Psychological Disorders

DSM-5 Criteria

1. the person experiences clinically significant disturbance in their thinking, emotional regulation, or behavior

2. the clinically significant disturbance reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning

3. the clinically significant disturbance is most likely associated with significant distress in social, occupational, or other important activities

4. the source of disturbance resides within the person, and is not a culturally approved response to a common stressor or loss such as the death of a loved one

5. the disturbance is not simply attributed to socially deviant behavior or conflicts that are primarily between the individual and society unless the deviance or conflict results from the clinically significant disturbance that resides within that person

models of abnormality

the medical model, the psychological model, the sociocultural model

medical model of abnormality

disordered thoughts, feelings, and behaviors are caused by physical disease; linked to genetics, damage to parts of the brain or nervous system, hormone imbalances, and neurotransmitter activity

Thomas Szasz

wrote The Myth of Mental Illness in 1961, arguing that mental illness is a socially defined, relative concept used to cast aside people who are deviant

psychological model of abnormality

mental disorders are caused and then maintained by negative life experiences- both past and present; experiences include prolonged illness, natural disasters, war, physical and sexual abuse, etc; in this we see Freud, behaviorism and cognitive social learning, and humanism

the sociocultural model of abnormality

the social and cultural context in which we live also effects the kinds of stresses we’re exposed to, the kinds of disorders we’re likely to have, and the treatment we’re likely to get; stems from research that different disorders appear differently in different cultures; evidence comes from the fact that certain disorders are near exclusive to regional groups

biopsychosocial model

combines all three models of abnormality

culture bound symptoms

characterized by alterations of behavior dependent on regions

amok

brief period of brooding following by a violent outburst, often resulting in murder; triggered by a perceived insult and is found only among men in Malaysia, Papua New Guinea, Philippines, etc

diagnosis

the process of identifying and grouping mental disorders with similar symptoms

DSM-5

most widely used classification system in the USA; provides a comprehensive list of psychological disorders that are grouped into 19 broad categories; lists prominent symptoms for each disorder in concrete behavioral terms

True

T/F: There are concerns about the DSM-5, including lack of reliability, bias in clinical judgements, diagnostic labels may impact perception, and issues of comorbidity

personality disorders

if one’s personality is highly inflexible and maladaptive and is also abnormal in comparison to his/her/their culture and causes distress; 1-6% of the population has them

borderline personality

lack of identity; pattern of instability in self-image, mood, and social relationships; these people are uncertain of their goals and values; feel empty and bored; cling to others with fierce dependence; extreme fear of abandonment; impulsive and have a habit of running away and fighting; 2/3 of these people are women; Marilyn Monroe

antisocial personality

these people have a hard time with close relationships; absence of conscience and guilt, remorse, or empathy; 80% of people who have this are men; people are nothing but objects; can be clever, charming, and liars; less excitable, may come from broken homes

major depressive disorder

mood disorder characterized by deep sadness and despair without a discernible cause; diminished pleasure or interest; intense feelings of worthlessness, guilt, and self blame; relentlessness and agitation; fatigue, slowness, and lack of energy; “common cold” of mental disorders; 4-5% of Americans will experience this bad enough to interfere with daily functioning

teen

Depression rises around the ____ years, increases through adulthood, then peaks at middle age, then declines

True

T/F: twice as many women as men seek treatment for depression

50, 20

Biology plays a role in depression: ___% rate for identical twins, if one has depression; __% rate for fraternal

norepinephrine and serotonin

depression is associated with lower levels of these neurotransmitters

Freud

Who had this theory: Depression can be a reaction to loss, this can then be internalized into feelings of self blame, worthlessness, and suicided

behaviorist

What theory is the following: depression is traced to one’s history of reinforcement and perception of control; people get depressed when they are unable to produce for themselves a high rate of positive reinforcement; depression is a form of learned helplessness; prolonged exposure to uncontrollable outcomes may cause apathy, inactivity, loss of motivation, and pessimism

social cognitive aspects of depression

• patients viewed themselves, their world, and the future through dark glasses

• these patients distorted reality by focusing more attention on negative events than on positive ones

• depressed people are more down on those they know as well

depressive explanatory style

a tendency to attribute bad events to factors that are internal rather than external, stable rather than unstable, and global rather than specific; factors within self are more likely to impair other aspects of life

cycle of depression

people who are depressed need social support, but behave in ways that drive people away; they dismiss attempts to show that they are good and only learn to trust when recognition of badness is admitted to

suicide

one million people per year die by this; females attempt more than males but males complete more; people who may complete this often pull away from others

bipolar disorder

produces wild fluctuations that range from manic (a euphoric, overactive state) to depressed (a state of hopelessness and apathy); alternate uncontrollably between the two extremes, in cycles that last from days to months

mania

an exhilarating state of mind; boundless in energy, filled with self esteem, and confident; mind races at full speed; person is entertaining, witty, imaginative, quick to make connections between ideas, and filled with creativeness

creativity

Bipolar people score higher on what scales of certain tests?

bipolar traits

easily distracted, move from one project to another, stay awake at night, sensitive to stimulation; delusions of grandeur; make promises they cannot keep, take risks; loud, fast talking, frenzied; psychotic features; followed by bout of depression

60-80, 40

Genes explain ____% of bipolar development risk, very heritable; ___% of identical twins, 5% of fraternal

norepinephrine

this neurotransmitter is higher in people with mania

appraise

People suffering from bipolar do this to their internal states; they dread the manic episode and it takes over their thoughts

anxiety

a normal response to threatening and stressful situations; 25% of Americans will experience this strongly enough at least once that it could be a disorder; persistent, gnawing undercurrent; has no object

generalized anxiety disorder

feeling aroused and not knowing why; the person is highly sensitive to criticism, has difficulty making decisions, dwells on past mistakes, and worries constantly and excessively

panic disorder

frequent, sudden, and intense rushes of anxiety, usually lasting for several minutes; symptoms include chest pains, heart palpitations, hyperventilation, shortness of breath, choking and smothering sensations, fainting; accompanied by feelings of unreality and detachment from one’s body and by a fear of losing control

True

T/F: people may develop fear of public places (agoraphobia) because they do not want to embarrass themselves when having a panic attack

the day

When do panic attacks strike most often?

biological panic attack explanation

attacks are accompanied by changes in the prefrontal cortex; this explanation is may also be due to panic attacks being able to be treated by drugs

psychological panic attack explanation

many patients report the first attack strokes shortly after an illness, miscarriage, or other traumatic event; people with the disorder are highly attuned to their bodies and are prone to misinterpret the signals in ways that are catastrophic; therapy may also alleviate attacks

phobia

an intense and irrational fear of a specific object or situation

Freud’s phobia theory

individuals are anxious about hidden impulses and cope by displacing their anxiety onto substitute objects that are less threatening and easier to avoid

behaviorist phobia theory

phobias can develop through conditioning or can be learned by the observation of someone else’s fear reaction to an object or other forms of classical conditioning; phobias originate in a personal experience or observation and spread through stimulus generalization

unlearn

phobias are long lasting after the precipitating experience because we tend to avoid phobic objects, denying ourselves the opportunity to ______ our fears

social anxiety disorder

an exaggerated fear, in children or adults, of situations that invite public scrutiny; most prevalent of disorders; shame may be a factor

• Ex: public speaking anxiety or stage fright

true

T/F: anxiety is universal

cognitive

Culture influences the _______ component of anxiety, so the symptoms people worry about, how they interpret those symptoms, and their beliefs about the causes of anxiety all depend on the values and ideaologies to which they are exposed

cultural heritage

this can influence the source of anxiety and the way it’s expressed, so mental health workers must self consciously step outside their way of thinking to counsel

trauma

means “wound"“; half the U.S. population has been exposed to this

PTSD

7-8% of the U.S. population develop this; a person must have been exposed to actual or threatened death, serious injury, or sexual violence; can include directly experiencing the event, assisting in damage control after the event, witnessing the event as it occurred to others, or learning that the event happened to a loved one

PTSD phenomenology

there are physiological and psychological symptoms of PTSD; including irritable bowel, migraines, increased heart rate, flashbacks, poor concentration, lack of sleep, etc.

psychological history PTSD theory

prior history of anxiety can be predictive; also family histrory

environmental and severity factors of PTSD

childhood exposure to catastrophe; younger than 10 parental separation; maladaptive caregivers; experience of assault or abuse; also serious physical injury can all be predictive

Gender factors of PTSD

females are more susceptible, there are higher rates of sexual assault, intimate partner violence, and abuse among females

Cultural factors of PTSD

Latinx individuals are at higher risk and experience more severe syptoms

obsessive compulsive disorder

a crippling anxiety ailment characterized by constant obsessions and compulsions; begins in late adolescence and early adulthood; most know their habits are irrational but cannot stop; may feel shame and humiliation

obsessions

the intrusion into consciousness of persistent, often disturbing thoughts

compulsions

behavior rituals performed in response to obsessions

psychoanalysis theory of OCD

obsessive thoughts leak forbidden sexual and aggressive urges into consciousness, compelling the person to devise elaborate rituals as a countermeasure

• ex: compulsive washing symbolizes a person’s need to cleanse the soul

behaviorism theory of OCD

compulsions ensure because they help reduce anxiety- many compulsions can be extinguished by exposing patients to source of obsession but preventing them from responding to it

biology theory of OCD

antidepressants can help; PET scans also show that the brain can be overactive in the region of habitual behaviors in people with OCD