Psychological Disorders and Normalcy

Normalcy and Abnormalcy

• Normal behavior is social conformity, or behaviors that are not uncommon but are comfortable for the individual.
• People in a society can have different behaviors that are not uncommon and still consider them normal, provided they don't cause distress or violate norms.
• Normality depends on personal comfort, as well as conforming to the criteria for each category or type of disorder.
• Criteria for determining abnormal behavior include violation of norms, statistical rarity, personal discomfort, and maladaptiveness.

Psychological Disorder

• Psychological disorder is dysfunction within an individual. It's associated with distress or impairment in functioning, and a response that's not typical or culturally expected.
• The 4 D's of psychological disorder include psychological dysfunction (breakdown in cognitive, emotional or behavioral functioning), distress or impairment (individual is extremely upset and cannot function properly), atypical or not culturally expected (deviates from the average or norm), and dangerousness (creates potential harm).
• Duration of the behavior is important to consider, as constant fluctuation is normal, but sustained changes are concerning.

Clinical Psychology and Assessment

• Clinical assessment systematically evaluates and measures psychological, biological, and social factors.
• Diagnosis involves determining whether a particular psychological problem meets all criteria for a particular disorder.
• Epidemiology examines the distribution of diseases, disorders, and health-related behaviors in a population.
  • Prevalence is the number of active cases in a population during a given period.
  • Point prevalence is the proportion of active cases in a population at a specific time.
  • Lifetime prevalence is the estimate of cases of a particular disorder occurring at any point in someone's life.

Theoretical Approaches

• One-Dimensional takes a singular approach to understanding the cause of a disorder
• Multidimensional seeks a cause based on interconnected factors

Genetic Contributions

• Genes are long molecules of DNA located on chromosomes.
• Chromosomes are chain-like structures within a cell's nucleus.
• Genetic makeup influences behaviors
• Twin studies are used to observe genetic makeup correlation amongst twins.
• Epigenetics are factors outside of inherited DNA that still alter traits.

Biological and Neurological Bases

• Neuroscience studies the nervous system, focusing on the brain's understanding of behavior, emotions, and cognitive process.
• Neurotransmitters act as chemical messengers of the body, and include dopamine (pleasure), epinephrine (fight-or-flight), serotonin (mood), norepinephrine (concentration), GABA (calming), glutamate (memory), and endorphins (euphoria).
• The nervous system, composed of the brain stem (essential autonomic functioning), hindbrain (regulates breathing and heartbeat), midbrain (movement/sensory input & arousal), thalamus (relating sensory information to the rest of the brain), hypothalamus (regulating behavior & hormones), and limbic system (emotions), functions to support body functions.

Axis V: Global Assessment of Functioning

• Describes the overall level of psychological, social, and occupational functioning of an individual.

Learning

• Classical conditioning: a neutral stimulus is paired with a response until it elicits that response.
• Unconditioned stimulus: natural stimulus, evoking a natural or unlearned response.
• Unconditioned response: natural or unlearned response.
• Conditioned stimulus: newly conditioned response.
• Conditioned response: newly conditioned response from the conditioned stimulus.
• Extinction: the behavior is eliminated if the conditioned stimulus is shown long enough.
• Stimulus generalization: similar objects will evoke similar responses.

Learned Optimism/Positive Psychology

• Optimists/upbeat attitude tend to function better mentally and physically.
• Prepared learning is essential for survival.

Cognitive Theories of Depression

-Cognitive errors in thinking negatively about the world, oneself, and the future. -Negative schemas are enduring negative thoughts about aspects of life. -Negative self-evaluation schemas are the belief that one cannot do anything correctly. -Dichotomous thinking, Overgeneralization: making generalizations about a negative aspect, and Personalization: a tendency for individuals to relate external events to themselves, are examples of cognitive errors.

Labeling and Mislabeling

• Describing someone's problems based on past imperfections and mistakes, allowing them to define their identity (e.g., "I am ugly" because of past experiences).

Stress

• Stress is a two-way process involving stressors and an individual response.
• Primary appraisal is asking, "What does this situation mean?" and how it will affect you
• Secondary appraisal is about your feelings about the stressor or the produced stress.

Memory

• Anosognosia: no memory of one’s own illness symptoms/condition.
• Confabulation is filling in memory gaps with imaginary experiences. -Disorientation is when someone cannot identify time, places, and persons.
• De Javu: unfamiliar perceived as familiar
• Jamais Vu: familiar perceived as unfamiliar
• Hypermnesia: increased memory
• Paramnesia: false or perverted memory
• Amnesia: loss of memory

Labeling and Mislabeling

-Portraying one's identity on the basis of imperfections and past mistakes, allowing them to define one's identity.

Theoretical Approaches in Explaining the Etiology of Psychological Disorders

• One-dimensional approach looking for a single cause
• Multidimensional approach seeking a cause based on a system

Gene-Environment Interaction

• Genotype (genetic makeup) interacts with the environment to create mental health risks or vulnerabilities.

Social Factors

• Unemployment/Poverty/Crime/Poor Educational Level: contribute to depression and isolation when under stress.
• Family Systems Theory examines families as interacting systems with unique communication and structure patterns.
• Interpersonal Perspective focuses on how interpersonal interactions can be a cause/contributor (e.g., learned helplessness).

Suicide

• Death seekers: clearly intend to end their life.
• Death initiators: clearly intend to end their lives but believe that the process has already begun.
• Death ignorers: do not believe that their self-inflicted death means the end of their existence.
• Death darers: experience mixed feelings and ambivalence.

Specific Phobias

• Irrational fear of a specific object, situation (or natural environment) that hinders functioning.

Social Anxiety Disorder

• Fear or anxiety about potential humiliation or scrutiny in social situations

Panic Disorder

• Characterized by sudden and intense episodes of terror or dread, without apparent trigger

PTSD/Acute Stress Disorder

• Exposure to trauma (direct experience, witness, learn event happened to close family member, repeated exposure)

Adjustment Disorder

• Develops within 3 months of an identifiable stressor. Symptoms stop once the stressor is gone.

Types of Amnesia

• Retrograde amnesia: Inability to retrieve information about past events before the onset of amnesia
• Anterograde amnesia: Inability to retrieve new information after the onset of amnesia

Anxiety Disorders

• Separation Anxiety Disorder: involves concerns or separation that occurs over an extended period.
• Selective Mutism: lack of speech in a social situation

Substance-Use Disorders

• Substances: chemical compounds that alter mood or behavior.
• Psychoactive substances are also included as they alter mood or behaviors.
• Individuals ingest substances at moderate levels that do not cause significant interference to their social, educational, occupational functioning are labeled as substance use.

Eating Disorders

• Pica
• Rumination Disorder
• Avoidant/Restrictive Food Intake Disorder
• Anorexia Nervosa
• Bulimia Nervosa
• Binge-Eating Disorder

Sleep Disorders

• Enuresis is repeated voiding of urine in bed/clothes.
• Encopresis is repeated passage of feces into inappropriate places.
• Insomnia, hypersomnia, and narcolepsy are examples of other sleep disorders.

Neurocognitive Disorders

• Delirium: characterized by impaired consciousness and cognition for hours or days.
• Major Neurocognitive Disorder is a gradual deterioration of brain functioning, with decline in cognitive abilities like memory, judgment, speech and other cognitive functions.
• Mild Neurocognitive Disorder reflects the early stages of cognitive decline.
• Dementia is an impairment of cognitive ability associated with severe symptoms impacting daily living.

Traumatic Brain Injury and Other Conditions

• Symptoms lasting more than one week.
• Lewy Body Disease.
• Parkinson's Disease.
• HIV Infection
• Substance-related issues.
• Huntington’s Disease.

Psychological Interventions for Disorders

• Psychodynamic: focuses on unconscious thoughts.
• Humanistic: focuses on individual experiences; client-centered, support groups.
• Cognitive: focuses on changing thought patterns.
• Behavioral: focuses on changing behaviors.
• Biological: focuses on medication.

Ethical Considerations

• Informed consent
• Confidentiality
• Competency
• Interruptions of services with death, relocation, or illness of clients.
• Psychologists should discuss the limits of confidentiality, and how the info will be shared with parties and organization who are involved in the process of treatment/care.
• Before recording, psychologist must obtain permission if it involves audio or visual media.

Telepsychology

• Telepsychology uses telecommunication technologies to provide psychological services.

Global Health Crisis

• COVID-19 significantly impacted people's mental health, and especially those who are vulnerable, including mothers, racial and ethnic minorities, children, people experiencing poverty, and those with pre-existing conditions.

Frontline Workers

• Frontline workers in the face of COVID-19 are vulnerable and at a higher risk of facing different mental issues.
• Exposure to stress, anxiety, and depression can affect productivity, and can lead to unhealthy behaviors like substance use and risky behavior, such as suicide.

Vaccinations

• COVID-19 vaccination is associated with decreased anxiety and depression symptoms for individuals with lower education, and who rent their housing or are not able to telework

Other Information

• Many psychological disorders have a multi-dimensional perspective, such as various factors contributing to their issues, e.g., biological, psychological, or social factors.