Disorders

Clinical Psychology: Psychological Disorders

Psychopathology

  • Definition: The study of psychological disorders.

  • Psychological Disorders: Persistently harmful thoughts, feelings, and actions that are:

    • Deviant: Deviates from social norms in a given culture.

    • Distressful: Unpleasant or upsetting to the individual or others.

    • Dysfunctional: Interferes with daily functioning.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)

  • Purpose: Used for diagnosing psychological disorders.

  • Methodology: Involves a structured clinical interview with patients about their behaviors and symptoms.

  • Categories: Contains 20 categories of psychological disorders, for example:

    • Depressive Disorders: Includes 8 disorders.

    • Anxiety Disorders: Includes 12 disorders.

  • Pros and Cons of Diagnostic Labels:

    • Benefits: Facilitates research and treatment.

    • Drawbacks: Can lead to stigma; disorders may be viewed as fixed/categorical.

Diathesis-Stress Model

  • Concept: Psychological disorders arise from:

    • Diathesis: Inherent vulnerability.

    • Stressors: Environmental stressors.

  • Illustration: High levels of stress can manifest or not manifest a disorder based on existing vulnerability.

Medical Student Syndrome

  • Definition: The phenomenon where medical students see symptoms in themselves as they learn about diseases, similar to psychology students with psychological disorders.

Anxiety-Related Disorders

  • Types of Disorders:

    • Generalized Anxiety Disorder (GAD)

    • Panic Disorder

    • Obsessive-Compulsive Disorder (OCD)

Generalized Anxiety Disorder (GAD)

  • Characteristics: Unrealistic, excessive, persistent worry; not linked to specific stressors.

  • Symptoms:

    • Emotional: Tension, nervousness.

    • Physical: Racing heart, motor tension/shaking.

    • Cognitive: Negative information bias, decreased focus.

  • Prevalence: Lifetime prevalence of 5%, twice as frequent in women; onset typically before age 30.

  • Causes:

    • Heritability around 30-40%.

    • Triggered by a convergence of stresses and fear of loss of control.

Panic Disorder

  • Characteristics: Discrete panic attacks; unpredictable context.

  • Symptoms: Physical symptoms like heart palpitations, trembling, shortness of breath.

  • Prevalence: Lifetime prevalence of 4%, more frequent in women; onset between 18-34 years old.

  • Causes:

    • Heritability 30-40%.

    • Patients misinterpret physiological responses.

Obsessive-Compulsive Disorder (OCD)

  • Characteristics: Unwanted thoughts (obsessions) and dysfunctional actions (compulsions).

    • Common obsessions: contamination, something bad will happen.

    • Common compulsions: checking, cleaning.

  • Prevalence: Lifetime prevalence of 2%, occurrence in both genders; onset between 18-34 years old.

  • Causes:

    • Heritability of 40-50%.

    • Biological: Elevated glucose consumption in frontal regions of the brain.

Anxiety Treatments

  • Strategies:

    • Relaxation techniques.

    • Systematic desensitization / exposure therapies.

    • Cognitive-behavioral therapy.

  • Medications:

    • Xanax, Prozac; decrease CNS activity.

Mood-Related Disorders

  • Types of Disorders:

    • Dysthymic Disorder (Persistent Depressive Disorder)

    • Major Depression

    • Bipolar Disorder

Major Depressive Disorder

  • Definition: Intense negativity lasting 2 weeks or more, shown through various symptoms (e.g. depressed mood, loss of interest, sleep disturbances).

  • DSM-5 Criteria: At least 5 symptoms for 2 weeks, including:

    • Depressed mood.

    • Significant weight changes.

    • Sleep disturbances.

    • Impaired thinking.

  • Prevalence: 12% of adults in Canada, twice as frequent in women.

    • Increasingly diagnosed in younger individuals (ages 15-19).

  • Causes:

    • Heritability of 40-50%.

    • Neurotransmitter dysregulation in the brain.

Bipolar Disorder

  • Definition: Alternation between depression and mania.

  • Characteristics of Mania: High energy, elation, but can lead to irritability and risky behavior.

  • Prevalence: 2% of the population; typically diagnosed in adolescence/early adulthood.

  • Causes:

    • Heritability of 70-90%.

    • Dysregulation of dopamine.

Mood Disorder Treatments

  • Medications:

    • Antidepressants (Prozac, Zoloft) to increase neurotransmitter activities.

    • Lithium carbonate for mood stabilization in Bipolar Disorder.

  • Alternative Treatments:

    • Aerobic exercise, cognitive-behavioral therapy, electroconvulsive therapy.

Schizophrenia

  • Definition: A disorder characterized by disorganized thinking, disturbed perceptions, and inappropriate emotions.

  • Symptoms: Positive symptoms (hallucinations, delusions) and negative symptoms (flat affect, social withdrawal).

  • Prevalence: Affects about 1% of the population.

  • Causes:

    • Heritability ~80%, environmental factors such as prenatal conditions.

    • Neurological changes including dopamine dysfunction.

Treatment for Schizophrenia

  • Antipsychotic Drugs: Treat symptoms of psychosis but have limited effectiveness on negative symptoms; side effects can occur (e.g., dizziness, tremors).

Personality Disorders

  • Definition: Pervasive and inflexible patterns of behavior impacting social functioning.

  • Clusters of Disorders:

    • Cluster A: Odd or eccentric behaviors (e.g., Paranoid, Schizoid).

    • Cluster B: Dramatic, emotional behaviors (e.g., Antisocial, Borderline, Histrionic).

    • Cluster C: Anxious behaviors (e.g., Avoidant, Dependent).

  • Specific Disorders:

    • Histrionic Personality Disorder: Attention-seeking, dramatic emotional displays.

    • Borderline Personality Disorder: Instability in mood and relationships.

    • Antisocial Personality Disorder: Disregarding others' rights, deceitful behavior.