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Psychological Science - Third Canadian Edition - Chapters Fourteen and Fifteen Notes.docx

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INTRODUCTION TO PSYCHOLOGY (CHAPTERS 14 & 15) HOW ARE PSYCHOLOGICAL DISORDERS CONCEPTUALIZED AND CLASSIFIED?  PSYCHOLOGICAL DISORDERS ARE CLASSIFIED INTO CATEGORIES - E. Kraeplin recognized that not all patients with mental disorders suffer from the same disorder - The idea of categorizing mental disorders was not officially adopted until 1952, when the Diagnostic and Statistical Manual of Mental Disorders was published which remains the standard categorization - Disorders are described in terms of symptoms and patients must meet specific criteria to receive a particular diagnosis - Patients do not receive a single label; instead are classified through MULITAXIAL SYSTEM which is based on realization that various factors affect mental health - Diagnosis include evaluations on 5 axes  PSYCHOLOGICAL DISORDERS ARE ASSESSED - Examination of a person’s mental state to diagnose possible psychological disorders - The first goal of assessment is to make a diagnosis so that appropriate treatment can be provided - Ongoing assessment helps mental health workers understand whether progress is being made in treatment - Assessment depends on how a person comes into contact with mental health workers; some come to emergency rooms and are given a mental status exam to provide a snapshot of his/her psychological functioning; some are encouraged by family and friends to see a mental health professional - In a clinical review, interviewer’s skills determine the quantity and value of information obtained - Unstructured interviews = topics of discussion vary, the interviewer probes different aspects of the person’s problems, are highly flexible, overly dependent on the interviewer’s skills - Structured interviews = standardized questions are asked in the same order each time, patients’ answers are coded according to a predetermined formula, diagnosis is based on the specific patterns of responding - A psychological assessor can gain information by observing the client’s behaviour - Another source of information regarding psychopathology is psychological testing - A common problem with all self-report assessments is that to make a favourable impression respondents sometimes distort the truth or lie outright - Another assessment method is neuropsychological testing; the client performs actions such as copying a picture which requires an ability to planning, coordinating, or remembering; by highlighting actions that the client performs poorly, the assessment might indicate problems with a particular brain region - EVIDENCE-BASED ASSESSMENT = an approach to clinical evaluation in which research guides the evaluation of mental disorders, the selection of appropriate psychological tests and neuropsychological methods, and the use of critical thinking in making a diagnosis - DISSOCIATIVE IDENTITY DISORDER (multiple personality disorder) = involve the occurrence of two or more distinct identities in the same individual; most common theory for it is that children cope with abuse by pretending it is happening to someone else and they dissociate their mental states from their physical bodies; the dissociated state takes on its own identity; often identities will have periods of amnesia; difficult to tell if a person is faking CAUSES OF PSYCHOLOGICAL DISORDERS:  The DIATHESIS-STRESS MODEL provides one way of thinking about the onset of mental disorders  an individual can have an underlying vulnerability or predisposition to a mental disorder  the vulnerability may not be sufficient to trigger a mental disorder, but stressful circumstances can assist in that  if the stress levels exceeds an individual’s ability to cope, the symptoms of mental disorder will occur  evidence indicates that some mental disorders may arise from prenatal problems  during adolescence and childhood, environmental toxins and malnutrition can put an individual at risk for mental disorders  evidence is emerging that neurological dysfunction contributes to the expression of many mental disorders  brain regions that may function differently in individuals with mental disorders  neural dysfunctions on neurotransmitters’ role in mental disorders  reactions to environmental conditions or as involving various defence mechanisms  thoughts and emotions are shaped by environment and can influence behaviour, including disordered behaviour  the FAMILY SYSTEMS MODEL proposes that an individual’s behaviour must be considered within a social context; problems that arise are manifestations of problems within the family; family interactions can contribute to the disorder and whether the family is likely to be helpful or detrimental to the client’s progress in therapy  the SOCIO-CULTURAL MODEL views psychopathology as the result of the interaction between individuals and their cultures  disorders like schizophrenia appear more common among the lower socio-economic classes, whereas disorders like anorexia are more common in middle and upper classes  differences in occurrence are due to differences in lifestyles, expectations, opportunities among classes  in COGNITIVE-BEHAVIOURAL APPROACH, the belief is that abnormal behaviour is learned  mental disorders result from classical and operant conditioning  dependence on alcohol, drugs, anti-social personality disorders, and childhood attention deficit disorder are more likely to happen to men  anorexia and post-traumatic stress disorder are more common in women  mental disorders can be categorized as internalizing disorders (those with negative emotions such as distress and fear) and externalizing disorders (those of disinhibition like alcohol); therefore disorders associated with internalizing are more prevalent in women and those associated with externalizing are more prevalent in men  most mental disorders show universal and culture-specific symptoms  disorders with a strong biological component are more similar across cultures, whereas those heavily influenced by learning and by context will more likely differ across cultures ANXIETY DISORDERS:  due to the arousal of the autonomic nervous system, chronic anxiety also causes bodily symptoms such as sweating, dry mouth, rapid pulse, shallow breathing, increased blood pressure, and increased muscular tension  can result in hypertension, headaches, intestinal problems, cause tissue damage  because of their high levels of autonomic arousal, those who suffer also exhibit restless and pointless motor behaviours such as toe tapping and fidgeting  PHOBIC DISORDER - The fear is exaggerated and out of proportion to the actual danger - Specific phobias involve particular objects and situations - Social phobia includes being afraid of public speaking, speaking up in class, meeting new people, and eating in front of others; one of the earliest forms of mental disorder to develop; the more social fears a person has, the more likely the person will develop other disorders  GENERALIZED ANXIETY DISORDER - A diffuse state of constant anxiety not associated with any specific object or event - Can occur in response to almost anything - Results in distractibility, fatigue, irritability, sleep problems, headaches, restlessness, and muscle pain - Women are more diagnosed than men  PANIC DISORDER - Women are twice as likely to be diagnosed as men - Involves sudden and overwhelming attacks of terror that seemingly come out of nowhere or are cued by external stimuli or internal thought processes - Panic attacks can last for several minutes and people feel like they’re going crazy or dying - Those who experience panic attacks during adolescence are likely to develop other anxiety disorders - AGORAPHOBIA = the fear of being in situations in which escape is difficult or impossible (ex: being in a crowded mall)  OBSESSIVE-COMPLUSIVE DISORDER - Involves frequent intrusive thoughts and compulsive actions - More common in women - Those with OCD anticipate catastrophe and loss of control and checking is the only way to calm the anxiety MOOD DISORDERS:  DEPRESSIVE DISORDERS - To be diagnosed, a person must have one of two symptoms: depressed mood or loss of interest in pleasurable activities - other symptoms include appetite and weight changes, sleep disturbances, loss of energy, difficultly concentrating, feelings of self-reproach or guilt, and thoughts of death and suicide - only long lasting episodes that impair a person’s life are diagnosed as mood disorders - tends to persist over time for them - women are nearly twice as likely to be diagnosed with major depression as men are - DYSTHYMIA is a mild to moderate severity - In its most severe form, depression is a leading cause of disability in Canada and worldwide - Depression is the leading risk factor for suicide - Rates of depression are higher for women than men because women’s multiple roles in societies can cause stress that result in increased incidence of depression; likely due to overwork  BIPOLAR DISORDERS - A mood disorder characterized by alternating periods of depression and mania - Was known as manic depression - Manic episodes are characterized by elevated mood, increased activity, diminished need for sleep, racing thoughts and extreme distractibility - Heightened levels of activity and euphoria which results in excessive involvement in pleasurable but foolish activities - Hypomanic episodes are characterized by heightened creativity and productivity and can be extremely pleasurable and rewarding - Less common than depression - Commonly emerges during late adolescence or early adulthood CAUSES OF MOOD DISORDERS:  Studies of twins, of families and of adoptions support the notion that depression has a genetic component  Genetic research suggests that major depression involves a deficiency of one or more monoamines (neurotransmitters that regulate emotion and arousal)  Brain waves of depressed people show low activity in some regions in the left hemisphere  Biological rhythms also have been implicated  Depressed patients enter REM sleep more quickly and have more of it  Many show a cyclical pattern of depression depending on the season called SEASONAL AFFECTIVE DISORDER  Studies have implicated life stressors in many cases of depression such as interpersonal loss  Depression is likely in the face of multiple negative events  Relationships contribute to the development of depression, and alter people’s experiences when depressed  Cognitive processes also play a role; A. Beck proposed that depressed people think negatively about themselves, their situation and the future – he called this the COGNITIVE TRIAD  Depressed people blame misfortunes on personal defects while seeing positive occurrences as the result of luck  Depressed people make ERRORS IN LOGIC  The LEARNED HELPLESSNESS MODEL is where people see themselves as unable to have any effect on events in their lives; the attributions people make for negative events refer to personal factors that are stable and global; they feel hopeless about making positive changes in their lives SCHIZOPHRENIA:  Characterized by alterations in perceptions, emotions, thoughts, or consciousness  Refers to a split between thought and emotion  Is a psychotic disorder  Not all cases are identical; there are subtypes  Characterized by a combination of abnormalities that result in impaired social, personal, and vocational functioning  Two categories of symptoms:  POSITIVE SYMPTOMS - Are excesses - Include delusions (false beliefs based on incorrect inferences about reality) that have many types - The type of delusion can be influenced by cultural factors (ex: German and Japanese patients have higher rates for delusions of grandeur) - Also includes hallucinations (false sensory perceptions that are experienced without an external source) - Usually are auditory; as voices that are accusatory, telling the person he/she is evil - Also includes loosening of associations in which the person shifts between unrelated topics when speaking; more extreme cases involve clang associations = the stringing together of words that rhyme but have no link; make it very difficult for people with schizophrenia to communicate - Also includes disorganized behaviour = acting in strange or unusual ways (ex: wearing multiple layers on hot days)  NEGATIVE SYMPTOMS - Becoming isolated and withdrawn - Slowed speech - Reduced speech output - Monotonous tone of voice - Symptoms are more common in men than women - Negative symptoms usually persist even when medication is taken; positive ones usually are eliminated - May be associated with transmitter dysfunction BIOLOGICAL INFLUENCES OF SCHIZOPHRENIA:  If one parent has it, the risk of a child developing the disease is 13%  If both parents have it, the risk is 50%  Genetic component of schizophrenia represents a predisposition rather than destiny  Those with the disease have rare mutations of their DNA about 3 to 4 times more often than do healthy people  No single gene causes it, but rather multiple genes likely contribute to the disorder  Ventricles in people are enlarged; so brain tissue is reduced in the frontal and medial temporal lobes  A problem in the connection between brain regions  Maybe due to abnormality in neurotransmitters  Might involve abnormalities in the glial cells that make up the myelin sheath  Because the disease is most often diagnosed when people are in their 20s or 30s, it is hard to assess whether brain impairments occur earlier in life  Children at risk for this disease display increasingly abnormal motor movements  Scientists determined 5 factors that predicted the onset of psychotic disorders: a family history of the disease, greater social impairment, higher levels of paranoia, a history of substance abuse, and higher levels of unusual thought ENVIRONMENTAL FACTORS OF SCHIZOPHRENIA:  Increased stress of urban environments can trigger the onset of the disorder  Some believe there is a schozvirus and that living in the close quarters of a big city increases the likelihood of the virus spreading  Some researchers have reported finding antibodies in the blood of people with schizophrenia that are not found in those without the disorder  Those diagnosed are more likely to have been born during the winter and early spring  Retrospective studies suggest that the mothers of those with the disease are more likely than other mothers to have contracted influenza during the second trimester PERSONALITY DISORDERS:  Are classified on axis II  Usually last throughout the lifespan with no expectation of change  Divided into three groups:  Remain controversial  May not seem to affect daily life as much as BORDERLINE PERSONALITY:  Characterized by disturbances in identity, in affect and in impulse control  Patients are considered on the borderline of normal and psychotic  People with this seem to lack a strong sense of self, they cannot tolerate being alone and have an intense fear of abandonment  Can be very manipulative to control relationships  There is emotional instability with episodes of depression, anxiety, anger and irritability  Hallmark of this illness is impulsivity which can include sexual promiscuity, physical fighting, binge eating and purging  Self-mutilation, cutting and burning is associated  Diminished capacity in the frontal lobes which help control behaviour  Evidence has linked low serotonin levels to the impulsive behaviour  There is a strong relationship between the disorder and trauma/abuse; other theories implicate early interactions with caretakers who were unreliable ANTI-SOCIAL PERSONALITY DISORDER:  Marked by a lack of empathy and remorse  When people behave in socially undesirable ways  Tend to be hedonistic  Psychopaths are the extreme version of this  More common in men than in women  Is most apparent in late adolescence and early childhood and improves around age 40  Cannot be diagnosed before 18, but the person must have displayed anti-social conduct before age 15  Punishment seems to have very little effect on them; people with this often repeat the bad behaviour  50% of the prison population meets criteria for this  EEG examinations have demonstrated that criminals who meet the criteria have slower alpha wave activity which indicates a lower level of arousal and may explain why they engage in sensation-seeking behaviour (low arousal = they do not experience punishment as aversive)  There are amygdala abnormalities; smaller ones and being less responsive to negative stimuli  Deficits in frontal-lobe functioning  Factors such as low socio-economic status, dysfunctional families and childhood abuse may also be important CHILDHOOD DISORDERS:  AUTISM - Characterized by deficits in social interaction, by impaired communication and by restricted interests - More common in males - Varies in severity - ASPERGER’S SYNDROME is high-functioning autism in which children of normal intelligence have deficits in social interaction and theory of mind - Those with it are unaware of others - As babies, they do not smile at caregivers, do not respond to vocalizations and may actively reject physical contact with others - Do not establish eye contact - Have severe impairmen
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