PSY1411 - Chapter 14

Psychological Disorders

  • Mental Disorder: Persistent disturbance or dysfunction in behavior, thoughts, or emotions that results in significant distress or impairment.

    • No universal agreement on a precise definition.

  • Medical Model: Conceptualizes abnormal psychological experiences as illnesses, akin to physical diseases.

    • Key Aspects:
    • Biological and environmental causes.
    • Defined symptoms.
    • Possible cures mentioned in the DSM.
    • DSM-5: Diagnostic and Statistical Manual of Mental Disorders (2013) serves as the primary reference for diagnosing mental disorders.
Global Perspective on Mental Disorders
  • Major mental disorders appear similarly in different countries and cultures.
  • Cultural context influences the experience, description, assessment, and treatment of mental disorders.
  • Cultural Concepts:
    • Cultural Syndromes: specific patterns of symptoms understood within a particular cultural context.
    • Cultural Idioms of Distress: shared ways of expressing distress within a cultural group.
    • Cultural Explanations: culturally specific ways of understanding and explaining mental illness.
Medical Model Vocabulary
  • Signs: Observable indicators of a condition.
  • Symptoms: Subjective experiences reported by the patient.
  • Disorder: A disruption in normal physical or mental function.
  • Disease: A diagnosable medical condition.
  • Diagnosis: Identification of a condition.
  • Comorbidity: Two or more conditions occurring at the same time.
Psychological Models
  • Biopsychosocial Model: Interactions of biological, psychological, and social factors in understanding health and illness.
  • Diathesis-Stress Model: Proposes that mental disorders develop from an interaction between predispositional vulnerability (diathesis) and stress from life experiences.
  • RDoC Initiative: Focuses on defining dimensions of functioning (biological, behavior, symptoms) rather than traditional diagnostic categories.
Dangers of Labeling
  • Psychiatric labels can lead to significant negative consequences, such as stigmatization.
    • Can hinder help-seeking behavior, contribute to a negative self-view, and reduce self-esteem.
  • Important to apply labels to disorders and not individuals themselves.
Anxiety Disorders
  • Phobias & Panic: Marked by persistent, excessive fear and avoidance.
    • Types of Phobias:
    • Specific Phobia: Irrational fear of a specific object or situation (e.g., spiders).
    • Social Phobia: Intense fear in social situations.
    • Agoraphobia: Fear of public spaces.
    • Panic Disorder: Characterized by recurrent unexpected panic attacks.
Classical Conditioning of Phobia
  • Phobia can develop through learned associations.
    • Example: A child bitten by a dog develops fear of dogs.
    • Neutral Stimulus: The dog.
    • Unconditioned Stimulus: The dog bite.
    • Unconditioned Response: Pain and resulting fear.
    • Conditioned Stimulus: The dog (after learning).
    • Conditioned Response: Fear.
Generalized Anxiety Disorder (GAD) Criteria
  • Criteria for Diagnosis:
    1. Excessive anxiety about various events for more days than not for at least 6 months.
    2. Difficulty controlling worry.
    3. Associated with at least three of six symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance.
    4. Distress or impairment in functioning areas.
    5. Not due to substance use or another physiological condition.
Obsessive-Compulsive Disorder (OCD)
  • Characterized by repetitive and intrusive thoughts (obsessions) and ritualistic behaviors (compulsions).
  • Distinct brain circuitry involvement distinguishes OCD from anxiety disorders.
  • Affects roughly 2% of the population, with moderate to strong heritability.
Post-Traumatic Stress Disorder (PTSD)
  • Symptoms include chronic physiological arousal, intrusive thoughts about the trauma, and avoidance of reminders of the trauma.
  • Neural correlates identified through brain imaging: heightened amygdala activity, decreased medial prefrontal cortex activity.
Mood Disorders
  • Major Depressive Disorder (MDD): Severe depressed mood lasting 2 weeks or more, includes feelings of worthlessness, lethargy, and sleep/appetite disturbances.
    • Persistent Depressive Disorder (PDD): Similar cognitive and bodily problems but less severe, lasting at least 2 years.
    • Double Depression: Co-occurrence of MDD and PDD.
Seasonal Affective Disorder (SAD)
  • Characterized by depressive symptoms in a seasonal pattern, typically related to decreased sunlight exposure.
  • Affects approximately 18% of the U.S. population, with variability in risk based on gender and socioeconomic status.
Causes of Depression
  • Neurotransmitter depletion (e.g., norepinephrine, serotonin).
  • Genetic factors and the Diathesis-Stress Model.
  • Helplessness Theory: Difficulty finding resolutions leads to feelings of helplessness.
  • Beck’s Model: Negative self and world views contribute to depression.
Bipolar Disorder
  • Characterized by cycles of abnormal mood elevations (mania) and depressions.
  • High heritability rates, with a 40–70% concordance in identical twins.
  • Shared genetic risks with schizophrenia.
Schizophrenia
  • Features include distorted perception of reality, emotional blunting, and disturbances in thought, motivation, and behavior.
    • Symptoms classified as positive (hallucinations, delusions) and negative (lack of motivation, social withdrawal).
  • Environmental risk factors include complications during pregnancy, cannabis use, and brain abnormalities.
Autism Spectrum Disorder (ASD)
  • Early childhood condition marked by communication deficits and restricted behavioral patterns.
  • Higher prevalence in boys (ratio of 4:1).
  • Early interventions (e.g., therapy) can improve outcomes for affected children.
Attention Deficit Hyperactivity Disorder (ADHD) & Conduct Disorder
  • ADHD: Difficulties with inattention or hyperactivity leading to impairment.
  • Conduct Disorder: Involves aggressive behavior toward people/animals and violation of rules. Prevalence: 12% boys, 9% girls.
Personality Disorders
  • Characterized by deeply ingrained, inflexible patterns of thinking and behavior that cause distress and functional impairments.
  • Clusters of Personality Disorders in DSM-5-TR:
    • Cluster A (Odd/Eccentric): Paranoid, Schizoid, Schizotypal.
    • Cluster B (Dramatic/Emotional): Antisocial, Borderline, Histrionic, Narcissistic.
    • Cluster C (Anxious/Fearful): Avoidant, Dependent, Obsessive-Compulsive.
Self-Harm Behaviors
  • Includes suicidal behaviors (10th leading cause of death in the U.S.) and non-suicidal self-injury (self-harm without intent to die).
  • Increased incidence in adolescence with motives often tied to emotional distress and a desire to escape painful situations.
  • Understanding genetic and neurobiological influences on these behaviors remains limited.