ch 15 Psychological Disorders

psych disorder

marked by a clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior

Martin Seligman

Positive Psychology and “dogs learned helplessness”

medical model

biological/neuroscience perspective

biopsychosocial approach

general approach positing bio, psych, and social attributes to know a disorder’s context; epigenetics also informs our understanding of disorders

diagnostic classification in psychiatry and psychology

1. predicts the disorder’s future course [ex) depression: life falls apart slowly]

2. suggests appropriate treatment [ex) if depression is genetic you may take meds]

3. prompts research into its causes [ex) research your depression]

DSM-5

diagnostic and Statistical Manual of Mental Disorders

Describes disorders and estimates their occurrence

DSM-5 changes

• labels change (ex: autism spectrum disorder)

• new/altered diagnosis; some are controversial

• New categories such as “online gambling”

DSM-5 criticism

hard to tell how to generalize anxiety disorder ; may contribute to pathologizing of everyday life

DSM-5 benefits

system helps mental health professionals communicate and is useful in research

Mental disorders seldom lead to violence and _______________ of violence is unreliable

clinical prediction

Risk factors of disorders

academic failure, low birth weight, neurochemical imbalance, caring for those who are chronically ill or have cognitive disorder

SSRI

selective serotonin reuptake inhibitors

wildly used anti-depressants

Anxiety disorders

marked by distressing, persistent anxiety or maladaptive behavior

generalized anxiety disorder (GAD)

• person who is CONTINUOUSLY tense and in state of autonomic NS. Can’t work, always fidgets

• Medication = Paxil [SSRIs]

• women > men

• constant fight/flight

• classical conditioning, genes, natural selection

Panic Disorder

• person who has sudden episodes of dread and lives in fear of the next attack

• Takes medication; looks at paper bag to slow down breathing

• No clear trigger

• can occur spontaneously

phobia

• irrational fear; avoidance of specific objects, actives, or situations; extreme fear = can’t function

• SSRI and therapy

• caused by reinforcement

agoraphobia

fear of public spaces

obsessive compulsive disorder (OCD)

• characterized by persistent and repetitive thoughts (obsessions), actions (compulsions) or both

• management techniques

• caused by genes and anterior cingulate cortex (hyperactive brain)

• often in teens and YA

hoarding OCD

collecting stuff - just like ariel from Little Mermaid

checking OCD

stove, window, door, - over do it so they are unable to function

counting OCD

count everything such as counting the steps you take; if they mess up they have to redo it and that inhibits them from functioning

cleaning OCD

couldn’t touch anything - Monica from Friends

perfection OCD

needs everything to be in an exact order or you can’t live with yourself - ex) you look in the mirror and you need to look pretty

Obsessions (thoughts)

concern with dirt, germs, or toxins; something terrible happening, symmetry, order

compulsions (behavior)

excessive hand washing, repeating rituals such as up/down from a chair, or checking doors, car brakes, homework

Posttraumatic stress disorder (PTSD)

• haunting memories turn to nightmares; social withdrawal, jumpy, insomnia, last 4 weeks or more after trauma, numbness

• often in war veterans, survivors of abuse/trauma

• caused by classical conditioning and generalized stimulus that can be affected by genes or brain

reinforcement in conditioning disorders (PTSD, Anxiety, OCD)

can help maintain a developed and generalized phobia (negative reinforcement can take away the thing that gives you anxiety)

anterior cingulate cortex

attention director in the frontal lobe that is hyperactive during OCD

Major Depressive Disorder (MDD)

• Person who have depressed mood OR loss of interest/pleasure plus 4 or more symptoms (5 total); must be for 2+ weeks

• women are twice as likely to get it

• from stressful events or genetics

• common cold for psych disorders

• depression comes earlier for each generation

Persistent depressive disorder (dysthymia)

• 3 symptoms including mildly depressed mood

• women are twice as likely to get it

• teens will be tested for this in 1 year

MDD and dysthymia symptoms

• poor concentration

• indecisiveness

• feel hopelessness

• poor appetite

• insomnia/hypersomnia

• low energy

• low self esteem

Seasonal affective disorder (SAD)

• when there is less sun, in a depressed mood (symptoms same to MDD); often in fall/winter

• light therapy will help

• women 2x as likely

Bipolar disorder (manic-depressive disorder)

• Alternative between hopelessness than overexcited mania; lethargy of depression and excitedness

• therapy, acceptance, medication

• less common than MDD

• 2x in women

• Brain lacks serotonin and no norepinephrine

• Mania is wild and makes bad decisions; predictors for suicide

chronic schizophrenia [process schizophrenia]

• appears at late adolescence or early adulthood

• as people age, psychotic episodes last longer and recovery periods shorten

• medication to balance dopamine receptors (ex: Thorazine)

• genetic predisposition

Acute schizophrenia (reactive schizophrenia)

• can be any age; response to traumatic event, extended recovery period

• medicate with Thorazine

• genetic predisposition

Chronic and Acute schizophrenia symptoms share

• delusions

• hallucinations

• disorganized thinking/speech

• diminished inappropriate emotion/action

who is the most susceptible to mood disorders

women (in most countries except spain)

based on twin studies, what disorders tend to have the most heritability

Bipolar and schizophrenia

depressed brain

brain actiivty is slow and low

left frontal lobes are less active - norepinephrine (fight/flight) and serotonin (happiness) are low

What do PET scans show about bipolar disorders

depressed brain is not active while manic state is extremely active. It is an extreme change

nutritional effects from depressive disorders

all diseases are linked to inflammation, blood starts to go bad

MUST eat healthy, sleep, and exercise

social-cognitive perspective of mood disorders and bipolar

• pessimist

• self focused rumination: only think about yourself; keep thinking about all the bad things about yourself

• self blame - pessimism

• self-defeating beliefs and negative explanatory style contribute to the cycle of depression

Positive Explanatory style

• break up with romantic partner

• remember this is temporary

• be specific of what is good not bad

• do not self blame, think of the external factors

• leads to successful coping

depressive cycle

• Stressful experience

• negative explanatory style

• depressed mood

• cognitive and behavioral changes

suicide

affects 1 million people globally

People feel disconnected from or as if they are a burden to others

non-suicidal self injury (NSSI)

Cutting, burning, hitting, pulling hair, etc.

1 in 5 people do this

research in suicide rates

• collectivists societies tend to have the most suicide clusters

• males are more successful in suicide because they commit the more dangerous acts

reasons for NSSI

gain relief

ask for help and gain attention

relieve guilt

conform to group

often found in teens (frontal lobe is not developed)

brain abnormalities for schizophrenia

• excess number of dopamine receptors (causes hyperactivity, delussions and hallucinations)

• enlarged ventricles and less gray matter

hallucinations

false perception

ex) hear/see dead grandma

delusions

false belief

ex) “I’m Jesus Christ”

Thorazine treats

schizophrenia and bipolar disorder

paxil treats

GAD, Panic Attacks, Phobias

schizophrenia is

not only determined by genes but also the environment; those with the gene do have a higher risk of getting the disorder

categories of disorders

1. anxiety disorder

2. mood disorders

3. Schizophrenia

4. dissociative disorders

5. personality disorders

6. eating disorders

7. somatoform disorders

8. factitious disorders

Dissociative disorders

conscious unawareness becomes separated (dissociated) from previous memories, thoughts, and feelings

VERY VERY RARE

Dissociative Identity Disorder (DID)

• previously called multiple personality disorder

• when a person shows 2 or more signs of alternative distinct personalities, suppressed so they just forget the memories

• NOT schizophrenia as they are still somewhat in touch with reality

• caused by suggestion or hypnosis

Dissociative Amnesia

Complete loss of identity due to trauma

only from trauma NO brain injury (not like regular amnesia)

Dissociative fugue

loss of identity and also travels away caused by trauma

ex) appeared in NY but don’t know how they got their and who they are

Personality disorders

behavior patterns that are enduring and disruptive - impair social function

personality disorders cluster A

really weird (eccentric or odd behaviors)

• Paranoid personality disorder; everything is out to get them

• conspiracy theory

personality disorders cluster B

Dramatic or impulsive behaviors

ex) historic personality disorder - theatrical, sexually provocative, DRAMATIC

personality disorders cluster C

• Dependent personality disorder = SO CLINGY

• Anxiety cluster

anti-social personality disorder

lack of conscience (to wrong doing)

genetic predisposition that interacts with environment to produce altered brain activity

NOT ABOUT osical interaction just Bad behaviors

leads to sociopaths or psychopaths

sociopaths

nurtred (environmental)

nervous all the time, Hot mess, emotional burts, often uneducated, form attachemnt (2-3 people) disorganized

psychopaths

• native (born)

• charming personality, intelligent, not often caught when they do crimes

• mimic emotions, no emotions

• All killers are psychopaths but not all psychopaths are killers

PET scans for normal and murderers

illustrates reduced activation in the frontal cortex for the murder showing lack of emotion

Borderline personality

• can’t regulate emotions or thoughts

• impulsive and has unstable relationships

• can lead to stalking behaviors

• treatment through cognitive behavorial therapy

• caused by genetics and environment

narcissistic personality disorder

• sense of superiority

• feel entitle and prefer friends that are weak or unpopular

• fragile self-esteem and are prone to be envious

• treatment in psychotherapy

• often in famous people and more men than women

• from genetics and environment

Body Dysmorphic Disorder

nothing to do with eating

everytime yo u see your body you seem grotesque

anorexia nervosa

• starvation and extremely underweight

• often found in adolescent females

bulimia nervosa

• binge eat then pruge fasting and excessive exercise

binge eat disorder

significantly bindge eat and they FEEL DISGUSTED or have gilt. THEY DO NOT PURGE or fast, exercise excessively

etiology for anorexia, bulimia, and binge eating

culture pressure

low seefl esteem

negative meotions

stressful experience

genetics

somatoform disorders

experiencing physical symptoms of a disease for which there is no appearent physical cause

“hysteria” according to Freud

aka stress disorders

hypochondriasis

preoccupied with imaginary ailments

unrealistically interpret normal aches / pains as mroe serious illness

treat with CBT (cognitive behavorial therapy)

found in early adults and comes from life experiences , nurture, and personality

conversion disorder

psychological loss fof a specific voluntary body function

to avodi conflcit with stressful situtation

psychotherapy and physical therapy will help

in more females

reaction to stressful situation cause this

Factitious Disorders

AKA Munchausen’s Syndrome

• feign physical or emotional illness with the GOAL to assume the role of a patient

• there are no standard therapies

• and it is RARE to get this

• it is unknown what the cause is but is linked to past severe illness or abuse

Attention Deficit Hyperactive Disorder (ADHD)

• Doesn’t have psychosis/set list of symptoms that affect the mind

• know the basics

• main issues = they have a lot of thoughts