Psych

Biological Vulnerabilities in Psychiatry

  • Schizophrenia

    • Strong genetic influence on developing schizophrenia.

    • Shared environments contribute to risk factors.

    • Identical twins exhibit a 48% concordance rate for schizophrenia.

    • Genetic Vulnerabilities

    • Affect neurotransmitters, which are linked to the presence of positive symptoms in schizophrenia:

      • Dopamine
      • Influences movement, emotional response, and pleasure response.
      • Norepinephrine
      • Associated with emotional response; can subdue logical thought.
      • GABA
      • Low levels can lead to reduced inhibition, which may manifest in inappropriate behaviors.

Sexual Attitudes and Disorders

  • Kinsey's Research

    • The first major studies of American sexual attitudes conducted by Alfred Kinsey.

  • Gender Dysphoria

    • Classified in ICD-11 using the label "Gender Incongruence."
    • Post-operative outcomes for individuals who transition from female-to-male tend to be better.

  • Paraphilias

    • Defined as experiencing frequent sexual urges involving:
    • Objects
    • Non-consenting partners
    • Painful or humiliating situations.
    • Examples include:
    • Exhibitionism
      • Urge to expose oneself for shock value; does not involve interest in contact; boosts self-esteem.
    • Voyeurism
      • Watching people who are unaware they are being watched; thrills from the possibility of being caught.
    • Frotteurism
      • Sexual urge to briefly rub or touch non-consenting individuals in public spaces.
    • Sexual Sadism
      • Inflicting pain or humiliation on partners.
    • Sexual Masochism
      • Deriving pleasure from receiving pain or humiliation.
    • Hypoxyphilia
      • Engaging in autoerotic asphyxiation; often glamorized in pornography and has increased prevalence in college students.
    • To be diagnosed with paraphilia, the individual must be at least 16 years old.
    • Treatment Options for Paraphilias
    • Covert Sensitization
      • Pairs fetishistic objects with aversive stimuli to create negative associations.
    • Antiandrogens
      • Medications used to lower testosterone levels to help manage symptoms.

Schizophrenia Onset and Related Disorders

  • Onset of Schizophrenia

    • Includes a prodromal phase, which is characterized by decreasing engagement in social activities.
    • Schizophreniform Disorder
    • Symptoms persist for more than 1 month, but less than 6 months.
    • Brief Psychotic Disorder
    • Symptoms last for less than 1 month.
    • Schizoaffective Disorder
    • Involves a combination of schizophrenia symptoms and mood disorder (depression or bipolar).
    • Delusional Disorder
    • Characterized by the presence of one or more delusions lasting at least one month without other positive symptoms.

  • Classifying Symptoms

    • Positive Symptoms
    • The presence of something abnormal, e.g., hallucinations or delusions.
    • Negative Symptoms
    • The absence of normal behavior, such as emotional flatness or lack of motivation.
    • Catatonia
    • A specific negative symptom category.
    • Command Hallucinations
    • Involvement of voices that command individuals to perform certain actions.

Cultural and Familial Impacts

  • Cultural Influences on Schizophrenia

    • Experiences in U.S. culture regarding schizophrenia are overwhelmingly negative.
    • Families may display high levels of expressed emotion, impacting the individual’s mental health.

  • **Physical Side Effects of Treatment