UNIT 5 NOTES

Psychological Disorders

• History of Psychological Disorders

  • Psychological Disorder — a disturbance in people’s thoughts, emotions, or behaviors that causes distress or suffering and impairs daily lives

    • In the Middle Ages, psychological disorders were believed to be evil spirits that possessed someone

    • medical model — psychological disorders have physical causes and can be diagnosed, treated, and even sometimes cured

      • diagnosis — putting a name to the symptoms/issue

      • etiology — the cause of the issue

      • prognosis — forecast/how the issue is predicted to behave in the future

    • biopsychosocial approach — some people are genetically predisposed to mental illness

      • epigenetics — molecular mechanisms by which environments can influence genetic expression (without a DNA change)

    • diathesis-stress model — genetic predisposition + environmental stressors = influenced psychological disorders

• Abnormal Behavior Criteria:

  • deviance — culturally unacceptable behavior

  • personal distress — self-reported feelings/actions/behaviors

  • maladaptive behavior — non-beneficial coping mechanisms

• Classification of Psychological Disorders:

  • categorical approach — putting psychological disorders into categories that don’t overlap

  • dimensional approach — putting psychological disorders onto a spectrum that may overlap

• American Psychological Association:

  • DSM-5 — Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

• World Health Organization

  • International Classification of Mental Disorders (ICD)

Psychological Disorders

• Anxiety Disorders — a group of disorders characterized by excessive fear and anxiety & related maladaptive behavior

  • generalized anxiety disorder — an anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal

  • social anxiety disorder — intense fear and avoidance of social situations

    • taijin kyofusho — fear of interpersonal relationships (cultural, usually in Japan)

  • panic disorder — an anxiety disorder marked by unpredictable, minutes-long episodes of intense dread in which a person may experience terror and accompanying chest pain, choking, or other frightening sensations; often followed by worry over a possible next attack

    • ataque de nervios — type of panic disorder characterized by screaming, loss of control, and crying (cultural, found in the Iberian peninsula and the Caribbean)

  • posttraumatic stress disorder (PTSD) — a disorder characterized by haunting memories, nightmares, hypervigilance, avoidance of trauma-related stimuli, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience

  • Types of Anxiety Disorders

    • specific phobia — an anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity, or situation

      • agoraphobia — fear or avoidance of situations, such as crowds or wide open places, where one may experience a loss of control and panic

      • arachnophobia — fear of spiders

    • obsessive-compulsive disorder (OCD) — a disorder characterized by unwanted repetitive thoughts (obsessions), actions (compulsions), or both

    • hoarding disorder — persistent difficulties parting with possessions, regardless of their value

  • Factors Causing Anxiety Disorders:

    • biological factor

      • concordance rate — the percentage of twins that have the same psychological disorder(s) even if they were raised apart

      • genetic link

    • learning factor

      • conditioning

        • ex: Little Albert

      • could also be evolutionary

    • cognitive factor

      • pessimism can lead to anxiety disorders

    • stress (long-term)

• Mood Disorders

  • Types of Mood Disorders:

    • major depressive disorder — a disorder in which a person experiences five or more symptoms lasting two or more weeks, in the absence of drug use or a medical condition, at least one of which must be either (1) depressed mood or (2) loss of interest or pleasure

      • other symptoms may include: reduced energy, sleeping/cognitive problems

      • anhedonia — diminished ability to feel pleasure

    • persistent depressive disorder — a disorder in which people experience a depressed mood on more days than not for at least 2 years (formerly called dysthymia)

    • bipolar disorders — a group of disorders in which a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania (formerly called manic-depressive disorder)

      • mania — a hyperactive, wildly optimistic state in which dangerously poor judgment is common

  • Causes of Mood Disorders:

    • genetic vulnerability

    • the brain: lower brain activity in depressive episodes

    • social-cognitive: people with mood disorders have negative emotions 🤯

      • rumination — compulsive fretting; overthinking our problems and their causes

  • Helping with Mood Disorders:

    • depression is widespread (~350 million people worldwide suffer from it)

    • women are more likely to seek and get help

  • Issues with Mood Disorders:

    • self-harm

    • suicide

      • nationality, race, gender, age, sexuality contribute to suicide

      • Wednesdays and the months of April and May are the most common times people commit

• Psychotic Disorders

  • Types of Psychotic Disorders

    • schizophrenia

      • positive symptoms → inappropriate symptoms that are present

        • hallucinations

        • delusions

        • disorganized speech

        • oftentimes paranoia

      • negative symptoms → appropriate symptoms that are absent

        • absence of emotion

        • catatonia — withdrawal; the trope of sitting and staring

      • types of schizophrenia

        • paranoid schizophrenia

        • catatonic schizophrenia

        • disorganized schizophrenia

        • undifferentiated schizophrenia

      • acute schizophrenia — (also called reactive schizophrenia) a form of schizophrenia that can begin at any age; frequently occurs in response to a traumatic event, and from which recovery is much more likely

      • chronic schizophrenia — (also called process schizophrenia) — a form of schizophrenia in which symptoms usually appear by late adolescence or early adulthood. as people age, psychotic episodes last longer and recovery periods shorten

    • Causes of Schizophrenia

      • genetic predisposition

      • abnormal brain tissue

        • high levels of dopamine

        • low activity in frontal lobe; high activity in hypothalamus (unknown whether these conditions are a cause or effect of schizophrenia)

      • prenatal environment — infections like the flu or maternal starvation can cause schizophrenia in the child

      • stress/trauma does not cause schizophrenia, only worsens or triggers it

• Other Disorders

  • Dissociative Disorders

    • dissociative amnesia — a disorder in which people with intact brains reportedly experience memory gaps; people with dissociative amnesia may report not remembering trauma-related specific events, people, places, or aspects of their identity and life history

      • fugue state — temporary memory loss, characterized by physically wandering

    • dissociative identity disorder (DID) — a rare dissociative disorder in which a person exhibits 2 or more distinct and alternating personalities (formerly called multiple personality disorder)

      • conscious awareness separate from body

      • dissociation from consciousness, memory, identity, emotion, perception, body representation, behavior, motor control

      • extremely rare

• Other Types of Disorders:

  • somatic symptom disorder — a disorder characterized as people having physical pain but no physical cause, highly distressing to patients

  • conversion disorder — a disorder characterized as people having symptoms that affect their motor control but no physical cause

  • illness anxiety disorder — a disorder characterized as an excessive worry about having a medical condition (formerly known as hypochondria)

• Neurodevelopmental Disorders:

  • autism spectrum disorder (ASD) — a disorder that appears in childhood and is marked by limitations in communication and social interaction, and by rigidly fixated interests and repetitive behaviors

  • attention deficit hyperactivity disorder (ADHD) — a disorder marked by extreme inattention and/or hyperactivity and impulsivity

• Personality Disorders:

  • extreme inflexible clusters

  • Cluster A — odd/eccentric

    • schizoid personality disorder — a pattern of detachment from social relationships and a restricted range of emotional expression

    • schizotypal personality disorder — a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior

    • paranoid personality disorder — a pattern of distrust and suspiciousness that others’ motives are interpreted as malevolent

  • Cluster B — dramatic/impulsive

    • antisocial personality disorder — a pattern of disregard for, and violation of, the rights of others

    • borderline personality disorder — a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity

    • histrionic personality disorder — a pattern of excessive emotionality and attention seeking

    • narcissistic personality disorder — a pattern of grandiosity, need for admiration, and lack of empathy

  • Cluster C — anxious/fearful

    • avoidant personality disorder — a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

    • dependent personality disorder — a pattern of submissive and clinging behavior related to an excessive need to be taken care of

    • obsessive-compulsive personality disorder — a pattern of preoccupation with orderliness, perfectionism, and control

  • Causes of Personality Disorders:

    • interaction between environment and biology

• Eating Disorders

  • anorexia nervosa — persistent energy intake restriction; intense fear of gaining weight or of becoming fat; disturbance in self-perceived weight or shape

  • bulimia nervosa — recurrent episodes of binge eating; recurrent inappropriate compensatory behaviors to prevent weight gain; self-evaluation that is unduly influenced by body shape and weight

  • binge eating disorder — recurrent episodes of binge eating a (definitely) large amount that most people would eat in a similar period of time; must occur at least once per week for three months

  • Causes of Eating Disorders:

    • biological factors — mothers usually are the ones to pass down eating disorders, usually to their daughters

    • personality factors

    • sociocultural factors like social media

    • cognitive factors

Therapy

• Modern Approaches:

  • psychotherapy — trained therapist using psychological techniques to overcome a patient’s psychological difficulties

  • biomedical therapy — treating a disorder using medication only

  • insight therapy — therapy that aims to improve psychological functioning by increasing a person’s awareness of underlying motives and defenses

  • eclecticism — combination of above therapies

• Ethical Principles:

  • nonmaleficence

  • fidelity

  • integrity

  • respect of rights, dignity

• Psychoanalysis/Psychodynamics

  • free association — letting the client “take the wheel”

  • resistance — blocking from consciousness of anxiety-laden materials

  • interpretation — analyst’s noting of dream meanings

  • transferring — patient’s transfer to the analyst of emotions

  • modern therapies

    • have no id-ego-superego

    • emphasis on childhood

• Humanism:

  • need for self-fulfillment

  • focus on growth, not curing the disorder

  • client-centered therapy

    • active listening — empathetic listening in which the listener echoes, restates, and seeks clarification

    • unconditional positive regard — a caring, accepting, nonjudgmental attitude, which Carl Rogers believed would help clients develop self-awareness and self-acceptance (aka unconditional regard)

• Hypnosis:

  • effective in treating pain and anxiety

  • social influence theory — the theory that we, as a species, want to be good always

  • dissociation theory — splits or levels in consciousness

• Behaviorism:

  • classical conditioning techniques

    • counterconditioning — behavior therapy procedures that use classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors; include exposure therapies and aversive conditioning

    • exposure therapy → systematic desensitization, virtual reality exposure therapy, aversive conditioning

  • operant conditioning techniques

    • token economy — people earn a token for exhibiting a desired behavior, can trade in for a reward

• Cognitive: new, more adaptive ways of thinking

  • cognitive triad — anxiety against oneself, the world, and the future

  • rational-emotive behavior therapy (REBT) — a confrontational cognitive therapy that challenges illogical, self-defeating attitudes and assumptions

  • dialectical behavioral therapy (DBT) — balance of opposing ideas, that ideas can be coexisting, changing self-defeating thinking/behavior

• Biomedical Therapy:

  • psychopharmacology — the study of the effects of drugs on mind and behavior

  • antipsychotic medications

    • used to treat schizophrenia

    • tardive dyskinesia — facial/muscular spasming

  • antianxiety medications

  • Types of Drug Therapy

    • antidepressant medications

      • SSRIs — selective serotonin reuptake inhibitors

      • SNRIs — serotonin-nonadrenaline reuptake inhibitors

    • mood stabilizing medications

      • lithium (for Bipolar Disorder, controls mania)

  • Types of Biomedical Therapy

    • electroconvulsive therapy — a biomedical therapy for severe depression in which a brief electric current is sent through the brain of an anesthetized person

    • alternative neurostimulation therapies

      • transcranial electrical stimulation

      • magnetic stimulation

      • deep brain stimulation

    • psychosurgery (lobotomy)