Module 47-Introduction to Psychological Disorders
Biological Influences on Psychopathology:
1. Evolution 2. Individual genes 3. Brain structure & chemistry
Insomnia Disorder Criteria (symptoms)
1. Feeling unsatisfied with amount or quality of sleep (trouble falling asleep, staying asleep, or returning to sleep) 2. Sleep disruption causes distress or diminished everyday functioning 3. Happens three or more nights each week 4. Occurs during at least three consecutive months 5. Happens even with sufficient sleep opportunities 6. Independent from other sleep disorders (such as narcolepsy) 7. Independent from substance use or abuse 8. Independent from other mental disorders or medical conditions
Socio-cultural Influences:
1. Stress 2. Roles 3. Expectations 4. Definitions of normality & disorder
Psychological Influences:
1. Stress 2. Trauma 3. Learned Helplessness 4. Mood-related perceptions and memories 5. Individual genes
predictors of violence
1. alcohol or drug use 2. previous violence 3. gun availability 4. brain damage
In one study that followed people for up to 25 years after a first suicide attempt, ________ eventually died by suicide
5 %
American children and adolescents who identify as transgender or gender nonconforming are ________________ more likely than their peers to be diagnosed with a psychological disorder
7 times
The percentage of Americans who reported suffering from a phobia of a specific object or situation in 2015 was:
8.7
Tonya is interested in studying psychological disorders. If she wants to study the classification system most often used in the United States, she should read the:
DSM-5
Rates of Disorders
Depressive & Bipolar disorders = 9.3 Phobia of specific object or situation = 8.7 Social anxiety disorder = 6.8 ADHD = 4.1 PTSD = 3.5 Generalized anxiety = 3.1 Schizophrenia = 1.1 Obsessive-compulsive disorder = 1.0
DSM-5
Diagnostic and Statistical Manual of Mental Disorders
A lawyer is distressed by feeling the need to wash her hands 100 times a day. She has little time to meet with clients, and her colleagues are wondering about her competence. Her behavior would probably be labeled disordered, because it is _________________, that is, it interferes with her day-to-day life.
Dysfunctional or Maladaptive
The American Psychiatric Association's DSM-5 was released in:
May 18, 2013
national differences in suicide rates
Russia = double US US = double Spain Lithuanians = 7x more likely to die by suicide than Greeks
Lynette is released after a 4-week stay at a psychiatric hospital. She needs to find an apartment near her job because she cannot afford a car. When she talks to potential landlords, how should she describe herself?
She should not tell them she was in a psychiatric hospital. Many people react negatively to those labeled "mentally ill."
DSM-5 provides mental health professionals with:
a common language for clinicians to communicate about their patients and establishes consistent and reliable diagnoses that can be used in the research of mental disorders.
If one psychiatrist or psychologist diagnosed someone with one of these disorders, there was a 70 percent chance that another mental health worker would independently give the same diagnosis.
adult posttraumatic stress disorder childhood autism spectrum disorder
In field trials assessing the reliability of the DSM-5 categories, clinician agreement on _____________________________.
adult posttraumatic stress disorder and childhood autism spectrum disorder was near 70 percent.
People may choose death as ___________________________.
an alternative to current or future suffering, a way to switch off unendurable pain and relieve a perceived burden on family members
These disorders occur mostly in Western cultures:
anorexia nervosa & bulimia nervosa *food-abundant Western cultures.
Psychological disorders may share an underlying dynamic, such as _____________, while differing in the ______________________________.
anxiety symptoms manifested in a particular culture.
Which of the following was the highest reported psychological disorder in the United States within the past year?
anxiety disorders
vulnerability-stress model
approaches that emphasize how individual vulnerabilities interact with external stresses or circumstances to produce specific mental disorders, such as depression The biopsychosocial approach gave rise to the vulnerability-stress model,1 which assumes that individual dispositions combine with environmental stressors to influence psychological disorder
George, a gay man who is not open about his sexual orientation in his work environment due to fear of discrimination, is likely to:
be at greater risk for mental health problems due to social stigma.
People with disorders are more likely to ______________________.
be victims than perpetrators of violence
The risk of suicide increases when people who have been depressed __________________________________.
begin to rebound and become capable of following through
Dr. Cobbs believes that psychological disorders are influenced by genetic predispositions and physiological states. He is also aware that inner psychological dynamics, social dynamics, and culture influence psychological disorders. Dr. Cobbs believes in a _____ model.
biopsychosocial
Dr. Phelps believes that psychological disorders are influenced by genetic predispositions and physiological states. He is also aware that inner psychological dynamics, social dynamics, and culture influence psychological disorders. Dr. Phelps believes in a _____ model.
biopsychosocial
Those who engage in NSSI often have experienced _______________.
bullying, harassment, or stress
In the Middle Ages, you might have said, "The devil made her do it." Believing that, you might have approved of a harsh cure that would drive out the evil demon. Thus, people considered "mad" were sometimes:
caged or given "therapies" such as genital mutilation, beatings, removal of teeth or lengths of intestines, or transfusions of animal blood
Clinicians __________ predict who is likely to do harm.
cannot
People tend to stigmatize those with psychological disorders and the stigma of mental illness can ____________________________.
cause people to hide their symptoms and to avoid seeking treatment
Cassi frequently engages in NSSI. This is actually a risk factor for suicidal thoughts and future suicide attempts for Cassi because her NSSI co-exists with:
depression
The stresses and demoralization of poverty can precipitate disorders, especially __________________________ in women and ______________ in men.
depression in women substance abuse in men
NSSI (non-suicidal self injury)
direct, deliberate destruction of body tissue in the absence of any intent to die mostly adolescents and females cut or burn their skin, hit themselves, or insert objects under their nails or skin
Label someone as "mentally ill" and people may __________________.
fear them as potentially violent
Therapists who thought they were watching an interview of a psychiatric patient perceived him as ______________________.
frightened of his own aggressive impulses -and- passive, dependent type
Those who engage in NSSI are typically suicide _________, not suicide _______________.
gesturers attempters
About half of people with a disorder experience their first symptoms by the _________, and three-quarters do so by the _______________.
half = mid-teens 3/4 = mid-twenties
According to one research team, suicide is ________ to predict.
hard
Researchers continue to try to solve the suicide puzzle and developed an app that________________, while other research teams are developing ______________________.
harvests phone data to predict suicide risk by studying teen volunteers' tone of voice, language, photos, music choice, and sleep disturbances suicide-predicting AI (artificial intelligence) algorithms from psychological assessments, health records, or social media posts
Most homicide is committed by _____________________.
healthy people in the grip of everyday emotions using guns
In late adulthood, suicide rates __________, with the highest rate among those _______
increase worldwide over age 70
Gay, transgender, and gender-nonconforming youth facing an unsupportive environment, including family or peer rejection, are also at __________________.
increased risk of attempting suicide
In most countries, suicides have been _______________.
increasing
ICD
international classification of diseases
Elsa is a 50-year-old teacher who is openly gay. According to the American Psychiatric Association (APA), Elsa's LGBTQ identity:
is not classified as an illness
A large pharmaceutical company is conducting a clinical trial for a new antidepressant to treat major depressive disorder. They are concerned with the efficacy and safety of the new drug. Their perspective is most in line with the _____ model.
medical
At one time, disordered people were simply warehoused in asylums. Asylums have been replaced with psychiatric hospitals, where attempts are made to diagnose and cure people suffering from psychological disorders. This BEST illustrates one of the beneficial consequences of the _____ model.
medical
Gena believes that people with psychological disorders are suffering from diseases that have physical causes that can be diagnosed, treated, and sometimes even cured. Gena believes in the _____ model of psychological disorders.
medical
Helena believes that people with psychological disorders are suffering from diseases that have physical causes that can be diagnosed, treated, and sometimes even cured. Helena believes in the _____ model of psychological disorders.
medical
Thirty-seven-year-old Steven is a single male who has suffered from depression all his life. He has been in treatment for the last week and a half and has begun taking an antidepressant. He is starting to feel better, but he is tired of living this way and does not want to face another depressive episode. In terms of risk factors for suicide, Steven is _____ likely to attempt suicide _____.
more; because his energy and initiative are rebounding
Seventy-five-year-old Walter lost his wife to a heart attack 2 years ago, and most of his friends have passed away. His children live in other states, and he has no pets. In terms of risk factors for suicide, Walter is _____ likely to attempt suicide _____.
more; because the suicide rate surges among older men
suicide rate differences
national gender race trait age other group day-of-the-week and seasonal year-by-year
Alcohol use disorder, obsessive-compulsive disorder, bipolar disorders, and schizophrenia symptoms appear at a median age ______________.
near 20
In one study, people watched recorded interviews. If told the interviewees were job applicants, the viewers perceived them as ______ and if told they were watching cancer or psychiatric patients, the viewers perceived the same interviewees as ________________.
normal different from most people
Suicide is usually _______________________.
not an act of hostility or revenge
Most violent criminals are ___________, and most mentally ill people are __________.
not mentally ill not violent
Self-injury rates ________________________.
peak higher for 15- to 19-year-old females than for same-age males
self-harm
people who self harm are seeking relief from uncomfortable and unpleasant emotions
Which disorder usually develops in childhood or adolescence?
phobic disorder
Based on information presented in the textbook, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of _____ disorder is fairly reliable.
posttraumatic stress
One predictor of psychiatric disorders that crosses ethnic and gender line is ________________.
poverty
Schizophrenia understandably leads to ____________.
poverty
A _____ disorder is a syndrome marked by a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior.
psychological
Following highly publicized suicides and TV programs featuring suicide,______________________.
rates of suicide sometimes increase
_____ is the mental disorder that is MOST likely to lead to poverty.
schizophrenia
NSSI is often __________________, as people may _______________. find relief from intense negative thoughts through the distraction of pain.
self-reinforcing find relief from intense negative thoughts through the distraction of pain
Gregory is an impoverished African-American teen who finds school stressful but performs at a moderate level academically. He has no relationship with his father but a close relationship with his mother and grandmother. Which factor MOST increases his vulnerability to developing a mental disorder?
socioeconomic status poverty
Although U.S. gun owners often keep a gun to feel safer, having a gun in the home _______________________________.
substantially increases the odds of a family member dying by suicide or homicide
Qwan often finds himself anxious in social situations. He avoids eye contact with others and regularly dismisses his fears of blushing uncontrollably as shyness. If Qwan were Japanese, he might be suffering from:
taijin-kyofusho
Suicide rates have been much higher among ___________________.
the rich, the nonreligious, and the unmarried
Epigenetics
the study of influences on gene expression that occur without a DNA change supports the vulnerability-stress model by showing how our DNA and our environment interact ***expressed or dormant gene depending on environment ***For some, that will be the difference between developing a disorder or not developing it.
The few people with disorders who commit violent acts tend to be ______________________.
those who experience threatening delusions and hallucinated voices that command them to act, or those who abuse substances
trait differences in suicide rates
trait differences: Among Swedes, those with obsessive-compulsive disorder are at higher risk of depression, thereby increasing their risk of suicide (de la Cruz et al., 2017). Suicidal thoughts may also increase when perfectionist people feel driven to reach a goal or standard—to become thin or straight or rich—and find it unattainable
Compared with cisgender American veterans, transgender veterans, who often feel stigmatized in the military, are also _______________ to die by suicide.
twice as likely
After Missouri repealed its tough handgun law, its suicide rate went ______ percent; when Connecticut enacted such a law, its suicide rate _________ percent.
up 15 % dropped 16 %
According to the U.S. Surgeon General's Office there is ____________________________ from casual contact with an individual who has a mental disorder
very little risk of violence or harm to a stranger
The vast majority of people who possess a specific risk factor for suicide ____________________.
will never engage in suicidal behavior
_______________ are more likely than ____________ to die by suicide.
women; men
Mass-killing shooters are mostly ________________.
young males
homosexuality
***1952 through December 9, 1973 was classified as a psychological disorder ***By day's end on December 10, it was not. ***APA made change because more and more of its members viewed same-sex attraction as a natural biological predisposition and not a psychological problem
gender differences in suicide rates
1. Women and girls are much more likely than men to consider or attempt suicide 2. Worldwide, men are twice as likely to actually die by suicide methods men use are more violent & lethal
Critics of DSM
1. casts too wide a net 2. brings "almost any kind of behavior within the compass of psychiatry (severe grief) 3. subjective labels = self-fulfilling prophecy ***Example: teachers & gifted students
diagnostic classification in psychiatry and psychology, classification also aims to:
1. outline symptoms 2. predict a disorder's future course 3. suggest appropriate treatment 4. prompt research into its causes *To study a disorder, we must first name and describe it.
In the United States, for example, __________ percent of all suicide attempts end in death. When firearms are involved, the number is ____________ percent.
13% 90%
The incidence of serious psychological disorders is ____________ among those ________________.
2.5 times higher below the poverty line
Major depressive disorder hits at a median age of _______________.
25
About 3 in 10 of those who think about suicide will actually attempt suicide, of whom ________ percent will die.
3 %
One six-year study tracked suicide cases among all 1.2 million people who lived in metropolitan Stockholm during the 1990s. Men exposed to a co-worker's suicide were ___________________ to also take their own lives, compared with nonexposed men.
3.5 times more likely
Between 1999 and 2017, Americans' suicidal thoughts and suicide rates both increased nearly ______________ percent,
40 %
The lowest rate of reported mental disorders was in __________, and the highest rate was in the _____________.
Nigeria United States
Risk Factors for Mental Disorders
*Academic failure *Birth complications *Caring for those who are chronically ill or who have a neurocognitive disorder *Child abuse and neglect *Chronic insomnia *Chronic pain *Family disorganization or conflict *Low birth weight *Low socioeconomic status *Medical illness *Neurochemical imbalance *Parental mental illness *Parental substance abuse *Personal loss and bereavement *Poor work skills and habits *Reading disabilities *Sensory disabilities *Social incompetence *Stressful life events *Substance abuse *Trauma experiences
medical model
*In the year 1900, researchers discovered that syphilis, a sexually transmitted infection, invades the brain and distorts the mind *triggered an eager search for physical causes of other mental disorders, and for treatments that would cure them. *Hospitals replaced Asylums *the concept that psychological diseases have physical causes that can be diagnosed, treated, and, in most cases, cured, often through treatment in a hospital
psychopathology
*a mental illness * needs to be diagnosed on the basis of its symptoms *needs to be treated through therapy
psychological disorder
-a syndrome (collection of symptoms) marked by a "clinically significant disturbance in an individual's cognition, emotion regulation, or behavior" (American Psychiatric Association, 2013). -Such thoughts, emotions, or behaviors are dysfunctional or maladaptive—they interfere with normal day-to-day life.
Mental and addictive disorders affected more than ____________ people globally in 2016," reported a major worldwide study.
1 billion
In one natural experiment investigating the poverty-pathology link, researchers tracked rates of behavior problems in North Carolina Native American children as economic development enabled a dramatic reduction in their community's poverty rate. When the study began, children of poverty exhibited more deviant and aggressive behaviors. After four years, children whose families had moved above the poverty line exhibited a _____________ in behavior problems. Those who maintained their previous positions below or above the poverty line exhibited _____________.
40 % decrease in behavior problems no change
In the United States __________________ experienced a mental illness within the last year
47 million 19 %
About ___________ Americans a year die by suicide, __________ with guns.
47,000 half
Poison and drug overdoses account for about _____ percent of suicide attempts and_________ percent of suicide fatalities.
80 % of attempts 14 % of fatalities
suicide rates
800,000 per year 1 every 40 seconds anxiety = 3x risk depression = 5x risk ***risk increases when they begin to rebound and become capable of following through
In one survey, _____ percent of Americans agreed that "increased government spending on mental health screening and treatment" would be a "somewhat" or "very" effective "approach to preventing mass shootings at schools"
84 %
In _________ percent of U.S. mass killings between 1982 and 2017, the killer had ______________________.
85 % no known prior contact with mental health professionals
How many suicides involving firearms end in death?
85 percent
To judge from surveys of 84,850 people across 17 nations, about _____________ percent of people at some point in their lives have thought seriously of suicide.
9 %
RDoC (Research Domain Criteria Project)
A newer classification approach that builds upon the DSM ***organizes disorders according to behaviors and brain activity, aiming to study them with "the power of modern research approaches in genetics, neuroscience, and behavioral science"
Protective Factors for Mental Disorders
Aerobic exercise Community offering empowerment, opportunity, and security Economic independence Effective parenting Feelings of mastery and control Feelings of security High self-esteem Literacy Positive attachment and early bonding Positive parent-child relationships Problem-solving skills Resilient coping with stress and adversity Social and work skills Social support from family and friends
All of the following are no longer diagnostic labels in DSM-5 EXCEPT:
Aspberger's
Psychologists worry that suicide rates may increase during the __________________, which caused widespread unemployment and social isolation.
COVID-19 pandemic
______________ or __________________ can be a challenge for people recently released from a psychiatric hospital.
Getting a job or finding a place to rent
year-by-year differences in suicide rates
In most countries, suicides have been increasing between 1999 and 2017, Americans' suicidal thoughts and suicide rates both increased nearly 40 percent
taijin kyofusho
Japanese culture social anxiety about physical appearance, a readiness to blush, and a fear of eye contact
susto
Latin America severe anxiety or panic in response to an emotional trauma or fear of black magic
Philippe Pinel (1745-1826) French Reformer
Madness is a sickness of the mind caused by severe stress and inhumane conditions. Curing requires moral treatment, including boosting patients' spirits by unchaining them and talking with them. He and others worked to replace brutality with gentleness, isolation with activity, and filth with clean air and sunshine. *Lunatic Balls
amok
Malaysia a sudden outburst of violent behavior (as in the English phrase "run amok")
immigrant paradox
Mexican Americans who have recently immigrated to the USA are less at risk than Mexican Americans born in the United States,
Immigrants to the United States from _____________averaged better mental health than their U.S.-born counterparts with the same ethnic heritage
Mexico, Africa, and Asia
day of the week and seasonal differences in suicide
Negative emotion tends to go up midweek 25 percent of U.S. suicides occur on Wednesdays Suicide rates are highest in April and May, and not (as commonly believed) over the winter holidays
Predicting Suicide
People who commit suicide tend to signal their intentions, often quite explicitly, such as by telling others about their suicidal thoughts. Research indicates that about 90% of people who commit suicide leave clear clues. ***In hindsight, families and friends may recall signs they believe should have forewarned them—verbal hints, giving possessions away, a sudden mood change, or withdrawal and preoccupation with death
The symptoms of _________- appear around age 10; _______ tend to appear later, around age 25.
Phobias; major depressive disorder
One analysis of 17 million Twitter users' data showed that sharing suicidal thoughts _________________.
Social suggestion may trigger suicidal thinking and behavior. had a ripple effect, spreading suicidal thinking through one's social network
The percentage of people with any mental disorder and the proportion of those disorders considered serious in various nations are as follows:
United States = 20 percent and 7 percent Ukraine = 16 percent and 5 percent Colombia = 15.5 percent and 5 percent New Zealand = 15 percent and 5.5 percent France = 16 percent and 3 percent Lebanon = 14 percent and 4 percent South Africa = 12 percent and 4 percent Netherlands = 10 percent and 4 percent Mexico = 8.5 percent and 3.5 percent Belgium = 7 percent and 4 percent Germany = 9 percent and 2 percent Israel = 6 percent and 4 percent Spain = 7 percent and 2.5 percent Italy = 7 percent and 2 percent Japan = 5.5 percent and 1.5 percent China = 5 percent and 1.5 percent Nigeria = 5 percent and 1 percent
racial differences in suicide rates
United States: *Whites and Native Americans die by suicide 2x as often as Blacks, Hispanics, and Asians *Indigenous Canadians 3x rate of other Canadians
NSSI is a risk factor for suicidal thoughts and future suicide attempts, especially when co-existing with _________________. If people do not find help, their nonsuicidal behavior may escalate to suicidal thoughts and, finally, to suicide attempts.
a bipolar disorder
In field trials assessing the reliability of the DSM-5 categories, clinician agreement on antisocial personality disorder and generalized anxiety disorder, agreement was:
closer to 20 percent
States with high gun ownership, and weaker gun safety laws, are states with _____________________________.
high suicide rates, even after controlling for poverty and urbanization
Those who engage in NSSI are generally ________ and ___________.
less able to tolerate & regulate emotional distress often both self-critical and impulsive
Compared with Mexican Americans born in the United States, Mexican Americans who have recently immigrated are
less at risk for mental disorders
Suicidal urges typically arise when people feel ____________________________.
like they don't belong or are a burden to others, when they feel trapped by a seemingly inescapable situation, or when they feel incapable of experiencing joy
How can we be helpful to someone who is talking suicide?
listen connect protect
These two disorders occur worldwide:
major depressive disorder and schizophrenia
Among the earliest to appear are the symptoms of antisocial personality disorder at age _____________ and of phobias at age __________.
median age 8 median age 10
Canada and England have simultaneously experienced the same gender difference and upward trend in __________________.
nonsuicidal self-injury
Arianna displays very dysfunctional behavior. She is unable to care for herself, cannot dress herself, and has limited understanding of her surroundings. Prior to the reform movement influenced by Philippe Pinel, Arianna's behavior would MOST likely have been considered:
the result of demon possession