Understanding Psychological Disorders

Psychological Disorder

• Psychological dysfunction within an individual involves distress or impairment and atypical/culturally unexpected responses.

Characteristics of a Normal Person

• Realistic life goals are present.
• The ability to learn from experience.
• The ability to control emotions.
• The ability to satisfy needs appropriately.
• Adequate needs for security.
• The ability to adjust to stressors.

Normality Criteria

• Normality is average in statistics.
• Personal comfort exists.
• Conforming to social norms defines normality.

Cultural Relativism

• There are no universal standards for labeling behavior as normal or abnormal.
• Behaviors are normal or abnormal relative to cultural norms.
• It is not necessary to have all characteristics to be considered normal; normality is ideal and a process.

Psychopathology

• Psychopathology is the scientific study of psychological disorders.

Guide in Defining Psychopathology: 5Ds

• Dysfunction: Breakdown in cognitive, emotional, or behavioral functioning.
• Distress: Unhappiness or pain affecting physical and psychological functions.
• Deviance: Atypical psychological or behavioral manifestations (violating social norms).
• Danger: Potential for self-harm or harm to others.
• Duration: Length or longevity of abnormal behavior/symptoms.

What is Not Normal?

• Unusualness: Uncommon behavior is considered abnormal.
• Discomfort: Suffering from discomfort and wanting to rid specific behavior.
• Maladaptiveness: Behaviors causing distress and preventing daily life functioning.
• Mental Illness: Identifiable physical process differing from "health" and leading to specific symptoms.

Determinants of Abnormality

• Determinants are causes of abnormality.

Three Groups of Determinants

• Biological determinants: Predisposing or precipitating factors.
• Psychological determinants: Factors such as behavior, thoughts, or emotions influenced by specific underlying reasons.
• Sociocultural determinants: Factors involved in the causation of abnormal behavior.

Predisposing Factors

• Make individuals prone or susceptible to disorders (remote effect).

Precipitating Factors

• The mentioned factors trigger the onset or causation of psychopathological condition (immediate effect).

Perpetuating Factors

• Maintain or exacerbate the problem once it has developed, preventing recovery.

Biological Determinants of Psychopathology

• Genetics: Predisposition is inherited, not the disorder itself.
• Brain Pathology: Dysfunction in the brain (hypoactive/hyperactive).
• Neuropathology (neurons): Nervous system comprises nerve cells.
• Gray Matter: Aggregation of unmyelinated nerve cells.
• White Matter: Aggregation of myelinated nerve cells (myelin sheath = white).
• Disturbance in function; not functioning normally.

Disorders Viewed from Neuropathology

• Intermittent disorder: Highly aggressive person with low serotonin and high dopamine.
• Highly anxious individual: Low GABA system, high norepinephrine.
• Schizophrenia: Less gray matter than normal.

Pathophysiology

• OCD: Difficulty in controlling urges (impulse control).
• Overactivity/Hyperactivity: Kleptomania, depression, ruminating events.

Amygdala

• Regulates emotional and motivational behavior, part of limbic system/basal ganglia.

Limbic System

• Regulates motivating and emotional behavior, part of basal ganglia.

Basal Ganglia

• Part of the limbic system, subcortical grey matter; coordinates movements.

Dysregulated Basal Ganglia

• Results in dysregulated pleasure principle, behaving like an animal.

Prefrontal Cortex

• Is a place where EGO and SUPEREGO are located.

Gamma-Aminobutyric Acid (GABA)

• Most prevalent inhibitory neurotransmitter, prevents transmission of neurons.

EGO

• Has executive functions like planning, organizing, decision making. Adheres to the reality principle.

SUPEREGO

• Uses inhibitory neurons, secretes GABA to inhibit ID, guided by reason.

Neurotransmitters Imbalances

• Either an excess or deficiency of certain neurotransmitters, which affects mood, cognition, and behavior.

Neurotransmitters

• Released at the synaptic gap and responsible for transmission of nerve impulses. Can be excitatory or inhibitory.
• Prevent the next neuron to fire an impulse; it will not stimulate the postsynaptic neuron. Hyperpolarization becomes negative.

Highly Anxious Individual

• Low GABA, high norepinephrine.

Depression

• Low serotonin.
• Drug: Will be antidepressants and raise the level of serotonin.

General Anxiety Disorder (GAD)

• Client is always apprehensive, and it prescribes the drug that lower norepinephrine and/or drug that will boost GABA.

Valium

• Tranquilizer can be prescribed to someone who is very anxious and is a GABA booster.

Antagonist Drugs

• Block/inhibit the effect of a naturally occurring substance or another drug by occupying the receptor site. Agonist: enhance/mimic effect.

Biology and Psychology

• There is nothing psychological that is not biological because we are biopsychosocial beings.
• Behavior: Any reaction or response to stimulus; it can be normal or abnormal.
• Survival needs include biological and psychological aspects, such as basic needs, relationships, and personal growth.
• What enables you to respond to stimulus is the biological system and brain.

Biological Deprivation

• Deprived of basic needs (essential for survival).

Toxic Chemicals

• Lead and mercury can affect the brain.

Brain Injury

• Damage can lead to amnesia. The hippocampus and Amygdala are responsible for memories.

Anterograde Amnesia

• Very forgetful, stuck in short-term memory, unable to form new memories.

Short-Term Memory (STM)

• Immediate, temporary memory; holds information for a brief period.

Long-Term Memory (LTM)

• System for storing information for extended periods.

Hippocampus

• Crucial for forming new long-term memories and plays a vital role in spatial/episodic memories.

Consolidate

• Process of transferring information from STM to LTM.

Body Constitution

• Biological makeup of the individual.

Psychological Determinants of Psychopathology

• Frustration: Due to personal or environmental factors.
• Stress: Chronic stress (long term).
• Conflict: Something an individual cannot get or have both.

Double Approach Conflict (Approach-Approach)

• Moving towards two desirable choices, but needing to choose only one.

Double Avoidance Conflict

• Both are undesirable, two evils

Approach-Avoidance Conflict

• Positive goal, negative consequences.

Psychological Deprivation

• Something is missing and lacking, leading to Attention-getting behavior.

Dissociative Identity Disorder (DID)

• Also known as multiple personality disorder (very common if they experienced abuse during childhood).

Excessive Use of Defense Mechanisms

• Unconscious in nature and used to protect the integrity of the ego; softens the impact of failure.
• If ego is threatening, defense mechanism must be used in moderation otherwise it becomes symptoms of psychopathology

Rationalization

• Attempts to justify actions or feelings with seemingly logical explanations.

Denial

• Involves ignoring painful realities, which is a symptom of conversion disorders if used excessively.

Conversion Disorder

• Functional Neurological Disorder.

Regression

• A mental defensive maneuver to escape and forget frustration.
• Example: hypersomnia (defensive maneuver).

Reaction Formation

• Repression is involuntary forgetting, and the attitude that is assumed opposes behavior.

Hypersomnia

• Always sleeping as a means of defensive maneuver.

Sociocultural Determinants

• The determinants are the impacts of War, Unemployment, Poverty, Pandemic, rural/urban area, and residential mobility.

Various Viewpoints of Psychopathology

• Biological, psychological (psychodynamic, cognitive, behavioral), and sociocultural perspectives.

Biological Perspective

• Neurotransmitter and hormone imbalances, genetic vulnerabilities, other defects or pathologies.

Amygdala

• Regulates motivational/emotional behavior (part of limbic system); fear network/emotional memory.
• If hyperactivated there are always memories.

Generalized Anxiety Disorder (GAD)

• May be a neurotransmitter imbalance (GABA not functioning).

Prefrontal Cortex

• Has inhibitory neurons that sends inhibitory signals to the limbic system controlled emotions (within what is acceptable).

Psychological Perspective

• Psychodynamic/ego; unconscious needs/conflicts.

Cognitive Perspective

• Thoughts, ideas, and perceptions.

Pessimistic

• Several cognitive distortions (magnification, selective abstraction).

Behavioral Perspective

• Abnormal behavior is learned, acquired, and reinforced (extrapsychic).

Handling a Case

• Rule out organicity (biological causes).

Typical Signs and Symptoms of Psychopathology

• Signs: Objective, from the examination.
• Symptoms: Subjective, listed by the patient.
• Syndrome: Group of signs and symptoms occurring together.

Consciousness

• State of awareness.

Disturbances of Consciousness

• Apperception: Perception modified by a person's own emotions and thoughts
• Sensorium: State of cognitive functioning; synonym of consciousness

Disturbances of Attention

• Attention is the ability to concentrate.
• Distractibility, Selective inattention, Hypervigilance.

Emotions

• Affect (Outward manifestation of emotion): Appropriate, Inappropriate, Blunted, Flat, Labile.
• Mood (Prolonged emotional state influencing emotion): Dysphoric, Euthymic.

Irritable Mood

• Feelings of frustration and annoyance.

Labile Mood

• Rapid, unpredictable changes between different emotional states.

Elevated Mood

• Excessively positive emotional state.

Euphoria

• Intense feeling of happiness or excitement.

Ecstasy

• Extreme form of euphoria.

Other Emotions

• Anxiety, fear, agitation, tension, panic, apathy, ambivalence.

Physiological Disturbances Associated Mood

• Anorexia, hyperphagia, insomnia, hypersomnia, diminished libido, constipation.

Memory Disturbances

• Amnesia is a partial or total inability to recall past experiences.
• Organic Amnesia is a amnesia due to physical factors.

Definitions of Subtypes of Amnesia

• Anterograde Amnesia is the loss of memory of events after the onset of amnesia.
• Blackout is a alcohol-related amnesia, often with reversible brain damage.
• Retrograde Amnesia is a loss of memory for events preceding the onset of amnesia. Psychogenic Amnesia is a amnesia due to emotional or psychological factors.

Paramnesia

• The disturbance of memory including confusion between reality and fantasy, involving distortions of recall and recognition.

Specific Types of Recall

• Types are Retrospective falsification, the confabulation, the false memory, the screen, and lethologica.

Distortions of Recognition

• FAUSSE RECONNAISSANCE: false recognition, déjà vu, jamais vu.

Hypermnesia and Additional Terms

• Hypermnesia is the exaggerated degree of retention and recall.
• Also defined is Flashbulb memory, flash back and Eidetic image.

Motor Behavior (Conation)

• The physical actions and movements, involving the initiation and execution of purposeful actions influenced by motivation and intention.

The Disruptions

• Disorganized/Abnormal Motor Behavior is a unusual activity, child-like behaviors, repeated purposeless movements, odd facial expressions and gestures.

Some Types of Symptoms

• Terms defined are Echopraxia, Catatonia, Catalepsy, catatonic rigidity, catatonic excitement, and more... Negativism, cataplexy, and so on...

Definition of Abnormality terms

• Includes stereotypy, command automatism, mutism, overactivity, psychomotor agitation,
• Terms as Sleepwalking (Somnambulism): Motor activity during sleep.

Continuation of Other Term Deviations

• Akinesia is lack of physical movement.
• Also includes twirling and acting out.

Descriptions of Terms like Aphasia or Apraxia

• Amnimia and coprophagia, dyskinesia, chorea, dystonia, and other abnormalities
• The types of Aphasia and Dysphasia (aphasia is loss of speech.)

Perception and Related Hallucinations

• Perception is the interpretation of sensory stimuli involving sight, sound, touch, taste, and smell. Can be distorted in psychopathology

Visuals of Related Content

• Includes micropsia is to be small whereas hallucinations are often in mood-congruent ways.

Hallucinations

• Hallucination content consistent.
• Mood-Incongruent: Hallucination content not consistent with mood. * Hallucinosis: Presence of hallucinations without a clear cause like psychosis or medical condition.

Illusions

• Illusions is a misinterpretations of real sensory stimuli.

Derealization

• Derealization: Feeling like the world is distant, foggy, or dreamlike; objects may appear distorted; sounds may seem muffled; feelings of unfamiliarity; altered time perception

Disturbances in Thinking Process

• Disturbance in thinking defined as a goal directed thought leading to an oriented conclusion but is deviated by abnormal thoughts.

Disturbances in the Form of Thought

• Terms describe Neologism, word salad, circumstantiality, and perseveration.

Disturbances in the Content of Thought

• Terms describe poverty of thoughts, delusions and overvalued ideas.
• Content Includes Bizarre delusions, mood related delusions.

Descriptions of Delusions, Reference and Control

• Terms are delusions of control, thought being controlled or stolen or broadcasted.
• Belief that neutral events have personal significance of one's actions.

Obsessive and Compulsive Thinking

• Terms include obsession, phobias and compulsions.

Thinking

• Logorrhea describes excessive talking as well as rapid or slow formation of ideas.

Terms used when describing others speech

• Stuttering is speech interruption as well as Tangentiality and logorrhea.

Disturbances in Verbal Behaviors

• Terms describe Echolalia, Agraphia, Glossorhea, Echolalia and Verbigeration. Terms include Agrammatism and Paragrammatism.
• Receptive and Expressive aphasias are also defined.