PSYCH CH 14

Psychopathology is the study of abnormal behavior and psychological dysfunction

Abnormality What is considered "abnormal" can change over time and differs between cultures

Abnormal thinking means having thoughts that are not realistic or are very negative

• Example: A person believes everyone is judging them, even when they’re just at a coffee shop.

Abnormal behavior includes actions that are very different from what most people do

• Example: Someone stops going to work and stays in their room all day because they feel very sad.

Hippocrates challenged the idea that illnesses of both the body and mind were caused by supernatural forces. Instead, he proposed that these issues resulted from an imbalance in the body's fluids, known as humors (like blood, phlegm, yellow bile, and black bile). Although his theory was not entirely correct, he was one of the first to suggest that abnormal thinking or behavior could be linked to biological processes in the body.

Situational context, this refers to the social or environmental setting where a person’s behavior occurs. It can influence how we interpret that behavior.

• Example: A person might act differently at a party (being social and lively) compared to being at home alone (being quiet and reserved).

Subjective discomfort this is the emotional distress someone feels when they engage in certain thoughts or behaviors.

• Example: A person might feel anxious and upset when they have to speak in front of a crowd, which makes them avoid public speaking.

Maladaptive This term describes behaviors or thoughts that prevent a person from functioning well in daily life or adapting to stress.

• Example: Someone who copes with stress by avoiding all social interactions may feel temporary relief but ultimately struggles with loneliness and missed opportunities.

Psychological disorder a psychological disorder is a pattern of thinking or behavior that causes significant distress, harms others, or makes it hard for a person to function in daily life.

• Example: Someone with severe anxiety may avoid social situations, impacting their relationships and work.

The insanity defense is a legal argument used when a person with a mental illness commits a crime but is not held responsible because they couldn’t understand right from wrong at that time.

• Example: If someone with a severe mental disorder commits a crime while experiencing a psychotic episode, they might use this defense in court

The biological model is a model This model explains psychological disorders as being caused by biological factors, such as changes in brain chemistry, structure, or genetics. This model explains disorders such as anxiety, depression, schizophrenia, genetic problems, brain damage, and so on.  

• Example: Conditions like depression may be linked to imbalances in neurotransmitters like serotonin. 

The psychodynamic model, a model, based on Freud's ideas, suggests that disordered thinking and behavior happen because people push away (or repress) troubling thoughts and memories into their unconscious mind.

• Example: Imagine someone who experienced a traumatic event in childhood but has no conscious memory of it. Because they haven't processed this experience, it might cause them to feel anxious or have relationship problems later in life. They might not understand why they feel this way, as the root cause is hidden in their unconscious mind

Cognitive psychologists study how people think, remember, and organize information. They focus on mental processes like perception, memory, and problem-solving.

• Example: A cognitive psychologist might explore how someone learns a new language and what strategies help them remember vocabulary.

Social perspective is a perspective that looks at how social interactions, family influences, and cultural backgrounds shape abnormal thinking and behavior.

• Example: A person might behave differently based on their cultural norms, such as how they express emotions or seek help for mental health issue

Cultural relativity is the idea that to understand and treat a person’s mental health issues, we must consider the unique characteristics of their culture. What is considered normal or abnormal can vary widely between culture

The conceptualization of culture and its influence on psychological function and disorders has been explained by 3 concepts

• Cultural syndromes: These are specific patterns of symptoms related to stress that are recognized within a particular culture. They may not always be seen as illnesses by that culture.

• Example: Ataque de nervios is a syndrome found in some Latin American cultures, characterized by symptoms like uncontrollable crying and shouting, often triggered by stress.

• Cultural idioms of distress: These are phrases or expressions used within a culture to describe feelings of distress or suffering, without referring to specific symptoms or disorders.

• Example: In some cultures, people might say they are feeling "nervios" to express anxiety, rather than using clinical terms.

• Cultural explanation or perceived case: This refers to the culturally specific ways people explain the causes of their symptoms or illnesses.

• Example: In some cultures, a person might believe their illness is caused by a spiritual issue or a loss of their soul, rather than a physical or psychological problem.

The biopsychosocial model a model views abnormal thinking and behavior as the result of a mix of biological, psychological, social, and cultural factors. It emphasizes that mental health issues are not caused by just one thing but by the interaction of many influences.

• Example: A person with depression might have a genetic predisposition (biological), negative thought patterns (psychological), lack of social support (social), and cultural pressures (cultural) all contributing to their condition.

DSM-5 is a book that describes and classifies all the different types of psychopathological or psychological disorders that people can experience, not just anxiety. Approximately 250 different psychological disorders. This book explains each disorder in terms of its symptoms, the typical path the disorder takes as it progresses, and a checklist of specific criteria that must be met for the diagnosis of that disorder to be made. 

The RDoC project, launched by the National Institute of Mental Health (NIMH), aims to create a new way to classify psychological disorders. It combines various types of information, including biological, psychological, and social factors, to better understand mental health.

Components: RDoC consists of several domains, each containing measurable ideas or constructs that help researchers study mental disorders more effectively.

ICD-10 is the International Classification of Diseases, Tenth Revision (ICD-10) is a system used to diagnose and classify various health conditions, including mental disorders. It provides standardized codes for different diseases and disorders 

Affect in psychology means “emotion” or “mood”. It includes how people show their feelings, such as happiness, sadness, or ange

Mood disorders, also known as affective disorders, involve disturbances in a person's emotional state. They can lead to extreme feelings, such as deep sadness or excessive happiness.

• Example: Stress or life changes can push someone into a mood disorder, causing them to feel very low or overly excited.

Major depressive disorder is a severe form of depression that can occur suddenly and often has no clear external cause. It significantly affects a person's ability to function.Sometimes called unipolar disorder, it involves emotional issues that exist at one end of the emotional spectrum (depression)

Manic describes a state of excessive excitement, energy, or irritability. It is often associated with mood disorders like bipolar disorder, where individuals may experience extreme highs (mania) followed by lows (depression)

Bipolar disorder involves mood swings that can range from normal to manic (very high energy) and may include episodes of depression.

• Bipolar I Disorder: Characterized by at least one manic episode, which may be followed or preceded by depressive episodes.

• Bipolar II Disorder: Involves episodes of major depression and hypomania (a milder form of mania) but no full manic episodes.

Behavior theorists link depression to learned helplessness whereas cognitive theorists point to distortions of thinking such as blowing negative events out of proportion and minimizing positive, good events. 

Causes 

• Behavioral: depression is linked to learned helplessness 

• This theory suggests that depression can result from feeling powerless after experiencing uncontrollable negative events. For example, if someone repeatedly faces failures, they may stop trying to change their situation, leading to depression.

• Cognitive: depression is linked to distorted thinking and negative self-defeating thoughts 

• Biological: depression is linked to variation in neurotransmitter systems depression is associated with changes in brain chemicals like serotonin, norepinephrine, and dopamine. These neurotransmitters play crucial roles in mood regulation.

• Genetics: Family history can increase the risk of depression, suggesting a genetic component.

Negative Thoughts: People who are depressed often have persistent negative thoughts about themselves, which can worsen their depression. This cycle can lead to feelings of helplessness, especially after experiencing uncontrollable negative events.

Risk Factors in Adolescents: Studies show that adolescents with depression often face specific social risk factors, such as:

• Being female or part of an ethnic minority.

• Living in poverty.

• Regular drug use or engaging in delinquent behavior.

In contrast, non-depressed adolescents typically come from two-parent households, have higher self-esteem, and feel more connected to their families and schools. This suggests that social support and a stable environment can protect against depression

Gray Matter Loss: Research indicates that individuals with a history of neglect or abuse (physical, emotional, or sexual) often show reduced gray matter in brain areas linked to mood regulation and emotional behavior. This loss can affect how they process emotions and respond to stress.

Specific Brain Areas: Studies have found that:

Adolescents with major depressive disorder (MDD) may have smaller volumes in certain brain regions, like the caudate (part of the basal ganglia).

Those with MDD might have increased volume in areas like the ventral diencephalon, which includes the hypothalamus, compared to those with bipolar disorder (BD).

Functional Neuroimaging: Imaging studies reveal that brain activity can differ between depressed youth and adults, with some areas being more or less active. This complexity highlights the need for tailored approaches in understanding and treating depression across different age groups

Anxiety disorder are a group of mental health conditions characterized by excessive or unrealistic anxiety. People with these disorders often experience intense fear or worry that interferes with daily life

• Example: A person feels overwhelming worry about everyday tasks, like going to work or meeting friends, even when there’s no real threat.

Free-floating anxiety This type of anxiety is not linked to any specific cause or situation. It feels like a general sense of unease or worry without a clear trigger

• Example: Someone feels anxious throughout the day without knowing why, experiencing a general sense of dread

A phobia is an intense, irrational fear of a specific object, situation, or activity. This fear is persistent and can lead to avoidance behavior

Social anxiety disorder known as social phobia is the fear of social interactions where one might be judged or evaluated negatively. It can cause significant anxiety in everyday situations

Specific phobia is an irrational fear of some object or particular situation such as fear of dogs, or fear of being in small enclosed spaces 

• Example: A student avoids school events because they fear being judged by classmates when speaking in front of others.

Claustrophobia is the fear of being in a small, enclosed space 

Trypanophobia is fear of injections or hypodermic needles  

Odontophobia fear of dental work

Hematophobia fear of blood 

Ablutophbia fear of washing and bathing 

Acrophobia fear of heights 

Tonitrophobia fear of thunder

Arachnophobia is fear of spiders 

Agoraphobia is fear of being in a place or situation from which escape is difficult or impossible

•  Example: Someone avoids going to crowded places, like shopping malls, because they fear they won’t be able to escape if they feel anxious.

A panic attack is a sudden episode of intense fear that triggers physical symptoms like a racing heart, sweating, and shortness of breath. People often feel like they are dying or losing control.

Duration: Panic attacks can last from a few minutes to about half an hour, typically peaking within 10 minutes

Panic disorder involves repeated panic attacks and persistent worry about having more attacks, which can lead to changes in behavior to avoid situations where attacks might occur

Generalized anxiety disorder is a disorder in which a person has feelings of fear and impending doom along with physical symptoms of stress, which lasts 6 months or more 

Generalized Anxiety Disorder (GAD) is characterized by excessive, uncontrollable worry about various aspects of life, lasting for six months or more. Symptoms include restlessness, fatigue, and difficulty concentrating.

Obsessive-compulsive disorder or OCD involves recurring, intrusive thoughts (obsessions) that cause anxiety, which is relieved by performing repetitive behaviors (compulsions). For example, someone might wash their hands repeatedly to ease fears of contamination

Posttraumatic stress disorder PTSD develops after experiencing or witnessing a traumatic event. Symptoms include flashbacks, nightmares, severe anxiety, and avoidance of reminders of the trauma, lasting more than a month

Acute stress discover (ASD) is a disorder occurs within a month of a traumatic event and includes symptoms like anxiety, dissociation, and flashbacks. If symptoms persist beyond a month, it may develop into PTSD

Behaviorists believe that anxious behaviors, including phobias, are learned responses.

•  For example, a child may develop a fear of dogs after being bitten, a classic case of conditioned fea

Magnification is a cognitive distortion where individuals exaggerate the significance of negative events or downplay positive ones. 

• For instance, someone might think, "If I fail this test, my life is over," even if it’s just one exam.

All-or-nothing thinking is the tendency This is the tendency to see things in black-and-white terms, believing that if something isn’t perfect, it’s a total failure.

• Example: A student thinks, “If I don’t get an A, I’m a complete failure

Overgeneralization involves making broad conclusions based on a single event, interpreting one negative experience as a pattern of failure.

• Example: After failing one test, a student believes, “I’ll never succeed in school.”

Minimization is the tendency to downplay or ignore one’s successes and positive traits.

• Example: Someone might say, “Winning that award doesn’t mean anything; anyone could have done it

Amygdala Activation: Functional neuroimaging studies show that the amygdala, a brain area involved in processing fear, is more active in individuals with phobias, PTSD, and social anxiety disorder when exposed to fear-inducing stimuli.

Dissociative disorders are disorders involve a disconnection between thoughts, memories, feelings, and identity. They often arise as a response to trauma 

Automatic pilot drinking happens when the route is familiar and frequently traveled. One part of the conscious mind was thinking about work, school, or whatever was uppermost in the mind, while the lower center of consciousness was driving the car, stopping at signs and lights, and turning when needed. This split in conscious attention is very similar to what happens in dissociative pronounced and involuntary

Dissociative symptoms can be present not only in dissociative disorders but in others as well, including PTSD and borderline personality disorder

In dissociative amnesia,involves memory loss about personal information or events, often related to trauma.

• Example: A person may forget their name or significant life events after experiencing a traumatic even

In retrograde amnesia, This type of amnesia involves the inability to recall memories formed before a specific event, often due to brain injury.

• Example: After a car accident, a person may forget everything that happened in the years leading up to the accident

A dissociative fugue occurs when a person suddenly travels away from home (the flight) and afterward can’t remember the trip or even personal info such as identity. They might become confused about identity and sometimes even take a whole new identity in the new place and this is common in times of disasters or war 

Dissociative identity disorder (DID) involves having two or more distinct identities or personality states within one person.

• Example: A person may switch between different identities, each with its own memories and behaviors

Psychodynamic theory suggests that mental disorders stem from the repression of threatening or unacceptable thoughts and feelings. Repression acts as a defense mechanism, keeping distressing memories or impulses out of conscious awareness.

• Example: A person who experienced trauma may unconsciously block memories of the event to avoid the associated pain

Dissociative disorders involve significant repression, leading to forgetting distressing memories or experiences. Individuals may disconnect from their thoughts, feelings, or sense of identity.

• Example: Someone who has experienced severe trauma might not remember specific details about the event, as their mind protects them from the emotional pain

Thought avoidance refers to the habit of avoiding certain thoughts or feelings, which can be negatively reinforced. When a person successfully avoids thinking about something distressing, they feel relief, which encourages them to continue avoiding those thoughts.

• Example: If someone feels anxious about past trauma, they might distract themselves with work or hobbies to avoid thinking about it, reinforcing the avoidance behavior

depersonalization/derealization disorder involves feelings of detachment from oneself (depersonalization) or from the environment (derealization). People may feel as if they are observing themselves from outside their bodies or that their surroundings are unreal.

Brain Activity: Research shows that individuals with this disorder have lower brain activity in areas responsible for body awareness compared to those without the disorder. This can contribute to their feelings of disconnection.

3 eating disorder 

• Anorexia nervosa: also called anorexia Anorexia is an eating disorder where individuals (often young females) severely restrict their food intake, leading to significantly low body weight.

• Symptoms: This can cause hormonal imbalances, weak heart muscles, low blood pressure, loss of muscle tissue, and in females, a lack of menstruation. Other signs include fatigue, diarrhea, and sleep disturbances

• Bulimia nervosa: also called bulimia involves cycles of binge eating (consuming large amounts of food in a short time) followed by purging behaviors to prevent weight gain.

• Purging Methods: This can include vomiting, misuse of laxatives, fasting, or excessive exercise. Individuals often feel guilt and shame about their eating habit

• Binge eating disorder is characterized by recurrent episodes of binge eating without purging. Individuals feel a lack of control over their eating.

• Key Difference: Unlike bulimia, those with binge eating disorder do not engage in compensatory behaviors to avoid weight gain

Sexual dysfunction refers to difficulties experienced during any stage of sexual activity, affecting sexual interest, arousal, or response.

Areas Affected: It can involve issues like lack of desire, inability to become aroused, delayed orgasm, or pain during intercourse. This can stem from physical health issues, psychological factors, or relationship problems

Some of the sexual dysfunctions are 

• Sexual arousal disorder: This disorder involves the inability to achieve or maintain sexual arousal during sexual activity.

• Example: A woman may struggle to become physically aroused despite wanting to engage in sexual activity

• Sexual desire disorder This includes a lack of sexual interest or activity over time.

• Example: A man may find that he has little to no interest in sex, leading to distress in his relationship

• Sexual pain disorder This disorder causes pain during sexual intercourse, making it difficult or impossible to engage in sexual activity.

• Example: A woman may experience significant pain during penetration, which can lead to avoidance of sexual intimacy

• The orgasmic disorder This involves difficulty reaching orgasm during sexual stimulation.

• Example: A woman may find it challenging to achieve orgasm even with adequate arousal and stimulation

• Sexual addiction refers to uncontrollable sexual behaviors or urges that can harm relationships and daily functioning.

• Example: An individual may feel compelled to engage in sexual activities despite negative consequences, such as relationship issues or financial problems

Sexual desire or arousal disorder includes female sexual interest/arousal disorder and male hypoactive sexual desire disorder. Disorders related to the physical act of intercourse include erectile disorder and genito pelvic pain/penetration disorder and last disorders related to the timing or inability to reach orgasm include premature (early) ejaculation, female orgasm disorder, and delayed ejaculation 

Some sexual dysfunction stem from physical sources known as organic factors and others can be caused by purely social-cultural factors or psychological factors 

Organic factors include physical problems such as illnesses, side effects from medication, the effects of surgeries, physical disabilities, and even the use of illegal and legal drugs such as alcohol, and cocaine. Chronic illnesses such as diabetes cancer or stroke can belong to this category of factors 

Personality disorder is when a person adopts a persistent rigid and maladaptive pattern of behavior that interferes with normal social interactions 

Paranoid personality disorder people believe everyone is out to get them. They are not the easiest people to get along with due to their distrust of others. They’re suspicious, interested in the motives of others, and have some hidden agenda or ill intent  

Example: A person may constantly suspect that friends are talking behind their back or plotting against them.

Antisocial personality disorder (ASPD) they’re “against society. It’s a disorder in which a person uses other people without worrying about their rights or feelings and often behaves in an impulsive or reckless manner without regard for the consequences of that behavior. Likely to lie, disobey rules, and break the law. May be irritable or aggressive   

Borderline personality disorder (BLPD) intense and unstable relationships, impulsive behavior, an unstable sense of self, and a strong fear of abandonment.

• Example: A person with BPD may idealize a friend one moment and then feel angry and abandoned the next, leading to chaotic relationships

A dependent personality disorder is people that need constant attention and someone to take care of them. They’re passive and reply to others or possibly just a single individual like a parent or partner  to assume responsibility for many areas of their life 

Schizophrenia is a severe disorder that involves disordered thinking, bizarre behavior, hallucinations, and an inability to distinguish between reality and fantasy.

Symptoms:

• Hallucinations: Hearing voices or seeing things that aren’t there.

• Delusions: Strongly held false beliefs, such as thinking one is being persecuted.

• Disorganized Speech: This can include making up words or stringing together unrelated phrases, often referred to as "word salad."

Example: A person with schizophrenia might believe that their thoughts are being controlled by external forces and may express this through disorganized speech.

Psychotic describes a state where an individual cannot distinguish between what is real and what is not, often seen in conditions like schizophrenia

Delusions are false beliefs that remain fixed despite evidence to the contrary.

Delusions of Persecution: Believing that others are trying to harm them.

• Example: A person might think that their coworkers are plotting against them.

Delusions of Reference: Believing that common elements of the environment, like TV shows or conversations, are specifically about them.

• Example: Someone might think that a character in a movie is sending them secret messages

Delusions of influence belief that one is being controlled by external forces, such as aliens or supernatural entities.

• Example: A person might think that the devil is controlling their actions

Delusions of grandeur or grandiose delusion The belief that one has exceptional abilities or a special mission, often feeling powerful or important.

• Example: Someone might believe they are destined to save the world or are a famous celebrity 

Hallucination is when people hear voices or see things from people that are not there (false sensation)

• Example: Hearing voices that others cannot hear, which may command or comment on their actions.

Flat affect is a condition in which the person shows little or no emotion expression 

• Example: A person may appear emotionless even in situations that typically elicit strong feelings, like receiving bad news.

Disorganized or odd behavior ranging from periods of immobility to odd gesturing or facial grimaces, wildly excessive movement, or total lack thereof is called catatonia 

Catatonia disturbed behavior A state of disturbed behavior that can range from immobility to excessive movement. It may include unusual postures or lack of response to the environment.

• Example: A person might remain motionless for long periods or exhibit frantic, purposeless movements

Positive symptoms symptoms of schizophrenia are excesses of behavior, including hallucinations, delusions, and disorganized thinking.

• Example: Experiencing vivid hallucinations or holding strong delusions despite evidence to the contrary

Negative symptoms of schizophrenia indicate a reduction or absence of normal functions, such as lack of emotion, poor motivation, and social withdrawal.

• Example: A person may show little interest in social activities or have a flat affec

The stress vulnerability model explains that individuals may have a biological sensitivity to certain disorders, which can develop under specific environmental stressors or emotional challenges.

• Example: A person with a genetic predisposition to schizophrenia may only develop the disorder after experiencing significant life stress, such as trauma or loss.

Diffusion Tensor Imaging (DTI) is a type of MRI that maps the brain's white matter by tracking how water molecules move. It helps visualize the pathways of nerve fibers, providing insights into brain structure and health.

White Matter and Gray Matter are two types of tissue in the brain and spinal cord, each with distinct roles:

Gray Matter

• What it is: This part of the brain contains the cell bodies of neurons (the brain's nerve cells, and synapses).

• Function: It processes information, like thinking and controlling movements.

• Example: The outer layer of the brain, where you think and make decisions, is gray matter.

White Matter

• What it is: This part contains the long fibers (axons) that connect different brain areas. These fibers are covered in a fatty substance called myelin, which makes them look white.

• Function: It helps different parts of the brain communicate quickly.

• Example: The pathways that send signals from one part of the brain to another, like from the thinking area to the movement area, are white matter.

In short, gray matter is where processing happens, and white matter is like the wiring that connects everything