AP PSYCH Unit 11 Part 1 -Explaining & Classifying Psych/Clinical Disorders

Dysfunction

disruption of a person’s ability to live their life productively, or in a way that impairs their relationships, ability to think clearly, communicate with others, hold a job, or deal with stressful events

Distress

causing worrisome and causing anxiety

Deviation from social norms

not typical of one’s society’s normal behavior

Positive/negative effects of diagnosing

Positive: acessess to treatment, validation & understanding, research & awareness, legal & educational support

Negitive: stigma, racism, sexism, ageism, discrimination

Diagnostic and Statistical Manual (DSM) of Mental Disorders

The APA wrote a Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe psychological disorders. The most recent edition, DSM-5 (May 2013) describes 400 psychological disorders (compared to 60 in the 1950s. Catagories include: Neurodevelopmental Depressive, Anxiety, Schizophrenia & Other Spectrum Disorders, Dissociative Disorders, Sleep-Wake Disorders - and more!

International Classification of Mental Illnesses

Stands for International Classification of Disease. Most current edition is 11(2019). Developed by the World Health Organization. Used to standardize health information across the world.

Disorders

a clinically significant syndrome characterized by disturbances in an individual’s cognition, emotion regulation, or behavior.

Neurodevelopmental disorders

group of conditions that begin in childhood and affect brain development, causing difficulties in emotions, learning, self-control, or social functioning. Causes include genetic mutations, prenatal environment (toxins/infections), complications during birth

ADHD

Marked by inattention, hyperactivity, and/or impulsivity. Symptoms must be present in multiple settings (e.g., school + home)

Two types: Inattentive (e.g., daydreaming, forgetfulness), Hyperactive-Impulsive (e.g., fidgeting, interrupting), Or combined type

Autism spectrum disorder (ASD)

Characterized by challenges in social communication and restricted, repetitive behaviors. Symptoms appear in early childhood. Varies widely (it's a spectrum)

May include: Difficulty with eye contact or social cues, Intense focus on specific interests, Sensory sensitivities

Schizophrenic spectrum disorders

A group of disorders characterized by confused and disconnected thoughts, emotions, and perceptions

The person loses contact with reality to a considerable extent

Schizophrenia is not a single problem; it has no single cause or cure

It is a collection of symptoms that indicates an individual has serious difficulties trying to meet the demands of life

Positive symptoms of Schizophernia

the presence of inappropriate behaviors (hallucinations, disorganized or delusional talking)

Delusions (paranoid and grandiose)

An untrue belief that is unshakably held despite evidence to the contrary and indicates an abnormality in individual’s thought processes

Common delusions: Delusions of persecution, Delusions of infidelity, Delusions of love , Grandiose delusions, Religious delusions

Hallucinations

Sensations that appear real but are created by your mind (Hearing, seeing, feeling, smelling, or even tasting things that are not real)

Auditory hallucinations are the most common type

Disorganized thinking or speech (word salad)

symptom of severe disorganized thinking, characterized by a confused, incoherent mixture of seemingly random words and phrases.

Catatonic excitement

a severe, hyperkinetic state of motor agitation, restlessness, and impulsive, often aggressive behavior

Catatonic stupor

a severe neuropsychiatric syndrome characterized by a profound lack of movement, speech, and environmental interaction

Flat affect

lack of emotion in face and tone

Possible causes of schizophrenia

Neurochemical: excess dopamine & dopamine receptors 

Brain Anatomy: enlargement of the ventricles of the brain, thinning of cerebral tissue

Brain activity: increased activity in amygdala, thalamus (when experiencing hallucinations), low activity in the frontal lobes

genetic/biological links (prenatal virus, dopamine hypothesis)

there is a 46% concordance rate for identical twins with one twin suffering schizophrenia

Newborn: Maternal virus during mid-pregnancy

Major depressive disorder

(Unipolar Disorder): Occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions

Signs Include:

Lethargy and fatigue

Feelings of worthlessness

Loss of interest in family & friends

Loss of interest in activities

Persistent depressive disorder

(Dysthymia) When depression lasts most of the day for a period of at least two years

Bipolar I

depressive moods that at least two weeks and manic moods that last at least one week

Bipolar II

same depression as BP I, but hypomania lasts four or more days without life the ranting consequences or psychotic episodes

Manic episodes and hypomanic episodes

In the manic phase, a person experiences elation, extreme confusion, distractibility, and racing thoughts

Often this person is irresponsible, has exaggerated self esteem, and exhibits irrational, risky behavior

Anxiety disorders

Anxiety: a general state of dread or uneasiness that a person feels in response to a real or imagined danger

People suffering from anxiety disorders feel an abnormal level anxiety

Specific phobia (e.g., acrophobia and arachnophobia)

Marked by a persistent and irrational fear of an object or situation that disrupts behavior. Phobias range in intensity from mild to extremely severe. Most people deal with phobias by simply avoiding what frightens them. Phobias are learned and maintained by reinforcing the effects of avoidance, which reduces anxiety but not the phobias

Agoraphobia

fear of going outside

Panic disorder

Minutes-long episodes of intense dread which may include feelings of terror, chest pains, choking, or other frightening sensations The intense anxiety makes people avoid situations that cause it, Can cause secondary disorders, such as agoraphobia. Smokers have at least doubled risk of panic disorder

Ataque de nervios

Cultural concept of distress in Latin America, culturally recognized syndrome involving intense emotional upset in response to a stressful or traumatic event such as after family conflict or grief

Common Symptoms: Screaming or crying, Trembling or fainting, Aggressive outbursts, Feeling of heat rising in the chest/head, Sometimes amnesia for the event, Not considered a mental illness, but a normal response to stress in certain cultures

example of how culture shapes expressions of distress

Biopsychosocial model

a holistic, patient-centered approach to healthcare that posits health and illness are determined by the interaction of biological, psychological, and social factors

Diathesis-stress mode

posits that mental disorders result from a combination of a pre-existing vulnerability (diathesis) and environmental stressors

Social anxiety disorder

Fearful, anxious or avoidant of social interactions and situations that involve the possibility of being scrutinized

Taijin kyofusho

social anxiety disorder in which a person fears offending or embarrassing others — not themselves — through their appearance, smell, facial expressions, or eye contact

Seen mostly in Japanese and Korean cultures, Reflects collectivist values: harmony and sensitivity to others

Generalized anxiety disorder (GAD)

Persistent and uncontrollable tenseness and apprehension, Autonomic arousal, Inability to identify or avoid the cause of certain feelings, The patient often feels inadequate, is oversensitive, can’t concentrate and suffers from insomnia

OCD - related disorders

Body Dysmorphic Disorder - preoccupation with self-perceived flaws in outward body appearance

Trichotillomania - literally pulling your own hair out

OCD

Obsessive Compulsive Disorder (OCD): Persistence of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) that cause distress

Obsession vs. compulsion

unwanted, intrusive thoughts, urges, or images causing distress, while compulsions are repetitive behaviors or mental acts performed to neutralize that anxiety.

Hoarding disorder

characterized by persistent difficulty discarding or parting with possessions, regardless of their actual value. Often co-occurs with OCD, anxiety, or depression. Was once seen as a subtype of OCD, now is its own diagnosis

Dissociative disorders

Conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings

Symptoms: Having a sense of being unreal, Being separated from the body, Watching yourself as if in a movie

Dissociative identity disorder (DID)

The coexistence of more than one personality in an individual

Previously known as Multiple-Personality Disorder

The different personality states may take control at different times

This is the rarest of the Dissociative Disorders

Dissociative amnesia (with and without fugue)

The sudden inability to recall important personal events or information

Usually associated with stressful events

Amnesiacs remember how to speak and usually retain some general knowledge, but may forget who they are, where they live and work, or who their family is

Post traumatic stress disorder (PTSD)

A disorder in which victims of traumatic events experience the original event in the form of dreams or flashbacks

This disorder is common among veterans of military combat and survivors of acts of terrorism, natural disasters such as floods or tornadoes, other catastrophes such as a plane crash, and human aggression such as r@pe or assault

The event that triggers the disorder overwhelms a person’s sense of reality and ability to cope

May begin shortly after a traumatic experience or it may develop much later

Anorexia nervosa

an eating disorder characterized by predominant food restriction, body image disturbance, fear of gaining weight, and an overwhelming desire to be thin.[1] These characteristics often mean individuals undergo severe malnutrition as a result of the disorder.

Bulimia nervosa

an eating disorder characterized by regular, often secretive bouts of overeating followed by self-induced vomiting or purging, strict dieting, or extreme exercise, associated with persistent and excessive concern with body weight.

Personality disorders

Personality disorders are characterized by inflexible and enduring behavior patterns that impair social functioning

They are usually without anxiety, depression, or delusions

The DSM-5 breaks these up into three clusters - A, B and C

Cluster A - Odd/Eccentric, Cluster B - Dramatic, Emotional, or Erratice, Cluster C - Anxious or Fearful

Paranoid PD

Distrust and suspicion of others

Schizoid PD

Detachment from social relationships; limited emotional expression

Schizotypal PD

Acute discomfort in close relationships; eccentric behaviors and thoughts

Antisocial PD

The person (usually men) exhibits a lack of conscience for wrongdoing, even toward friends and family members. Formerly, this person was called a sociopath or psychopath

Symptoms May Include: Lack of empathy or affection, No regard for right and wrong, Using charm or wit to manipulate others, Intimidation of others, Violent or aggressive behavior

Histrionic PD

Wants to be center of attention

May dress provocatively or exaggerate illnesses in order to gain attention

Also tend to exaggerate friendships and relationships, believing that everyone loves them 

Narcissistic PD

Characterized by extreme self-centeredness/ They exaggerate their achievements, expecting others to recognize them as being superior

Generally uninterested in the feelings of others and may take advantage of them

Borderline PD

Marked by intense emotional instability, impulsivity, and unstable relationships. Often begins in early adulthood

Key Symptoms Include: Fear of abandonment, Unstable and intense relationships Identity disturbance (unstable self-image)

Avoidant PD

Social inhibition, feelings of inadequacy, hypersensitivity to criticism

Dependent PD

Excessive need to be taken care of; submissive and clinging behavior

Obsessive-compulsive PD

Preoccupation with orderliness, perfectionism, and control (different from OCD)

diagnosing disorders

Diagnosing psychological disorders requires specialized training & the use of evidence-based diagnostic tools

3 criteria: Deviant, Distressful, and Dysfuctional

the learning theory (social-cognitive)

Fear conditioning leads to anxiety. This anxiety then becomes associated with other objects or events (stimulus generalization)

Reinforcement maintains our phobias and compulsions when we avoid or escape the feared situation to reduce anxiety

We can also develop fear responses through observational learning.

Negative Symptomys of Schiophernia

the absence of appropriate behaviors (expressionless faces, rigid bodies); includes catatonic stupor & flat affect