Psych 102, Week 12

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DSM criteria for Major Depressive Disorder (B, C, D, and E)

B) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning C) The episode is not attributable to the physiological effects of a substance or to another medical condition D) The occurrence of the major depressive episode is NOT better explained by schizoaffective disorder, schizophrenia, schizphreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders E) There has never been a manic episode or a hypomanic episode

Borderline PD DSM-5 Criteria

- A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1. Frantic efforts to avoid real or imagined abandonment. 2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. e.g: loving individual one second but hating them another second 3. Identity disturbance: markedly persistently unstable self-image or sense of self. 4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). 5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour. 6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 7. Chronic feelings of emptiness ("something is missing"). 8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). 9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Who is Psychopathic? (Prevalence)

-0.6-1% in the general population -3.5% in the business world -15-25% of prison populations; but less common amongst female prisoners (16-17%) -11% of female violent criminals; 31% of male violent criminals -57-97% of serial killers -In general, males are more likely to be psychopaths than females

Prevalence of Autism

-1 in 88 children in the U.S. have autism spectrum disorder -Rates of disorder is 5 times more common in boys (1 our of 54) than in girls (1 out of 252) -Rates of autistic spectrum disorder have increased dramatically since the 1980s -Between 2000 and 2008, the rate of autism diagnoses in the U.S. increased 78% -It is possible that the rise in prevalence is the result of broadening of the diagnosis, increased efforts to identify cases in the community, and greater awareness + acceptance of the diagnosis -Mental health professionals are now more knowledgable about autism spectrum disorder and are better equipped to make the diagnosis, even in subtle cases

How common is anxiety disorder

-25-30% of the US population meets the criteria for at least one anxiety disorder during their lifetime -Anxiety disorders are the most frequently occurring class of mental disorders and are often comorbid with each other and with other mental disorders

Which region of the brain plays a role in OCD? How?

-A brain region that is believed to play a critical role in OCD is the orbitofrontal cortex, an area of the frontal lobe involved in learning and decision-making. -In people with OCD, the orbitofrontal cortex becomes especially hyperactive when they are provoked with tasks in which, for example, they are asked to look at a photo of a toilet or of pictures hanging crookedly on a wall. -The orbitofrontal cortex is part of a series of brain regions that, collectively, is called the OCD circuit; this circuit consists of several interconnected regions that influence the perceived emotional value of stimuli and the selection of both behavioral and cognitive responses. -As with the orbitofrontal cortex, other regions of the OCD circuit show heightened activity during symptom provocation, which suggests that abnormalities in these regions may produce the symptoms of OCD. -Consistent with this explanation, people with OCD show a substantially higher degree of connectivity of the orbitofrontal cortex and other regions of the OCD circuit than do those without OCD. -These findings were based on imaging studies, and they highlight the potential importance of brain dysfunction in OCD. -However, one important limitation of these findings is the inability to explain differences in obsessions and compulsions. Another limitation is that the correlational relationship between neurological abnormalities and OCD symptoms cannot imply causation.

Learning phobias through verbal transmission or information

-A child whose parents, siblings, friends, and classmates constantly tell her how disgusting and dangerous snakes are may come to acquire a fear of snakes

Attention Deficit/Hyperactivity Disorder

-A child with ADHD shows a constant pattern of inattention and/or hyperactive and impulsive behavior that interferes with normal functioning. -Some of the signs of inattention include great difficulty with and avoidance of tasks that require sustained attention (such as conversations or reading), failure to follow instructions (often resulting in failure to complete school work and other duties), disorganization (difficulty keeping things in order, poor time management, sloppy and messy work), lack of attention to detail, becoming easily distracted, and forgetfulness. -Hyperactivity is characterized by excessive movement, and includes fidgeting or squirming, leaving one's seat in situations when remaining seated is expected, having trouble sitting still (e.g., in a restaurant), running about and climbing on things, blurting out responses before another person's question or statement has been completed, difficulty waiting one's turn for something, and interrupting and intruding on others. -Frequently, the hyperactive child comes across as noisy and boisterous. -The child's behavior is hasty, impulsive, and seems to occur without much forethought; these characteristics may explain why adolescents and young adults diagnosed with ADHD receive more traffic tickets and have more automobile accidents than do others.

Hallucination

-A hallucination is a perceptual experience that occurs in the absence of external stimulation. -Auditory hallucinations (hearing voices) occur in roughly two-thirds of patients with schizophrenia and are by far the most common form of hallucination. -The voices may be familiar or unfamiliar, they may have a conversation or argue, or the voices may provide a running commentary on the person's behaviour. -Less common are visual hallucinations (seeing things that are not there) and olfactory hallucinations (smelling odors that are not actually present). Such as prolonged use of amphetamines, methamphetamines, and cocaine

Childhood vaccinations and autism

-A medical journal published an article showing that autism is triggered by the MMR (measles, mumps, and rubella) vaccine -The article was retracted by the journal after accusations of fraud on the part of the lead researcher -People still fear that vaccinations may cause autism, and more than 10% of parents of young children refuse or delay vaccinations because of this -Studies have shown that the quantity of immunogens from vaccines received during the first 2 years of life were not at all related to the development of autism spectrum disorder. There is not a relationship between vaccinations and autism spectrum disorders -The notion that autism spectrum disorder is caused by vaccinations is appealing because it provides a simple explanation for the condition

Development of schizophrenia and events during pregnancy

-A number of environmental factors that could impact normal brain development might be at fault. -High rates of obstetric complications in the births of children who later developed schizophrenia have been reported. -In addition, people are at an increased risk for developing schizophrenia if their mother was exposed to influenza during the first trimester of pregnancy. -Research has also suggested that a mother's emotional stress during pregnancy may increase the risk of schizophrenia in offspring. -One study reported that the risk of schizophrenia is elevated substantially in offspring whose mothers experienced the death of a relative during the first trimester of pregnancy.

Hopelessness theory

-A particular style of negative thinking leads to a sense of hopelessness, which then leads to depression -According to this theory, hopelessness is an expectation that unpleasant outcomes will occur or that desired outcomes will not occur, and there is nothing one can do to prevent such outcomes. -A key assumption of this theory is that hopelessness stems from a tendency to perceive negative life events as having stable ("It's never going to change") and global ("It's going to affect my whole life") causes, in contrast to unstable ("It's fixable") and specific ("It applies only to this particular situation") causes, especially if these negative life events occur in important life realms, such as relationships, academic achievement, and the like. -Suppose a student who wishes to go to law school does poorly on an admissions test. If the student infers negative life events as having stable and global causes, she may believe that her poor performance has a stable and global cause ("I lack intelligence, and it's going to prevent me from ever finding a meaningful career"), as opposed to an unstable and specific cause ("I was sick the day of the exam, so my low score was a fluke"). -Hopelessness theory predicts that people who exhibit this cognitive style in response to undesirable life events will view such events as having negative implications for their future and self-worth, thereby increasing the likelihood of hopelessness—the primary cause of depression. -One study testing hopelessness theory measured the tendency to make negative inferences for bad life effects in participants who were experiencing uncontrollable stressors. -Over the ensuing six months, those with scores reflecting high cognitive vulnerability were 7 times more likely to develop depression compared to those with lower scores.

Bipolar Disorder

-A person with bipolar disorder (commonly known as manic depression) often experiences mood states that vacillate between depression and mania; that is, the person's mood is said to alternate from one emotional extreme to the other (in contrast to unipolar, which indicates a persistently sad mood).

ADHD and parenting

-ADHD is likely not caused by poor parenting -Genetic studies suggested that the family environment does not seem to play much of a role in the development of this disorder and if it did, the concordance rates would be higher for fraternal twins and adoptive siblings than studies have shown -ADHD is triggered more by genetic and neurological factors and less by social or environmental ones

ADHD prevalence

-ADHD occurs in about 5% of children. -On the average, boys are 3 times more likely to have ADHD than are girls; however, such findings might reflect the greater propensity of boys to engage in aggressive and antisocial behaviour and thus incur a greater likelihood of being referred to psychological clinics. -Children with ADHD face severe academic and social challenges. Compared to their non-ADHD counterparts, children with ADHD have lower grades and standardized test scores and higher rates of expulsion, grade retention, and dropping out (Loe & Feldman, 2007). they also are less well-liked and more often rejected by their peers (Hoza et al., 2005).

Prevalence of Schizophrenia

-About 0.5-1.5% of the population experiences schizophrenia in their lifetime, and usually the disorder is first diagnosed during early adulthood (teens-early 30s). -Slightly more common in men

Prevalence of GAD

-About 5.7% of the U.S. population will develop symptoms of generalized anxiety disorder during their lifetime, and females are 2 times as likely as males to experience the disorder (APA, 2013). -Generalized anxiety disorder is highly comorbid with mood disorders and other anxiety disorders (Noyes, 2001), and it tends to be chronic. -Also, generalized anxiety disorder appears to increase the risk for heart attacks and strokes, especially in people with preexisting heart conditions (Martens et al., 2010).

Prevalence of panic DISORDERS

-Affects 4.7% of Americans during their lifetime (lectures says 2 percent) -Most cases develop in their late teens- early 20s (18-25) -The prognosis is good: there are good behavioural and drug treatments for this disorder -People with panic disorder often experience a co-morbid disorder, such as another anxiety disorder or major depressive disorder

Which phobia is listed in the DSM-5 as a separate anxiety disorder

-Agoraphobia -Fear of the marketplace -Characterized by intense fear, anxiety, and avoidance of situations in which it might be difficult to escape or receive help if one experiences symptoms of a panic attack -These situations include public transportation, open spaces like parking lots, enclosed spaces like stores, crowds, or being outside the home alone -1.4% of Americans experience agoraphobia during their lifetime

Types of Anxiety Disorders in DSM-5

-All persistent and/or irrational sorts of anxiety/fear -Panic Disorder -Generalized Anxiety Disorder (GAD) -Social Anxiety Disorder (Social Phobia) -Specific Phobia

Brain abnormalities in kids with ADHD

-Brain imaging studies have shown that children with ADHD exhibit abnormalities in their frontal lobes, an area in which dopamine is in abundance. -Compared to children without ADHD, those with ADHD appear to have smaller frontal lobe volume, and they show less frontal lobe activation when performing mental tasks. -One of the functions of the frontal lobes is to inhibit our behaviour. -Thus, abnormalities in this region may go a long way toward explaining the hyperactive, uncontrolled behavior of ADHD.

Schizoid Personality Disorder

-Cluster A -Lacks interest and desire to form relationships with others; aloof and shows emotional coldness and detachment; indifferent to approval or criticism of others; lacks close friends or confidants; not due to schizophrenia or other psychotic disorders, not an autism spectrum disorder

Men vs. Women Schizophrenia

-Negative symptoms (e.g., social withdrawal, lack of motivation, flat emotions) tend to predominate in men -Depressive episodes, paranoid delusions, and hallucinations tend to predominate in women

Interaction of genes + environment in developing schizophrenia

-Although adoption studies have supported the hypothesis that genetic factors contribute to schizophrenia, they have also demonstrated that the disorder most likely arises from a combination of genetic and environmental factors, rather than just genes themselves. -For example, investigators in one study examined the rates of schizophrenia among 303 adoptees (Tienari et al., 2004). A total of 145 of the adoptees had biological mothers with schizophrenia; these adoptees constituted the high genetic risk group. -The other 158 adoptees had mothers with no psychiatric history; these adoptees composed the low genetic risk group. -The researchers managed to determine whether the adoptees' families were either healthy or disturbed. -The adoptees were considered to be raised in a disturbed family environment if the family exhibited a lot of criticism, conflict, and a lack of problem-solving skills. -The findings revealed that adoptees whose mothers had schizophrenia (high genetic risk) and who had been raised in a disturbed family environment were much more likely to develop schizophrenia or another psychotic disorder (36.8%) than were adoptees whose biological mothers had schizophrenia but who had been raised in a healthy environment (5.8%), or than adoptees with a low genetic risk who were raised in either a disturbed (5.3%) or healthy (4.8%) environment. -Because the adoptees who were at high genetic risk were likely to develop schizophrenia only if they were raised in a disturbed home environment, this study supports a diathesis-stress interpretation of schizophrenia—both genetic vulnerability and environmental stress are necessary for schizophrenia to develop, genes alone do not show the complete picture.

Hoarding Disorder

-Although hoarding was traditionally considered to be a symptom of OCD, considerable evidence suggests that hoarding represents an entirely different disorder (Mataix-Cols et al., 2010). -People with hoarding disorder cannot bear to part with personal possessions, regardless of how valueless or useless these possessions are. -As a result, these individuals accumulate excessive amounts of usually worthless items that clutter their living areas. -Often, the quantity of cluttered items is so excessive that the person is unable use his kitchen, or sleep in his bed. -People who suffer from this disorder have great difficulty parting with items because they believe the items might be of some later use, or because they form a sentimental attachment to the items (APA, 2013). -Importantly, a diagnosis of hoarding disorder is made only if the hoarding is not caused by another medical condition and if the hoarding is not a symptom of another disorder (e.g., schizophrenia).

How GADS develops

-Although there have been few investigations aimed at determining the heritability of generalized anxiety disorder, a summary of available family and twin studies suggests that genetic factors play a modest role in the disorder. -Cognitive theories of generalized anxiety disorder suggest that worry represents a mental strategy to avoid more powerful negative emotions, perhaps stemming from earlier unpleasant or traumatic experiences. -Indeed, one longitudinal study found that childhood maltreatment was strongly related to the development of this disorder during adulthood (Moffitt et al., 2007); worrying might distract people from remembering painful childhood experiences.

Dissociative Amnesia

-Amnesia refers to the partial or total forgetting of some experience or event. -An individual with dissociative amnesia is unable to recall important personal information, usually following an extremely stressful or traumatic experience such as combat, natural disasters, or being the victim of violence. -The memory impairments are not caused by ordinary forgetting. Some individuals with dissociative amnesia will also experience dissociative fugue (from the word "to flee" in French), whereby they suddenly wander away from their home, experience confusion about their identity, and sometimes even adopt a new identity. -Most fugue episodes last only a few hours or days, but some can last longer. One study of residents in communities in upstate New York reported that about 1.8% experienced dissociative amnesia in the previous year (Johnson, Cohen, Kasen, & Brook, 2006).

Body Dysmorphic Disorder

-An individual with body dysmorphic disorder is preoccupied with a perceived flaw in her physical appearance that is either nonexistent or barely noticeable to other people (APA, 2013). -These perceived physical defects cause the person to think she is unattractive, ugly, hideous, or deformed. -These preoccupations can focus on any bodily area, but they typically involve the skin, face, or hair. The preoccupation with imagined physical flaws drives the person to engage in repetitive and ritualistic behavioral and mental acts, such as constantly looking in the mirror, trying to hide the offending body part, comparisons with others, and, in some extreme cases, cosmetic surgery (Phillips, 2005). -An estimated 2.4% of the adults in the United States meet the criteria for body dysmorphic disorder, with slightly higher rates in women than in men.

Postpartum Depression

-Another subtype, peripartum onset (commonly referred to as postpartum depression), applies to women who experience major depression during pregnancy or in the four weeks following the birth of their child. -These women often feel very anxious and may even have panic attacks. -They may feel guilty, agitated, and be weepy. They may not want to hold or care for their newborn, even in cases in which the pregnancy was desired and intended. -In extreme cases, the mother may have feelings of wanting to harm her child or herself. -In a horrific illustration, a woman named Andrea Yates, who suffered from extreme peripartum-onset depression (as well as other mental illnesses), drowned her five children in a bathtub. -Most women with peripartum-onset depression do not physically harm their children, but most do have difficulty being adequate caregivers (Fields, 2010). -A surprisingly high number of women experience symptoms of peripartum-onset depression. A study of 10,000 women who had recently given birth found that 14% screened positive for peripartum-onset depression, and that nearly 20% reported having thoughts of wanting to harm themselves (Wisner et al., 2013).

Brain abnormalities in schizophrenia

-Brain imaging studies reveal that people with schizophrenia have enlarged ventricles, the cavities within the brain that contain cerebral spinal fluid. -This finding is important because larger than normal ventricles suggests that various brain regions are reduced in size, thus implying that schizophrenia is associated with a loss of brain tissue. -In addition, many people with schizophrenia display a reduction in gray matter (cell bodies of neurons) in the frontal lobes, and many show less frontal lobe activity when performing cognitive tasks. -The frontal lobes are important in a variety of complex cognitive functions, such as planning and executing behaviour, attention, speech, movement, and problem solving. -Hence, abnormalities in this region provide merit in explaining why people with schizophrenia experience deficits in these of areas.

Marijuana use and schizophrenia

-Another variable that is linked to schizophrenia is marijuana use. -Although a number of reports have shown that individuals with schizophrenia are more likely to use marijuana than are individuals without schizophrenia, such investigations cannot determine if marijuana use leads to schizophrenia, or vice versa. -However, a number of longitudinal studies have suggested that marijuana use is, in fact, a risk factor for schizophrenia. -A classic investigation of over 45,000 Swedish conscripts who were followed up after 15 years found that those individuals who had reported using marijuana at least once by the time of conscription were more than 2 times as likely to develop schizophrenia during the ensuing 15 years than were those who reported never using marijuana; those who had indicated using marijuana 50 or more times were 6 times as likely to develop schizophrenia. -More recently, a review of 35 longitudinal studies found a substantially increased risk of schizophrenia and other psychotic disorders in people who had used marijuana, with the greatest risk in the most frequent users. -Other work has found that marijuana use is associated with an onset of psychotic disorders at an earlier age. -Overall, the available evidence seems to indicate that marijuana use plays a causal role in the development of schizophrenia, although it is important to point out that marijuana use is not an essential or sufficient risk factor as not all people with schizophrenia have used marijuana and the majority of marijuana users do not develop schizophrenia. -One plausible interpretation of the data is that early marijuana use may disrupt normal brain development during important early maturation periods in adolescence. -Thus, early marijuana use may set the stage for the development of schizophrenia and other psychotic disorders, especially among individuals with an established vulnerability.

Fantasy Model of Dissociation

-Antecedent variables that through mediators and moderators lead to trauma and dissociation -Antecedent variables include: Suggestive influences (hypnosis, leading questions), media and sociocultural influences, co-existing or ambiguous psychological symptoms, highly aversive events (childhood abuse) -Mediators and Moderators include: Fantasy-proneness, Fantasy activity, Suggestibility, High negative emotionality, Cognitive distortion/failures, sleep disruption, social support, developmental level, dysfunctional family relationships, genetic/biological vulnerability -Trauma and Dissociation: Self-reports of trauma, false memories of trauma, acceptance of implicit and explicit suggestions, dissociate experiences and symptoms -Suggests that external influences (therapist) can affect suggestive individuals in such a way so as to produce false memories and generate dissociative experiences

Risk Factors for Antisocial Personality Disorder

-Antisocial personality disorder is observed in about 3.6% of the population; the disorder is much more common among males, with a 3 to 1 ratio of men to women, and it is more likely to occur in men who are younger, widowed, separated, divorced, of lower socioeconomic status, who live in urban areas, and who live in the western United States . -Compared to men with antisocial personality disorder, women with the disorder are more likely to have experienced emotional neglect and sexual abuse during childhood, and they are more likely to have had parents who abused substances and who engaged in antisocial behaviours themselves

Seasonal pattern

-Applies to situations in which a person experiences the symptoms of major depressive disorder only during a particular time of year (e.g., fall or winter). In everyday language, people often refer to this subtype as the winter blues.

Prevalence of OCD

-Approximately 2.5% of the U.S. population will experience OCD in their lifetime and, if left untreated, OCD tends to be a chronic condition creating lifelong interpersonal and psychological problems. -Little gender difference -Onset usually in late teens to early 20s (slightly younger on-set in males) -Prognosis for recovery - given some treatment - is quite good

Prevalence of DID

-Around 1-3% of the general population -12-16% of psychiatric outpatients -More common in females -Approximately 50% of all new cases originate within the US or Canada -It has been suggested that 67% of all new cases in the US in 200-2010 originated from just 5 research groups

Women vs. Men and Depression

-Around 10-25% of women and 5-12% of men will experience a clinical depression at least once in their lives This could be due to.. 1) Gender-related differences in physiology 2) Men being more reluctant to seek treatment; more likely to regard a depression as a weakness 3) Alcoholism, which has a higher incidence in men, may mask depression 4) Gender-specific social factors and traumas

Social anxiety disorder development through conditionoing

-As with specific phobias, it is highly probable that the fears inherent to social anxiety disorder can develop through conditioning experiences. -For example, a child who is subjected to early unpleasant social experiences (e.g., bullying at school) may develop negative social images of herself that become activated later in anxiety-provoking situations. -Indeed, one study reported that 92% of a sample of adults with social anxiety disorder reported a history of severe teasing in childhood, compared to only 35% of a sample of adults with panic disorder.

Positive Symptoms of Schizophrenia

-Audible thoughts (hearing own thoughts repeated by a voice) -Thought broadcasting (Think everyone around them knows their thoughts) -Voices arguing -Voices commenting on ones actions -Thought withdrawl -Thought insertion -Delusional perception

DSM-5 Criteria for Bipolar I disorder

-Basically the same as Bipolar II, but includes those episodes (manic and/or mixed) not allowed in a diagnosis of Bipolar II -Includes depression, hypomania, mania, and/or mixed episodes

Risk factors for Bipolar Disorder

-Bipolar disorder is considerably less frequent than major depressive disorder. -In the United States, 1 out of every 167 people meets the criteria for bipolar disorder each year, and 1 out of 100 meet the criteria within their lifetime. -The rates are higher in men than in women, and about half of those with this disorder report onset before the age of 25. -Around 90% of those with bipolar disorder have a comorbid disorder, most often an anxiety disorder or a substance abuse problem. -Unfortunately, close to half of the people suffering from bipolar disorder do not receive treatment.

Schizotypal Personality Disorder

-Cluster A -Exhibits eccentricities in thought, perception, emotion, speech, and behavior; shows suspiciousness or paranoia; has unusual perceptual experiences; speech is often idiosyncratic; displays inappropriate emotions; lacks friends or confidants; not due to schizophrenia or other psychotic disorder, or to autism spectrum disorder

Dissociative Identity Disorder

-By far, the most well-known dissociative disorder is dissociative identity disorder (formerly called multiple personality disorder). Not same as schizophrenia -People with dissociative identity disorder exhibit two or more separate personalities or identities, each well-defined and distinct from one another. -They also experience memory gaps for the time during which another identity is in charge (e.g., one might find unfamiliar items in her shopping bags or among her possessions), and in some cases may report hearing voices, such as a child's voice or the sound of somebody crying (APA, 2013). -DID is clearly a legitimate and serious disorder, and although some people may fake symptoms, others suffer their entire lives with it.

Trauma and stressor-related disorders

-Category of disorders includes several disorders: -PTSD -Reactive Attachment Disorder -Disinhibited Social Engagement Disorder -Acute Stress Disorder -Adjustment Disorder

Common triggers for mood episodes

-Changes of seasons -Changes in sleep -Changes at work -Relationship stress -Pregnancy/childbirth -Grief and loss -Drugs and alcohol -Holidays *positive and negative experiences can trigger mood episodes*

Schizophrenia

-Characterized by disturbances in thought, perception, emotion, and behaviour -Most people with schizophrenia experience significant difficulties in many day-to-day activities, such as holding a job, paying bills, caring for oneself (grooming and hygiene), and maintaining relationships with others. -Frequent hospitalizations are more often the rule rather than the exception with schizophrenia. Even when they receive the best treatments available, many with schizophrenia will continue to experience serious social and occupational impairment throughout their lives. -First, schizophrenia is not a condition involving a split personality; that is, schizophrenia is not the same thing as dissociative identity disorder (better known as multiple personality disorder). Schizophrenia is considered a psychotic disorder, or one in which the person's thoughts, perceptions, and behaviors are impaired to the point where she is not able to function normally in life. In informal terms, one who suffers from a psychotic disorder (that is, has a psychosis) is disconnected from the world in which most of us live.

Anxiety disorder

-Characterized by excessive and persistent fear and anxiety, and by related disturbances in behaviour -Cause considerable distress compared to just anxiety

Common obsessions

-Characterized by recurrent and persistent thoughts, impulses, or urges that are experienced as intrusive and inappropriate and causes distress (unwanted) -Those thoughts, impulses, or images are not simply excessive worries about real-life problems -Often attempts are made to ignore or suppress the thoughts, impulses, or images -- or neutralize them with other thoughts/actions (leading to the "Thought Avoidance Paradox") -Recognize that obsessional thoughts, impulses, or images are product of their own mind -Common obsessions include concerns about germs and contamination, doubts ("Did I turn the water off?"), order and symmetry ("I need all the spoons in the tray to be arranged a certain way"), and urges that are aggressive or lustful. -Usually, the person knows that such thoughts and urges are irrational and thus tries to suppress or ignore them, but has an extremely difficult time doing so. These obsessive symptoms sometimes overlap, such that someone might have both contamination and aggressive obsessions.

Learning phobias through modelling

-Child who observes someone else reacting fearfully to spiders may later express the same fears even though spiders never presented any danger to him -This phenomenon has been observed in both humans and nonhuman primates

Life Problems From ADHD

-Children diagnosed with ADHD face considerably worse long-term outcomes than do those children who do not receive such a diagnosis. -In one investigation, 135 adults who had been identified as having ADHD symptoms in the 1970s were contacted decades later and interviewed. -Compared to a control sample of 136 participants who had never been diagnosed with ADHD, those who were diagnosed as children: -had worse educational attainment (more likely to have dropped out of high school and less likely to have earned a bachelor's degree); -had lower socioeconomic status -held less prestigious occupational positions -were more likely to be unemployed -made considerably less in salary -scored worse on a measure of occupational functioning (indicating, for example, lower job satisfaction, poorer work relationships, and more firings); -scored worse on a measure of social functioning (indicating, for example, fewer friendships and less involvement in social activities) -were more likely to be divorced -were more likely to have non-alcohol-related substance abuse problems. -Longitudinal studies also show that children diagnosed with ADHD are at higher risk for substance abuse problems. One study reported that childhood ADHD predicted later drinking problems, daily smoking, and use of marijuana and other illicit drugs (Molina & Pelham, 2003). The risk of substance abuse problems appears to be even greater for those with ADHD who also exhibit antisocial tendencies.

Classically conditioned phobias

-Classical conditioning is a form of learning in which a previously neutral stimulus is paired with ann unconditioned stimulus that reflexively elicits and unconditioned response, eliciting the same response through its association with the unconditioned stimulus. This response is called the conditioned response e.g: Child bitten by dog may fear dogs because of past association with pain. Dog bite = UCS, fear = UCR. Dog = CS fear = CR

Succesful psychopaths

-Cleckley also wrote of high functioning, so-called successful, psychopaths, such as businessmen, physicians, and scientists. These individuals/successful psychopaths, were often raised in more favourable environments such as in high social-economic status environments. These individuals are egocentric, superficial charm, and irresponsible. Integrated in society and functioning well (very little empathy for other individuals so can succeed in work place) -Businessmen, scientists, medicine, powerful positions

Cleckley's Mask of Sanity

-Cleckley was one of the first people to define psychopathy and his book, the mask of sanity, serves as the authoritative delineation on the diagnostic traits of psychopathy

Paranoid Personality Disorder

-Cluster A -Harbors a pervasive and unjustifiable suspiciousness and mistrust of others; reluctant to confide in or become close to others; reads hidden demeaning or threatening meaning into benign remarks or events; takes offense easily and bears grudges; not due to schizophrenia or other psychotic disorders

Antisocial Personality Disorder

-Cluster B -Continuously violates the rights of others; history of antisocial tendencies prior to age 15; often lies, fights, and has problems with the law; impulsive and fails to think ahead; can be deceitful and manipulative in order to gain profit or pleasure; irresponsible and often fails to hold down a job or pay financial debts; lacks feelings for others and remorse over misdeeds -No moral compass like most people, act as though they neither have a sense of nor care about right or wrong. Represents a serious problem for others and for society in general -According to the DSM-5, the individual with antisocial personality disorder (sometimes referred to as psychopathy) shows no regard at all for other people's rights or feelings. -This lack of regard is exhibited a number of ways and can include repeatedly performing illegal acts, lying to or conning others, impulsivity and recklessness, irritability and aggressiveness toward others, and failure to act in a responsible way (e.g., leaving debts unpaid). -The worst part about antisocial personality disorder, however, is that people with this disorder have no remorse over one's misdeeds; these people will hurt, manipulate, exploit, and abuse others and not feel any guilt. Signs of this disorder can emerge early in life; however, a person must be at least 18 years old to be diagnosed with antisocial personality disorder. -A useful way to conceptualize antisocial personality disorder is boiling the diagnosis down to three major concepts: disinhibition, boldness, and meanness. -Disinhibition is a propensity toward impulse control problems, lack of planning and forethought, insistence on immediate gratification, and inability to restrain behavior. -Boldness describes a tendency to remain calm in threatening situations, high self-assurance, a sense of dominance, and a tendency toward thrill-seeking. -Meanness is defined as "aggressive resource seeking without regard for others," and is signaled by a lack of empathy, disdain for and lack of close relationships with others, and a tendency to accomplish goals through cruelty.

Histrionic Personality Disorder

-Cluster B -Excessively overdramatic, emotional, and theatrical; feels uncomfortable when not the center of others' attention; behavior is often inappropriately seductive or provocative; speech is highly emotional but often vague and diffuse; emotions are shallow and often shift rapidly; may alienate friends with demands for constant attention

Narcissistic Personality Disorder

-Cluster B -Overinflated and unjustified sense of self-importance and preoccupied with fantasies of success; believes he is entitled to special treatment from others; shows arrogant attitudes and behaviors; takes advantage of others; lacks empathy

Borderline Personality Disorder

-Cluster B -Unstable in self-image, mood, and behavior; cannot tolerate being alone and experiences chronic feelings of emptiness; unstable and intense relationships with others; behavior is impulsive, unpredictable, and sometimes self-damaging; shows inappropriate and intense anger; makes suicidal gestures -Instability in interpersonal relationships, self-image, and mood, and marked impulsivity - People with borderline personality disorder cannot tolerate the thought of being alone and will make frantic efforts (including making suicidal gestures and engaging in self-mutilation) to avoid abandonment or separation (whether real or imagined). Their relationships are intense and unstable; for example, a lover may be idealized early in a relationship, but then later vilified at the slightest sign she appears to no longer show interest. -These individuals have an unstable view of self and, thus, might suddenly display a shift in personal attitudes, interests, career plans, and choice of friends. For example, a law school student may, despite having invested tens of thousands of dollars toward earning a law degree and despite having performed well in the program, consider dropping out and pursuing a career in another field. People with borderline personality disorder may be highly impulsive and may engage in reckless and self-destructive behaviors such as excessive gambling, spending money irresponsibly, substance abuse, engaging in unsafe sex, and reckless driving. They sometimes show intense and inappropriate anger that they have difficulty controlling, and they can be moody, sarcastic, bitter, and verbally abusive.

Dependent Personality Disorder

-Cluster C -Allows others to take over and run her life; is submissive, clingy, and fears separation; cannot make decisions without advice and reassurance from others; lacks self-confidence; cannot do things on her own; feels uncomfortable or helpless when alone

Obsessive-Compulsive Personality Disorder

-Cluster C -Pervasive need for perfectionism that interferes with the ability to complete tasks; preoccupied with details, rules, order, and schedules; excessively devoted to work at the expense of leisure and friendships; rigid, inflexible, and stubborn; insists things be done his way; miserly with money

Avoidant Personality Disorder

-Cluster C -Socially inhibited and oversensitive to negative evaluation; avoids occupations that involve interpersonal contact because of fears of criticism or rejection; avoids relationships with others unless guaranteed to be accepted unconditionally; feels inadequate and views self as socially inept and unappealing; unwilling to take risks or engage in new activities if they may prove embarrassing

Cognitive theories of panic disorder

-Cognitive factors may play an integral part in panic disorder. -Generally, cognitive theories (Clark, 1996) argue that those with panic disorder are prone to interpret ordinary bodily sensations catastrophically, and these fearful interpretations set the stage for panic attacks. -For example, a person might detect bodily changes that are routinely triggered by innocuous events such as getting up from a seated position (dizziness), exercising (increased heart rate, shortness of breath), or drinking a large cup of coffee (increased heart rate, trembling). -The individual interprets these subtle bodily changes catastrophically ("Maybe I'm having a heart attack!"). -Such interpretations create fear and anxiety, which trigger additional physical symptoms; subsequently, the person experiences a panic attack. -Support of this contention rests with findings that people with more severe catastrophic thoughts about sensations have more frequent and severe panic attacks, and among those with panic disorder, reducing catastrophic cognitions about their sensations is as effective as medication in reducing panic attacks (Good & Hinton, 2009).

Cognitive theories of depression

-Cognitive theories of depression take the view that depression is triggered by negative thoughts, interpretations, self-evaluations, and expectations. -These diathesis-stress models propose that depression is triggered by a "cognitive vulnerability" (negative and maladaptive thinking) and by precipitating stressful life events. -Beck theorized that depression-prone people possess depressive schemas, or mental predispositions to think about most things in a negative way.

Communication deficits examplse

-Complete lack of speech -One word responses (Yes or No responses only, even to complex questions) -Echoed speech (repeating what another person says either immediately or several hours or even days later) -Difficulty maintaining conversation because of an inability to reciprocate others' comments -Problems in understanding nonverbal cues such as facial expressions, gestures, and postures that facilitate normal communication

Compulsion

-Compulsions are repetitive and ritualistic behaviours (hand washing, checking) or mental acts (praying, counting) that are typically carried out primarily as a means to minimize the distress that obsessions trigger or to reduce the likelihood of a feared event. May be performed according to self-imposed rules -Behaviours/thoughts are focused on preventing or reducing distress or preventing some dreaded outcome; however, they are not realistically connected to what they are designed to reduce or prevent -Compulsions often include such behaviours as repeated and extensive hand washing, cleaning, checking (e.g., that a door is locked), and ordering (e.g., lining up all the pencils in a particular way), and they also include such mental acts as counting, praying, or reciting something to oneself. -Compulsions characteristic of OCD are not performed out of pleasure, nor are they connected in a realistic way to the source of the distress or feared event. -May temporarily relieve anxiety of someone with OCD.. and do not have to physically eliminate anxiety associated with the obsession or clearly be the cause of obsessions

Classical conditioning and panic disorders

-Conditioning theories of panic disorder propose that panic attacks are classical conditioning responses to subtle bodily sensations resembling those normally occurring when one is anxious or frightened. -For example, consider a child who has asthma. -An acute asthma attack produces sensations, such as shortness of breath, coughing, and chest tightness, that typically elicit fear and anxiety. -Later, when the child experiences subtle symptoms that resemble the frightening symptoms of earlier asthma attacks (such as shortness of breath after climbing stairs), he may become anxious, fearful, and then experience a panic attack. -In this situation, the subtle symptoms would represent a conditioned stimulus, and the panic attack would be a conditioned response. -The finding that panic disorder is nearly three times as frequent among people with asthma as it is among people without asthma (Weiser, 2007) supports the possibility that panic disorder has the potential to develop through classical conditioning.

Generalized Anxiety Disorder

-Continuous state of excessive, uncontrollable, and pointless worry and apprehension. At least 6 months or longer -Often has multiple features of the other anxiety disorders. -People with generalized anxiety disorder often worry about routine, everyday things, even though their concerns are unjustified and it is difficult to control their worry -For example, an individual may worry about her health and finances, the health of family members, the safety of her children, or minor matters (e.g., being late for an appointment) without having any legitimate reason for doing so. -A diagnosis of generalized anxiety disorder requires that the diffuse worrying and apprehension characteristic of this disorder—what Sigmund Freud referred to as free-floating anxiety—is not part of another disorder, occurs more days than not for at least six months, and is accompanied by any three of the following symptoms: restlessness, difficulty concentrating, being easily fatigued, muscle tension, irritability, and sleep difficulties. -According to the DSM-5, the anxiety/worry has to be associated with 3 or more of the following: restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

Unsuccessful psychopaths

-Convicted for psychopathic crimes -Many prisoners psychopathic

Remission in Individuals with BPD

-DSM definition of personality disorder = pervasive patterns of symptoms that do not normally remit -High rate of remission in BPD patients: By about 4 years after initial diagnosis, about 50% of individuals with BPD have remitted from their diagnosis, no longer meet criteria for diagnosis of BPD.. but doesn't necessarily mean their quality of life has improved -Important because BPD has been questioned if it is an actually bonafide personality disorder.. b/c there is such a high rate of remission, many theorists have argued that BPD is better classified as no being a personality disorder

Delusion

-Delusions are beliefs that are contrary to reality and are firmly held even in the face of contradictory evidence. Many of us hold beliefs that some would consider odd, but a delusion is easily identified because it is clearly absurd. -A person with schizophrenia may believe that his mother is plotting with the FBI to poison his coffee, or that his neighbour is an enemy spy who wants to kill him. These kinds of delusions are known as paranoid delusions, which involve the (false) belief that other people or agencies are plotting to harm the person. -People with schizophrenia also may hold grandiose delusions, beliefs that one holds special power, unique knowledge, or is extremely important. -Other delusions include the belief that one's thoughts are being removed (thought withdrawal) or thoughts have been placed inside one's head (thought insertion). Another type of delusion is somatic delusion, which is the belief that something highly abnormal is happening to one's body (e.g., that one's kidneys are being eaten by cockroaches).

Depersonalization/Derealization Disorder

-Depersonalization/derealization disorder is characterized by recurring episodes of depersonalization, derealization, or both. -Depersonalization is defined as feelings of "unreality or detachment from, or unfamiliarity with, one's whole self or from aspects of the self". -Individuals who experience depersonalization might believe their thoughts and feelings are not their own; they may feel robotic as though they lack control over their movements and speech; they may experience a distorted sense of time and, in extreme cases, they may sense an "out-of-body" experience in which they see themselves from the vantage point of another person. -Derealization is conceptualized as a sense of "unreality or detachment from, or unfamiliarity with, the world, be it individuals, inanimate objects, or all surroundings" (APA, 2013, p. 303). -A person who experiences derealization might feel as though he is in a fog or a dream, or that the surrounding world is somehow artificial and unreal. -Individuals with depersonalization/derealization disorder often have difficulty describing their symptoms and may think they are going crazy (APA, 2013).

Genetic basis of ADHD

-Family and twin studies indicate that genetics play a significant role in the development of ADHD. -Burt (2009), in a review of 26 studies, reported that the median rate of concordance for identical twins was .66 (one study reported a rate of .90), whereas the median concordance rate for fraternal twins was .20. -This study also found that the median concordance rate for unrelated (adoptive) siblings was .09; although this number is small, it is greater than 0, thus suggesting that the environment may have at least some influence. -Another review of studies concluded that the heritability of inattention and hyperactivity were 71% and 73%, respectively.

Depression biological explanations

-Depression is linked to abnormal activity in several regions of the brain including those important in assessing the emotional significance of stimuli and experiencing emotions (amygdala), and in regulating and controlling emotions (like the prefrontal cortex, or PFC). -Depressed individuals show elevated amygdala activity, especially when presented with negative emotional stimuli, such as photos of sad faces. -Heightened amygdala activation to negative emotional stimuli among depressed persons occurs even when stimuli are presented outside of conscious awareness, and it persists even after the negative emotional stimuli are no longer present. -Additionally, depressed individuals exhibit less activation in the prefrontal, particularly on the left side. -Because the PFC can dampen amygdala activation, thereby enabling one to suppress negative emotions, decreased activation in certain regions of the PFC may inhibit its ability to override negative emotions that might then lead to more negative mood states. -These findings suggest that depressed persons are more prone to react to emotionally negative stimuli, yet have greater difficulty controlling these reactions.

Depressive Schemas

-Depressive schemas contain themes of loss, failure, rejection, worthlessness, and inadequacy, and may develop early in childhood in response to adverse experiences, then remain dormant until they are activated by stressful or negative life events. -Depressive schemas prompt dysfunctional and pessimistic thoughts about the self, the world, and the future. -Beck believed that this dysfunctional style of thinking is maintained by cognitive biases, or errors in how we process information about ourselves, which lead us to focus on negative aspects of experiences, interpret things negatively, and block positive memories. -A person whose depressive schema consists of a theme of rejection might be overly attentive to social cues of rejection (more likely to notice another's frown), and he might interpret this cue as a sign of rejection and automatically remember past incidents of rejection. -Longitudinal studies have supported Beck's theory, in showing that a preexisting tendency to engage in this negative, self-defeating style of thinking—when combined with life stress—over time predicts the onset of depression. -Cognitive therapies for depression, aimed at changing a depressed person's negative thinking, were developed as an expansion of this theory (Beck, 1976).

Disorganized/Abnormal Motor Behaviour

-Disorganized or abnormal motor behaviour refers to unusual behaviours and movements: becoming unusually active, exhibiting silly child-like behaviours (giggling and self-absorbed smiling), engaging in repeated and purposeless movements, or displaying odd facial expressions and gestures. =-In some cases, the person will exhibit catatonic behaviours, which show decreased reactivity to the environment, such as posturing, in which the person maintains a rigid and bizarre posture for long periods of time, or catatonic stupor, a complete lack of movement and verbal behaviour.

Disorganized thinking

-Disorganized thinking refers to disjointed and incoherent thought processes—usually detected by what a person says. -The person might ramble, exhibit loose associations (jump from topic to topic), or talk in a way that is so disorganized and incomprehensible that it seems as though the person is randomly combining words. -Disorganized thinking is also exhibited by blatantly illogical remarks (e.g., "Fenway Park is in Boston. I live in Boston. Therefore, I live at Fenway Park.") and by tangentiality: responding to others' statements or questions by remarks that are either barely related or unrelated to what was said or asked. For example, if a person diagnosed with schizophrenia is asked if she is interested in receiving special job training, she might state that she once rode on a train somewhere. -To a person with schizophrenia, the tangential (slightly related) connection between job training and riding a train are sufficient enough to cause such a response.

Dissociative Disorders (types)

-Dissociative disorders are characterized by an individual becoming split off, or dissociated, from her core sense of self. -Memory and identity become disturbed; these disturbances have a psychological rather than physical cause. Dissociative disorders listed in the DSM-5 include: 1) dissociative amnesia 2) depersonalization/derealization disorder 3) dissociative identity disorder.

Early Warning Signs of Schizophrenia

-Early detection and treatment of conditions such as heart disease and cancer have improved survival rates and quality of life for people who suffer from these conditions. -A new approach involves identifying people who show minor symptoms of psychosis, such as unusual thought content, paranoia, odd communication, delusions, problems at school or work, and a decline in social functioning—which are coined prodromal symptoms—and following these individuals over time to determine which of them develop a psychotic disorder and which factors best predict such a disorder. - A number of factors have been identified that predict a greater likelihood that prodromal individuals will develop a psychotic disorder: genetic risk (a family history of psychosis), recent deterioration in functioning, high levels of unusual thought content, high levels of suspicion or paranoia, poor social functioning, and a history of substance abuse. -Further research will enable a more accurate prediction of those at greatest risk for developing schizophrenia, and thus to whom early intervention efforts should be directed.

Community risk factors for antisocial personality development (predictors)

-Economic deprivation (elementary) -Community disorganization (middle + high school) -Availability of drugs (elementary, middle, and high school) -Neighbourhood adults involved in crime (middle and high school)

Genetics and autism

-Exact causes of autism spectrum disorder remain unknown despite massive research efforts over the last 2 decades -Autism appears to be strongly influenced by genetics, as identical twins show concordance rates of 60-90%, whereas concordance rates for fraternal twins and siblings are 5-10% -Many different genes and gene mutations have been implicated in autism -Among the genes involved are those important in the formation of synaptic circuits that facilitate communication between different areas of the brain -A number of environmental factors are also thought to be associated with increased risk for autism spectrum disorder, at least in part, because they contribute to new mutations -These factors include exposure to pollutants, such as plant emissions and mercury, urban versus rural residence, and vitamin D deficiency

Risk factors of schizophrenia

-Family history of schizophrenia -Urbanicity -Migration -1st or 2nd trimester maternal infection or malnutrition -Obstetric and perinatal complications -Cannabis or stimulant use -Parental age >35 years -Male gender

Genetic influences and environmental factors in antisocial personality development

-Family, twin, and adoption studies suggest that both genetic and environmental factors influence the development of antisocial personality disorder, as well as general antisocial behaviour (criminality, violence, aggressiveness). -Personality and temperament dimensions that are related to this disorder, including fearlessness, impulsive anti sociality, and callousness, have a substantial genetic influence. -Adoption studies clearly demonstrate that the development of antisocial behaviour is determined by the interaction of genetic factors and adverse environmental circumstances. -For example, one investigation found that adoptees of biological parents with antisocial personality disorder were more likely to exhibit adolescent and adult antisocial behaviours if they were raised in adverse adoptive family environments (e.g., adoptive parents had marital problems, were divorced, used drugs, and had legal problems) than if they were raised in a more normal adoptive environment. -Researchers who are interested in the importance of environment in the development of antisocial personality disorder have directed their attention to such factors as the community, the structure and functioning of the family, and peer groups. Each of these factors influences the likelihood of antisocial behavior. One longitudinal investigation of more than 800 Seattle-area youth measured risk factors for violence at 10, 14, 16, and 18 years of age (Herrenkohl et al., 2000). The risk factors examined included those involving the family, peers, and community.

Fear vs. Anxiety

-Fear involves an instantaneous reaction to an imminent threat, whereas anxiety involves apprehension, avoidance, and cautiousness regarding a potential threat, danger, or other negative event

Emil Kraepen

-First to make the distinction between 2 psychotic disorders : Dementia praecox and manic depression -He believed that Schizophrenia was due to brain illness/damage

Diagnosis of OCD

-For a diagnosis of OCD the obsessions/compulsions must be present in the absence of other identifiable disorders -Infatuation is not OCD -Perfectionism is (usually) not OCD

Suicide

-For some people with mood disorders, the extreme emotional pain they experience becomes unendurable. Overwhelmed by hopelessness, devastated by incapacitating feelings of worthlessness, and burdened with the inability to adequately cope with such feelings, they may consider suicide to be a reasonable way out. -Suicide, defined by the CDC as "death caused by self-directed injurious behavior with any intent to die as the result of the behavior" (CDC, 2013a), in a sense represents an outcome of several things going wrong all at the same time. -Not only must the person be biologically or psychologically vulnerable, but he must also have the means to perform the suicidal act, and he must lack the necessary protective factors (e.g., social support from friends and family, religion, coping skills, and problem-solving skills) that provide comfort and enable one to cope during times of crisis or great psychological pain.

Specific phobia

-Formerly known as simple phobia -Exposure to the stimulus almost always results in intense anxiety that may culminate in a situation-specific panic attack -Individual experiences excessive, distressing, and persistent fear or anxiety about a specific object or situation (such as animals, enclosed spaces, elevators, or flying) -The fear and anxiety a phobic stimulus elicits is typically disruptive to the person's life -Excessive and persistent fear cued by the presence or anticipation of a specific object/situation (e.g., heights, flying, animals) -Exposure to the stimulus almost always results in intense anxiety that may culminate in a situation-related panic attack

Social Anxiety Disorder

-Formerly known as social phobia -Characterized by extreme and persistent fear or anxiety and avoidance of social situations in which the person could potentially be evaluated negatively by others -Typically lasts 6 months or more -Severe physiological reactions often develop which may or may not lead to a panic attack -The person will avoid the particular anxiety-provoking social situations, often resulting in significant impairments and distress -Heart of the fear and anxiety is the person's concern that he may act in humiliating or embarrassing way, such as appearing foolish, showing symptoms of anxiety (blushing), or doing or saying something that might lead to rejection (such as offending others) -Social anxiety disorder is common in the United States; a little over 12% of all Americans experience social anxiety disorder during their lifetime -Adults with this disorder are more likely to experience lower educational attainment and lower earnings, and perform more poorly at work and are more likely to be unemployed, and report greater dissatisfaction with their family lives, friends, leisure activities, and income

DSM 5: Schizophrenia Spectrum

-From order of less to more severe: 1) Delusional disorder 2) Brief psychotic disorder 3) Schizophreniform disorder 4) Schizophrenia 5) Schizoaffective disorder

Major risks of psychoapthy

-High rates of criminal and other disruptive activities. -High risk for violent crime. -High rates of recidivism (PCL-R is strong indicator of violent re-offence). -Elevated risk of drug use and addiction. -Some theorists believe that psychopaths are responsible for half of all serious crime.

Major risks of BPD

-High risk for completed suicide: 3-10% of cases (most completed suicides after age 30). BPD patients will make an average of ~3 suicide attempts in their life. -A majority of BPD patients will be diagnosed with a comorbid mood or anxiety disorder.

Risk factors for suicide

-Higher among people with substance abuse problems -Risk of suicidal behaviour is especially high among those who have made a prior suicide attempt. Among those who attempt suicide, 16% make another attempt within a year and over 21% make another attempt within four years -Suicidal individuals may be at a high risk for terminating their life if they have a lethal means in which to act, such as having a firearm in the home -Withdrawal from social relationships, feelings as though one is a burden to others and engaging in reckless and risk-taking behaviours may be precursors to suicidal behaviour -A sense of entrapment or feeling unable to escape one's miserable feelings or external circumstances (e.g., an abusive relationship with no perceived way out) predicts suicidal behavior. -Tragically, reports of suicides among adolescents following instances of cyberbullying have emerged in recent years. In one widely-publicized case a few years ago, Phoebe Prince, a 15-year-old Massachusetts high school student, committed suicide following incessant harassment and taunting from her classmates via texting and Facebook (McCabe, 2010).

Creativity and Bipolar Disorder

-Hypomanic may show more productivity -Long list of creative geniuses that suffer from a psychological disorder -Empirical studies of psychological disorders and creativity: Relative incidence of creative professions among individuals with schizophrenia, bipolar disorder, or depression; found that for schizophrenia no increase in creative professions for patient but there is for sibling + offspring. -For bipolar disorder, both the patient and siblings and offspring are more likely to have a creative profession -For depression, no good evidence that there is an increase incidence of creative professions

Neurotransmitters and schizophrenia

-If we accept that schizophrenia is at least partly genetic in origin, as it seems to be, it makes sense that the next step should be to identify biological abnormalities commonly found in people with the disorder. -One such factor that has received considerable attention for many years is the neurotransmitter dopamine. -Interest in the role of dopamine in schizophrenia was stimulated by two sets of findings: drugs that increase dopamine levels can produce schizophrenia-like symptoms, and medications that block dopamine activity reduce the symptoms. -The dopamine hypothesis of schizophrenia proposed that an overabundance of dopamine or too many dopamine receptors are responsible for the onset and maintenance of schizophrenia. -More recent work in this area suggests that abnormalities in dopamine vary by brain region and thus contribute to symptoms in unique ways. -In general, this research has suggested that an overabundance of dopamine in the limbic system may be responsible for some symptoms, such as hallucinations and delusions, whereas low levels of dopamine in the prefrontal cortex might be responsible primarily for the negative symptoms. -In recent years, serotonin has received attention, and newer antipsychotic medications used to treat the disorder work by blocking serotonin receptors.

First recorded case of DID

-In 1797, 4-year-old Mary Reynolds had a personality that was melancholy and shy. -A second personality emerged when she was 19: This one was witty and extraverted. -This second personality became increasingly dominant; at 36 only Mary's second personality remained. -This case is considered typical of DID patients: strict upbringing; the original personality is shy and sad; the second personality is uninhibited and fun loving.

The Spanos Thesis

-In 1994, Nicholas Spanos argued that DID is a "social construction." -He pointed out that the syndrome had changed since becoming popular in the 1980s: -Older cases involved 2-3 personalities; newer cases commonly involved a dozen+. -Moreover, only a small number of psychiatrists had reported seeing many of the cases. -Spanos argued DID is a form of role-playing between patients (seeking attention of therapist) and therapists (urge for discovery). -He called this a sociocognitive model of DID.

Prevalence of specific phobias

-In the U.S, around 12.5% of the population will meet the criteria for specific phobia at some point in their lifetime

Stressful life events and depression

-Indeed, it has long been believed that stressful life events can trigger depression, and research has consistently supported this conclusion. -Stressful life events include significant losses, such as death of a loved one, divorce or separation, and serious health and money problems; life events such as these often precede the onset of depressive episodes. -In particular, exit events—instances in which an important person departs (e.g., a death, divorce or separation, or a family member leaving home)—often occur prior to an episode. -Exit events are especially likely to trigger depression if these happenings occur in a way that humiliates or devalues the individual. For example, people who experience the breakup of a relationship initiated by the other person develop major depressive disorder at a rate more than 2 times that of people who experience the death of a loved one. -Likewise, individuals who are exposed to traumatic stress during childhood—such as separation from a parent, family turmoil, and maltreatment (physical or sexual abuse)—are at a heightened risk of developing depression at any point in their lives. -A recent review of 16 studies involving over 23,000 subjects concluded that those who experience childhood maltreatment are more than 2 times as likely to develop recurring and persistent depression.

Leo Kanner

-Leo Kanner described an unusual neurodevelopmental condition he observed in a group of children and called it early infantile autism -Early infantile autism was characterized by the inability to form close emotional bonds, speech and language abnormalities, repetitive behaviours, and an intolerance of minor changes in the environment and in normal routines -Autism spectrum disorder in DSM-5 is a direct extension of this

Results of Major Depressive Disorder

-Major depressive disorder is a serious and incapacitating condition that can have a devastating effect on the quality of one's life. -The person suffering from this disorder lives a profoundly miserable existence that often results in unavailability for work or education, abandonment of promising careers, and lost wages; occasionally, the condition requires hospitalization. -The majority of those with major depressive disorder report having faced some kind of discrimination, and many report that having received such treatment has stopped them from initiating close relationships, applying for jobs for which they are qualified, and applying for education or training. -Major depressive disorder also takes a toll on health. -Depression is a risk factor for the development of heart disease in healthy patients, as well as adverse cardiovascular outcomes in patients with preexisting heart disease. -Completed suicide occurs in around 8-15% of individuals w/ severe Major Depressive disorder -Greater #of physical illnesses and decreased physical and social functioning

Prevalence of Major Depressive Disorder

-Major depressive disorder is considered episodic: its symptoms are typically present at their full magnitude for a certain period of time and then gradually abate. -Approximately 50%-60% of people who experience an episode of major depressive disorder will have a second episode at some point in the future; those who have had two episodes have a 70% chance of having a third episode, and those who have had three episodes have a 90% chance of having a fourth episode. -Although the episodes can last for months, a majority a people diagnosed with this condition (around 70%) recover within a year. -However, a substantial number do not recover; around 12% show serious signs of impairment associated with major depressive disorder after 5 years. -In the long-term, many who do recover will still show minor symptoms that fluctuate in their severity.

Is autism spectrum disorder the same as an intellectual disability?

-NO -These two conditions are often co-morbid, but the DSM-5 specifies that the symptoms of autism spectrum disorder are not caused OR explained by intellectual disability

Risk Factors for Major Depressive Disorder

-Major depressive disorder is often referred to as the common cold of psychiatric disorders. -Around 6.6% of the U.S. population experiences major depressive disorder each year; 16.9% will experience the disorder during their lifetime. -It is more common among women than among men, affecting approximately 20% of women and 13% of men at some point in their life. -The greater risk among women is not accounted for by a tendency to report symptoms or to seek help more readily, suggesting that gender differences in the rates of major depressive disorder may reflect biological and gender-related environmental experiences. -Lifetime rates of major depressive disorder tend to be highest in North and South America, Europe, and Australia; they are considerably lower in Asian countries. -The rates of major depressive disorder are higher among younger age cohorts than among older cohorts, perhaps because people in younger age cohorts are more willing to admit depression. -A number of risk factors are associated with major depressive disorder: unemployment (including homemakers); earning less than $20,000 per year; living in urban areas; or being separated, divorced, or widowed. -Comorbid disorders include anxiety disorders and substance abuse disorders.

Mania

-Mania is a state of extreme elation and agitation. -When people experience mania, they may become extremely talkative, behave recklessly, or attempt to take on many tasks simultaneously. The most recognized of these disorders is bipolar disorder.

Why prevalence rate of ADHD is increasing?

-Many people believe that rates of ADHD have increased in recent years -Parent-reported prevalence of ADHD among children (4-17 years old) in the United States increased by 22% during a 4-year period, from 7.8% in 2003 to 9.5% in 2007 -Increases were greatest for older teens, multiracial and Hispanic children, and children with a primary language other than English -A major weakness of both studies was that children were not actually given a formal diagnosis. -Instead, parents were simply asked whether or not a doctor or other health-care provider had ever told them their child had ADHD; the reported prevalence rates thus may have been affected by the accuracy of parental memory. -Nevertheless, the findings from these studies raise important questions concerning what appears to be a demonstrable rise in the prevalence of ADHD. Although the reasons underlying this apparent increase in the rates of ADHD over time are poorly understood and, at best, speculative, several explanations are viable: -ADHD may be over-diagnosed by doctors who are too quick to medicate children as a behaviour treatment -There is greater awareness of ADHD now than in the past. Nearly everyone has head of ADHD, and most parents and teachers are aware of its key symptoms. Parents may be quick to take their children to a doctor if they believe that their child possesses these symptoms, or teachers may be more likely now than in the past to notice the symptoms and refer the child for evaluation -The use of computers, video games, iPhones, and other electronic devices has become pervasive among children in the early 21st century and these devices could potentially shorten children's attention spans -ADHD diagnostic criteria have changed over time

Panic disorders and agoraphobia

-Many people with panic disorder develop agoraphobia, which is marked by fear and avoidance of situations in which escape might be difficult or help might not be available if one were to develop symptoms of a panic attack

Mood Disorders

-Mood disorders are characterized by severe disturbances in mood and emotions—most often depression, but also mania and elation. -All of us experience fluctuations in our moods and emotional states, and often these fluctuations are caused by events in our lives. -We become elated if our favorite team wins the World Series and dejected if a romantic relationship ends or if we lose our job. At times, we feel fantastic or miserable for no clear reason. -People with mood disorders also experience mood fluctuations, but their fluctuations are extreme, distort their outlook on life, and impair their ability to function.

Biological Basis of Mood Disorders

-Mood disorders have been shown to have a strong genetic and biological basis. Relatives of those with major depressive disorder have double the risk of developing major depressive disorder, whereas relatives of patients with bipolar disorder have over nine times the risk. -The rate of concordance for major depressive disorder is higher among identical twins than fraternal twins (50% vs. 38%, respectively), as is that of bipolar disorder (67% vs. 16%, respectively), suggesting that genetic factors play a stronger role in bipolar disorder than in major depressive disorder. -People with mood disorders often have imbalances in certain neurotransmitters, particularly norepinephrine and serotonin. -These neurotransmitters are important regulators of the bodily functions that are disrupted in mood disorders, including appetite, sex drive, sleep, arousal, and mood. -Medications that are used to treat major depressive disorder typically boost serotonin and norepinephrine activity, whereas lithium—used in the treatment of bipolar disorder—blocks norepinephrine activity at the synapses (Fig.2).

Major Depressive Disorder

-Most common type of depressive disorder, also called unipolar depression -According to the DSM-5, the defining symptoms of major depressive disorder include "depressed mood most of the day, nearly every day" (feeling sad, empty, hopeless, or appearing tearful to others), and loss of interest and pleasure in usual activities. -In addition to feeling overwhelmingly sad most of each day, people with depression will no longer show interest or enjoyment in activities that previously were gratifying, such as hobbies, sports, sex, social events, time spent with family, and so on. -Friends and family members may notice that the person has completely abandoned previously enjoyed hobbies; for example, an avid tennis player who develops major depressive disorder no longer plays tennis.

Is anxiety disorder more common in women or men

-Much more common in women; within a 12-month period around 23% women and 14% of men will experience at least one anxiety disorder

Nutritional factors and ADHD

-Much of the public believed that hyperactivity was caused by sugar and food additives, such as artificial coloring and flavoring. -Undoubtedly, part of the appeal of this hypothesis was that it provided a simple explanation of (and treatment for) behavioral problems in children. -A statistical review of 16 studies, however, concluded that sugar consumption has no effect at all on the behavioural and cognitive performance of children. -Additionally, although food additives have been shown to increase hyperactivity in non-ADHD children, the effect is rather small. -Numerous studies, however, have shown a significant relationship between exposure to nicotine in cigarette smoke during the prenatal period and ADHD. -Maternal smoking during pregnancy is associated with the development of more severe symptoms of the disorder.

Negative symptoms of schizophrenia

-Negative symptoms are those that reflect noticeable decreases and absences in certain behaviours, emotions, or drives. -A person who exhibits diminished emotional expression shows no emotion in his facial expressions, speech, or movements, even when such expressions are normal or expected. -Avolition is characterized by a lack of motivation to engage in self-initiated and meaningful activity, including the most basic of tasks, such as bathing and grooming. -Alogia refers to reduced speech output; in simple terms, patients do not say much. -Another negative symptom is asociality, or social withdrawal and lack of interest in engaging in social interactions with others. -Anhedonia, refers to an inability to experience pleasure. One who exhibits anhedonia expresses little interest in what most people consider to be pleasurable activities, such as hobbies, recreation, or sexual activity.

Risk Factors for PTSD

-Not everyone who experiences a traumatic event will go on to develop PTSD; several factors strongly predict the development of PTSD: trauma experience, greater trauma severity, lack of immediate social support, and more subsequent life stress. -Traumatic events that involve harm by others (e.g., combat, rape, and sexual molestation) carry greater risk than do other traumas (e.g., natural disasters). -Factors that increase the risk of PTSD include female gender, low socioeconomic status, low intelligence, personal history of mental disorders, history of childhood adversity (abuse or other trauma during childhood), and family history of mental disorders. -Personality characteristics such as neuroticism and somatization (the tendency to experience physical symptoms when one encounters stress) have been shown to elevate the risk of PTSD. -People who experience childhood adversity and/or traumatic experiences during adulthood are at significantly higher risk of developing PTSD if they possess one or two short versions of a gene that regulates the neurotransmitter serotonin (Xie et al., 2009). -This suggests a possible diathesis-stress interpretation of PTSD: its development is influenced by the interaction of psychosocial and biological factors.

Diathesis-stress interpretation of major depressive disorder

-Not everyone who experiences stressful life events or childhood adversities succumbs to depression—indeed, most do not. -Diathesis-stress interpretation of major depressive disorder, in which certain predispositions or vulnerability factors influence one's reaction to stress, would seem logical. -A study by Caspi and others (2003) suggests that an alteration in a specific gene that regulates serotonin (the 5-HTTLPR gene) might be one culprit. -These investigators found that people who experienced several stressful life events were significantly more likely to experience episodes of major depression if they carried one or two short versions of this gene than if they carried two long versions. -Those who carried one or two short versions of the 5-HTTLPR gene were unlikely to experience an episode, however, if they had experienced few or no stressful life events. -Numerous studies have replicated these findings, including studies of people who experienced maltreatment during childhood (Goodman & Brand, 2009). In a recent investigation conducted in the United Kingdom (Brown & Harris, 2013), researchers found that childhood maltreatment before age 9 elevated the risk of chronic adult depression (a depression episode lasting for at least 12 months) among those individuals having one (LS) or two (SS) short versions of the 5-HTTLPR gene (Fig.4). Childhood maltreatment did not increase the risk for chronic depression for those have two long (LL) versions of this gene. Thus, genetic vulnerability may be one mechanism through which stress potentially leads to depression.

Deficits in social interaction examples

-Not initiating conversations with other children -Turning head away when spoken to -No eye contact with others -Prefer playing alone rather than with others -Appears as if child is living in a personal and isolated social world others are simply not privy to or able to penetrate

Cognitive factors in the development and maintenance of PTSD

-One model suggests that two key processes are crucial: disturbances in memory for the event, and negative appraisals of the trauma and its aftermath. -According to this theory, some people who experience traumas do not form coherent memories of the trauma; memories of the traumatic event are poorly encoded and, thus, are fragmented, disorganized, and lacking in detail. -Therefore, these individuals are unable remember the event in a way that gives it meaning and context. -A rape victim who cannot coherently remember the event may remember only bits and pieces (e.g., the attacker repeatedly telling her she is stupid); because she was unable to develop a fully integrated memory, the fragmentary memory tends to stand out. -Although unable to retrieve a complete memory of the event, she may be haunted by intrusive fragments involuntarily triggered by stimuli associated with the event (e.g., memories of the attacker's comments when encountering a person who resembles the attacker). -This interpretation fits previously discussed material concerning PTSD and conditioning. The model also proposes that negative appraisals of the event ("I deserved to be raped because I'm stupid") may lead to dysfunctional behavioral strategies (e.g., avoiding social activities where men are likely to be present) that maintain PTSD symptoms by preventing both a change in the nature of the memory and a change in the problematic appraisals.

Most well-established risk factor for developing social anxiety disorder

-One of the most well-established risk factors for developing social anxiety disorder is behavioral inhibition -Behavioral inhibition is thought to be an inherited trait, and it is characterized by a consistent tendency to show fear and restraint when presented with unfamiliar people or situations. -Behavioral inhibition is displayed very early in life; behaviorally inhibited toddlers and children respond with great caution and restraint in unfamiliar situations, and they are often timid, fearful, and shy around unfamiliar people. -A recent statistical review of studies demonstrated that behavioral inhibition was associated with more than a sevenfold increase in the risk of development of social anxiety disorder, demonstrating that behavioral inhibition is a major risk factor for the disorder.

Serotonin and suicide

-One possible contributing factor in suicide is brain chemistry. -Contemporary neurological research shows that disturbances in the functioning of serotonin are linked to suicidal behavior. -Low levels of serotonin predict future suicide attempts and suicide completions, and low levels have been observed post-mortem among suicide victims. -Serotonin dysfunction is also known to play an important role in depression; low levels of serotonin have also been linked to aggression and impulsivity. -The combination of these three characteristics constitutes a potential formula for suicide—especially violent suicide. -A classic study conducted during the 1970s found that patients with major depressive disorder who had very low levels of serotonin attempted suicide more frequently and more violently than did patients with higher levels.

Classical conditioning and PTSD development

-PTSD learning models suggest that some symptoms are developed and maintained through classical conditioning. -The traumatic event may act as an unconditioned stimulus that elicits an unconditioned response characterized by extreme fear and anxiety. -Cognitive, emotional, physiological, and environmental cues accompanying or related to the event are conditioned stimuli. -These traumatic reminders evoke conditioned responses (extreme fear and anxiety) similar to those caused by the event itself (Nader, 2001). -A person who was in the vicinity of the Twin Towers during the 9/11 terrorist attacks and who developed PTSD may display excessive hypervigilance and distress when planes fly overhead; this behavior constitutes a conditioned response to the traumatic reminder (conditioned stimulus of the sight and sound of an airplane). -Differences in how condition-able individuals are help to explain differences in the development and maintenance of PTSD symptoms (Pittman, 1988). -Conditioning studies demonstrate facilitated acquisition of conditioned responses and delayed extinction of conditioned responses in people with PTSD (Orr et al., 2000).

Posttraumatic Stress Disorder (PTSD)

-PTSD was listed among the anxiety disorders in previous DSM editions. -Characterized by intense fear, helplessness, or horror (disorganized/agitated behaviour in children) resulting from the experience of, witnessing of, or hearing about, an extremely traumatic event -In DSM-5, it is now listed among a group called Trauma-and-Stressor-Related Disorders. -For a person to be diagnosed with PTSD, she be must exposed to, witness, or experience the details of a traumatic experience (e.g., a first responder), one that involves "actual or threatened death, serious injury, or sexual violence". -These experiences can include such events as combat, threatened or actual physical attack, sexual assault, natural disasters, terrorist attacks, and automobile accidents. This criterion makes PTSD the only disorder listed in the DSM in which a cause (extreme trauma) is explicitly specified.

Panic attacks

-Panic attacks themselves are not mental disorders -Around 23% of Americans experience isolated panic attacks in their lives without meeting the criteria for panic disorder, indicating that panic attacks are fairly common

Family risk factors for antisocial personality development (predictors)

-Parental virus (Predictor middle school) -Parental Criminality (middle + high school) -Poor family management (middle + high school) -Family conflict (middle + high school) -Parental attitudes favourable to violence (elementary school) -Frequent moves (high school)

Serial killers

-Partially successful psychopaths -Disguised several crimes but then caught for crime

Peer risk factors for antisocial personality development (predictors)

-Peer delinquency (elementary, middle, and high school) -Gang membership (middle and high school)

Why are people more likely to develop phobias of things that do not represent much actual danger to themselves?

-People are more likely to develop phobias of things that do not represent much actual danger to themselves, such as animals and heights, and are less likely to develop phobias towards things that present legitimate danger in contemporary society, such as motorcycles and weapons -One theory suggests that the human brain is evolutionarily predisposed to more readily associate certain objects or situations with fear. -This theory argues that throughout our evolutionary history, our ancestors associated certain stimuli (e.g., snakes, spiders, heights, and thunder) with potential danger. -As time progressed, the mind has become adapted to more readily develop fears of these things than of others. -Experimental evidence has consistently demonstrated that conditioned fears develop more readily to fear-relevant stimuli (images of snakes and spiders) than to fear-irrelevant stimuli (images of flowers and berries) (Öhman & Mineka, 2001). -Such prepared learning has also been shown to occur in monkeys. In one study (Cook & Mineka, 1989), monkeys watched videotapes of model monkeys reacting fearfully to either fear-relevant stimuli (toy snakes or a toy crocodile) or fear-irrelevant stimuli (flowers or a toy rabbit). -The observer monkeys developed fears of the fear-relevant stimuli but not the fear-irrelevant stimuli.

How do people with antisocial personality disorder view the world and others and themselves

-People with antisocial personality disorder seem to view the world as self-serving and unkind. -They seem to think that they should use whatever means necessary to get by in life. -They tend to view others not as living, thinking, feeling beings, but rather as pawns to be used or abused for a specific purpose. -They often have an over-inflated sense of themselves and can appear extremely arrogant. They frequently display superficial charm; for example, without really meaning it they might say exactly what they think another person wants to hear. They lack empathy: they are incapable of understanding the emotional point-of-view of others. People with this disorder may become involved in illegal enterprises, show cruelty toward others, leave their jobs with no plans to obtain another job, have multiple sexual partners, repeatedly get into fights with others, and show reckless disregard for themselves and others (e.g., repeated arrests for driving while intoxicated) (APA, 2013).

Obsessive-Compulsive Disorder (OCD)

-People with obsessive-compulsive disorder (OCD) experience thoughts and urges that are intrusive and unwanted (obsessions) and/or the need to engage in repetitive behaviors or mental acts (compulsions). -Feels compelled to think certain thoughts or perform certain actions -- even if those thoughts/actions make no sense and even if they know it -A person with this disorder might, for example, spend hours each day washing his hands or constantly checking and rechecking to make sure that a stove, faucet, or light has been turned off. -Obsessions are more than just unwanted thoughts that seem to randomly jump into our head from time to time, such as recalling an insensitive remark a coworker made recently, and they are more significant than day-to-day worries we might have, such as justifiable concerns about being laid off from a job. -Rather, obsessions are characterized as persistent, unintentional, and unwanted thoughts and urges that are highly intrusive, unpleasant, and distressing. -Around 20% only have obsessions, or only compulsions. The remained experiences both obsession and compulsions -The obsessions/compulsions are extreme in OCD

Suicide and mental disorders

-Suicide is not listed as a disorder in the DSM-5; however, suffering from a mental disorder—especially a mood disorder—poses the greatest risk for suicide. -Around 90% of those who complete suicides have a diagnosis of at least one mental disorder, with mood disorders being the most frequent. -In fact, the association between major depressive disorder and suicide is so strong that one of the criteria for the disorder is thoughts of suicide, as discussed above (APA, 2013).

Panic Disorder

-People with panic disorder experience recurrent (more than one) and unexpected panic attacks, along with at least one month of persistent concern about additional panic attacks, worry over the consequences of the attacks, or self-defeating changes in behaviour related to the attacks (e.g., avoidance of exercise or unfamiliar situations) -The panic attacks cannot result from the physiological effects of drugs and other substances, a medical condition, or another mental disorder -A panic attack is defined as a period of extreme fear or discomfort that develops abruptly and reaches a peak within 10 minutes. -Its symptoms include palpitations, pounding heart, or accelerated heart rate; sweating; trembling/shaking; feelings of shortness of breath and/or choking, chest pain/discomfort, nausea, dizziness, derealization or depersonalization, fear of losing control or going crazy, fear of dying, numbness or tingling sensations, chills or hot flushes. -Sometimes panic attacks are expected, occurring in response to specific environmental triggers (such as being in a tunnel); other times, these episodes are unexpected and emerge randomly (such as when relaxing). -According to the DSM-5, the person must experience unexpected panic attacks to qualify for a diagnosis of panic disorder. -Experiencing a panic attack is often terrifying. Rather than recognizing the symptoms of a panic attack merely as signs of intense anxiety, individuals with panic disorder often misinterpret them as a sign that something is intensely wrong internally (thinking, for example, that the pounding heart represents an impending heart attack). -Panic attacks can occasionally precipitate trips to the emergency room because several symptoms of panic attacks are, in fact, similar to those associated with heart problems (e.g., palpitations, racing pulse, and a pounding sensation in the chest). -Unsurprisingly, those with panic disorder fear future attacks and may become preoccupied with modifying their behavior in an effort to avoid future panic attacks. For this reason, panic disorder is often characterized as fear of fear.

Persistent Depressive Disorder

-People with persistent depressive disorder (previously known as dysthymia) experience depressed moods most of the day nearly every day for at least two years, as well as at least two of the other symptoms of major depressive disorder. -People with persistent depressive disorder are chronically sad and melancholy, but do not meet all the criteria for major depression. However, episodes of full-blown major depressive disorder can occur during persistent depressive disorder (APA, 2013).

Personality disorders

-People with personality disorders exhibit a personality style that differs markedly from the expectations of their culture, is pervasive and inflexible, begins in adolescence or early adulthood, and causes distress or impairment (APA, 2013). -Generally, individuals with these disorders exhibit enduring personality styles that are extremely troubling and often create problems for them and those with whom they come into contact. Their maladaptive personality styles frequently bring them into conflict with others, disrupt their ability to develop and maintain social relationships, and prevent them from accomplishing realistic life goals.

Alcohol and social anxiety disorder

-People with social anxiety disorder may resort to self-medication, such as drinking alcohol, as a means to avert the anxiety symptoms they experience in social situations -Use of alcohol when faced with such situations may become negatively reinforcing: encouraging individuals with social anxiety disorder to turn to the substance whenever they experience anxiety symptoms -The tendency to use as alcohol as a coping mechanism for social anxiety comes with a hefty consequence: a number of large scale studies have reported a high rate of comorbidity between social anxiety disorder and alcohol use disorder

Childhood trauma and DID

-People with this disorder tend to report a history of childhood trauma, some cases having been corroborated through medical or legal records. -Almost every authentic case of DID involves some severe childhood trauma -Research by Ross et al. (1990) suggests that in one study about 95% of people with DID were physically and/or sexually abused as children. -Of course, not all reports of childhood abuse can be expected to be valid or accurate. -However, there is strong evidence that traumatic experiences can cause people to experience states of dissociation, suggesting that dissociative states—including the adoption of multiple personalities—may serve as a psychologically important coping mechanism for threat and danger. -The theory is that, under severe stress, some children allow the normal "self" to retreating to unconsciousness while another self emerges to absorb the punishment or deal with the trauma. This is known as he post-traumatic or traumatic model of DID -The stressor is quite often either severe discipline or sexual abuse -DID is often conceptualized as the "most severe, chronic, complex, child-hood onset form of post-traumatic stress disorder (PTSD)

Early theories of causes of autism

-Placed the blame squarely on the shoulders of the child's parents, particularly the mother -Bettelheim suggested that a mother's ambivalent attitudes and her frozen and rigid emotions toward her child were the main causal factors in childhood autism -No scientific evidence exists supporting his gclaims

Asperger's disorder

-Previous edition of the DSM included a diagnosis of Asperger's disorder which is generally recognized as a less severe form of autistic disorder -Individuals diagnosed with Asperger's disorder were described as having average or high intelligence and a strong vocabulary, but exhibiting impairments in social interaction and social communication -Research has failed to demonstrate that Asperger's disorder differs qualitatively from autistic disorder -DSM-5 does not include it, which is problematic for individuals no longer eligible for special services -Some individuals with autism spectrum disorder can work independently as adults but most do not because the symptoms cause serious impairments in their lives

Does ADHD fade away by adolescence?

-Previously, ADHD was thought to fade away by adolescence. -Longitudinal studies have suggested that ADHD is a chronic problem, one that can persist into adolescence and adulthood. -A recent study found that 29.3% of adults who had been diagnosed with ADHD decades earlier still showed symptoms. -This study also reported that nearly 81% of those whose ADHD persisted into adulthood had experienced at least one other comorbid disorder, compared to 47% of those whose ADHD did not persist.

Types of social situations in which individuals with social anxiety disorder avoid

-Public speaking -Having a conversation -Meeting strangers -Eating in restaurants -Using public restrooms -Although many people become anxious in social situations like public speaking, the fear, anxiety, and avoidance experienced in social anxiety disorder are highly distressing and lead to serious impairments in life.

Replaying of the event

-Recurrent and intrusive recollections: images, thoughts, or perceptions -Acting/feeling as if the event was happening again: a reliving of the experience; also illusions, hallucinations, and flashback episodes -Intense psychological and/or physiological distress upon exposure to cues that symbolize or resemble some aspect of the triggering event

Psychopathy

-Represents a constellation of personality characteristics that include.. -Gib -Manipulative -Callous -Emotionless -Irresponsible -Impulsive -Aggressive -Interspecies predators

Support for Sufferers of PTSD

-Research has shown that social support following a traumatic event can reduce the likelihood of PTSD. -Social support is often defined as the comfort, advice, and assistance received from relatives, friends, and neighbours. -Social support can help individuals cope during difficult times by allowing them to discuss feelings and experiences and providing a sense of being loved and appreciated. -A 14-year study of 1,377 American Legionnaires who had served in the Vietnam War found that those who perceived less social support when they came home were more likely to develop PTSD than were those who perceived greater support. -In addition, those who became involved in the community were less likely to develop PTSD, and they were more likely to experience a remission of PTSD than were those who were less involved.

Causes of panic disorder

-Researchers are not entirely sure what causes panic disorder. -Children are at a higher risk of developing panic disorder if their parents have the disorder, and family and twins studies indicate that the heritability of panic disorder is around 43%. -The exact genes and gene functions involved in this disorder, however, are not well-understood. -Neurobiological theories of panic disorder suggest that a region of the brain called the locus coeruleus may play a role in this disorder. -Located in the brainstem, the locus coeruleus is the brain's major source of norepinephrine, a neurotransmitter that triggers the body's fight-or-flight response. -Activation of the locus coeruleus is associated with anxiety and fear, and research with nonhuman primates has shown that stimulating the locus coeruleus either electrically or through drugs produces panic-like symptoms. -Such findings have led to the theory that panic disorder may be caused by abnormal norepinephrine activity in the locus coeruleus.

Repetitive patterns of behaviour or interests examples

-Rocking, head-banging, or repeatedly dropping an object and picking it up -May show great distress at small changes in routine or the environment -Child may throw a temper tantrum if an object is not in its proper place or if a regularly-scheduled activity is rescheduled -Individual may show highly restricted and fixated interests that appear to be abnormally intense (e.g. person might learn and every detail about something even though doing so serves no apparent purpose)

Prevalence of PTSD

-Roughly 7%-8% of adults in the United States, including 9.7% of women and 3.6% of men, experience PTSD in their lifetime, with higher rates among people exposed to mass trauma and people whose jobs involve duty-related trauma exposure (e.g., police officers, firefighters, and emergency medical personnel) (APA, 2013). -30-50% of all cases are found in victims of rape, in those experiencing military combat, and in those who have been held captive, or in those who have lived through genocide -Usually begins ~3 months following the trauma -Nearly 21% of residents of areas affected by Hurricane Katrina suffered from PTSD one year following the hurricane (Kessler et al., 2008), and 12.6% of Manhattan residents were observed as having PTSD 2-3 years after the 9/11 terrorist attacks (DiGrande et al., 2008).

Safety behaviours performed by individuals with social anxiety disorder

-Safety behaviours are mental or behavioural acts that reduce anxiety in social situations by reducing the chance of negative social outcomes -Although these behaviours are iintended to prevent the person with Social Anxiety Disorder from doing something awkward that might draw criticism, these actions usually exacerbate the problem because they do not allow the individual to disconfirm his negative beliefs, often eliciting rejection and negative reactions from others -Avoiding eye contact -Rehearsing sentences before speaking -Talking only briefly -Not talking about oneself -Assuming roles in social situations that minimize interaction with others (e.g., taking pictures, setting up equipment, helping prepare food) -Asking people many questions to keep the focus off of oneself -Selecting a position to avoid scrutiny or contact with others (sitting in the back of the room) -Wearing bland, neutral clothes to avoid drawing attention to oneself -Avoiding substances or activities that might cause anxiety symptoms (such as caffeine, warm clothing, and physical excercise)

Hypomania

-Similar to best day of ur life and stretching it out for weeks and months -Nothing dangerous but it could lead to mania (dangerous) -Sleep less, talkative, charismatic, active (intellectual and business), productive

Cortisol and depression

-Since the 1950s, researchers have noted that depressed individuals have abnormal levels of cortisol, a stress hormone released into the blood by the neuroendocrine system during times of stress. -When cortisol is released, the body initiates a fight-or-flight response in reaction to a threat or danger. -Many people with depression show elevated cortisol levels, especially those reporting a history of early life trauma such as the loss of a parent or abuse during childhood. -Such findings raise the question of whether high cortisol levels are a cause or a consequence of depression. -High levels of cortisol are a risk factor for future depression, and cortisol activates activity in the amygdala while deactivating activity in the PFC (McEwen, 2005)—both brain disturbances are connected to depression. -Thus, high cortisol levels may have a causal effect on depression, as well as on its brain function abnormalities (van Praag, 2005). Also, because stress results in increased cortisol release (Michaud, Matheson, Kelly, Anisman, 2008), it is equally reasonable to assume that stress may precipitate depression.

Prevalence of Personality Disorders

-Slightly over 9% of the U.S. population suffers from a personality disorder, with avoidant and schizoid personality disorders the most frequent (Lezenweger, Lane, Loranger, & Kessler, 2007). -Two of these personality disorders, borderline personality disorder and antisocial personality disorder, are regarded by many as especially problematic.

Validity of Dissociative amnesia

-Some have questioned the validity of dissociative amnesia (Pope, Hudson, Bodkin, & Oliva, 1998); it has even been characterized as a "piece of psychiatric folklore devoid of convincing empirical support" (McNally, 2003, p. 275). -Notably, scientific publications regarding dissociative amnesia rose during the 1980s and reached a peak in the mid-1990s, followed by an equally sharp decline by 2003; in fact, only 13 cases of individuals with dissociative amnesia worldwide could be found in the literature that same year. -Further, no description of individuals showing dissociative amnesia following a trauma exists in any fictional or nonfictional work prior to 1800. -However, a study of 82 individuals who enrolled for treatment at a psychiatric outpatient hospital found that nearly 10% met the criteria for dissociative amnesia, perhaps suggesting that the condition is underdiagnosed, especially in psychiatric populations (Foote, Smolin, Kaplan, Legatt, & Lipschitz, 2006).

Suicide and Bipolar Disorder

-Suicide rates are extremely high among those with bipolar disorder: around 25-60% (textbook says 35%) of individuals with this disorder attempt suicide at least once in their lifetime, and between 4-19% (textbook says 4-19%) complete suicide. -3rd leading cause of death among 15-24 year olds -6th leading cause of disability for people aged 15-44 years

Suicide rates

-Suicide rates can be difficult to interpret because some deaths that appear to be accidental may in fact be acts of suicide (e.g., automobile crash). Nevertheless, investigations into U.S. suicide rates have uncovered these facts: -Suicide was the 10th leading cause of death for all ages in 2010. -There were 38,364 suicides in 2010 in the United States—an average of 105 each day (CDC, 2012). -Suicide among males is 4 times higher than among females and accounts for 79% of all suicides -Firearms are the most commonly used method of suicide for males, whereas poisoning is the most commonly used method for females. -From 1991 to 2003, suicide rates were consistently higher among those 65 years and older. Since 2001, however, suicide rates among those ages 25-64 have risen consistently, and, since 2006, suicide rates have been greater for those ages 65 and older. -This increase in suicide rates among middle-aged Americans has prompted concern in some quarters that baby boomers (individuals born between 1946-1964) who face economic worry and easy access to prescription medication may be particularly vulnerable to suicide (Parker-Pope, 2013). -The highest rates of suicide within the United States are among American Indians/Alaskan natives and Non-Hispanic Whites (CDC, 2013b). -Suicide rates vary across the United States, with the highest rates consistently found in the mountain states of the west (Alaska, Montana, Nevada, Wyoming, Colorado, and Idaho).

During what months do suicide rates peak?

-Suicide rates peak during the springtime (April and May), not during the holiday season or winter. -In fact, suicide rates are generally lowest during the winter months

Contagious effect of suicide

-Suicides can have a contagious effect on people. -For example, another's suicide, especially that of a family member, heightens one's risk of suicide. -Additionally, widely-publicized suicides tend to trigger copycat suicides in some individuals. -One study examining suicide statistics in the United States from 1947-1967 found that the rates of suicide skyrocketed for the first month after a suicide story was printed on the front page of the New York Times. -Austrian researchers found a significant increase in the number of suicides by firearms in the three weeks following extensive reports in Austria's largest newspaper of a celebrity suicide by gun. -A review of 42 studies concluded that media coverage of celebrity suicides is more than 14 times more likely to trigger copycat suicides than is coverage of non-celebrity suicides. -This review also demonstrated that the medium of coverage is important: televised stories are considerably less likely to prompt a surge in suicides than are newspaper stories. -Research suggests that a trend appears to be emerging whereby people use online social media to leave suicide notes, although it is not clear to what extent suicide notes on such media might induce copycat suicides. -Nevertheless, it is reasonable to conjecture that suicide notes left by individuals on social media may influence the decisions of other vulnerable people who encounter them (Luxton, June, & Fairall, 2012).

Symptoms of PTSD

-Symptoms of PTSD include: -recurrent, involuntary, and intrusive distressing memories of the event (dreams, memories) -flashbacks (states that can last from a few seconds to several days, during which the individual relives the event and behaves as if the event were occurring at that moment -persistent avoidance of stimuli connected to the event -persistently negative emotional states (e.g., fear, anger, guilt, and shame) or cognition related to the traumatic event(s) -feelings of detachment from others, irritability -proneness toward outbursts, and an exaggerated startle response (jumpiness). -persistent symptoms of increased arousal and reactivity -For PTSD to be diagnosed, these symptoms must occur for at least one month and must cause significant distress or impairment in social, occupational, or other areas.

Original "Borderline" meaning

-The "borderline" in borderline personality disorder was originally coined in the late 1930s in an effort to describe patients who appeared anxious, but were prone to brief psychotic experiences—that is, patients who were thought to be literally on the borderline between anxiety and psychosis

Subtypes of Depression

-The DSM-5 lists several different subtypes of depression. -These subtypes—what the DSM-5 refer to as specifiers—are not specific disorders; rather, they are labels used to indicate specific patterns of symptoms or to specify certain periods of time in which the symptoms may be present. -Seasonal pattern, postpartum depression

Main symptoms of Schizophrenia

-The main symptoms of schizophrenia include hallucinations, delusions, disorganized thinking, disorganized or abnormal motor behaviour, and negative symptoms.

Prevalence of Borderline Personality Disorder

-The prevalence of borderline personality disorder in the U.S. population is estimated to be around 1.4% (1-2% diagnosed), but the rates are higher among those who use mental health services; approximately 10% of mental health outpatients and 20% of psychiatric inpatients meet the criteria for diagnosis (APA, 2013). -In the US, individuals with borderline PD make up 10-20% of all psychiatric outpatients, and 15-40% of all psychiatric inpatients. -A recent Norwegian study of 221 twin pairs found a concordance rate for borderline PD of 35% in monozygotic pairs, and 7% in dizygotic pairs (some hereditary component but not all-encompassing) *Research underfunded compared to schizophrenia, bipolar disorder* -Women account for 70% of patients with this disorder in clinical settings -Most common age of first presentation is in late adolescence -Additionally, borderline personality disorder is comorbid with anxiety, mood, and substance use disorders

Genetic component of OCD

-The results of family and twin studies suggests that OCD has a moderate genetic component. -The disorder is five times more frequent in the first-degree relatives of people with OCD than in people without the disorder. -Additionally, the concordance rate of OCD among identical twins is around 57%; however, the concordance rate for fraternal twins is 22%. -Studies have implicated about two dozen potential genes that may be involved in OCD; these genes regulate the function of three neurotransmitters: serotonin, dopamine, and glutamate. -Many of these studies included small sample sizes and have yet to be replicated. Thus, additional research needs to be done in this area.

ADHD and dopamine

-The specific genes involved in ADHD are thought to include at least two that are important in the regulation of the neurotransmitter dopamine. -Medications used in the treatment of ADHD, such as methylphenidate (Ritalin) and amphetamine with dextroamphetamine (Adderall), have stimulant qualities and elevate dopamine activity. -People with ADHD show less dopamine activity in key regions of the brain, especially those associated with motivation and reward, which provides support to the theory that dopamine deficits may be a vital factor in the development this disorder.

Conditioning and OCD

-The symptoms of OCD have been theorized to be learned responses, acquired and sustained as the result of a combination of two forms of learning: classical conditioning and operant conditioning. -Specifically, the acquisition of OCD may occur first as the result of classical conditioning, whereby a neutral stimulus becomes associated with an unconditioned stimulus that provokes anxiety or distress. When an individual has acquired this association, subsequent encounters with the neutral stimulus trigger anxiety, including obsessive thoughts; the anxiety and obsessive thoughts (which are now a conditioned response) may persist until she identifies some strategy to relieve it. -Relief may take the form of a ritualistic behavior or mental activity that, when enacted repeatedly, reduces the anxiety. -Such efforts to relieve anxiety constitute an example of negative reinforcement (a form of operant conditioning). -Negative reinforcement involves the strengthening of behavior through its ability to remove something unpleasant or aversive. Hence, compulsive acts observed in OCD may be sustained because they are negatively reinforcing, in the sense that they reduce anxiety triggered by a conditioned stimulus.

Personality

-The term personality refers loosely to one's stable, consistent, and distinctive way of thinking about, feeling, acting, and relating to the world.

P.E. Bleuler

-The word schizophrenia first coined by the Swiss psychiatrist Eugen Bleuler in 1911, derives from Greek words that refer to a "splitting" (schizo) of psychic functions (phrene) (Green, 2001). -The split he was trying to describe was not between 2 personalities; rather it was between the various facets of the mind: personality, memory, emotion, perception, etc. (Not same as split personality disorder) -Unlike Kraeplin, he thought that schizophrenia was not an organic disorder.. not due to brain damage -Bleuler also known for coming up with term autism (self)

Genetic basis of schizophrenia

-There is considerable evidence suggesting that schizophrenia has a genetic basis. -The risk of developing schizophrenia is nearly 6 times greater if one has a parent with schizophrenia than if one does not. -Additionally, one's risk of developing schizophrenia increases as genetic relatedness to family members diagnosed with schizophrenia increases. -When considering the role of genetics in schizophrenia, as in any disorder, conclusions based on family and twin studies are subject to criticism. This is because family members who are closely related (such as siblings) are more likely to share similar environments than are family members who are less closely related (such as cousins); further, identical twins may be more likely to be treated similarly by others than might fraternal twins. -Thus, family and twin studies cannot completely rule out the possible effects of shared environments and experiences. Such problems can be corrected by using adoption studies, in which children are separated from their parents at an early age. -One of the first adoption studies of schizophrenia conducted by Heston (1966) followed 97 adoptees, including 47 who were born to mothers with schizophrenia, over a 36-year period. -Five of the 47 adoptees (11%) whose mothers had schizophrenia were later diagnosed with schizophrenia, compared to none of the 50 control adoptees. Other adoption studies have consistently reported that for adoptees who are later diagnosed with schizophrenia, their biological relatives have a higher risk of schizophrenia than do adoptive relatives.

Psychophysiological differences from neutral identity state (often occurs in dissociative identity disorder), and the traumatic identity disorder (also occurs in dissociative identity disorer)

-There tends to be at least one identity that is neutral in nature and one identity that is dealing with the trauma that the person experienced. -When you expose the person to neutral or trauma-related memory scripts, what you will see is that in the latter case, that is when the two personalities listen to trauma-related memory scripts, there are distinct differences in the physiological variables that the two different identities exhibit. In all cases, the traumatic identity state will show greater psychophysiological arousal in response to the trauma-related memory script than the neutral identity state.

How people's thoughts about their distressed moods can increase risk and duration of depression

-Third cognitive theory -This theory, which focuses on rumination in the development of depression, was first described in the late 1980s to explain the higher rates of depression in women than in men. -Rumination is the repetitive and passive focus on the fact that one is depressed and dwelling on depressed symptoms, rather that distracting one's self from the symptoms or attempting to address them in an active, problem-solving manner. -When people ruminate, they have thoughts such as "Why am I so unmotivated? I just can't get going. I'm never going to get my work done feeling this way". -Women are more likely than men to ruminate when they are sad or depressed (Butler & Nolen-Hoeksema, 1994), and the tendency to ruminate is associated with increases in depression symptoms, heightened risk of major depressive episodes, and chronicity of such episodes (Robinson & Alloy, 2003)

Emotional deficits in antisocial personality disorder

-Those with antisocial tendencies do not seem to experience emotions the way most other people do. -These individuals fail to show fear in response to environment cues that signal punishment, pain, or noxious stimulation. -For instance, they show less skin conductance (sweatiness on hands) in anticipation of electric shock than do people without antisocial tendencies. -Skin conductance is controlled by the sympathetic nervous system and is used to assess autonomic nervous system functioning. When the sympathetic nervous system is active, people become aroused and anxious, and sweat gland activity increases. Thus, increased sweat gland activity, as assessed through skin conductance, is taken as a sign of arousal or anxiety. For those with antisocial personality disorder, a lack of skin conductance may indicate the presence of characteristics such as emotional deficits and impulsivity that underlie the propensity for antisocial behavior and negative social relationships. -While emotional deficits may contribute to antisocial personality disorder, so too might an inability to relate to others' pain. -In a recent study, 80 prisoners were shown photos of people being intentionally hurt by others (e.g., someone crushing a person's hand in an automobile door) while undergoing brain imaging. -Prisoners who scored high on a test of antisocial tendencies showed significantly less activation in brain regions involved in the experience of empathy and feeling concerned for others than did prisoners with low scores on the antisocial test. -Notably, the prisoners who scored high on the antisocial test showed greater activation in a brain area involved self-awareness, cognitive function, and interpersonal experience. The investigators suggested that the heightened activation in this region when watching social interactions involving one person harming another may reflect a propensity or desire for this kind of behaviour.

Diagnosis of Panic Disorder

-To be diagnosed with Panic Disorder you also need to display one or both of the following for one month following an attack: 1) Persistent concerns or worry about having another attack or the consequences of having an attack 2) Significant change in one's behaviour

Diagnostic criteria for Bipolar Disorder

-To be diagnosed with bipolar disorder, a person must have: experienced a manic episode at least once in his life; although major depressive episodes are common in bipolar disorder, they are not required for a diagnosis. -According to the DSM-5, a manic episode is characterized as a "distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy lasting at least one week," that lasts most of the time each day. -During a manic episode, some experience a mood that is almost euphoric and become excessively talkative, sometimes spontaneously starting conversations with strangers; others become excessively irritable and complain or make hostile comments. -The person may talk loudly and rapidly, exhibiting flight of ideas, abruptly switching from one topic to another. -These individuals are easily distracted, which can make a conversation very difficult. They may exhibit grandiosity, in which they experience inflated but unjustified self-esteem and self-confidence. -For example, they might quit a job in order to "strike it rich" in the stock market, despite lacking the knowledge, experience, and capital for such an endeavor. -They may take on several tasks at the same time (e.g., several time-consuming projects at work) and yet show little, if any, need for sleep; some may go for days without sleep. Patients may also recklessly engage in pleasurable activities that could have harmful consequences, including spending sprees, reckless driving, making foolish investments, excessive gambling, or engaging in sexual encounters with strangers (APA, 2013). -During a manic episode, individuals usually feel as though they are not ill and do not need treatment. However, the reckless behaviors that often accompany these episodes—which can be antisocial, illegal, or physically threatening to others—may require involuntary hospitalization (APA, 2013). -Some patients with bipolar disorder will experience a rapid-cycling subtype, which is characterized by at least four manic episodes (or some combination of at least four manic and major depressive episodes) within one year.

Mixed episode

-Transition from mania to depression is often accompanied by a mixed episode -Involves characteristics of depression and mania -e.g: theory of how society works becomes very dark. extended hospitalization

Psychopathy diagnosis

-Typically diagnosed using Psychopathy checklist.. now revised as PCL-R -20 items listed in the PCL-R -Problem because it has a predictor-criterion overlap issue.. e.g. juvenile delinquency, revocation of conditional release, and criminal versatility are all characteristics of an individual who is a criminal. Becomes a bit circular to use this as a means of predicting criminal activity because you are measuring criminal activity as a predictor of criminal activity -Psychopathy Checklist Revised (PCL-R) results in under-diagnosis in community and student samples, because not all psychopathic individuals exhibit a criminal lifestyle

Depression

-Vague term that refers to intense and persistent sadness -Depression is a heterogeneous mood state - it consists of a broad spectrum of symptoms that range in severity -Depressed people feel sad, discouraged, and hopeless. These individuals lose interest in activities once enjoyed, often experience a decrease in drives such as hunger and sex, and frequently doubt personal worth. Depressive disorders vary by degree.

Men with antisocial personality disorder are more likely than women with antisocial personality disorder to

-do things that could easily hurt themselves or others receive three or more traffic tickets for reckless driving -have their driver's license suspended -destroy others' property -start a fire on purpose -make money illegally do anything that could lead to arrest -hit someone hard enough to injure them -hurt an animal on purpose

Taphophobia

-fear of being buried alive

Hematophobia

-fear of blood

Cynophobia

-fear of dogs

Claustrophobia

-fear of enclosed spaces

Aerophobia/Aviophobia

-fear of flying

Acrophobia

-fear of heights

Trypanophobia

-fear of injections

Ophidiophobia

-fear of snakes

Arachnophobia

-fear of spiders

Xenophobia

-fear of strangers

Zoophobias

-phobias specific to certain animals/creatures

Women with antisocial personality disorder are more likely than men with antisocial personality to

-run away from home overnight -frequently miss school or work -lie frequently forge someone's signature -get into a fight that comes to blows with an intimate partner -live with others besides the family for at least one month -harass, threaten, or blackmail someone

3 learning pathways that phobias can be acquired through (according to Rachman)

1) Classical conditioning 2) Modelling 3) Verbal transmission or information

In what 3 main areas do children with Autism spectrum disorder show disturbances in?

1) Deficits in social interaction 2) Deficits in communication 3) Repetitive patterns of behaviour and interests -These disturbances appear early in life and cause serious impairments in functioning

2 general categories of mood disorders

1) Depressive Disorders in which depression is the main feature 2) Bipolar and related disorders in which mania is the defining feature

Factor analyses of characteristics of individuals with psychopathy (4 factors)

1) Interpersonal: -Glibness, superficial charm (smooth talking, engaging and slick). - Grandiose sense of self-worth. -Pathological lying. -Conning/manipulative (uses deceit to cheat others for personal gain). 2) Affective: -Lack of remorse or guilt (no feelings or concern for losses, pain and suffering of others). -Shallow affect/Emotional poverty (limited range or depth of feelings). -Callous/lack of empathy. -Failure to accept responsibility for own actions. 3) Lifestyle: -Parasitic lifestyle (exploitative financial dependence on others). Irresponsibility (repeated failure to fulfill or honor commitments and obligations). -Impulsivity. -Lack of realistic, long-term goals. 4) Antisocial: -Poor behavioural control (frequent verbal abuse and inappropriate anger). -Early behavioural problems. -Juvenile delinquency. -Revocation of conditional release (violating parole or other release). Criminal versatility (diversity of criminal offenses).

Why Dissociative Identity Disorder is Controversial

1) Some believe that people fake symptoms to avoid the consequences of illegal actions (e.g., "I am not responsible for shoplifting because it was my other personality"). In fact, it has been demonstrated that people are generally skilled at adopting the role of a person with different personalities when they believe it might be advantageous to do so. As an example, Kenneth Bianchi was an infamous serial killer who, along with his cousin, murdered over a dozen females around Los Angeles in the late 1970s. Eventually, he and his cousin were apprehended. At Bianchi's trial, he pled not guilty by reason of insanity, presenting himself as though he had DID and claiming that a different personality ("Steve Walker") committed the murders. When these claims were scrutinized, he admitted faking the symptoms and was found guilty (Schwartz, 1981). 2) Rates of the disorder suddenly skyrocketed in the 1980s. Tapering off in early 2000s. -More cases of DID were identified during the five years prior to 1986 than in the preceding two centuries. Although this increase may be due to the development of more sophisticated diagnostic techniques, it is also possible that the popularization of DID—helped in part by Sybil, a popular 1970s book (and later film) about a woman with 16 different personalities—may have prompted clinicians to over-diagnose the disorder. Casting further scrutiny on the existence of multiple personalities or identities is the recent suggestion that the story of Sybil was largely fabricated, and the idea for the book might have been exaggerated (Nathan, 2011).

DSM-5 Criteria for Schizophrenia

A) 2+ of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). One must be (1), (2), or (3): 1) Delusions 2) Hallucinations 3) Disorganized speech (e.g., frequent derailment or incoherence) 4) Grossly disorganized or catatonic behaviour 5) Negative symptoms (i.e., diminished emotional expression or avolition/lack of volition) B) For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning) C) Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). D) The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition

Dissociative Identity Disorder DSM-5 Criteria

A) Disruption of identity characterized by 2 or more distinct personality states, which may be described in some cultures as an experience of possession. This disruption in identity often involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behaviour, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual B) Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting C) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D) The disturbance is not a normal part of a broadly accepted cultural or religious practice. Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play.

Manic episode criteria for diagnosis

A) Distinct period of abnormally and persistently elevated or expansive mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day B) 3 + of the following are present to a significant degree: -Inflated self-esteem or grandiosity -Decreased need for sleep (e.g., feels rested after only 3 hours of sleep) -More talkative than usual or pressure to keep talking -Flight of ideas or subjective experience that thoughts are racing -Distractibility -Increase in goal-directed activity or psychomotor agitation -Excessive involvement in activities that have a high potential for painful consequences (e.g., unrestrained buying sprees, sexual indiscretions, foolish business investments) Stevens examples: -Showing signs of psychosis -Psychosis is not the same as psychopathy -Psychosis is not necessarily associated with an increase incidence of violence -Delusions of grandeur (e.g. theory to explain society, but people did not believe the theory) -Little sleep (1-2 hours/night) -Constantly writing, reading (prolific, but not productive. Writing nonsensical)

Criteria for diagnosis of major depressive disorder (A)

A) To receive a diagnosis of major depressive disorder, one must experience a total of 5+ symptoms present during the same 2-week period. -At least one of the two symptoms must be either 1) depressed mood or 2) loss of interest or pleasure Other symptoms: -depressed mood -significant weight loss (when not dieting) or weight gain and/or significant decrease or increase in appetite; -difficulty falling asleep or sleeping too much (insomnia or hypersomnia) -psychomotor agitation (the person is noticeably fidgety and jittery, demonstrated by behaviors like the inability to sit, pacing, hand-wringing, pulling or rubbing of the skin, clothing, or other objects) OR psychomotor retardation (the person talks and moves slowly, for example, talking softly, very little, or in a monotone) -fatigue or loss of energy -feelings of worthlessness or guilt -difficulty concentrating and indecisiveness -suicidal ideation: thoughts of death (not just fear of dying), thinking about or planning suicide, or making an actual suicide attempt.

DSM-5 Criteria for Bipolar II Disorder

A. Criteria have been met for at least one hypomanic episode and at least one major depressive episode. B. There has never been a manic episode (or a Mixed Episode). (Involves depression, hypomania, not manic and or/mixed episodes) -An individual must have had at least one major depressive episode, and one manic episode

Psychophysiological differences in psychopaths

Psychopaths have been shown to exhibit the following psychophysiological differences: • low heart rate • low electrodermal reactivity (measure skin conductance response of psychopathy... reduced level of skin conductance increases relative to non-psychopaths) • diminished augmentation of startle response (surprise) by aversive stimuli • diminished suppression of startle response by pleasant stimuli

DSM-5 personality disorders (3 clusters)

The DSM-5 recognizes 10 personality disorders, organized into 3 different clusters. -Cluster A disorders include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. People with these disorders display a personality style that is odd or eccentric. -Cluster B disorders include antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder, and borderline personality disorder. People with these disorders usually are impulsive, overly dramatic, highly emotional, and erratic. -Cluster C disorders include avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder (which is not the same thing as obsessive-compulsive disorder). People with these disorders often appear to be nervous and fearful.

Risk Factors for BPD

• Borderline Personality Disorder is associated with higher rates of childhood adversity (e.g., sexual abuse, physical abuse, neglect, insecure attachments). • Affective instability and impulsivity are usually present by late childhood.

Types of OCD disorders

•Obsessive-Compulsive Disorder •Body-Dysmorphic Disorder •Hoarding Disorder •Trichotillomania (hair-pulling disorder) •Excoriation (skin-picking) disorder


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