Psychology Unit 5 - Psychological Disorders

Psych 101 - Mercer University

what is the medical model of psychological disorders?

views disorders as diseases, improves communication among professionals

what are the criticisms of the medical model

labeling, pseudoexplanations, passive patient role

labeling

Labeling is the process of classifying a cluster of symptoms into a standardized diagnostic category (using manuals like the DSM) to facilitate professional communication and determine the appropriate medical treatment.

pseudoexplanations

if something sounds like an explanation, but it really isn’t that is called a pseudoexplanation

passive patient role

when a person is too ill to make decisions, so they rely fully on the doctor to direct their care

diagnosis

identification of the actual disorder

etiology

cause of the disorder

prognosis

predicted outcome of the disorder

prevalence

how common the disorder is

onset

timing as to when symptoms actually occur

statistical abnormality

behavior that is rare or unusual compared to what most people do

maladaptive behavior

behavior that interferes with a person’s ability to funtion effectively in daily life

ex: banging head towards the wall

personal distress

individual emotional discomfort while still functioning everyday normally

continuum

there are degrees of abnormalities. there is a range or scale where changes happen gradually, with no clear dividing lines between one line and the next

stereotypes of mental illness

personal weakness, incurable, violent, bizarre

personal weakness

the mistaken idea that a person’s illness or struggles come from a lack of strength or willpower.

incurable

the false belief that a condition cannot improve or recover no matter what treatment is given.

violent and dangerous

the stereotype that someone is likely to harm others simply because of their condition

strange/bizarre behaviors

actions that are viewed as unusual or outside social norms, often misinterpreted without understanding the person’s experience.

neurosis

mental health condition where a person stays in touch with reality but struggles with anxiety and fear, or other distressing thoughts

psychosis

severe mental state where a person loses touch with reality and may experience hallucinations or delusions. seeing things, etc.

neurosis vs. psychosis

neurosis maintains reality with reality; psychosis loses reality with delusions/hallucinations

what is used to classify disorders

DSM-5: Diagnostic and statistical manual of the psychiatric association

Anxiety Disorder

1. Anxiety - 17% prevalence rate

GAD

generalized anxiety disorder - free floating anxiety, no specific threat, high autonomic arousal (palms sweating, heart racing, etc) - happens even while doing basic tasks

phobic disorder

irrational fear of object or situation; specific threat

mild: personal distress, maladaptiveness

panic disorder

• panic attack - random attacks of panic and thinking of panic-inducing things

• most panic attacks are often following a stressful period, not during it.
  

agoraphobia

• fear of public, wide open spaces, and crowds

• some with severe cases may become housebound, because they are afraid of even their backyard

• more common with women than men

• onset usually in late adolescence, early adulthood

panic disorder with agoraphobia symptoms

chest pains, sweating, numbness, and thinking he was gonna die

obsessive compulsive disorder (OCD)

• obsesstions: intrusive and recurring thoughts

  • always looking for germs, some sort of violence, or sexual thoughts

• compulsions - always doing ritualistic behaviors that serve no useful function (washing you hands after shaking someones hand or counting stairs or ceiling tiles)

• obsessions cause anxiety, compulsions reduce it

• 2-4% prevalence rate

obsessive compulsive personality disorder

people with this disorder have a preoccupation with orderliness, perfectionism and control. they are not flexible at all. they struggle to do things the way other people might.

etiology of anxiety disorders

biological factors, classical conditioning, observational learning/modeling, stress

biological factors

weak genetic disposition - if parent or grandparent had it, you might have it too. doesn’t mean you are destind to have it, but it is likely.

other biology - arousal, heart palptitations

neurotransmitters - lower GABA

classical conditioning

explains phobians and some anxiety disorders by showing how a neutral stimulus becomes associated with fear.

observational learning/modeling

if a mother is out gardening, and the garden snake appears and the mom goes running into the house and the child sees this, the child learns that the snake is dangerous.

stress

can also contribute to developing anxiety disorders

psyhosomatic disease

genuine physical problem with physical causes - affected by psychology

ex: ulcers because stress can increase stomach acid and weaken the protective lining, which makes the physical condition worse.

somatoform disorders

these disorders are psychological conditions in which a person experiences physical symptoms that cannot be fully explained by a medical condition, injury, or substance

symptoms are real to the person, but they stem from psychological factors

prior to diagnosis, lots of doctors have already been consulted for the disorder.

somatization disorder

variety of symptoms - someone with this disorder will have a large variety of physical symptoms but none have a medical cause (hand trembling, next week they are deaf, next week they cant walk, etc) with no physical cause

not hypochondriasis

conversion disorder

apparent loss of functioning in some part of their physical existence (ex., blindness, deafness, etc.)

glove anesthesia - loss of feeling from wrist to fingers, but can still feel the rest of the hand

• not possible because of the nerve structure in the palm.

hypochondriasis (somatoform disorder)

nothing wrong with the person but they keep thinking that something is wrong with them in terms of their health

might think they have brain cancer when they have a small headache.

usually have high knowledge of diseases, meds or treatment.

etiology of somatoform disorders

histrionic personality, the sick role

histrionic personality - somatoform disorders

making a big deal out of small things

• this can feed into making a big deal out of seeing a pimple and thinking it is cancer

the sick role

pattern of behavior that people fall into when they are sick. they want to be “taken care of” like a child, like you are when you are actually a child.

you are trained into thinking good things happen when you are sick, so you are “sick” all the time

dissociative disorders

loss of contact with part of consciousness or disruption with who you are as a person

dissociative amnesia

psychologically caused, not physically

main causes are severe stress or emotional trauma

varied time range - can forget everything about to to just a few miunutes that are blank

varied domains affected - specific event forgotten vs. entire identity.

procedural memory still intact - driving, tying shoes, etc.

dissociative fugue

everything from dissassociative amnesia applies here

they forget who they used to be and become a whole new person

etiology: stress and emotional trauma

dissociative identity disorder

multiple distinct personalities living in person that are all very different from each other and they all reside on one another. behavioral control shifts from one personality to another.

etiology: severe childhood emotional trauma

treatment: integration - the goal of therapy is to merge all the seperate personalities back into one unified identity

mood disorder - depressive disorder

symptoms:

dysphoria, anxiety, irritability, low self-esteem, lack of energy, disruption of eating and sleeping habits, anhedonia (including sex drive), loss of interest in social activities

prevalence - 7% of people will experience some form of depressive disorder in their life

anhedonia

the things that make you happy dont make you happy anymore

bipolar disorder

2 extremes: extremely happy or extremely sad

• euphoria - increased energy, optimism, decreased need for sleep, feelings of invulnerability, mind racing

• mania is not a mild feeling. impossible to feel mania forever. will eventually crash

• onset usually 24-31; no gender difference

• treatment: lithium for mood; anti-psychotics if needed

Mood disorders etiology - genetic predisposition

if parents had it, u are likely to have it

Mood disorders etiology - neurotransmitter imabalances

lower norepinephrine - for energy and serotonin

serotonin - for mood

dopamine - for addictions

treatment: drugs to raise the level of these neurotransmitters

Mood disorders etiology - stress

can trigger predisposition

can ause a mood disorder even int he absence of a genetic predisposition or neurotransmitter imbalance

schizophrenic symptoms

irrational thoughts and delusions

no logical thought between one thought and another

examples of positive symptoms for schizophrenia (things added)

delusions, hallucinations, disorganized speech, bizarre behaviors

negative symptoms of schizophrenia (things taken away)

flat affect, poor hygiene, lower persistence/effort at work/school

course and outcome factors for schizophrenia

sudden and later onset predict better results. social support helps.

etiology of schizophrenia

strong genetic disposition, neurotransmitter (dopamine), brain structures

strong genetic disposition - schizophrenia

identical twins have a 48% chance of getting if one of the 2 twins get it

fraternal twins drops down to 17%

no relationship: 1-1.5% of population

if 2 schizophrenic parents make a child, the child has a 46% chance of getting schizophrenia

neurotransmitter - schizophrenia

too much dopamine can lead to these symptoms

brain structures (ventricles)

empty spaces in your brain called ventricles and some evidence that shows schizophrenia people have larger ventricles than non-schizophrenic people

personality disorder video - obsessive personality traits

perfectionism, orderliness, rigidity

personality disorder video - narcissistic personality traits

inflated self-importance, need for admiration, low empathy

personality disorder video -antisocial personality disorder traits

criminal behavior, rule breaking, lack of remorse

4% of population

personality disorder video - antisocial personality disorder traits biological links?

low serotonin function

object correlation relationship

if a baby looks into your eyes and sees happiness and pleasure, the baby also feels happy and feels pleasure

personality disorder video - borderline personality disorder traits

instability, impulsivity, emotional swings, fear of abandonment, self-destruction

causal factors - BPD

• Environmental Factors: Many people with BPD report childhood trauma, abuse, neglect, or separation from caregivers.

• Brain Structure: Potential changes in areas of the brain that control impulses and emotional regulation.

who provides treatment of psychological disorders?

• Clinical psychologist (Ph.D.; Psy.D.)

  • Theory-based treatment

• Counseling Psychologist (M.S., Ph.D.)

  • Don't really deal with any of the disorders we’ve discussed

• Psychiatrist (M.D.)

  • Medical treatment’

  • A physician, just like any other doctor, chose to specialize in disorders

• Clinical psychologists can’t prescribe, will refer to psychiatrist if he/she thinks necessary

Behavior therapies

• Systematic desensitization - treatment for phobias 

  • Very effective

  • If someone hs phobia of spider, the first step would be to close your eyes and visualize the spider in your head. The person will probably start reacting and the therapist will probably teach the person different relaxation methods. Can teach a person how to control thay response. 

exposure therapy

• Patient is exposed to a feared situation in a controlled setting

  • Learned that the situation is harmless (classical conditioning)

  • Even via virtual reality

  • Useful for a variety of anxiety disorders (OCD, agoraphobia, PTSD)

aversion therapy

• Classical conditioning

• basically pairing a behavior with something negative to stop it.

  • Ex: shocking a pedophile everytime he looks at a picture of a child or smt

Social skills training

• Poor social skills can impair interpersonal relationships

  • Being friendly, small talk, and appropriate self-disclosure

  • Expressing anger

• Role-playing with a therapist, videos

Cognitive behavioral therapy (CBT)

• Change maladaptive thinking

  • overgeneralizing , dwelling on the negative, spiraling

• Teach the patient coping skills & strategies

  • Teaching how to navigate these difficulties

  • Effectiveness of CBT is well-researchd, validated

Biomedical therapies

• Most disorders have medication that can be used to deal with the symptoms

• Tranquilizers - dealing with anxiety disorders

  • Valium, xanax

Antipsychotics

• First-generation drugs (older)

  • Chlorpromazine (mild)

  • Haloperidol (haldol; strong, beh suppression)

• Side effects (trembling/rigidity, tardive dyskenisesia - loss of control around the mouth)

• Many newer (second gen) drugs today (less TD risk)

• Relapse when off

antidepressants (depressive disorders)

• Prozac, elavil, paxil, zoloft

• SSRIs, have been shown to increase suicide risk

Mood stabilizers (bipolar disorder)

Lithium

Electroconvulsive therapy (ECT)

• Sending a current through persons brain to make the brain convulse

• Severe depression

• Enough to make other treatments effective

• Controversial