Exam 5

Psychopathology

Psychopathology

the study of psychological disorders, including their symptoms, etiology (causes), and treatment.

Psychological disorder

a condition characterized by abnormal thoughts, feelings, and behaviors.

Behaviors, thoughts, and inner experiences that are atypical, dysfunctional, or dangerous are signs of psychological disorders.

Wakefield (1992):

Proposed a more influential concept in which he defines psychological disorders as a harmful dysfunction.

Dysfunction

occurs when an internal mechanism (e.g., cognition, perception, learning) breaks down and cannot perform its normal function.

For a dysfunction to be be classed as a disorder, it must also be harmful

leads to negative consequences for the individual or for others, as judged by the standards of the individual’s culture.

Diagnosis

appropriately identifying and labeling a set of defined symptoms

DSM-5 is the classification system used

by most mental health professionals.

Diagnostic features

overview of the disorder.

Diagnostic criteria

specific symptoms required for diagnosis.

Prevalence

percent of population thought to be afflicted.

comorbidity

the co-occurrence of two disorders

Supernatural perspective

psychological disorders attributed to a force beyond scientific understanding.

Psychosocial Perspective

Emphasizes the importance of learning, stress, faulty and self-defeating thinking patters, and environmental factors. Views the cause of psychological disorders as a combination of biological and psychosocial factors.

Diathesis-Stress Model:

Integrates biological and psychosocial factors to predict the likelihood of a disorder.

Diathesis + Stress → Development of a disorder

Fear

an instantaneous reaction to an imminent threat.

Anxiety

apprehension, avoidance, and cautiousness regarding a potential threat, danger, or other negative content.

phobias

Involves excessive, distressing, and persistent fear or anxiety about a specific object or situation.

Acrophobia

heights

Aerophobia

flying

Arachnophobia

spiders

Claustrophobia

enclosed spaces.

Agoraphobia

Characterized by intense fear, anxiety, and avoidance of situations in which it might be difficult to escape or receive help if one experiences a panic attack.

Classical Conditioning.

Child is bitten by dog (US) → dogs become associated with biting (CS) → child experiences fear around dogs (CR).

Vicarious Learning.

Child observes cousin react with fear around spiders → child later expresses the same fears even though spiders have never presented any danger to him.

Verbal transmission of information.

A child is continuously told that snakes are dangerous → child starts to fear snakes.

social anxiety disorder

Characterized by extreme and persistent fear or anxiety and avoidance of social situations in which the person could potentially be evaluated negatively by others, leading to serious impairments in life.

Associated with lower educational attainment, lower earning, poor work performance, unemployment.

Safety behaviors

mental or behavioral acts that reduce anxiety in social situations by reducing the chance of negative social outcomes.

comorbidity w alcohol use disorder

Behavioral inhibition

a consistent tendency to show fear and restraint when presented with unfamiliar people or situations.

Panic disorder

recurrent and unexpected panic attacks, along with at least one month of persistent concern about additional panic attacks, worry over the consequences of the attacks, or self-defeating changes in behavior related to the attacks.

Comorbidity - anxiety disorders or major depressive disorder.

Panic attack

a period of extreme fear or discomfort that develops abruptly and reaches a peak within 10 minutes.

Locus coeruleus

in the brainstem is possibly involved

Major source of norepinephrine (neurotransmitter that triggers flight-or-flight response).

Conditioning Theories

Panic attacks are classical conditioning responses to subtle bodily sensations resembling those normally occurring when one is anxious or frightened.

Cognitive Theories

Individuals with panic disorder are prone to interpret ordinary bodily sensations catastrophically, setting the state for panic attacks.

In some patients, reducing catastrophic cognitions about sensations has proven to be as effective as medication in reducing panic attacks.

generalized anxiety disorder

A relatively continuous state of excessive, uncontrollable, and pointless worry and apprehension.

Restlessness, difficulty concentrating, being easily fatigued, muscle tension, irritability, and sleep difficulties.

cognitive theories (anxiety disorder)

Worry represents a mental strategy to avoid more powerful negative emotions perhaps stemming from earlier unpleasant or traumatic experiences.

Worrying acts a distraction from remembering painful childhood experiences.

obsessive compulsive disorder

Involves thoughts and urges that are intrusive and unwanted (obsessions) and/or the need to engage in repetitive behaviors or mental acts (compulsions).

Obsessions

persistent, unintentional, and unwanted thoughts and urges that are highly intrusive, unpleasant, and distressing

common obsessions in OCD

Concerns about germs and contamination Doubts Order and symmetry Aggressive or lustful urges

Compulsions

repetitive and ritualistic acts, typically carried out primarily as a means to minimize the distress that obsessions trigger or to reduce the likelihood of a feared event.

Not performed out of pleasure. The person usually knows these obsessions and compulsions are irrational but suppressing them is extremely difficult.

Body Dysmorphic Disorder

Involves a preoccupation with a perceived flaw in the individuals physical appearance that is either nonexistent or barely noticeable to other people.

Hoarding Disorder (OCD)

Involves great difficulty in discarding possessions, regardless of how valueless/useless they are, usually resulting in an accumulation

Why are hoarders unable to let go of items?

They think items might be useful at a later time.

Sentimental attachment to items.

conditioning theories (OCD)

Symptoms of OCD are learned responses resulting from both classical and operant conditioning.

Neutral stimulus + unconditioned stimulus → anxiety or distress.

Once association has been acquired, encounters with the NS trigger anxiety and obsessive thoughts.

Anxiety and obsessive thoughts continue until a strategy is identified to relieve it.

Relief may be ritualistic behavior or mental activity that reduces anxiety.

Compulsive acts become negatively reinforcing.

OCD Circuit

Several interconnected regions that influence perceived emotional value of stimuli and selection of behavioral and cognitive responses.

Abnormalities in these areas may produce symptoms of OCD.

Orbitofrontal cortex

involved in learning and decision making.

provoked w negative stimuli

OCD in the brain

Anterior cingulate cortex

hoarding disorder

prefrontal cortex

body dysmorphic disorder

obitofrontal cortex

obsessive compulsive disorder

PTSD

Individual was exposed to, witnessed, or experienced the details of a traumatic experience (“actual or threatened death, serious injury, or sexual violence”)

symtoms of PTSD

Intrusive and distressing memories of the event.

Flashbacks – states during which individual relives the event and behaves as if it were occurring at that moment.

Avoidance of stimuli connected to the event.

Persistently negative emotional states.

Feelings of detachment from others.

Irritability.

Proneness toward outbursts.

Exaggerated startle response.

risk factors of PTSD

Trauma experience. Those involving harm by others carry greater risk than those that do not.

Lack of immediate social support. Social Support (comfort, advice, and assistance from relatives, friends, and neighbors) can reduce the risk of developing PTSD.

Subsequent life stress. Female gender.

Low socioeconomic status. Low intelligence.

Personal history of mental disorders. History of childhood adversity.

Family history of mental disorders. Personality characteristics – neuroticism and somatization (tendency to experience physical symptoms when one encounters stress).

Possession of one or two short versions of a gene that regulates serotonin.

conditioning theories of PTSD

Traumatic event (UCS) → Extreme fear and anxiety (UCR).

Cognitive, emotional, physiological, and environmental cues associated with the traumatic event become conditioned stimuli.

Traumatic reminders (CS) → Extreme fear and anxiety (CR).

Cognitive Theories of PTSD

1.Disturbances in memory for the event. Poorly encoded memories of trauma can become fragmented, disorganized, and lacking in detail.

Individuals cannot remember event in a way that gives meaning and context.

May become haunted by these fragments involuntarily triggered by stimuli associated with the event.

2. Negative appraisals of the trauma and its aftermath (e.g., ”I deserve to be raped because I am stupid”).

May lead to dysfunctional behavioral patterns that maintain symptoms and prevent changes in the problematic appraisals.

Mania

(extreme elation and agitation) is the main feature.

Seasonal pattern

applies to situations in which a person experiences the symptoms of major depressive disorder only during a particular time of year.

Peripartum onset (postpartum depression

major depression during pregnancy or in the four weeks following the birth.

Persistent depressive disorder (dysthymia)

– depressed moods most of the day nearly every day for at least two years, as well as at least two of the other symptoms of major depression.

bipolar disorder

Involves mood states that fluctuate between depression and mania.

Symptoms of Mania

Excessively talkative. Excessively irritable.

Exhibit flight of ideas – talk loudly and rapidly, abruptly switching from one topic to another. Easily distracted.

Exhibit grandiosity – inflated but unjustified self-esteem and self-confidence. Show little need for sleep.

Take on several tasks at once. Engage in reckless behaviors.

Elevated levels of cortisol

are found in depression.

Cortisol activates the amygdala and

deactivates the prefrontal cortex (disturbances connected to depression).

Mood disorders often

involve imbalances in neurotransmitters. (serotonin and norepinephrine.)

Medications for depression

usually increase serotonin and norepinephrine

Medication for bipolar

Lithium, which blocks norepinephrine activity at the synapse.

Amygdala (mood disorders)

important in assessing the emotional significance of stimuli and experiencing emotions.

Prefrontal cortex

important in regulating and controlling emotions.

Cognitive theories suggest that depression

is triggered by negative thoughts, interpretations, self-evaluations, and expectations.

Aaron Beck (1960s)

Theorized that depression-prone people possess mental predispositions to think about most things in a negative way (depressive schemas).

Depressive schemas

contain themes of loss, failure, rejection, worthlessness, and inadequacy.

Hopelessness Theory

Specific negative thinking style → sense of hopelessness → depression.

Negative thinking

refers to a tendency to perceive negative life events as having stable (”It’s never going to change”) and global (“It’s going to affect my whole life”) causes.

Hopelessness

expectation that unpleasant outcomes will occur or desired outcomes will not occur, and there is nothing one can do to prevent such outcomes (seen as the primary cause of depression).

Rumination

repetitive and passive focus on the fact that one is depressed and dwelling on depressed symptoms, rather than distracting one’s self from the symptoms or attempting to address them in an active, problem-solving manner.

Hallucinations

perceptual experience that occurs in the absence of external stimulation. (Auditory hallucinations are most common).

Delusions

beliefs that are contrary to reality.

Paranoid delusions

belief that other people or agencies are plotting to harm them.

Grandiose delusions

belief that one holds special power, unique knowledge, or is extremely important.

Somatic delusions

belief that something highly abnormal is happening to one’s body.

Disorganized thinking

disjointed and incoherent thought processes.

Catatonic behaviors

decreased reactivity to the environment

Negative Symptoms

decreases and absences in certain behaviors, emotions, drives.

Avolition

lack of motivation to engage in self-initiated and meaningful activity.

Alogia

reduced speech output.

Asociality

social withdrawal.

Anhedonia

inability to experience pleasure.

Dopamine hypothesis

an overabundance of dopamine or too many dopamine receptors are responsible for the onset and maintenance of schizophrenia.

Drugs that increase dopamine levels can produce schizophrenia-like symptoms.

Medications that block dopamine activity reduce the symptoms.

High levels of dopamine in the limbic system

hallucinations and delusions

Low levels of dopamine in the prefrontal cortex

negative symptoms

Brain Anatomy

Enlarged ventricles.

Reduced gray matter in the frontal lobes.

Many show less frontal lobe activity when performing cognitive tasks.

Dissociative Disorders

Characterized by an individual becoming, split off, or dissociated, from their core sense of self - Memory and identity become disturbed.

Dissociative Amnesia

Inability to recall important personal information.

Usually follows a stressful or traumatic experience.

Dissociative fugue

individual suddenly wanders away from home, experiences confusion about their identity, and in some cases may adopt a new identity.

Depersonalization/Derealization Disorder

Characterized by recurring episodes of depersonalization, derealization, or both.

Depersonalization

feelings of “unreality or detachment from, or unfamiliarity with, one’s whole self or from aspects of the self”

Derealization

a sense of ”unreality or detachment from, or unfamiliarity with, the world, be it individuals, inanimate objects, or all surroundings”

Dissociative Identity Disorder

Individual exhibits two or more separate personalities or identities.

personality disorder

Characterized by a pervasive and inflexible personality style that differs markedly from the expectations of the individuals culture and causes distress or impairment.

Cluster A

Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder

Cluster B

Antisocial personality disorder Histrionic personality disorder Narcissistic personality disorder Borderline personality disorder