14 / Psychological Disorders

Medical Model

proposes that it is useful to think of abnormal behavior as a disease.

What are the three medical concepts proven valualble in the treatment and study of abnormailty?

1. Diagnosis

2. Etiology

3. Prognosis

What is Diagnosis?

Diagnosis involves distinguishing one illness from another.

What is Etiology?

Etiology refers to the apparent causation and developmental history of an illness.

What is Prognosis?

Prognosis is a forecast about the probable course of an illness.

What are the 3 criteria of abnormal behavior?

1. Deviance

2. Maladaptive behavior

3. Personal distress

Deviance

behavior that deviates from societal norms.

Maladaptive behavior

impairment of everyday activities

Personal distress

subjective report of great personal distress.

What is the DSM?

Diagnositic and Statistical Manual of Mental Disorders

Describe the 5 axis used for diagnosis.

• Axis 1: Clinical Disorders

• Axis 2: Personality and Developmental Disorders

• Axis 3: General Medical Conditions

• Axis 4: Psychosocial and Environemental Problems

• Axis 5: Global Assessment of Functioning (GAF)

Generalized Anxiety Disorder

is marked by a chronic, high level of anxiety that is not tied to any specific threat.

• Prevalence: ~5%

Specific Phobia

involves a persistent and irrational fear of an object or situation that presents no realistic danger.

• Prevalence: ~10% + 2/3 female

Panic Disorder

characterized by recurrent attacks of overwhelming anxiety that usually occur suddenly and unexpectedly

• Prevalence: 2/3 female

Agoraphobia

is a fear of going out to public places

Obsessive-Compulsive Disorder (OCD)

is marked by persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions).

• Prevalence (of full-fledged OCD): ~2–3%

Posttraumatic Stress Disorder (PTSD)

involves enduring psychological disturbance attributed to the experience of a major traumatic event.

• Prevalence: ~7% (likely higher among military returnees from the Afghanistan and Iraq wars)

[…] is one key predictor of vulnerability.

intensity of one’s reaction at the time of the traumatic event

LARGELY, what are the etiologies of anxiety-related disorders?

• Biological Factors

• Conditioning and Learning

• Cognitive Factors

• Stress

Describe the biological factors in the etiology of anxiety-related disorders.

• Heredity

  • Concordance rates: indivate the percentage of twin pairs or other pairs of relative who exhibit the same disorder.

• Neurochemical activity

  • Neurotransmitters

  • Therapeutic drugs → release GABA → disturbances in neural circuits using GABA

Describe conditioning and learning in the etiology of anxiety-related disorders.

• Anxiety-related disorders can be acquired through classical conditioning and maintained through operant conditioning.

• Tendency to develop phobias of certain types of objects/situations can be explained by preparedness.

• Evolved module for fear leaning

Explain the evolved model for fear learning

It was said that this evolved module is automatically activated by stimuli related to past survival threats in evolutionary history and that it is relatively resistant to intentional efforts to suppress the resulting fears.

Describe the cognitive factors in the etiology of anxiety-related disorders.

According to cognitive theorists, some people are more likely to suffer from anxeity problems because they tend to:

1. Misinterpret harmless situations as threatening.

2. Focus excessive attention on perceived threats.

3. Selectively recall information that seems threatening.

Describe the stress in the etiology of anxiety-related disorders.

Research has demonstrated that PTSD and other types of anxiety disorders can be stress related.

It is sometimes/often believed that high stress often helps to precipitate or to aggravate anxiety disorders.

Dissociative disorders

are a class of disorders in which people lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity.

Dissociative Amnesia

is a sudden loss of memory for important personal information that is too extensive to be due to normal forgetting.

Dissociative Identity Disorder (DID)

involves a disruption of identity marked by the experience of two or more largely complete, and usually very different, personalities.

What is Dissociative Amnesia usually attributed to?

excessive stress

What is Dissociative Identity Disorder (DID)’s etiology?

Causes are abscure, but it seems to be influenced by

• Book and movie portrayals of dissociative identity disorder and reinforcement from their therapist.

• Severe emotional trauma from childhood.

Major depressive disorder

when people show persistent feelings of sadness and despair and a loss of interest in previous sources of pleasure.

What is the central feature of major depressive disorder?

Anhedonia

What is anhedonia?

a diminished ability to experience pleasure.

Bipolar disorder

is marked by the experience of both depressed and manic periods

Seasonal Affective Disorder (SAD)

is a type of depression that comes and goes with seasonal patterns.

Dysthymic Disorder

is a mild, long-lasting form of depression

(also called persistent depressed disorder)

LARGELY, hat are the Caues of Depressive and Bipolar disorders?

• Genetic Vulnerality

• Neurochemical and Neuroanatomical Factors

• Hormonal Factors

• Cognitive Factors

• Interpersonal Roots

• Precipitating Stress

Learned helplessness

passive “giving up” behavior produced by exposure to unavoidable aversive events (such as uncontrollable shock in the lab)

People who exhibit a […] are especially vulnerable to depression.

pessimistic explanatory style

Schizophrenia

is a disorder marked by delusions, hallucinations, disorganized thinking and speech, and deterioration of adaptive behavior.

• Prevalence ~1%

What are the symptoms of schizophrenia?

• Delusions

  • Delusions of grandeur

• Hallucinations

• “Word Salad”

• Waxy flexibility

• Disturbed Emotion

What are negative symptoms?

involve behavioral deficits

Ex. flattened emotions, social withdrawal, apathy, impaired attention, poor grooming, lack of persistence at work or school, and poverty of speech.

What are positive symptoms?

involve behavioral excesses or pecularities

Ex. hallucinations, delusions, incoherent thought, agitation, bizarre behavior, and wild flight of ideas.

What are delusions?

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

(includes delusions of grandeur)

What are delusions of granduer?

when people maintain that they are famous or important.

What are hallucinations?

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

What is “word salad”?

where a person’s speech becomes disorganized, making it difficult for others to understand what they are trying to express.

What is waxy flexibility?

Whn a person puts up some slight even push-back or resistance to any attempt to change their position.

What are disturbed emotions?

When normal emotional tone is disrupted in a variety of ways, such as:

• Flattening of emotions

• Little emotional responsiveness

• Inappropriate emotional responses that don’t tell with the situation or with what they are saying.

• Emotionally volatile / aggression.

What are the different types of schizophrenia?

• Paranoid schizophrenia

• Catatonic schizophrenia

• Disorganized schizophrenia

• Undifferentiated schizophrenia

Describe paranoid schizophrenia.

thought to be dominated by delusions of persecution, along with delusions of grandeur.

Describe catatonic schizophrenia.

was marked by striking disturbances, ranging from the muscular rigidity seen in a withdrawn state called a catotonic stupor to random motor activity seen in a state of catatonic excitement.

Describe disorganized schizophrenia.

was viewed as a particularly severe syndrome marked by frequent incoherence, obvious deterioration in adaptive behavior, and virtually complete social withdrawal.

Describe undifferentiated schizophrenia.

diagnosis when people who were clearly schizophrenic could not be placed into any of the other categories.

LARGELY, what are the causes of schizophrenia?

• Genetic vulnerability

• Neurochemical factors

• Triggered

• Structural Abnormalities in the Brain

• Neurodevelopmental Hypothesis

• Expressed Emotion

• Stress

Explain genetic vulnerability as a possible cause of schizophrenia.

• In twin studies, average concordance rates are 48% for identical twins & 17% for fratnernal twins.

• Child born to two schizophrenic parents have 46% probability of developing it.

What is the neurochemical factor in schizophrenia? Explain it.

Dopamine hypothesis

Dopamine hypothesis asserts that excess dopamine activity is the neurochemical basis for schizophrenia.

Increased dopamine synthesis and release in specific regions of the brain may be the crucial factor that triggers schizophrenic illness in vulnerable individuals.

What might trigger schizophrenia in individuals?

Recent research has suggested that marijuana use during adolescence may help precipitate schizophrenia in young people who have a genetic vulnerability to the disorder.

What structural abnormalities in the brain might cause schizophrenia?

• Enlarged brain ventricles ←→ schizophrenix disturbance

  • This is debated bc it could be the cause or consequence of schizophrenia

What is the neurodevelopmental hypothesis?

asserts that schizophrenia is caused in part by various disruptions in the normal maturational processes of the brain before or at birth.

What is expressed emotion?

is the degree to which a relative of schizophrenix patient displays highly critical or emotionally overinvolved attitudes toward the patient.

What is Autism (Autism Spectrum Disorder)?

is characterized by profound impairment of social interaction and communication and severely restricted interests and activities, usually apparent by the age of 3. 

Personality disorders

are a class of disorders marked by extreme, inflexible personality traits that cause subjective distress or impaired social and occupational functioning.

Antisocial personality disorder

is marked by impulsive, callous, manipulative, aggressive, and irresponsible behavior.

Borderline personality disorder

is marked by instability in social relationships, self-image, and emotional functioning.

Narcissistic personality disorder

is marked by a grandiose sense of self-importance, a sense of entitlement, and an excessive need for attention and admiration.

Paranoid personality disorder

is characterized by a pervasive distrust and suspicion of others, even when there is no basis for such beliefs

Histrionic personality disorder

is characterized by a pervasive pattern of excessive emotionality and attention-seeking.

Avoidant personality disorder

is characterized by pervasive pattern of social inhibition, feelings of inadequacy, and a high sensitivity to negative evaluation.

What are eating disorders?

Eating disorders are severe disturbances in eating behavior characterized by preoccupation with weight concerns and unhealthy efforts to control weight.

Anorexia Nervosa

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

What are the two sub-types of anorexia nervosa?

• Restricting type anorexia nervosa

• Binge-eating/purging type anorexia nervosa

What is bulimia nervosa?

involves habiturally engaging in out-of-control overeating, followed by unhealthy compensatory efforts, such as self-induced vomiting, fasting abuse of laxatives and diuretics, and excessive exercise.

What is binge-eating disorder?

involves distress-inducing eating binges that are not accompanied by purging, fasting, and excessive exercise seen in bulimia.

LARGELY, what are the etiologies of eating disorders?

• Genetic Vulnerability

• Personality Factors

• Cultural Values

• Role of the Family

• Cognitive Factors