Chapter 14 Textbook Terms

Psychopathology

sickness or disorder of the mind; psychological disorder

Etiology

factors that contribute to the development of a disorder

Moral treatment

a therapy that involved close contact with and careful observation of patients; created by Philippe Pinel (who was inspired by the caring treatment of Jean-Baptiste Pussin)

Hippocrates' classification of pyschopathologies

mania, melancholia, and phrenitis (mental confusion); believed that bodily fluids cause mental illness

Maladaptive

behaviors that interfere with the person's ability to respond appropriately in some situations; ex: washing your hands so many times a day that they are raw

Deciding if a behavior represents psychopathology

(1) Does the person act in a way that deviates from cultural norms for acceptable behavior? (2) Is the behavior maladaptive? (3) Is the behavior self-destructive, does it cause the individual personal distress, or does it threaten other people in the community? (4) Does the behavior cause discomfort and concern to others, thus impairing a person's social relationships?

Frequency of psychopathology

psychological disorders are common around the globe, in all countries and all societies; these disorders account for the greatest proportion of disability in developed countries

Diagnosis

putting a label on a loose cluster of symptoms remains; Emil Kraepelin was the first to classify different disorders

Diagnostic and Statistical Manual of Mental Disorders (DSM)

groups disorders based on similarity in symptoms, thereby providing a shared language and classification scheme; constantly revised and updated; also allows care providers to bill health insurance companies for treatment

Three sections of the DSM-5

(1) an introduction with instructions for using the manual; (2) diagnostic criteria for all of the disorders, which are grouped so that similar categories of disorders are located near each other; (3) a guide for future psychopathology research

Categorical approach issue of the DSM-5

the DSM-5 implies that a person either has a psychological disorder or does not; does not capture differences in severity of the disorder; implies a distinct cutoff between the absence and presence of psychopathology (but psychopathology is actually more nuanced)

Dimensional approach

alternative type of evaluation that considers psychological disorders along a continuum on which people vary in degree rather than in kind; recognizes that many psychological disorders are extreme versions of normal feelings; diagnosis is relatively easy at the extremes but more ambiguous in between

NIMH's Research Domain Criteria (RDoC)

a method that defines basic aspects of functioning and considers them across multiple levels of analysis, from genes to brain systems to behavior; meant to guide research rather than classify disorders for treatment

Comorbidity

the co-occurrence of two or more disorders in a single individual; not represented in the DSM; may occur due to common underlying factors

P factor

the underlying factor that was involved in all types of psychological disorders; high p scores are associated with suicide attempts, psychiatric hospitalizations, criminal behaviors; may be the underlying cause of comorbidity

Assessment

in psychology, examination of a person's cognitive, behavioral, or emotional functioning to diagnose possible psychological disorders; can involve self-reports by the person seeking treatment, psychological testing, observations, and interviews with others who know the person well

Neuropsychological method assessment

patients perform tasks that require an ability such as planning, coordinating, or remembering; highlighting actions that the client performs poorly can indicate problems with a particular brain region; goal of assessment is to diagnose and find a beneficial treatment

Evidence-based assessment

an approach to clinical evaluation in which research guides the evaluation of psychopathology, the selection of appropriate psychological tests and neuropsychological methods, and the use of critical thinking in making a diagnosis

Diathesis-stress model

a diagnostic model proposing that a disorder may develop when an underlying vulnerability (genetic or environmental) is coupled with a precipitating event

Biological factors of psychopathology

differences in brain anatomy in those with psychological disorders; brain regions that may function differently; feta/childhood environments may affect the central nervous system in ways that contribute to psychological disorders; epigenetic processes may effect disorders

Family systems model

a diagnostic model that considers problems within an individual as indicating problems within the family; developing a profile of an individual's family interactions can be important for understanding the factors that may be contributing to the disorder

Sociocultural model

a diagnostic model that views psychopathology as the result of the interaction between individuals and their cultures; lower socioeconomic status and psychopathology may be mutually reinforcing

Cognitive-behavioral approach

a diagnostic model that views psychopathology as the result of learned, maladaptive thoughts and beliefs; these thoughts and beliefs are learned, so they can be unlearned through treatment

Internalizing disorders

characterized by negative emotions, and they can be divided into broad categories that reflect the emotions of distress and fear; major depressive disorder, generalized anxiety disorder, and panic disorder; more prevalent in women

Externalizing disorders

characterized by impulsive or out-of-control behavior; alcoholism, conduct disorders, and antisocial personality disorder; more prevalent in men

Disorders cross-culturally

cultural expectations likely have a stronger influence on the expression of some disorders than others; disorder heavily influenced by learning, context, or both is more likely to differ across cultures; cultural factors can be critical in determining how a disorder is expressed and how an individual will respond to different types of therapies

Cultural syndromes

disorders that include a cluster of symptoms that are found in specific cultural groups or regions

Anxiety disorders

psychological disorders characterized by excessive fear and anxiety in the absence of true danger; they are common and can cause health, cognitive, and social issues

Generalized anxiety disorder (GAD)

a diffuse state of constant anxiety not associated with any specific object or event; person is constantly on the alert for problems; results in distractibility, fatigue, irritability, and sleep problems, as well as headaches, restlessness, light-headedness, and muscle pain

Social anxiety disorder (social phobia)

a fear of being negatively evaluated by others; includes fears of public speaking, speaking up in class, meeting new people, and eating in front of others

Specific phobia

a fear of a specific object or situation that is exaggerated and out of proportion to the actual danger; specific phobias include fear of snakes (ophidiophobia), fear of enclosed spaces (claustrophobia), and fear of heights (acrophobia)

Agoraphobia

an anxiety disorder marked by fear of being in situations in which escape may be difficult or impossible; being in such situations causes panic attacks

Development of anxiety disorders

biased thinking (tendency to perceive neutral situations as threatening); excessive focus on perceived threats (exaggerating and recalling threatening events more easily); learning (may develop a fear by seeing others being afraid); biological basis (inhibited children)

Depressive disorders

presence of sad, empty, or irritable mood along with bodily symptoms and cognitive problems that interfere with daily life

Major depressive disorder

a disorder characterized by severe negative moods or a lack of interest in normally pleasurable activities; must experience a major depressive episode (experiencing depressed mood for two weeks)

Persistent Depressive Disorder (Dysthymia)

a form of depression that is not severe enough to be diagnosed as major depressive disorder but lasts longer; must have a depressed mood most of the day, more days than not, for at least 2 years; personality disorder

Roles of gender/culture in depressive disorders

in developing countries, there is a greater stigma with depression, treatment is harder to access, people don't want to admit to being depressed; mental illness stigma and shame in Asian American, Latinx, LGBTQIA+, and some religious communities; women are diagnosed at a higher rate (due to more stigma with men and due to women being overworked in multiple roles)

Causes of depression

there is a genetic factor (we know this because of twin studies); medications like SSRIs can alleviate symptoms; situational factors such as life stressors may be a cause of depression; quality of social relationships plays a role; negative thoughts about self, world, and future (cognitive triad) are a cause

Learned helplessness

a cognitive model of depression in which people feel unable to control events in their lives; external locus of control; may be a cause of depression

Bipolar disorders

disorders marked by alternating or intermixed periods of mania and depression

Mania

an elevated mood that feels like being "on the top of the world"; possibly involves a sense of agitation and restlessness rather than positivity

Manic episodes

last at least one week and are characterized by abnormally and persistently elevated mood, increased activity, diminished need for sleep, grandiose ideas, racing thoughts, and extreme distractibility; "out of character" behaviors that they regret once the mania has subsided

Bipolar I disorder

a disorder characterized by extremely elevated moods during manic episodes and, frequently, depressive episodes as well; manic episodes in bipolar I disorder cause significant impairment in daily living (often result in hospitalization)

Bipolar II disorder

a disorder characterized by alternating periods of extremely depressed and mildly elevated moods; experience less extreme mood elevations, called hypomania

Origins of bipolar disorders

family history of a bipolar disorder is the strongest and most consistent risk factor for bipolar disorders; hereditary nature of bipolar disorders is complex and not linked to just one gene

Joiner's hypothesis for suicidal desires

we desire death when both the need to belong and the need for competence are frustrated; even if people want to die, they are only able to kill themselves after repeated self-preparation (self harm, drugs, risky behaviors)

Psychosis

a break from reality in which the person has difficulty distinguishing real perceptions from imaginary ones

Schizophrenia

a psychological disorder characterized by alterations in thoughts, in perceptions, or in consciousness, resulting in psychosis; impaired social, personal, or vocational functioning

Positive symptoms

features that are present in schizophrenia but not in typical behavior; ex: delusions, hallucinations, disorganized speech

Negative symptoms

characteristics missing in schizophrenia that are typically part of daily functioning; ex: apathy, lack of emotion, and slowed speech and movement

Delusions

false beliefs based on incorrect inferences about reality; people persist in their beliefs despite evidence that contradicts those beliefs; alterations of social processing, affiliation, and group perception

Hallucinations

false sensory perceptions that are experienced without an external source; they seem real; hallucinations are associated with activation in areas of the cortex that process external sensory stimuli

Disorganized speech

incoherent speech patterns that involve frequently changing topics and saying strange or inappropriate things; demonstrate a loosening of associations and frequently change topics; word salad

Disorganized behavior

acting in strange or unusual ways, including strange movement of limbs, bizarre speech, and inappropriate self-care, such as failing to dress properly or bathe

Catatonic behavior

a decrease in responsiveness to the environment; remaining immobilized for hours; include a rigid, mask-like facial expression with eyes staring into the distance; mindlessly repeat words they hear (echolalia)

Negative symptoms in schizophrenia

symptoms of schizophrenia that are marked by deficits in functioning, such as apathy, lack of emotion, and slowed speech and movement; associated with a poorer prognosis; negative symptoms are more resistant to medications than positive symptoms (antipsychotics)

Genetic factors of schizophrenia

schizophrenic people have mutations in their DNA in genes related to brain development and to neurological function; multiple genes or gene mutations contribute in subtle ways to the expression of the disorder

Schizophrenia as a brain disorder

ventricles are enlarged in people with schizophrenia, and the brain tissue is reduced in frontal lobes and medial temporal lobes; altered or reduced connection among brain regions; results from abnormality in neurotransmitters

Schizophrenics in childhood

strong indicators of schizophrenia include a family history of schizophrenia, greater social impairment, higher levels of suspicion/paranoia, a history of substance abuse, and greater frequency of unusual thoughts

Environmental factors of schizophrenia

growing up in a dysfunctional family may increase the risk of developing schizophrenia for those who are genetically at risk; heavy cannabis use, stress of urban environments, schizovirus/maternal inflammation are all risk factors for those that are genetically at risk

Obsessive-compulsive disorder (OCD)

a disorder characterized by frequent intrusive thoughts and compulsive actions

Obsessions

recurrent, intrusive, and unwanted thoughts, ideas, or mental images that increase anxiety

Compulsions

particular acts that people with OCD feel driven to perform over and over to reduce anxiety; ex: cleaning, checking, and counting

Pure obsession OCD

obsessive thoughts are not accompanied by an associated behavior

Causes of OCD

people are aware that their obsessions and compulsions are irrational, yet they are unable to stop them; the disorder results from conditioning; OCD runs in families (genetic); can be triggered from environmental factors (streptococcal infection

Anorexia nervosa

an eating disorder characterized by excessive fear of becoming fat and therefore restricting energy intake to obtain a significantly low body weight; criteria include both objective measures of thinness and psychological characteristics that indicate an abnormal obsession with body weight

Bulimia nervosa

an eating disorder characterized by the alternation of dieting, binge eating, and purging

Binge-eating disorder

an eating disorder characterized by binge eating that causes significant distress

Causes of eating disorders

there is a genetic factor; when people have genetic predispositions for eating disorders, they will tend to develop the disorders if they live in societies with an abundance of food

Addiction

a behavioral disorder where use of a substance continues despite negative consequences and a desire to quit; not in DSM

Substance use disorders

DSM classifies substance use disorders by their substance; ex: alcohol use disorder, cannabis use disorder, opioid use disorder; involve taking substance longer than intended, being unable to stop using, craving it, experiencing impairments in daily life

Tolerance

a person needs to consume more of a particular substance to achieve the same subjective effect

Withdrawal

physiological and psychological state characterized by feelings of anxiety, tension, and cravings for the addictive substance

Causes of addiction

dopamine activity in nucleus accumbens underlies the wanting properties of taking drugs; prefrontal cortex, amygdala, thalamus, hippocampus, insula (craving) all important for addiction

Addiction progression

initial drug use is associated with euphoria on occasion; tolerance leads people to need to use more and more of the drug (drug starts to lose its pleasure); person starts desiring the drug more (due to withdrawl)

Addiction vulnerability

adolescents high in sensation seeking are more likely to try drugs; genetic components of addiction, especially for alcoholism (many genes that lead to characteristics risky for addiction)

Addiction in context (Vietnam soldiers)

1/5 soldiers returning home were addicted to one or more substance; however, once home, 95 percent of the soldiers who used heroin no longer used drugs within months; shows that addiction is created and maintained within a specific environment

Trauma

a prolonged psychological and physiological response to a distressing event, often one that profoundly violates the person's beliefs about the world; ex: threat of death or serious injury, the loss of a loved one

Childhood trauma

children who are exposed to repeated stressors are more likely to develop psychopathology as adults and have altered stress responses; protective factors can buffer children from the harmful effects of early life stress

DSM's trauma-and stressor-related disorders

describes disorders in which a person has trouble overcoming exposure to a highly stressful event

Post-traumatic stress disorder (PTSD)

a disorder that involves frequent nightmares, intrusive thoughts, and flashbacks related to an earlier trauma; often try to avoid situations that remind them of their trauma

Genetics of PTSD

those with certain genetic markers related to serotonin functioning were much more likely to show PTSD symptoms; exposure to stimuli associated with past trauma leads to activation of the amygdala

Dissociative disorders

disorders that involve disruptions of identity, of memory, or of conscious awareness; a functional response to an extremely distressing or traumatic event (protects the person by splitting them from the event)

Dissociative amnesia

a person forgets that an event happened or loses awareness of a substantial block of time

Dorothy Joudrie shooting her husband

after years of abuse, she shot her husband 6 times; her husband said she was very calm and removed while shooting; when the police came she was distraught and said she had found him dead (dissociative amnesia)

Dissociative fugue

disorder involves a loss of identity and travel to a new location; fugue state often ends suddenly, with the person unsure how they ended up in unfamiliar surroundings

Jeff Ingram's dissociative fugue

he traveled to Colorado from Washington with no memory of his previous life; he was on TV begging for someone to tell him who he was; his fiancée brought him home (she felt familiar to him)

Dissociative identity disorder (DID)

the occurrence of two or more distinct identities in the same individual, along with memory gaps in which the person does not recall everyday events; individual people can manifest dozens of different personas, each with different memories, preferences, and personalities; most report being severely abused as children

Controversy with DID

many researchers remain skeptical about whether DID is a distinct psychological disorder; symptoms and treatments of DID are similar to those of other trauma disorders, but a diagnosis of DID can be very stigmatizing; people may have ulterior motives for claiming DID, such as denying responsibility for their behavior after being accused of a crime

Borderline personality disorder

a personality disorder characterized by disturbances in identity, in affect, and in impulse control; wide variety of unstable behaviors; more common in women; lack a strong sense of self; diminished capacity in the frontal lobes

Relationship between BPD and trauma

70-80 percent of those with borderline personality disorder have experienced physical or sexual abuse or witnessed extreme violence

Personality Disorders

psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning; interact with the world in ways that are maladaptive and unresponsive to feedback

Cluster A personality disorders

characterized by odd or eccentric behavior; paranoid (tense, suspicious), schizoid (socially isolated), and schizotypal (peculiarities of thought, appearance, and behavior) personality disorders make up this group

Cluster B personality disorders

characterized by dramatic, emotional, or erratic behaviors; histrionic (needs immediate gratification), narcissistic (self-absorbed), borderline, and antisocial personality disorders

Cluster C personality disorders

characterized by anxious or fearful behavior; avoidant (easily hurt/embarrassed), dependent (indecisive, needs assurance), and obsessive-compulsive (perfectionist, indecisive) personality disorders

Personality disorder—trait specified

diagnosed if that person is impaired in some area of function and displays pathological levels of one or more traits, even if the person does not meet the criteria for any other specific personality disorder

Antisocial personality disorder

a personality disorder in which people engage in socially undesirable behavior, are hedonistic and impulsive, and lack empathy; more common in men

Psychopathy

refers to people with antisocial personality disorder who also are extremely uncaring, are willing to hurt others for personal gain, and display behaviors that are more extreme than those associated with antisocial personality disorder

Biology of antisocial personality disorder

psychopaths do not become anxious when they are subjected to aversive stimuli; don't feel fear or anxiety; have slower alpha-wave activity (lower level of arousal, so do not learn from punishment); high levels of callous/unemotional traits; less active/smaller amygdalae; abnormal brain activity when trying to empathize; environmental factors (malnutrition/abuse in childhood)

Autism spectrum disorder

a developmental disorder characterized by impaired communication, restricted interests, and deficits in social interaction; impairments in social interactions and restrictive or repetitive behaviors