Psych Disorders Part 1 PDF

Psych Disorders Part 1 Learning Outcomes Discuss how we define psychopathology/mental illness Discuss a brief history of diagnosing mental illnesses Characterize mood disorders Major Depression, Bipolar Characterize anxiety disorders GAD, Panic Disorder, Phobias, Obses...

Psych Disorders Part 1 Learning Outcomes Discuss how we define psychopathology/mental illness Discuss a brief history of diagnosing mental illnesses Characterize mood disorders Major Depression, Bipolar Characterize anxiety disorders GAD, Panic Disorder, Phobias, Obsessive- Compulsive Disorder, PTSD Psychopathology Statistics  1 in 4 Americans over 18 has a diagnosable disorder in a given year  Nearly 50% of Americans will have some form of disorder at some point in their life  Depressive disorder, ADHD, anxiety, substance-related or addiction-related most common  Only 7% of U.S. severely affected  People often believe the mentally ill are dangerous, but people with mental illnesses are 10x more likely to be victims Mental Illnesses are often VERY misunderstood Media portrayals promote stigmas and stereotypes  The History of Psychological Disorders  The earliest views of psychopathology explained these disorders as the result of possession from demons or evil spirits  “treatments” included exorcism, bloodletting, and potions  In 1700s used mental institutions (asylums) where people were often starved, beat, and isolated  Currently,we view psychopathology as health problems that require treatment Psychopathology  Psychopathology is a mental illness  How do we define what a ‘mental illness’ is? 1. Abnormality 2. Social deviance 3. Significant, subjective distress 4. Impairment  Defining Mental Illness  1) Abnormality: e.g., statistical rarity  However, are all statistical rarities a disorder? Defining Mental Illness  2) Social deviance: Deviating from expected social norms  However…  Not all socially deviant behavior is disordered  Can be a product of the times  E.g., “female hysteria”  Drapetomania was a supposed mental illness in the 1850s centered around promoting slavery  Defining Mental Illness  3) Significant, subjective distress  “I felt the need to clean my room at home every Sunday and would spend four to five hours at it. I would take every book out of the bookcase, dust and put it back. At the time I loved doing it. Then I didn’t want to do it anymore, but I couldn’t stop. The clothes in my closet hung exactly two fingers apart…. I made a ritual of touching the wall in my bedroom before I went out because something bad would happen if I didn’t do it the right way. I had a constant anxiety about it as a kid, and it made me think for the first time that I might be nuts.”  From an individual with OCD  Not all disorders cause distress (e.g., manic phase of bipolar)  Defining Mental Illness  Someforms of distress and disability are the expected response to an event  E.g., grief over the death of a loved one  This would not be classified as a disorder unless it persists  Defining Mental Illness  4) Impairment  Dysfunction- Interference with one’s ability to function in everyday life  Same issue may not be impairing for different people E.g., fear of heights vs fear of ocean Biopsychosocial Model Biological Factors Genes, Health Social Psychologic Factors al Factors Family life, Self-esteem, Peers coping skills  Diathesis-Stress Model  Disorders usually develop when an underlying biological vulnerability is coupled with a stressful circumstance  The more stressful your life is… the more likely you will develop a psychological disorder Disorder Categories  APA publishes Diagnostic and Statistical Manual of Mental Disorders.  Currently on the 5th edition, and is updated frequently Classifyingmental illnesses is NOT easy  Disorders described by observable symptoms DSM  The DSM gives information about: The typical age of onset Predisposing factors Course of the disorder Prevalence of the disorder Sex ratio of those affected Culturalissues that might affect diagnosis Symptoms  DSM Approaches  2 approaches to diagnoses: 1. Categorical approach – either the person has the disorder or they do not No wiggle room, no ability to capture differences in severity of disorder 2. Dimensional approach – view the disorders on a continuum People vary in degree of disorder Symptoms can be present in ‘normal’ and ‘ill’ people… what matters is the severity and impact of the symptom DSM is not without criticisms…  Some critics argue the DSM uses an outdated categorical approach  Some critics argue the DSM promotes overdiagnosis  Some critics argue that high comorbidities may indicate inaccurate diagnoses  Diagnoses are not objective, and are products of the time (including prejudices) But DSM supporters say…  Ifused correctly and is empirically validated, the DSM can be a reliable and useful tool for diagnosis  As viewpoints on disorders change, so does the DSM  Becoming more dimensional, including new diagnoses, updating diagnoses, etc.  Disclaimer!! There are more disorders in the DSM than we will discuss in this class These disorders are much more nuanced than our discussions in this class Mood Disorders  Moods are subtle, long-lasting states… so mood disorders occur when our long-lasting and normally subtle states are disrupted  Affect about 20% of the population  Major Depression  Bipolar Disorder  Major Depressive Disorder (MDD)  Defined: chronic or recurrent major depressive episodes  Major depressive episodes- state of lingering depressed mood and/or diminished interest in pleasurable activities (anhedonia), along with symptoms such as weight changes and sleep difficulties Episodes typically last 6 months-1 year Experience average of 5-6 episodes over lifetime  Affects ~16% of Americans 2x as common in women Most common in 30’s   Explanations for MDD  Complex interplay of biological, social, and psychological influences  Life events can set the stage for depression  Social support can decrease as depressive symptoms increase  Self-Sustaining Cycle  The activities that can help you get out of depression are extremely hard to do when suffering from depression Bipolar Disorder (Not abbreviated BPD!)  Defined: mood disorder marked by a history of at least one manic episode A period of abnormally & persistently elevated, expansive, or irritable mood  Other possible symptoms Less need of sleep Inflated self-esteem Grandiose plans/ideas Excessive involvement in pleasurable activities  Bipolar Disorder  Bipolar is characterized as alternating between depression and mania  Depression usually precedes or immediately follows manic episodes  Equally as common in men & women Explanations and Facts for Bipolar Disorder  Heavy genetic component  One of the most genetically influenced mental disorders. Twin studies show 60-85% heritability  EXTREMELY difficult to treat  Manic : “Why do I need meds? I’m GREAT!”  Depressed : “Why bother?”  Often first mistaken as depression, and antidepressants may trigger mania Suicide MDD and Bipolar at significantly higher risk for suicide More than 30,000 people die by suicide each year (11th leading cause of death) Ifyou or someone you know is having suicidal thoughts: www.suicidepreventionhotline.org or 1-800-273-8255 (TALK) Suicide  Anxiety Disorders  Anxiety is normal, and often adaptive! In these disorders, anxiety becomes excessive and harmful  Affects about 30% of the population  Generalized Anxiety Disorder (GAD)  Panic Disorder  Phobias  Obsessive-Compulsive Disorder (OCD)  Posttraumatic Stress Disorder (PTSD) Generalized Anxiety Disorder (GAD)  Continual feelings of worry, anxiety, physical tension, and irritability across many areas of life functioning  Spend 60% of time worrying vs 18% of average person  Often develops following a major stressful event  Prone to “self-medication” Usage of drugs and/or alcohol to relieve symptoms  Believed to be the core anxiety disorder which others develop from  Panic Disorder  repeatedpanic attacks, along with persistent concerns of future attacks or changes in personal behavior to avoid attacks  Panic Attacks Intense bouts of fear Sweating, dizziness, light-headedness, racing heartbeat Feelings of unreality, impending death, or going crazy  Panic attacks occur in many disorders Can even occur in absence of any disorder 20-25% of college students will experience one  Phobias  Defined: intense fear of an object or a situation that’s greatly out of proportion to its actual threat  Can be related to animals, objects, or situations E.g., fear of snakes or spiders Or even environments, such as agoraphobia- fear of situations in which escape is difficult Guess That Phobia! Claustrophobia Fear of being closed in and having no escape Pyrophobia Fear of fire Thalassophobia Fear of the ocean or deep, open water Tetraphobia Fear of the number four Ephebiphobia Fear of teenagers Hippopotomonstrosesquippedalioph obia Fear of long words Arachibutyrophobia Fear of getting peanut butter stuck to the roof of your mouth Phobophobia Fear of phobias Phobias  Phobias often target the same things as ordinary fears- the difference is the intensity  Obsessive-Compulsive Disorder (OCD) Obsessions- recurrent and persistent distress-causing thoughts, feelings, or impulses Intrusive thoughts about “unacceptable” topics such as contamination, sex, violence, etc Compulsions- repetitive actions performed to reduce stress, often driven by obsessions  Obsessive-Compulsive Disorder (OCD) compulsions:  Common  Repeatedly checking things (e.g., locks, ovens)  Performing tasks in specific ways  Washing and cleaning repeatedly  Counting  Hoarding  Spend at least an hour every day immersed in obsessions, OCD  One of the more misunderstood disorders  Media portrayals often focus on the “compulsive” side rather than the “obsessions” or anxiety/fearful aspects  Often depicted as silly, but it is extremely debilitating  Focuses a lot on cleanliness  Posttraumatic Stress Disorder (PTSD) feature: exposure to a traumatic  Defining event and reacted with intense fear, horror, or helplessness  Re-experiencing trauma through:  Distressing recollections/dreams  Feelings of reliving trauma  Intense distress/physiological arousal when exposed to reminders Can occur even when reminders aren’t exact copies of original stressor  E.g., veterans and fireworks  Explanations for Anxiety Disorders  Learningtheories: anxious responses are acquired through conditioning  Anxietyarises from unpredictable and/or uncontrollable negative events  Stimulus generalization- can spread to other similar situations  Reinforcement- leave situations to reduce anxiety (e.g., negative reinforcement!)  Observational learning Fears may be transmitted by others Monkeys acquire fear of snakes by watching other monkeys  Explanations for Anxiety Disorders  Biological influences  Prepared fears- in nature, certain fears are adaptive (e.g., snakes, spiders, heights) so are easier to acquire Monkey & snakes study supports this idea too!  Genetic predispositions Twin studies support large genetic component Associatedwith high neuroticism (which is moderately to largely heritable) Learning Outcomes Discuss how we define psychopathology/mental illness Discuss a brief history of diagnosing mental illnesses Characterize mood disorders Major Depression, Bipolar Characterize anxiety disorders GAD, Panic Disorder, Phobias, Obsessive- Compulsive Disorder, PTSD