Psychological Disorders

Quizlet: http://quizlet.com/61523556/flashcards

Psychological disorder= deviant, distressful, dysfunctional behavior

• deviant- between cultures, what is considered abnormal
• distressful- worries you or others
• dysfunctional- makes it difficult to function in society
• all 3 must be present for it to be considered a disorder

Ancient Treatments: trephination, exorcism, being caged beaten and burned--didn't work, obviously

Medical Perspective: Philippe Pinel- madness is not demonic possession, it is an ailment of the mind

• began to use medical model after it was discovered syphilis lead to mental disorder

1. etiology: cause and development of disorder
2. diagnosis: identify symptoms, distinguish from other disorders
3. treatment: fix ailment through medicine and therapy
4. prognosis: forecast for the future

Classifying disorders

• American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM)
• describes 400 disorders
• determines how prevalent the disorder is
• reliable diagnoses
• criticized for labeling any behavior as a disorder, stigmatizing disorders
• 5 axises categorize ailments

1. clinical syndrome?
2. personality disorder or mental retardation?
3. general medical conditions?
4. psychosocial or environmental problems?
5. what is global assessment of their functioning (0-100)?

• psychological disorders are stigmatized. Some experiments that show this stigma:
• David Rosenhan: went into mental hospital and said “I am hearing voices”, observed how nurses treated him differently
• Ellen Langer: showed people tapes of interviews, she said the interviewee was schizophrenic. The people watching the tapes identified plenty of warning signs (even though there actually were none)!

Anxiety Disorders

Normal anxiety: anxious at times, during stressful situations, relaxed during stress-free times

disorders= distressing, persistent anxiety, or maladaptive behaviors to reduce anxiety

• Generalized Anxiety Disorder= continually tense, apprehensive, autonomic nervous system arousal lasts months, years
• unable to identify the source of stress
• Panic Disorder= unpredictable, so can come on at any moment
• chest pains, choking, fear--often confused with a heart attack
• some fear panic attacks themselves, so they avoid places where they occur
• you can have panic attacks without having a panic disorder

Phobias= persistent irrational fear of object/situation that disrupts behavior

--(700 documented phobias, including rare ones such as uxoriphobia=fear of your wife)

Obsessive Compulsive Disorder

• occasionally, we all have obsessive thoughts: getting a song stuck in your head, offensive thoughts
• we also get impulsive: cleaning everything before guests arrive
• OCD= persistence of unwanted thoughts, urge to engage in senseless, repetitive behavior
• distrust your own senses- “hands look clean, but I probably missed a spot”
• want to stop, but overwhelmed by anxiety if they can’t do their rituals
• in the brain, high levels of activity in frontal lobe: directing attention and routine

PTSD (post-traumatic stress disorder)

after trauma, it is normal to experience anxiety and dreams

four or more weeks of haunting memories, nightmares, social withdrawal, jumpy anxiety, sleep problems= PTSD

• most are resilient to trauma: only 10% women and 20% men develop PTSD after a traumatic event
• half of adults claim experiencing one tragic event, most don’t have PTSD

Learning perspective= fear conditioning is a big part of developing anxiety

• stimulus generalization= anxiety becomes associated with events: fear of heights becomes a fear of flying

Biological Perspective= we are predisposed to fear certain things, easily develop these fears

• predispositions and genetics: twins are more likely to share phobias
• anxiety, OCD etc. linked with overactive anterior cingulate cortex- part of brain that monitors actions and checks for errors

dissociating= separating consciousness

• happens to all of us- going on autopilot when driving home, mind wandering during a conversation
• we have different personalities in different situations (with friends v. grandparents)

Dissociative Disorders- conscious awareness separated from previous memories, feelings

1. sense of being unreal
2. sense of separation from the body
3. feels like you are watching yourself as if you are in a movie

• dissociative identity disorder (DID)- person has 2+ alternating personalities
• occurs in response to extreme trauma from childhood
• original personality can’t remember what other personalities do
• distinct brain and body states with different personalities: handedness, accent, gender change
• galvanic skin sweat response differs between personalities
• shifting visual activity and eye muscle movements
• DID is critiqued for the following reasons:

1. dramatic rise in diagnosis since popular movies began to discuss the disorder
2. average number of personalities increased from 3-12 since popularity rose
3. almost exclusively found in North America
4. nobody goes to therapists for DID- therapists discover the disorder once a patient is in therapy for something else: it is as though the therapist wants to diagnose it
5. diagnosed people are highly imaginative
6. studies involved hypnosis-- hypnosis often gives misleading information
7. symptoms become more dramatic after therapy

• supporters push back:

1. nearly all patients for DID had traumatic childhoods
1. may be a desperate attempt to detach from abusive experience
2. create stranger personality that can deal with struggles

• critics: then why didn’t holocaust children suffer from DID?

Schizophrenia= “split mind”- disconnect from reality

disease of the brain with symptoms to the mind- widely accepted and debilitating disorder

• 1% of population affected, men have stronger symptoms

1. disorganized and delusional thinking- “word salad” when speaking (nonsensical sentence arrangement) delusions of grandeur or persecution
2. disturbed perceptions- sensory stimulations not from the environment (hearing voices)
3. inappropriate emotions and actions- laugh at tragic news, become catatonic, engage in a repetitive motion for hours on end

• unable to have selective attention- slight details are distracting
• schizophrenia is a cluster of different disorders
• positive symptoms- symptoms that normal people don’t have (hallucinations)
• negative symptoms- absence of behavior that normal people have (emotion)
• chronic/process schizophrenia: develops slowly, hard to recover from
• displays negative symptoms
• acute schizophrenia: develops quickly, easier to recover from
• displays positive symptoms

1. paranoid schizophrenia: preoccupied with hallucinations/delusions
2. disorganized schizophrenia: messy speech or behavior; flat, inappropriate behavior
3. catatonic schizophrenia: immobility; excess fidgeting; negativity; parrot talking
4. residual schizophrenia: withdrawal after hallucinations have disappeared
5. undifferentiated schizophrenia: many systems

• caused by higher than average levels of dopamine and receptors
• some drugs mimic effects of schizophrenia
• apparently, smoking pot increases risk of developing disease
• abnormal activity in frontal cortex, thalamus, amygdala, out-of-sync neurons
• loss of brain tissue, enlargement of ventricles (fluid-filled areas)
• causes: mother gets flu while pregnant- chance increases 2-3%
• genetics- siblings, parents, fraternal twins and identical twins increase chances
• environmental factors can cause genes to express
• warning signs:
• birth complications: low oxygen/birth weight
• short attention span, bad muscle coordination
• disruptive and withdrawn behavior, emotional unpredictability
• poor peer relations and solo play
• 50% of homeless have a mental disorder- many schizophrenics can’t keep a job

Mood disorders

depression: it is normal to feel negative, isolated, discouraged or sad after a bad experience

Major depressive disorder (“common cold” of psychological disorders)

• 5.8% men and 9.5% women suffer from depression
• more than 17% will experience at some point in life
• depression that lasts 2 weeks or more, not from illness or drugs=major depressive disorder

1. lethargy and fatigue
2. feelings of worthlessness
3. loss of interest in family and friends, activities
4. changes in appetite or sleep

Dysthymic Disorder

• between low mood and major depressive disorder--daily depression for 2+ years

Bipolar Disorder

• alternation between depression and mania
• manic symptoms include being hyperactive, wildly optimistic, sleepless, euphoric, talkative, sexual, creative
• many famous writers wrote during their manic phases
• depressive symptoms include gloomy, withdrawn behavior, indecisive, slow-thinking

Theory of depression

1. gender differences: women are twice as likely
2. therapy speeds recovery, though depression mostly goes away by itself
3. stress causes depression
4. depression rates are increasing, especially for teens
1. willingness to discuss feelings?
2. overdiagnosis?

biological perspective: mood disorders run in families

• linkage analysis: choose family that has depression, look at genomes, find links
• association studies: find connections to other traits
• neurotransmitters: reduction of norepinephrine and serotonin
• non-medication remedies: exercise, omega-3 fatty acids
• brain energy consumption rises and falls with depressive and manic states

Social-Cognitive perspective

• depression is result of your own negative explanatory style- stable (constant), global (important to the functioning of your whole world), internal (blame yourself)

1. negative, stressful events
2. pessimistic explanatory style
3. hopeless depressed state

Personality Disorders: inflexible, enduring behaviors that impair social functioning

Antisocial Personality Disorder

• formerly known as sociopath/psychopath
• usually men, lack of conscience for wrongdoing
• no sense of guilt or fear: ruthless, aggressive, violent
• if intelligent→ clever con artist
• signs begin to show in adolescence- impulsive, uninhibited, don’t care about social rewards
• strongest predictor: animal cruelty as a child
• most criminals don’t have APD- they have morality: loyal to gangs and families
• serial killers almost always have APD- killing is simply a habit
• lover levels of stress hormones before stressful situation, lower adrenaline
• reduced activity in frontal lobe-- can’t make sound decisions
• poverty in childhood, mistreatment, paired with genetic disposition= APD
• success is possible: CEO’s, police officers, extreme athletes

Rates of Disorders

• 50% have a bout with a disorder, 1/7 had bout within past year
• most cases are mild, and people recover without therapy
• major depressive disorder-- 17%
• alcohol dependence-- 14%
• social phobias-- 13%
• other phobias-- 11%

Therapy

history: strange, debilitating, inhumane treatments

Philippe Pinel and Dorothy Dix started humane movements to care for the mentally sick

psychotherapy: go talk to counselor- emotionally charged, private conversation

biomedical therapy: drugs or procedures that act on nervous system prescribed

• eclectic approach: use both, as suited to person’s needs--quite effective

psychoanalysis: freud invented this approach with the couch

• bring tensions with id, ego and superego to surface to deal with them, opening up about deep dark desires releases their associated anxiety
• patients resist telling everything, but a good therapist can see when they are resisting and interpret meaning through what patients censor
• over time, patient will open up
• transference- patients will transfer their feelings onto their therapist

1. cannot be proven or disproven
2. takes a long time and is very expensive

psychodynamic: inspired by Freud- face-to-face counseling sessions

• therapists understand symptoms and themes across important relationships in patient’s life
• interpersonal psychotherapy- focuses on symptom relief, current relationships, social skills

Humanistic Therapy: try to boost feelings of self-worth, awareness, acceptance

1. emphasizes present and future rather than past
2. focus on conscious thought, rather than unconscious
3. take responsibility for feelings rather than finding hidden causes
4. promote growth rather than cure illness (call patients “clients” instead!)

• client-centered therapy: answers are within you, therapist just listens
• non-directive: therapist doesn’t judge or give advice
• active listening: shows that the therapist is really paying attention

1. paraphrase back what client said
2. invite clarification- “can you give me an example?”
3. reflect feelings- “that sounds frustrating!”

Behavior Therapy: learn principles to eliminate unwanted behaviors

• treats phobias, anxiety, sexual disorders-- sole goal is to relieve symptoms and fix behavior problems in the present
• don’t try to dig into unconscious mind and find out about past
• symptoms are a learned behavior developed through association
• counterconditioning: condition new response to stimuli
• exposure therapy: expose patient to things they fear in controlled way
• develop new relationship with stimulus
• systematic desensitization: associate pleasant, relaxed state with increasing levels of exposure to phobia stimuli

• aversive conditioning: give negative association to unwanted behavior
• drugs that induce vomiting mixed with alcohol- makes drinking unpleasant
• doesn’t work in long term--requires people to spike their own drink
• operant conditioning: behavior modification through reward and punishment
• effective in treating children and autism
• token economy: in an institution, good behavior rewarded with points or tokens

Cognitive Therapy: teaches adaptive ways of thinking to change actions

• Aaron Beck suggests that depressed patients believe they can never be happy, associate their failings with depression
• gently questions patients so that they think positively about their lives
• depressed people don’t have a self-serving bias
• Rabin: patients keep journal of positive events, write how they helped to cause the event
• Stress inoculation training
• Meichenbaum: trained people to restructure thinking in stressful situations

Cognitive Behavior Therapy (CBT): alter way people act and think

• very effective in treating OCD
• compulsive thoughts analyzed, treat compulsions with counterconditioning

Group Therapy- used when multiple people suffer from the same issue

• cheaper, and psychologically strengthening: you are not alone!
• family therapy: treats family as a unit- positive relationships and communication

Popularity: cognitive (49%), psychodynamic (28%), family (19%)

Is psychotherapy effective?-- 89% say that therapy was satisfactory

• therapy skeptics argue:

1. natural regression to normalcy--people get better on their own
2. patients need to feel like the therapy was worth it, since it cost so much money/time
3. patients tend to like their therapists, even if they didn’t really help

• clinicians think:

1. that they are good therapists
2. that if a patient decides to see another therapist, it is because the patient had some new disorder or changing needs--not that they are a bad therapist
3. that even if they don’t see results, the patients are okay, and are probably improving

• Hans Eysenck- ⅔ of therapy patients recovered, ⅔ non-therapy patients recovered
• meta-analysis: people who go to therapy usually benefit more
• statistically combines results of many studies
• outcome 80% better if treated, and recovery is faster

Odd treatments

1. EMDR-- Eye Movement Desensitization and Reprocessing
1. unlock and reprocess traumatic memories by waving fingers in front of face
2. Light Exposure Therapy-- treats Seasonal Affective Disorder
1. scientifically validated!

commonalities of all therapies:

1. hope for demoralized people (placebo)
2. new perspective on life
3. empathic, trusting, caring relationship

• culture and values of therapist plays role in relationship--cultural nuances should mesh
• therapist shopping is common

Clinical psychologists: PhD, experts, treat more severe disorders

Social Worker: everyday personal and childhood programs

counselor: problems arising from family issues, child abuse, substance abuse

psychiatrist: gone to medical school, prescribes drugs

Biomedical Therapies: drugs, surgery, electrical shock therapy

• psychopharmacology: since invention in 1960’s, fewer people in mental hospitals
• antianxiety drugs relax system by increasing GABA
• selective serotonin reuptake inhibitors- serotonin stays in synaptic gap, elevating serotonin levels (takes 4 weeks)
• also promotes neurogenesis: growing new brain cells!
• mood stabilization--lithium controls manic episodes
• psychologists theorize that it monitors levels of norepinephrine and glutamate
• Brain Stimulation: electroconvulsive therapy-- we don’t know why, but it works!
• for very depressed people
• muscle relaxants, then 100-volt shock to the forehead
• relieves all symptoms for about a month
• repetitive transcranial magnetic stimulation
• pulsating magnetic coil placed over prefrontal regions of brain
• psychosurgery
• tries to remove certain tissue--very rare, because it is irreversible
• Egas Moníz developed the lobotomy by cutting nerves connecting frontal lobes and emotion centers
• modern way--stereotactic radiosurgery: focused beams of radiation