Psychological Disorders - Lecture 16

PTSD

Diagnosis criteria:

• individual was exposed to, witnessed, or experienced a traumatic experience (“actual or threatened death or serious injury'“)

• symptoms occur for at least one month

Symptoms:

• intrusive and distressing memories of the event

• flashbacks - states during which individual relives the event and behaves as it were

• avoidance of stimuli connected to event

• persistently negative emotional states

• feelings of detachment from others

• irritability

• exaggerated startle response

4 Main Categories of Symptoms

• re-experiencing symptoms

  • nightmares, flashbacks, triggers such as something you can see, hear, or smell

  • avoiding situations that remind you of event

  • negative changes in beliefs or feelings

  • hyperarousal (difficulty sleeping, concentrating, exaggerated startle response

Major Depressive Disorder

• “Depressed mood most of the day, nearly every day” for at least 2 weeks

• loss of interest and pleasure in usual activities

• additional symptoms:

  • weight loss/gain

  • increase/decrease in appetite

  • difficulty falling asleep/getting too much sleep

  • psychomotor agitation/retardation

  • fatigued/loss of energy

  • thoughts/feelings of worthlessness or excessive guilt

  • difficulty concentrating

  • indecisiveness

  • suicidal ideation

• in some cases, there is no apparent reason for symptoms

• for others, symptoms are triggered by a negative life event(s)

• Comorbidity is common w/ anxiety and substance use disorders

Beck and Cognitions

• cognitive theories suggest that depression is triggered by negative thoughts, interpretations, and expectations

• Aaron Beck

  • pioneered cognitive therapy

  • theorized that depression-prone people possess mental predisposition to think about most thinks in a “negative” way (depressive schemas)

Depressive Schemas

• prompt dysfunctional and pessimistic thoughts about the self, world, and the future

• maintained by cognitive biases which lead to focus on negative aspects of experiences

• other cognitive theories emphasize negative thinking

Bipolar Disorder

• involves mood states that typically fluctuate between depression and mania

• Symptoms of mania:

  • extremely happy or irritable mood

  • excessively talkative

  • exhibit flight of ideas - talk loudly and rapidly, abruptly switching topics

  • exhibit grandiosity - inflated but unjustified self-esteem and self-confidence

  • show little need for sleep

  • take on several tasks at once, and much more than could typically be accomplished

  • engage in impulsive or reckless behavior

• average age of onset is early to mid-twenties

Schizophrenia

Postitive symptoms:

• Hallucinations - perpetual experience that occurs in the absence of external stimulation (auditory hallucinations are most common; “false perceptions”)

• Delusions - beliefs that are contrary to reality (“false beliefs”)

  • paranoid delusions - belief that other people or agencies are plotting to harm them (also called delusions of persecution)

  • grandiose delusions

  • delusions of reference - coincidences = tied to themselves

  • delusions of being controlled

  • the content of hallucinations is often tied to delusional beliefs

  • content is all typically negative or threatening

• Disorganized thinking - disjointed and incoherent thought processes (and speech)

• Disorganized or abnormal motor behavior - unusual behaviors/movements

  • Catatonic behaviors - decreased reactivity to the environment; may be completely still and unresponsive for extended period of time

Negative symptoms of schizophrenia

• decreases and absences in certain behaviors, emotions, drive

  • Avolition - lack of motivation

  • Alogia - reduced speech output

  • Asociality - social withdrawal

  • Anhedonia - inability to experience pleasure

• overall, the person may appear uncommunicative and disconnected from their environment

Etiology for Schizophrenia

• Genetics - risk is 6 times greater one parent has schizophrenia

• Neurotransmitters:

  • dopamine hypothesis - overabundance of dopamine

  • high levels of dopamine in the limbic system - hallucinations and delusions

  • low levels of dopamine in prefrontal cortex - negative symptoms

• Brain Anatomy:

  • enlarged ventricles, reduced gray matter in frontal lobes

  • less frontal lobe activity

• Events during pregnancy

Neuro-developmental Disorders

• involve developmental problems in personal, social, academic, and intellectual functioning

• developed at a young age

ADHD

• constant pattern of inattention and/or hyperactive and impulsive behavior

• increased risk for low educational attainment, low socioeconomic status

Symptoms of ADHD - Inattention

• difficulty sustaining attention

• failure to follow instructions

• disorganization

• lack of attention to detail;

• easily distracted, forgetful

Symptoms of ADHD - Hyperactivity

• excessive movement

• interrupting and intruding on others

• blurting out

• difficulty waiting one’s turn

Autism Spectrum Disorder

General categories:

• deficits in social interaction

• deficits in communication

• repetitive patterns of behavior or interests