Psy Ch 13

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Psy Ch 13
2013-11-17 14:09:56
Psych disorders

Psych disorders
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  1. No known society is free of what two disorders
    depression and schizophreniza
  2. psychological disorders
    ongoing patterns of thoughts, feelings, and actions that are deviant, distressful, and dysfunctional
  3. deviant
    • means different
    • however, it can vary with context, culture, and time
  4. ADHD
    • attention deficit hyperactivity disorder
    • a psychological disorder marked by the appearance by age 7 of one or more of 3 key symptoms: extreme inattention, hyperactivity, and impulsivity
    • Is diagnosed 2-3 times more in boys
    • Skeptics point to a single genetic variation: a Y chromosome
  5. What development or discovery helped further the reform of mental health
    in 1800's, when it was discovered that syphilis infects the brain and distorts the mind
  6. Philippe Pinel
    • (1745-1826) opposed the brutal treatments of mental pts
    • insisted that madness is not demon possession but a sickness of the mind caused by severe stresses and inhumane conditions
    • Helped start the reform toward mental health
  7. What perspectives can help us understand psychological disorders?
    The medical model and the biopsychological approach
  8. medical model
    the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and in most cases, cured, often through treatment in a hospital
  9. psychopathology
    a mental illness
  10. The biopsychosocial approach
    assesses the whole set of interacting influences and assumes that disorders arise from genetic predispositions and physiological states(evolution, genes, brain structure and chemistry); inner psychological dynamics (stress, trama); and social-cultural circumstances (roles, expectations, what is considered normality and disorder)
  11. What does the biopsychosocial approach recognize?
    • that the mind and body are inseparable
    • Negative emotions contribute to physical illness and physical abnormalities contributes to negative emotions
  12. susto
    a condition in Latin america which lays claim to a condition marked by severe anxiety, restlessness, and a fear of black magic
  13. Taijin-kyofusho
    • a social anxiety about one's appearance combined with a readiness to blush and a fear of eye contact
    • appears in Japan
  14. amok
    In Malaysia, describes a sudden outburst of violent behavior (thus the phrase "run amok")
  15. How and why do clinicians classify psychological disorders?
    • They classify by using DSM-IV-TR, which provides diagnostic guidelines and categories that aid mental health professionals by providing a common language and shared concepts for communication and research
    • *Most U.S. health insurance org's require DSM-IV-TR diagnoses before they will pay for therapy
  16. How are psychological disorders diagnosed?
    based on assessments, interviews, and observations, many clinicians diagnose by answering questions from five levels, or axes, of the DSM-IV-TR
  17. DSM-IV-TR
    • The American psychiatric Ass.'s Diagnostic and Statistical Manual of Mental Disorders, 4th ed, updated as a 2000 "text revision"
    • a widely used system for classifying psychological disorders
    • reliability stems in part from it's reliance on structured-interview procedures
    • *some critics fault the manual as casting to wide of a net
  18. 5 levels of axes of the DSM-IV-TR
    • Axis I: Is a clinical syndrome present?
    • Axis II: Is a personality disorder or mental retardation present? (Clinicians may or may not select one of more)
    • Axis III: Is a general medical condition, such as diabetes, hypertension, or arthritis also present?
    • Axis IV: Are psychosocial or environmental problems, such as school or housing issues, also present?
    • Axis V: What is the Global Assessment of this person's functioning? Clinicians assign a code from 0-100
  19. Symptoms associated with Axis 1
    • Any disorders first diagnosed in infancy - teenhood
    • Cognitive disorder
    • Mental due to medical condition
    • Substance-related abuse
    • Psychotic disorder
    • Mood/anxiety disorder
    • Somatoform disorders
    • Faked disorders
    • Dissociative disorders
    • Eating/sleeping disorder
    • Sexual or gender ID disorder
    • Impulse-control
  20. un-DSM
    • a diagnostic manual of human strengths to accompany the DSM-IV-TR
    • The Values in Action Classification of Strengths
    • an expression of the positive psychology movement
    • assesses 6 clusters of 24 strengths
    • Mental health workers have used these categories to get their clients to consider what makes a good life
  21. 6 clusters of strengths in the un-DSM
    • Wisdom and knowledge - creativity; curiosity; love of learning; open-minded
    • Courage - (overcoming opposition) bravery; perseverance; honesty and zest
    • Humanity- love, kindness
    • Justice - teamwork, fairness, leadership
    • Transcendence - appreciation of beauty, hope, humor, spirituality
    • Temperance - forgiveness and mercy, modesty and humility
    • "Wise Choices Help Justyne Toward Temple"
  22. Why do some psychologists criticize the use of diagnostic labels?
    • Labels can create preconceptions that bias our perceptions of the person's past and present behavior
    • The insanity defense raises moral and ethical questions about how a society should treat people who have disorders and have committed crimes
  23. Benefits of diagnostic labels
    • mental health professionals use labels to:
    • communicate about their cases
    • to comprehend the underlying causes
    • to discern effective treatment programs
  24. Anxiety disorders
    • psychological disorders characterized by distressing, persistent anxiety or dysfunctional behaviors that reduce anxiety
    • 5 types
  25. 5 considered types of anxiety disorders
    • Generalized anxiety disorder
    • Panic disorder
    • Phobias
    • Obsessive-compulsive disorder
    • Post-traumatic stress disorder
    • *in it's own way, each harms quality of life
    • "General Pat Phoned, Ordered Posts"
  26. Generalized anxiety disorder
    • an anxiety disorder in which a person is unexplainably and continually tense, apprehensive, often jittery, agitated, and sleep defrived, concentration is difficult
    • can lead to high BP
    • many people w this were maltreated and inhibited as children
    • 2/3 are women
    • by age 50, generalized anxiety is rare
  27. Panic disorder
    • an anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations
    • may be misperceived as heart attack or other serious physical ailment
    • smokers have at least double risk
  28. Phobias
    an anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity or situation
  29. social phobia
    • is shyness taken to an extreme
    • an intense fear of being scrutinized by others, avoid potentially embarrassing social situations such as speaking up, eating out, or going to parties, will sweat, tremble, or have diarrhea when doing so
  30. agoraphobic
    fear or avoidance of situations in which escape might be difficult or help unavailable when panic strikes
  31. Obsessive-compulsive disorder
    an anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions)
  32. Post traumatic stress disorder
    • an anxiety disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers four weeks or more after a traumatic experience
    • was once called "shellshock" or "battle fatigue"
    • a sensitive limbic system seems to increase vulnerability (by flooding body with stress hormones again and again)
    • Genes may also play a roll
  33. post-traumatic growth
    • positive psychological changes as a result of struggling with extremely challenging circumstances and life crises
    • include an increased appreciation for life, more meaningful relationships, increased personal strength, changed priorities, and a richer spiritual life
  34. Two contemporary perspectives in today's psychology
    learning and biological
  35. According to psychoanalytic theory, what produces the thoughts and feelings that mark anxiety disorders?
    • Freud viewed anxiety disorders as a manifestation of mental energy associated with the discharge of repressed impulses
    • *because, according to him, we REPRESS these feelings and impulses
  36. How does the learning perspective view anxiety disorders
    views anxiety disorders as a product of fear conditioning, stimulus generalization, reinforcement of fearful behaviors, and observational learning of others' fear
  37. Two specific learning processes that can contribute to anxiety
    • Stimulus generalization - (the car was hit when driver ran stop sign, not I twinge of unease when any car approaches from a side street)
    • Reinforcement - helps maintain our phobias and compulsions after they arise, avoiding or escaping fear reduces anxiety, thus reinforcing behavior
  38. How does the biological perspective consider anxiety disorders?
    • considers the role that fears of life-threatening animals, objects, or situations played in natural selection and evolution
    • the genetic inheritance of a high level of emotional reactivity
    • abnormal responses in the brain's fear circuits
  39. anterior cingulate cortex
    • a brain region that monitors our actions and checks for errors
    • seems especially likely to be hyperactive in those with OCD
  40. fear circuits within the amygdala
    can be created when fear-learning experiences traumatize the brain
  41. somatoform disorder
    • psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause
    • 2 types: conversion disorder and hypochondriasis
  42. conversion disorder
    • a rare somatoform disorder (more common in Freud's day) in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found
    • Ex: unexplained paralysis, blindness, or inability to swallow
  43. hypochondriasis
    • a somatoform disorder in which a person interprets normal physical sensation as symptoms of disease
    • Pt's and physicians fail to confront psychological root
  44. dissociative disorders
    • among the rare and most bewildering disorders
    • disorder of consciousness in which a person appears to experience a sudden loss of memory or change in identity, often in response to an overwhelmingly stressful situation (painful memories, thoughts and feelings)
  45. DID
    • dissociative identity disorder
    • formerly called multiple personality disorder
    • a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities
    • each personality having it's own voice and mannerisms
    • typically original personality denies any awareness of the other(s)
  46. Skeptics on DID
    • skeptics question whether DJD is genuine disorder or an extension of our normal capacity for personality shifts
    • find it suspicious that the disorder is so localized in time and space. Outside N.America much less prevalent
    • such findings point to a cultural phenomenon - a disorder created by therapists in a particular social context
  47. mood disorders
    • psychological disorders characterized by emotional extremes which take two principle forms:
    • 1. major depressive disorder (w it's prolonged hopelessness and lethargy)
    • 2. bipolar disorder (person alternates btwn depression and mania)
  48. mania
    an overexcited, hyperactive state
  49. depression
    • called the "common cold" of psychological disorders
    • #1 reason people seek mental health services
    • leading cause of disability worldwide
    • often response to past and current loss
  50. major depressive disorder
    a mood disorder in which at least 5 signs of depression (including lethargy, feelings of worthlessness, or loss of interest or pleasure) last two or more weeks and are not caused by drugs or a medical condition
  51. bipolar
    • you know this one, much less common than general depression
    • effects men & women equally
    • especially prone to composers, artists, poets, novelists, and entertainers
    • Not so much w people who rely on precision and logic, as architects, designers, and journalists
  52. View of Psychoanalytic theory on depression
    may view depression as unresolved anger toward one's parents, turned inward against self
  53. View of biological perspective on depression
    focuses on genetic predispositions, abnormalities in brain structures and functions, and neurotransmitter imbalances
  54. View of social-cognitive perspective on depression
    examines the influence of self-defeating beliefs, learned helplessness, negative attributions, and stressful experiences
  55. View of biopsychosocial approach on depression
    considers the interaction of these andother
  56. What might explain the Western world's rising incidence of depression among young people?
    • may be due to the rise of individualism and the decline of commitment to religion and family
    • *this is a correlational finding, so cause-effect relationship is not clear yet
  57. linkage analysis
    • how some researchers are trying to tease out the genes that put people at risk for depression
    • points to a chromosome neighborhood, (within a family, comparing those affected and those who aren't , over several generations)
  58. two neurotransmitters which play a role in mood disorders
    norepinephrine and serotonin
  59. norepinephrine
    • neurotransmitter, increases arousal and boosts mood, is scarce during depression and overabundant during mania
    • *most people w history of depression have history of habitual smoking - may indicate attempt to self-medicate since nicotine can temporarily increase norepinephrine and boost mood
  60. serotonin
    • neurotransmitter, scarce during depression
    • *there are some genes under scrutiny for coding for proteins that control the activity of serotonin. In combination with significant stress, formed a receipe for depression
  61. treatments for depression
    • Drugs that relieve depression tend to increase norepinephrine or serotonin supplies by blocking either their reuptake (like prozac, zoloft and paxil do with serotonin) or their chemical breakdown
    • Repetitive physical exercise, such as jogging, reduces depression as it increases serotonin
    • Boosting serotonin may promote recovery by stimulating hippocampus neuron growth
  62. explanatory style
    • who or what someone blames for their failures
    • partly explains why some people get depressed and others dont
  63. vicious cycle of depression
    • 1. negative, stressful events -> interpreted through:
    • 2. A ruminating, pessimistic explanatory style -> create:
    • 3. a hopeless, depressed state -> that:
    • 4. hampers the way we think and act -> This, in turn, fuels back to #1
  64. schizophrenia
    • means "split mind" - chief example of psychotic disorder
    • a cluster or group of severe disorders characterized by disorganized (fragmented and bizarre) and delusional thinking, disturbed perceptions, and inappropriate emotions and actions
    • 5 subtypes or groups
    • typically strikes during late adolescence, affects men very slightly more than women
    • seems to occur in all cultures
  65. psychotic disorder
    a psychological disorder in which a person loses contact w reality, experiencing irrational ideas and distorted perceptions
  66. delusions
    • false beliefs, often of persecution or grandeur, that may accompany psychotic disorders
    • **those with paranoid tendencies are particularly prone to delusions of persecution
  67. word salad
    jumbled ideas within sentences (schizophrenia)
  68. selective attention
    • the normal ability to give undivided attention to one set of sensory stimuli while filtering out others
    • *disorganized thoughts of schizophrenia may result from a breakdown of selective attention
  69. hallucinations
    • sensory experiences w/o sensory stimulation
    • a person w schizophrenia may hallucinate seeing, feeling, tasting, or smelling things that are not there
    • most often hallucinations are auditory, frequently voices making insulting remarks or giving orders
  70. flat affect
    an emotionless state, happens w schizophrenia
  71. positive symptoms w/ schizophrenia
    • pts may experience hallucinations, talk in disorganized and deluded ways, and exhibit inappropriate laughter, tears, or rage
    • *the presence of inappropriate behaviors
  72. negative symptoms w schizophrenia
    • pts have toneless voices, expressionless faces, or mute and rigid bodies
    • *the absence of appropriate behaviors
  73. Chronic schizophrenia
    • also called process schizophrenia
    • when schizophrenia is a slow-developing process, so it emerges gradually, recovery is doubtful
    • often exhibit the persistent and incapacitating negative symptom of social withdrawal
  74. acute schizophrenia
    • also called reactive schizophrenia
    • when schizophrenia develops suddenly following particular life stresses, recovery is much more likely
    • they more often have the positive symptoms that are more likely to respond to drug therapy
  75. 5 subtypes of schizophrenia
    • Paranoid
    • Disorganized
    • Catatonic
    • Undifferentiated
    • Residual
    • "Please Don't Cum Until im Ready"
  76. Paranoid Schizophrenia
    • preoccupation with delusions or hallucinations
    • often with themes of persecution or grandiosity
  77. Disorganized Schizophrenia
    Disorganized speech or behavior, or flat or inappropriate emotion
  78. Catatonic Schizophrenia
    Immobility (or excessive, purposeless movement), extreme negativism, and/or parrotlike repeating of another's speech or movements
  79. Undifferentiated Schizophrenia
    Many and varied symptoms
  80. Residual Schizophrenia
    Withdrawal, after hallucinations and delusions have disappeared
  81. What might cause schizophrenia
    • brain abnormalities
    • abnormal brain activity
    • dopamine overactivity
    • maternal virus during mid pregnancy
    • genetic factors
  82. Brain abnormalities w schizophrenia
    • Brain abnormalities, including enlarged, fluid-filled cerebral cavities and corresponding decreases in the cortex. (the greater the shrinkage, the more severe the thought disorder)
    • Brain scans reveal abnormal activity in the frontal lobes, thalamus (filters sensory signals), and amygdala( the fear processing center)
  83. How does dopamine affect schizophrenia
    • it may intensify the positive symptoms 
    • people w schizophrenia have increased receptors for this neurotransmitter - a sixfold excess for the D4 dopamine receptor
    • therefore, drugs that block dopamine receptors often lessen the symptoms
  84. Abnormal brain activity associated with schizophrenia
    • brain scans have shown many people w schizophrenia have abnormal activity in multiple areas
    • some have abnormally low activity in the frontal lobes, which are critical for reasoning, planning, and problem solving
    • also display noticeable decline in brain waves that reflect synchronized neural firing in frontal lobes
    • Therefore, out-of-sync neurons may disrupt integrated functioning of neural networks, and possible contribute to symptoms
  85. two known risk factors for schizophrenia
    • low birth weight and oxygen deprivation during delivery
    • famine may also increase risk
  86. Mid-pregnancy viral infection associated with schizophrenia
    • may be a casual factor
    • But evidence suggests if a mothers blood indicated she had been exposed to the flu during the first half of pregnancy, chances of developing schizophrenia tripled. No such increase if in second half of pregnancy
  87. myelin
    a fatty substance that coats the axons of some nerve cells and lets impulses travel at high speed through neural networks
  88. personality disorders
    psychological disorders characterized by disruptive, inflexible, and enduring behavior patterns that impair people's social functioning
  89. What characteristics are typical of personality disorders?
    • One cluster expresses eccentric behaviors
    • Another cluster expresses anxiety
    • Yet another cluster exhibits dramatic or impulsive behaviors
  90. schizoid personality disorder
    • involves emotionless disengagment
    • belongs to the cluster of personality disorders which express eccentric (odd or unusual) behaviors
  91. avoidant personality disorder
    • withdrawn, due to a fearful sensitivity to rejection
    • among cluster of personality disorders which express anxiety
  92. histrionic personality disorder
    • attention-getting...
    • among cluster of personality disorders which exhibit dramatic or impulsive behaviors
  93. narcissistic personality disorder
    • self-focused and self-inflating
    • among cluster of personality disorders which exhibit dramatic or impulsive behaviors
  94. antisocial personality disorder
    • formerly called a sociopath or psychopath 
    • most troubling and heavily researched personality disorder
    • a personality disorder in which the person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members.
    • feels and fears little
    • May be aggressive and ruthless of a clever con artist
  95. Ages that symptoms start showing for psychological disorders
    • Usually by early adulthood
    • Symptoms of antisocial p.d. and phobias are among earliest to appear, at 8 - 10 yrs. 
    • Symptoms of alcohol dependency, OCD, bipolar, and schizophrenia appear near 20 yrs.
    • Major depression usually at 25 yrs.