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Psychological Disorders - PS101 Lecture - November 14th and 16th 2011.docx

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Iuliana Baciu

PS101 Lecture - Psychological Disorders – November 14 , 16 , and 18 2011: RED = additional notes from PowerPoint BLACK = notes from PowerPoint slides during the lecture Video: A History of Mental Illness:  People who were not able to function like the majority were not considered normal were put to death or punished (mostly women)  It is a medical model b/c it looks at the majority of people – doesn’t look at how people accept these people  In all cases, mental illness seen as different and bad  1951 – neuroleptic drugs diminished effects of psychosis – to help treat (not completely) schizophrenia they can’t tell what’s real or what’s not – can’t tell between thoughts of self or others thoughts  Hear all conversations with equal emphasis (if in crowd of people talking) – only way to take control is to run out of room  Have hallucinations and visions – think these voices are real because their brain tells then they are real Video: Schizophrenia (2 Cases): Beautiful Minds:  Thought voices were God – told him to stand in middle of hallway – got genes from father who also had schizophrenia, who developed game theory – experienced periods where he could regain his full intellectual capacity – but still went into places of insanity, he said he lost all of his mathematic abilities when he had religious hallucinations – but when he went back to school, his math ability completely came back – he also had visual hallucinations – unusual that both of the cases were able to function highly in society – won Nobel prize and got a Ph.D. – father’s relations with reality were almost normal – b/c of treatment form hospital – he was forced to accept that this was reality – he tried to fight it – people become numb and absent – look like they are not a part of this world – how they are able to function Abnormal Behaviour:  Medical model – (totally subjective, relative – how we accept minorities in general – most likely functioning types of minorities – how we look at them, not that they are considered not normal) vs. the social model – (subjective)  The medical model proposes that it is useful to think of abnormal behaviour as a disease o Thomas Szasz and others argue against this model, contending that psychological problems are “problems in living,” rather than psychological problems.  Normality – not a state, what majority of people do  What is abnormal behaviour?  3 criteria: o Deviant – Is it deviant, or does it violate societal norms? o Maladaptive - Is it maladaptive, that is, does it impair a person’s everyday behaviour? o Causing personal distress - Does it cause them personal distress?  All three criteria do not have to be met for a person to be diagnosed with a psychological disorder…diagnoses involve value judgments.  Antonyms such as normal vs. abnormal imply that people can be divided into two distinct groups, when in reality, it is hard to know when to draw the line.  A continuum of normal/abnormal  We are defining, these realities don’t really exist Figure 14.2 Normality and Abnormality as a Continuum Prevalence, Causes, and Course:  Epidemiology  Epidemiology is the study of the distribution of mental or physical disorders in the population.  Epidemiology studies show an increase in people diagnosed with autism compared to 15-20 years ago  Prevalence  Refers to the percentage of a population that exhibits a disorder during a specified time period.  To diagnose a person with a mental illness – they need to show certain symptoms and certain behaviours  Lifetime prevalence  The percentage of people who have been diagnosed with a specific disorder at any time in their lives.  Current research suggests that about 44% of the adult population will have some sort of psychological disorder at some point in their lives.  Diagnosis  A diagnosis is a means of distinguishing one illness from another.  Etiology  Refers to the apparent causation and developmental history of an illness.  Prognosis  The prediction of what can happen (future of person with a mental illness – chance of healing/functioning normally) - a forecast about the probable course of an illness. Figure 14.5 – Reported 1-Year Prevalence of Psychological Disorders – mood and anxiety disorders are more prevalent in females, and substance dependence is more prevalent in males How we define abnormality - as a minority – even though mental illness affects around 44% of people Psychodiagnosis: The Classification of Disorders:  A taxonomy of mental disorders was first published in 1952 by the American Psychiatric Association - the DSM.  This classification scheme is now in its 4th revision, which uses a multiaxial system for classifying mental disorders o Diagnostic and Statistical Manual of Mental Disorders – 4 ed. (DSM – 4TR)  5 axes/dimensions:  Axis 1 – Clinical Syndromes o The diagnoses of disorders are made on Axes I and II, with most falling on Axis I.  Axis 2 – Personality Disorders or Mental Retardation  Axis 3 – General Medical Conditions o A person’s physical disorders are listed on Axis III  Axis 4 – Psychosocial and Environment Problems o The types of stress they have experienced in the past year are on Axis IV.  Axis 5 – Global Assessment of Functioning o Axis V estimates the individual’s current level of adaptive functioning.  The remaining axes are used to record supplemental information.  The goal of this multiaxial system is to impart information beyond a traditional diagnostic label. Clinical Syndromes: Anxiety Disorders:  The anxiety disorders are a class of disorders marked by feelings of excessive apprehension and anxiety.  Generalized anxiety disorder  Marked by a chronic, high level of anxiety that is not tied to any specific threat… “free-floating anxiety”  Phobic disorder – Activity PsychInquiry  Marked by a persistent an irrational fear of an object or situation that presents no realistic danger.  Particularly common are acrophobia – fear of heights, claustrophobia – fear of small, enclosed places, brontophobia – fear of storms, hydrophobia – fear of water, and various animal and insect phobias.  Specific focus of fear  Panic disorder and agoraphobia  Characterized by recurrent attacks of overwhelming anxiety that usually occurs suddenly and unexpectedly.  These paralyzing attacks have physical symptoms (anxiety). After a number of these attacks, victims may become so concerned about exhibiting panic in public that they may be afraid to leave home, developing agoraphobia or a fear of going out in public.  Obsessive compulsive disorder (OCD)  Marked by persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions). Obsessions often center on inflicting harm on others, personal failures, suicide, or sexual acts.  Common examples of compulsions include constant hand washing, repetitive cleaning of things that are already clean, and endless checking and rechecking of locks, etc.  Post-traumatic stress disorder (PTSD)  Video Phobias Activity: PsychInquiry:  They are extreme fears or avoidance of certain external stimuli or of particular social situations  2 main categories of phobias – specific phobias and social phobias  Specific phobia – an intense fear and avoidance of some specific stimulus – subtypes include animal type (particular animals/insects), natural environment type (heights, storms, ect.), blood-injection injury type (medical procedures), and situational type (driving, enclosed spaces)  Social phobia – an intense fear and avoidance of a particular social situation such as going to a party or making a public presentation  Unconditional response -fear (spider biting you)  After conditioning: conditioned stimulus – spider, conditional response – fear (see what could happen)  Phobia: spiders – avoidance response is don’t walk on grass, stimulus removed – walk on grass, therefore fear reduced – conditioned through negative reinforcement  Once the conditioned response of fear is acquired through classical conditioning, the avoidance behaviour is acquired through operant conditioning  Evolutionary perspective – vicarious learning still doesn’t explain why most people develop a phobic reaction to a small # of stimuli. Why are so many people afraid of snakes but not electrical cords? Could phobias represent extreme reactions to… Etiology of Anxiety Disorders:  Biological factors  Genetic predisposition, anxiety sensitivity o Twin studies suggest a moderate genetic predisposition to anxiety disorders. o They may be more likely in people who are especially sensitive to the physiological symptoms of anxiety.  GABA circuits in the brain o Abnormalities in neurotransmitter activity at GABA synapses have been implicated in some types of anxiety disorders, and abnormalities in serotonin synapses have been implicated in panic and obsessive-compulsive disorders.  Conditioning and learning  Many anxiety responses, especially phobias, are acquired through classical conditioning or observational learning o Parents who model anxiety may promote the development of these disorders through observational learning.  Many anxiety responses, especially phobias, are maintained through operant conditioning  Cognitive factors  Judgments of perceived threat o Cognitive theories hold that certain styles of thinking, over interpreting harmless situations as threatening, for example, make some people more vulnerable to anxiety disorders. o The personality trait of neuroticism has been linked to anxiety disorders, and stress appears to precipitate the onset of anxiety disorders.  Stress  A precipitator Figure 14.6 – Twin Studies of Anxiety Disorders: Figure 14.7 – Conditioning as an Explanation for Phobias: Figure 14.8 – Cognitive Factors in Anxiety Disorders: Clinical Syndromes: Somatoform Disorders:  Somatization Disorder  Somatoform disorders are physical ailments that cannot be explained by organic conditions. o They are not psychosomatic diseases, which are real physical ailments caused in part by psychological factors. (Recall from chapter 13 that psychosomatic disease as a category has fallen into disuse). o Individuals with somatoform disorders are not simply faking an illness, which would be termed malingering.  Somatization disorder is marked by a history of diverse physical complaints that appear to be psychological in origin. o They occur mostly in women and often coexist with depression and anxiety disorders.  Conversion Disorder  Conversion disorder is characterized by a significant loss of physical function (with no apparent organic basis), usually in a single organ system…loss of vision, partial paralysis, mutism, etc…glove anesthesia, for example, is neurologically impossible - (certain loss of function in a certain area of the body – it is a disease that is creates by the mind – there is no explanation for the loss of feeling in a certain body area)  Hypochondriasis  Hypochondriasis is characterized by excessive preoccupation with health concerns and incessant worry about developing physical illnesses.  Somatoform disorders often emerge in people with highly suggestible, histrionic personalities and in people who focus excess attention on their physiological processes (they focus excessively on themselves and their health). o They may be learned avoidance strategies, reinforced by attention and sympathy.  Etiology o Reactive autonomic nervous system o Personality factors o Cognitive factors o The sick role – because they love the attention of people taking care of them – they do not know how to ask for attention appropriately, and they need more attention – thus they pretend to be sick to get attention, when you think you are sick, you start to have symptoms Figure 14.10 – Glove Anesthesia: Clinical Syndromes: Dissociative Disorders:  Dissociative disorders are a class of disorders in which people lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity.  Dissociative amnesia  Raising Cain Video  A sudden loss of memory for important personal information that is too extensive to be due to normal forgetting.  Memory loss may be for a single traumatic event or for an extended time period around the event.  Dissociative fugue  When people lose their memory for their entire lives along with their sense of personal identity…forget their name, family, where they live, etc., but still know how to do math and drive a car.  Dissociative identity disorder  Formerly multiple personality disorder  Involves the coexistence in one person of two or more largely complete, and usually very different, personalities
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