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Chapter 14

PSY100H1 Textbook Notes: Ch.14 -Psychological Disorders

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Ashley Waggoner Denton

Chapter 14: Psychological Disorders  Capgras syndrome involves an otherwise perfectly lucid person believing that a family member or friend has been replaced by an identical looking imposter  Psychopathology: a disorder of the mind causing the individual personal How Are Psychological Disorders Conceptualized and Classified  It is important to consider certain criteria in determining whether behaviour represents psychopathology o 1. Does the behaviour deviate from cultural norms o 2. Is the behaviour maladaptive o 3. Is the behaviour causing the individual personal distress Psychological Disorders are classified into categories  Etiology: factors that contribute to the development of a disorder  Diagnostic and statistical manual of mental disorders  Multiaxial system: the system used in the DSM that provides assessment along five axes describing important mental health factors  Diagnoses include evaluations on five dimensions, or axes: pg. 632 o 1. Clinical disorders o 2. Mental retardation or personality disorder o 3. Medical conditions o 4. Psychosocial problems o 5. Global or overall assessment of how well the person is functioning Psychological Disorders Must be Assessed  Assessment: in psychology, examination of a person’s mental state to diagnose possible psychological disorders  The first goal of assessment is make a diagnosis so that appropriate treatment can be provided  Because the course and probably outcome, or prognosis, of different mental disorders can vary  A patient in this condition may be given a mental status exam to provide a snapshot of his or psychological functioning  In this clinical interview, the interviewer’s skills determine the quantity and value of information obtained. A good interviewer expresses empathy, builds rapport quickly, is nonjudgmental and trusting, and supports the clients efforts to find out what is wrong and how it might be addressed Structured vs. Unstructured Interviews  Most interviews are unstructured  In structured interviews, standardized questions are asked in the same order each time o Most common is Structured Clinical Interview for DSM, through which diagnoses are made according to DSM criteria Types of Testing  Gain valuable info from client’s behaviour  Another source of info regarding psychopathology is psychological testing  The most widely used questionnaire for psychological assessment is the Minnesota Multiphasic Personality Inventory (MMPI)  Neuropsychological testing: the client performs actions such as copying a picture, drawing a design from memory, sorting cards that show various stimuli into categories based on size, shape, or colour, placing block into slots on a board while blindfolded and tapping fingers rapidly o Each task requires an ability such as planning, coordinating, or remembering o By highlighting actions that the client performs poorly, the assessment might indicate problems with a particular brain region Evidence-Based Assessment  Evidence-based assessment is 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  Scientific research indicates that many mental disorders occur together, a state known as comorbidity; mental disorders commonly overlap  People who are depressed often have substance abuse disorders, so an evidence-based assessment approach would indicate that people found to be depressed should also be assessed for comorbid conditions such as substance abuse Dissociative Identity Disorder is a Controversial Diagnosis  Dissociate identity disorder (DID): (multiple personality disorder) the occurrence of two or more distinct identities in the same individual o Involves disruptions of identity, of memory, and of conscious awareness o Most ppl diagnosed with DID are women who report being severely abused as children o Different identities develop to deal with different traumas Psychological Disorders Have Many Causes  Diathesis-stress model: a diagnostic model that proposes that a disorder may develop when an underlying vulnerability is coupled with a precipitating event o an individual can have an underlying vulnerability or predisposition (known as diathesis) to a mental disorder; this diathesis can be biological, such as a genetic predisposition to a specific disorder, or environmental, such as childhood trauma Biological Factors  biological factors often reflect vulnerabilities, and situational factors often play prominent roles in the expression of mental disorders  as the diathesis-stress model reminds us, single explanations (nature or nurture) are seldom sufficient for understanding mental disorders Psychological Factors  family systems model: a diagnostic model that considers symptoms within an individual as indicating problems within the family  socio-cultural model: a diagnostic model that views psychopathology as the result of the interaction between individuals and their cultures o differences in occurrences of disorders are due to differences in lifestyles, in expectations and in opportunities among classes Cognitive-Behavioual factors  cognitive-behavioural approach: a diagnostic model that views psychopathology as the result of learned maladaptive cognitions Sex-Differences in Mental Disorders  schizophrenia and bipolar disorder are equally likely in both sexes  one way of categorizing mental disorders is to divide them into 2 major groups: internalizing disorders, those characterized by negative emotions such as distress and fear, and externalizing disorders, those characterized by disinhibition, such as alcoholism, conduct disorders, and anti-social behaviour (pg.640) Cultural and Mental Disorders  mental disorders may be very similar around the world but still reflect cultural differences  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  culture-bound syndromes: disorders mainly found in specific cultures and regions Can Anxiety Be the Root of Seemingly Different Disorders  anxiety disorders are characterized by excessive anxiety in the absence of true danger There Are Different Types of Anxiety Disorders Phobic Disorders  phobia is a fear of a specific object or situation  specific phobias involve particular objects and situations  social phobia: a specific phobia that is sometimes called social anxiety disorder, is a fear of being negatively evaluated by others o being afraid of public speaking, speaking up in class, meeting new people, and eating in front others Generalized Anxiety Disorder  generalized anxiety disorder (GAD) a diffuse state of constraint anxiety not associated with any specific object or event  constantly being anxious and worry incessantly about even minor matters  more common in women than males Panic Disorder  panic disorder: an anxiety disorder characterized by sudden, overwhelming attacks of terror  people who experience panic disorders during adolescence are esp. likely to develop other anxiety disorders  agoraphobia: an anxiety disorder marked by fear in situations in which escape may be difficult or impossible Obsessive-Compulsive Disorder  Obsessive-Compulsive Disorder: an anxiety disorder characterized by frequent intrusive thoughts and compulsive actions  Obessions are recurrent, intrusive and unwanted thoughts or ideas or mental images; they often include fear of contaminations, of accidents, or of one’s own aggression  Compulsions are particular acts that the OCD patient feels driven to perform over and over again  people with OCD fear what they might do or might have done, and checking is the only way to calm the anxiety Anxiety Disorders Have Cognitive, Situational and Biological Components  Scientific method: inhibition and social anxiety o Hypothesis: people who had an inhibited temperamental style as children will more likely have anxiety disorders alter in life o Conclusion: biological factors seem to play important role in development of anxiety disorders  a paradoxical aspect of OCD is that people are unaware that their obsessions and compulsions are irrational o disorder may result from conditioning  the caudate, a brain structure involved in suppressing impulses is smaller and has structural abnormalities in people with OCD and thalamus as well  OCD can sometimes be triggered by environmental factors; researchers have speculated that an autoimmune response damages the caudate, thereby producing symptoms Are Mood Disorders Extreme manifestations of Normal Moods? There Are Different Types of Mood Disorders  Mood disorders reflect extreme emotions: depressive disorders feature persistent and pervasive feelings of sadness, and bipolar disorders involve radical fluctuations in mood Depressive Disorders  Major depression: a disorder characterized by severe negative moods or a lack of interest in normally pleasurable activities o To be diagnosed with one of two symptoms: depressed (often irritable) mood or loss of interest in pleasurable activities. In addition, the person must have other symptoms such as appetite and weight changes, sleep disturbances, loss of energy, difficultly concentrating, feelings of self-approach or guilt and frequent thoughts of death and suicide  Dysthymia: a form of depression that is not sever enough to be diagnosed as major depression; must have a depressed mood most of the day, more days than not, for at least 2 years; often precedes major depression  Depression is so prevalent that it is sometimes called the common cold of mental disorders  Low income, lack of education, and difficultly family relationships contribute to mental disorders in women Bipolar Disorders  Bipolar disorder: a mood disorder characterized by alternating periods of depression and mania  Manic episodes are characterized by elevated mood, increased activity, diminished need for sleep, grandiose ideas, racing thoughts, and extreme distractability. During episodes of mania, heightened levels of activity and euphoria often result in excessive involvement in pleasurable but foolish activities, thus they regret doing it once the mania has subsided  Hypomanic episodes: are often characterized by heightened creativity and productivity in people’s lives and can be extremely be pleasurable and rewarding; they are not too disruptive in people’s lives  Equal in both women and men  Commonly emerges late adolescence or early adulthood  Reported more frequently by Canadians under age 55, who might be somewhat biased toward willingness to report symptoms  Lithium is a drug prescribes for manic-depressive disorder o Side effects is that it blunts positive feelings; can rob people of creative energy Mood Disorders Have Cognitive, Situational and Biological Components  Depression has a negative component  Concordance rates (ie. The percentage of twins who share the same disorder) between identical twins are generally around 4 times higher than rates between fraternal twins  in families with bipolar disorder, successive generations have more severe disorders and earlier age of onset  major depression involves a deficiency of one or more monoamines (neurotransmitters that regulate emotion and arousal and motivate behaviour)  damage to the left prefrontal cortex can lead to depression, but damage to the right hemisphere does not  biological rhythms have been implicated in depression; enter REM sleep more quickly and have more of it; one symptom of depression is excessive sleeping and tiredness  seasonal a
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