Untitled Flashcards Set

DSM-5 Definition:

• A mental disorder is defined as a syndrome characterized by clinically significant disturbances in cognition, emotion regulation, or behavior.

• These disturbances reflect dysfunction in psychological, biological, or developmental processes.

• Associated with significant distress or disability in social, occupational, or other important activities.

• Culturally accepted responses to stressors are not considered disorders unless they stem from dysfunction.

Common Criteria for Identifying a Disorder

• Deviance (Context & Culture): Behaviors that deviate significantly from societal norms; context matters (e.g., hearing voices in spiritual contexts vs. clinical settings).

• Disability (Impairment): Significant impairment in daily functioning, affecting work, relationships, and self-care (e.g., severe depression hindering daily activities).

• Discomfort (Distress): Substantial emotional or physical distress that interferes with well-being (e.g., anxiety or panic attacks).

• Danger (Risk of Harm): Behaviors posing threats to self or others, such as self-harm or violent actions.

Mental Health Definition

• According to the World Health Organization, mental health is a state of well-being where individuals realize their potential, cope with stress, work productively, and contribute to the community.

• Freud summarized mental health as the ability 'to love and to work.'

Epidemiology

• The study of the distribution and determinants of mental disorders in populations.

• Investigates patterns of mental illness, risk factors, and protective factors to understand prevalence rates (e.g., depression's lifetime prevalence is about 17% in the U.S.).

Research Components

• Statistical Significance: Results unlikely to occur by chance, typically with a p-value < 0.05, indicating meaningful effects.

• Clinical Significance: Practical importance of treatment effects, showing meaningful symptom improvement, even without statistical significance.

• Symptom Reduction: Evaluates how well interventions reduce symptoms, with terms like partial and complete remission.

• Placebo Effect: Improvement due to belief in treatment rather than the treatment itself; placebo-controlled trials help distinguish real effects.

• Meta-Analysis: Combines results from multiple studies to derive stronger conclusions about treatment efficacy.

Behavioral Genetics

• Heritability: Estimates the genetic contribution to trait variation; e.g., schizophrenia has an 80% heritability estimate.

• Methods for Studying Genetic Influences:

  • Family History Studies: Examining disorders among relatives.

  • Twin Studies: Comparing identical and fraternal twins to assess genetic influence.

  • Adoption Studies: Evaluating adopted individuals to distinguish genetic from environmental influences.

• Epigenetics: Studies how environmental factors affect gene expression without altering DNA, influencing mental illness development.

Neurotransmitters & Their Functions

• Acetylcholine (ACh): Important for memory and muscle movement; deficiencies linked to Alzheimer’s disease.

• Norepinephrine (NE): Involved in stress responses and mood regulation; low levels associated with depression.

• Dopamine (DA): Regulates pleasure and reward; linked to schizophrenia (excess) and Parkinson’s disease (deficiency).

• Serotonin (5HT): Influences mood and emotional regulation; low levels associated with depression and anxiety disorders.

• Glutamate (Glu): Main excitatory neurotransmitter; excess linked to schizophrenia.

• Gamma-Aminobutyric Acid (GABA): Main inhibitory neurotransmitter; regulates anxiety; enhanced by anti-anxiety medications.

Learning Theories

• Classical Conditioning: Learning through association; e.g., conditioned emotional responses like fear from past experiences.

• Stimulus Generalization: Responding similarly to similar stimuli; e.g., fear of all dogs after being bitten by one.

• Stimulus Discrimination: Learning to distinguish between different stimuli; e.g., recognizing safe vs. dangerous dogs.

• Operant Conditioning: Learning through consequences; behaviors are influenced by reinforcement and punishment.

Reinforcement and Punishment

• Reinforcement: Increases likelihood of behavior; can be positive (adding a pleasant stimulus) or negative (removing an unpleasant stimulus).

• Punishment: Decreases likelihood of behavior; can be positive (adding an unpleasant stimulus) or negative (removing a pleasant stimulus).

• Schedules of Reinforcement: Patterns dictating reinforcement frequency (fixed/variable ratio or interval).

• definition of abnormality: Abnormality refers to behaviors, thoughts, or feelings that deviate significantly from what is considered normal or typical in a given culture or context. It often implies something unusual or unhealthy that might affect a person's well-being or functioning.

• Interviews (structured and unstructured): Interviews can be structured or unstructured, with structured interviews using a set list of questions for all candidates, ensuring consistency, while unstructured interviews are more flexible, allowing for open-ended conversations that can explore candidates' thoughts and experiences in depth. Structured interviews are like following a recipe to get a consistent dish, while unstructured ones are akin to improvising a meal based on available ingredients.

• Purpose of neuropsych batteries: Neuropsych batteries are collections of tests designed to assess various cognitive functions like memory, attention, and problem-solving. They help psychologists understand how the brain is working and identify any areas that may be affected by injury or illness, providing a clearer picture of a person's mental abilities.

• Projective tests: Projective tests are psychological assessments that encourage people to express their thoughts, feelings, and desires through ambiguous stimuli, like pictures or words. The idea is that when faced with unclear prompts, individuals will project their own unconscious feelings onto these stimuli, revealing insights about their personality and emotions.

• aptitude test: measure of accumulated effects of educational/traininf experiences that attempts to forecast future performances

• attitude and interest tests: measure range & strength of person's interests, attitudes, preferences & values

• intelligence test: measure of general mental ability & various specific intellectual abilities (verbal reasoning, quantitative skills, abstract thinking, visual recognition & memory)

• neuropsychological test: measure deficits in behavior, cognition, emotions known to correlate with brain dysfunction and damage

• Personality tests: Personality tests are tools designed to help us understand our individual traits, preferences, and behaviors. They typically ask a series of questions that reflect our thoughts and feelings in different situations, allowing us to see how we relate to others and what motivates us. The results can give us insights into our strengths and weaknesses, and help improve our personal and professional relationships.

• objective test: requires answers/rating to specific questions that are scored quantitatively

• cross cultural validation: whether measures or tests, that were originally generated in single culture are applicable, meaningful, & thus valid when applied to member of another culture

• The DSM (publisher, what information is in it, orientation, other classification manuals) :The DSM, or Diagnostic and Statistical Manual of Mental Disorders, is a book published by the American Psychiatric Association that provides standardized criteria for diagnosing mental health conditions. It includes detailed descriptions of various disorders, their symptoms, and guidelines on how to classify them. This manual is essential for mental health professionals as it helps them understand and communicate about mental illnesses consistently. Other manuals, like the ICD (International Classification of Diseases), also provide classification but may include a broader range of health issues beyond just mental health.

• Co-morbidity: Co-morbidity refers to the presence of two or more diseases or medical conditions in a patient at the same time. For example, a person with diabetes might also have heart disease. This can make treatment more complicated since the conditions can affect each other and require different types of management.

• Classical (Monothetic) Method: Requires a fixed, specific set of symptoms for diagnosis. If one symptom is missing, the diagnosis is not given. Example: If a disorder requires A, B, and C, but you only have A and B, you don’t qualify.

• Polythetic Method: Allows flexibility by listing multiple possible symptoms, but only a subset is required for diagnosis.Example: A disorder may have 9 possible symptoms, but you only need 5 to be diagnosed.

Who can do therapy

• Licensed professionals: such as clinical psychologists, counselors, social workers, and psychiatrists can provide therapy.

• Psychiatrists: (MDs) can also provide therapy but usually focus on medication management.

Who prescribes psychiatric medications:

• Psychiatrists (MD or DO) and, in some cases, psychiatric nurse practitioners.

• Some psychologists in certain states (with additional training) can prescribe

A few famous people from the history of psychology

• Sigmund Freud – Psychoanalysis, unconscious mind.

• Carl Jung – Analytical psychology, archetypes.

• B.F. Skinner – Behaviorism, reinforcement.

• John Watson – Founder of behaviorism.

• Jean Piaget – Cognitive development.

• Wilhelm Wundt – Father of psychology.

The Rosenhans study

• 1973 experiment where healthy individuals faked schizophrenia symptoms to get admitted to psychiatric hospitals.

• Showed flaws in psychiatric diagnosis and how labels stick.

Hysteria

• An old diagnosis for unexplained physical and emotional symptoms (often in women).

• Historically linked to Freud and early psychoanalysis.

• Now understood as part of conversion disorder (a somatic symptom disorder).

1st biological revolution

• The shift from psychological explanations of mental illness to biological ones.

• Began with syphilis and general paresis discovery, showing a disease could cause mental illness.

Types of hallucinations

• Auditory (most common) – hearing voices.

  • voice commenting

  • voice conversing

• Visual – seeing things that aren’t there.

• Olfactory – smelling things.

• Somatic Tactile – feeling sensations on the skin.

• Gustatory – tasting things.

Hallucinations and delusions, most common types

• Hallucinations = False sensory experiences (seeing, hearing, smelling, etc.).

• Delusions = False beliefs, like paranoia or thinking you’re God.

  • Persecutory

  • jealousy

  • guilt, sin

  • grandiose

  • religious

  • somatic

  • delusion of reference

  • delusion of being controlled

  • delusion of mind reading

• Most common: Auditory hallucinations & persecutory delusions (thinking people are out to get you).

Different psychotic disorders discussed – their symptoms

• Schizophreniform – hallucinations, delusions, disorganized speech/behavior + neg symptoms (1-6 months)

• Schizoaffective disorder – schizophrenia + mood disorder (depression/bipolar).

• Delusional disorder – only delusions, no hallucinations.

• Brief psychotic disorder – sudden psychosis, short-term (less than a month).

Antipsychotic medications

• 1st Generation

  • D2 blockers

  • Mesolimbic system

  • Positive Symptoms

    • Low Potency

      • Chlorpromazine (Thorazine)

      • Tifluoperazine (Stelazine)

        • Effects: Sedation, Anticholinergic Effects, Orthostatic Hypotension

    • High Potency

      • Fluphenazine (Prolixin)

      • Halperidol (Haldol)

        • Effects: Extrapyramidal effects (EPS)

• 2nd Generation

  • 5HT-2 blockers

  • Prefrontal Cortex

  • Positive and Negative Symptoms

Stages of schizophrenia

1. Premorbid

2. Prodromal – Early signs (social withdrawal, odd behavior).

3. Active (Psychotic) – Full symptoms (hallucinations, delusions).

4. Residual – Symptoms lessen but functional decline continues.

Positive and negative symptoms

• Positive

  • Hallucinations

  • Auditory

  • Voices commenting

  • Voices conversing

  • Somatic-tactile

  • Olfactory

  • Visual

  • Bizarre behavior

  • Clothing, appearance

  • Social, sexual behavior

  • Aggressive-agitated behavior

  • Repetitive-stereotyped behavior

  • Delusions

  • Persecutory

  • Jealousy

  • Guilt, sin

  • Grandiose

  • Religious Somatic

  • Delusions of reference

  • Delusions of being controlled

  • Delusions of mind reading

  • Thought broadcasting

  • Thought insertion

  • Formal thought disorder

  • Tagentiality

  • Incoherence

  • Illogicality

  • Circumstantiality

  • Pressure of speech

  • Distractible speech

  • Clanging

• Negative

  • By Observation

    • Reduced Speech

    • Poor Grooming

    • Limited Eye Contact

  • With Questioning

    • Reduced Emotional Responsiveness

    • Reduced Interest

    • Reduced Social Drive

Neurotransmitters associated with schizophrenia

• Dopamine (DA) – Excess in some brain areas (positive symptoms).

• Glutamate – Dysfunction may explain negative symptoms.

• Serotonin – Involved in newer antipsychotic drugs.

Stimulus overload

• Difficulty filtering irrelevant information → leads to hallucinations and paranoia.

• Linked to problems in sensory gating in schizophrenia.

When schizophrenia develops

• Typically late teens to early 30s.

• Males: Earlier onset (late teens–early 20s).

• Females: Later onset (late 20s–early 30s).

Diathesis stress and biopsychosocial models

• Diathesis-Stress Model – Genetic predisposition + environmental stress = mental illness.

• Biopsychosocial Model – Mental illness results from biological, psychological, and social factors

Diagnostic specificity and sensitivity

• Specificity – Correctly ruling out people without the disorder.

• Sensitivity – Correctly identifying people with the disorder.

Prevalence and incidence

• Prevalence – Total cases in a population at a given time.

• Incidence – New cases appearing in a specific timeframe.

Schizophrenia and prenatal illness

• Prenatal factors like maternal infections (flu), malnutrition, stress increase risk.

• Winter births have a slightly higher risk (linked to infections during pregnancy)

Heritability studies

• Twin studies: 50% risk if identical twin has schizophrenia.

• Adoption studies: Biological relatives of those with schizophrenia have higher risk, even if raised apart.

Degeneration and eugenics

• degeneration theory: steady decline in mental functioning & social adaptation from one generation to another

• eugenics: improving human species by breeding ppl with desirable traits

Dangerousness in mental illness

• Most people with schizophrenia are NOT violent.

• Small increased risk for violence only with substance abuse.

• More likely to be victims than perpetrators.

Cultural impact on psychosis

• Symptoms vary across cultures.

• Western: More paranoid delusions.

• Non-Western: More spiritual or religious hallucinations.

Major side effects of antipsychotics/polypharmacy

• Extrapyramidal symptoms (EPS) – Tremors, rigidity (like Parkinson’s).

• Tardive dyskinesia – Involuntary facial movements.

• Metabolic syndrome – Weight gain, diabetes risk.

• Polypharmacy – Using multiple medications, increases side effects.

Brain circuits in schizophrenia

• Dopamine pathways involved:Mesolimbic (too much DA) → Positive symptoms.Mesocortical (too little DA) → Negative symptoms.

• Enlarged ventricles, reduced gray matter, and frontal lobe dysfunction.

New novel treatments for schizophrenia

• Third-Gen Antipsychotics (e.g., Aripiprazole) – Stabilizes dopamine.

• Psychedelic research (e.g., ketamine) – Investigated for resistant symptoms.

• rTMS (repetitive transcranial magnetic stimulation) – Potential for auditory hallucinations.

• Digital therapeutics – Smartphone-based cognitive therapy.