psychological disorders + Therapy

What is the DSM-5?

Diagnostic and Statistical Manual of Mental Disorders

In the current edition, the DSM-5 (2013), disorders are described in terms of observable symptoms, and an individual must meet specific criteria to receive a particular diagnosis.

The DSM-5 consists of three sections:

(1) an introduction with instructions for using the manual

(2) diagnostic criteria for all of the disorders, which are grouped so that similar disorders are located near each other,

(3) a guide for future psychopathology research that describes conditions not yet officially recognized as disorders, such as internet gaming disorder (the persistent and recurrent use of the internet to engage in games).

diathesis-stress model

The idea that a disorder may develop when an underlying vulnerability (diathesis) is coupled with stress.

This explanation is based on two factors. First, an individual may have a diathesis, which is an underlying vulnerability or predisposition to a psychological disorder. This vulnerability can be biological, such as a genetic predisposition to a specific disorder.

Alternatively, the vulnerability can be environmental, such as childhood trauma. By itself, the vulnerability may not be enough to trigger a psychological disorder. Instead, the disorder can be brought on by the addition of a second factor: stress. If the stress level is more than the person can cope with, the symptoms of a psychological disorder may emerge.

biopsychosocial approach

The biopsychosocial approach holds that most psychological disorders are influenced by biological, psychological, and sociocultural factors.

The biological aspect of this approach focuses on how physiological factors—such as brain function, neurotransmitter imbalances, and genetics—contribute to psychological disorders

The psychological aspect of the biopsychosocial approach considers that thoughts, emotions, personality, and learned experiences influence the development of psychological disorders.

Finally, sociocultural and other situational factors—such as family relationships, socioeconomic status, natural disasters, and the cultural context in which a person is born and raised—are related to the development of psychological disorders

generalized anxiety disorder

An anxiety disorder characterized by a state of constant anxiety not associated with any specific object or situation.

Symptoms: People with this disorder are constantly anxious and worry incessantly about even minor matters. They even worry about being worried! Because the anxiety is not focused, it can occur in response to almost anything, so the person is constantly on the alert for problems. This high level of alertness results in distractibility, fatigue, irritability, and sleep problems as well as headaches, restlessness, lightheadedness, and muscle pain

Panic Disorder

An anxiety disorder that consists of sudden overwhelming attacks of terror with worry about having additional panic attacks.

symptoms: the panic attacks seemingly come out of nowhere, though they may be brought on by external stimuli or internal thought processes. Panic attacks typically last for several minutes. Symptoms include sweating and trembling, racing heart, shortness of breath, chest pain, dizziness, lightheadedness, and numbness and tingling in the hands and feet. People experiencing panic attacks often feel that they are going crazy, that they are dying, or as if they are about to be hit by a train and cannot escape.

Specific Phobia

An anxiety disorder marked by fear of a specific object or situation that is exaggerated and out of proportion with any actual danger.

symptoms:A specific phobia is classified based on the object of the fear. Common specific phobias include fear of snakes (ophidiophobia), fear of enclosed spaces (claustrophobia), and fear of heights (acrophobia). Another common specific phobia is fear of flying (aviophobia). Some people find flying terrifying, even though the odds of dying in a plane crash are extraordinarily small compared with the odds of dying in a car crash. For those who need to travel frequently for their jobs, a fear of flying can cause significant impairment in daily living.

obsessive-compulsive disorder symptoms

involves frequent intrusive thoughts that create anxiety and compulsive actions that temporarily reduce the anxiety. OCD is more common in women than men, and it generally begins in early adulthood

obssession (ocd)

Obsessions are recurrent, intrusive, and unwanted thoughts or urges or mental images that increase anxiety. They often include intense worry and fears of contamination, of accidents, or of one's own aggression.

compulsion (ocd)

Compulsions are particular acts that the person feels driven to perform over and over again to reduce anxiety.

When a person with OCD engages in the compulsive behavior, he or she experiences a temporary reduction in the anxiety caused by the obsession.

For instance, people who have an obsessive fear of germs might engage in the compulsion of repeatedly washing their hands.

People diagnosed with OCD are aware that their obsessions and compulsions are irrational, yet they are unable to stop them.

What are the symptoms of a major depressive episode?

A major depressive episode is characterized by a persistent, low mood or loss of interest/pleasure in daily activities, lasting at least two weeks. Key symptoms include significant changes in weight or appetite, sleep disturbances, fatigue, feelings of worthlessness, trouble concentrating, and recurrent thoughts of death or suicide (based on google)

What is learned helplessness? How is it related to major depressive disorder?

a phenomenon that occurs when people come to see themselves as unable to have any effect on events in their lives

Similarly, people who are experiencing learned helplessness come to expect that bad things will happen to them and believe they are powerless to avoid negative events.

Their explanations for negative events refer to unchanging personal factors rather than to temporary situational factors.

This pattern leads them to feel hopeless about making positive changes in their lives. Unfortunately, this hopelessness is a key symptom of depression that can lead to thoughts of suicide.

What is bipolar disorder?

Bipolar disorder is a mood disorder with recurrent episodes of depression and mania.

These manic episodes are characterized by abnormally and persistently elevated mood, increased energy level and physical activity, diminished need for sleep, grandiose ideas, racing thoughts, and extreme distractibility.

positive symptoms of schizophrenia

Symptoms of schizophrenia that are additional unusual experiences or behaviors, such as delusions, hallucinations, and disorganized speech or behavior.

negative symptoms of schizophrenia

Symptoms of schizophrenia that are deficits in functioning, such as apathy, lack of emotion, slowed speech, and slowed movement.

Hallucinations

False sensory experiences in the absence of any genuine external input.

Delusions

False beliefs that reflect breaks from reality

Borderline Personality Disorder

A personality disorder characterized by disturbances in identity, in moods, and in impulse control.

Unstable moods, personal relationships, and self-image; impulsivity

People with borderline personality disorder seem to lack a strong sense of self. They cannot tolerate being alone and have an intense fear of abandonment. Because they desperately need an exclusive and dependent relationship with another person, they can be very manipulative in their attempts to control relationships.

borderline individuals have emotional disturbances. Emotional instability is a key feature of the disorder. Episodes of depression, anxiety, anger, irritability, or some combination of these states can last from a few hours to a few days. Shifts from one mood to another usually occur for no obvious reason.

antisocial personality disorder

A personality disorder marked by disregard for and violation of the rights of others and by lack of remorse

People with APD are willing to take advantage of others and hurt them without showing any concern or remorse for their behavior. They tend to focus on their own pleasure, seeking immediate gratification of their wants and needs with no thought about others. Such individuals can be superficially charming and rational, but they can also lack insight and be insincere, shameless, unsocial, and incapable of love.

autism spectrum disorder

A developmental disorder characterized by deficits in social interaction, by impaired communication, and by restricted, repetitive behavior and interests.

As babies, they do not smile at their caregivers, do not respond to vocalizations, and may actively reject physical contact with others. They do not establish eye contact and do not use their gaze to gain or direct the attention of those around them

Children with autism show severe impairments in verbal and nonverbal communication. Even if they vocalize, it is often not because they are trying to communicate. Such deficits are evident by 14 months of age

A third set of deficits includes restricted, repetitive behaviors and interests. Though children with autism spectrum disorder seem not to notice people around them, they are acutely aware of their surroundings.

A disorder characterized by excessive activity or fidgeting, inattentiveness, and impulsivity.

Overly active, inattentive, and impulsive. They need to have directions repeated and rules explained over and over.

Although they are often friendly and talkative, they can have trouble making and keeping friends because they miss subtle social cues and make unintentional social mistakes, such as interrupting or intruding where they are not wanted.

Many of these symptoms are exaggerations of typical childhood behaviors, and thus the line between normal and atypical behavior is hard to draw.

biological therapy

Treatment for psychological disorders that is based on medical approaches to illness and disease.

Psychotherapy

Psychological treatment aimed at changing thoughts, feelings, and behaviors.

Psychoanalysis/Psychodynamic therapy

Freud's theory that unconscious forces, such as wishes, desires, and hidden memories, determine behavior.

goal: Help clients become aware of unconscious conflicts and defense mechanisms

therapy method: Psychoanalysis with free association and dream analysis

humanistic therapy

Treatment for psychological disorders in which a therapist works with clients to help them develop their full potential for personal growth through greater insight.

goal: Help clients fulfill their potential for personal growth

therapy methods: Client-centered therapy with active listening and unconditional positive regard

Rogers's Client-Centered Therapy

client-centered therapy encourages people to fulfill their potential for personal growth through greater self-understanding. In other words, when clients gain insight into their problems, they have the chance to become the best people they can be.

One key aspect of client-centered therapy is the creation of a safe and comforting setting in which clients can access their true feelings. An important factor in achieving this goal is the relationship between therapist and client. A good client/therapist relationship can give clients hope that they will receive the help they need

Another key aspect of humanistic therapy is active listening, in which the therapist listens attentively to clients, repeats the clients' concerns to help them clarify their feelings, and asks for further clarification when necessary

systematic desensitization

Therapy technique in which the client imagines or is exposed to situations that produce increasing anxiety while learning to relax.

First, the client creates a fear hierarchy, or a list of situations in which fear occurs, with the fears ranked from least to greatest.

The next step is relaxation training, in which the client learns to alternate muscular tension with muscular relaxation and to use other relaxation techniques.

Exposure therapy is often the next step. While relaxed, the client is asked to enact or imagine scenarios further up the fear hierarchy.

exposure and response prevention

Therapy technique that exposes a client to a stimulus that causes anxiety because it triggers obsessive thoughts and then prevents the client from engaging in compulsive behavior to reduce that anxiety.

In this variation of exposure therapy, clients are directly exposed to the anxiety-producing stimuli but are prevented from engaging in the compulsive behavior that reduces the anxiety.

Thus clients who obsess about germs would be required to touch a dirty doorknob and then be instructed not to immediately engage in the compulsive behavior of washing their hands afterward

As with exposure therapy for panic disorder, the goal is to break the conditioned link between a particular stimulus and a compulsive behavior.

When this break occurs, the avoidance response to stimuli that cause obsessive thoughts is eventually extinguished.

Anxiety is reduced, which then reduces the need for the compulsive behavior. This form of therapy is highly effective for treating people with OCD

Operant Procedure

Form of therapy used to treat antisocial personality disorder (APD) in which a therapist helps the client learn to associate certain behaviors with specific desirable outcomes.

It can be applied to treatment when a therapist uses reinforcers to increase desirable behaviors, such as providing reinforcement to prisoners with APD who pursue education.

In this way, operant procedures can replace maladaptive behavior patterns with more socially appropriate behavior patterns.

These approaches seem to work best when the therapist controls reinforcement, the client cannot leave treatment, and the client is part of a group.

This behavior therapy cannot be implemented on an outpatient basis, because the client could then leave treatment at any time and, once outside of therapy, might receive reinforcement for antisocial behavior.

For these reasons, therapy for APD is most effective in a residential treatment center or a correctional facility.

Cognitive Behavioral Therapy (CBT)

Treatment for psychological disorders in which a therapist incorporates techniques from cognitive therapy and behavior therapy to help clients correct faulty thinking and maladaptive behaviors.

Suppose a client has social anxiety disorder—that is, a fear of being viewed negatively by others. This disorder makes it hard for her to meet new people.

The therapist will encourage the client to examine other people's reactions to her and understand how she might be wrong about how other people view her.

At the same time, the therapist will teach the client how to change her own behavior, perhaps by learning how to engage other people in conversation.

CBT may be the most widely used version of psychotherapy. It is one of the most effective therapies for many types of psychological disorders, especially anxiety disorders and depressive disorders

Because anxiety disorders and depressive disorders are often comorbid, CBT that addresses symptoms of both disorders at the same time is especially effective

group therapy

goal: Provide support while also improving social skills cost-effectively

therapy methods: Often uses an eclectic mix of psychotherapy approaches

Therapists came to realize that in some instances group therapy offers advantages over individual therapy.

The most obvious benefit is cost.

Group therapy is often much less expensive than individual treatment.

Because it is less expensive, it is available to more people. In addition, the group setting gives people an opportunity to improve their social skills and learn from other people's experiences. Indeed, group therapy can sometimes be more helpful for people than individual psychotherapy