psychological disorders

psychological disorders

persistently harmful thoughts, feelings, and actions

criteria that define disorder

one's behavior is deviant, distressful, and dysfunctional, ultimately can impair one's ability to function

deviant

out of the norm

distressful

causes discomfort for the individual

dysfunctional

is maladaptive (unhealthy)

how many american adults have experienced symptoms of psych disorders during the previous year (according to NCS-R)

approximately 1 out of 4, 26%

what else did the NCS-R find

most people in the US with symptoms of mental disorder (59%) received no treatment during the past year. of those who did treatment provided was often inadequate

reasons people don't seek mental health treatment

- lack of insurance

- low income

- live in developing countries where facilities are not available

- lack of awareness

- fear of being stigmatized

most people manage to weather psych symptoms without needing professional intervention or becoming debilitated, why?

mild/moderate symptoms diminish with passage of time and improvements of the person's overall situation

DSM: diagnostic and statistical manual of mental disorders (DSM-5 tr)

system for classifying psychological disorders-> ultimately used to identify disorders.

classification: orders and describes symptoms

main problem of DSM

concept of labeling.

labeling effects how we perceive others.

DSM-5 tr:

- describes more than 260 specific psychological disorders

- provides codes for each disorder

- provides symptoms, frequency, and typical course and risk factors for each disorder.

- describes the specific criteria that must be met for diagnoses

according to the course text, DSM has been criticized for what?

use of ARBITRARY CUTOFFS to draw the line between people with and without a particular disorder

anxiety

an unpleasant emotional state characterized by physical arousal and feelings of tension, apprehension, and worry

anxiety disorders

extreme anxiety is the main diagnostic feature and causes significant disruptions in the person's cognitive, behavioral, or interpersonal

generalized anxiety disorder (GAD)

a person is unexplainably and continually in a state of tension, apprehension, and autonomic nervous system arousal. anxiety can be attributed to a variety of factors

physiological symptoms of anxiety:

heart palpitations, shortness of breath, dizziness, sweaty palms, feeling edgy and shaking

panic disorder

an anxiety disorder where the anxiety suddenly and frequently escalates into a terrifying panic attack

panic attack:

a sudden episode of extreme anxiety that rapidly escalates in intensity

- unpredictable minutes-long episodes including feelings of intense dread and terror, shortness of breath, dizziness, heart palpitations, chest pain, choking sensations and other frightening sensations.

people with panic disorder are often hypersensitive to what?

signs of physical arousal

triple vulnerabilities model of panic disorder includes:

- a biological predisposition toward anxiety (genetic)

- a low sense of control over potentially life-threatening events (fear of what could happen, feeling out of control)

- an oversensitivity to physical sensations

all combine to make a person more vulnerable to panic

agoraphobia

extreme fear of experiencing a panic attack or other embarrassing or incapacitating symptoms in a public situation and avoidance of situations in which escape might be difficult or help unavailable.

conversion disorder (somatic symptom disorders)

a type of somatic symptom disorder which involves a pattern in which symptoms or deficits affecting sensory or voluntary motor functions lead one to think that a patient has a medical or neurological condition (partial paralysis, blindness, deafness, etc.) does not intentionally produce or fake symptoms and can respond to treatment

phobias

a persistent and irrational fear of a specific object, situation, or activity

in general population, mild irrational fears that don't significantly interfere with a person's ability to function and are very common

most cope without being overwhelmed with anxiety so would not be diagnosis with a psychological disorder

specific phobia (simple phobia):

an excessive, intense and irrational fear of a specific object, situation, or activity that is actively avoided or endured with marked anxiety

incapacitating terror and anxiety interfere with the person's ability to function in daily life

13% of general population at some point will suffer from a phobia, and twice as many women as men

five categories of specific phobia:

- fear of situations (flying, driving, tunnels, bridges, elevators, crowds, enclosed places)

- fear of features of the natural environment(heights, water, thunderstorms, or lightening)

- fear of injury or blood (injections, needles, medical or dental procedures)

- fear of animals and insects (snakes, spiders, dogs, cats)

- other (vomiting, choking, clowns)

social anxiety disorder (social phobia)

extreme and irrational fear of being embarrassed, judged or scrutinized by others in social situations. avoids specific places and situations such as public speaking, eating out, parties, etc., or will suffer while doing so. will ultimately appear as extremely shy.

obsessive-compulsive disorder (OCD)

disorder in the category of obsessive compulsive and related disorders, characterized by intrusive, repetitive, and unwanted thoughts (obsessions) and/or repetitive behaviors or mental acts that an individual feels driven to perform(compulsions).ultimately believe will prevent something bad from happening.

most common types of compulsive rituals:

- washing

- checking

- symmetry and precision (ordering/arranging)

- counting

most common types of obsessions:

- contamination

- pathological doubt

- violent or sexual thoughts

post-traumatic stress disorder (PTSD)

anxiety disorder characterized by exposure to a highly traumatic event which results in recurrent, involuntary and intrusive memories of the event, avoidance of stimuli and situations associated with the event, negative changes in thoughts, moods and emotions, and a persistent state of heightened physical arousal

some people are more vulnerable to PTSD because:

- vulnerability to PTSD can be inherited

- personal or family history of psychological disorders are more likely to develop PTSD when exposed to an extreme trauma

- magnitude of the trauma

- multiple traumas

traumatic event

experiencing or witnessing severely threatening, uncontrollable events with fear, helplessness or horror. can produce PTSD

acute stress disorder

the reaction from traumatic stress from 3 days after the event that can last for up to 4 weeks.

without the extreme symptoms, adjustment disorder would be more appropriate

dissociative experience (dissociative disorders)

a break or disruption in consciousness during which awareness, memory and personal identity become separated or divided

a temporary mild dissociative experience, a temporary "break"/"separation" in your memory or awareness is NORMAL

dissociative disorders

a category of psychological disorders in which extreme and frequent disruptions of awareness, memory, and personal identity impair the ability to function

two categories of dissociative disorders:

1. dissociative amnesia (can occur with or without dissociative fugue)

2. dissociative identity disorder

dissociative amnesia

dissociative disorder involving the partial or total inability to recall important personal information. Response to stress, trauma, or an extremely distressing situation

dissociative fugue (fyoog)

a type of dissociative amnesia involving sudden and unexpected travel away from home, extensive amnesia, and identity confusion

stress-related, though unclear why and how this happens. when "awakened" person remembers the past but not the fugue state.

dissociative identity disorder (DID)

(multiple personality disorder) involves extensive memory disruptions along with the presence of two or more distinct identities or "personalities"

considered to result from efforts of traumatized victims to detach themselves from the experience of severe and prolonged abuse.

DID is usually associated with which other psych disorders?

major depressive disorder, anxiety, PTSD.

not all are convinced DID is a genuine psych disorder. 1970's became popular due to media

personality disorders:

maladaptive patterns of thoughts, emotions, and interpersonal functioning that are stable over time and across situations, and that deviate from the expectations of the individual's culture.

cluster A- odd, eccentric cluster of personality disorders:

- paranoid personality disorder

- schizoid personality disorder

- schizotypal personality disorders

paranoid personality disorder

exhibits pervasive mistrust and suspiciousness of others. see others as out to get them or as a threat.

schizoid personality disorder

pervasive detachment from social relationships, emotionally cold and flat, indifferent to praise or criticism from others, preference for solitary activities, lacking close friends, emotionless disengagement

schizotypal personality disorder

odd thoughts, speech, emotional reactions, mannerisms, and appearance, impaired social and interpersonal functioning

cluster B- dramatic, emotional, erratic cluster:

- antisocial personality disorder

- borderline personality disorder

- histrionic PD

- narcissistic PD

- borderline PD

- antisocial PD

antisocial personality disorder

borderline personality disorder

histrionic PD

shallow, attention-getting emotions and goes to great lengths to gain others' praise and reassurance

narcissistic PD

exaggerate their own importance, have lots of success fantasies, can't accept criticism, often responds with rage or shame

borderline PD

personality disorder characterized by instability of interpersonal relationships, self-image, and emotions, and marked impulsivity.

views world in black and white. poor impulse control, self-defeating behavior including self harm, irrational emotions.

biosocial developmental theory of BPD:

the viewt hat bpd is the outcome of a unique combination of biological, psychological, and environmental factors. some children are born with a biological temperament that is characterized by extreme emotional sensitivity, impulsivity, and more negative emotions. More vulnerable to BPD esp. when caregivers do not teach proper tools when childrearing.

antisocial personality disorder

most troubling personality disorder, exhibits a lack of conscience for wrongdoing, aggressive, ruthless, clever con artists. pervasive pattern of disregarding and violating the rights of others. does not experience guilt or remorse.

typically seen in childhood and adolescence.

cluster c- anxious, fearful cluster:

- avoidant personality disorder

- dependent personality disorder

- obsessive compulsive disorder

avoidant personality disorder

fearful sensitivity to rejection

dependent personality disorder

excessive need to be taken care of, submissive, clinging, fear of separation, inability to assume responsibility

obsessive-compulsive personality disorder

rigid preoccupation with orderliness, personal control, rules or schedules, that interfere with completing tasks, unreasonable perfectionism.

mood disorders

psychological disorders characterized by emotional extremes that come in two forms resulting in disturbed emotions that cause psychological distress and impair daily functioning:

1. major depressive disorder

2. bipolar disorder

major depressive disorder

a mood disorder characterized by extreme and persistent feelings of despondency, worthlessness, and hopelessness, causing impaired emotional, cognitive, behavioral, and physical functioning.

must last for 2 or more weeks

commonly the onset is result of stressful life events

what is the "common cold" of psychological disorders

major depressive disorder

- women are twice as likely as men to be diagnosed with major depressive disorder why?

-> considered due to a greater degree of chronic stress in daily life combined with lesser sense of personal control then men

- considered more prone to dwell on problems

seasonal affective disorder (SAD)

mood disorder with episodes of depression typically occurs during the fall and winter and subside during the spring.

(most common amongst women and those who live in northern latitudes)

persistent depressive disorder (dysthymic disorder)

a disorder involving chronic feelings of depression that is often less severe than major depressive disorder.Ultimately a chronic case of the blues that usually continues for years

what is depression the result of?

learned helplessness: self-defeating beliefs after experiencing uncontrollable painful events

depressed people tend to explain bad events in terms that are:

- stable (will last forever)

- global (effects everything, pervasive negativity and internal pessimism, often results in suicidal thoughts and preoccupations with death)

- internal (its all my fault)

common amongst people with depression:

- about 10% suffering with major depressive disorder attempt suicide

- abnormal sleep patterns are common with sporadic awakenings at night

biochemical key of depressed brain:

neurotransmitters: messenger molecules that shuttle signals between nerve cells

neurotransmitters that are scarce during depression

norepinephrine and serotonin

drugs that alleviate mania reduce which neurotransmitter?

norepinephrine

bipolar disorder

involving periods of extreme euphoria and excitement and alternating periods of normalcy, and sometimes periods of incapacitating depression. (formerly called manic depression)

euphoric (manic) episodes

a sudden, rapidly escalating emotional state characterized by extreme euphoria (mania), excitement, physical energy, and rapid thoughts and speech. poor sleep and grandiose thinking

symptoms of a manic episode:

- uncharacteristically euphoric and excited for several days or longer

- unable to sleep but boundless energy

- wildly inflated self-esteem, supreme self-confidence (often grandiose plans for obtaining wealth, power and fame and sometimes delusional)

- rapid speech (thoughts race faster)

- easily triggered flight of ideas (shifts of topics)-grandiose, agitated or verbally abusive when questioned

consequences of manic episode:

- run up bills

- disappear for weeks

- sexual promiscuous

- commit illegal acts

(far less common than major depressive disorder and no differences between the sexes)

cyclothymic disorder:

mood disorder characterized by moderate but frequent mood swings that are not severe enough to qualify as bipolar disorder.

- can have mood swings for two years or longer

- usually perceived as being extremely moody, unpredictable, and inconsistent

onset of depressive and bipolar disorders:

- genetic predisposition

- differences in the activation of structures in the brain

- disruptions in brain chemistry (abnormal levels of neurotransmitters)

- stress

- cigarette smoking

schizophrenia

psychological disorder in which the ability to function is impaired by severely distorted beliefs, perceptions, and thought processes

- translated means "split mind"

characteristics of schizophrenia: 1. disorganized thinking

thoughts that are fragmented, bizarre, and distorted by false beliefs (delusions)

delusions: false beliefs that persists despite compelling contradictory evidence

types of delusions:

delusions of reference: reflect the person's false conviction that other people's behavior and ordinary events are somehow personally related to them (they are talking about me, the tv is talking to me, etc)

delusions of grandeur: belief that the person is extremely powerful

delusions of persecution: believe others are plotting against them or trying to harm them or someone close to them

delusions of being controlled: the belief that outside forces (aliens, government, random people)

somatic: the belief that the person has a physical defect or medical problem

jealous delusions: cause a person to believe that their partner is unfaithful and constantly look for evidence that their belief is true

mixed of unspecified delusions: mixed delusions means that the person has multiple types of delusions, but none are more common than another

(unspecified delusions don't fit into a specific category)

characteristics of schizophrenia: 2. disturbed perceptions

perceive things that are not there (hallucinations)

most common, auditory and visual hallucinations. usually connected to delusional thinking. major episode, impossible to distinguish from reality

3. inappropriate thought processes (emotions and actions: deficits in behavioral or emotional functioning)

- perform senseless compulsive acts.

- flat affect (emotionless expression)

- catatonic (remain motionless for hours on end followed by agitation)

- alogia: greatly reduced production of speech with limited/brief, empty comments.

- avolition: inability to initiate or persist in even simple forms of goal-directed behaviors (dressing, bathing, engaging in social activities).

categories of symptoms in schizophrenia include:

positive and negative symptoms

negative symptoms of schizophrenia:

toneless voices, flat affect (emotionless face), rigid bodies, alogia, and avolition. reduced emotionless expression. the absence of appropriate behavior.

positive symptoms of schizophrenia:

experience delusions, hallucinations, disorganized speech, and inappropriate behaviors—the presence of inappropriate behavior.

causes of schizophrenia

- excess of receptors for dopamine, believed to cause increased positive symptoms.

- genetic factors: beyond question.

- enlargement of the ventricles in the brain.

- abnormal shrinkage of brain tissue in the cerebral cortex.

- low brain activity in the frontal lobes.

- smaller than normal thalamus.

- prenatal viral infections.

- loss of gray matter tissue and lower overall volume of the brain is associated with clinical symptoms and decreased cognitive functioning among those with schizophrenia.

[no single biological, psychological, or social factor as a causal agent]

psychological therapies (psychotherapy)

is a planned, emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties.

most common therapeutic mentalities:

- psychoanalytic perspective

- humanistic perspective

- psychodynamic perspective

- behavioral perspective

- cognitive perspective

- cognitive behavioral perspective (CBT)

- positive psychology

whats a psychoanalysts job

to bring these repressed feelings into conscious awareness where patients can deal with them

psychoanalysis was developed by who?

sigmund freud in 1900's

what did freud assume about our psychological problems?

our psychological problems are fueled by childhood repressed conflicts stored in the unconcious

whats the result of patients being conscious of their repressed feelings

patients develop more adaptive emotions and patterns of behavior when they achieve insight and resolve the unconscious conflicts that were maintaining maladaptive emotions and behavior.

techniques in psychoanalysis include free association and dream analysis:

free association: the patient spontaneously reports all her thoughts, mental images, and feelings while lying on a couch

psychoanalyst usually sits out of view and asks questions to encourage flow of associations

what are blocks of free association thought of as

blocks in free association, such as sudden silence or abrupt change of topic were thought to be signs of resistance

resistance:

the patient's conscious orunconscious attempts to block the process ofrevealing repressed memories and conflicts.

dream interpretation (another psychoanalytic technique)

interpretations: explanations of the unconscious meaning of the patient's behavior, thoughts, feelings or dreams

- defensive responses increase resistance

transference:

the patient transfer's emotions and desires originally associated with significant persons in the patient's life unconsciously onto the psychoanalyst.

how does a therapist purposely remain?

therapist purposely remains neutral to produce "optimal frustration" in the patient, so they transfer and project unresolved conflicts onto the psychoanalyst.