Psychological Disorders

Psychological Disorders
Schizophrenia
experience distortion or disruption to
their experience of reality (psychosis)
may hear or see or feel things that aren’t
there, develop associations between
things that shouldn’t be associated;
Normal patterns of reactions become
disorganized
Positive Symptoms (normal people lack, but
patients have ABUNDANCE of)
Hallucinations affect your perception;
see, hear, feel, or even taste and smell
things that aren’t there or you will
experience distortions of your
perception
(similar effect can be produced with
hallucinogenic drugs, so make sure to rule
that out when diagnosing someone with
schiz)
Delusions beliefs that are improbable or
impossible, and sometimes emerge
because of weird or seemingly random
associations that the person makes
Negative Symptoms (normal people have,
patients LACK)
absence of emotional reactions (flat affect)
absence of normal speech→ (most extreme
version) is complete catatonia where the
patient seems zombielike, or unresponsive
With current treatments, people with
positive symptoms seem to respond better
to treatment and have a better likelihood of
recovering and leading a reasonably normal
life. People with more negative symptoms
seem to have a poorer longterm
prognosis.
With current treatments, people with
positive symptoms seem to respond better
to treatment and have a better likelihood of
recovering and leading a reasonably normal
life. People with more negative symptoms
seem to have a poorer longterm
prognosis.
Biological component
Hypofrontality occurs shrinkage of the
cortex, and a lack of activation in the frontal
lobes
Enlarged ventricles when you look at an
MRI of the brain ventricles are the areas
where cerebrospinal fluid flows through the
brain, and those areas get bigger when
other areas of the brain shrink.
degree of abnormality in the brain is
correlated with the severity of symptoms
BUT it isn’t clear whether the brain
abnormalities cause the symptoms or are a
consequence of the disorder
Personality Disorders
rigid and problematic or extreme versions
of the traits we all have
Personality becomes disorder when it
causes problems for the person in terms of
subjective distress or impairment
odd/eccentric personalities (includes
schizotypal, which is characterized by odd
thinking and behaviors)
anxious or fearful personalities (includes
dependent and avoidant personalities,
associated with different types of social
anxiety)
Dramatic or erratic behaviors
Borderline Personality Disorder
very volatile emotions, and some very
dichotomous or blackandwhite thinking=
either great or terrible, friend or enemy, no
in between. Not a lot of inbetween or
subtlety about their reactions to the world
or to people.
Tend to have impulse control problems and
tend to be selfish and appear manipulative
/High levels of neuroticism, low levels of
conscientiousness agreeableness/
Antisocial Personality Disorder
/Low levels of conscientiousness and
agreeableness, but unlike borderline has
low levels of neuroticism
don’t tend to be afraid of much and they are
calm in social situations where others might
get nervous = might be because they don’t
really have strong bonds with other people,
and tend to not care how others view them
Mood Disorders
high or low moods that are prolonged,
painful, disruptive, or inappropriate for the
situation
Major Depressive Disorder = includes:
depressed mood, loss of interest in things
that used to be important, loss of appetite,
fatigue or insomnia, agitation, and feelings
of worthlessness or guilt, or when severe:
loss of contact with reality.
Diagnosis of major depression occurs with
longlasting or recurring depressive
episodes.
could lead to both subjective distress and
impairment.
Heritable component for depression; but
it’s likely that genes interact with
experience to produce depression or,
conversely, to produce resistance to
depression.
Manic Episode: opposite of a depressive
episode
elated energetic powerful/grandiose,(don’t
need sleep) very impulsive and risky, (little
thought of consequences/ feeling that things
can’t possibly go wrong) loss of contact with
reality=person believes that they are
supernatural/royalty/smarter than everyone
else in the world OR some feel very irritable
and angry.
might not have ‘subjective distress’
associated with it, but it could certainly lead
to impairment
Hypomanic Episode is a milder version of a
manic episode
definitely more ‘up’ than normal but
doesn’t include any delusions or really
extreme behaviors: people may be more
productive than usual, or more creative and
excitable. It isn’t a disorder, all by itself, and
people report that it feels pretty great.
Bipolar Disorder alternate two ends of
a spectrum or two extremes (mania and
depression) in the same person at
different times
Bipolar I: manic episodes, and may also
include depressive episodes or mild
depressive symptoms that alternate with
the manic episodes.
Bipolar II: hypomanic episodes as well as
depressive episodes
twin studies have revealed a much stronger
association between identical twins for
bipolar, compared to major depression, and
this suggests a stronger genetic role for
bipolar disorder.
Variations
Dysthymia is a milder chronic depression
Cyclothymia is a milder chronic version of
Bipolar
Specific versions of depression associated
with major hormone fluctuations
e.g.) Postpartum depression
variations suggest that there are definite
biological triggers for mood episodes that
are separate from how good or bad your
life experience might be
Anxiety Disorders
fear or worry that is out of control or out of
proportion
major consideration is the subjective distress
of the person with anxiety and the likelihood
that anxiety will impair aspects of the
person’s life
Generalized Anxiety Disorder (GAD) Always
present. Isn’t tied to a particular trigger or
situation
People tend to always be worried or on
edge, but not about anything specific
Panic Disorder
seem to come out of nowhere (although
worrying about panic can bring on a panic
attack) and is an extra large and unhelpful
fightorflight reaction complete with high
heart rate, sweating, trembling, shortness of
breath, and a feeling like you’re about to
die.
only diagnosed if you’ve had repeated
panic attacks and it has affected your life
negatively
Specific Phobias are tied to very specific
triggers fear has to be out of proportion
to the risk, and it has to cause subjective
distress or lead to some sort of impairment
e.g.) you have fear of dogs and you quit
your job because your coworker who is
blind uses a service dog.
Social Anxiety Disorder is related to this
category because the similar symptoms are
similar triggers are social situations where
you might feel evaluated or judged
e.g.) job interview or public speaking,
parties
Not technically anxiety disorders
PostTraumatic Stress Disorder, or PTSD has
a specific trigger that starts the disorder;
anxiety is major component of symptoms
Traumatic event is defined= the person felt
that their life was at risk or where they are
exposed to the trauma of others.
ObsessiveCompulsive Disorder
(OCD)obsessions or compulsions must take
up a significant amount of time or cause
distress or impairment, and can’t be
explained by some other disorder
Obsessions are intrusive thoughts or ideas
that the person tries to suppress or get rid
of.
Compulsions are mental acts or actions (like
praying, counting, or hand washing) that are
used to reduce anxiety (typically brought on
by the obsessions).
genetic or heritable component to anxiety
disorders, as well as obsessive compulsive
disorders
strong heritable component to the
personality trait of neuroticism
genes associated with the production and
use of neurotransmitters like
norepinephrine that are associated with
alarm and fear reactions
people can learn to be afraid of specific
stimuli, and that specific events can trigger
the onset of symptoms
Diagnosis
DSM5
Categorical approach = people are
described as having a disorder or not and
being diagnosed with a specific disorder
within a specific category of disorders
Dimensional approach = people are rated
along a spectrum for each symptom and
their final ‘diagnosis’ would be a
description of where they are at for each
symptom
g.) similar to the Big Five model to describe
personality.
Descriptive = under diagnostic criteria
provide descriptions of the symptoms
associated with each disorder other
details about success rates for some
treatments.
does not provide information about the
causes of the disorder. This allows it to be
used by a wide range of clinicians who may
not all agree on those details
Diagnosis for a disorder includes checklists
of symptoms, duration of symptoms, and
other factors
Where do disorders come from?
there are interactions
between the biological or genetic factors
and the learning or environmental factors
disorders can have multiple causes
not everyone who experiences the same
thing or has the same genes will develop
the same disorders
Psychoanalytic Perspective
disordered behavior as a consequence of
the unconscious mind protecting the
conscious mind, or as some failure of the
ego to balance between the id and
superego.
Humanistic Perspective
failing to improve or achieve the ideal
version of the self
Biological Perspective
focus on genetic and physiological
explanations for disorders
Learning Perspective
based on classical and operant conditioning
explanations for behavior
Defining disorders
statistically rare
biological dysfunction
not functioning properly
subjective distress
whether someone is suffering as a result of
the symptom or trait
impairment
Must rule out alternatives
e.g.)medical causes of symptoms/side
effects of prescribed meds
"abnormal" = need diagnosis for treatment
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