Psyc 001 Chapter 14: Psychological Disorders

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psychopathology

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sickness or disorder of the mind

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etiology

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factors that contribute to the development of a disorder

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multiaxial system

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the system used in the DSM; it calls for assessment along five axes that describe important mental health facts

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categorical approach (diagnosis)

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implies that a persona either has a mental disorder or does not; this approach fails to capture difference in the severity of a disorder

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dimensional approach (diagnosis)

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consider mental disorders along a continuum in which people vary in degree rather than in kind

a dimensional approach recognizes that many mental disorders are extreme versions of normal feelings, such as the normal experiences of depression or anxiety

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assessment

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in psychology, examination of a person's mental state to diagnose possible psychological disorders

primary goal: to make a diagnosis

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clinical interview

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the interviewer's skills determine the quantity and value of information obtained

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unstructured interview

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topics of discussion vary as the interviewer probes different aspects of the person's problems; highly flexible

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structured interview

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clinicians ask standardized questions in the same order each time

ex: Structured Clinical Interview for DSM (SCID)

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Evidence-based assessment

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an approach to clinical evaluation in which research guides the evaluation of mental disorders, the selection of appropriate psychological tests and neuropsychological methods, and the use of critical thinking in making a diagnosis

example: scientific research indicates that many mental disorders occur together (like depressed people have substance abuse problems). Therefore, an evidence-based assessment approach would indicate that people found to be depressed should also be tested for substance abuse

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comorbidity

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many mental disorders occur together (overlap)

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diathesis-stress model

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a diagnostic model that propose an individual can have an underlying vulnerability or predisposition (diathesis) to a mental disorder.

the diathesis can be biological or environmental. The vulnerability may not be sufficient to trigger a mental disorder, but the addition of stressful circumstances can tip the scales. If the stress level exceeds an individual's ability to cope, the symptoms of mental disorder will occur.

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family systems model

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a diagnostic model that considers symptoms within an individual as indicating problems within the family.

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sociocultural model

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a diagnostic model that views psychopathology as the result of the interaction between individuals and their cultures.

ex: schizophrenia appears to be more common among the lower socioeconomic classes. From the sociocultural perspective, these differences in occurrence are due to differences in lifestyles, in expectations, in opportunities between classes.

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cognitive-behavioral approach

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a diagnostic model that views psychopathology as the result of learned, maladaptive thoughts and beliefs

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internalizing disorders

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characterized by negative emotions, and they can be grouped into categories that reflect the emotions of distress and fear; more prevalent in women

Examples: depression, generalized anxiety disorder, panic disorder

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externalizing disorders

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characterized by disinhibition; more prevalent in men

Examples: alcoholism, conduct disorders, and antisocial behavior

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culture-bound syndromes

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these disorders occur mainly in specific cultures or regions

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anxiety disorders

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characterized by excessive anxiety in the absence of true danger

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specific phobias

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involve particular objects and situations

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social phobia (social anxiety disorder)

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fear of being negatively evaluated by others

can include: fears of public speaking, speaking up in class, meeting new people, eating in front of others

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generalized anxiety disorder (GAD)

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a diffuse state of constant anxiety not associated with any specific object or event

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posttraumatic stress disorder (PTSD)

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a mental disorder that involves frequent nightmares, intrusive thoughts, and flashbacks related to an earlier trauma

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panic disorder

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an anxiety disorder that consists of sudden, overwhelming attacks of terror

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agoraphobia

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an anxiety disorder marked by fear of being in situations in which escape may be difficult or impossible

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obsessive-compulsive disorder (OCD)

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an anxiety disorder characterized by frequent intrusive thoughts and compulsive actions

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obsessions

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recurrent, intrusive, and unwanted thoughts or ideas or mental images

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compulsions

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are particular acts that the OCD patient feels driven to perform over and over again

OCD runs in families; OCD-related genes appear to be the neurotransmitter glutamate

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mood disorders (affective disorders)

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classified into to categories:
1. depressive disorder: feature persistent and pervasive feelings of sadness

2. bipolar disorders involve radical fluctuations in mood

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major depression

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a mood disorder characterized by severe negative moods or a lack of interest in normally pleasurable activities

other symptoms: appetite and weight changes, sleep disturbances, loss of energy, difficulty concentrating, feelings of self-reproach or guilt, and frequent thoughts of death

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dysthymia

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a form of depression that is not severe enough to be diagnosed as major depression

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bipolar disorder

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a mood disorder characterized by alternating periods of depression and mania

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manic episode

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characterized by elevated mood, increased activity, diminished need for sleep, grandiose ideas, racing thoughts, and extreme distractibility

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Selective Serotonin Reuptake Inhibitors (SSRIs)

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selectively increase another monoamine, serotonin

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seasonal affective disorder (SAD)

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results in periods of depression that correspond to the shorter days of winter in northern latitudes

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cognitive triad

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negative thoughts about self, situation, and the future

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learned helplessness

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a cognitive model of depression in which people feel unable to control events in their lives

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Dissociative disorders

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Mental disorders that involve disruptions of identity, of memory, or of conscious awareness

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dissociative amnesia

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a person forgets that an event happened with loss or loses awareness for a substantial block of time

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dissociative fugue

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this disorder involves a loss of identity

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Dissociative identity disorder (DID)

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formerly known as multiple personality disorder

the occurrence of two or more distinct identities in the same individual

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schizophrenia
(table 14.4 p650)

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a psychological disorder characterized by a split between though ant emotion. It involves alterations in thoughts, in perceptions, or in consciousness

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positive symptoms

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symptoms of schizophrenia that are marked by excesses of functioning, such as delusions, hallucination, and disorganized speech or behavior

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negative symptoms

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symptoms of schizophrenia that are marked by deficits in functioning, such as apathy, lack of emotion, and slowed speech and movement

more common in men than in women

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delusions
(table 14.5 p651)

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(positive symptom of schizophrenia) false beliefs based on incorrect inferences about reality

ex: persecution, reference, grandeur (belief that they have great power, knowledge, or talent), identity, guilt, control

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hallucinations

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(positive symptom of schizophrenia) false sensory perceptions that are experienced without an external source

frequently auditory, but can also be visual

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loosening of associations

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a speech among some people with schizophrenia in which their thoughts are disorganized or meaningless

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disorganized behavior

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acting in strange or unusual ways, including strange movement of limbs, bizarre speech, and inappropriate self-care, such as failing to dress properly or bathe

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clang associations

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the stringing together of words that rhyme but have no another apparent link

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catatonic schizophrenia

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might mindlessly repeat words they hear (echolalia)

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Personality disorders and Associated characteristics

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Odd or Eccentric Behavior (paranoid, schizoid, schizotypal)

Anxious or fearful behavior (avoidant, dependent, obsessive-compulsive)

Dramatic, Emotional, or Erratic Behavior (Histrionic, narcissistic, borderline, antisocial)

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borderline personality disorder

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a personality disorder characterized by disturbances in identity, in affect, and in impulse control

more than twice as common in women as in men

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antisocial personality disorder (APD)

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a personality disorder marked by a lack of empathy and remorse

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psychopath

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people who seem willing to take advantage of and hurt others without any evidence of concern or of remorse

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autistic disorder (autism)

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a developmental disorder characterized by deficits in social interaction, by impaired communication, and by restricted interests

males with autism outnumber females with autism 3 to 1

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autism spectrum disorders

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covers the range of symptoms of autistic disorder

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Asperger's syndrome

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high functioning autism

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pronoun reversal

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children with autism replace "I" with "you"

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attention deficit hyperactivity disorder

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a disorder characterized by restlessness, inattentiveness, and impulsivity.