Chapter 15

Bipolar Disorder

At the opposite pole from depression is mania: an abnormally high state of exhilaration. Someone with bipolar disorder experiences episodes of both depression and mania, typically alternating between the two; they may experience racing thoughts, rapid speech, impulsive/reckless behavior, distractibility; there are different types of bipolar disorder that are defined by the individual's characteristics of depression and mania.

DSM

Diagnostic and Statistical Manual of Mental Disorders; designed to provide objective criteria and categories for diagnosing mental disorders; currently in its 5th edition (DSM-5); the DSM editors have classified many disorders along a spectrum of symptoms and in degrees from mild to severe, rather than as discrete categories; gives information about: •Typical age of onset •Predisposing factors •Course of the disorder •Prevalence of the disorder •Sex ratio of those affected •Cultural issues that might affect diagnosis •Symptoms of each disorder; Critics argue that the diagnosis of mental disorders, unlike those of medical diseases, is inherently a subjective process. They believe that the DSM fosters overdiagnosis, confuses serious mental disorders with everyday problems in living, overlooks the negative consequences of being given a diagnostic label, creates an illusion of objectivity; Supporters of the DSM believe that reliability in diagnosis improves when the DSM criteria are used correctly and when empirically validated objective tests are used.

Agoraphobia

Fear of fear; fear of being away from a safe place or person; fear of being in an uncomfortable situation; often causes panic attacks; people who have it extreme essentially stay inside their entire lives and may have enablers who help them get anything they need from the outside world.

Personality Disorders

Involve impairments in personality that cause great distress to an individual and impair his or her ability to get along with others;

Generalized Anxiety Disorder

Involves continuous, chronic anxiety and worry that interferes with daily functioning; involves a sense of foreboding and dread that occurs on a majority of days during a 6 month period; life experiences and genetics may contribute to the disorder.

Panic Disorder

Involves sudden, intense attacks of profound fear; panic attacks are common in the aftermath of stress,, prolonged emotion, specific worries, and frightening experiences, and can involve feelings of dizziness, tightness in the chest, sweating, crying spells, or severe feeling of being overwhelmed; those who go on to develop a disorder tend to interpret the attacks as a sign of impending disaster.

Depression

Major depression involves emotional, behavioral, cognitive, and physical changes that are severe enough to disrupt a person's ordinary functioning; symptoms include distorted thinking patterns, feelings of worthlessness and despair, physical ailments such as fatigue and loss of appetite or increased appetite, loss of interest in formerly pleasurable activities; it is argued that people who have depression may have a better view of what the world is actually like; women are twice as likely as men to suffer from major depression, but depression in men may be underdiagnosed; men who are depressed often try to mask their feelings by withdrawing, abusing alcohol or other drugs, driving recklessly, behaving violently; vulnerability creates stress; moderately heritable, scientists are still searching for the specific genes; experiences with violence and potential neglect, especially in childhood, increase the risk of developing major depression in adulthood; many depressed people have a history of separations, losses, rejections, impaired/insecure attachments.

OCD

Obsessive-Compulsive Disorder; obsessions are recurrent, unwished for thoughts or images; compulsions are repetitive, ritualized behaviors that a person feels unable to control; some with OCD have abnormalities in an area of the prefrontal cortex (controls inhibition) which may contribute to their cognitive and behavioral rigidity; parts of the brain involved in fear and responses to threat are also more active than normal in people with OCD; Hoarding Disorder - never getting rid of anything; hoarders had less activity in parts of the brain involved in decision making, problem solving, spatial orientation, memory.

PTSD

Posttraumatic Stress Disorder; people who live through a traumatic experience and have a lot of difficulty recovering, involving nightmares, flashbacks, insomnia, increased physiological arousal, never really getting over the event, feelings of guilt, misreading situations, blaming themselves, inherent belief that the world is a dangerous place; increased vulnerability to traumatic events because of • genetic vulnerability (smaller hippocampus, important for memory and emotional aspects of memories; twins: if one has PTSD the other one is more likely to get it) • a history of psychological problems (depression, anxiety, substance abuse disorder may lead to PTSD) • a lack of social and cognitive resources (victims may not have social support to talk about or fully understand what happened); differences in gender and ethnicity play a role in likelihood of recovery, women are three times less likely to recover from PTSD than men are); most people never fully recover after it reaches clinical impairment level.

Projective Tests

Psychological tests to help determine a diagnosis; Ex. the Rorschach inkblot test or, with children, anatomically detailed dolls; they consist of ambiguous pictures, sentences, or stories; may have lower reliability and validity because the results are very open for interpretation; when they are used in the legal arena they can create problems, especially in custody disputes or diagnosing disorders.

Objective Tests

Reliability and validity can. be more systematically verified for objective tests; inventories; MMPI or PAI; involve standardized objective questionnaires; typically include scales on which people are asked to rate themselves, inventories are only as good as their questions are how knowledgeably they are interpreted; they are cost effective, often require less time to administer, scoring can often be done by a computer, and are highly reliable. and valid; however, they self-report data which makes it easier for test-takers to fake test results, and are sometimes too structured to represent the complexity and diversity of human experience.

Phobias

Unrealistic fears of specific situations, activities, or things; snakes, insects, heights, claustrophobia (being trapped in tight spaces), public speaking, drowning, blood/needles; if someone encounters their fear on a very regular basis, they are at clinical impairment level.