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90 Cards in this Set

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Psychological disorders
A harmful dysfunction in which behaviour is judged:
-atypical, disturbing, maladaptive, and unjustifiable.
Definition of behaviour as normal or abnormal over time and across cultures.
-a routine behaviour in one culture may be regarded as disordered in another.
-homosexuality was dropped as abnormal in1973 by American Psychiatric Association.
-nicotine dependence was added to the disorders.
WHO’s statistics on disorders (2001).
450 million people worldwide suffer from psychological disorders.
-mental disorders account for 15.4% of the years of life lost due to death or disability worldwide.
Prevalence and cost of psychological disorders in Canada Statistics Canada (2003); Public Health Agency of Canada (2002).
-cost of psychological disorders in 1993 = 7.331 billion
-in 1999, 1.5 million hospital days were due to admissions for different psychological disorders.
-increase in hospital admissions for eating disorders by 34% between 1987-1999 for females age 15 and below.
Understanding psychological disorders:
-possessed by demons.
-witches in league with devil.
-victims of God’s punishment.
Perceived causes of abnormality
-movements of sun or moon, lunacy--full moon, and evil spirits.
-ancient treatments included exorcisms, rituals and chants
Consequences of a threatening behaviour
-people were caged like animals, beaten, burned, castrated, mutilated, and their blood was replaced with animal’s blood.
Pinel (1745-1826) opposed this brutal treatment
madness was caused by severe stresses and inhumane conditions, not because of demons.
Pinel proposed a moral treatment
-boosting patients’ morale and talking with them.
-replacing brutality with gentleness.
-isolation with activity and filth with clean air and sun.
Medical model
abnormal behaviour has physical causes
Definition of mental illness as psychopathology
-needs to be diagnosed on the basis of its symptoms and cured through therapy
A disease affects only the body, hence, no mental illness (Szasz,1990)
-abnormal behaviour usually involves a deviation from social norms rather than an illness.
-deviations are ‘problems in living’ rather than medical problems
Medical model’s concepts in the treatment and study of abnormality
diagnosis, aetiology, epidemiology, prevalence and prognosis
distinguishing one illness from another
causation and developmental history of an illness
distribution of mental/physical disorders in a population
percentage of a population that exhibits a disorder during a specified time period
forecast about the probable course of an illness
Bio-psycho-social perspective
The biological, sociocultural, and psychological factors interact to produce psychological disorders
Reasons for a psychological disorders
-a growth blocking difficulty in the environment.
-person’s perception or interpretation of the events.
-person’s bad habits and poor social skills
Definition and criteria in the diagnosis of abnormality
(1) deviance,
(2) maladaptive behaviour
(3) personal distress
Classifying psychological disorders
Diagnostic and Statistical Manual of Mental Disorders (DSM) by American Psychiatric Association in1952.
-Fourth edition (DSM-IV) released in 1994 included improvements based on research.
A current authoritative scheme for classifying psychological disorders is the DSM-IV-TR, updated as a 2000 ‘text revision’.
-progress in making psychodiagnosis reliable, valid, and scientific.
In 2010, the American Psychiatric Association released the first draft of the upcoming DSM-5, a revision to appear in 2013.
Proposed changes to the diagnostic labels.
-mental retardation to become intellectual developmental disorder.
-new proposed categories of disorders; hypersexual disorder, hoarding disorder, and binge-eating disorder.
Aim of the new DSM-5
-to support the integration of psychiatric diagnoses into mainstream medical practice.
The eleventh edition of the World Health Organization’s International Classification of Diseases (ICD-11).
-covers both medical and psychological disorders; expected in 2014.
Goals of diagnostic classification.
-describe a disorder and predict its future course.
-imply appropriate treatment and stimulate research into its causes.
Widely used scheme for classifying psychological disorders
-DSM-IV was developed in coordination with ICD-10; WHO’s International Classification of diseases
-DSM-IV is a multiaxial system of classification comprised of five separate dimensions or axes
-diagnosis of disorders is made on Axes I and II.
-clinicians record most types of disorders on Axis I.
-Axis II lists personality disorders or mental retardation
People may receive diagnosis on both Axes I and II
Axis III
patient’s physical disorders (general medical conditions).
Axis IV of DSM-IV
types of stresses experienced by the individual in the past year (psychosocial and environmental problems)
Axis V of DSM-IV
individual’s current level of adaptive functioning (social and occupational behaviour).
highest level of functioning in the past year.
Increase in the number of disorder categories from 100 to 400 over the past 50 years
-chances of an adult to meet the criteria of a disorder has increased to 30%.
Culture specific disorders on DSM-IV.:
Anorexia nervosa and bulimia are found in the Western cultures.
Susto is found in Latin America.
-sever anxiety, restlessness, fear of black magic, reflects soul loss.
Latah is observed in women in Malaysia.
-hysteria and echolalia.
Fajin-kyofusho is found in Japan.
-social anxiety with one’s appearance; readiness to blush and a fear of eye contact.
Whakama is a New Zealand Maori construct.
-shame, self-abasement, feelings of inferiority, inadequacy, self-doubt, shyness, excessive modesty and withdrawal.
Witiko is a disorder in Algonquin Indians in Canada.
-individual is possessed by Witiko spirit, a man eating monster.
-cannibalistic behaviour or suicide ideation to avoid acting on the cannibalistic urges.
Koro is observed in Southeast Asian men.
-impotence resulting from obsessive fear that penis is retracting.
Culture specific disorders on DSM-IV.:
Anorexia nervosa and bulimia are found in the Western cultures.
Sinking heart is a condition of distress in the Punjabi culture.
-physical sensations in the heart or chest.
-caused by excessive heat, exhaustion, worry, or social failure.
-resembles depression and cardiovascular disease.
Amok is found in Malaysia, Philippines and Thailand.
-sudden rage and homicidal aggression.
-stress, sleep deprivation and social withdrawal.
Pibloktoq is a type of Arctic hysteria found in Inuit.
Labelling psychological disorders:
Labels are helpful in diagnosis; involve value judgements on normal or abnormal behaviour
The criteria of mental illness is not value-free as the criteria of physical illness.
-a malfunctioning heart or kidney is pathological regardless of the personal values.
-judgements about mental illness reflect prevailing cultural values, social trends, and political forces, and scientific knowledge.
-antonyms; normal–abnormal and mental health–mental illness divide people into two groups.
Distinction of normal from abnormal
-everybody acts in deviant ways, displays some maladaptive behaviour, and experiences personal distress.
-labels create preconceptions that guide our perceptions and our interpretations.
Biasing power of diagnostic labels
Test of clinical insight of mental health workers.
-pseudo-patients were sent to the hospitals who complained of ‘hearing voices’.
-reported their life histories honestly.
-exhibited no further symptoms.
-only provided false personal information.
Most were diagnosed as ‘schizophrenics’ and were kept in the hospital for 2-3 weeks.
-clinicians searched for early incidents in the life histories of these patients and hospital behaviour that confirmed the diagnosis.
-even the normal behaviours of the patients were misinterpreted as symptoms (e.g., taking notes).
-when informed about this experiment, clinicians did not accept their blunders.
Labels stigmatize people
A confederate called people in Toronto who were advertising furnished rooms for rent.
-when she asked if the room was available, the answer was yes.
-when she said she was about to be released from a mental hospital, the answer was ¾ of the time no.
-also no, when she said she was calling for her brother who was about to be released from the jail.
Influence of media on perceptions of disorders and stereotype formation
-‘beautiful mind’(mathematician Nash’s portrayal).
-homicidal, freaks, violent criminals and alcoholics.
-90% of mental patients are not dangerous.
-anxious, depressed and socially withdrawn.
Measurement of psychological disorders:
Methods of assessing psychological disorders
-open-ended and structured interviews.
-self-reports, observations, and questionnaires.
-rating scales, and psychological tests.
Problems of the techniques
-reliability and the validity of the instruments
Anxiety disorders:
Feelings of excessive apprehension and anxiety.
Most of us feel anxiety on certain occasions.
-avoid eye contact.
-avoid talking to someone (shyness).
-anxious of public speaking.
Types of anxiety disorders.
-Generalized anxiety disorder.
-Panic disorder and agoraphobia.
-Phobic disorder.
-Obsessive compulsive disorder.
Generalized anxiety disorder
A chronic, high level of anxiety not tied to any specific threat.
-person is tense, apprehensive, and in a state of autonomic nervous system arousal.
Symptoms of generalized anxiety disorder.
-dizziness, sweating palms, heart palpitations, and ringing in the ears.
-unfocused, out of control and having negative feelings.
-2/3 are women, who are tense and jittery, and worried about the happening of bad things.
person cannot identify the cause of the anxiety.
Panic disorder and agoraphobia
Sudden and recurring attacks of overwhelming anxiety.
-a minutes-long episode of intense dread.
-experiencing terror and accompanying chest pain.
-choking, or other frightening sensation.
Misperceived as a heart attack
shortening of breath, heart palpitation ,dizziness, and trembling
Agoraphobia is the fear of open or public places
people avoid being outside of house, in a crowd, on a bus or on an elevator
Phobic disorder.
An individual’s anxiety has a specific focus.
-persistent and irrational fear of an object or situation that presents no realistic danger.
-common phobias are of animals, insects, heights, blood or tunnels.
-people with social phobia avoid potentially embarrassing social situations.
Obsessive-compulsive disorder.
-Obsessions: thoughts that repeatedly intrude on one’s consciousness in a distressing way.
-Compulsions: actions that one feels forced to carry out.
Persistent obsession and compulsion interfere with normal living
repeatedly checking one’s handbag for the keys
Obsessions often centre on inflicting harm on others, personal failure, suicide, or sexual acts.
Post-traumatic stress disorder (PTSD)
Triggered by a variety of traumatic events.
-rape or assault.
-a severe automobile accident.
-a natural disaster.
-witnessing of someone’s death.
The greater one’s emotional distress during a trauma, the higher the risk for post-traumatic symptoms
A sensitive limbic system seems to increase vulnerability.
-floods the body with stress hormones as images of the traumatic experience erupt into consciousness.
-Brain scans of PTSD patients suffering memory flashbacks reveal aberrant and persistent right temporal lobe activation.
The role of genes shows that some PTSD symptoms may actually be genetically predisposed.
PTSD surface after months/years after a person’s exposure to severe stress
Symptoms of PTSD.
-re-experiencing the traumatic event in the form of nightmares and flashback.
-emotional numbing, alienation.
-problems in social relations.
-an increased sense of vulnerability.
-Elevated arousal, anxiety, anger, and guilt.
-risk for substance abuse, depression, and suicide attempts.
PTSD symptoms usually decline gradually over time.
-recovery is gradual, symptoms never completely disappear.
Impressive survivor resiliency of those who do not develop PTSD
-half of adults experience at least one traumatic event in their lifetime.
-about 1/10 women and 1/20 men develop PTSD
-Suffering can lead to ‘benefit finding’ called post-traumatic growth.
-Struggle with challenging crises leads people later to report an increased appreciation for life.
Suffering has transformative power.
-compared with those unchallenged by any adversity, people who face some adversity -enjoy better mental health and well-being
Explaining anxiety disorders
Psychoanalytic approach (Freud).
-repression of threatening impulses causes anxiety.
Biological and learning approaches:
The leaning approach.
1. Fear conditioning
experience of unpredictable negative events that are beyond the control of the individual results in anxiety.
2. Stimulus generalization.
a person attacked by a pit bull generalizes the fear to all the dogs.
3. Reinforcement.
escaping the feared situation reduces anxiety.
4. Observational learning.
learning of fear by observing others’ fears.
Mood disorders
-Common cold of psychological disorders.
-Emotional disturbances of varied kinds that disrupt physical, perceptual, social, and thought processes.
Types of mood disorders
1. major depressive disorder or unipolar disorder.
2. bipolar disorder (manic-depressive disorder).
Major depressive disorder (diagnosis)
-two or more weeks of depressed mood; no apparent reason.
-feelings of worthlessness.
-diminished interest or pleasure in most activities.
Depression increases in winter from 11% to 29% called seasonal affective disorder (SAD).
Symptoms for major depression.
-feeling discouraged about the future.
-dissatisfaction with one’s life.
-isolated from others.
-difficulty concentrating.
-sleep disturbances.
-weight loss/gain and loss of libido.
-suicidal tendencies.
-lack of energy/exhaustion.
Depression statistics by Canadian Health Agency (2002)
-about 8% of Canadians endure a depressive disorder at some time in their lives.
-1% suffer from a bipolar disorder.
-young Canadians and females are more vulnerable to depression.
Bipolar disorder (manic- depressive)
Alternating between the hopelessness and lethargy of depression and the overexcited state of mania
-People return to the normal mood after a depressive episode
Some people rebound to the manic episode.
-over talkative, overactive, elated, needs little sleep, sexually less inhibited, loud, undependable and hard to interrupt.
Maladaptive symptoms of mania.
-euphoric mood, hyperactivity and wild optimism.
Theories of depression
Explanations of mood disorders.
-biological and social-cognitive perspectives.
The biological perspective.
-genetic predispositions and biochemical imbalances.
Genetic influences.
-high risk of depressive disorder among the family members.
-50% chances of depression in identical twins.
-70% chances of bipolar disorder in identical twins.
-20% chances among fraternal twins.
Linkage analysis is used to identify genes involved in depression
Biochemical imbalances
Neurotransmitters play a major role.
-norepinephrine is high during the manic but low during the depressive phase.
-serotonin level is low during depression.
The social-cognitive perspective
Psychological processes related to information processing are the cause of depression.
-negative thoughts influence biochemical processes that accentuate depressing thoughts, --e.g., ‘self-defeating beliefs’.
-depressed people magnify bad events, minimize good ones.
-have negative assumptions about themselves, the situations, and the future.
-self defeating beliefs may arise from ‘learned helplessness’.
Gender differences in uncontrollable events
35% of women and 16% of men feel overwhelmed by the new situation and the tasks
Our attributions of failures and bad events explain depression
Depressed attributional style
Depressed people explain their setbacks in characteristic way along three dimensions.
-internal rather than external (it’s my fault).
-stable rather than unstable (it will not change).
-global rather than specific (it affects all of my life).
‘split mind’
Schizophrenic disorders are a class of disorders.
-delusions, hallucinations, disturbed emotions disorganized speech and deterioration of adaptive behaviour.
-biobehaviorual disorder that is manifested in cognition (Heinrichs,2005).
Prevalence estimates by WHO (2002)
1% of the world population suffer from schizophrenia; about 24 millions across the world.
Symptoms of schizophrenia:
Delusions and irrational thoughts
false beliefs, often of persecution or grandeur, that may accompany psychotic disorder
Beliefs of schizophrenics
-thoughts are controlled by some external force.
-thinking becomes chaotic rather than logical.
-loosening of association; people shift topics in disjointed way.
Sensory perceptions that occur in the absence of a real, external stimulus; distortion of perceptual input
The most common hallucinations are auditory.
-reporting of hearing voices of nonexistent or absent people talking to them.
-voices provide an insulting commentary on the person’s behaviour.
-voices may be argumentative or issue commands.
Emotional disturbances
Normal emotional tone is disrupted.
-little emotional responsiveness called ‘blunted or flat affect’.
-inappropriate emotional responses that do not relate to the situation or to what they are saying.
Deterioration of adaptive behaviour
Deterioration in the quality of the person’s routine functioning.
-work, social relations, and personal care.
-friends will often make remarks such as ‘Bush just isn’t himself anymore’.
Subtypes of schizophrenia
Four types of schizophrenic disorders, and a category for people who do not fit into any of the first three categories.
-Paranoid schizophrenia.
-Catatonic schizophrenia
-Disorganized type.
-Undifferentiated type.
-Paranoid schizophrenia.
Dominated by delusions of persecution and delusions of grandeur.
-become suspicious of friends and relatives or may attribute the persecutions to mysterious, unknown persons.
-believe, they are important people, frequently seeing themselves as great inventors or as famous religious or political leaders.
-Catatonic schizophrenia
Marked by striking motor disturbances, ranging from muscular rigidity to random motor activity.
-some go into an extreme form of withdrawal known as ‘catatonic stupor’.
-remain motionless and seem oblivious to the environment for long periods of time.
-become hyperactive and incoherent called ‘catatonic excitement’.
-some alternate between these dramatic extremes.
-Disorganized type.
Severe deterioration of adaptive behaviour.
-emotional indifference and frequent incoherence.
-virtually complete social withdrawal.
-aimless babbling and giggling are common.
-delusions often centre on bodily functions.
-Undifferentiated type.
Schizophrenics who cannot be placed in any of the three categories.
-marked by idiosyncratic mixtures of schizophrenic symptoms and is fairly common.
Aetiology of schizophrenia
-The aetiology of schizophrenia is like other disorders.
-Genetic vulnerability.
-Heredity plays a role in the development of schizophrenia.
-Twin studies on schizophrenia
Neurochemical factors
Changes in the activity of neurotransmitters in the brain.
-excess dopamine activity is a possible cause of schizophrenia.
drugs used in the treatment of schizophrenia dampen dopamine activity in the brain.
abnormalities in neural circuits using ‘glutamate’ as a neurotransmitter may play a role in -schizophrenia.
Structural abnormalities in the brain.
The cognitive deficits in information processing suggest that schizophrenia may be caused by neurological deficits
Neurodevelopmental hypothesis
-schizophrenia may be caused by disruptions in the normal maturational processes of the brain before or at birth.
-any form of abuse to the brain during prenatal development or during the birth causes neurological damage.
-increases individual’s vulnerability to schizophrenia later in life.
The sources of abuse
-viral infections and malnutrition.
-obstetrical complications during the birth.
-greater risk of schizophrenia if exposure to flu epidemic during the fetal development (influenza in Finland during 1957).
-children of mothers who suffered from influenza during pregnancy are also at greater risk.
Prenatal malnutrition increases risk of schizophrenia
-a cohort prenatally exposed to a sever famine during the World War II in 1944-45 showed higher incidence of schizophrenia.
Psychological factors
Initial belief of some psychologists.
-no environmental causes of schizophrenia unless the person has some family history of schizophrenia.
Stress plays a key role in triggering schizophrenic disorders.
-biological and psychological factors influence individual’s vulnerability to schizophrenia.
-high stress may precipitate schizophrenia in someone who is vulnerable.
Personality disorders
People with personality disorders display certain personality traits to an excessive degree and in rigid ways.
-undermines their adjustment, usually without anxiety, depression, or delusions.
Personality disorders emerge during late childhood or adolescence and continue throughout adulthood
DSM IV lists ten personality disorders.
Antisocial personality disorder.
-person violates the rights of others.
-fails to accept social norms.
-is unable to sustain consistent work behaviour.
-exploitative and reckless (82% men, 18% women).
Avoidant personality disorder
person is usually withdrawn and anxiously sensitive toward rejection (50% both).
Schizoid personality disorder
person is socially disengaged and shows eccentric behaviours (78% men, 22% women).
Histrionic personality disorder.
person displays shallow, attention-getting emotions and every effort to get others’ praise and reassurance (15% men, 85% women).
Narcissistic personality disorder
person exaggerates his/her own importance, has fantasies of success, and reacts to criticism with rage or shame (70% men, 30% women).
Borderline personality disorder
person has an unstable identity, Borderline personality disorder unstable relationships and unstable emotions (38% men, 62% women).
Antisocial personality disorder has both biological and psychological causes.
Antisocial personality disorder has both biological and psychological causes.
-twin and adoption studies indicate the role of biological factors in antisocial behaviour.
-PET scans of murderers’ brains indicate low activity in their frontal lobe, which controls impulses.
Role of biological and social factors in criminality.
-babies whose backgrounds were marked by both biological and social problems were twice as likely to be criminal offenders than those with either biological or social risks.
Dissociative disorders
Dissociation is incapacity to integrate one’s thoughts, feelings, or experiences into one’s consciousness.
conscious awareness becomes separated from previous memories, thoughts, and feelings.
experience of a sudden loss of memory or change in identity
Dissociative identity disorder
-person exhibits two or more distinct and alternating personalities.
-each personality has its own voice and mannerisms, and the original one typically denies any awareness of the other/s.