Abnormal Psych Test Review

Psychological Disorders

"a syndrome marked by a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior."

Conversion Disorder

-(Functional Neurological Symptom Disorder) is a disorder in which a person experiences very specific genuine physical symptoms with no physiological basis. ○ Typically covers areas which are controlled voluntarily - Vision, swallowing, etc.

Positive Symptoms

■ ADDS inappropriate behavior ● Hallucinations ● Disorganized speech ● Inappropriate emotions

Negative Symptoms

■ REMOVES appropriate behavior ● Toneless voices ● Expressionless faces

Rosenhan and Pseudo-Patients

The aim of this study was to test the hypothesis that psychiatrists cannot reliably tell the difference between people who are sane and those who are insane. The main study is an example of a field experiment. ● These two experiments demonstrated to Rosenhan that we (and many institutions) are not able to successfully diagnose disorders or discern between the sane and insane. ○ It also showed the danger of dehumanizing and labeling patients - since once labeled, his Pseudo-patients were linked to that label.

Personality Disorders

are characterized by inflexible and enduring behavior patterns that impair social function. ● There are three categories or clusters of Personality Disorders. ● The different Personality Disorders in each cluster tend to be fairly similar,

Factitous Disorders

are disorders in which a person acts as if they have an illness by creating or exaggerating symptoms. ○ This is often seen as Munchausen Syndrome. ○ In these disorders, people are motivated to create medical issues in order to receive attention, sympathy etc. ■ While this also relates to a bodily symptom, it is purposely created rather than felt as the result of a psychological issue ● All of these are commonly caused by other

Binge Eating Disorder

is a disorder characterized by binge-eating episodes, accompanied by distress, disgust, or guilt, but without the purging associated with Bulimia. ● Eating Disorders most often affect adolescent girls. ● Family environment may provide the basis of the growth of eating disorders. ● Many with eating disorders have low self-evaluations, set perfectionist standards, fret about falling short, and are concerned with how others see them.

Illness Anxiety Disorder

is a disorder in which a person interprets normal physical sensations as symptoms of a disease. ○ Formerly known as Hypochondriasis. ■ Basically, every slight physical sensation is caused by a terrible disease no matter what a doctor says. ● A headache must be a brain tumor, etc.

Bulimia Nervosa

is an eating disorder in which a person alternates binge eating with purging (vomiting or laxatives), excessive exercise or fasting. ○ People often feel bouts of depression and anxiety during and following binges. ○ Weight typically fluctuates within or above normal ranges.

Anorexia Nervosa

is an eating disorder in which a person maintains a starvation diet despite being significantly underweight. ○ Despite being underweight, people with Anorexia typically feel fat, are afraid of being fat, and are obsessed with losing weight.

Biomedical Model

the concept that diseases, or psychological disorders, have physical causes that can be diagnosed, treated, and in most cases, cured, often through treatment in a hospital.

Borderline Personality Disorder

○ Characterized by a pattern of instability in moods, behavior, self-image and functioning. ■ Think mood swings - intense episodes of anger, anxiety, etc, which can last a few hours to a few days. ● A person with BPD might see anger in a neutral face. ○ Often accompanied by impulsive behavior, severe anxiety, suicidal thoughts or self-harming behavior. ○ Again, the cause is seen as a blend of genetic and social factors (trauma, etc.).

Dependent Personality Disorder

○ Characterized by feelings of helplessness, submissiveness, and the need for an excessive amount of advice and reassurance. ■ Also includes things like an intense fear of abandonment, pessimism, difficulty being alone, a willingness to tolerate mistreatment and tendency to be naive. ● Think needy or clingy behavior. ○ Again - Genetics/Social Factors (Overprotective parenting styles).

Histrionic Personality Disorder

○ Characterized by intense, unstable emotions and distorted self-images. ○ Sufferers depend on the approval of others for their self-esteem. ■ They are often dramatic and overly concerned with their appearance. ■ They constantly seek approval. ■ Often seen as shallow. ○ Again - Genetics and Social Factors.

Three Categories/Clusters

○ Cluster A (Odd, bizarre, eccentric) ■ Paranoid, Schizoid, Schizotypal ○ Cluster B (Dramatic, Erratic) ■ Anti-Social, Borderline, Histrionic, and Narcissistic ○ Cluster C (Anxious, Fearful) -Avoidant, Dependent, Obsessive Compulsive (Personality Disorder)

Delusions

○ False beliefs, often of persecution or grandeur, that may accompany psychotic disorders. ■ These delusions can be paranoid and prone to a feeling of persecution. ■ Often sentences become jumbled into word salad.

What makes a behavior abnormal or disordered?

○ It is atypical ○ Violates cultural standards ○ Is disturbing to others ○ Is disturbing to yourself ○ Unjustifiable/irrational ○ Maladaptive

Obsessive Compulsive Personality Disorder

○ Just to clarify it from Obsessive Compulsive Disorder as an Anxiety related disorder. ○ This is a person who is preoccupied with orderliness, perfectionism, and interpersonal control. ■ Reluctant to delegate tasks, is stubborn, devoted to work and productivity over leisure and friendship. ● Think - more about their behavior than personal anxiety, although they are similar sounding.

Hallucinations

○ These are false sensory experience, such as seeing something in the absence of an external visual stimulus. ■ They may see, feel, taste or smell things that are not there. ■ Typically hallucinations will be auditory - voices insulting or giving orders.

Etiology

○ This is 1: The causes and progress of a disease or disorder, or 2: the branch of medical and psychological science concerned with the systematic study of the causes of physical and mental disorders.

Intern's Syndrome

○ This is also called Medical Student Disorder, among many other things. ■ It refers to the condition among medical (and psychology students) to see the symptoms of the disorders (and diseases) they are studying in themselves. ● Don't self diagnose or see symptoms in yourself that aren't there.

Acute/Reactive Schizophrenia

○ This version of Schizophrenia are more likely to have the positive symptoms that respond well to medication.

DSM-V

○ We are currently using the DSM-5 to classify psychological disorders. ■ Under this system, a person will be compared to criteria in the manual, and if they meet those criteria, they can be diagnosed with a disorder. ● The DSM-5 came out recently (2013). ● It changed some labels: ○ Autism and Asperger's have been combined into Autism Spectrum Disorder. ○ Mental Retardation became Intellectual Disability ○ Hoarding disorder and binge-eating disorder have been added. ■ There are other changes as well.

Chromic/Process Schizophrenia

○ With this version of Schizophrenia, most people who have it exhibit the negative symptoms of social withdrawal.

Generalized Anxiety Disorder

● An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal. ○ Remember, the Autonomic Nervous System regulates internal functions like heartbeat, pupil dilation and the fight or flight response. ● People with this condition are often jittery, agitated, or sleep deprived. ● Concentration is difficult. ● Often accompanied by a depressed mood. ● Can lead to high blood pressure. ● By age 50 Generalized Anxiety Disorder becomes fairly rare.

Antisocial Personality Disorder

● Antisocial Personality Disorder ○ A person exhibits a lack of conscious for wrongdoing, even towards friends and family. ○ May be aggressive, ruthless, and impulsive. ○ People suffering from this are often referred to as a sociopath. ○ Criminal behavior is not required, but it is common. ○ As with other personality disorders, there are genetic and social causes (trauma, poverty, etc).

Anxiety Disorders and Stress Related Problems

● Anxiety Disorders are disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety.

Understanding Mood Disorders

● Behavioral and cognitive changes accompany depression. ● Depression is widespread. ● Women's risk of depression is almost double men's. ● Most major depressive episodes end on their own. ● Stressful events related to work, marriage, and close relationships often precede depression. ● Depression continues to affect more people, earlier in life than it has in the past. ● Mood disorders run in families. ● Depressed brain states can be seen in brain scans. ● Your thoughts and moods will interact. ● Depression feeds itself.

Narcissistic Personality Disorder

● Narcissistic Personality Disorder ○ A person will have an inflated sense of their own importance, as well as a need for admiration. ■ Think boastful, pretentious, feeling superior or self-obsessed. ○ Behind this, their self-esteem is fragile. ■ They are bad at being criticized for example. ○ People suffering from this will be unhappy when they don't get the admiration they crave. ○ Again, it is likely due to genetic factors, as well as social factors (excessive pampering or criticism from parents).

Common Phobias

● Ophidiophobia ○ Snakes ● Ailurophobia ○ Cats ● Cynophobia ○ Dogs ● Technophobia ○ Technology ● Phobiaphobia ○ What do you think this one is?

Bipolar Disorder

● Characterized by periods of deep depression and mania. ○ These phases alternate week to week/month to month, not daily or momentarily. ■ Mania is a mood disorder marked by a hyperactive, euphoric, wildly optimistic state. ● While in a manic state people with bipolar disorder are overly talkative, overactive, elated and easily irritated. They will sleep less, be loud, and flighty. ○ Eventually they will return to a normal or depressed state (and will shift back to mania eventually). ● The diagnosis of bipolar in teenagers has risen greatly, but it should drop as the DSM-5 added Disruptive Mood Dysregulation Disorder. ○ This will cover the extreme anger and outbursts of the teenagers that previously were diagnosed as bipolar. ● Bipolar Disorder is much less common than Major Depressive Disorder, but often leads to more dysfunction.

Major Depressive Disorder

● Depression is the number-one reason people seek mental health services. ● Major Depressive Disorder occurs when a person experiences, in the absence of drugs or other medical conditions, two or more weeks with five or more symptoms of depression. ○ One of these symptoms has to be depressed mood or loss of interest or pleasure. ○ The other symptoms include: ■ Significant weight loss or gain when not dieting or a decrease/increase in appetite. ■ Insomnia or sleeping too much ■ Physical agitation or lethargy ■ Fatigue/Loss of energy ■ Feeling worthless, or excessive or inappropriate guilt ■ Problems in thinking, concentrating, or making decisions ■ Recurrent thoughts of death and suicide

Dissociative Amnesia

● Dissociative Amnesia is a memory disorder characterized by sudden autobiographical memory loss (details of their personal life). ○ Can last hours to years. ● This is not like forgetting your keys, people with Dissociative Amnesia forget things like their name, address, friends, family, etc. ● May occur as a response to trauma or stress. ○ It might also be genetic. ■ It is NOT the result of damage to the brain like some other types of amnesia.

Dissociative Disorders

● Dissociative Disorders are disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. ○ These disorders are treated mostly with therapy.

Dissociative Fugue

● Dissociative Fugue is psychological disorder characterized by amnesia for personal identity, personality and other characteristics of individuality, with unplanned travel or wandering. ○ It is usually short lived, but can last months or longer. ○ Sometimes this is also associated with the establishment of a new identity to replace the one that was lost. ● Like Dissociative Amnesia, it is most likely caused by trauma.

Dissociative Identity Disorder

● Dissociative Identity Disorder (DID) is a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. ○ Formerly called Multiple Personality Disorder. ● Each personality has its own voice and mannerisms. ● The original personality denies awareness of the others. ● Can happen for a variety of reasons, but is usually related to early trauma.

Labeling Disorders

● In Psychiatry and Psychology classifications attempt to describe a disorder, predict its course, apply treatment, and stimulate research. ● These classifications are organized in the American Psychological Association's Diagnostic and Statistical Manual of Mental Disorders. ● While labeling disorders can be helpful (which we will talk about in a moment), it can also cause problems. ● Once a label has been applied, patients can be viewed differently or treated differently (both by people and doctors). ○ Remember: Framing ● Finding a job or a place to live can be hard once a person is labeled. ● Gender atypical disorders can bring greater sympathy or concern.

Historical Views of Abnormality

● In the past, Mental Disorders might have been attributed to the stars, gods, evil spirits, an imbalance of the humors, or the devil. ● Mentally ill people were considered "mad" and housed in poor conditions without legitimate treatment. ○ If you remember from History class as late as the 1800s in America they were just a part of the standard prison population (think Dorothea Dix). ● Treatments often included things like beatings, burning, castration, pulling teeth, removing parts of the body or giving transfusions of animal blood. ○ As late as the 1960s things like electroshock therapy were used frequently to treat disorders.

Hoarding Disorder

● In the vein of Obsessive Compulsive Disorder there is Hoarding Disorder ○ This is a persistent difficulty discarding or parting with possessions because of a perceived need to save them. ■ People with hoarding disorder will have distress at the thought of getting rid of things, regardless of their actual value. ● People with this disorder don't often see it as a problem.

The Insanity Defense

● Insanity is a legal term. ○ Under this the question is, can the individual determine right from wrong? Can they understand the consequences of their actions? ■ If this is used as a defense in a trial, this is what has to be proven - not that a defendant had a mental disorder.

Causes (Etiology)

● Learning ○ We feel anxiety due to learned behaviors. ■ Remember: Generalization ● We talked about this in that you can teach a child to avoid cars, which will generalize to trucks. ○ In anxiety we see it in that a person attacked by a dog might generalize that anxiety to all dogs. ■ Reinforcement ● Avoiding anxiety feels good so it reinforces phobic behavior. ○ This is the same with Compulsive behaviors - completing the compulsion feels good so the behavior is reinforced. ● Observational Learning ○ We can learn fears and anxiety by observing others fears. ■ Monkeys reared in the wild with a fear of snakes can pass on that fear to lab raised offspring when the offspring observed their parent's fear of snakes. ● Cognitive ○ Our interpretations and irrational beliefs can cause feelings of anxiety. ● Biological Perspective ○ Natural Selections ■ We fear things that can pose a threat to our survival. ■ Modern behaviors can be seen as exaggerated behaviors from our past survival techniques. Ex: Checking our territory can be seen in checking an already locked door. ● Genes can lead to a resistance to or prevalence for anxiety disorders ● Generalized anxiety, panic attacks, PTSD, and obsessions/compulsions can manifest as an over arousal of brain areas involved in impulse control and habitual behaviors.

Mood Disorders

● Mood disorders are psychological disorders characterized by emotional extremes.

Paranoid Personality Disorder

● Paranoid Personality Disorder ○ People suffering from PPD are paranoid, mistrust people and are suspicious of others when there is no reason to be suspicious. ○ They tend to be unforgiving, hypersensitive, are cold/distant in relationships and cannot see their role in problems. ○ Appears in early adulthood. ○ More common in men than women. ○ Is likely caused by genetic factors, but can be the result of childhood trauma. ● Schizoid and Schizotypal are also related to social anxiety and paranoia.

Persistent Depressive Disorder

● Persistent Depressive Disorder (also known as Dysthymia) is characterized by a mildly depressed mood more often than not for at least two years. ● A person with Persistent Depressive Disorder will display at least two of the following symptoms: ○ Problems regulating appetite ○ Problems regulating sleep ○ Low energy ○ Low self-esteem ○ Difficulty concentrating and making decisions ○ Feelings of hopelessness

Somatic Symptom Disorders

● Somatic Symptom Disorders are psychological disorders in which the symptoms take a somatic (bodily) form without apparent physical cause. ○ Basically, this Disorder occurs when your psychological state produces physical results. ■ Example: You become nervous or dizzy before your parents arrive home without physical cause. ● (Note, this is a category of disorders, and also its own disorder)

Causes ??

● The brains of schizophrenic patients seem to be overly responsive to dopamine. ○ Research finds that they have six times as many dopamine receptors as needed. ■ This might create the positive symptoms such as hallucinations and paranoia. ● The brains of Schizophrenic patients often show abnormal activity. ○ This can be seen as low brain activity (dysfunction) in the frontal lobes. ● The brains of Schizophrenia patients (and future patients, and sometimes their relatives) will develop enlarged, fluid-filled areas in their brain (called ventricles), with shrinkage in the areas around them - often the cortex, corpus callosum, and thalamus. ● Genetics can play a role as well.

Phobias

● These are anxiety disorders marked by a persistent, irrational fear and avoidance of a specific object, activity or situation. ○ Many people have fears, but they cross over into a disorder when people become incapacitated by their efforts to avoid their fears. ○ Specific phobias can focus on animals, insects, heights, blood, enclosed spaces...etc. ● It can also manifest as Social Anxiety Disorder ○ This is an intense fear of social situations, leading to the avoidance of such. ■ People with this disorder have an intense fear of being scrutinized by others, avoid potentially embarrassing situations, and can sweat/tremble in these situations. ● Worrying about worrying can increase worrying. ○ When you are worried about insomnia, it causes insomnia. ○ Worrying about a panic attack, can cause a panic attack. ● When phobias become so severe you avoid situations where you have felt fear/panic before, it can become Agoraphobia. ○ This is the fear or avoidance of situations, such as crowds or wide open spaces where one has felt loss of control and panic.

Neurodevelopmental Disorders

● These disorders are characterized by impairments in the growth and development of the brain or central nervous system ○ Can refer to a disorder of brain function that affects emotion, learning ability, self-control, and memory.

Eating Disorders

● These disorders are instances where psychological influences outweigh biological wisdom.

Impulse Control and Conduct Disorders

● These disorders involve problems with the self-control of emotions or behaviors.

Post Traumatic Stress Disorder

● This is 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. ○ We all have bad memories, embarrassing moments, etc, but it does not cross over into PTSD until the impact is severe and persistent. ○ PTSD can appear in survivors of accidents, war, disasters, and violent/sexual assaults. ■ 1 in 4 of 103,788 veterans from Iraq and Afghanistan were diagnosed with a psychological disorder - most of them PTSD. ● Overall 1 in 10 women and 1 in 20 men develop PTSD. ○ The greater the emotional distress, the greater the chance of PTSD. ● Sometimes struggling with these emotions can lead to Posttraumatic Growth ○ These are positive psychological changes as a result of struggling with extremely challenging circumstances and life crises.

Obsessive Compulsive Disorder

● This is a disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions). ○ We all can be obsessed with thoughts or engage in compulsive behavior, but it is not disordered until it persistently interferes with everyday living and causes distress. ■ Washing your hands is normal, washing so much you rub your skin raw will cause distress, etc. ● The person will often know their thoughts/actions are irrational, which increases anxiety surrounding the behaviors, as they continue to take up more and more time, which can lead to the prevention of effective functioning. ○ Often appears in the late teens or twenties. ■ Only about 2-3 percent of people cross the line into OCD.

Body Dysmoprhic DIsorder

● This is a disorder in which you can't stop thinking about one or more perceived flaws in your appearance. ○ These are typically minor or not observable to others. ■ This crosses over into disorder when you feel so ashamed or anxious you avoid social situations. ● At times, people with BDD will pursue cosmetic procedures to "fix" their perceived flaws, but it typically only provides temporary relief before the anxiety returns.

Autism Spectrum Disorder

● This is a disorder that appears in childhood and is marked by significant deficiencies in communication and social interactions, and by rigidly fixated interests and repetitive behaviors. ● Autism is a Spectrum disorder, which means that there are varying levels of functioning. ○ Some people on the spectrum will be wildly intelligent, but be poor at social interactions. ■ But since it is a spectrum symptoms can be more severe. ● Appears to be caused by genetic influences and abnormal brain development. ○ As is standard so far, if one identical twin is diagnosed with the disorder, there is a high chance for the other. ○ The brain development issues can be seen in areas that work on mirroring - the Autistic brain will show less activity in mirroring actions (like yawning when someone else does).

Oppositional - Defiant Disorder

● This is a disorder which presents as an ongoing pattern of an angry/irritable mood, defiant /argumentative behavior, and vindictiveness to those in authority. ● Symptoms can include: ○ Temper tantrums ○ Arguing with authority ○ Trying to annoy or upset others; being easily annoyed. ○ Blaming others for your mistakes. ○ Frequent outbursts of anger or resentment. ○ Being spiteful. ○ Swearing. ○ Saying mean and hurtful things when upset. ■ Remember: This is to an excessive or maladaptive level - we have all felt these things. ● This disorder is also genetic (brain function) and environmental (lack of supervision, or abuse/neglect).

Seasonal Affective Disorder w/Seasonal Pattern

● This is a mood disorder subset in which people who have normal mental health throughout most of the year exhibit depressive symptoms at the same time each year - mostly in the winter. ● Typically people that suffer from this will present with the symptoms of Major Depressive Disorder. ● This disorder was actually removed in the DSM-5. ○ It was replaced with the specifier "with seasonal pattern." ■ So an example would be "Major Depressive Disorder, with seasonal pattern." ● You can also be diagnosed with "Bipolar Disorder, with seasonal pattern."

Tourette's Syndrome

● This is a psychological disorder characterized by multiple motor tics and at least one vocal tic. ○ A tic is a sudden, repetitive, nonrhythmic motor movement or vocalization. ■ A motor tic can be something like eye blinking or head jerking. ■ A vocal tic can be a noise, throat clearing, or grunting. ● You are probably thinking of Coprolalia, which is a type of vocal tic that involves saying objectionable or taboo words/phrases. ○ This is only 10% of people with Tourette's. ● Tourette's is caused by genetic factors.

Attention Deficit Hyperactivity Disorder

● This is a psychological disorder marked by the appearance by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity. ○ Can lead to social, academic and vocational problems. ● ADHD is diagnosed three times more often in boys than girls. ● It is often debated if this is over diagnosed, or if normal children are being labeled for being slightly overactive. ● This disorder is caused by Genetics, but some will blame extensive TV watching and video games.

Cyclothymia

● This is a rare mood disorder that is very similar to Bipolar Disorder. ● It is characterized by shifts between a mild depression and hypomania, a milder form of mania. ○ To be diagnosed with it you will not have entered periods of major depression or full on mania.

Conduct Disorder

● This is a serious behavioral and emotional disorder found in children and teens, which is characterized by: ○ Aggressive behavior ■ Fighting, bullying, etc. ○ Destructive behavior ■ Arson, Vandalism, etc. ○ Deceitful behavior ■ Lying, shoplifting, etc. ○ Violation of rules ■ Running away, skipping school, etc. ● People with Conduct Disorder generally have little guilt or remorse about hurting others. ● Caused by Genetics, Defects or Injuries in areas of impulse control/emotion in the brain, as well as social/environmental factors (bad home life, etc.)

Diathesis - Stress Model

● This is a theory that explains behavior/disorder as the result of biological and environmental factors. ○ Diathesis is the hereditary disposition to a disorder. ○ Stress is the environmental load put on us as people. ■ Under this model mental disorders (like schizophrenia) are produced by a hereditary disposition and environmental factors.

Panic Disorder

● This is 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. Often followed by worry of another attack. ○ These are known as Panic Attacks. ● Includes heart palpitations, shortness of breath, choking sensations, trembling, or dizziness. ○ Can be mistaken as a heart attack. ● Smokers are at double the risk of having a panic disorder.

Thomas Szasz and labeling

● Thomas Szasz was a theorist who believed that mental illness was a myth because there are no biological, chemical, or physical traces of most mental illness. ○ Therefore, the labels associated with Mental Illness was political. ■ People were labeled as mentally ill when they were threatening to society and locked up to prevent any problems. ● Szasz saw this as wrong, because according to him they were not mentally ill without a physical/biological marker.

Biopsychosocial Model

● Under the Biopsychosocial Approach all behavior, normal or disordered, comes from the interaction of nature and nurture. ○ That is, the diagnosis and treatment of disorders is not only biological, but must also consider the environment, a person's interpretations of events, bad habits and/or bad social skills.

General Symptoms

● delusions, hallucinations, disorganized speech, and/or diminished or inappropriate emotional expression. ■ Disturbed perceptions ■ Disorganized thinking and speech ■ Diminished, inappropriate emotions

Schizophrenia

● is a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished or inappropriate emotional expression.