Psychology - Chapter 15: Psychological Disorders

Mood Disorders: Major Depressive Disorder (MDD): Risk Factors

-Higher incidence in women than men (about 2:1) -Unemployment -Low income -Urban living -Relationship problems -Substance abuse

Attention Deficit Hyperactivity Disorder (ADHD)

-Inattention -Hyperactivity/Impulsivity -Diagnosed more often in boys than girls -Changes over development

Post-Traumatic Stress Disorder (PTSD): Symptoms

-Intrusive, painful memories- flashbacks -Jumpiness, hypervigilance -Negative emotional state -Detachment, outbursts- anger -Avoidance of reminders These symptoms must last at least one month

Post-Traumatic Stress Disorder (PTSD): Risk Factors

-Lack of social support -Additional life stress after the trauma -Severity of trauma -Being harmed by another person -History of mental illness -Less emotionally stable

Potential Causes of O-C Symptoms

-Moderate heritability -Genes involved in regulation of neurotransmitters

Mood Disorders: Gene-environment Interaction

-Much higher incidence of chronic depression in individuals with a short version of the gene in combination with childhood maltreatment -Supports idea of genetic vulnerability affected by environmental input: diathesis-stress model

Type C: Nervous/Fearful - Obsessive-Compulsive Personality Disorder

-Needs perfectionism, strict with rules, order, details schedules. -Rigid, inflexible and stubborn to the point of damaging relationships, causing other life problems -NOT the same as Obsessive-Compulsive Disorder, which often results from a traumatic event, but the symptomology is similar

Mood Disorders: Biological Factors: Neurotansmitters

-Norepinephrine -Serotonin -Medications boost these in cases of depression. -Bipolar medication (lithium)= blocks norepinephrine activity

Cluster A: Odd/Eccentric - Schizoid Personality Disorder

-Not interested in relationships, cold, detached. -Doesn't care about approval/criticism -Not psychotic/schizophrenic/autistic

Schizophrenia: Biological Causes - Genes

-One of highest heritability of all psychological disorders -Need to consider shared environment too -Greatest risk is for those with genetic predisposition AND maladaptive family environment (diathesis-stress)

Panic Disorder: Possible Causes - Behavioral (conditoning)

-Physiological symptoms (CS) -Panic Attacks (CR)

Risk Factors for Suicide

-Substance abuse -Those with a prior attempt -Opportunity -Social withdrawal, increased risky behaviors, sense of being "trapped"

Cluster A: Odd/Eccentric - Paranoid Personality Disorder

-Suspicious and Mistrustful -Sees hidden, threatening, messages in others actions (even when they are harmless)- Not psychotic/schizophrenic

Dissociative Identity Disorder

-Two or more separate personalities/people in one body. -The "Host" person, and then additional personalities that appear. -Individual "alters" often cannot remember what happens when "other" identities are in control -Sometimes hear voices. -Evidence suggests that severe trauma may be a risk factor/ partial cause of this

Type B: Impulsive, Overly Dramatic, Emotional, Erratic - Borderline Personality Disorder

-Unstable , doesn't want to be alone, feels empty, needs intense relationships (which tend to fall apart), may move rapidly from intense love to intense hate and back again. -Impulsive, self-harming behavior. Intense anger/Frustration, Suicidal gestures

Schizophrenia: Biological Causes - Brain Regions

-Ventricles increased in size -Indicates reduction in other areas -Reduced volume in frontal lobe

__ in 2 are frightened by people with mental illness

1

Lifetime prevalence for Bipolar Disorder is ___%

1%

Lifetime prevalence of Schizophrenia is ___%

1%

Four D's of Psychological Disorders

1)Deviance - Statistical rarity and behavior contrary to societal norms 2)Distress - Subjective experience is unpleasant 3)Dysfunction - Interferes with social, occupational, and/or family functioning 4)Danger - Behavior results in threat to self or others

About ____ of the US population meets criteria for one personality disorder

10%

Suicide is the ____ leading cause of death

10th

Lifetime Prevalence of Social Anxiety Disorder: ___%

12%

Most common psychological disorder diagnosed (specific phobia): ____% lifetime prevalence

12.5%

Lifetime prevalence of OCD is ____%

2.3%

Lifetime prevalence of Body Dysmorphic Disorder is ____%

2.4%

___% of Americans experience panic attacks

23%

Most common (anxiety disorders) of all disorders: ___%-___% of US population meets criteria for at least one of these in their lifetime -Specific phobia -Social anxiety disorder -Panic disorder -Generalized anxiety disorder (GAD)

25%-30%

Higher risk for suicidal attempt (___%) and suicide completion (___% -___%) than for those with major depression

33%; 15%-19%

__ in 5 think it is harder to admit to having a mental illness than other illness

4

Lifetime prevalence of Attention Deficit Hyperactivity Disorder (ADHD) is ____%

5%

Lifetime prevalence of Generalized Anxiety Disorder (GAD) is ____%

5.7%

Mood Disorders: Major Depressive Disorder (MDD): ___% of population will have an episode in a year; about ___% of population will develop MDD in lifetime

6.6%; 70%

Lifetime prevalence of PTSD is ___%

7%

____% of those who complete suicide were diagnosed with at least one mental disorder

90%

Bipolar Disorder

A mood disorder characterized by mood states that vacillate between depression and mania

Major Depressive Disorder

A mood disorder in which a person experiences, in the absence of drugs or another medical condition, two or more weeks with 5 or more symptoms at least one of which must be either (1) depressed mood or (2) loss of interest or pleasure

Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

A pre-existing manual the outlines the criteria that represents disorders -Categories of disorders -Describes disorder, symptoms, and common treatments -Prevalence -Risk facotrs -Comorbidity

Schizophrenia

A psychological disorder characterized by major disturbances in thoughts, perception, emotion, and behavior with symptoms that include hallucinations, delusions, disorganized thoughts and behaviors, and negative symptoms such as a lack of emotional expression or motivation

Potential Causes of O-C Symptoms: Learning (Mowrer's two-factory theory)

-Acquired through classical conditioning -Maintained through operant conditioning

Personality Disorders: Maladaptive Behaviors

-Behavior is very different from the cultural expectations. -Inflexible and pervasive -Causes impairment -Appears early in life.

Bipolar Disorder: Symptoms

-Can also have a history of depression -Once you have an episode of mania it is Bipolar Disorder. -Person can go from one extreme to another. -Some experience rapid cycling with 4 or more episodes in one year

Mood Disorders: Cognitive Factors: Negative Thoughts (Maladaptive Thinking)

-Can trigger depression -Depressive Schemas: Certain ways of thinking about specific interactions/events that trigger depression

Advantages of a proper diagnosis

-Common language -Guide to treatment -Justify payment for treatment

Autism Spectrum Disorder (ASD): Symptoms

-Deficits in social-emotional reciprocity -Deficits in nonverbal communication Difficulties with relationships •Presence of restricted/repetitive behaviors/interests

Dissociative Disorders: Types

-Dissociative amnesia -Dissociative fugue Depersonalization/de-realization -Dissociative Identity Disorder (formerly multiple personality disorder)

Schizophrenia: Biological Causes - Neurotransmitters

-Dopamine hypothesis - depends on brain region -High DA in limbic system: Positive symptoms -Low DA in prefrontal cortex: Negative symptoms

Cluster A: Odd/Eccentric - Schizotypal Personality Disorder

-Eccentric thoughts, perceptions, emotions and actions -Suspicious of others, idiosyncratic speech, inappropriate emotions/actions -Not schizophrenia/psychotic/autism

Attention Deficit Hyperactivity Disorder (ADHD): Long-Term Outcomes CAN include

-Educational/occupational problems -Social/interpersonal difficulties -Increased risk for substance abuse problems

Panic Disorder: Panic attack

-Extreme fear or discomfort: people report feeling like they are going to die -Abrupt onset and peak within 10 minutes -Can be cued (expected) or un-cued (unexpected) -Not a disorder in itself

Schizophrenia: Negative Symptoms (Absence of healthy behaviors)

-Flat affect (no emotion showing in the face) -Reduced social interaction -Anhedonia (no feeling of enjoyment) -Avolition (less motivation, initiative, focus on tasks) -Alogia (speaking less) -Catatonia (moving less)

Dissociative Fugue

-Forget who they are, may leave their home, may reestablish themselves in a new identity elsewhere -Lasts hours, days, longer

Attention Deficit Hyperactivity Disorder (ADHD): Potentially caused by

-Genetic factors -Dopamine - deficient levels -Brain - smaller volumes, delayed "cortical maturation" -Increased risk for children whose mothers smoke in pregnancy

Schizophrenia: Positive Symptoms (Presence of problematic behaviors)

-Hallucinations -Delusions -Disorganized thinking -Disorganized behavior

Mood Disorders: Biological Factors: Brain Regions

Amygdala and prefrontal cortex

Which of the following is a common characteristic of all dissociative disorders? -Becoming split off, or dissociated, from one's core sense of self -Rapidly fluctuating mood -Memory loss -Feeling sad and hopeless over a long period of time

Becoming split off, or dissociated, from one's core sense of self

Perspectives on Psychological Disorders: Diathesis-Stress Model

Biology and Psychosocial explanations

A woman who alternates bouts of productive and boundless energy with episodes of inactivity, feelings of worthlessness and suicide, and days in which she cannot get out of bed may be suffering from the symptoms of: -Major depressive disorder. -Bipolar disorder. -Dissociative identity disorder. -Generalized anxiety disorder.

Bipolar Disorder

Bipolar Disorder: Mania

Characterized by extremely cheerful and euphoric mood, excessive talkativeness, irritability, increased activity levels, and other symptoms

Personality Disorders

Characterized by inflexible and pervasive personality style that differs markedly from the expectations of one's culture and causes distress and impairment; people with these disorders have a personality style that frequently brings them into conflict with other and disrupts their ability to develop and maintain social relationships

Mood Disorders

Characterized by severe disruptions in mood and emotions

Personality Disorders: Three Clusters of Personality Disorders

Cluster A - "odd, eccentric" Cluster B - "erratic, dramatic, emotional" Cluster C - "anxiety, fearfulness"

Comorbidity

Co-occurrence of two (or more) disorders

Mood Disorders: Biological Factors: Hormones

Cortison

Mood Disorders: Major Depressive Disorder (MDD): Subtypes - Persistent Depressive Disorder (formerly Dysthymia)

Depressed mood + 2 other symptoms -Lasts at least two years.

Depressive Disorders

Depression is the main feature. -Sadness, discouraged, hopeless, loss of interest in activities

Diagnosis

Determining what disorder(s) are present in the individual

Schizophrenia: Course of Development

Development can be acute or chronic

Perspectives on Psychological Disorders: Biological

Disorders linked to biology

Kevin has been diagnosed with dissociative identity disorder. This means that Kevin... -Has difficulty establishing a secure relationship with others -Displays characteristics of two or more distinct personalities. -Cannot recall information that is still present in his memory. -Is likely to take a sudden trip, perhaps even assuming a new identity, and he will not remember any experiences he had during the trip.

Displays characteristics of two or more distinct personalities.

Schizophrenia: "Splitting of Functions"

Disturbances in thought, perception, emotion, behavior

Generalized Anxiety Disorder (GAD)

Excessive, uncontrollable worry for at least 6 months and accompanied by at least 3 behavioral, cognitive, or physical symptoms (Restlessness, difficulty concentrating, irritability, physical fatigue, muscle tension, poor sleep)

Normal versus _____ versus ______ _____

Fear; pathological anxiety

Type B: Impulsive, Overly Dramatic, Emotional, Erratic - Narcissistic Personality Disorder

Feels very self-important for no reason, fantasies of own success, feels as if they deserve special treatment, arrogant, takes advantage of others, lacks empathy

Neurodevelopmental Disorders

First diagnosed in childhood and involve developmental problems in academic, intellectual, and social functioning

Mood Disorders: Major Depressive Disorder (MDD): Symptoms

Five or more total symptoms (one of which has to be depressed mood or anhedonia) for at least two weeks -Depressed mood most of the day -Markedly diminished interest or pleasure in activities (anhedonia) -Significant increase or decrease in appetite or weight -Insomnia, sleeping too much, or disrupted sleep -Lethargy, or physical agitation -Fatigue or loss of energy nearly every day -Worthlessness, or excessive/inappropriate guilt -Daily problems in thinking, concentrating, and/or making decisions -Recurring thoughts of death and suicide

Dissociative Amnesia

Forgetting part or all of: -Experience/event that is personal -Usually related to stress/trauma

Stress

From the environment (Nurture

Mood Disorders: Cognitive Factors: Hopelessness Explanatory Theory

IGS more likely to lead to depression -Internal: It's because of something about ME -Global: Everything in my life is a failure -Stable: It will always be like this ESU leads to effective coping -External: It's because of something about the situation -Specific: I failed at this, but I can do other things -Unstable: Things will get better

Perspectives on Psychological Disorders: Supernatural

Illnesses caused by black magic or spirits and possession a common explanation

Hoarding Disorders

Inability to part with possessions -Accumulate clutter to the point that use and safety of home may be severely impacted -Behavior cannot be caused by another medical or psychological disorder

Obsessive-Compulsive and Related Disorders

Includes OCD, Body Dysmorphic Disorder, Hoarding Disorder

Panic Disorder: Possible Causes - Genetics/Heritability

Increased risk among first-degree relatives

Panic Disorder: Possible Causes - Cognitive

Interpretation of physiological symptoms is key

Obsessive-Compulsive and Related Disorders: What do they have in common?

Intrusive, unpleasant thoughts, repetitive behaviors, interfere with life

Mood Disorders: Major Depressive Disorder (MDD): Subtypes - Seasonal Pattern (SAD)

Involves a recurring seasonal pattern of depression, usually during winter's short, dark, cold days.

Type B: Impulsive, Overly Dramatic, Emotional, Erratic - Antisocial Personality Disorder

Lacks empathy and remorse, violates others personal rights (prior to age 15 antisocial) -Liar, fighter, problems with the law, deceitful and manipulative if given a reason

Post-Traumatic Stress Disorder (PTSD): Causes

Learning and Cognitive Models

Bipolar and related disorders

Mania is the important feature. -Talkative, reckless, overly energetic, multitasking in the extreme

Potential Causes of O-C Symptoms: Brain Studies

More neuron connections in orbitofrontal cortex: used in decision-making and learning

Post-Traumatic Stress Disorder (PTSD)

Must involve exposure to, witnessing, or experiencing details of traumatic event involving actual or threatened death, serious injury, or sexual violence

How common are psychological disorders

Nearly half of all Americans will meet criteria for a psychological disorder at some point in their lives

Mood Disorders: Cognitive Factors: Hopelessness Theory

Negative thinking --> Hopelessness --> Depression -Thinking that negative events are stable and global -Those without depression are more likely to view the same events as unstable and specific

DSM-5 Categories

Neurodevelopmental Disorders -Schizophrenia Spectrum and Other Psychotic Disorders -Bipolar and Related Disorders -Depressive Disorders -Anxiety Disorders -Obsessive-Compulsive and Related Disorders -Trauma and Stressor Related Disorders -Dissociative Disorders -Somatic Symptom Disorders -Feeding and Eating Disorders -Elimination Disorders -Sleep-Wake Disorders -Sexual Dysfunctions -Gender Dysphoria -Disruptive, Impulse Control, and Conduct Disorders -Substance Use and Addictive Disorders -Neurocognitive Disorders -Personality Disorders -Paraphilic Disorders Other Disorders

Diathesis

Predisposition or risk for a psychological disorder (nature) -Biological: Genes -Psychological: Personality Traits

Body Dysmorphic Disorder

Preoccupied with perceived flaws (actually nonexistent or barely noticeable) and behaviors to compensate - repetitive acts or rituals

Dissociative Disorders

Primary features is that a person becomes dissociated, or split off, from their core sense of self, resulting in disturbances in identity and memory -Individual dissociates from core sense of self -Controversial category of disorders

Schizophrenia: Chronic Course of Development

Process, develops more slowly, more negative symptoms, lifelong treatment is often necessary

Schizophrenia: Acute Course of Development

Reactive, likely a reaction to a stressor(s), positive symptoms are more common, recovery is more likely

Panic Disorder

Recurrent, unexpected panic attacks and plus one month of worry about attacks (or behavioral changes related to attacks

Depersonalization Disorder

Recurring De-realization: -Feeling that things are unreal or being detached from the world -Foggy, dreaming, world is not real

De-realization Disorder

Recurring Depersonalization: -Feeling like you are outside of yourself -Don't recognize or feel ownership for thoughts and feelings

Mood Disorders: Biological Factors: Genetics

Relatives with depression= 2x the risk

Mood Disorders: Cognitive Factors

Ruminating on depressed feelings increases risk for and duration of depression experience

Psychological Disorders (As defined by the American Psychiatric Association)

Significant disturbance that reflects a dysfunction, results in distress/impairment, and is outside of cultural expectations

Treatments: Supernatural

Stoning, trepanation (a hole in the head), chained to walls, and exorcisms

Perspectives on Psychological Disorders: Psychosocial Explanation

Stress, learning, problematic thinking

Panic Disorder: Possible Causes - Biological

Studies of the locus coeruleus

Type C: Nervous/Fearful - Dependent Personality Disorder

Submissive, clings to others, let others (or need others) to run their lives, no confidence, won't do things alone, feels helpless

Which of the following is not a reason that ADHD may be overdiagnosed? -There is greater awareness of ADHD now than in the past. -What might seem like inattention to some parents and teachers could simply reflect exposure to too much technology. -The amount of ADHD in the population has actually increased tenfold since it was first identified. -Doctors are too quick to medicate children as a behavior treatment.

The amount of ADHD in the population has actually increased tenfold since it was first identified.

Bipolar Disorder

Used to be called "manic depression"

Type C: Nervous/Fearful - Avoidant Personality Disorder

Very sensitive to negative evaluations to others. Avoids interpersonal contact, avoid others unless they can receive unconditional acceptance. Feels inadequate, won't do anything that feels embarrassing

Stigma

a mark of disgrace associated with a particular circumstance, quality, or person.

The combination and interaction of the two (Diathesis and stress) is what results in...

a psychological disorder

Perspectives on Psychological Disorders: Biological - Some psychological disorders seem to be...

at least partially heritable (Nature)

OCD

Obsessions: persistent, unintentional, unwanted thoughts Compulsions: behaviors with goal of reducing obsessions

Mood Disorders: Major Depressive Disorder (MDD): Subtypes - Peripartum/Postpartum

Occurs during a pregnancy or after a woman delivers a child (even a year after). -Includes anxiety, panic attacks

Type B: Impulsive, Overly Dramatic, Emotional, Erratic - Histrionic Personality Disorder

Overly dramatic, emotional, needs to be the center of attention, seductive/provocative behavior, shallow emotions, lacks empathy, takes advantage

Social Anxiety Disorder (Social Phobia)

Persistence fear or anxiety about negative evaluation by others and avoidance of situations where that might occur

Phobia (Greek for fear)

Persistent fear or anxiety about a specific object or situation