Chapter 15 Mental Illness

M’Naghten rule

 to be regarded as insane, people must be so disordered that they do not understand what they are doing.

Tarasoff case

a therapist who has a reason to believe that a client is dangerous to someone must warn the endangered person or take other steps to prevent harm

General Anxiety Disorder

frequent, exaggerated worries

Monoamine oxidase inhibitors (MAOIs)

 block the metabolic breakdown of dopamine, norepinephrine, and serotonin 

Selective serotonin reuptake inhibitors (SSRIs)

 block reuptake of only serotonin

Tricyclic drugs

•  interfere with the axons ability to reabsorb certain hormones like dopamine/serotonin/norepinephrine

Depression treatment

• ECTs; antidepressants; cognitive therapy

ECT, electroconvulsive therapy

a brief electrical shock is administered across the patients head to induce a convulsions similar to epilepsy

Depression Causes

• faulty cognitions, rumination, internal attributions for negative things, genetic predispositions, more common in women

Bipolar Treatment

drugs like lithium carbonate

Seasonal Affective Disorder Treatment

phototherapy

Seasonal Affective Disorder

• becoming depressed during a particular season

Tardive dyskinesia

a condition characterized by tremors and involuntary movements

Dopamine hypothesis

•  the underlying cause of schizophrenia is excessive realse of dopamine

Neurodevelopmental hypothesis

Nervous system impairments that develop around the time of birth (not necessarily genetic) (people in North born in winter are at greater risk)

Causes of Schizophrenia

• A biological predisposition activated by stress

• Evidence indicates a genetic link

• Neurodevelopmental hypothesis

• Dopamine hypothesis

Positive symptoms

presence of behavior

Negative Symptoms

lack of behavior

Catatonia

• Catatonic postures; waxy flexibility

• Alternates with repetitive activity

Diagnosis of Schizophrenia

• A deterioration of daily functioning AND

• They show at least one symptom (hallucinations, thought disorders, delusions)

Delusions

• Persecution

• Grandeur (they think they are much more important than they are)

• Somatic (delusions about their bodies, can fly, can stop the heart)

• Control (feels that they have alien chip or government chip , or that they can control things)

• Reference (sees messages to themselves everywhere)

Positive Symptoms of Schizophrenia

Thought and Speech disorders

Hallucinations

Delusions

Negative Signs of Schizophrenia

• Flattened, blunted emotions, apathetic

• Poverty of speech

• Social withdrawal

• Lack of initiative

• Inability to experience pleasure

Schizophrenia

• Reactive: a single episode (happens during a very traumatic event in your life)

• Process: chronic and recurrent

Dissociative Disorder

• Dissociative Amnesia: people forget who they are or recognize where they are (very short term, but only affects personal memory)

• Dissociative Identity Disorder (Multiple Personality Disorder)

• Dissociative Fugue State

Somatoform Disorders

• Physical Symptoms without apparent causes

• Somatization Disorder: Pain, heart symptoms, gastrointestinal symptoms

• Conversion Disorder: Blindness, deafness, loss of feeling paralysis

• Often occurs in response to an event

Obsessive-Compulsive Disorders

• Obsession (thought) leads to compulsion (behavior)

• Obsessions center on doubts/uncertainty or fear of doing something prohibited

• Common Categories: counting, checking, cleaning, avoidance

Phobic Disorders

• Agoraphobia: feeling of terror if you have to be in an unfamiliar place alone

• Social Phobias

• Specific Phobias

Panic Disorder

Attacks of terror, hyperventilation, more common in women, afraid that they are dying

Neuroses

• People are anxious, fearful, unhappy, depressed

• Behavioral/Perceptual Strategies no longer work well

• Person knows that something is wrong

• Anxiety Disorder

• Panic Disorder

• Phobic Disorder

Psychoses

• Severely Disordered Thinking, like Schizophrenia

• Delusional

• Person may be unaware that anything is wrong

Antabuse

effective in treating alcoholism

Methadone

a substitute for other opiates

personality disorder

 a maladaptive, inflexible way of dealing with the environment and other people

Exposure therapy with response prevention

 the person is prevented from performing the obsessive ritual

Exposure therapy

creates extinction, but spontaneous recovery of the phobia can occur

Systematic desensitization

a method of gradually exposing people to the object of their fear

How are diagnoses done?

• Clinical approach: based on experience of a therapist

• The actuarial approach: Applying statistical rules based on research

• Research approach shows actuarial approach to be superior

Classification of Mental Disorders

• The DMS-V and the ICD-10 (International Statistical Classification of Diseases and Related Health Problems)

Biopsychosocial model

• biological , psychological, and sociological aspects of abnormal behavior.