Module 47-Introduction to Psychological Disorders

Biological Influences on Psychopathology:

1. Evolution 2. Individual genes 3. Brain structure & chemistry

Insomnia Disorder Criteria (symptoms)

1. Feeling unsatisfied with amount or quality of sleep (trouble falling asleep, staying asleep, or returning to sleep) 2. Sleep disruption causes distress or diminished everyday functioning 3. Happens three or more nights each week 4. Occurs during at least three consecutive months 5. Happens even with sufficient sleep opportunities 6. Independent from other sleep disorders (such as narcolepsy) 7. Independent from substance use or abuse 8. Independent from other mental disorders or medical conditions

Socio-cultural Influences:

1. Stress 2. Roles 3. Expectations 4. Definitions of normality & disorder

Psychological Influences:

1. Stress 2. Trauma 3. Learned Helplessness 4. Mood-related perceptions and memories 5. Individual genes

predictors of violence

1. alcohol or drug use 2. previous violence 3. gun availability 4. brain damage

In one study that followed people for up to 25 years after a first suicide attempt, ________ eventually died by suicide

5 %

American children and adolescents who identify as transgender or gender nonconforming are ________________ more likely than their peers to be diagnosed with a psychological disorder

7 times

The percentage of Americans who reported suffering from a phobia of a specific object or situation in 2015 was:

8.7

Tonya is interested in studying psychological disorders. If she wants to study the classification system most often used in the United States, she should read the:

DSM-5

Rates of Disorders

Depressive & Bipolar disorders = 9.3 Phobia of specific object or situation = 8.7 Social anxiety disorder = 6.8 ADHD = 4.1 PTSD = 3.5 Generalized anxiety = 3.1 Schizophrenia = 1.1 Obsessive-compulsive disorder = 1.0

DSM-5

Diagnostic and Statistical Manual of Mental Disorders

A lawyer is distressed by feeling the need to wash her hands 100 times a day. She has little time to meet with clients, and her colleagues are wondering about her competence. Her behavior would probably be labeled disordered, because it is _________________, that is, it interferes with her day-to-day life.

Dysfunctional or Maladaptive

The American Psychiatric Association's DSM-5 was released in:

May 18, 2013

national differences in suicide rates

Russia = double US US = double Spain Lithuanians = 7x more likely to die by suicide than Greeks

Lynette is released after a 4-week stay at a psychiatric hospital. She needs to find an apartment near her job because she cannot afford a car. When she talks to potential landlords, how should she describe herself?

She should not tell them she was in a psychiatric hospital. Many people react negatively to those labeled "mentally ill."

DSM-5 provides mental health professionals with:

a common language for clinicians to communicate about their patients and establishes consistent and reliable diagnoses that can be used in the research of mental disorders.

If one psychiatrist or psychologist diagnosed someone with one of these disorders, there was a 70 percent chance that another mental health worker would independently give the same diagnosis.

adult posttraumatic stress disorder childhood autism spectrum disorder

In field trials assessing the reliability of the DSM-5 categories, clinician agreement on _____________________________.

adult posttraumatic stress disorder and childhood autism spectrum disorder was near 70 percent.

People may choose death as ___________________________.

an alternative to current or future suffering, a way to switch off unendurable pain and relieve a perceived burden on family members

These disorders occur mostly in Western cultures:

anorexia nervosa & bulimia nervosa *food-abundant Western cultures.

Psychological disorders may share an underlying dynamic, such as _____________, while differing in the ______________________________.

anxiety symptoms manifested in a particular culture.

Which of the following was the highest reported psychological disorder in the United States within the past year?

anxiety disorders

vulnerability-stress model

approaches that emphasize how individual vulnerabilities interact with external stresses or circumstances to produce specific mental disorders, such as depression The biopsychosocial approach gave rise to the vulnerability-stress model,1 which assumes that individual dispositions combine with environmental stressors to influence psychological disorder

George, a gay man who is not open about his sexual orientation in his work environment due to fear of discrimination, is likely to:

be at greater risk for mental health problems due to social stigma.

People with disorders are more likely to ______________________.

be victims than perpetrators of violence

The risk of suicide increases when people who have been depressed __________________________________.

begin to rebound and become capable of following through

Dr. Cobbs believes that psychological disorders are influenced by genetic predispositions and physiological states. He is also aware that inner psychological dynamics, social dynamics, and culture influence psychological disorders. Dr. Cobbs believes in a _____ model.

biopsychosocial

Dr. Phelps believes that psychological disorders are influenced by genetic predispositions and physiological states. He is also aware that inner psychological dynamics, social dynamics, and culture influence psychological disorders. Dr. Phelps believes in a _____ model.

biopsychosocial

Those who engage in NSSI often have experienced _______________.

bullying, harassment, or stress

In the Middle Ages, you might have said, "The devil made her do it." Believing that, you might have approved of a harsh cure that would drive out the evil demon. Thus, people considered "mad" were sometimes:

caged or given "therapies" such as genital mutilation, beatings, removal of teeth or lengths of intestines, or transfusions of animal blood

Clinicians __________ predict who is likely to do harm.

cannot

People tend to stigmatize those with psychological disorders and the stigma of mental illness can ____________________________.

cause people to hide their symptoms and to avoid seeking treatment

Cassi frequently engages in NSSI. This is actually a risk factor for suicidal thoughts and future suicide attempts for Cassi because her NSSI co-exists with:

depression

The stresses and demoralization of poverty can precipitate disorders, especially __________________________ in women and ______________ in men.

depression in women substance abuse in men

NSSI (non-suicidal self injury)

direct, deliberate destruction of body tissue in the absence of any intent to die mostly adolescents and females cut or burn their skin, hit themselves, or insert objects under their nails or skin

Label someone as "mentally ill" and people may __________________.

fear them as potentially violent

Therapists who thought they were watching an interview of a psychiatric patient perceived him as ______________________.

frightened of his own aggressive impulses -and- passive, dependent type

Those who engage in NSSI are typically suicide _________, not suicide _______________.

gesturers attempters

About half of people with a disorder experience their first symptoms by the _________, and three-quarters do so by the _______________.

half = mid-teens 3/4 = mid-twenties

According to one research team, suicide is ________ to predict.

hard

Researchers continue to try to solve the suicide puzzle and developed an app that________________, while other research teams are developing ______________________.

harvests phone data to predict suicide risk by studying teen volunteers' tone of voice, language, photos, music choice, and sleep disturbances suicide-predicting AI (artificial intelligence) algorithms from psychological assessments, health records, or social media posts

Most homicide is committed by _____________________.

healthy people in the grip of everyday emotions using guns

In late adulthood, suicide rates __________, with the highest rate among those _______

increase worldwide over age 70

Gay, transgender, and gender-nonconforming youth facing an unsupportive environment, including family or peer rejection, are also at __________________.

increased risk of attempting suicide

In most countries, suicides have been _______________.

increasing

ICD

international classification of diseases

Elsa is a 50-year-old teacher who is openly gay. According to the American Psychiatric Association (APA), Elsa's LGBTQ identity:

is not classified as an illness

A large pharmaceutical company is conducting a clinical trial for a new antidepressant to treat major depressive disorder. They are concerned with the efficacy and safety of the new drug. Their perspective is most in line with the _____ model.

medical

At one time, disordered people were simply warehoused in asylums. Asylums have been replaced with psychiatric hospitals, where attempts are made to diagnose and cure people suffering from psychological disorders. This BEST illustrates one of the beneficial consequences of the _____ model.

medical

Gena believes that people with psychological disorders are suffering from diseases that have physical causes that can be diagnosed, treated, and sometimes even cured. Gena believes in the _____ model of psychological disorders.

medical

Helena believes that people with psychological disorders are suffering from diseases that have physical causes that can be diagnosed, treated, and sometimes even cured. Helena believes in the _____ model of psychological disorders.

medical

Thirty-seven-year-old Steven is a single male who has suffered from depression all his life. He has been in treatment for the last week and a half and has begun taking an antidepressant. He is starting to feel better, but he is tired of living this way and does not want to face another depressive episode. In terms of risk factors for suicide, Steven is _____ likely to attempt suicide _____.

more; because his energy and initiative are rebounding

Seventy-five-year-old Walter lost his wife to a heart attack 2 years ago, and most of his friends have passed away. His children live in other states, and he has no pets. In terms of risk factors for suicide, Walter is _____ likely to attempt suicide _____.

more; because the suicide rate surges among older men

suicide rate differences

national gender race trait age other group day-of-the-week and seasonal year-by-year

Alcohol use disorder, obsessive-compulsive disorder, bipolar disorders, and schizophrenia symptoms appear at a median age ______________.

near 20

In one study, people watched recorded interviews. If told the interviewees were job applicants, the viewers perceived them as ______ and if told they were watching cancer or psychiatric patients, the viewers perceived the same interviewees as ________________.

normal different from most people

Suicide is usually _______________________.

not an act of hostility or revenge

Most violent criminals are ___________, and most mentally ill people are __________.

not mentally ill not violent

Self-injury rates ________________________.

peak higher for 15- to 19-year-old females than for same-age males

self-harm

people who self harm are seeking relief from uncomfortable and unpleasant emotions

Which disorder usually develops in childhood or adolescence?

phobic disorder

Based on information presented in the textbook, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of _____ disorder is fairly reliable.

posttraumatic stress

One predictor of psychiatric disorders that crosses ethnic and gender line is ________________.

poverty

Schizophrenia understandably leads to ____________.

poverty

A _____ disorder is a syndrome marked by a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior.

psychological

Following highly publicized suicides and TV programs featuring suicide,______________________.

rates of suicide sometimes increase

_____ is the mental disorder that is MOST likely to lead to poverty.

schizophrenia

NSSI is often __________________, as people may _______________. find relief from intense negative thoughts through the distraction of pain.

self-reinforcing find relief from intense negative thoughts through the distraction of pain

Gregory is an impoverished African-American teen who finds school stressful but performs at a moderate level academically. He has no relationship with his father but a close relationship with his mother and grandmother. Which factor MOST increases his vulnerability to developing a mental disorder?

socioeconomic status poverty

Although U.S. gun owners often keep a gun to feel safer, having a gun in the home _______________________________.

substantially increases the odds of a family member dying by suicide or homicide

Qwan often finds himself anxious in social situations. He avoids eye contact with others and regularly dismisses his fears of blushing uncontrollably as shyness. If Qwan were Japanese, he might be suffering from:

taijin-kyofusho

Suicide rates have been much higher among ___________________.

the rich, the nonreligious, and the unmarried

Epigenetics

the study of influences on gene expression that occur without a DNA change supports the vulnerability-stress model by showing how our DNA and our environment interact ***expressed or dormant gene depending on environment ***For some, that will be the difference between developing a disorder or not developing it.

The few people with disorders who commit violent acts tend to be ______________________.

those who experience threatening delusions and hallucinated voices that command them to act, or those who abuse substances

trait differences in suicide rates

trait differences: Among Swedes, those with obsessive-compulsive disorder are at higher risk of depression, thereby increasing their risk of suicide (de la Cruz et al., 2017). Suicidal thoughts may also increase when perfectionist people feel driven to reach a goal or standard—to become thin or straight or rich—and find it unattainable

Compared with cisgender American veterans, transgender veterans, who often feel stigmatized in the military, are also _______________ to die by suicide.

twice as likely

After Missouri repealed its tough handgun law, its suicide rate went ______ percent; when Connecticut enacted such a law, its suicide rate _________ percent.

up 15 % dropped 16 %

According to the U.S. Surgeon General's Office there is ____________________________ from casual contact with an individual who has a mental disorder

very little risk of violence or harm to a stranger

The vast majority of people who possess a specific risk factor for suicide ____________________.

will never engage in suicidal behavior

_______________ are more likely than ____________ to die by suicide.

women; men

Mass-killing shooters are mostly ________________.

young males

homosexuality

***1952 through December 9, 1973 was classified as a psychological disorder ***By day's end on December 10, it was not. ***APA made change because more and more of its members viewed same-sex attraction as a natural biological predisposition and not a psychological problem

gender differences in suicide rates

1. Women and girls are much more likely than men to consider or attempt suicide 2. Worldwide, men are twice as likely to actually die by suicide methods men use are more violent & lethal

Critics of DSM

1. casts too wide a net 2. brings "almost any kind of behavior within the compass of psychiatry (severe grief) 3. subjective labels = self-fulfilling prophecy ***Example: teachers & gifted students

diagnostic classification in psychiatry and psychology, classification also aims to:

1. outline symptoms 2. predict a disorder's future course 3. suggest appropriate treatment 4. prompt research into its causes *To study a disorder, we must first name and describe it.

In the United States, for example, __________ percent of all suicide attempts end in death. When firearms are involved, the number is ____________ percent.

13% 90%

The incidence of serious psychological disorders is ____________ among those ________________.

2.5 times higher below the poverty line

Major depressive disorder hits at a median age of _______________.

25

About 3 in 10 of those who think about suicide will actually attempt suicide, of whom ________ percent will die.

3 %

One six-year study tracked suicide cases among all 1.2 million people who lived in metropolitan Stockholm during the 1990s. Men exposed to a co-worker's suicide were ___________________ to also take their own lives, compared with nonexposed men.

3.5 times more likely

Between 1999 and 2017, Americans' suicidal thoughts and suicide rates both increased nearly ______________ percent,

40 %

The lowest rate of reported mental disorders was in __________, and the highest rate was in the _____________.

Nigeria United States

Risk Factors for Mental Disorders

*Academic failure *Birth complications *Caring for those who are chronically ill or who have a neurocognitive disorder *Child abuse and neglect *Chronic insomnia *Chronic pain *Family disorganization or conflict *Low birth weight *Low socioeconomic status *Medical illness *Neurochemical imbalance *Parental mental illness *Parental substance abuse *Personal loss and bereavement *Poor work skills and habits *Reading disabilities *Sensory disabilities *Social incompetence *Stressful life events *Substance abuse *Trauma experiences

medical model

*In the year 1900, researchers discovered that syphilis, a sexually transmitted infection, invades the brain and distorts the mind *triggered an eager search for physical causes of other mental disorders, and for treatments that would cure them. *Hospitals replaced Asylums *the concept that psychological diseases have physical causes that can be diagnosed, treated, and, in most cases, cured, often through treatment in a hospital

psychopathology

*a mental illness * needs to be diagnosed on the basis of its symptoms *needs to be treated through therapy

psychological disorder

-a syndrome (collection of symptoms) marked by a "clinically significant disturbance in an individual's cognition, emotion regulation, or behavior" (American Psychiatric Association, 2013). -Such thoughts, emotions, or behaviors are dysfunctional or maladaptive—they interfere with normal day-to-day life.

Mental and addictive disorders affected more than ____________ people globally in 2016," reported a major worldwide study.

1 billion

In one natural experiment investigating the poverty-pathology link, researchers tracked rates of behavior problems in North Carolina Native American children as economic development enabled a dramatic reduction in their community's poverty rate. When the study began, children of poverty exhibited more deviant and aggressive behaviors. After four years, children whose families had moved above the poverty line exhibited a _____________ in behavior problems. Those who maintained their previous positions below or above the poverty line exhibited _____________.

40 % decrease in behavior problems no change

In the United States __________________ experienced a mental illness within the last year

47 million 19 %

About ___________ Americans a year die by suicide, __________ with guns.

47,000 half

Poison and drug overdoses account for about _____ percent of suicide attempts and_________ percent of suicide fatalities.

80 % of attempts 14 % of fatalities

suicide rates

800,000 per year 1 every 40 seconds anxiety = 3x risk depression = 5x risk ***risk increases when they begin to rebound and become capable of following through

In one survey, _____ percent of Americans agreed that "increased government spending on mental health screening and treatment" would be a "somewhat" or "very" effective "approach to preventing mass shootings at schools"

84 %

In _________ percent of U.S. mass killings between 1982 and 2017, the killer had ______________________.

85 % no known prior contact with mental health professionals

How many suicides involving firearms end in death?

85 percent

To judge from surveys of 84,850 people across 17 nations, about _____________ percent of people at some point in their lives have thought seriously of suicide.

9 %

RDoC (Research Domain Criteria Project)

A newer classification approach that builds upon the DSM ***organizes disorders according to behaviors and brain activity, aiming to study them with "the power of modern research approaches in genetics, neuroscience, and behavioral science"

Protective Factors for Mental Disorders

Aerobic exercise Community offering empowerment, opportunity, and security Economic independence Effective parenting Feelings of mastery and control Feelings of security High self-esteem Literacy Positive attachment and early bonding Positive parent-child relationships Problem-solving skills Resilient coping with stress and adversity Social and work skills Social support from family and friends

All of the following are no longer diagnostic labels in DSM-5 EXCEPT:

Aspberger's

Psychologists worry that suicide rates may increase during the __________________, which caused widespread unemployment and social isolation.

COVID-19 pandemic

______________ or __________________ can be a challenge for people recently released from a psychiatric hospital.

Getting a job or finding a place to rent

year-by-year differences in suicide rates

In most countries, suicides have been increasing between 1999 and 2017, Americans' suicidal thoughts and suicide rates both increased nearly 40 percent

taijin kyofusho

Japanese culture social anxiety about physical appearance, a readiness to blush, and a fear of eye contact

susto

Latin America severe anxiety or panic in response to an emotional trauma or fear of black magic

Philippe Pinel (1745-1826) French Reformer

Madness is a sickness of the mind caused by severe stress and inhumane conditions. Curing requires moral treatment, including boosting patients' spirits by unchaining them and talking with them. He and others worked to replace brutality with gentleness, isolation with activity, and filth with clean air and sunshine. *Lunatic Balls

amok

Malaysia a sudden outburst of violent behavior (as in the English phrase "run amok")

immigrant paradox

Mexican Americans who have recently immigrated to the USA are less at risk than Mexican Americans born in the United States,

Immigrants to the United States from _____________averaged better mental health than their U.S.-born counterparts with the same ethnic heritage

Mexico, Africa, and Asia

day of the week and seasonal differences in suicide

Negative emotion tends to go up midweek 25 percent of U.S. suicides occur on Wednesdays Suicide rates are highest in April and May, and not (as commonly believed) over the winter holidays

Predicting Suicide

People who commit suicide tend to signal their intentions, often quite explicitly, such as by telling others about their suicidal thoughts. Research indicates that about 90% of people who commit suicide leave clear clues. ***In hindsight, families and friends may recall signs they believe should have forewarned them—verbal hints, giving possessions away, a sudden mood change, or withdrawal and preoccupation with death

The symptoms of _________- appear around age 10; _______ tend to appear later, around age 25.

Phobias; major depressive disorder

One analysis of 17 million Twitter users' data showed that sharing suicidal thoughts _________________.

Social suggestion may trigger suicidal thinking and behavior. had a ripple effect, spreading suicidal thinking through one's social network

The percentage of people with any mental disorder and the proportion of those disorders considered serious in various nations are as follows:

United States = 20 percent and 7 percent Ukraine = 16 percent and 5 percent Colombia = 15.5 percent and 5 percent New Zealand = 15 percent and 5.5 percent France = 16 percent and 3 percent Lebanon = 14 percent and 4 percent South Africa = 12 percent and 4 percent Netherlands = 10 percent and 4 percent Mexico = 8.5 percent and 3.5 percent Belgium = 7 percent and 4 percent Germany = 9 percent and 2 percent Israel = 6 percent and 4 percent Spain = 7 percent and 2.5 percent Italy = 7 percent and 2 percent Japan = 5.5 percent and 1.5 percent China = 5 percent and 1.5 percent Nigeria = 5 percent and 1 percent

racial differences in suicide rates

United States: *Whites and Native Americans die by suicide 2x as often as Blacks, Hispanics, and Asians *Indigenous Canadians 3x rate of other Canadians

NSSI is a risk factor for suicidal thoughts and future suicide attempts, especially when co-existing with _________________. If people do not find help, their nonsuicidal behavior may escalate to suicidal thoughts and, finally, to suicide attempts.

a bipolar disorder

In field trials assessing the reliability of the DSM-5 categories, clinician agreement on antisocial personality disorder and generalized anxiety disorder, agreement was:

closer to 20 percent

States with high gun ownership, and weaker gun safety laws, are states with _____________________________.

high suicide rates, even after controlling for poverty and urbanization

Those who engage in NSSI are generally ________ and ___________.

less able to tolerate & regulate emotional distress often both self-critical and impulsive

Compared with Mexican Americans born in the United States, Mexican Americans who have recently immigrated are

less at risk for mental disorders

Suicidal urges typically arise when people feel ____________________________.

like they don't belong or are a burden to others, when they feel trapped by a seemingly inescapable situation, or when they feel incapable of experiencing joy

How can we be helpful to someone who is talking suicide?

listen connect protect

These two disorders occur worldwide:

major depressive disorder and schizophrenia

Among the earliest to appear are the symptoms of antisocial personality disorder at age _____________ and of phobias at age __________.

median age 8 median age 10

Canada and England have simultaneously experienced the same gender difference and upward trend in __________________.

nonsuicidal self-injury

Arianna displays very dysfunctional behavior. She is unable to care for herself, cannot dress herself, and has limited understanding of her surroundings. Prior to the reform movement influenced by Philippe Pinel, Arianna's behavior would MOST likely have been considered:

the result of demon possession