ch 14

Suicide

11th leading cause of death, 3rd in teens and young adults

What is the DSM-IV-TR?

A classification system for all psychological disorders recognized by the American Psychological Association, which describes disorders and has criteria for each, as well as background info and possible treatment options.

How is psychological disorder defined?

An ongoing pattern of behavior, thought processes, and/or feelings that disrupt a person's daily life, impair their ability to function and cause them distress/discomfort; deviant, distressful and dysfunctional.

What is antisocial personality disorder? What characterizes this disorder (behaviorally, biologically)?

Antisocial personality disorder is a long-term pattern of irresponsible, impulsive and unscrupulous behavior. It's not someone who is antisocial but someone who goes against societal rules in a negative way. Characterized by: • Problems with jobs, relationships • Callous, manipulative, exploitative • Lack anxiety, remorse, guilt • May be charming, intelligent • Less sensitive to punishment Good con artists and criminals. Biological: • Genetic influence! • Less responsive to physiological arousal - easier to pass lie detectors! • Decreased release of stress hormones • Decreased brain response to distress

What are anxiety disorders?

Anxiety disorders are a mix of subjective (worry, fear, nervousness, dread, inability to relax) and physical (sympathetic arousal - trembling, sweating, racing heart, dizziness, nausea, increased heart rate) symptoms that combine to intense, persistent, disruptive and excessive anxiety.

What are some biological and psychological factors involved in mood disorders?

Biological factors: genetic influence, brain activity, neurotransmitters (NE, 5-HT, DA), and stress response Psychological factors: hopelessness, learned helplessness, external locus of control, reaction to positive/negative events, perfectionism, and negative explanatory style (see below).

What are some biological and psychological factors involved in anxiety disorders?

Biological: genetic influence, autonomic nervous system, brain affected! Psychological: attentional bias, low self-efficacy, learning

What is meant by culture-general and culture-specific psychological disorders?

Culture-general disorders (found in all cultures) Culture-specific disorders (not cross cultural)

What are global, stable, and internal attributions? How do these relate to depression?

Global attributions - over generalize (ex. Doing poorly on 1 test = can't do anything right) Stable attributions - permanent/ will go into future (ex. One break up = no one will ever love me) Internal attributions - self blame (it's all my fault)

About what percentage of American adults will have a psychological disorder in their lifetime?

Half of adults will experience a psychological disorder in their lifetime and 75% of them will show symptoms by age 24

What are mood disorders? Know the ones we covered, symptoms, characteristics, how they differ.

Mood (affective) disorders are extremes of mood that are inconsistent /out of proportion to the events in the person's life.

How are psychological disorders related to poverty?

More common among people who live in poverty (does poverty cause psych disorders or do disorders cause poverty - probably both; but there is evidence for poverty causing disorders) -When family moved out of poverty, decreased number of psych disorders

What are the issues associated with applying a diagnostic label to someone?

Once you apply a label to someone, they may be stigmatized by that label and their normal behaviors would be interpreted as symptoms. Then it would be like a self-fulfilling prophecy.

What are personality disorders?

Personality disorders are long-standing, inflexible, disruptive, dysfunctional patterns of behavior and thought that impair social functioning. There are three clusters: 1. Odd-eccentric (paranoid, schizoid, schizotypal) 2. Anxious-fearful (dependent, OCD, avoidant) 3. Dramatic-erratic (histrionic, narcissistic, borderline, antisocial)

What are positive and negative symptoms and why is this distinction important?

Positive symptoms  reflect additions of abnormality (presence of symptom not in normal people) Hallucinations, delusions, inappropriate behavior, compulsivity Negative symptoms  absence of regular behaviors Social withdraw, catatonia, flat effect If more predominantly negative symptoms  less likely to get better

What factors may predict suicide?

Predicting is hard, but there are indicators: Giving away prized possessions, someone who is impulsive, someone who has a plan, history of alcohol dependence, people who talk about suicide, previous attempts in the past, someone who is about to come out of their depression or rebound (now have energy)

What characterizes antisocial personality disorder (psychosocially

Psychosocial: • Poverty and abuse There is a higher rate of abuse but it's hard to tell if these people are lying or telling the truth about it. The disease itself could be a product of poverty but APD could also cause downward economic mobility so it's a kind of chicken/egg dilemma, here.

What is schizophrenia? Why is it so disabling?

Schizophrenia is disordered thoughts and perceptions, irrational ideas, inappropriate emotions and behaviors and a loss of contact with reality. It is so disabling because the person doesn't know that they're ill.

Major Depression:

Symptoms: sadness, crying, hopeless, pessimism, lack of motivation, low energy, loss of interest, guilt, inadequacy, low self-esteem, anxiety, worthlessness, concentration, isolation, anhedonia (absence of pleasure, nothing makes them feel better/happy) • Long period of continual sadness and hopelessness; person may feel guilt, low self-esteem, worrying, pessimistic expectations for the future, no happiness anywhere • Lasts for at least two weeks and recurs continually • Shows up for the first time in young adulthood • It's common!

How did/does the biopsychosocial model explain psychological disorder?

The Biopsychosocial model says that mental illness comes from an interaction of biological, social and psychological factors. Biological factors include: brain, genes, hormones, chemicals, neurotransmitters, drugs; psychological factors include: how someone interprets actions in their life, attributions; social/environmental factors include: stress, economic status, social support and culture (culture specific/general disorders).

What are the problems with defining psychological disorder/psychopathology?

The problem with defining it is that there is no distinct boundary to mentally ill, so one definition doesn't always fit

At what age does schizophrenia usually appear?

Typically develops late teens  early 20's Slightly more common in men/more severe Gradual onset (less likely to get better) ¼ of people get better; ½ stay same; ¼ get worse

How does the diathesis-stress model explain psychological disorder?

Very much like biopsychosocial but more emphasis on the role that stress plays People have different predispositions toward development of a mental illness; this predisposition or diathesis may come from genes or early experiences - Whether someone goes on to develop a mental disorder depends on the combination between predisposition and amount of stress - If someone has a very low predisposition for disorder, it will take a lot of stress for them to develop that order

Agoraphobia:

fear of separation from a safe place or person and in extreme cases people refuse to leave their home (stoop kid hey arnald)

Generalized Anxiety Disorder:

free-floating, continual, long-lasting anxiety for no particular reason symptoms: trouble concentrating, easily startled, dread, worry, irritability, tense, insomnia, hyper-vigilance, exaggerated startle, nausea, dizziness

Phobias:

intense, irrational fears of particular objects or situations; fear is excessive and out of proportion to the threat

Bipolar Disorder:

manic depression; alternation between depression and mania (agitated emotional state) • emotions = euphoria and irritability; cognition = poor judgment and optimism; behavior = hyperactive, talkative, reckless, insomnia • equally common between men and women

OCD:

obsessions (thoughts), compulsions (behaviors), anxiety, time consuming, genetic influence

PTSD:

occurs after traumatic incident in which person witnessed or experienced horrific, uncontrollable events common in people who have lived through disasters, lived in war zones/violent neighborhood, were victims of sexual assault, etc. • person feels they have no control over what happened (powerlessness) • some people are more vulnerable than others, particularly those w/ a more reactive nervous system • symptoms: flashbacks, nightmares, jumpy, cranky, withdrawn, insomnia

Panic Disorder:

panic attacks without cause symptoms: sudden, intense anxiety, no cause, unpredictable, dizziness, chest pain, sweating, trembling, suffocation

Who is most likely to commit suicide?

• 65 years old or older more likely to commit suicide • Native Americans and European Americans have a much greater rate of suicide than Hispanic, Asian, and African Americans • Men are more likely to succeed in killing themselves, but women much more likely to make suicide attempts (women have higher rates of depression) • High socioeconomic status more likely to commit suicide • Unmarried • People who are not religious Women are more likely to attempt suicide; men are more likely to succeed.(hard to kill urself in the kitchen)

What are some biological factors associated with schizophrenia?

• Excess of dopamine receptors, drugs block these - involved with positive symptoms • Less glutamate activity than normal people - involved with negative symptoms • Brain: enlarged ventricles (fluid filled spaces in the brain), shrinkage of brain tissue, widespread abnormalities • Genetic influence - people with relatives who are schizophrenic are more likely to be; if one identical twin has it, there's a 50% chance the other will  not totally genetic b/c if it was there'd be 100% correlation between the twins o Low birth weight, oxygen deprived, babies born in winter/spring show signs of being more inclined towards schizophrenia, older dad Sociocultural/psychological factors: don't play a large role. Stress can precipitate schizophrenia in those already prone to it but these factors are small causes to the disorder.

What are the most common types of hallucinations in schizophrenia? Know the different types of delusions we covered.

• Hallucinations (perception without sensory input), auditory being most common (voices) • Delusions (false but strongly held beliefs) o Grandeur: person feels much greater/more important than they actually are o Persecution: belief that other people out to get you o Reference: think that things/ people are referring to them Think that thoughts are being stolen, implanted, or broadcasted

What are the symptoms? of schizophrenia?

• Hallucinations and delusions • Attentional problems (filtering, loose associations, disorganized thinking and speech) Emotional disturbances (flat affect and inappropriate emotions) • Social problems (ie: withdrawal) • Behavioral problems o Catatonic stupor/catatonia (rigid immobility for periods of time) o Waxy flexibility (you can pose them and they'll stay in that pose) o Repetitive, compulsive behaviors w/ no purpose (ie: folding paper over and over)