PSYC 105 Introductory Psychology II Disorders PDF

PSYC 105 Introductory Psychology II CHAPTER 15: PSYCHOLOGICAL DISORDERS Lectures What is a Mental Disorder, History of Mental Disorders, and the DSM-5-TR (Nov 18) Anxiety-Related Disorders (Nov 20) Depression (Nov 22) Bipolar Disorders and Schizophrenia (Nov 25) Personality Disorders, Dissociative...

PSYC 105 Introductory Psychology II CHAPTER 15: PSYCHOLOGICAL DISORDERS Lectures What is a Mental Disorder, History of Mental Disorders, and the DSM-5-TR (Nov 18) Anxiety-Related Disorders (Nov 20) Depression (Nov 22) Bipolar Disorders and Schizophrenia (Nov 25) Personality Disorders, Dissociative Disorders, and Childhood Disorders (Nov 27)  Defining Mental Disorders Statistical rarity Subjective distress Impairment Societal/cultural disapproval Biological dysfunction  History of Mental Disorders Demonic Model Mental disorders are due to evil spirits Demons, exorcisms, witches, moon and stars Trephining  History of Mental Disorders Medical Model Mental disorders are due to physical health issues Asylums Blood-letting Moral Treatment  History of Mental Disorders Modern Era Deinstitutionalization Community-based resources  Diagnosing Why do we diagnose? To improve communication between professionals and disciplines To give the client a term for what they are experiencing To choose the best treatments To aid research  Misconceptions about Diagnosing Diagnosing is just putting people into “boxes” Argued that psychologists believe that all people with a diagnosis are the same Diagnoses are unreliable Argued that no two psychologists ever agree on the same diagnosis  Misconceptions about Diagnosing Diagnoses are invalid Argued that diagnosing doesn’t tell us anything useful Diagnoses stigmatize people Argued that that labels are self-fulfilling prophecies, and influence how others treat them Rosehan’s (1973) pseudopatient study  The DSM-5-TR Diagnostic and Statistical Manual of Mental Disorders Diagnostic criteria Set of symptoms, such that a client must have X number of possible symptoms, within Y amount of time Symptoms must not be due to medical conditions or substances  The DSM-5-TR Other features Prevalence Atheoretical biopsychosocial approach How development and culture may affect disorders  The DSM-5-TR Criticisms Comorbidity between disorders Categorical approach vs dimensional approach  Anxiety-Related Disorders Typical onset is from teenage years to early adulthood Somatic disorders (which feature anxiety): Somatic symptom disorder Intense anxiety regarding physical symptoms Illness anxiety disorder Intense anxiety regarding physical symptoms that cannot be found by medical professionals  Generalized Anxiety Disorder Excessive and uncontrollable worry Worries about numerous minor topics Experiences muscle tension, irritability, difficulties sleeping, and difficulties with concentration  Panic Disorder Repeated, unexpected, panic attacks that cause the individual to change their behaviour or that the individual persistently worries about 20-25% of university students experience at least one panic attack in the past year  Agoraphobia Avoidance of, or intense distress in, locations where escape may be difficult or embarrassing, or help would be unavailable, if panic attack-like symptoms began ◦ Public transit ◦ Open spaces ◦ Enclosed places ◦ Outside of the home alone ◦ Lines or crowds  Social Anxiety Disorder Afraid of the evaluation of others and believe they lack the same social skills as other people Avoid social situations or endure them with intense distress  Specific Phobias Significant and recurrent fear or anxiety of specific objects or situations Animals, insects, storms, water, elevators, darkness, clowns, etc.  Posttraumatic Stress Disorder Exposure to actual or threatened death, serious injury, or sexual violence Many symptoms: ◦ Intense distress when reminded about event ◦ Attempts to avoid or supress memories ◦ Anhedonia ◦ Exaggerated startle response  Obsessive-Compulsive Disorder Obsessions ◦ Recurrent & persistent thoughts, images, or urges that are considered intrusive & unwanted Compulsions ◦ Repetitive behaviours or mental acts that are done in response to an obsession, but are unable to realistically prevent distress or feared future event  Psychological Factors in Anxiety-Related Disorders Classical conditioning ◦ Neutral stimulus becomes a conditioned stimulus, which causes fear and anxiety (Little Albert and the white rat) Operant conditioning ◦ Negative reinforcement of avoidance/escape response Observational learning ◦ Learning from watching others  Psychological Factors in Anxiety-Related Disorders Information/Misinformation ◦ Being told something, which encourages anxious behaviours Catastrophizing ◦ Assuming the worst outcome will occur Anxiety sensitivity ◦ Awareness of internal sensations and fear of fear  Psychological Factors in Anxiety-Related Disorders Intolerance of uncertainty ◦ Fear of the unknown future Metacognitions ◦ Beliefs and worries about our own thought patterns  Biological Factors in Anxiety-Related Disorders Twin studies show small to moderate genetic contributions for all anxiety disorders Low levels of serotonin and GABA Evolutionarily prepared learning Neuroticism is elevated in most anxiety disorders, especially GAD  Mood Disorders Most commonly associated with feeling down (depression), but also with excessively elevated/expansive mood (mania) Major Depressive Bipolar I Disorder Disruptive Mood Disorder Dysregulation Disorder Persistent Depressive Bipolar II Disorder Premenstrual Disorder (Dysthymia) Dysphoric Disorder Seasonal Affective Cyclothymic Disorder Disorder  Major Depressive Disorder Significantly depressed mood or anhedonia Significant change in weight/appetite, insomnia or hypersomnia, worthlessness, thoughts of suicide Most often it features recurrent episodes  Psychological Factors in Major Depression Life events model ◦ Stressful life events trigger depression ◦ Loss of a significant relationship Behavioural model ◦ Lack of positive reinforcement ◦ Continued withdrawal and deterioration in social skills  Psychological Factors in Major Depression Interpersonal model ◦ Depressed individuals seek excessive reassurance and talk pessimistically, which drives others away ◦ Coyne (1976) – Talking to depressed people study  Psychological Factors in Major Depression Learned helplessness model (Seligman) ◦ Dog is blocked from escaping shocks ◦ Taken to new room, where escape is possible ◦ Does not learn to escape shocks ◦ In humans?  Psychological Factors in Major Depression Cognitive model (Beck) ◦ Cognitive triad ◦ Negative schemas/cognitive distortions Depressive realism  Biological Factors in Major Depression Genetic contribution, but role of specific genes is still debated Serotonin, norepinephrine, and dopamine all involved Neuroticism especially high  Bipolar Disorders Mania/hypomania ◦ Significantly elevated, expansive, or irritable mood ◦ Grandiosity, increased goal directed activity, decreased need for sleep, engagement in risky activities  Bipolar Disorders Bipolar I Disorder ◦ Have experienced a manic episode Bipolar II Disorder ◦ Have experienced a hypomanic episode, as well as major depression  Factors in Bipolar Disorders Biological factors ◦ Heritability may be as high as 85% ◦ Serotonin and dopamine likely involved ◦ Antidepressant induced mania Psychological factors ◦ Stressful life events ◦ Sleep disruptions Suicide 3rd leading cause of death in children, adolescents, and young adults Also, very high in Indigenous populations and the elderly Women attempt more, but more men die by suicide  Suicide Predictors of attempting suicide ◦ Current planning/ideation ◦ Previous attempts ◦ Hopelessness ◦ Depression ◦ Comorbid substance abuse or other mental disorders ◦ Recent major life stressor  Schizophrenia Positive symptoms ◦Delusions – Strongly held irrational beliefs ◦ Persecutory, grandiose, erotomanic, somatic, etc. ◦Hallucinations – Auditory or visual sensory stimuli that are not real ◦ www.youtube.com/watch?v=0vvU-Ajwbok  Schizophrenia Disorganized symptoms ◦Disorganized speech – Loose associations between ideas ◦Disorganized behaviour – Behaviour that does not fit context ◦Catatonia ◦ Waxy flexibility, echolalia, purposeless activity  Schizophrenia Negative symptoms ◦Apathy – No motivation, even for personal hygiene ◦Flat affect – No emotional responses ◦Asociality – No interest in others ◦Alogia – Very limited speech ◦Anhedonia  Factors in Schizophrenia Schizophrenogenic mothers ◦ Cold, overprotective, rejecting mothers broke the child’s brain Expressed emotion ◦ Family is high in criticism, hostility, and over-involvement ◦ Has both genetic contributions, and may emerge as a result of the stress associated with diagnosis ◦ Differs between cultures  Factors in Schizophrenia Brain abnormalities ◦ Enlarged ventricles ◦ Hypofrontality Marijuana use  Factors in Schizophrenia Neurotransmitters ◦ Original dopamine hypothesis ◦ Excessive stimulation of some dopamine receptors, but lack of stimulation at others Genetics ◦ Family, twin, and adoption studies show significant genetic influences  Factors in Schizophrenia Diathesis-stress model  Personality Disorders Common characteristics ◦ Persistent ways of behaving across situations ◦ Causes enduring emotional distress/impairment Controversies ◦ Distress and impairment may not be apparent to the individual ◦ Lower reliability, questionable validity ◦ High comorbidity rates  Borderline Personality Disorder Preoccupied with fears of abandonment Instability in mood, identity, and relationships Highly impulsive Chronic feelings of emptiness Repeated suicide attempts or self-harm behaviours  Proposed Explanations for Borderline Personality Disorder Psychoanalytic concept of “splitting” Difficulties regulating emotions Neuroticism Childhood sexual abuse  Psychopathic personality Subset of antisocial personality disorder Lack empathy Highly manipulative Charming and engaging Frequently commit crimes  Proposed Explanations for Psychopathic Personality Underarousal hypothesis Fearlessness hypothesis Genetic contribution Childhood physical abuse  Dissociative Disorders Depersonalization/derealization disorder ◦ Multiple episodes of depersonalization or derealization or both Dissociative amnesia ◦ Memory loss following a stressful/traumatic experience Dissociative fugue ◦ Dissociative amnesia, combined with fleeing the area Dissociative Disorders Dissociative identity disorder ◦ Two or more personality states ◦ “Host” and “alters” ◦ Different respiration rates, brain wave activity, eyesight, handedness, voice patterns, etc. ◦ Amnesia between alters has not been supported  Proposed Explanations for Dissociative Identity Disorder Posttraumatic model ◦ Individual compartmentalizes their identity in response to childhood abuse ◦ Abuse histories have not always been supported, and abuse is not specific to DID  Proposed Explanations for Dissociative Identity Disorder Sociocognitive model ◦ Beliefs of, techniques used by, therapists help to create the “alters” ◦ Significant empirical support ◦ Clients rarely report alters before beginning therapy ◦ Techniques like hypnosis can implant false memories ◦ Therapists often encourage clients to name the alters ◦ Number of alters often increases during therapy ◦ Dissociation is associated with daydreaming/fantasizing  Childhood Disorders Autism spectrum disorders ◦ Severe deficits in language, social bonding, and imagination, and intelligence ◦ Repetitive and restrictive behaviours Proposed explanations ◦ Genetics, parental age at conception ◦ MMR vaccine (illusory correlation) ◦ Improved/more liberal diagnostic criteria  Childhood Disorders Attention-deficit/hyperactivity disorder ◦ Restless, emotional outbursts as preschoolers ◦ Refuse to stay seated, do not follow directions, can’t stay focused, and have temper tantrums Proposed explanations ◦ Genetic contribution ◦ Decreased brain volume and frontal lobe activation ◦ Over diagnosed? Example Multiple Choice Mark, Jim, and Eric are all on an elevator and feeling very nervous. Mark is afraid he is going to have a panic attack. Jim is afraid that the elevator is going to get stuck, and they will be trapped. Eric is afraid that Mark and Jim can see how anxious he is. What disorder would Jim be diagnosed with? a. Panic disorder b. Specific phobia c. Social anxiety disorder d. Generalized anxiety disorder Example Multiple Choice Beck’s cognitive triad is defined as negative views of a. The self, world, and future b. The self, friends, and family c. The past, present, and future d. The self, others, and work Example Multiple Choice Which of the following is a disorganized symptom of schizophrenia? a. Anhedonia b. Hallucinations c. Apathy d. Catatonia