PSYC - Chapter 14

Psychological disorder

any pattern of behavior, thinking, or emotional function that causes someone significant distress, poses a danger to themselves or others, impairs their ability to function in daily life or involves a combination of these factors

Psychopathy

the scientific study of psychological disorders

Trephining

cutting holes into the skull of a living person, was done to release the "demons" supposedly possessing the individual

Hippocrates

illnesses were the result of the body's vital fluids, or humors

Exorcisms

the formal casting out of a demon through a religious ritual, were used to rid people of unusual thinking or behavior

Witchcraft

people experiencing psychological disorders were likely called witches and put to death

Medical model

psychological disorders can be diagnosed, and have an etiology, course, & prognosis

Typical

frequently occurring behavior and common ways of thinking

Atypical

behavior or thinking that is rare or deviates from society's norms

Situational context

the social or environmental setting of a person's behavior

Subjective discomfort

emotional distress while engaging in a particular behavior or thought process

Maladapative

dysfunctional thinking or behavior that does not allow a person to fit into society or function normally

Four D’s of psychological disorders

1. deviant

2. danger

3. distress

4. dysfunctional

Insanity

determined by lawyers and judges; legal term

Biological Model

psychological disorders are caused by faulty neurotransmitters systems, genetic problems, brain damage & dysfunction, or some combination of those causes

Psychodynamic View

disordered thinking and behavior is the result of repressing one's threatening thoughts, memories, and concerns in the unconscious mind

Behaviorist view

disordered behavior was learned just like other behavior

Cognitive View

maladaptive functioning is the result of illogical thinking patterns, also referred to as mental models or schemas

Sociocultural perspective

Disordered thinking or behavior is shaped within the context of social interactions, family influences, the social group to which one belongs, and the culture within which the family and social group exist

WEIRD

western, educated, industrialized, rich, and democratic

Cultural relativity

the need to consider the unique characteristics of the culture in which the person with a disorder was nurtured to be able to correctly diagnose and treat the disorder

Cultural idioms of distress

terms or phrases used to describe suffering or distress within a given cultural context

Cultural explanations or perceived causes

culturally defined ways of explaining the source or cause of symptoms or illness

Cultural syndromes

sets of particular symptoms of distress found in particular cultures, which may or may not be recognized as an illness within the culture

Biopsychosocial perspective

A person may have a genetically inherited tendency for a type of disorder, but may not develop a full-blown disorder unless the family and social environments produce the right stressors at the right time in development

DSM-5-TR

describes 300 disorders in terms of symptoms, the typical path of progression, and specific criteria that must be met in order for a diagnosis

Advantages and Disadvantages of the DSM-5-TR

Advantages: standardization of diagnosis, clear operational definitions

Disadvantages: promotes a medicalized model, used as proscriptive rather than descriptive

Research Domain Criteria (RDoC) project

promotes research that incorporates all of these advances and other types of information to provide a knowledge base for classifying psychological disorders based on dysregulation and dysfunction in biological & psychological functioning

Hierarchical Taxonomy of Psychopathology (HiTOP)

a diagnostic approach that involves hierarchical and dimensional aspects, conceptualizing mental health along a spectrum, and mental problems along a continuum

Comorbidity

the presence of more than one mental disorder at a time

Labeling theory

there does not appear to be strong evidence of diagnostic labels themselves prompting the type of stigmatization and negative biases that others have suggested

Disorders of Mood

• MDD

• SAD

• Bipolar Disorder

Major depressive disorder (MDD)

severe depression that comes on suddenly and seems to have no external cause, or is too severe for current circumstances

most common disorder of mood

twice as likely to be diagnosed in women than in men

Symptoms of MDD

• Depressed for most of every day

• Anhedonia

• Feel tired

• Have trouble sleeping or sleep too much

• Experience changes in appetite and significant weight changes

• Experience excessive guilt or feelings of worthlessness

• Have trouble concentrating

• May experience delusional thinking or hallucinations

Anhedonia

markedly diminished interest or pleasure in (almost) all activities

Seasonal affective disorder (SAD)

depressive episodes that occur at certain times of the year, often during fall and winter months

Suicide

More than 90% of suicides are associated with a psychological disorder, with depression being the most likely cause, and more so in individuals with substance use disorders

The rates of suicide are not the same for all genders or races/ethnicity

Bipolar disorder

periods of mood that may range from normal to manic

related to ADHD — 3 times more common in people with BPD and MDD

Bipolar I Disorder

BPD with episodes of depression and full mania

Bipolar II Disorder

BPD with episodes of MDD and hypomania

Hypomania

a level of mood that is elevated but at a level below or less severe than full mania

Manic episodes

episodes of excessive excitement, energy, elation, irritability, or hyperactivity

Mixed features

experience some symptoms of mania and depression at the same time

Causes of Mood Disorders

Behavioral — learned helplessness

Cognitive — distorted thinking

Biological — neurotransmitters (serotonin, norepinephrine, and dopamine)

• Genetic — tendency for mood disorders to appear in genetically related individuals at a higher rate

Anxiety

the anticipation of some future threat, often associated with worry, vigilance, and muscle tension

Treatment for MDD

Pharmacotherapy: SSRIs, SNRIs

Depression-focused therapy: able to get some good insights of stuff

Both: can be helpful depending on severity

Electroconvulsive therapy: Brief, controlled electric current to the brain while the patient is under anesthesia

Anxiety Disorders

disorders in which the main symptom is persistent & disproportionate or unrealistic anxiety, often characterized by excessive apprehension, worry, or fear

Excessive

greater than it should be given the circumstances

Unrealistic

not practical for the situation or circumstances

Phobia

an irrational, persistent fear of something

Free-floating anxiety

anxiety that is unrelated to any specific and known cause

Social anxiety disorder

fear of interacting with others or being in a social situation

Specific phobia

an irrational fear of some object or specific situation

Panic attack

a sudden onset of extreme panic with various physical symptoms

Physical: racing heart, shaking, shortness of breath

Psychological: state of terror, going to die

Panic disorder

disorder in which panic attacks occur more than once or repeatedly and cause persistent worry or changes in behavior

Generalized anxiety disorder

disorder in which a person has excessive anxiety and worry (apprehensive expectations) about multiple things, accompanied by physical and cognitive symptoms of stress, which lasts 6 months or more

Obsessive-Compulsive Disorder (OCD)

disorder in which intruding, recurring thoughts (obsessions) create anxiety that is relieved by performing a repetitive, ritualistic behavior or mental act (compulsion)

Treatment for OCD

CBT: Goal is to get the person to go some time without the compulsions and/or obsessions; teach them facts behind unnecessary actions

Drugs: SSRIs

Exposure/Response Prevention: forcefully exposed to fear stimulus

Acute stress disorder (ASD)

a disorder resulting from exposure to a major stressor

Symptoms: dissociation, recurring nightmares, problems in concentration

Posttraumatic stress disorder (PTSD)

a disorder when the symptoms associated with ASD last for more than 1 month

more common in women and in those who served in the military

Treatment for PTSD

Drugs: SSRIs, benzodiazepines

CBT: restructure how the person thinks about the event; teach them strategies to manage the anxiety

Debriefing: group therapy

Adjustment disorders

disorders resulting from exposure to a stressor

Symptoms: anxiety, depression, or conduct that are out of proportion to the severity of the stressor

Prolonged grief disorder

a disorder associated with intense grief and other symptoms of loss, emotional pain, or disengagement from typical life activities, which are greater than what would be expected a year or longer after the death of a significant other

Individuals must have three or more significant symptoms present nearly every day for at least the last month

Causes of anxiety, trauma, and stress disorders

Behavioral — anxious behavioral reactions are learned

Cognitive — results from illogical, irrational thought processes

Biological — genetic factors, neurotransmitters systems (GABA, serotonin, norepinephrine), more active amygdala

Magnification

the tendency to interpret situations as being far more harmful, dangerous, or embarrassing than they actually are

All-or-nothing thinking

thought process in which a person believes their performance must be perfect or the result will be a total failure

Overgeneralization

interpreting a single negative event as a never-ending pattern of defeat

Minimization

giving little or no emphasis to one's success or positive events and traits

Treatment for Anxiety

Systematic desensitization

1. learn relaxation techniques

2. create fear hierarchy

3. work through fear hierarchy while relaxing

Dissociative disorders

disorders in which there is a break in conscious awareness, memory, the sense of identity, or combination

Dissociative amnesia

the individual cannot remember the kind of information contained in episodic long-term memory

usually associated with a stressful or emotionally traumatic experience and cannot be easily explained by simple forgetfulness (psychological cause)

can occur with and without fugue

Dissociative fugue

“flight”

when a person suddenly travels away from home and afterward cannot remember the trip or even personal information

Dissociative identity disorder (DID)

disorder occurring when an individual seems to experience at least two or more distinct personalities

core personality experiences blackouts

Causes of Dissociative Disorders - Models

1. posttraumatic model = core aspects are the result of trauma; symptoms of DID are a fear response

2. sociocognitive model = DID may be unintentionally constructed by therapist cuing, media influences, and sociocultural expectations about what DID is supposed to be like

Causes of Dissociative Disorders - Views

Psychodynamic — the repression of threatening or unacceptable thoughts and behavior as a defense mechanism at the heart of all disorders

Cognitive/Behavioral — the person may feel guilt, shame, or anxiety when thinking about disturbing experiences or thoughts and start to avoid thinking about them (thought avoidance); shaping

Biological — lower brain activity in areas responsible for their sense of body awareness

Depersonalization/derealization disorder

a dissociative disorder in which people feel detached and disconnected from themselves, their bodies, and their surroundings

Aura

a subjective sensory experience that can occur immediately before a seizure or migraine, including flashes of light, smells, numbness, or feelings of unreality

Eating disorders

• anorexia nervosa

• bulimia nervosa

• binge-eating disorder

Anorexia nervosa

a condition in which a person reduces eating to the point that their body weight is significantly low, or less than minimally expected

Physical effects: diarrhea, loss of muscle tissue, loss of sleep, low blood pressure, a lack of menstruation, dehydration, severe body chemical dysfunction, and possibly organ damage

highest mortality rate of eating disorders (0.51% per year)

Bulimia nervosa

a condition in which a person develops a cycle of "bingeing" or overeating enormous amounts of food in one sitting, then using inappropriate methods for avoiding weight gain (purging)

Physical effects: tooth decay, enlarged salivary glands, heart problems, fatigue, seizures, damage to intensinal tract, and chemical imbalances

Causes of Eating Disorders

cause is not yet understood

Risk factors; body dissatisfaction, increasing sensitivity to food & its reward value, fear & anxiety, history of neglect or abuse, being an adolescent female

Sexual dysfunction

a problem with sexual functioning or with the actual physical workings of the sex act

• sexual interest

• arousal

• response

40 to 45 percent of women and 20 to 30 percent of men have at least one sexual dysfunction

Causes of Sexual Dysfunction

Physical — illness, side effects of medication, surgeries, drugs

Sociocultural — negative attitudes, being in a stigmatized group

Psychological — low self-esteem, anxiety, depression, self-consciousness, history of sexual abuse or assault

Personality Disorders

1. Those in which individuals are seen as odd or eccentric by others

1. Paranoid

2. Schizoid

3. Schizotypal

2. Those in which the thinking and behavior of the person is very dramatic, emotional, or erratic

4. Antisocial

5. Borderline

6. Histrionic

7. Narcissistic

3. Those in which the main emotion is anxiety or fearfulness

8. Avoidant

9. Dependent

10. Obsessive-compulsive

Paranoid personality disorder

personality disorder in which a person exhibits pervasive and widespread distrust and suspiciousness of others

most often male

Antisocial personality disorder (ASPD)

disorder in which a person uses other people without worrying about their rights or feelings and often behaves in an impulsive or reckless manner without regard for the consequences of that behavior

Dark Triad

Dark Triad of ASPD

1. Machiavellianism = cynical and deceitful

2. Narcissism = self-importance and entitlement

3. Psychopathy = low affect, antisocial, manipulative

Sadism — gaining joy from harming others

Borderline personality disorder (BLPD)

maladaptive personality pattern in which the person is moody, is unstable, lacks a clear sense of identity, and often clings to others with a pattern of self-destructiveness, chronic loneliness, and disruptive anger in close relationships

Dependent personality disorder

personality disorder in which the person is clingy, submissive, or fearful of separation

Causes of Personality Disorders

Cognitive-behavioral — specific behavior is learned through reinforcement & modeling

Genetic — close biological relatives of people with disorders are more likely to have the disorders

Other — disturbances in family relationships & communication, childhood abuse & neglect, overly strict parenting, overprotective parenting, parental rejection

Schizophrenia

a psychotic disorder in which there is an inability to distinguish what is real from fantasy as well as disturbances in thinking, emotions, behavior, and perception

Psychotic

an individual's inability to separate what is real from what is fantasy

Symptoms of schizophrenia

• delusions

• speech disturbances

• attention problems

• hallucinations

• emotional disturbances

must have at least two or more symptoms for at least 1 month to be diagnosed

Delusions

false beliefs held by a person who refuses to accept evidence of their falseness

Delusions of persecution

the belief that others are trying to hurt them in some way

Delusions of reference

the belief that other people, television characters, and even books are specifically talking to them

Delusions of influence

the belief that they are being controlled by external forces

Delusions of grandeur

the belief that they are powerful and can save the world or have a special mission

Speech disturbances

making up words, repeating words or sentences persistently, stringing words together on the basis of sounds, and experiencing sudden interruptions in speech and thought

Hallucinations

false sensory perceptions

auditory hallucinations are most common