Psychology Chapter on Schizophrenia and Disorders

Psychological Disorders

• Psychological disorders are conditions involving abnormal thoughts, feelings, and behaviors.
• Defining "abnormal" is complex, encompassing various factors such as personal values, cultural expectations, and statistical deviations from the norm.
• Harmful, distressing, and dysfunctional behaviors or feelings are indicative of potential disorders.

What is Abnormal?

• Defining what's normal vs. abnormal is challenging.
• Diagnosticians need to consider individual personal values and the expectations of the person's surrounding culture.
• Expectations within the culture of origin and current expectations play crucial roles.
• General assumptions about human nature also influence the assessment.
• Statistical deviation from the norm and the degree of harmfulness, suffering, and impairment are also considered.

Social Construct 3 D's

• Distressing: Behaviors or feelings causing distress to the individual or others.
• Dysfunctional: Behaviors or feelings interfering with daily functioning.
• Deviant: Behaviors or feelings violating societal norms.

Historical Perspectives on Deviant Behavior

• Demonological View: Abnormal behavior viewed as a result of supernatural forces.
• Treatment involved trephination (drilling holes in the skull).
• Early Biological Views: Hippocrates emphasized mental illnesses being biological/physical illnesses affecting the brain.
• General Paresis: Linked disorders to physical causes, such as syphilis.

Historical Perspectives on Deviant Behavior (Goya)

• Francisco de Goya's art reflected societal beliefs of the time regarding possession by the devil.
• Disordered people were often considered to be tormented by evil spirits.

The Vulnerability-Stress Model

• This model posits that individuals have varying levels of vulnerability to developing psychological disorders.
• Various factors including genetic predisposition, biological characteristics, psychological traits, previous maladaptive behaviors, and low social support contribute to an individual's vulnerability.
• Stressors such as economic hardship, trauma, interpersonal conflicts, job loss or other demands, exacerbate the vulnerability; leading to a higher risk for developing a psychological disorder.
• Currently experienced stress factors also play a large role in the development of psychological disorders.

Diagnosing Psychological Disorders

• Reliability: Consistency and agreement among clinicians using the same diagnostic system.
• Validity: Diagnostic categories accurately capturing the essential features of specific disorders.

The DSM-5

• Released in 2013 by the American Psychiatric Association.
• Integrates categorical and dimensional approaches for diagnosis.
• Requires detailed behavioral descriptions for proper diagnosis.
• Uses five axes/dimensions to assess both the individual and their life situation.

Dimensions (Axes)

• Axis I: Clinical Symptoms (e.g., depression, schizophrenia, social phobia).
• Axis II: Developmental & Personality Disorders (e.g., autism, mental retardation, personality disorders).
• Axis III: Physical Conditions (e.g., brain injury that affect mental illness).
• Axis IV: Severity of Psychosocial Stressors (e.g., loss of a loved one, new job, college, etc.)
• Axis V: Highest Level of Functioning (both current & in previous year).

Personality Trait Dimensions

• Negative Emotionality: Distress, anxiety, depression among others.
• Disinhibition: Impulsivity, irresponsibility, acting out.
• Introversion: Social withdrawal and avoidance of intimacy.
• Antagonism: Callousness, manipulation, hostility, and aggression.
• Compulsivity: Perfectionism and rigidity.

Anxiety Disorders

• Anxiety disorders involve excessive fear or apprehension.
• Not fear of a real threat, but rather an apprehension about a future threat or potential threat (e.g., worrying).
• Specific symptoms include emotional distress, cognitive worry, physiological changes (e.g., elevated heart rate), and avoidance behaviors.
• Common examples include phobias, generalized anxiety disorder, and obsessive-compulsive disorder.

Phobic Disorder

• Characterized by a strong, irrational fear of an object or situation.
• Often emerges in childhood/adolescence.
• Commonly endured and can worsen overtime.
• Impairment depends on how often the feared object or situation is encountered.
• Examples include agoraphobia (fear of open spaces), social phobias, and specific phobias.

Generalized Anxiety Disorder

• Characterized by a diffuse and free-floating anxiety not tied to any specific event/condition.
• The sense of something bad happening, coupled with a sense of not knowing what that something is.

Panic Disorder

• Characterized by intense, unpredictable panic attacks accompanied by physical and psychological symptoms.
• Fear of a future panic attack occurring.

Obsessive-Compulsive Disorder (OCD)

• Involves obsessions (repetitive, unwanted thoughts) and compulsions (repetitive behaviors or mental acts).
• Symptoms vary among individuals.
• 2.5% of the population.

Neuroscience of OCD

• Executive dysfunction model suggests difficulty with impulse control and behavioral inhibition.
• Modulatory control model emphasizes dysfunction in the orbitofrontal cortex and associated areas.

Causal Factors in Anxiety Disorders and OCD (Biological)

• Genetics: Higher concordance rates among twins suggest a genetic component.
• GABA: Low GABA levels potentially contribute to highly reactive nervous systems.
• Gender Differences: Females experience anxiety disorders more frequently than males.

Causal Factors in Anxiety Disorders and OCD (Psychological)

• Psychodynamic Explanations: Neurotic anxiety stems from unconscious impulses threatening to overwhelm ego defenses.
• Cognitive Explanations: Maladaptive thoughts and beliefs, and potentially catastrophic appraisals contribute to anxiety disorders.

Causal Factors in Anxiety Disorders and OCD (Learning)

• Learning Explanations: Classical conditioning suggests associating stimuli with pain/trauma could lead to anxiety. Modeling also plays a role in the development of anxiety.

Causal Factors in Anxiety Disorders and OCD (Sociocultural)

• Sociocultural factors: Culture significantly shapes what is considered important, and some disorders are specific to cultural contexts.

Eating Disorders

• Anorexia Nervosa: Intense fear of being fat; extreme restriction of food intake.
• Bulimia Nervosa: Binge eating followed by compensatory behaviors such as purging.

Causes of Anorexia and Bulimia

• Environmental Factors: Common in industrialized cultures where beauty is equated with thinness.
• Objectification Theory: Cultural emphasis on viewing one's body as an object.
• Personality Factors: Anorexics often have intensely high achievement standards; Bulimics often feel depressed or anxious.
• Genetics: Identical twins exhibit higher concordance rates for eating disorders.

Mood (Affective) Disorders

• Depression: Persistent low mood, loss of interest, and other symptoms beyond a typical bad day.
• Major Depressive Disorder (clinical depression): Severe and prolonged depression.
• Dysthymia: Chronic low mood.
• Bipolar Disorder: Cycles of depression and mania.
• Manic State: Euphoric mood, grandiosity, rapid speech.

Mood (Affective) Disorders (Symptoms)

• Emotional: sadness, hopelessness, anxiety.
• Motivational: loss of interest, lack of drive, difficulty starting activities.
• Cognitive: negative cognitions about oneself, the world, and the future.
• Somatic: loss of appetite, lack of energy.

Prevalence and Course of Mood Disorders

• Rising prevalence of depression, particularly in young adults born after 1960.
• Gender differences: Women are twice as likely to experience unipolar depression, whereas onset typically occurs earlier for women than men.
• No significant difference in prevalence of bipolar disorder between men and women.

Causal Factors in Mood Disorders (Biological)

• Genetic Predisposition: Genetic factors play a role.
• Biochemical Differences: Potentially underactive levels of norepinephrine, dopamine, and serotonin may contribute.

Causal Factors in Mood Disorders (Psychological)

• Early traumatic experiences/rejections may create vulnerability.
• Cognitive Processes: Negative thoughts and beliefs about one's self, the world, and the future may contribute to depression.
• Humanistic View: Self-worth based on attainment can lead individuals to react more strongly to failures.

Causal Factors in Mood Disorders (Learning/Environmental)

• Loss of Reinforcement: Reduced positive reinforcement can contribute.
• Environmental Factors: A stressful environment and poor parenting may lead to poorer coping skills and potentially low self-esteem.

Causal Factors in Mood Disorders (Sociocultural)

• Culture: Influences concepts of self-worth and may vary in the prevalence of different mood disorders.

Dissociative Disorders

• Psychogenic Amnesia: Selective memory loss following trauma.
• Psychogenic Fugue: Loss of all personal identity.
• Dissociative Identity Disorder (DID): Presence of two or more separate personalities within the same individual.
• DID is linked to severe childhood trauma, as the multiple identities are seen as coping mechanisms.

Schizophrenia

• Characterized by severe disturbances in thinking, perception, emotional expression, and behavior.
• Includes hallucinations, delusions, disorganized speech, and blunted affect.
• Subtypes include paranoid, disorganized, catatonic, and undifferentiated schizophrenia.

Schizophrenia (Type I)

• Predominantly exhibits Positive Symptoms (e.g. hallucinations, delusions, disordered speech & thought).
• Generally, better prognosis.

Schizophrenia (Type II)

• Primarily characterized by Negative Symptoms (e.g. absence/lack of normal emotions, expression, motivation). -Generally, poorer prognosis with a long history of poor functioning.

Schizophrenia (Biological Factors)

• Genetics: Higher concordance rates in twins, suggesting possible a genetic contribution.
• Brain Structure: Enlarged ventricles (spaces within the brain) are often observed in individuals with schizophrenia.
• Neurodegenerative Hypothesis: Progressive loss of brain tissue.

Schizophrenia (Biochemical Factors)

• Dopamine Hypothesis: Overactivity of dopamine in the brain potentially contributes.

Schizophrenia (Psychological/Environmental Factors)

• Freud's Theory: Defense mechanism regression (retreating to an earlier development stage).
• Life Stress: Life stress plays a potential role, and is not generally accepted by all researchers. Individuals with stressful or chaotic personal histories may be more vulnerable.
• Cognitive Processes: Potential defect in the ability to filter information, leading to more extreme or less normal responses.
• Family Characteristics: High in expressed emotion and overly involved families may contribute to the development of the illness.

Personality Disorders

• Stable and maladaptive patterns of thinking, feeling, and behaving.
• Examples include antisocial, narcissistic, borderline, avoidant, and obsessive-compulsive personality disorders.
• These disorders persist throughout adulthood interfering with social and personal functioning; and are typically diagnosed after adolescence.

Antisocial Personality Disorder

• Predominantly characterized by a disregard for others' rights, impulsivity, aggression, and deceitfulness; often exhibiting a severe lack of empathy.
• Tend to be impulsive and unable to delay gratification.
• Often exhibit disruptive or even violent behaviors, and potentially a lack of guilt/anxiety.

Antisocial Personality Disorder (Causal Factors)

• Biological factors: Genetic predisposition, and potential dysfunction involving brain areas responsible for self-control or decision-making processes.
• Psychodynamic Factors: Lack of a developed superego (internalized conscience)
• Learning Factors: Exposure to violent behaviors (modeling), and/or inattention to children's needs and or failure to receive empathy potentially contributing.
• Cognitive Factors: Consistent failure to anticipate or think through potential long-term negative consequences, potentially contributing to the development or worsening of this disorder.

Borderline Personality Disorder

• Characterized by instability in mood, behavior, and relationships.
• Symptoms include difficulty regulating emotions, intense and unstable relationships, impulsive behaviors, and potentially self-harm/suicidal tendencies.

Borderline Personality Disorder (Causal Factors)

• Chaotic personal history and stressful childhood, including a history of non-affirming or rejecting caregiving.
• Biological factors may also be contributing.

Disorders of Childhood and Old Age

• Childhood Disorders: Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).
• Over 20% of children under 5.
• ADHD: Characterized by inattention and/or hyperactivity-impulsivity.
• ASD: Characterized by difficulties with communication, social interaction, and repetitive behaviors.

Disorders of Childhood and Old Age (ASD)

• Prevalence has increased significantly in recent decades.

Dementia in Old Age

• Gradual loss of cognitive abilities accompanying brain deterioration.
• Examples include Alzheimer's, Parkinson's, and Huntington's diseases.
• Alzheimer's: Most common type of dementia, characterized by deterioration in frontal and temporal lobes and the destruction of acetylcholine.

Chromosomes and Genes

• Chromosomes are composed of DNA, with each containing multiple genes.
• Genes hold the blueprint for an organism's genetic traits.
• Every somatic cell in the body (excludes sperm and egg cells) has 46 chromosomes (23 pairs).

This quiz explores the biochemical hypotheses related to schizophrenia and examines psychological factors suggested by Freud. It also delves into characteristics of autism and Alzheimer's disease, including biological changes and symptomatology associated with various mental disorders.