified

False

True or false: “symptoms tell us very little about the root cause which is multifacted

True

What is the DSM-5?

• Classification system by the American Psychiatric Association

• It’s used to diagnose and classify abnormal behavior

• Has complex diagnostic criteria for each disorder

What are some criticisms of the DSM-5?

1. # rose from 128 to 541 (too much medical criteria)

2. Relies on categorical than dimensional model

3. Medicalizes and pathologizes social deviance (can over-medicalize normal behavior)

4. High levels of comorbidity between disorders

What’s the “Sane in Insane Places”

• Experiment where 8 people tried to admit themselves in a mental hospital by saying they were hearing unclear voices that said “empty” “hollow” and “thud”

• Everything else that happened afterwards was their true behavior

What were “Sane in Insane Places” results?

• mental health professional said most were schizophrenic

• kept them in the hospitals for 3 to 52 days (average was 19)

• After being discharged, they still had that label

• In remission, they said the abnormal behavior had subsided temporality and can recur

True or false: the hospital staff identified the pseudo-patients as impostors

False

Who is Thomas Szasz?

• A critique of the medical model. Argued minds cannot be “sick” like bodies

Where did Thomas Szasz our abnormal behavior come from?

a) Ourselves

b) Nowhere

c) Depends

d) Problems in living

d) Problems in living

Define: Anxiety Disorders

• feelings of anxiety, and has no external cause

True or false: “most anxieties are transient but can become excessive and intrusive in daily life ”

True

Name some physical symptoms of anxiety

• sleep issues

• feelings of panic

• gastrointestinal complaints

What’s the prevalence of anxiety

19%

What’s the onset of anxiety disorders?

is most likely diagnosed earliest among all other classes of disorders

Define: Generalized Anxiety Disorder

• Chronic, high levels of anxiety

• Symptoms: headaches, insomnia, heart racing

You spend what % worry and ruminating?

60%

What is the prevalence of GAD?

3-6%

What is the demographic?

• Females in their midlife are most often diagnosed

Define: Phobic Disorder

• intense, irrational fears of specific objects (like olives) or situations (walking into a crowded room) that have no real danger

Can a full-blown panic attack may follow exposure to the stimulus?

Yes

True or false: the impact varies depending on the level of functional impairment the phobia has (does it stop you in any way, or can you avoid it?)

True

What is the prevalence of Phobic Disorder?

10%

What is the demographic of Phobic Disorder?

2/3 diagnosed are females (66%)

Define: Panic Disorder

• panic attacks that happen frequently and can last from a few seconds or a few hours

• happens randomly, no warning

• Anxiety suddenly rises to a peak, and you feel a sense of impending inevitable doom

List the symptoms of a panic disorder

1. heart palpitations

2. shortness of breath

3. sweating

4. faintness and dizziness

5. urge to urinate

6. gastric sensations

7. imminent death

What is the prevalence of Panic Disorder?

3.5% of lifetime

What is the demographic of Panic Disorder?

late teens/ early adulthood (yeah makes sense the world is going to crap when its our time to be adults)

Are the causes of anxiety disorders multifaceted?

Yes

What are the causes of anxiety disorders?

• genetic

• serotonin deficiency

• overactive autonomic nervous system

• behavioral perspective (learned response to stress)

• cognitive perspective (growing out of inaccurate and inappropriate thinking’s and beliefs about circumstance in a person’s world”_

What’s the key diagnostic criteria for PTSD?

1. exposure to actual or threatened death, severe injury, or sexual violence

2. Intrusion symptoms (involuntary recollections of traumatic events via flashbacks with dissociation, nightmares)

3. Avoidance: avoiding external triggers or situations based of that traumatic event, leading to social isolation

4. Disturbances in thinking & mood: constantly believing negative thoughts, or personalization

5. Disruptions in physiological arousal and reactivity: hypervigilance, self-destructive behavior

True or false: majority of people who survive traumatic events are diagnosed with PTSD

false! only a minority

Define: Complex PTSD

• Prolonged and repeated traumatic experiences

• emotion dysregulation

• interpersonal relationship dysregulation

• externalizing/behavior dysregulation

• cognitive difficulties (self perception is altered, dissociation)

Define: Mood Disorders

emotional disturbances of various kinds that may spill over to disrupt physical, perceptual, social and thought process

Name the Bipolar and Related Disorders

1. Bipolar I

2. Bipolar II

3. Cyclothymic Disorder

Name the Depressive Disorders

1. Major depressive disorder

2. Disruptive mood dysregulation disorder

3. Premenstrual dysphoric disorder

4. Persistent depressive disorder

Define: Major Depressive Disorders

a severe from of depression that interferes with concentration, decision making and sociability

What’s the onset of Major Depressive Disorder?

can happen at any tine, most before age of 40

What’s the prevalence of MDD

13-16%

True or false: the rate of depression is decreasing throughout the world because people are more happy!

False: depression rate is going up (duh?) we’re not sure why though

True or false: people are developing major depression at increasingly younger ages

True

Define: recurrence

average # of episodes at 5 to 6, average length of episodes at 5-7 months

List the criteria for MDD

1. significant impairment almost every day for more than a few weeks

2. constant feeling of sadness, despair, or emptiness, hopelessness

3. no longer interest in things that brought you joy

4. you don’t have the desire to experience pleasure anymore (.eg. anhedonia)

List some other symptoms for MDD

• huge weight loss

• alterations in appetite

• changes in sleeping patterns

• slowed psychomotor activity

• fatigue/ loss of energy and motivation

• lower self esteem

• repeating thoughts of death

• suicidal ideation

What are the potential biological causes of MDD?

• neurotransmitters serotonin, dopamine and norepinephrine play a role in depression but we’re unsure of its mechanism

• Neuroimaging shows certain brain structures (area 25, right anterior insula) associated with risk of depression

• Brain imaging studies show brains of people with depression have less activation when viewing faces displaying emotion (numbing)

What are some other potential causes of MDD?

• stress of life reduces positive things (people isolate themselves further)

• learned helplessness (perceive events in one life as uncontrollable and that you cannot escape, thus the hopelessness)

• faulty cognitions: view yourself as a loser, blaming yourself whenever something goes wrong

Define: Bipolar I disorder

• a disorder where an individual alternates between periods of euphoric feelings of mania and depressions

What are the symptoms of Bipolar I disorder

• risk or reckless behavior

• pressured speech and racing thoughts

• decreased need for sleep

• inflated self-esteem? grandiosity

• abnormally and persistently elevated or irritable mood

True or false: swings between highs and lows may occur a few days a[art or may alternate over a period of years

True

True or false: periods of depression aren’t longer than periods of mania

false

What’s the prevalence of Bipolar 1 Disorder: 1-2%

1-2%

What’s the onset of bipolar 1 disorder

Late teens or early 20’s

What’s the demographics for Bipolar I disorder?

diagnosed equally among males and females

Define: Bipolar II disorder

episodes of depression along with hypomania (less severe change in mood and behavior compared to mania)

True or false: Bipolar II disorder is easier to diagnose

False, it’s much harder

Name some of the highs of Bipolar I disorder

• over-excitement

• restlessness

• high sex-drive

• becoming more impulsive

• being more impulsive

• drug and alcohol abuse

• poor concentration

Name some of the lows of Bipolar I disorder

• sadness

• insomnia

• thoughts of suicide or attempting suicide

• uncontrollable crying

• changes in appetite

• loss of energy

• trouble concentrating

• trouble making decisions

What are the causes of bipolar disorders?

• mainly biological

• Substance uses increases the risk

• Hereditary vulnerability

Define: Schizophrenia

• severe distortion of reality

• thinking, perception and emotion can deteriorate

• withdrawal from social interaction

• displays of bizarre behavior

What is the prevalence of Schizophrenia?

1%

What is the onset of Schizophrenia?

late teens or early adulthood

List some characteristic of schizophrenia (1)

decline from a pervious level of function: may no longer do the activities they use to do

disturbances of thought and language: strange use of logical and language (thinking doesn’t make sense and the way they process information is faulty)

delusions: firmly held, unshakable beleif’s with no basis in reality

List some characteristic of schizophrenia (2)

• perceptual disorders: may not perceive the world as other people do (hallucinations)

• emotional disturbances: show lack of emotion where even dramatic events produce little or no emotional response

• withdrawal: showing little interest in others, leading to catatonia

Define: process schizophrenia

• symptoms develop slowly and subtly

• they gradually withdraw from the world

• excessive daydreaming

• blunting of emotions

• reaches to a point where others cannot overlook it

True or false: process schizophrenia is harder to treat

True

Define: reactive schizophrenia

• onset of symptoms is sudden and conscious (oblivious)

• easier to treat

Define: Personality Disorders

• inflexible and maladaptive behavior patterns that inhibit a person from functioning normally in society

• rarely experience personal distress and lead normal lives

• below the surface… no

What’s the prevalence

10% (varies)

True or false: personality disorders are the most reliable diagnose of all mental ilness

false!!!!!!!!!!

Define: antisocial personality disorder (sociopathic personality)

• “disorder where individuals show no care for moral and ethical rules of society or the likes of others”

Do people of APD appear cold and offputing?

No! They are quite charming, likable and intelligent (at first)

However, you soon realize how manipulative and deceptive they are.

They lack guilt, don’t have anxiety about wrongdoing and cannot tolerate frustration

What are the potential causes of APD?

• childhood abuse or neglect/aces

• family history of mental illness

• diagnosis of childhood conduct disorder

Define: Borderline Personality Disorder

• A disorder where individuals have difficulty developing a secure sense of who they are

• they rely on relationships with others to define their identity, if they get rejected… uh oh!

True or false: individuals with BPD trust others, emotionally stable and are not impulsive or self destructive. They are secure of themselves and feel amazing

FALSE! loud incorrect buzzer! they do not trust others, and emotional wise… yikes. They’re impulsive and empty and self-destructive. Basically the opposite of everything i’ve said

Causes of Borderline Personality Disorder

• in their childhood, their emotions were discounted and or criticized. Because of that, they didn’t learn how to control their emotions

• Early trauma, most likely childhood sexual trauma - correlated with BPD, PTSD, and complex PTSD

What is Linehan’s Biosocial Model of BPD?

• It’s a transaction between a biologically vulnerable child and an invalidating environment

Define: Biologically vulnerable

• heightened reactivity

• sensitivity

• slow return to baseline

Define: invalidating environment

• negates, dismisses, punishes a behavior independent of the actual validity of the behaviour

The core of BPD is ______________

emotion dysregulation

BPD criteria are _______ of emotion dysregulation (anger outbursts or reactivity of mood) or _____________ emotion dysregulation (dissociation, self harm, impulsivity)

• direct outcomes

• efforts to regulate

Define: Obsessive Compulsive Disorder (OCD)

a disorder where an individual is plagued by wanted thoughts or feelings that they must do actions against their wills (I have to close the door three times or i will get sick for 10 weeks)

Define: Obsessions

persistent, unwanted thoughts or ideas that keep happening

Define: Compulsions

an irresistible urge to repeatedly do some strange and unreasonable act

True or false: people do not experience extreme anxiety if they cannot do that act. The compulsions do not bring relief

False, they do have extreme anxiety if they cannot do the act they want to, and those compulsions bring little relief

OCD has strong evidence of

a) biological causes

b) no causes

d) what the hell are you talking about

d) heredity causes

a) biological causes

What is the prevalence of OCD

2-3%

How many Canadians die by suicide each year

a) 5000

b) 6000

c) 4000

d) 3000

c) 4000