Psychology 14 and 15: Disorders and Treatments

Final exam study practice

Disorder definition

Abnormal behavior as distressing and harmful to self and others

Two main systems for disorer diagnosis

• DSM (American Psychiatric Association) - Diagnostic and Statistical Manual of Mental Disorders

• ICD (World Health Organization) - International Classification of Diseases

Autism Spectrum Disorder (ASD)

• Wide spectrum of impairment

• Impairment in:

• Social ability and interpretation of social situations

• Communication skills; language delays

• Sometimes cognitive impairments

• Theory of Mind

Autism symptoms

• Repetitive behavior: Rocking, spinning, hand movements

• 'Stimming'

• Sensitivity to environmental stimuli

• Desire for routine

Savantism

A rare condition where people with significant mental disabilities or autism exhibit extraordinary, isolated talents

Causes of autism

• Primarily biological: Concordance rates for MZ twins between 70-90%

• Parental age a risk factor

• Differences in brain structure

• Brain growth during the first two years tends to be very fast but becomes abnormally slow during adolescence

• NOT due to vaccinations

• Are rates of ASD increasing?

ABA treatment

An evidence-based, structured, and highly individualized treatment for individuals with autism and developmental disorders. It improves social interaction, communication, learning, and self-care skills by breaking down tasks into small, teachable steps, and using positive reinforcement to increase desired behaviors

ADHD

• Impulse control disorder

• Restless, impulsive, inattentive

• Can have inattention + hyperactivity or just one

• Difficulty in following instructions, maintaining attention on tasks, maintaining friendships

Causes of ADHD

• Biological: MZ twin concordance rate of 55%

• Impairment in the connection between frontal lobes and the limbic system

• Environmental risk factors: Lead contamination; low birth weight; prenatal exposure to alcohol, tobacco

ADHD treatment

• Medications: Ritalin, Dexedrine, Adderall

• Meds increase dopamine, norepinephrine

Diathesis-Stress Model

A psychological theory explaining that mental disorders develop from a combination of pre-existing vulnerability (diathesis) and environmental stress

General Anxiety Disorder (GAD)

• Excessive anxiety and worry more days than not for 6 months

• Person finds it difficult to control the worry

GAD symptoms

• Restlessness/feeling keyed up or on edge

• Being easily fatigued

• Difficulty concentrating or mind going blank

• Irritability

• Muscle tension

• Sleep disturbance

Primary five different anxiety disorders

Generalized Anxiety Disorder (GAD), Panic Disorder, Phobic Disorders, Obsessive- Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD)

Panic Disorder

Sudden occurrence of multiple physiological symptoms that contribute to a feeling of stark terror; panic attacks

Phobic Disorder

Excessive fear of an object or situation

• Specific phobias: Snakes, heights, elevators, germs, etc.

•Social anxiety: Fear of being scrutinized and criticized by others; meeting new people; public speaking

• Agoraphobia

Obsessive Compulsive Disorder (OCD)

•Obsessions: Repetitive, intrusive thoughts

•Compulsions: Ritualistic behaviors designed to fend off obsessions

Causes of OCD

• MZ twin concordance 63- 87%

• Dysfunction in caudate nucleus of basal ganglia; involved in impulse suppression

• Low serotonin

• Strep infection as a young child

Post Traumatic Stress Disorder (PTSD)

• Occurs after traumatic event

• Hypervigilance

• Avoidance of stimuli associated with the trauma

• Flashbacks, intrusive thoughts, nightmares

Cognitive Therapy

Helping a client identify and correct distorted thinking about self, others or the world

Cognitive Restructuring/Reframing

Teaches clients to question the automatic beliefs, assumptions and predictions that often lead to negative thinking; replace with more realistic and positive beliefs

Cognitive Behavioral Therapy (CBT)

A blend of cognitive and behavioral therapeutic strategies

Anxiety Disorder treatment

• Medication for anxiety disorders often act to increase GABA (agonists)

• Example: Benzodiazepines (Valium, Xanax)

• Medication: SSRIs help with social phobia, but cognitive and behavioral methods are treatments of choice

• Panic Disorder treatments often combine medication and CBT

Treatment of OCD

• OCD treatments blend medication and CBT with focus on Exposure and Response Prevention (ERP)

• Expose client to triggering stimulus

• Client learns not to engage in compulsion as response to trigger

Major Depressive Disorder (MDD)

Profound, persistent period of depression for two or more weeks as indicated by:

• Depressed mood

• Markedly diminished interest and pleasure

• Significant weight loss or gain

• Insomnia or hypersomnia

• Psychomotor agitation or retardation

MDD Symptoms

• Fatigue or loss of energy

• Feelings of worthlessness and excessive guilt

• Diminished ability to think, concentrate and make decisions

• Recurrent thoughts of death or suicidal ideation

Persistent Depressive Disorder (Dysthymia)

• Chronic (2+ years) of ‘low grade’ depression

• Doesn’t meet criteria for MDD

• Differences from MDD in intensity and level of functioning

Dysthymia symptoms

• Poor appetite or overeating

• Insomnia or hypersomnia

• Low energy or fatigue

• Low self-esteem

• Poor concentration or difficulty making decisions

• Feelings of hopelessness

Bipolar Disorders

• Depression is unipolar (one side of mood spectrum)

• Bipolar disorders include both manic and depressive episodes (two sides of mood spectrum)

Bipolar I

• History of manic episode(s)

• History of depressive episode(s)

Bipolar II

• History of hypomanic episode(s)

• History of major depressive episode(s)

Manic Episode

Distinct period of abnormally and persistently elevated, expansive and/or irritable mood

Manic episode symptoms

• Inflated self-esteem or grandiosity

• Decreased need for sleep

• More talkative than usual or pressure to keep talking

• Racing thoughts

• Distractibility (attention too easily drawn to unimportant or irrelevant stimuli)

• Increase in goal-directed activity or psychomotor agitation

• Excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., unrestrained buying sprees, sexual indiscretions)

Hypomanic Episode

• Restless, consumed with confidence, energized

• Not as prone to the gloom following mania

• Hypomanic states generate bursts of creative work

Mixed Episode

Alternation between mood states within an episode

• Special case of rapid cycling

Mood disorder causal factors

• Biological

• Situational

• Cognitive

Mood disorder biological factors

• Medications targeting norepinephrine and serotonin modulate mood

• Heritability estimates for MDD = 33-45%

• Depression related to diminished activity in left prefrontal cortex and increased activity in right prefrontal cortex

Dysfunctional Attitudes

Helplessness theory: Individuals who are prone to depression automatically attribute negative experiences to causes that are internal, stable and global

Mood disorders treatment

• Cognitive-behavioral (CBT) approaches

• Medication

• Change depressive thought patterns; learned optimism

Personality Disorder

An enduring pattern of inner experience and behavior

• Deviates markedly from the expectations of the individual’s culture

• Is pervasive and inflexible

• Has an onset in adolescence or early adulthood

• Is stable over time

• Leads to either significant personal distress or impairment in social-occupational role functioning

Personality disorders

• Narcissistic Personality Disorder (NPD)

• Antisocial Personality Disorder (ASPD)

• Borderline Personality Disorder (BPD)

Narcissistic Personality Disorder

Pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy

• Grandiose sense of self- importance

• Preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love

• Believes he/she is special and unique and can only be understood by, or should associate with, other special or high-status people

Antisocial Personality Disorder

• Pervasive pattern of disregard for and violation of rights of others

• Law violations, deceit, impulsivity, aggressiveness, disregard for safety, irresponsibility, lack of remorse

Psychopathy

• Glibness/superficial charm

• Grandiose sense of self-worth

• Need for stimulation

• Pathological lying

• Conning/manipulative

• Lack of remorse

• Shallow affect

• Callous/lack of empathy

Borderline Personality Disorder

• Unstable moods; anger outbursts

• Intense and volatile interpersonal relationships

• Self-mutilation or suicide threats to get attention or manipulate others

• Self-image fluctuates; unstable sense of self

• Sees others as ‘all good’ or ‘all bad’

Personality disorder treatments

• Medications: Do not specifically target personality disorders, but can help with related symptoms (e.g., violent tendencies with ASPD)

• CBT

• Difficult to treat because person often thinks there’s nothing wrong

Schizophrenia

Characterized by psychosis: Losing touch with reality

• Profound disruption of basic psychological processes

• Distorted perception of reality

• Altered or blunted emotion

• Disturbances in thought, motivation and behavior

• Occurs in about 1% of the population

Delusion

A patently false belief system, often bizarre and grandiose, that is maintained in spite of its irrationality

Hallucination

A false perceptual experience that has a compelling sense of being real despite the absence of external stimulation

Schizophrenia treatment

• Medication reduces hallucinations and bizarre interpersonal behaviors in many but not all patients

• May manage but often does not fully eradicate delusional thinking

• Difficult to change well- established behaviors

Cyclothymic Disorder

A chronic, mild form of bipolar disorder characterized by chronic mood swings, including periods of hypomanic symptoms and depressive symptoms that last for at least two years (one year in children)

Seasonal Affective Disorder (SAD)

A type of depression related to changes in seasons, typically starting in fall/winter due to reduced sunlight and lifting in spring

Psychoanalytic approach to treating mood disorders

Focuses on exploring unconscious conflicts, early life experiences, and maladaptive patterns to alleviate depression and related symptoms

Humanistic approach to treating mood disorders

Treats individuals by fostering self-actualization, self-awareness, and personal growth rather than focusing solely on symptom reduction

Behavioral approach to treating mood disorders

Focuses on modifying actions and routines to directly improve mood

Body dysmorphic disorder

A mental health condition where a person spends a lot of time worrying about flaws in their appearance

Dissociative disorder examples

• Dissociative Identity Disorder (DID)

• Dissociative Amnesia

• Derealization Disorder

Somatic Symptom Disorder

A mental health condition characterized by intense, excessive anxiety about physical symptoms such as pain, fatigue, or dizziness that cause significant distress or daily dysfunction

Evidence-Based Practice (EBP)

A decision-making approach in healthcare, psychology, and education that integrates the best current research evidence with clinical expertise and patient/client values

Deep brain stimulation

A surgical treatment that uses a pacemaker-like device to send electrical pulses to specific brain areas, calming, blocking, or overriding abnormal brain activity

Neurofeedback definition

A non-invasive, drug-free "brain training" technique that teaches your brain to function more efficiently by providing real-time feedback on its electrical activity