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Lecture 9

PSY100 Lecture 9.docx

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University of Toronto St. George
Alison Luby

PSY100 Lecture #9 March 26, 2012 Psychological Disorders Conceptions of Mental Illness . 24% adults suffer from a disorder and 31% show significant symptoms What is Mental Illness? Criteria (for abnormal behaviour): . Statistical infrequency . Uncommon in the population . E.g., hearing voices, thinking you were abducted by a UFO . However, what about genius/world-class ability/minority views? . Personal distress . Produces emotional pain . However, what about mania (super hyper opposite of depression)/psychopaths (lack of remorse/distress from external events? . Violation of social norms . We need to take into account age/gender/culture/situation/current social trends to determine the broken norms . People show strong disapproval when norms are broken . Disability/dysfunction/maladaptive behaviour . Difficult to function in everyday life . However, what about laziness or being sick of your job (the illness varies on a degree)? . All four exist together (from normal to abnormal) and a combination of all should be considered . Maladaptive behaviour is more focused on to identify whether or not it is a disorder . Certain conditions are culture-bound (specific to one or more societies) DSM-IV-TR . Diagnostic and Statistical Manual of Mental Disorders (DSM) . Controlled by American Psychiatric Association (APA) which creates criteria for mental disorders . Diagnostic systems help therapist to: . Defines/pinpoints people’s psychological problems . Research ways to offer best type of treatment . Communicate with others about the disorder . DSM contains a multi-axial system: . Axis I . Clinical disorders . Axis II . Personality disorders and mental retardation . Axis III-IV . Supplemental info (general medical condition, psychosocial/environmental problems, global assessment of functioning on a 1 (want to suicide) -100 (productive/happy) scale) Anxiety Disorders . Characterized by excessive anxiety in the absence of real/true danger . +1-4 people will develop at some point Types . Phobia . Intense fear of an object/situation out of proportion to actual threat . Specific phobias . Intense fear of objects/places/situations out of proportion to actual threat . Social Phobia (social anxiety disorder) . Fear of public appearances where embarrassment/humiliation is possible . Generalized anxiety disorder . Continual feelings of worry/anxiety/physical tension/irritability (can take up 60% of each day) . Called free-floating/nonspecific anxiety as well . Panic disorder . Repeated and unexpected panic attacks . Agoraphobia . Fear of being in a place/situation from which escape is difficult/embarrassing/help is unavailable in the event of a panic attack . Avoidance of social situations/open spaces and might become housebound . Obsessive-compulsive disorder (OCD) . Repeated and lengthy (> 1 hour/day) immersion in obsessions & compulsions . Obsessions . Persistent ideas/thoughts/impulses that are unwanted/inappropriate/cause distress . What a person might do/have done . Compulsions . Behaviours associated with thoughts (repetitive actions to avoid some outcome/reduce anxiety) . Impulsions (do something over and over again because you like doing it) . People with OCD realize irrationality, but experience anxiety if they don’t do it) Explanations . Psychological . Faulty cognitions . Interpreting ambiguous situations as threatening . Focusing much attention on the threats . Maladaptive learning . Classically conditioned anxiety to some behaviour . Operant conditioning (negative reinforcement) keeps it going . Learn it through observational learning . Biological . E.g. twin studies show anxiety disorders are genetically influenced . Amygdala activation in response to novel faces in those with anxiety . Genes that control glutamate cause increased neural firing in people with OCD . Problems with the caudate nucleus (involved in suppressing impulses) . This makes the prefrontal cortex overactive to compensate . Environmental Mood Disorders and Suicide . Reflect extreme emotions: . Depressive disorders . Bipolar disorders . Major depression . Recurrent state where person experiences a lingering depressed mood/diminished interest in pleasurable activities Symptoms . Exaggerated feelings of worthlessness/hopelessness/guilt . Weight loss/gain . Sleep difficulties/excessive sleep . Problems concentrating/making decisions/thinking clearly . Frequent thoughts of death/suicide . Often coupled with anxiety disorders . Most likely starts in 30s . Women twice likely to be diagnosed as men . Women do inner voice of guilt (internalize) . Men externalize (alcohol/drugs/violence) . Dysthymic disorder . Patter of mild-moderate depression . Depressed mood most of the day + time for at least two years (usually lasts 5-10 years) . Bipolar disorder . Conditions of alternating periods of depression and mania (manic episodes) . Some experience manic episodes and some hypo manic episodes (less extreme mood elevations that are less disruptive which can feel rewarding) . Equal prevalence in men/women Explanations . Biological factors . Genetics . Decreased activity in brain areas associated with planning (*left prefrontal cortex) . Imbalances in neurotransmitter systems (e.g., serotonin/norepinephrine/dopamine) . Situational factors (e.g. life stressors/interpersonal loss) . Problems relating to others (e.g. seek excessive reassurance which leads to rejection/being disliked) . Behavioural model of depression . Try different things and receive no payoff, so gives up . Stop pleasant activities . Cognitive model of depression . Negative views of self/future/experience . Negative schemas probably start from early experiences of loss/failure/etc. . Aaron Beck’s idea (cognitive therapy of depression) that cognitive errors lead to depressing thoughts but we can learn to think of these events in a healthy manner . E.g. blame misfortunes on themselves and success to luck . Overge
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