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Chapter 8

Chapter 8 Drugs and Behaviour.doc

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Bruce Mc Kay

Chapter 8 o Mental Illness o Psychological disorders, characterized by alterations in thinking, mood, or behaviour and can be associated with significant distress and impaired functioning o Can vary from mild to severe o Second leading cause of human disability and premature death in Canada o The medicathmodel o 19 century attempts to understand or explain mental illnesses involved either magical or religious explanations such as demon possession or biophysical explanations o Medical model has been attacked by both psychiatrists and psychologists o According to the medical model, the patient appears with a set of symptoms and on the basis of these symptoms a diagnosis is made as to which disease that patient has o Once disease is known its cause can be determined and the patient provided with a cure o For an infectious disease such as tuberculosis or syphilis, a set of symptoms suggests a particular disorder, but a specific diagnostic test for the presence of certain bacteria or antibodies is used to confirm the diagnosis, identify the cause, and clarify the treatment approach, once infection is cleared up, the disorder is cured o For mental disorders a set of behavioral symptoms is about al we have to define and diagnose the disorder o Mental illness affects thinking, mood, or behaviour and can be associated with distress and impairment of functioning o Symptoms can vary from mild to severe and may require hospitalization o Despite the attacks on the medical model, it is still seems to guide much of the current thinking about behavioral disorders o Classification of Mental Disorders o Psychotherapeutic Drugs:  Drugs that are prescribed for their effects in relieving symptoms of anxiety, depression, or other mental disorders o Anxiety is a normal and common human experience o Physical symptoms often associated with activation of the autonomic nervous system, anxiety disorders o Antianxiety drugs, tend to think of anxiety not as a behavioral symptom but rather as an internal state that causes the disorders o In recent years, psychiatrists have increasingly used selective reuptake inhibitors, classified as antidepressants, to treat obsessive-compulsive disorder and other anxiety disorders o Since 1987, hospitalization rates for anxiety disorders in general hospitals have decreased by 49% o Anxiety Disorders: o Panic disorder:  Recurring, unexpected panic attacks and by subsequent concern about future attacks or about the meaning of the attacks o Specific Phobias  Excessive or unreasonable fear of a specific situation or object (elevators, flying, enclosed spaces, some type of animal) o Social Phobia  Overwhelming, persistent fear of social or performance situations (speaking in public) o Obsessive-compulsive Disorder (ocd)  Unwanted and repeated thoughts, feelings, or images that are intrusive and inappropriate and that cause marked distress, compulsions are urgent, repetitive behaviour, such as hand washing, counting or repeatedly “checking” o PTSD  Person has been exposed to an event that involved actual or threatened death or serious injury, and the person reacted with intense fear or helplessness. The person persistently re-experiences the event through recollections, dreams, or a sudden feeling as if the event were occurring o Generalized Anxiety Disorder  Generalized anxiety disorder is characterized by excessive anxiety and worry about a number of events or activities, such as school, work performance, or finances, and lasting for a period of sic months or longer o Psychosis: o Major disturbance of normal intellectual and social functioning in which there is loss of contact with reality, believing that you are napoleon or Christ is an example of this withdrawal from reality o Organic psychoses and functional psychoses o Organic:  Has a known physical cause, brain tumors or infections, metabolic or endocrine disorders, degenerative neurological diseases, chronic alcohol use, and high doses of stimulant drugs such as amphetamine or cocaine o Functional:  Those for which there is no known or obvious physical cause  Person who has a chronic psychotic condition for which there is no known cause will probably receive the diagnosis of Schizophrenia o Mood Disorders: o Appearance of depressed or manic symptoms o Have no single cause but several factors such as a biochemical imbalance in the brain, psychological factors, and socioeconomic factors tend to make some individuals prone to such disorders  Bipolar disorders: both manic and depressive episodes have been observed at some time  Major depression, in which only depressive episodes are reported o Anxiety and Panic Disorders o Symptoms: shortness of breath, dizziness or faintness, palpitations or accelerated heart rate, trembling, sweating, choking, numbness, fear of dying, or fear of going crazy or doing something uncontrolled o A neuropeptide found in the gut and in the brain, cholecystokinin (CCK), appears to play a fundamental role in panic that can be modeled in animals o Injections of CCK in control subjects an people with panic disorder can cause a panic attack o Patients with panic disorder need a lower dose than control subjects suggesting they are more sensitive to the anciogenic (anxiety producing) effects of CCK o Diazepam is relatively ineffective in the long-term management of panic disorder and is ineffective in animal models of panic symptoms o Don’t know cause of panic disorder, but can be related to increased anxiety in their lives that led to depression before their first panic attack o Anxiety and depression are important to the development of panic disorders o Panic evolves at some point following repeated depressive and anxiety episodes o Consist primarily of autonomic symptoms, cardiovascular disturbances, or cognitive symptoms including depersonalization and fear of losing control, accompanied by phobic or depressive symptoms o Research suggests that the amygdala, structure deep within the brain serves as a communication hub that signals the presence of a threat and triggers a fear response or anxiety o Children of adults with anxiety disorders are at a much greater risk of an anxiety disorder than the general population, gene and parent factors o Treatment of Mental Disorders o Before 1950  1917, when a physical treatment was first demonstrated to be effective in serious mental disorders  Patients with psychosis had general paresis, syphilitic infection of the nervous system
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