Psychological Disorders
chronic schizophrenia
(also called process schizophrenia) a form of schizophrenia in which symptoms usually appear by late adolescence or early adulthood. As people age, psychotic episodes last longer and recovery periods shorten.
acute schizophrenia
(also called reactive schizophrenia) a form of schizophrenia that can begin at any age, frequently occurs in response to an emotionally traumatic event, and has extended recovery periods.
The Biological Perspective of Depression
-Depressive disorders and bipolar disorder run in families. -Summarizing the major twin studies, one research team estimated the heritability of major depressive disorder—the extent to which individual differences are attributable to genes—at 40 percent -Neuroscientists have also discovered altered brain structures in people with bipolar disorder. These studies discovered decreased white matter (myelinated axons) and enlarged fluid-filled ventricles -Neurotransmitter systems also influence depressive disorders and bipolar disorder. Norepinephrine, which increases arousal and boosts mood, is scarce during depression and overabundant during mania. Drugs that decrease mania reduce norepinephrine. -Serotonin is also scarce or inactive during depression -study of New Zealand young adults found that the recipe for depression combined two necessary ingredients—significant life stress plus a variation of a serotonin-controlling gene
Biology
-Genes: some genes influence disorders by regulating brain levels of neurotransmitters (serotonin, glutamate) -experience affects gene expression: epigentic marks
How do conditioning, cognition, and biology contribute to the feelings and thoughts that mark anxiety disorders, OCD, and PTSD?
-Through classical conditioning, our fear responses can become linked with formerly neutral objects and events. In a classic experiment, an infant—"Little Albert"—learned to fear furry objects that researchers paired with loud noises. In other experiments, researchers have created anxious animals by giving rats unpredictable electric shocks
How can the biological and social-cognitive perspectives help us understand depressive disorders and bipolar disorder?
-Women's risk of major depressive disorder is nearly double men's -girls also become more vulnerable than boys to eating disorders, self-injury, and anxiety -The factors that put women at risk for depression (genetic predispositions, child abuse, low self-esteem, marital problems, and so forth) similarly put men at risk (Kendler et al., 2006). Yet women are more vulnerable to disorders involving internalized states, such as depression, anxiety, and inhibited sexual desire. Women experience more situations that increase their risk for depression, such as receiving less pay for equal work, juggling multiple roles, and caring for children and elderly family members (Freeman & Freeman, 2013). Men's disorders tend to be more external—alcohol use disorder, and disorders related to antisocial conduct, and lack of impulse control. When women get sad, they often get sadder than men do. When men get mad, they often get madder than women do. -Most major depressive episodes self-terminate:Therapy often helps and tends to speed recovery. But even without professional help, most people recover from depression and return to normal. -Stressful events related to work, marriage, and close relationships often precede depression. -Compared to generations past, depression strikes earlier (now often in the late teens) and affects more people, with the highest rates among young adults in developed countries
What brain abnormalities are associated with schizophrenia?
-an excess number of dopamine receptors -Some people diagnosed with schizophrenia have abnormally low brain activity in the frontal lobes, areas that help us reason, plan, and solve problems
How and why do clinicians classify psychological disorders
-classification aims to predict a disorder's future course, suggest appropriate treatment, and prompt research into its causes
why do some psychologists criticize the use of diagnostic labels?
-diagnostic labels can be subjective, or even value judgements masquerading as science -once we label a person, we view that person differently -labels can be self-fulfilling -Label someone as "mentally ill" and people may fear them as potentially violent. That reaction may fade as people better understand that many psychological disorders involve diseases of the brain, not failures of character. Public figures have helped foster this understanding by speaking openly about their own struggles with disorders such as depression and substance abuse. The more contact we have with people with disorders, the more accepting our attitudes become (Corrigan et al., 2014).
Symptoms of Schizophrenia
-hallucinations: false perceptions: see, feel, taste, or smell things that exist only in their minds. Most often, the hallucinations are voices -delusions:a false belief, often of persecution or grandeur, that may accompany psychotic disorders. -disturbed perceptions -disorganized speech -diminished and inappropriate emotions<impaired theory of mind (difficulty perceiving facial expressions), flat affect state (no apparent feeling) Physical Symptoms: -enlarged ventricles -reduced gray matter Behavioral Symptoms: -paranoia, catatonic, delusional -lacks awareness, emotion, empathy -undifferentiated: confused, disorganized speech, both positive and negative symptoms
What factors increase the risk of suicide, and what do we know about nonsuicidal self-injury?
-national differences -racial differences:Within the United States, Whites and Native Americans kill themselves twice as often as Blacks, Hispanics, and Asians -gender differences:Women are much more likely than men to attempt suicide (WHO, 2011). But men are two to four times more likely (depending on the country) to actually end their lives. -age difference and tends -suicide rates have been much higher among the rich, the nonreligious, and those single, widowed, or divorced -day of the week and seasonal differences:Negative emotion tends to go up midweek, which can have tragic consequences -suicide rates increase with unemployment during economic recessions
What increases vulnerability to mental disorders?
-one predictor of mental disorder—poverty—crosses ethnic and gender lines. The incidence of serious psychological disorders is 2.5 times higher among those below the poverty line
Why are some of the new or altered diagnoses in the DSM-5 controversial?
-overmedication -bringing "almost any kind of behavior within the compass of psychiatry" -calling normal traction to tragic life events as a psychological disorder
How many people have, or have had, a psychological disorder? Is poverty a risk factor?
-the lowest rate of reported mental disorders was in Nigeria, the highest rate in the United States. Moreover, immigrants to the United States from Mexico, Africa, and Asia averaged better mental health than their U.S.-born counterparts with the same ethnic heritage -The U.S. National Institute of Mental Health (2015) has estimated that just under 1 in 5 adult Americans currently have had a "mental, behavioral, or emotional disorder (excluding developmental and substance use disorders)" or have had one within the past year
the biopsychosocial approach
-to call psychological disorders "sicknesses" tilts research toward the influence of biology and away from the influence of personal histories and social and cultural surroundings -But in the study of disorders, as in so many other areas, biological, psychological, and social-cultural influences together weave the fabric of our behaviors, our thoughts, and our feelings. -Major depressive disorder and schizophrenia occur worldwide -eating disorders are more common in food-abundant Western cultures -such disorders may share an underlying dynamic while differing in symptoms -Disorders reflect genetic predispositions and physiological states, inner psychological dynamics, and social and cultural circumstances. -The biopsychosocial approach gave rise to the vulnerability-stress model, which argues that individual characteristics combine with environmental stressors to increase or decrease the likelihood of developing a psychological disorder -Research on epigenetics (literally, "in addition to genetic") supports the vulnerability-stress model by showing how our DNA and our environment interact. In one environment, a gene will be expressed, but in another, it may lie dormant. For some, that will be the difference between developing a disorder or not developing it.
NEGATIVE THOUGHTS AND NEGATIVE MOODS GENDER
-women may respond more strongly to stress -This gender stress difference may help explain why, beginning in their early teens, women have been nearly twice as vulnerable to depression.
Objectives
15.1: Define psychological disorder. 15.2: Discuss how the medical model and the biopsychosocial approach influence our understanding of psychological disorders. 15.3: Describe how and why clinicians classify psychological disorders, and explain why some psychologists criticize the use of diagnostic labels 15.4 Identify and describe the symptoms of schizophrenia, PTSD, Major Depressive Disorder, and OCD. 15.5 Describe how conditioning, cognition and biology contribute to the above mentioned disorders. 15.6 Understand factors contributing to suicidal behavior.
explanatory style
ANOTHER DIAGRAM
At what times of life do disorders strike?
Among the earliest to appear are the symptoms of antisocial personality disorder (median age 8) and of phobias (median age 10). Alcohol use disorder, obsessive-compulsive disorder, bipolar disorder, and schizophrenia symptoms appear at a median age near 20. Major depressive disorder often hits somewhat later, at a median age of 25.
panic disorder
An anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations.
What factors contribute to the onset and development of schizophrenia?
Biological factors include abnormalities in brain structure and function and a genetic predisposition to the disorder. Environmental factors such as nutritional deprivation, exposure to virus, and maternal stress contribute by activating the genes that increase risk. Exposure to many environmental triggers can increase the odds of developing schizophrenia.
Researchers believe that conditioning and cognitive processes are aspects of learning that contribute to anxiety-related disorders. What biological factors also contribute to these disorders?
Biological factors include inherited temperament differences and other gene variations; experience-altered brain pathways; and outdated, inherited responses that had survival value for our distant ancestors.
What is the biopsychosocial approach, and why is it important in our understanding of psychological disorders?
Biological, psychological, and social-cultural influences combine to produce psychological disorders. This approach helps us understand that our well-being is affected by our genes, brain functioning, inner thoughts and feelings, and the influences of our social and cultural environment.
treatments for PTSD
Cognitive-behavioral therapy and stress management Systematic desensitization Stress-inoculation therapy: Therapists teach clients skills for overcoming problems that: Increase stress Result from PTSD Biological therapies Selective serotonin reuptake inhibitors (SSRIs) Benzodiazepines
What does it mean to say that "depression is a whole-body disorder"?
Many factors contribute to depression, including the biological influences of genetics and brain function. Social-cognitive factors also matter, including the interaction of explanatory style, mood, our responses to stressful experiences, and changes in our patterns of thinking and behaving. Depression involves the whole body and may disrupt sleep, energy, and concentration.
How do genes influence schizophrenia? What factors may be early warning signs of schizophrenia in children?
Might some people be more genetically vulnerable to schizophrenia? Yes. The 1-in-100 odds of any person's being diagnosed with schizophrenia become about 1 in 10 among those who have a sibling or parent with the disorder. -Adoption studies help untangle genetic and environmental influences. Children adopted by someone who develops schizophrenia do not "catch" the disorder. Rather, adopted children have an elevated risk if a biological parent is diagnosed with schizophrenia (Gottesman, 1991). Genes matter. -there is a genetic link -things can "turn on" schizophrenia genes
persistent depressive disorder (dysthymia)
Mood disorder involving persistently depressed mood, with low self-esteem, withdrawal, pessimism, or despair, present for at least 2 years, with no absence of symptoms for more than 2 months.
Do psychological disorders predict violent behavior?
Most violent criminals are not mentally ill, and most mentally ill people are not violent. People with disorders are more likely to be victims than perpetrators of violence Psychological disorders only rarely lead to violent acts, and focusing gun restrictions only on mentally ill people will likely not reduce gun violence (Friedman, 2012). Better predictors of violence are use of alcohol or drugs, previous violence, and gun availability. The mass-killing shooters have one more thing in common: They tend to be young males.
The Brain
Our experiences change our brain, paving new pathways. Traumatic fear-learning experiences can leave tracks in the brain, creating fear circuits within the amygdala. Generalized anxiety disorder, panic attacks, phobias, OCD, and PTSD express themselves biologically as overarousal of brain areas involved in impulse control and habitual behaviors. These disorders reflect a brain danger-detection system gone hyperactive—producing anxiety when no danger exists.
Natural Selection
Our phobias focus on such specific fears: spiders, snakes, and other animals; enclosed spaces and heights; storms and darkness. Those fearless about these occasional threats were less likely to survive and leave descendants.
what is the relationship between poverty and psychological disorders?
Poverty-related stresses can help trigger disorders, but disabling disorders can also contribute to poverty. Thus, poverty and disorder are often a chicken-and-egg situation; it's hard to know which came first.
Environmental Triggers for Schizophrenia
Researchers identified other possible early warning signs, including a mother whose schizophrenia was severe and long-lasting; birth complications (often involving oxygen deprivation and low birth weight); separation from parents; short attention span and poor muscle coordination; disruptive or withdrawn behavior; emotional unpredictability; poor peer relations and solo play; and childhood physical, sexual, or emotional abuse
Are psychological disorders universal or culture-specific? Explain with examples.
Some psychological disorders are culture-specific. For example, anorexia nervosa occurs mostly in Western cultures, and taijin kyofusho appears largely in Japan. Other disorders, such as schizophrenia, are universal—they occur in all cultures.
Social-Cognitive Perspective of Depression
The social-cognitive perspective explores how people's assumptions and expectations influence what they perceive. Many depressed people view life through the dark glasses of low self-esteem (Orth et al., 2016). Their intensely negative assumptions about themselves, their situation, and their future lead them to magnify bad experiences and minimize good ones
What is the value, and what are the dangers, of labeling individuals with disorders?
Therapists and others apply disorder labels to communicate with one another using a common language, and to share concepts during research. Clients may benefit from knowing that they are not the only ones with these symptoms. The dangers of labeling people are that (1) people may begin to act as they have been labeled, and (2) the labels can trigger assumptions that will change people's behavior toward those labeled.
Schizophrenia
a disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression. -Criteria: lasts at least 6months
posttraumatic stress disorder (PTSD)
a disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia that lingers for four weeks or more after a traumatic experience -about half of us will experience at least one traumatic event in our lifetime
obsessive-compulsive disorder (OCD)
a disorder characterized by unwanted repetitive thoughts (obsessions), actions (compulsions), or both.
bipolar disorder
a disorder in which a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania. (Formerly called manic-depressive disorder.) -potent predictor of suicide -afflicts as many men as women -Americans are twice as likely as people of other countries to have ever had a diagnosis of bipolar disorder
major depressive disorder
a disorder in which a person experiences, in the absence of drugs or another medical condition, two or more weeks with five or more symptoms, at least one of which must be either (1) depressed mood or (2) loss of interest or pleasure
psychotic disorders
a group of psychological disorders marked by irrational ideas, distorted perceptions, and a loss of contact with reality
mania
a hyperactive, wildly optimistic state in which dangerously poor judgement is common
explanatory style
a person's habitual way of explaining events, typically assessed along three dimensions: internal/external, stable/unstable, and global/specific -Self-defeating beliefs may arise from learned helplessness, the hopelessness and passive resignation humans and other animals learn when they experience uncontrollable painful events
attention-deficit/hyperactivity disorder (ADHD)
a psychological disorder marked by the appearance by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity
Psychological disorder
a syndrome marked by a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior -interfere with normal day-to-day life (dysfunctional or maladaptive) -over time, definitions of what makes for a "significant disturbance" have varied ex. homosexuality -stigma and stresses that people who are gay, lesbian, transgender, and gender nonconforming often experience can increase the risk of mental health problems
survivor resiliency
ability to recover after severe stress
phobia
an anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity, or situation
generalized anxiety disorder
an disorder an anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal.
Cognition
by observing others, we can learn to fear what they fear -people with anxiety disorders tend to be hypervigilant<they attend more to threatening stimuli, they more often interpret unclear stimuli as threatening, they more often remember threatening events -anxiety is especially common when people cannot switch off such intrusive thoughts and perceive a loss of control and a sense of helplessness
rumination
compulsive fretting; overthinking about our problems and their causes
nonsuicidal self-injury
direct, deliberate destruction of body tissue in the absence of any intent to die
Unfocused tension, apprehension, and arousal are symptoms of __________ disorder.
generalized anxiety
reinforcement
helps maintain learned fears and anxieties -anything that enables us to avoid or escape a feared situation can reinforce maladaptive behaviors
A person with schizophrenia who has __________ (positive/negative) symptoms may have an expressionless face and toneless voice. These symptoms are most common with __________ (chronic/acute) schizophrenia and are not likely to respond to drug therapy. Those with __________ (positive/negative) symptoms are likely to experience delusions and to be diagnosed with __________ (chronic/acute) schizophrenia, which is much more likely to respond to drug therapy.
negative; chronic; positive; acute.
stimulus generalization
occurs when a person experiences a fearful event and later develops a fear of similar events.
Those who experience unpredictable periods of terror and intense dread, accompanied by frightening physical sensations, may be diagnosed with a __________ disorder.
panic
If a person is focusing anxiety on specific feared objects or situations, that person may have a __________.
phobia
anxiety disorders
psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety
DSM-5
the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; a widely used system for classifying psychological disorders.
Medical model
the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and, in most cases, cured, often through treatment in a hospital. -we speak of the mental health movement: a mental illness needs to be diagnosed on the basis of its symptoms. It needs to be treated through therapy
Three other anxiety disorders
→Generalized anxiety disorder, in which a person is unexplainably and continually tense and uneasy. →Panic disorder, in which a person experiences panic attacks—sudden episodes of intense dread—and fears the next episode's unpredictable onset. →Phobias, in which a person is intensely and irrationally afraid of a specific object, activity, or situation.
