Psychological Disorders 122 Exam 1

Psychology

The field concerned with the nature, development, and treatment of psychological disorders

Stigma

o Destructive beliefs and attitudes held by a society that are ascribed to groups considered different in some way

o Psychological disorders remain the most stigmatized condition in the 21^st century

Defining Psychological Disorders

•The disorder occurs within the individual

•It involves clinically significant difficulties in thinking, feeling, or behaving

•It usually involves personal distress of some sort

•It involves dysfunction in psychological, developmental, and/or neurobiological processes that support mental functioning 

•It is not a culturally specific reaction to an event

•It is not primarily a result of social deviance or conflict with society

Biological Origins

•Biological ~ “medical model” of mental illness

•Assumes that all disease is caused by a malfunction of some aspect of the body, mainly the brain )”psychopathology”

•Genetics, such as a predisposition toward mental illness.

•Biological and psychological explanations of mental illness most often exist simultaneously.

Psychogenic Origins

•Proposes that the roots of mental illness are in psychological causes such as conflict, frustration, emotional disturbance, or cognitive factors. Origins in hypnosis

Discovery of the Unconscious

There are unconscious influences on behavior

People can be unaware of the causes of their behavior

Freud's Structures of the Mind

ID

• Present at birth

• Biological and unconscious

• Seeks immediate gratification

• When id is not satisfied, tension is produced and id drives a person to get rid of tension

Ego 

• Primarily conscious 

• Medicates between demands of reality and id’s demands for immediate gratification

Superego

• A person's conscience

• Develops as we incorporate parental and society values

Franz Anton Mesmer

Hypnosis

• •Developed a “magnetic” cure in which magnetic forces were employed to heal (later called animal magnetism). 

• •Became very well known for this cure’s abilities

Philippe Pinel (1745–1826)

• Pioneered humane treatment in asylums

• People should be approached with compassion and dignity

• First, he unchained them and segregated them based on their behavior.

• He encouraged occupational therapy, favored baths and mild purgatives as physical treatments, and argued forcefully against the use of any type of punishment or exorcism.   

William Tuke 

• Followed his lead and treatment improved

• York Retreat (william tuke) 

• Benjamin Rush

• Wrote a book in which he encouraged more humane treatment

• However he still advocated bloodletting and use of rotating and tranquilizing chairs

Dorothea Diz

• (1802-1887)

• Crusader for improved conditions for people with psychological disorders

• Worked to establish 32 new public hospitals

• Took many of the people whom private hospitals could not accommodate

• Small staffs at public hospitals could not provide necessary individual attention that was a hallmark of moral treatment

Emil Kraepelin

• Goal classify mental illnesses

• 1883- published a list of mental disorders that was so thorough it was adopted in the world and lasted for decades

• The diagnostic and statistical manual of mental disorders (DSM) is a direct descendent of Kraepelin’s earlier work

• Still used today for those who work w/ mentally ill

• First to systematically study the effects of drugs on various cognitive and behavioral functions

What are paradigms? (Thomas Kuhn)

• A conceptual framework or approach within which a scientist works

  • A set of basic assumptions

  • A general perspective

  • An approach to conceptualizing the study of a subject and how to interpret data 

• Not the best perspective

Genetic Paradigm

•Almost all behavior is heritable to some degree 

•Genes do not operate in isolation from the environment. 

oThe environment shapes how our genes are expressed

oOur genes also shape our environments 

•Relationship between genes and environment is bidirectional

Neuroscience Paradigms

•Psychological disorders are linked to aberrant processes in the brain

•Three major components:

• Neurons 

  • Neurons - cells of the nervous system

  • 4 major parts

    • Cell body

    • Dendrites

    • Axons

    • Terminal buttons

  • Synapse - gap between neurons and nerve impulse travels down axon to synapse

• Neurotransmitters

  • Chemicals that allow neurons to send a signal across the synapse to another neuron

• Brain structure and function

  Surface of cortex

  Frontal, parietal, occipital, temporal lobes

  Prefrontal cortex - regulates the amygdala

• Neuroendocrine system

• •HPA Axis involved in response to stress

  oHypothalamus releases CRF

  oPituitary gland releases ACTH

  oAdrenal cortex promotes release of cortisol

Cognitive Behavioral Paradigms:

•Rooted in learning principles and cognitive science

•Problem behavior continues if it is reinforced 

•To alter behavior, modify the consequences

Such as time out or behavior activation

•Behaviorism criticized for ignoring thoughts and emotions

Cognition - oMental processes of perceiving, recognizing, conceiving, judging, and reasoning

Schema - oOrganized network of previously accumulated knowledge

Genetic approach

Understanding how genes and environments reciprocally influence one another 

Neuroscience Approach

The use of psychiatric drugs continues to increase

Antidepressants were the third most commonly prescribed medicine in 2013

Person can hold a neuroscience view about the nature of a disorder and yet recommend psychological intervention

Cognitive Behavior Therapy (CBT)

Attends to thoughts, perceptions, judgments, self-statements, and unconscious assumptions

•Cognitive Restructuring

oChanging a pattern of thought

oChanges in thinking can change feelings, behaviors, and symptoms

Beck’s Cognitive Therapy

•Initially developed for depression

•Depression caused by distorted perceptions

•“Third wave” treatments focus on spirituality, values, emotion, and acceptance

criteria for judging abnormality on a continuum from maladjustment to healthy adaptation

The "Four D's"

This framework helps assess psychological abnormality, with deviations from normal functioning and well-being considered: 

• Deviance: Behavior that differs significantly from accepted social norms or is statistically rare. 

• Distress: Experiences of prolonged and significant personal suffering, such as constant worry or overwhelming emotions. 

• Dysfunction/Maladaptive Behavior: Impairment in daily functioning, making it difficult for an individual to perform everyday activities. 

• Danger: Behavior that poses a risk of harm to oneself or others. 

Deviance

• Behavior that differs significantly from accepted social norms or is statistically rare. 

Distress

Experiences of prolonged and significant personal suffering, such as constant worry or overwhelming emotions

Dysfunction/Maladaptive Behavior

Impairment in daily functioning, making it difficult for an individual to perform everyday activities.

Danger

Behavior that poses a risk of harm to oneself or others

Review problems in labeling (Rosenhan article)

• Diagnostic labels being too “sticky” and shaping perceptions

  • Once you are diagnosed with a disorder, it is stuck with you and is a part of you now

  • Shaping perceptions means that other people who treat you will see your behaviors are related to the disorder

• Difficulty distinguishing the sane people from the insane people

• Normal people can easily get into a mental hospital as someone with a disorder

Review emergence and evolution of changes in DSM and identify important revisions culminating in current DSM 5

For each psychological disorder, the DSM5 provides:

Diagnostic criteria for a diagnosis

Criteria have become more detailed and concrete over time

Description of associated features

Laboratory findings, results from physical exams

Summary of research literature

Age of onset, course prevalence, risk, and prognosis factors, cultural and gender and differential diagnosis

•Defines diagnoses on the basis of symptoms 

oOur knowledge base is not yet strong enough to organize diagnoses around etiology 

DM 1 had 106 categories but DM 5 has 347 categories

Stress

is a by-product of poor or inadequate coping

Both positive stress and negative stress (distress) tax a person’s coping skills

True

Factors creating stress:

Nature of stressor

Experience of crisis

Life changes

Individual perception of stressor

Individual stress tolerance

Lack of external resources and social supports

Allostasis

Process of adaptation or achieving stability through change

—Stress hormones suppress immune system

And so…stress does not make people sick but it reduces immune system’s ability to function optimally

•Psychoneuroimmunology

• Study of •interaction between nervous system and immune system

Stress = Perceived Demands > Perceived Coping Ability

true

Some DSM Disorders are trigger

ed by exposure to stress:

Adjustment disorder

Posttraumatic stress disorder

—Primary Appraisal

Is Stressor:  harmful (distressor), harmless (benign) , or challenge (potential for gain/growth) (eustressor)?

—Secondary Appraisal

Perceived Coping Ability

Self-Efficacy:  Belief in one’s coping capacity

- Role of mastery experiences

What is the cathartic method, as pioneered by Breuer, primarily focused on?

Emotional release through recalling traumatic memories