PSYC 102: Chapter 13 Textbook

Psychological Disorder

• a clinically significant disturbance in an individual’s cognition, emotional regulation, or behavior that is usually associated with significant distress or disability in social, occupational and other important activities

• psychological disorders are syndromes that tend to occur simultaneously

Syndrome

A cluster of physical or mental symptoms that are typical of a particular condition or psychological disorder and that tend to occur simultaneously

Symptom

A physical or mental feature that may be regarded as an indication of a particular condition or psychological disorder

Psychopathology

• the scientific study of psychological disorders or the disorders themselves

Abnormal Psychology

• seeks to characterize the nature and origins of psychological disorders

Clinical Psychology

• the assessment and treatment of psychological disorders

To qualify a psychological disorder

A syndrome must not be:

a) an expectable response to common stressors and losses

b) a culturally approved response to a particular event

c) simple deviance from social norms

Socially acceptable behavior varies across cultures and over time, so it’s important to take social context into account when assessing whether an individual’s thought, feelings and behaviors are the result of a psychological disorder

Prevalence

Refers to how widespread a disorder is

Point prevalence: the percentage of ppl in a given population who have a given psychological disorder at a particular point in time

Lifetime prevalence: the percentage of people in a certain population who will have a given psychological disorder at any point in their lives

Psychological Disorder Statistics

• nearly half of the U.S population will experience at least one psychological disorder during their lifetime

• more than a quarter will experience two or more disorders

• a larger number of people are indirectly affected by these disorders

  • friends, family, coworkers and neighbors of those with a psychological disorder

DSM-5: Diagnostic and Statistical Manual of Psychological Disorders

• provides specific definitions for each of the different psychological disorders

  • makes it possible to determine which disorder, if any, a particular client has

  • provides 20 categories of psychological disorders

• each definition consists of lists of specific criteria, a certain number of which much be met for the disorder to be diagnosed

• diagnoses are important because they are the first step in understanding why clients are suffering and how they can be helped

• includes an appendix listing disorders that seem to appear in only some cultures

  • some of the disorders listed in the main section of the DSM-5 may vary by culture

• all of the DSM-5’s diagnostic categories are best understood in terms of their cultural setting

Clinical Assesment

• A procedure for gathering the information that is needed to evaluate a client’s psychological functioning and to determine whether a diagnosis is warranted

• often begin with a clinical interview

• the clinician’s goal is to explore the client’s current mental state, life circumstances and history

  • they pay careful attention to what clients say are concerns

  • look for any behaviors that may hint at difficulties that the clients are not reporting (eg. avoiding eye contact, shaking visibly)

  • they are alert to discrepancies between what they observe and problems that clients report

Clinical Interview

• Interview in which the clinician asks the client to describe their problems and concerns

• the full pattern of a client’s problems, together with their onset and course, usually allows the clinician to form an opinion as to whether the client has a psychological disorder

• clinicians may revise the diagnosis as they gain new information about the client’s current life circumstances and history, family and cultural background, and even how the client responds to a particular form of treatment

Self-Report Measures

• A standardized clinical assessment tool that consists of a fixed set of questions that a patient answers

• some are brief and target a well-defined set of symptoms

Projective Tests

• the client is asked to respond to unstructured or ambiguous stimuli

• in responding to these stimuli, clients cannot help but impose a structure of their own

• in the process of describing (or relying on) this structure, they are thought to provide valuable information about unconscious wishes and conflicts (implicit or hidden motives)

• not the most effective tests, lacking in validity

How are psychological disorders classified?

1) International Classification of Diseases published by WHO

• used to classify the diseases and health problems recorded in health records and death certificates

• there is a section on mental and behavioral disorders

2) DSM by American Psychiatric Association

• the standard guide in U.S on psychological disorders

Goals of DSM-5 Revision

• make the DSM as useful as possible for clinicians and clients

• ensure that changes were based on research evidence

• maintain continuity with prior editions whenever possible

• reflect the current scientific evidence

Benefits of Diagnostic Labels

-improved treatment of psychological disorders

-ensures that clients get the appropriate treatment

-help create a uniform framework for describing the difficulties a client is having, allowing the many different healthcare providers who work with the same client to coordinate treatments

-may provide relief and motivate the client to seek and obtain treatment

-facilitate research on psychological disorders

-otherwise wouldn’t know whether we could compare the results of different studies or pool results

-wouldn’t know how common any given disorder is

• wouldn’t be able to make rational decisions about how to allocate the resources that are available for research purposes

Downsides of Diagnostic Labels

-difficult to know which treatment to provide

-stigma is attached to psychological disorders

• people with psychological disorders and their family members are often viewed negatively

• affects how we perceive someone and how they perceive themselves

-self-defeating and destructive attitudes are reinforced by media portrayals of people with psychological disorders as violent criminals

-labels encourage researchers and clinicians to think of each psychological disorder as a fixed and enduring diagnosis

• labels have staying power

-encourage the view that each disorder is entirely separate from all other disorders

• overlap is harder to see

• hindering the search for common underlying mechanisms that might provide common treatment targets

How Psychologists Humanize Psychological Disorders

• not speaking of someone as “a depressive” or “a schizoprehnic” as though the person has no identity beyond the disorder

• use “person-first” language and speak of a client as “someone suffering from depression” or “a person with schizophrenia”

  • never losing track of the fact that ppl have an identity, value and dignity

Diathesis-Stress Model

Distinguishes the factors that create a risk for illness (the diathesis) from the factor that turns the risk into a problem (the stress)

• neither the diathesis nor the stress by itself causes the disorder

• the disorder emerges only if both are present

Diathesis: Early Life Experience

• experiencing child maltreatment doubles an individual’s risk for a later depression and anxiety

• a person’s tendency to become depressed or anxious usually remains unexpressed until the person experiences one or more stressful events

  • the combination triggers depression or anxiety

Other Diathesis

• early adversity

• genetic tendency

• how an individual thinks about the events they experience

• tendency to see oneself as responsible for stressful, negative events

• tendency to think excessively about past negative events

Likelihood of a psychological disorder developing per diathesis-stress model

• determined by the number and types of diatheses an individual has in conjunction with the number and types of stressful events that he or she experiences

• some diatheses and stressors have specific effects, placing individuals at elevated risk for some types of psychological disorders but not others

• other diatheses and stressors may create a general risk for several different types of psychological disorders

Biopsychosocial Model

A way of understanding what makes people healthy by recognizing that biological, psychological and social context/ factors all combine to shape health outcomes

• psychological functioning is incomplete unless it considers biological, psychological and social dimensions

Examples:

• genes that influence levels of brain neurotransmitters

• cognitive factors that influence how likely one is to ruminate or exhibit learned helplessness

• social factors such as whether one is isolated and lonely

Anxiety/ Anxiety-related disorders

Anxiety: A feeling of intense worry, nervousness, or unease

• anxiety-related disorders are the most common of all the psychological disorder

• characterized by excessive fear coupled with great efforts to avoid the feared object or situation

• this fear must cause clinically significant distress or impairment

• the person with the phobia knows that the fear is excessive, but this knowledge does not diminish the fear

• types of anxiety-related disorders:

  • specific phobias and social anxiety disorder

Specific Phobia

• a marked fear of or anxiety about particular objects or situations

• some are more common than others

• women are twice as likely as men to have specific phobias

• some phobias don’t have a major impact on the life of the person with the phobia

• others present significant obstacles to healthy functioning because the person suffering from a phobia almost always develops strategies for avoiding the phobic object

Proposed Cause of Specific Phobias

• the result of experiences that create a mental association between the phobic stimulus and a fear response

• the person experienced a painful, frightening or embarrassing event that produced a strong emotional response

• the stimulus, which used to be neutral, was somehow linked to the event and came to elicit fear

Social Anxiety Disorder

• an anxiety disorder characterized by extreme fear of being watched, evaluated, and judged by others

  • concerns center around a fear of negative AND positive evaluations

• “performance only” social anxiety: individual’s fears are limited to speaking or performing in public

• individuals desperately try to avoid situations in which they must expose themselves to public scrutiny

• women and men are equally affected by it

• typically emerge in childhood or adolescence

• can place individuals at elevated risk for depression

• when forced into uncomfortable social situations, affected individuals may try to fortify themselves with alcohol or dugs

  • substance abuse or dependence is a risk

Panic Disorder

An anxiety disorder characterized by the occurrence of unexpected panic attacks

• panic disorder is diagnosed when recurrent unexpected panic attacks lead to either behavioral or psychological problems

• sometimes develop a profound fear of having an attack

  • attack might be embarrassing or dangerous (eg. driving)

• individuals often develop a powerful tendency not to venture outside their designated “safe” places (eg. houses or bedrooms)

• often accompagnied by agoraphobia

Panic Attacks

• sudden episodes of uncontrollable fear or anxiety accompanied by terrifying bodily symptoms

• a individual suffering a panic attack fears losing control, going insane, having a heart attack or dying

• panic attacks usually produce feelings of unreality, intense terror and a sense of impending doom

• occur in almost all anxiety disorders

• the anticipation of an attack can be unbearable

Bodily Symptoms of Panic Disorders

• labored breathing

• choking

• dizziness

• tingling hands and feet

• sweating

• trembling

• heart palpitations

• chest pains

Agoraphobia

A fear of being in situations in which help might not be available or escape might be difficult or embarrassing

• can occur with or without panic disorder

• 1/3 individuals with agoraphobia are completely housebound and unable to work

Generalized Anxiety Disorder (GAD)

• characterized by continuous, pervasive, and difficult to control anxiety

• anxiety is not related to any one specific object or situation, but is related to a number of different events or activities

• twice as common in women as in men

• ppl w/ GAD worry almost all of the time, and this worry causes clinically significant distress or impairment

• often plagued by feelings of inadequacy, difficulties in concentrating and sleep disturbance

• enormous difficulty making decisions and worry afterward about whether each decision was a mistake

Bodily GAD Symptoms

• muscle tension

• excessive sweating

• racing heart

• difficulty breathing

• diarrhea

Pervasive Worrying as an Avoidance Behavior

• some researchers believe this

• worry may be a cognitive form of avoidance, in which one limits one’s negative emotional reactivity by leaping from one worry to the next

• the worrier settles for a chronic, relatively steady level of anxiety and is spared the much more intense levels of anxiety that would result without this running mental commentary

• long term cost of less fulfilling social and work lives

Obsessive-Compulsive Disorder (OCD)

• anxiety disorder that manifests itself through obsessions and/or compulsions

  • typically ppl w/ OCD have both

• affects both sexes equally

• results in serious problems in relationships and in the workplace

• in untreated, most cases worsen over time and are accompanied by recurrent bouts of depression

• often starts early in life

• might need hours to leave the house for simple errands due to their compulsions

• in most cases, patients know their behavior is irrational

  • however are unable to stop their thoughts and urges, and so are more tormented by them

Obsessions/Compulsions

Obsessions: Recurrent unwanted and disturbing thoughts

Compulsions: Ritualistic actions performed to control the obsessions

• both commonly involve concerns about dirt and contamination, fears of harming someone, and an extraordinary need for balance and symmetry

• obsessive thoughts can produce considerable anxiety and compulsions are attempts to counteract this anxiety

Mental Rituals

• compulsions that have no visible signs

• occur entirely within the mind

• represent a desperate attempt to manage obsessions

• clients w/ mental rituals are more impaired than others w/ OCD

  • also more likely to have a chronic course than others

Trauma and Stressor-Related Disorders (TSD)

• anxiety-related disorder triggered by events that involve actual or threatened death, serious injury or sexual violation

• women are more likely than men to suffer from this

Psychological Effects Following a Traumatic Event

• a period of numbness or dissociation, during which the sufferer feels alienated, socially unresponsive, and unaffected by the event

Subsequently…

• intrusive symptoms emerge, including recurrent nightmares and waking flashbacks of the traumatic event

  • can be so intense that sufferers may momentarily believe they are back in the situation

• flashbacks are often an accurate reflection of the event, but sometimes they are a composite of different events or different perspectives on the event

  • in other cases, the flashbacks may include images of what the sufferer thought might happen as part of the trauma

Dissociation

A person disconnects from their thoughts, feelings, memories or sense of identity

• includes daydreaming or feeling detached from one’s body or surroundings

• often a response to stress of trauma

Intrusive symptoms

• unwanted, distressing thoughts, images or sensations that repeatedly enter a person’s mind

Arousal Symptoms in Ppl with TSD

• ppl who suffer from TSD often display arousal symptoms showing that they are maintaining a high state of readiness to guard against harm

Symptoms:

• sleep disturbance

• agitation

• restlessness

• difficulties with concentration

• state of pervasive hypervigilance

Avoidance Symptoms in TSD Patients

• the traumatized tries to avoid thoughts, activities, people, objects or locations that relate to the traumatic event

Symptoms:

• negative alterations in cognition and mood

  • outbursts of anger and a loss of interest in things that once were pleasurable, or survivor guilt

Survivor Guilt

• feeling that one has. done something wrong by surviving a traumatic event when friends or relatives were harmed or killed

Acute Stress Disorder

• the stress reactions to trauma are of limited duration (less than one month)

PTSD

• response to the traumatic event is enduring and if symptoms persist for one month or more after the stressor

• women are more likely than men to develop PTSD

• only a small minority of people who experience traumatic events develop a stress disorder

Comorbidity

The occurrence of two or more disorder in a single individual at a given point in time

• there is considerable comorbidity among anxiety-related disorders, meaning that having one anxiety disorder makes it more likely that someone will also have another anxiety-related disorder at the same time

• suggests that there are risk factors at work that may combine and interact with stressful life circumstances to produce one or more anxiety-related disorders

General Risk Factors

Make someone vulnerable to more than one of these disorders

Specific Risk Factors

Make someone vulnerable to one of the disorders but not the others

Biological Risk Factors

• the person’s genetics

• anxiety-related disorders can be inherited

Condordance Rate

The probability that a person with a particular familial relationship to a patient has the same disorder as the patient

• higher for identical twins

Brain Activity in Anxiety-related disorders

Specific/social phobia: Brain regions involved in fear learning (amygdala and insula) seem to be especilaly aactive

PTSD: have less brain activation in prefrontal regions associated with emotion regulation

Panic disorder: stability in the autonomic nervous system

OCD: overactivity in the anterior cingulate cortex, insula, caudate, and putamen

• unclear whether this activity is the cause or consequence of the disorder

Vicarious Learning

Process where individuals learn new behaviors, skills or attitudes by observing others and the consequences of their actions, rather than through direct experience

• may create a psychological diathesis for a specific phobia

Evolutionary Fears

• humans are prepared for some associations (and so learn them quickly, but unprepared for other associations (might not learn them at all

• snakes, spiders and heights were common dangers for our primate ancestors

• natural selection may have favored animals that were innately predisposed to very quickly learning to fear snakes and high places

Mood-Related Disorders (aka Affective Disorders)

• disorders that involve prominent disturbances in a person’s positive and negative feelings states

• typically experience mood changes that are far more extreme and sustained than the typical day-to-day mood variations that most people experience

Major Depressive Order (aka Depression)

Mood-related disorder characterized by feelings of sadness or emptiness as well as anhedonia

• women are more likely than men to become depressed

• can be gravely disabling

• many experience considerable anxiety

• 20% suffer for psychotic delusions (unshakable false beliefs)

  • clients with this have depression that is more severe, less responsive to treatment, more likely to recur and more likely to lead to death

Anhedonia

Diminished interest or pleasure in nearly all of the activities that usually provide pleasure

eg. eating, exercising, spending time with friends

Diagnosis for Major Depressive Order

DSM-5 suggests a diagnosis of depression only when a client experiences depressed mood nearly every day, for at least 2 weeks, along ‘other symptoms’

• each person diagnosed with depression has a somewhat different profile (different combo of symptoms)

• any one’s pattern of symptoms may change over time

‘Other symptoms’

To qualify as depression, these symptoms must cause clinically significant distress or impairment

• loss or gain of weight

• changes in sleep (either more or less)

• feelings of restlessness or being slowed down

• excessive fatigue

• feelings of worthlessness

• a diminished ability to think, concentrate, or make decisions

• recurrent suicidal thought

Possible Reason for Women’s Higher Likelihood of Depression

• women’s greater use of maladaptive forms of rumination

• the gender gap emerges in early teenage years

• girls’ increased attention (often negative evaluation of) their rapidly changing bodies during early post-puberty years

Rumination

The process of repetitively turning emotional difficulties over and over in the mind

Likelihood of Recurrent Depressive Episode

If someone has had one depressive episode, the change of having another episode is 50%

If someone has had two depressive episodes, the chance of having another episode is 80%

Depression in Younger Individuals

Most common in adolescence thru middle adulthood

• the despair of adolescents often leads them to substance use

• apathy seen in missing classes

• irritability emerges as belligerence and defiance

• can emerge in children and older adults

• depression is less frequent in older adults than in younger adults, but depression in older adults is more likely to lead to suicide

  • anhedonia and cognitive predominate

Bipolar Disorder

Mood disorder characterized by manic (excited and energetic) episodes, often in addition to depressive episodes, with normal periods interspersed

• episodes do not need to alternate

• recurrent disorder, nearly everyone with BPD has recurrences, and between episodes, most experience mild-to-moderate symptoms

• not limited to adults, pediatric BPD has increased recently

Mixed States

• when depression and manic episodes occur simultaneously

Hypomania

• milder form of manic states distinguished by high spirits, happiness, self-confidence and a high level of nervous energy, seem unstoppable

• may jump from one plan to another

• seem unable to sit still for a moment

• quickly shift from unbounded elation to brittle irritation upon meeting even the smallest frustration

• breeds overconfidence and relentless pursuit of overly ambitious goals

Mania

• a state of high energy and excitement often characterized by racing thoughts, feeling of invincibility or omnipotence, or a lack of boundaries or inhibitions

• will likely stop taking mood-stabilizing medication, stay up all night or engage in endless talk that runs from one topic to another with no boundaries

• serious problems arise when hypomania develops into mania

Acute Mania

• feelings of invincibility are replaced by terror as the person loses grip on reality

• the feelings of omnipotence are short-lived

• may burst into song, smash furniture, exercise endlessly, rarely sleep, engage in reckless sexual escapades, gamble all their money away, drug and alcohol usage

Disruptive Mood Dysregulation Disorder

• frequent temper outbursts and a persistently angry or irritable mood

• this overlaps with bipolar disorder, but is distinguished by its ongoing rather than episodic nature

People most at the highest risk for death by suicide

• male, non-Hispanic or Native America

• either an adolescent or older adult

• when men attempt suicide, they are more likely to die

  • use methods that are irreversible, such as shooting themselves

People most at risk for attempting suicide

• young, unmarried, unemployed female

• women are more likely than men to cut their wrists or swallow a bottle of sleeping pills, methods that offer some chance of rescue

Suicide

• 90% of individuals who die by suicide had a psychological disorder at the time of their death

• individuals are more likely to attempt as they begin to recover from depression and emerge from closely supervised care

• times of greatest risk include weekend leaves from a hospital and the period immediately after discharge from a care facility

• suicide represents a way to end unbearable suffering

• heightened impulsivity is a factor; due to low levels of serotonin in the prefrontal cortex

  • prefrontal cortex is crucial for self-regulation and long-term planning

Suicide in BPD Patients

• the risk of suicide is greater among those with bipolar disorder than among those with any other psychiatric disorder, even depression

  • ppl w/ BPD rarely attempt during manic episodes or depressive episodes

  • depressive episodes: gloom is deepest, but so is inertia; they may not have the energy nor the follow-through to attempt

Risk Factors to Suicide “IS PATH WARM”

I = ideation (formation of ideas) regarding suicide

S = substance use

P = purposelessness

A = anger

T = trapped feelings

H = hopelessness

W = withdrawing from significant others

A = anxiety

R = recklessness

M = moodshifts

Risk Factors for Mood-Related Disorders: Genetics

• this pattern is very clear for BPD; 85% of the variability in BPD is thought to be due to genetic factors

• biological parents, not adoptive parents are the best predictors of an individual’s risk for depression

• people with one of either depression or BPD tend to have relatives with the same disorder but not the other

  • BPD and depression likely arose from different sources despite overlapping symptoms

Neurotransmitters in Mood-Related Disorders

• norepinephrine, dopamine, serotonin

• evidence for the involvement comes from how antidepressant and mood-stabilizing medications work by altering the availability of these chemicals at the synapse

• the relative balance of various neurotransmitter systems rather than their levels is what matters

Brain Activity in Depression/BPD

Depression: heightened brain activation in subgenual cingulate cortex

• when depression is successfully treated, brain activity in this region returns to normal levels

BPD: fewer activations in prefrontal cortical regions associated with emotion regulation, and more activations in the amygdala

Mood-related disorders may involve overactive emotion-generative brain systems, possibly due to a decreased ability to regulate these systems appropriately

Risk Factors for Mood-Related Disorders: How a person thinks (Beck)

• many depressed clients (or BPD) believe that both they and they world are wretched

Beck’s arguments

• in depression, the beliefs come first and they produce the depression

• depression stems from a set of intensely negative and irrational beliefs that some people hold

  • eg. they are worthless, that their future is bleak, whatever happens around them is sure to turn out for the worst

• these beliefs form the core of a negative cognitive schema

Negative Cognitive Schema

A mental framework in which a person consistently interprets events negatively

• leaves their mood nowhere to go but down

Risk Factors for Mood-Related Disorders: Explanatory Style

• how a person explains why bad things happen to them

• ppl are vulnerable to depression if their explanatory style is:

  • internal: I caused this to happen

  • global: This sort of thing will also happen in other areas of my life

  • stable: This is going to keep happening

• if smo has this explanatory style and then experiences a bad event, that individual’s risk for depression is elevated

Risk Factors for Mood-Related Disorders: Social

• interpersonal stress: stress that arises from interactions and relationships with other people

  • eg. losing a parent before age 11

• having a depressed and non-responsive caretaker, particularly in the first year of life, is associated with an elevated risk for depression

• greater risk for relapse if clients return to families after hospitalization, who show high levels of criticism and hostility

• depression is common across lower socioeconomic groups, and/or torn apart by war

Schizophrenia

• psychological disorder characterized by loss contact with reality and a breakdown of the normal functions of the mind, leading to bizarre perceptions

• typically diagnosed in late adolescence or early adulthood

• schizophrenia tends to begin earlier and have a more severe course in men than in women, but both are gravely impaired in their ability to function in everyday life

• the prospect for recovery for people w/ schizophrenia is discouraging

• the life expectancy for smo with schizophrenia is 15-20 years less than that for the general population, in part due to suicide and physical illness

Positive Symptos

• thoughts or behaviors that are not evident in healthy ppl

Positive Symptoms of Schizophrenia

• delusions: false beliefs that are rigidly maintained despite overwhelming contradictory evidence

• hallucinations: sensory experiences in the absence of any sensory input or stimulation

  • often auditory (hearing voices that sound real)

  • increased brain activation during hallucinations in primary auditory regions in temporal lobe

• disorganized behavior: unusual actions that are not usually seen in healthy individuals (eg. dressing peculiarly, becoming frenzied, acting menacing)

  • may seem inappropriate or “mad”, but is the direct result of the person’s thoughts and perception at the time

Common delusions

• grandiosity: clients believe that they are greatly important

• persecution: clients are convinced they are being singled out for punishment or death

• believe that someone else is controlling their thoughts/actions (aliens or CIA)

• delusions of reference: convinced that some neutral environmental event is somehow directed at them (think two strangers are talking about them)

Negative Symptoms

• absence of behaviors usually seen in healthy people

Negative Symptoms of Schizophrenia

• flattening or cessation of behavioral responses

  • eg. expressing little emotion, say little, engage in few activities

• catatonic behavior: standing or sitting frozen for hours on end, sometimes in unusual postures

• anhedonia: loss of interest in activities ordinarily expected to be pleasurable

  • also seem not to anticipate pleasure in the way healthy ppl do

• withdrawal from other ppl, sometimes happens very early and others gradually develop a more private and less socially connected life

  • the person’s thoughts become more idiosyncratic, making it more difficult to communicate with others

Cognitive Difficulties in Schizophrenics

• unable to maintain a coherent train of thought, rather skip from one idea to the next when they speak

• common for ppl w/ schizoprhenia to have significant impairments, including sensory processing, episodic memory and cognitive control

Dopamine Hypothesis

Hypothesis that schizophrenia is associated with an abnormally high level of activity in brain circuits that are sensitive to dopamine

• the dopamine hypothesis doesn’t tell the whole story, as schizophrenics may also suffer from insufficient dopamine stimulation in cortical circuits

Evidence:

• antipsychotics block one type of receptor for dopamine, and relieve many of the symptoms associated w/ schizophrenia

• amphetamines are stimulants whose effects include the enhancement of dopamine activity, resulting in temporary psychosis similar to schizophrenia

Glutamate Transmission in Schizophrenia

• they have dysfunction in glutamate transmission in their brains, either because they have insufficient glutamate or because they relatively insensitive

• drugs that increase glutamate activity alleviate both positive and negative symptoms of schizophrenia

Evidence:

• PCP blocks glutamate receptors and induces symptoms similar to those of schizophrenia

Structural Abnormalities in Brains in Schizophrenia

• a certain proportion of ppl w/ schizophrenia, especially males, have enlarged ventricles, which are fluid-filled cavities in the brain

• the ventricles become enlarged to compensate for the not enough brain filling the skull

• loss of gray matter in prefrontal regions that support working memory, and the degree of tissue loss seems to be correlated with symptom severity

• some of these brain differences precede the onset of psychosis, suggesting the possibility that preexisting brain abnormalities may serve as a biological diathesis for the disorder

Risk Factors for Schizophrenia: Genetic Factors

• schizophrenia runs in families (10x more likely)

  • however, increased risk among siblings might reflect a factor in the home environment

• likelihood of developing schizophrenia is the same for adopted children with biological schizophrenic parents

• symptoms are not the same between relatives

Risk Factors for Schizophrenia: Maternal Ill Health during Pregnancy

• a mother’s exposure to an infectious agent during pregnancy may increase the likelihood that her child will develop schizophrenia

• maternal malnutrition during pregnancy increases the risk that the child will later develop schizophrenia

Risk Factors for Schizophrenia: Birth Complications

• a period diminished oxygen supply to the newborn may interfere with the newborn’s brain development in a way that increases the likelihood that a genetic predisposition will eventually develop into schizophrenia

Risk Factors for Schizophrenia: Psychological Factors

• low-SES individuals are 9x more likely than high-SES individuals to develop schizophrenia

• schizophrenia impairs a person’s ability to work and thus limits earning power

  • as a result, schizophrenics suffer from downward drift in SES

• poverty, inferior status and low occupational rank are all stressful and they can help trigger schizophrenia is someone who is already vulnerable

Downward Drift

Individuals, particularly those with mental illness, experience a decline in their social and economic status over time, potentially leading to homelessness or isolation

Neurodevelopment Disorder

• a disorder that stems from brain abnormalities

• various risk factors suggests that schizophrenia is a neurodevelopment disorder

Schizophrenia Symptoms in Children

• many individuals who are eventually diagnosed with schizophrenia exhibit unusual behaviors in early childhood

• showed less positive emotion and more negative emotion in their facial expressions, compared with sibling who did not later develop schizophrenia

• unusual motor patterns, including odd hand movements

Laws for Psychological Disorders: Fundamental Questions

1) When should the state step in to protect people who are mentally unfit to protect themselves?

2) When should people be held responsible for their criminal actions?