Psych 1XX3 - Psychlogical disorders

the “four D’s”

• Deviance

• Distress

• Dysfunction 

• Danger

Deviance

• Refers to atypical thoughts and behaviours

• Having thoughts, emotions, and behaviours that are far from what others are doing / people with psychological disorders deviate in some way from the typical behaviour of others

Distress

• Refers to negative feelings related to thoughts and behaviour

• Intense negative feelings (anxiety, sadness, despair) due to behaviour indicate psychological disorder

• Psychological disorders cause strong feelings of distress

Dysfunction

• Refers to interference with everyday life

• Behaviour interferes with ability to function properly

• Psychological disorders cause dysfunction in completing everyday tasks but this dysfunction may also be voluntary

Danger

• Refers to the safety risk (to ones self or another) associated with thoughts and behaviour

• Psychological disorders cause a person to place themselves or others in danger

The DSM

• Proper diagnosis aided by guidelines from the DSM

• Categorizes and describes mental disorders 

• Lists the diagnostic criteria for a particular mental disorder allowing clinicians to see if a patient's symptoms match a specific disorder

Categorical classification model

The classified items differ from each other in kind, categories defined by rigid boundaries - can only belong to one specific category in a mutually exclusive matter

Dimensional classification model

• Classified items differ from each other in degree

• Better describes psychological disorder, have many overlaps

• Dont need to be linear

DSM 5 problems

• relies too heavily on a categorical classification model

• a high degree of comorbidity among many diagnoses

  • Comorbidity: the coexistence of two or more disorders at the same time

    • It's possible someone suffers from more than one disorder, or that diagnostic criteria overlap too much

Epidemiology

the study of the distribution of disorders in a population

Prognosis

 the probable course of an illness

Acute prognosis

short lasting with sudden onset

Chronic disorders

long lasting and develop over time

Episodic prognosis

have recurrent phases separated by periods of normal functioning

Prevalence

 the % of the population that exhibits the disorder during a specific time period

• = # of people in sample with characteristic / total # of people in sample

Point prevalence

measured at specific instance in time, many disorders are episodic people that don't display at this moment have/will show symptoms

Annual prevalence

includes anyone who has the disorder or have had it in the past year

Lifetime prevalence

 includes anyone who has or have had the disorder within their lifetime

Symptomatology

the collection of any behaviours, thoughts, or feelings that may be a potential indicator of a specific psychological disorder

Major depressive disorder symptomatology

• marked by intense, recurrent episodes of sadness

  • In between episodes, return to normal functioning

• Feels ungrounded, slip into routine of being indoors and eating junk + TV, trouble cncentrating and making disorders, feel helpless, no longer enjoy normal hobbies, mind filled with negative thoughts about failing yourself and family

Generalized anxiety disorder (GAD) symptomatology

• Marked by constant, severe anxiety

• Suffer from intense, prolonged fear, tension, and distress that are overwhelming and interfere with relationships and daily tasks

• Cause persistent feelings of anxiety that interfere with daily activity

• Feels repeatedly worried about what most ppl think are normal / causes continuous anxiety throughout various trivial situations

• Easily fatigued, sweaty palms, heart palpitations, difficulty concentrating, constant worries → knows fears are irrational but this does not relieve the feelings

• Can cause pervasive physical symptoms

Schizophrenia symptomatology

• Marked by disorganized thoughts and behaviours

• Positive symptoms and negative symptoms

Positive symptoms

the addition of abnormal behaviours (hallucinations, delusions)

• Acute, appear for brief periods at a time

• Hallucinations: perception of things that are not really there

  • Auditory → people hear voices saying negative things in their head or speaking from parts of the body

• Delusions: irrational beliefs

  • Believing one is being persecuted by others of thoughts are being manipulated

• Disorganized thinking: problems in organizing ideas

  • Communication abnormalities reflect inability to think logically

• Motor behaviour

  • Disorganized motor behaviour → dramatic changes in movement (catatonia), 

  • repeated frantic motor movements with no purpose (catatonic excitement)

  • Dramatic reductions in movement (catatonic stupor)

  • Catatonia = positive symptom

Negative symptoms

the absence of typical behaviours (loss of speech, pleasure from eating)

• Decreased engagement with the world

  • Less interested in people and real world events, more concerned with internal ideas or fantasies → leads to estrangement and neglect of personal appearance

  • The 5 As

    • Alogia: reduction in speech

    • Anhedonia: inability to feel pleasure

    • flat/blunt Affect: show very little emotional response

    • Asociality: inability to enagge in social interaction

    • Avolition: lack of motivation

Etiology

the cause, or set of causes, of a disorder

The biological etiology model (medical/disease model)

• Brain malfunction as the causal agent / psych disorder result from malfunction in the brain (genetics, atypical neurotransmitter activity, abnormal brain structures)

• Atypical neurotransmitter activity levels may cause disorders

  • Depression = low dopamine, more norepinephrine

  • Depression and anxiety = etiology of depression and anxiety

  • Drugs that alter neurotransmitter activity back to norm have varied and unpredictable success

• Abnormal brain structure may underlie psych disorders

  • Anxiety disorders = hyper active amygdala

the environmental model

• Considers the effect of environmetal factors (where we live, who we socialize with, what we consume)

  • Factors in our environment may give rise to psych disorders

Low socioeconomic status, stress, problems with relationships with others/high levels of dysfunction in families

the behavioural model

• Considers how the environment affects behaviour

• External factors are the issue, but it is our behaviours and emotion in response to them

the cognitive model

Focuses on maladaptive information processing / mental disorder results from maladaptive or inappropriate ways of selecting and interpreting info from the environment

• Maladaptive thoughts are reinforced by self generated misperceptions of reality (cognitive distortions) → occur in the absence of any external evidence 

  • Catastrophizing: overemphasize the negative outcomes of a mundane situation

  • overgeneralizing 

  • Discotomous thinking 

  • Selective abstraction

  • Personalizing 

  • Minimizing

DSM categories / sections

• Section I: intro, the history of development, and guidelines on how to use it.

• Section II: diagnostic criteria and codes for mental disorders. → Disorders are organized on an age timeline, those with younger age-of-onset are first. 

• Section III: conditions in need of further study → contains information and research that seems promising but needs further scientific evidence

Major depressive disorder (unipolar depression) Symptomology

• Decreased mood; loss of motivation; significant fluctuations in weight; lack of energy; thoughts of suicide; feelings of emptiness, worthlessness, and guilt

• Neurocognitive Deficits: difficulties with memory, attention, decision-making, and cognitive speed

• Symptoms must be continually experienced for at least 2 weeks

• One or more depressive episodes warrants a diagnosis

Dysthymia Symptomology

• Similar, but less severe, symptoms of MDD

• Symptoms are consistent rather than episodic (Dysthymia is also known as Persistent Depressive Disorder, PDD)

• Symptoms must be present for at least 2 years, with periods of normalcy lasting no longer than 2 months

Postpartum depression

• occurs within four weeks of childbirth. 

• severe cases with psychotic features → mothers kill their own newborn.

Seasonal affective disorder

• depression that follows a specific season, such as winter or summer

• Winter is the most common season associated with the seasonal pattern

• more common in countries like Canada and the United States where there is less sunlight in the winter months

Bipolar symptomology

• Episodic cycles of depression and mania

• Mania: excessively elated mood

  • Racing, grandiose thoughts and ideas

  • Potentially risky behaviour

  • Irritable mood—individuals may become argu-mentative when someone attempts to rationalize with them

• Similar neurocognitive deficits as MDD (except more severe)

Bipolar disorders

involves cycles between depression and mania

Bipolar I

at least one manic episode and one depressive episode. 

• the typical conception of bipolar disorder as it incorporates the two most extreme mood states

Bipolar II

requires one hypomanic episode andone depressive episode. 

• Hypomanic episodes

  • within hypomania the mood disturbance is not severe enough to cause marked impairment in functioning or to require hospitalization, and there are no psychotic features (delusions or hallucinations).

  • change in functioning in a hypomanic episode may take the form of a dramatic increase in efficiency, accomplishments, or even creativity.

Anxiety Disorders

a class of disorders marked by feelings of excessive apprehension and anxiety

Generalized anxiety disorder Symptomology

• Constant, severe anxiety

• Not attributed to specific targets (such as with phobias) but to generally anything from minor daily problems to larger life struggles

• Frequently accompanied by physical symptoms such as restlessness, fatigue, nausea, irritability, and sleeping problems

Phobic disorders

type of anxiety disorder marked by a persistent and irrational fear of an object or situation that presents no realistic danger.

Phobic disorders Symptomology

• A persistent and irrational fear of specific objects/situations that are otherwise harmless

• Individuals often recognize that their fear is irrational, but cannot help themselves

• Often accompanied by physical symptoms (e.g. trembling, heart palpitations, muscle tension)

Social anxiety disorder

• a marked fear of public appearances during which humiliation or embarrassment is possible

  • actively avoid situations where they may interact with others, are fearful of being scrutinized or evaluated by others

Specific phobias

• characterized by a persistent, intense, and irrational fear of specific objects, places, or situations

  • avoid the phobic objects and any exposure to the feared target results in an immediate anxiety response

  • five main categories: (1) animals (e.g., snakes, dogs, spiders); (2) natural environment (e.g., water, lightning storms, heights); (3) blood-injury-injection (e.g., sight of blood or an injury, receiving an injection); (4) situational (e.g., tunnels, bridges, enclosed spaces); or (5) other (e.g., vomiting, choking, costumed individuals such as clowns).

Panic disorders Symptomology

• Recurrent, unexpected, and sudden attacks of overwhelming anxiety

• Coupled with physical symptoms like as dizziness, shortness of breath, heart palpitations, trembling, and chest pains

• Often leads to being afraid to leave home due to a developed agoraphobia: a fear of situations where escape might be difficult (e.g., elevator), or where help would be unavailable should a panic attack occur