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Module 4-6.docx

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PSYC 100
Ingrid Johnsrude

Week 4 - when we gather info to make a diagnosis, we need to look at how it relates to the symptoms. - The individuals symptoms must cause distress or impair her ability to function in her daily life. The distress/impairment must be judged by a clinician to be clinically significant. - Clinically significant if: sufficiently significant, marked, or substantial in intensity or duration that the patient would benefit from professional treatment. - An individual cant receive a diagnosis of a mental disorder if the sole cause of his distress/impairment is external to him (ie. In his environment- if something sad has actually happened like a death then his sadness is justified, but if a person is constantly sad for no reason then theres a problem) - Individuals cant receive a diagnosis of a mental disorder if their behavior is voluntary. People with mental disorders don’t choose to behave as they do - A mental disorder is a behavioural or psychological pattern that’s associated with great amounts of distress or disability- relative to their daily or regular social lives - Normal is based on perception and knowledge, so one would need to understand the context in which an individual grew up to appreciate whether his behavior is disordered or not - Risk factors- what might leave people more susceptible include: biological, psychological, and socio-cultural risk factors. These included genetic predispositions, family history or family experiences, and aspects of a person’s life that might make him/her more or less likely to have trouble coping with problems such as lack of a support system, lower socioeconomic status, and living in a violent neighbourhood. - Genes do play a role in certain mental disorder - Children who grow up in homes with a lot of marital discord, will usually grow up with more aggression - Mental disorders are best understood as part of the diathesis-stress model - In a lot of disorders with strong genetic components, the genetic predisposition is only fully expressed when triggered by an environmental stress - When determining if someone has a mental disorder, you must look at: 1. behavious interfered with normal daily life 2. behaviours were predictable (culturally sanctioned) reactions to their environment (ie. Being sad while grieving) 3. actions were freely chosen, not a manifestation of a dysfunction - these questions are the basic criteria for a mental disorder according to the Diagnostic and Statistical Manual of Mental Disorders- the primary North American reference for mental disorders - three prong test means testing for the above mentioned 3 questions- ie. A patient’s symptoms will only qualify as mental disorder if they: 1. cause a clinically significant impairment in an individuals ability to function 2. are not a predictable reaction to an external environment 3. are not the result of an individuals voluntary choice - DSM-IV-TR: the diagnostic and statistical manual of mental disorders outlines the various mental disorders and the specific criteria required for each disorder diagnosis. Updates in the DSM are the result of changes in the way society views certain behaviours, and new research findings - When determining whether an individual meets the criteria for a mental disorder, psychologists usually combine their clinical experience and knowledge with objective, standardized tests that are suited to the culture/environment of the patient. - Homosexuality was removed from the DSM as being a mental illness when the third edition came out. - 4 of the most common types of disorders are: 1. anxiety disorders 2. mood disorders 3. autism spectrum disorders 4. schizophrenia major depression - a person who experiences persistenly low mood which affects the person’s ability to function normally - the biological component could be disruption of sleep- insomnia or sleeping too much - the psychological component could be sadness/hopelessness, loss of interest in life - social component is lack of interest in things one would normally enjoy, and no need for social interactions with friends anxiety disorders - 3 categories of symptoms: 1. physical symptoms of anxiety or fear 2. unrealistic anxiety or cognitive distress 3. escape or avoidance behaviors - biological symptoms: racing heart rate, increased blood pressure, muscle tension - psychological component: worrying that’s out of proportion to the situation, generalized anxiety that interferes with normal functioning - social component: afraid to be around people, other impairments in social situations schizophrenia - a severe psychological disorder characterized by disorganized thoughts, perception and behavior - biological component: diminished facial expression, may speak in a monotone voice, some physical momements may be repetitive or unsual - psychological component: delusions/hallucinations/paranoia, disorganized thoughts and speech - social component: impaired ability to identify emotional states of other people, inappropriate emotional reactions or absence of emotion autism spectrum disorder - a range of disorders consisting of autism, Asperger’s disorder, and other pervasive development disorders. Combinations and severity of symptoms vary among individuals - biological component: abnormal neurological development, sensitivity to sounds, smells, tastes, or sights - psychological components: repetitive or obsessive behaviours, inflexible adherence to routines or rituals - social components: impairment in using spoken and nonverbal communication, impaired ability to understand other’s feelings - dfg - Carlson discusses the cause of mental disorders in terms of an interaction between our genes and our environment known as the diathesis-stress model - Gender differences are commonly found in mental disorders (ie. Women are twice as likely to be diagnosed with anxiety and depression, while men are more likely to be diagnosed with antisocial personality disorders, intermittent explosive disorder, and substance use disorder) - Males are socialized to keep emotion in and be self-reliant, while women are socialized to show emotion and be nurturing Anxiety disorders- an irrational fear of situations or stimuli that aren’t actually dangerous 1. panic disorder: experience of reoccurring, unexpected panic attacks 2. specific phobia: experience of significant anxiety in response to a specific situation or object that doesn’t present an real danger 3. social phobia/social anxiety disorder: experience of significant anxiety in response to social situations or situations in which the individual is being evaluated 4. obsessive compulsive disorder: experience of obsessions (uncontrollable thoughts, images or impulses) and/or compulsions (repetitive behaviours or mental acts) 5. PTSD: re-experiencing a traumatic event and experiencing symptoms of anxiety in response to any stimuli that relate to the event 6. Generalized anxiety disorder: excessive and uncontrollable worry, often about common concerns for extended periods of time - Edna Foa: major research is in PTSD and OCD - Specific phobia- ie. Spider phobia, height phobia, these people aren’t actually anxious in general, only when it comes to these specific things, they will try to avoid confronting these situation - Panic disorder: diagnosed when the panic reaction occurs without being precipitated by a particular fear-arousing situation - People who have panic disorders may also have agoraphobia - Agoraphobia: when people experience intense anxiety about being in situations where they might not be able to escape if they need to or they might not be able to get help if they experience an attack - Panic attack: involves the sudden onset of intense fear and various physiological symptoms related to anxiety, such as a pounding heart, trembling, chest pain, shortness or breath etc… - A phobic disorder: panic-like reaction that occurs in response to specific stimulus or situations - 3 types of phobias: 1. agoraphobia 2. social phobia 3. specific phobia - obsessions: recurrent, unwanted thoughts or images that the individual recognizes as being irrational, yet they’re uncontrollable - compulsions: specific rituals or acts that are completed with the goal of reducing anxiety. - The most common obsessions are related to thoughts about contamination or germs. - Generalized anxiety disorder: marked by excessive and uncontrollable worrying about everyday events. Symptoms can include restlessness, muscle tension, and difficulty sleeping. - Somatoform disorders: category of mental disorder that involve physical symptoms similar to medical illness but for which no medical cause can be found. Symptoms must include: pain and gastrointestinal, sexual, and pseudo-neurological problems - Undifferentiated somatoform disorder: physical symptoms that can last at least 6 months and cant be explained due to a medical cause but don’t meet the threshold for somatization disorder. - Conversion disorder: symptoms that affect motor or sensory functioning that appear to be related to a neurological disorder or medical condition but don’t actually have any identifiable cause. The symptoms must relate to a psychological factor (eg. Onset of symptoms right after some sort of trauma) - Pain disorder: significant pain that’s associated with psychological factors (onset of pain symptoms immediately following a psychological trauma) - Hypochondriasis: preoccupation with having a serious medical condition despite significant evidence to the contrary - Body dysmorphic: preoccupation with a part of the body that’s perceived as defective (ie. An exaggerated defect) - Dissociative disorders: a group of mental disorders that are characterized by a “disruption in the usually integrated functions of consciousness, memory, identity, or perception. - While people with somatoform disorders avoid anxiety by developing physical symptoms, people with dissociative disorders respond to anxiety by disrupting their state of consciousness. These people often experience disruptions in their memory, some experience an altered state of identity. - Dissociative amnesia: one or more periods of time where an individual cant remember important personal information. This info is usually related to a traumatic or stressful experience. - Dissociative fugue: a person suddenly leaves home or work for no apparent reason and travels to a different city, forgetting who he is and where he came from (may adopt a new identity - Dissociative identity disorder: characterized by the presence of two or more distinct personalities within an individual. The person’s behavior is guided by different personalities at different times - Depersonalization disorder: the sensation that one is detached or outside of one’s body - Personality disorders: these people exhibit patterns of thought, feelings, interpersonal interactions, and impulse control that are considered inappropriate, or discordant with their culture. - To be a personality disorder, symptoms must be stable overtime and across a variety of situations. - Antisocial personality disorder: marked by a lack of empathy or care for others, lack of guilt for misdeeds, antisocial behavior, persistent lying, cheating, stealing - Borderline personality disorder: individuals typically have disturbances in their sense of self, difficulty regulating their mood, unstable interpersonal relationships, fear of abandonment. Self-injury is a common method of coping. Impulsivity is common and may lead to behaviours like substance abuse, gambling, many sexual partners Week 5 - A psychoactive substance: a chemical that acts on the central nervous system. It causes changes to a person’s emotions, perceptions or thoughts. - There are many psychoactive chemicals that act on the central nervous system where they affect brain function, resulting in changes to a person’s emotion, perceptions or thoughts. But not every usage of these chemicals causes a disorder - DSM IV TR breaks substance-related disorders into 2 types: 1. substance use disorders (dependence and abuse) 2. substance induced disorders (intoxication and withdrawl) - substance dependence: a repeated pattern of use that can result in tolerance, withdrawal, cravings, and difficulty cutting down despite wanting too. - a person is diagnosed with substance abuse when a person’s repeated use of a substance results in serious consequences. An individual has to meet the following criteria: 1. repeated failure to fulfill important obligations as a result of the substance (ie. Frequently skipping class) 2. repeated use of the substance in a situation that is dangerous (ie. Drinking and driving) 3. repeated legal problems related to the substance (ie. Being arrested for public intoxication) 4. continued use of the substance despite it causing problems in the persons social or interpersonal relationships - substance induced disorders: diagnosis is made if a person is intoxicated or experiencing withdrawal symptoms at the time he/she is being assessed. The person must be experiencing clinically significant negative or harmful behavioural changes or psychological effects to receive this diagnosis. - There are substance induced mental disorders - These disorders share characteristics of mental disorders such as psychosis, amnesia, sleep problems, anxiety and depression but are more associated with substance abuse - Psychologists, psychiatrists and doctors know to assess for substance abuse when a patient presents with symptoms of mania, amnesia or depression at an uncharacteristic age for that disorder to appear - Major symptoms of schizophrenia: delusions, hallucinations, grossly disorganized or catatonic behavior, disorganized thought and speech, flattened affect (dampened emotional responding), slowing of speech and movement. These can be grouped into 2 categories: 1. positive (presence) symptoms: (ie. Delusions, hallucinations, disorganized behavior, and disorganized speech) usually reflect an excess or distortion of a normal brain function. - Should reflect distortions of thought content, perception, behavioural control, and language and thought. 2. negative (absence) symptoms: (ie. Slowed speech or movement, flattened effect) reflect a diminution or loss of normal brain function - reflect a restriction in the range and intensity of emotional reactions, in the fluency and productivity of speech, and in goal-directed behavior. - in the past, antipsychotic medications worked primarily to alleviate positive symptoms. Newer drugs are now effective for negative symptoms as well schizophrenia: has 5 main subtypes that each feature a different symptom. All subtypes have at least two of the following: 1. delusions 2. hallucinations 3. disorganized speech 4. grossly disorganized or catatonic behaviour 5. negative symptoms (eg. Flattened effect, decrease in production of speech) - however, schizophrenia can be diagnosed on the basis of one symptom if it is a bizarre delusion. - If symptoms of schizophrenia only last 1-6 months, then its classified as a schizophreniform disorder - If a person experiences a mood episode (ie. Major depression), at the same time as exhibiting symptoms of schizo (hallucinations, delusions), then its classified as a schizoaffective disorder. - Delusional disorder: marked by the delusions that are considered non- bizarre. Based on things that could possibly happen (eg. Delusions about being followed, or being more important then you actually are) - Brief psychotic disorder: an episode of psychotic symptoms that lasts between one day and one month. - Shared psychotic disorder: the development of a delusion that is similar to a delusion already held by someone close to the individual. (eg. If a man with shizo has a delusion that the police have implanted a tracking device in his brain and then his wife develops a delusion that the police are following them, the wife would be diagnosed with share psychotic disorder) - Substance induced psychotic disorder: a disorder where the psychotic symptoms are judged to be a direct physiological consequence of taking a psychoactive drug or medication - Human genome project might help treat schizo: there will be a shift to more personalized treatments - The Diathesis-stress model is the leading explanation of psychosis and other psychological disorders (including depression and other anxiety disorders) - A persons diathesis (medical term for predisposition), or vulnerability, may be purely genetic or something that arose out of early childhood - Dopamine is one of the chemicals used to communicate among brain cells. Its been sugg
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