PSYC 4 - Psychological Disorders (M.47~52) #2

schizophrenia

schizo means split and phrenia means mind, refers to the mind's split from reality

psychotic disorder

inappropriate, present, appropriate, absent

hallucinate

delusions

false perceptions

selective attention

paranoid

Yes

flat affect state

impaired theory of mind

catatonia, motor behaviors

chronic schizopherenia

acute schizophrenia

dopamine overactivity, and abnormal brain activity and anatomy.

Most studies link it with abnormal brain tissue and genetic predispositions.

Prenatal development or delievery. Rish factors include low birth weight, maternal diabetes, older paternal age, and oxygen deprivation during delievery.

Are people at increased risk of schizophrenia if, during the middle of their fetal development, their country experienced a flu epidemic? Are people born in densely populated areas, where viral diseases spread more readily, at greater risk for schizophrenia? Are those born during the winter and spring months-those who were in utero during the fall-winter flu season-also at increased risk? In the Southern Hemisphere, where the seasons are the reverse of the Northern Hemisphere, are the months of above-average pre-schizophrenia births similarly reversed? Are mothers who report being sick with influenza during pregnancy more likely to bear children who develop schizophrenia? Does blood drawn from pregnant women whose offspring develop schizophrenia show higher-than-normal levels of antibodies that suggest a viral infection?

biological

Epigenetic

Brain abnormalities, prenatal environment, genetic factors, and environmental triggers.

negative, chronic

positive, actue

Biological factors include abnormalities in brain structure and function and a genetic predispositions to the disorder. Environmental factors such as nutritional deprivation, exposure to virus, and maternal stress contribute byactivating the genes that increase risk. Exposure to many environmental triggers can increase the odds of developing schizophrenia.

Schizophrenia involves the altered perceptions, emotions, and behaviors of a mind split from reality. It does not involve the rapid changes in mood or identity suggested by this comparison.

delusions

hallucination

onset is sudden, in response to stress

Schizophrenia is a psychotic disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotinal expression. Hallucinations are sensory expriences without sensory stimulation; delusions are false beliefs. Schizophrenia symptoms may be positive - the presence of inappropriate behaviors negative - the absence of appropriate behaviors

Schizophrenia typically strikes during late adolescence, affects mals slightly more often, and occurs in all cultures. In chronic/process schizophrenia, development is gradual and recovery is doubtful. In acute/reactive schizophrenia, onset is sudden-in reaction to stress-and prospects for recovery are brighter.

People with schizophrenia have an excess number of dopamine receptors, which may intensify brain signals, creating positive symptoms such as hallucinations and paranoia. Brain scans have revealed abnormal activity in the frontal lobes, thalamus, and amygdala, as well as a loss of neural connections across the brain network. Brain abnormalities associated with schizophrenia include enlarged, fluid-filled areas and corresponding shrinkage and thinning of cerebral tissue. Smaller-than-normal areas may include the cortex, the hippocampus, the corpus callosum, and the thalamus.

Possible contributing factors include maternal diabetes, older paternal age, viral infections or famine conditions during the mother's pregnancy, and low weight or oxygen deprivation at birth.

Twin and adoption studies indicate that the predisposition to schizophrenia is inherited. Multiple genes interact to produce schizophrenia. No environmental causes incariably produce schizophrenia, but environmentla events (prenatal viruses or maternal stress) may "turn on" genes in those who are predisposed to this disorder. Possible early warning signs include social withdrawal; a mother with severe and long-lasting schizophrenia; birth complications; seperation from parents; short attetion span; poor muscle coordination; emotional unpredictability; poor peer relations and solo play; seperation from parents; and childhood abuse.

dissociative disorders, dissociative fugue state

dissociative identiry disorder

The psychodynamic explanation of DID symptoms is that they are defenses against anxiety generated by unacceptable urges. The learning perspective attempts to explain these symptoms as behaviors that have been reinforced by relieving anxiety.

personality disorders

anxiety - such as fearful sensitivity to rejection that predisposes the withdrawn avoidant personality disorder eccentric or odd behaviors - such as those prompted by the magical thinking od schizotypal personality disorder dramatic or impulsive behaviors - such as the unstable, attention-getting borderline personality disorder & the self-focused and self-inflating narcissistic personality disorder, and-what we next discuss as an in-depth example-the callous & and often dangerous, antisocial personality disorder

antisocial personality disorder, 8, 15

Twin and adoption studies show that biological relatives of people with antisocial behavior. Researchers have also observed differences in the brain activity and structure of antisocial criminals. Negative environmental factors such as poverty or childhood abuse, may channel genetic traits such as fearlessness in more dangerous directions-toward aggressions and away from social responsibility.

anorexia nervosa

bulimia nervosa

binge-eating disorder

anorexia nervosa, bulimia nervosa

it is almost never reported outside North America

inflexible and enduring behavior patterns that impair social functioning

lower-than-normal activation in the frontal lobes

Bulimia is marked by weight flutuations within or above normal ranges.

Dissociative disorders are controversial, rare conditions in which conscious awareness seems to become separated from previous memories, thoughts, and feelings. Skeptics note that dissociative identity disorder, DID, increased dramatically in the late 20s century is rarely found outside North America; and may reflect role playing by people vulnerable to therapists' suggestions. Others view DID as a manifestation of feelings of anxiety, or as a response learned when behaviors are reinforced by anxiety-reduction.

Personality disorders are inflexible and enduring behavior patterns that impair social functioning. The ten DSM-5 disorders tend to form 3 clusters, characterized by 1. anxiety, 2 eccentric ot odd behaviors, and 3. dramatic or impulsive behaviors.

Antisocial personaliry disorder is characterized by a lack of conscience and, sometimes, by aggressive and fearless behavior. The amygdala is often smaller and the frontal lobes less active in people with this disorder, leading to impaired frontal lobe cognitive functions and decreased responsiveness to others' distress. Genetic predispositions may interact with the environment to produce these characteristics.

In those with eating disorders, psychological factors overwhelm the body's tendency to maintain a normal weight. Despite being significantly underweight, people with anorexia nervosa maintain a starvation diet, sometimes exercising excessively, and have an inaccurate self-perception. Those with bulimia nervosa binge and then compensate by purging, fasting, or excessively exercising. Those with binge-eating disorder binge but do not follow with purging, fasting, and exercising. Cultural pressures, low self-esteem, and negative emotions interact with stressful life experiences and genetics to produce eating disorders.

eating disorder - women or gay men anorexia nervosa - adolescent females bulimia nervosa - women in their late 10s and early 20s

Neurodevelopmental disorders

It's a condition of limited mental ability, indicated by an intelligence test score of 70 or below and difficulty adapting to the demands of life in 3 skill areas (conceptual, social, and practical).

It sppears in childhood and is marked by significant limitations in communication and social interaction, as well as rigidly fixated interests and repetitive behaviors.

A child (or an adult, less commonly) who displays extreme inattention and/or hyperactivity and impulsivity may be diagnosed with attention-deficit/hyperactivity disorder (ADHD). Controversies center on whether the growing number of ADHD cases reflect overdiagnosis or increased awareness of the disorder, and on the long-term effects of stimulant-drug treatment.

1. low intelligence test score (70 or below) 2. must have difficulty adapting to the normal demands of independent living, as expressed in 3 areas, or skills: 1) conceptual (language, reasing, and concepts of money, time, and number) 2) social (interpersonal skills, being socially responsible, following basic rules and laws, avoiding being vitimized), 3) practival (health and personal care, occupational skill, and travel).

Autism spectrum disorder

Attention-deficit, hyperactivity disorder

inattention, distractibility, hyperactivity, impulsivity

Stimulant drugs calm hyperacticity, and increase ability to sit and focus, and psychological therapies help with the distress of ADHD.

People with ASD are less imitative and show less activity in brain areas involved in mirroring others' actions. When people with ASD watch another person's hand movements, for example, their brain displays less-than-normal mirroring activity.

The DSM have breadened the diagnostic criteria for ADHD, leading to an increase in diagnoses without concurrent chages in children's attentional behavior. Critics suggest that these criteria are now too broad and may pathologize noremal behaviors, turning everyday childish rambunctiousness into a disorder.

Stone age - people were possessed by demons/sprits and trephining allowed for their escape Hippocrates - psychological functioning was due to disturbances in body fluids called "humours" Europe in Middle Ages - exorcisms were performed to drive away evil - asylums began to appear but the mentally ill were treated inhumanely 18th century (enlightenment) - Pinel ordered humane treatment and initiated the medical model (whose influence remains today) + medical model proposes that abnormal behavior be viewed as a disease and treated as one (like physical illnesses), it eventually gave rise to psychiatry and patients were treated in mental hospitals

No clear-cut way of distinguishing normal from abnormal behavior Context must sometimes be taken into consideration

1) Statistical Frequency - behavior that's infrequent is abnormal - definition is based strictly on numbers problem) - not all infrequent behaviors are judged as "abnormal" ex) exceptional athletic ability 2) Deviation from Social Norms problem) - abnormality is culturally relative - norms change over time - not all socially deviant behaviors are indicative of "abnormality" ex) burping in public 3) Behavior is Abnormal if it's Maladptive - everyday adaptive behavior is impaired problem) - this view makes a judgment about the consequences of behavior, which can be subjective ex)drinking alcohol isn't abnormal but if it interferes with daily functioning, it is 4) Psychological Distress - based on a person's subjective feeling of distress (they might not exhibit maladaptive behavior) problem) distress is not always experienced by people with psychological disorders

continuum

- it involves matching symptoms to pre-established categories of psychological disorders that are listed in The Diagnostic and Statistical Manual of Mental Disorders, DSM - is the basis for selecting a therapy and making a prognosis

a formal and standard diagnostic interview, personality and projective tests, interview with patient's family/friends

reliability

Yes

2013

16, 300

labeling may lead to a "self-fulfilling prophecy," patients behaves in accordance to expectations, a label can lead to social stigma, labels can "color one's perception" (eg, Rosenhan's study)

Generalized Anxiety Disorder, Phobic Disorders, Panic Disorder, Agoraphobia

pathological worry about minor matters, difficulty making decisions and concentrating, headaches, fatigue, nausea, sweating, restless, feeling on edge, difficulty sleeping

repeated, sudden and unexpected attecks of extreme anxiety, worry about when the next attack will occur, sweating, chest pains, weakness, faintness, fee like you're having a heart attack

Having fear of leaving the house alone, being in open/public spacses, standing in line, crowds, public transportation.

Simple or specific phobia, Social anxiety disorder

- anxiety is in response to a specific stimulus or setting ex) common phobias are fear of animals, height, blood, flying, closed spaces, water, storms, etc

fear of being negatively evaluated by others ex) public speacking, eating in restaurants, going to parties

It's recurrent, involuntary thoughts of images.

It's ritualistic behaviors (sometimes unobservable such as counting or praying) that one feels compelled to carry out ex) obsessed with the thought of germs leads to excessive/repeated hand-washing Compulsive behavior relieves the anxiety caused by the obsessive thoughts - hoarding, nail-biting, skin-picking fall under this category

- anxiety elicited by traumatic events (war, accident, rape, natural disaster) - traumatic event is re-experienced through flaskbacks and nightmares - emotional numbness, feeling disconnected from others, sleeping difficulties - irritability, anxiety, anger, guilt

- 2 or more personalities reside within the person - each personality has its own traits, names, mannerisms, age, etc - transitions can occur suddenly - the "host" personality is not aware of the existence of the other ones - lapses in memory, time loss, feeling detached from their body - often also suffer from anxiety, depression, substance abuse - controversial diagnosis; some question its existence

major depressive disorder, suicide, bipolar disorder

- #1 disorder for which people seek help - depression affects nearly twice as many women as men - onset can occur at any age but most common in 25~33 yrs old - depression will sometimes eventually lift on its own but risk of suicide during the depression is 5 times higher than for non-depressed people

depressed mood, lack of interest/pleasure inactivities, agitation/irritability, negative thoughts, feeling worthless/low self-esteem, sleeping difficulties, changes in weight, problems with thinking or concentrating, suicidal thoughts, unexplained aches and pains

- occurs more often when depression is lifting - 4 times as many men as women die from suicide but women make more attempts - highest suicide rates are in May - in Canada, suicide accounts for 24% of all deaths among 15~24 yr olds and is 2nd leading cause of death in 10~24 yr olds - rates are lower for married people than singles or divorces

- affected by lack of sunlight - tends to occur in the fall/winter - low energy, over-sleeping, carb craving, weight gain

- composers, artists, writers, and entertainers are more prone - mood swings (between mania and depression) punctuated by periods of normalcy

high energy, racing thoughts, euphoric mood, sleeplessness, optimisitism, self-importance, spending sprees, impaired judgment, impulsive, substance abuse

Splitting up of normally integrated cognitive functioning (not to be confused with multiple-personality)

Imparied attention, Affective disturbance (either "flat affect" or inappropriate emotions), Hallucinations - sensory perception that occur in the absence of real stimuli (commonly auditory ones), Thoght disorders - unable to maintain an orderly flow of ideas ("flight of ideas," derailment, word salad), Inappropriate motor - behavior - senseless, repetitive motions; catatonia (motionless), Delusions - false beliefs (eg. delusions of grandeur), Deterioration in quality of work, social relations and personal hygiene

- the onset is sudden rather than gradual - it developed quickly after a life stress

- slow-developing - prognosis is better with acute schizophrenia

Positive symptoms - behavioral excesses or peculiarities; presence of inappropriate behaviors eg) hallucnations, delusions, bizarre behaviors, flight of ideas Negative symptoms - behavioral deficits such as flat affect, social withdrawal, apathy, inattention Problem) patients don't neatly fit in 1 category