Abnormal Psychology Disorders Handout PDF

Prepared by: Pevi Mariz F. De Ocampo i. Historical Context ii. Integrative Approach to Psychopathology iii. Clinical Assessment and Diagnosis iv. Research Methods v. Trauma, Anxiety, Obsessive-Compulsive and Related Disorders vi. Somatic Symptoms and Dissociative Disorders...

Prepared by: Pevi Mariz F. De Ocampo i. Historical Context ii. Integrative Approach to Psychopathology iii. Clinical Assessment and Diagnosis iv. Research Methods v. Trauma, Anxiety, Obsessive-Compulsive and Related Disorders vi. Somatic Symptoms and Dissociative Disorders vii. Mood Disorders and Suicide viii. Schizophrenia and other Psychotic Disorders ix. Personality Disorders x. Substance Use Disorders xi. Disorders of Childhood, Disruptive and Impulse Control Disorder xii. Eating Disorders and Obesity xiii. Sexual Dysfunctions, Gender Dysphoria, and Paraphilic Disorders xiv. Neurocognitive Disorders xv. Psychological Treatment xvi. Societal and Legal Issues  Dr. Temple Grandin, professor of animal sciences at Colorado State University, has designed one-third of the livestock-handling facilities in the United States. She has published dozens of scientific papers and gives lectures throughout the world. Some of her lectures describe her new equipment and procedures for safer and more humane animal handling. As a baby, she had no desire to be held by her mother, though she was calm if left alone. As a young child, she seldom made eye contact with others and seemed to lack interest in people. She frequently threw wild tantrums. If left alone, she rocked back and forth or spun around repeatedly. She could sit for hours on the beach, watching sand dribble through her fingers, in a trancelike state. At age 2, she still had not begun talking and was labeled “brain- damaged” because doctors at that time did not know about autism spectrum disorder. Fortunately, Grandin’s mother was determined to find good teachers, learn ways to calm her daughter, and encourage her to speak and engage with others.  Grandin did learn to speak by the time she entered elementary school, although most of her social interaction deficits remained. When she was 12, Grandin scored 137 on an IQ test (which falls in the very superior range) but still was thrown out of a regular school because she didn’t fit in. She persisted, however, and eventually went to college, where she earned a degree in psychology, and then to graduate school, where she earned a PhD in animal sciences. Grandin has been able to thrive in her career and personal life. Still, she finds it very difficult to understand emotions and social relationships. She does not “read” other people well and often finds herself offending others or being stared at because of her social awkwardness. NEUROLOGICAL DISORDERS: o Neurodevelopmental disorders typically arise first in childhood o Neurocognitive disorders typically arise in older age NEURODEVELOPMENTAL DISORDERS: o Autism Spectrum Disorder o Attention-Deficit/Hyperactivity Disorder o Intellectual Disability o Learning, Communication, and Motor disorders NEUROCOGNITIVE DISORDERS: o Major and mild neurocognitive disorders o Delirium Autism spectrum disorder (ASD) involves impairment in two fundamental behavior domains: o deficits in social interactions and communications o restricted, repetitive patterns of behaviors, interests, and activities DSM-IV TR: Pervasive Developmental Disorders (PDDs) o Autism had an onset before age o Asperger’s Disorder: considered a high-functioning form of autism; often involving deficits in social interactions and restricted, repetitive behavior but no significant communication deficits. In the DSM-5, the PDD category has been dropped, and there is only one autism spectrum disorder Because the disorder presents differently depending on symptom severity, developmental level (e.g., IQ), and age, DSM-5 uses the term “spectrum” to capture the range of related but varied presentations. Several initial studies captured only about 50 to 60 percent of children who previously would have been diagnosed with Asperger’s disorder. Reciprocal Adoration: Compared to normally developing children, infants with autism spectrum disorder may not smile and coo in response to their caregivers or initiate play with their caregiver. Delayed Language Development: Approximately 50 percent of children with autism spectrum disorder do not develop useful speech. Those who do develop language may not use it as other children do. Echolalia: rather than generating their own words, they simply echoed what they hear. When trying to generate own words or sentences, language is one-sided and lacked social reciprocity. Self-stimulatory behaviors: Some children perform stereotyped and repetitive behaviors using some part of their body, such as incessantly flapping their hands or banging their head against a wall. Routines and Rituals: When any aspect of their daily routine is changed, they may become excessively frightened and highly distressed. Lack of symbolic play: Rather than engaging in symbolic play with toys, they may be preoccupied with one feature of a toy or an object. For the diagnosis of autism spectrum disorder, symptoms must have their onset in early childhood. Some children with autism spectrum disorder, such as the ability to play music without having been taught or to draw extremely well, or exceptional memory and mathematical calculation abilities. These persons sometimes are referred to as savants. However, such cases are quite rare (Bölte & Poustka, 2004) Approximately 30 percent of children with autism spectrum disorder develop seizure disorders by adolescence, suggesting a severe neurological dysfunction (Fombonne, 1999). When children with autism spectrum disorder are doing tasks that require perception of facial expressions, joint attention with another person, empathy, or thinking about social situations, they show abnormal functioning in areas of the brain that are recruited for such tasks. A major focus of socialization is helping children learn to pay attention, control their impulses, and organize their behaviors so that they can accomplish long-term goals. Developmental milestones for middle and late childhood? o The combined presentation requires six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity. o The predominantly inattentive presentation is diagnosed if six or more symptoms of inattention but less than six symptoms of hyperactivity-impulsivity are present. o The predominantly hyperactive/impulsive presentation is diagnosed if six or more symptoms of hyperactivity/impulsivity but less than six symptoms of inattention are present. o By definition, ADHD begins in childhood o In the DSM-5 is that the age limit for the onset of symptoms was raised from 7 years to 12 years o ADHD children with the combined presentation are more likely to have behaviors worsen over the course of development, and become severe enough to be diagnosed as a conduct disorder Abnormal activity has been seen in several areas, including the prefrontal cortex, which is key to the control of cognition, motivation, and behavior. Striatum: which is involved in working memory and planning Cerebellum: which is involved in motor behaviors. The cerebral cortex is smaller in volume in children, and there is less connectivity between frontal areas of the cortex and areas of the brain that influence motor behavior, memory and attention, and emotional reactions Prepared by: Pevi Mariz F. De Ocampo NEURODEVELOPMENTAL DISORDERS: o Autism Spectrum Disorder o Attention-Deficit/Hyperactivity Disorder o Intellectual Disability o Learning, Communication, and Motor disorders NEUROCOGNITIVE DISORDERS: o Major and mild neurocognitive disorders o Delirium Intellectual disability (ID) o also known as intellectual developmental disorder o formerly referred to as mental retardation o significant deficits in: Intellectual Functioning: Life Functioning: o abstract thinking, o Conceptual domain reasoning, learning problem o Social domain solving, & planning o Practical domain MILD LEVEL OF INTELLECTUAL DISABILITY: Individuals with mild intellectual disability have IQ scores ranging from 50–55 to approximately 70 and constitute by far the largest number of those diagnosed with this condition. Educational context: considered educable, and their intellectual levels as adults are comparable to those of average 8- to 11-yearold children. Statements such as the latter, however, should not be taken too literally. Social context: approximates that of adolescents but tend to lack normal adolescents’ imagination, inventiveness, and judgment. Ordinarily, they do not show signs of brain pathology or other physical anomalies, but often they require some measure of supervision because of their limited abilities to foresee the consequences of their actions. MODERATE LEVEL OF INTELLECTUAL DISABILITY: IQ scores ranging between 35–40 and 50–55 and, even in adulthood, attain intellectual levels similar to those of average 4- to 7-year-old children. Educational context: some can be taught to read and write a little and may manage to achieve a fair command of spoken language, their rate of learning is slow, and their level of conceptualizing is extremely limited. Social context: can achieve partial independence in daily self-care, acceptable behavior, and economic sustenance in a family or other sheltered environment. SEVERE LEVEL OF INTELLECTUAL DISABILITY: IQ scores ranging from 20–25 to 35–40 and commonly suffer from impaired speech development, sensory defects, and motor handicaps. Educational & social context: can develop limited levels of personal hygiene and selfh-elp skills, which somewhat lessen their dependency, but they are always dependent on others for care. However, many profit to some extent from training and can perform simple occupational tasks under supervision PROFOUND LEVEL OF INTELLECTUAL DISABILITY: Have IQ scores below 20–25 and are severely deficient in adaptive behavior and unable to master any but the simplest tasks. Useful speech, if it develops at all, is rudimentary. Educational & social context: must remain in custodial care all their lives and can usually be readily diagnosed in infancy because of the presence of obvious physical malformations or grossly delayed development. Have severe physical deformities, CNS pathology, and retarded growth are typical; convulsive seizures, mutism, deafness, and other physical anomalies. ENURESIS: the habitual involuntary discharge of urine, usually at night, after the age of expected continence (age 5). Bed-wetting that is not organically caused. o Primary functional enuresis: have never been continent o Secondary functional enuresis: have been continent for at least a year but have regressed. ENCOPRESIS: a symptom disorder of children who have not learned appropriate toileting for bowel movements after age 4. o About one-third of children with encopresis were also enuretic o Six times more boys than girls in the sample. Prepared by: Pevi Mariz F. De Ocampo NEURODEVELOPMENTAL DISORDERS: o Autism Spectrum Disorder o Attention-Deficit/Hyperactivity Disorder o Intellectual Disability o Learning, Communication, and Motor disorders NEUROCOGNITIVE DISORDERS: o Major and mild neurocognitive disorders o Delirium Major neurocognitive disorder is more commonly known as dementia when referring to older adults with degenerative disorders like Alzheimer’s disease Alzheimer’s disease: o a progressive and fatal neurodegenerative disorder o show clear evidence of a decline in learning and memory o begins with mild memory loss, but as the disease progresses the memory loss and disorientation quickly become profound In Alzheimer’s disease, neurons in the brain secrete a sticky protein substance called beta-amyloid much faster than it can be broken down and cleared away. This beta amyloid then accumulates into amyloid plaques  Neurofibrillary tangles are webs of abnormal filaments within a nerve cell. These filaments are made up of another protein called tau. In a normal, healthy brain, tau acts like scaffolding, supporting a tube inside neurons and allowing them to conduct nerve impulses. In Alzheimer’s disease the tau is misshaped and tangled. This causes the neuron tube to collapse. Parkinson’s disease: o characterized by motor symptoms such as resting tremors or rigid movements o underlying cause of this is loss of dopamine neurons in an area of the brain called the substantia o can involve psychological symptoms such as depression, anxiety, apathy, cognitive problems, and even hallucinations and delusions Huntington’s disease: o rare degenerative disorder of the central nervous system that afflicts about 1 in every 10,000 people o characterized by a chronic, progressive chorea (involuntary and irregular movements that flow randomly from one area of the body to another) o caused by a single dominant gene: Huntingtin gene on chromosome 4. o because the Huntingtin gene is a dominant gene, anyone who has a parent with the disease has a 50 percent chance of developing the disease Major neurocognitive disorder is characterized by a decline in cognitive functioning severe enough to interfere with daily living. o APHASIA: deterioration of language; difficulty producing the names of objects or people o APRAXIA: impairment of the ability to execute common actions such as waving good-bye or putting on a shirt o AGNOSIA: failure to recognize objects or people. People with major NCD may not be able to identify common objects, such as chairs or table DELIRIUM: characterized by disorientation, recent memory loss, and a clouding of attention; difficulty focusing, sustaining, or shifting attention. These signs arise suddenly, within several hours or days. SUNDOWNING: symptoms becoming worse at night o Early phase may include mild symptoms such as fatigue, decreased concentration, irritability, restlessness, or depression. o May involve mild cognitive impairments or perceptual disturbances, or even visual hallucinations. o As the delirium worsens, the person’s orientation becomes disrupted. “A patient may think she is in her childhood home instead of in the hospital.” What are the distinguishing factor/s between Delirium and other Neurocognitive disorders? Prepared by: Pevi Mariz F. De Ocampo EATING DISORDERS: o Anorexia Nervosa Restricting Type o Anorexia Nervosa Binge/Purge Type o Bulimia Nervosa o Binge-eating disorder ANOREXIA NERVOSA literally means “lack of appetite induced by nervousness.” o This definition is something of a misnomer, however, as a lack of appetite is neither the core difficulty nor necessarily even true. o At the heart of anorexia nervosa is a pursuit of thinness that is relentless and that involves behaviors that result in a significantly low body weight. Change from DSM-IV to DSM-5: Amenorrhea (cessation of menstruation) is no longer required for a person to be given the diagnosis. o People with the restricting type of anorexia nervosa simply refuse to eat and/or engage in excessive exercise as a way of preventing weight gain. o People with binge/purge type of anorexia nervosa periodically engage in binge eating or purging behaviors Many patients with anorexia nervosa deny having any problem. They may come to feel fulfilled by their weight loss. People with binge/purge type Anorexia Nervosa continue to be substantially below a healthy body weight, whereas people with bulimia nervosa typically are at normal weight or somewhat overweight. o Binge/purge type of anorexia nervosa does not engage in binges in which large amounts of food are eaten o Even small food consumption may feel binged and will be purged People with binge-eating disorder often are significantly overweight and say they are disgusted with their body and ashamed of their bingeing (Stunkard, 2011; Wonderlich et al., 2009). Binge-eating disorder resembles bulimia nervosa, except that a person with binge-eating disorder does not regularly engage in purging, fasting, or excessive exercise to compensate for binges o Atypical anorexia nervosa: all the criteria for anorexia nervosa are met, except that despite significant weight loss, the individual’s weight is within or above the normal range. o Bulimia nervosa of low frequency and/or limited duration: meeting all of the criteria for bulimia nervosa BUT binge eating and inappropriate compensatory behaviors is only less than once a week and/or for less than 3 months Prepared by: Pevi Mariz F. De Ocampo i. Historical Context ii. Integrative Approach to Psychopathology iii. Clinical Assessment and Diagnosis iv. Research Methods v. Trauma, Anxiety, Obsessive-Compulsive and Related Disorders vi. Somatic Symptoms and Dissociative Disorders vii. Mood Disorders and Suicide viii. Schizophrenia and other Psychotic Disorders ix. Personality Disorders x. Substance Use Disorders xi. Disorders of Childhood, Disruptive and Impulse Control Disorder xii. Eating Disorders and Obesity xiii. Neurocognitive Disorders xiv. Sexual Dysfunctions, Gender Dysphoria, and Paraphilic Disorders xv. Psychological Treatment xvi. Societal and Legal Issues oSexual dysfunctions in males and females oGender dysphoria oParaphilic disorders Sexual Dysfunction: impairment either in the desire for sexual gratification or in the ability to achieve it which varies markedly in degree. Sexual dysfunctions are grouped according to Desire and arousal and Orgasm and sexual pain. Sexual dysfunction are categorized according to the normal sexual arousal cycle: 1. The desire phase consists of fantasies about sexual activity or a sense of desire to have sexual activity. 2. The arousal phase is characterized both by a subjective sense of sexual pleasure and by physiological changes that accompany this subjective pleasure, including penile erection in the male and vaginal lubrication and clitoral enlargement in the female. Sexual dysfunction are categorized according to the normal sexual arousal cycle: 3. Orgasm is the third phase, during which there is a release of sexual tension and a peaking of sexual pleasure 4. The final phase is resolution, during which the person has a sense of relaxation and well-being. People vary greatly in the sexual activities they find arousing. PARAPHILIAS o Greek for “besides” + “love” o Atypical sexual preferences have been called paraphilias o Divided into those that involve: o consent of others and nonconsenting others o involve contact with others and no contact with others A paraphilic disorder is a paraphilia that is currently causing the individual significant distress or impairment, or entails personal harm or risk of harm to others. Prepared by: Pevi Mariz F. De Ocampo