chapter #15 - texbook

abnormal behaviour (3)

• mental illness

• psychological disorders

• psychopathology

historical understanding of mental illness

• people who behaved strangely were thought to be possessed by a demon

  • witches in league with the devil

  • victim of god’s punishment

medical model

• useful to think of abnormal behaviour as a disease

diagnosis

• distinguishing one’s illness from another

etiology

• apprentice causation and dvelopmental history of an illness

prognosis

• forecast about the probable course of an illness

criteria of abnormal behaviour (3)

• deviance

• maladaptive behaviour

• personal distress

deviance

• behaviour deviarws from what their society considers acceptable

maladaptive behaviour

• everyday adaptive behaviour is impaired

  • key crieria in substance use disorders

personal distress

• individuals report of great personal distress

stereotypes of psychological disorders

• incurable

• people are violent and dangerous

• peole with psychological disorders behave in bizarre ways

  • difficulty distinguishing normality from abnormality

DSM

• diagnostic statistical manual of mental disorders

• classifying psychological disorders

• place people in categories

epidemiology

• study of distribution of mental or physical disorders in a population

prevalence

• percentage of a population that exhibits a disorder during a specified time period

anxiety disorders

• feelings of excessive apprehension and anxiety

  • can be chronic

  • levels of anxiety with disturbing regularity

  • develop one then suffer from another

• generalized anxiety disorder

• chronic, high level of anxiety that is not tied to any specific threat

  • free-floating anxiety

  • worry about yesterday’s mistakes and tomorrow’s problem

  • worry about minor matters

    • muscle tension, diarrhea, vomiting, faintness, sweating, heart palpitations

specific phobia

• persistent and irrational fear of an object or situation that presents no real danger

  • can develop phobic responses to anything

  • origins lie in part in the visual similarity of the configurations to something dangerous

  • fears are irrational

  • unable to calm themselves when confronted by a ohobic object

panic disorders

• recurrent attacks of overwhelming anxiety that usually occur suddenly and unexpectedly

agoraphobia

• concerned about exhibiting panic in public

  • fear of public spaces

obsessive compulsive disorder

• uncontrollable intrusion of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions)

  • lost control of their mind and may be plagued by uncertainty

  • rituals that temporarily relieve anxiety

body-dysmorphic disorder

• unrelenting pre-occupation with what they perceive to be a physical flaw

excoriation

• skin picking

collyer brothers syndrome

• inability to dispose of things

  • families enable the hoarding

hoarding disorder

• difficulty discarding posessions

  • no matter how worthless

• hang on to items to avoid stress of throwinf them out

• hoard to extent that posessions disrupt normal lives

PTSD

• any variety of traumatic event

• does nut surface until after the stressor happens

• re-experincing traumatic event

potential causation of PTSD:

• intensity of ones reaction at the time of the traumatic event

• intense emotional reactions during or after the traumatic event → increased vulnerability to PTSD

complex post traumatic stress disorder

• broader

• dysregulation

• difficulties in relationships

• negative self-conceptm

etiology of anxiety

• biological factors

• conditioning and learning

• cognitive factors

• stress

biological factors of anxiety

• disturbances in neural circuits using GABA may play a role in some types of anxiety disorders

• genetic predisposition to anxiety drugs that reduce anxiety alter nt activitiy at synapses that release GABA

conditioning and learning

• anxiety responses may be acquired through classical condiioning and maintained through operant conditioning

• once a fear is acquired through classical conditionng the person may start avoiding anxiety-producing stimulus

preparedness

• people are biologically prepared by their evolutionary history to acquire fears much more easily than others

evolved module for fear learnining

• automatically activated by stimuli related to survival threats in evolutionary history

• resistant to intentional efforts to suppress the resulting fears

cognitive factors and anxiety

• certsin styles of thinking make people vulnerable to anxiety

• some people are prone to anxiety disorders cause they see thrat in every corner of their lives

suffer from problems with anxiety cause they tend to:

• misinterpret harmless situations as threatening

• focus excessive attention on perceived threats

• selectively recall info that seems threatening

executive function

• basic cognitive processes that underlies self-regulation, planning and decision making

stress and anxiety

• severe stress in childhood may increase vulnerability to disorders later

• linked early-life stress to an increased prevalence of mental disorders

• adversity in childhood may alter features of developing brain structure

• reactivity of HPA axis that regulates hormonal responses to stress

dissociative disorders

• people lost contact with portions of their consciousness or memroy

• disruptions in their sense of identity

dissociatie amnesia

• loss of memory for important personal info that is too extensive to be due to normal forgetting

  • can occur for single traumatic event or for an extended peropnd of time surrounding the event

  • rememeber matters unrelated to their identity

    • how to drive a car

    • do math

dissociative identity disorder

• disruption of identity

• 2+ personalities

  • different

  • divergences in behaviour go beyond those that people normally display in adapting to different roles in life

  • exhibit somatic symptoms

  • personalities are unaware of each other

etiology of DID

• individual identities in them are to blame for their behaviours, unpredictable moods and ill-advised actions

• attribute unique traits and memories to imaginary or alternate personalities

depressive and BPD

• people with these disorders may still achieve gratness cause they tend to be episodic

• episodes usually last 3-12m

mood disorders

• emotional disturbances of varied kinds that may spill over to disrupt physical, perceptual, scial and thought processes

major depressive disorder

• emotional extremes at oe end of the mood continuum because they experience periodic bouts of depression

• link between normal dejection and unhappiness and abnormal depression

• people show persistent deelings of sadness and despair and a a loss of interest in previous sources of pleasure

earlier onset of major dpressive disorder

• more recurrences

• severe symptoms

• worse prognosis

uncomplicated depression

• individuall eventually recovers and are no more likley to have a recurrence of depression than people with no history of a depressive disorder

anhedonia

• diminsihed ability to experience pleasure

  • central feature of depression

  • premenstrual dysphoric disorder

  • persistent depressive disorder

  • disruptive mood dysregulation disorder

bipolar disorder

• manic states are addictive

• escalate to higher levels that become scary and disturbing

• seen equally in males and females

bipolar i

• one or more manic epsiodes as well as periods of depression

bipolar ii

• epsiodes of major depression along with hypomania in which their change in mood and behaviour is less severe than thos ein full mania

manic episodes

• persons mood becomes elevated to the point of euphoria

cyclothymic disorder

• chronic

• mild syndrome of bpd

• hypomanic and depressive symptoms

  • do not meet full criteria

seasonal affective disorder

• type of depression that follows a seasonal pattern

postpartum depression

• type of depression that sometimes occur after childhood

etiology of depressive and BPD: genetic vulnerability

• genetic factors influence the likelihood of developing major depression and bpd

• disparity between identical and fraternal twins in concordance rates for mood disorders

• hereditary can create a predisposition to mood dysfunction

etiology of depressive and BPD: neurochemical and neuroanatomical factors

• correlations between mood disorders and abnormal levles of norepinephrine and serotonin

• reduced activation in specific areas of the brain that process the anticipation and experience of reword and reinforcement

low levels of serotonin

• underlying most forms of depression

etiology of depressive and BPD: cognitive factors

• roots of depression lie in how people explain the setbacks and other negative events they experience

• pessimistic explanatory style are vulnerable to depression

• depressed people who ruminate about depression remain depressed longer

learned helplessness

• passive giving up

• exposure to unavoidable aversive events

hindsight bias

• tendency to mould ones recall of the past to fit with how events turned out

• may help fuel depression

• view negative outcomes as foreseeable and inevitable

etiology of depressive and BPD: interpersonal roots

• inadequate social skillls

• lack social finesse needed for important reinforcers

• social rejection and lack of support may aggravate and deepen depression

etiology of depressive and BPD: precipitating stress

• strong link between stress and the onset of both major depression and bpd

• aversive stressors are more likely to trigger depression

schizophrenia

• delusions

• hallucinations

• disorganised speexh

• deterioration of adaptive behaviour

  • high visibility because of the severity of the illness and cause of they way its been portrayed

schizophrenia: symptoms

• delusions and irrational thought

• deterioration of adaptive behaviour

• hallucinations

• disturbed emotions

delusions

• false beleifs that are maintained even though they are out of touch with reality

  • private thoughts are being broadcasted to other people

  • thoughts are injected into their minds

  • thoughts are being controlled by external force

delusions of grandeur

• people maintain that they are famous or important

delusions of persecution

• brief suspicions about strangers behaviour to enduring concerns about elaborate plots attributed to family and friends

deterioration of adaptive behaviour

• noticeable deterioration in the quality of te persons routine functionnig in work, social relationships and personal care

hallucinations

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

  • hear voices

  • insulting,running commentary on the persons behaviour

  • argumentative

  • issue commands

disturbed emotions

• show little emotional responsiveness

• show inappropriate emotional responses

4 subtypes of schizophrenic disorders

• paranoid

• catatonic

• disorganized

• undifferentiated

paranoid schizophrenia

• delusions of persecution + grandeur

catatonic schizophrenia

• motor disturbances

• muscular rigidity

• catatonic excitement

  • withdrawn state

disorganized schizophrenia

• frequent incoherence

• deterioration in adaptive behavior

• complete social withdrawal

undifferentiated schizophrenia

• idiosyncratic mixtures of schizophrenic symptoms

positive symptoms

• behavioural excesses or peculiarities

• hallucinations

• delusions

• incoherent thought

• agitation

• bizarre behaviour

negative symptoms

• behavioural deficits

• flattened emotions

• social withdrawal

• apathy

• impaired attention

• poor grooming

• lack of persistence

• poverty of speech

etiology of schizophrenia: genetic vulnerability

• hereditiary

• genetics may account for 80%

• iq moderates the effect of genetic vulnerability as low IQ amplifies genetic risk

etiology of schizophrenia: neurochemical factors

• dopamine dysregulation

• structural abnormalities in the brain

• neurodevelopmental hypothesis

• expressed emotion

• precipitating stress

dopamine hypothesis

• excess dopamine activity is the neurochemical basis for schizophrenia

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

• elevated dopamine → foster positive symptoms

• reduced dopamine → foster negative symptoms

structural abnormalities in the brain: schizophrenia

• schizophrenienlarged ventricles and schizophrenic disturbance

  • degeneration of nearby tissue

• smaller hippocampus, thalamus and amygdala

neurodevelopmental hypothesis

• disruptions in normal maturation processes before and after birth

• insults to the brain during prenatal development can cause neurological damage

• viral infection or malnutrition

expressed emotion

• degree to which a relative of a schizophrenic patiend displays critical or emtoionally overinvolved attitudes towards the patient

high in expressed emotion

• relapse rates 3x of that of patients who have family low in expressed emotion

  • source of stress rather than social support

precipitating stress: schizophrenia

• biological and physiological factors influence individual vulnerability to schizophrenia

• patients who show strong emotional reaction to events are likely to have symptoms exacerbated by stress

personality disorders

• inflexible personality traits

• cause subjective distress or impaired social and occupational functioning

  • recognizable during adolescence or early adulthood

3 clusters

1. anxious/fearful

2. odd/eccentric

3. dramatic/impulsive

antioscial

• reject widely accepted social norms regarding normal principles

  • chronically exploit others

antisocial personality disorder

• impulsive, callous, manipulative, aggressive and irresponsible

  • rarely feel guilty about transgressions

  • lack conscience

  • rarely experience affection

  • tolerate little frustraton

  • psycopathy

borderline personality disorder

• instability in social relationshiops, self image and emotional functionng

  • fear of abandonment

  • switch between idolizing and devaluing themselves

  • frequent anger issues

  • impulsive

  • elevated risk for self injury

narcissistic personality disorder

• grandios sense of self importace, sense of entitlement and excessive need for attention and admiration

  • unique and superior to others

  • self-esteem is frafile

  • fish for compliments and threatend by criticism

etiology of personality disorders: genetic and environment (3)

• cognitive styles

• coping exposure

• exposure to stress

influenced by heredity

contributing factors to antisocial personality disorder

• dysfunctional familu

• erratic discipline

• parental neglect

• exposure to violence in one’s community