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Chapter 13 Psychological Disorders

by: Melantha Liu

Chapter 13 Psychological Disorders PSYCH 202

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Melantha Liu

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Hello, guys, this is one of the last chapters we have been learning so far! Are you ready for the final? My notes have consisted of valuable information from the book and the powerpoint in-class. Y...
Introduction to Psychology
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This 25 page Study Guide was uploaded by Melantha Liu on Thursday December 10, 2015. The Study Guide belongs to PSYCH 202 at University of Wisconsin - Madison taught by Patricia Coffey in Fall 2015. Since its upload, it has received 70 views. For similar materials see Introduction to Psychology in Psychlogy at University of Wisconsin - Madison.


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Date Created: 12/10/15
Chapter 13 Psychological Disorders Yiting Liu Outline 1. Identifying psychological disorders: what is abnormal? a. Classification of disorders b. Causation of disorders c. Dangers of labeling 2. Anxiety and obsessive-compulsive disorders: when fears take over a. Generalized anxiety disorder b. Phobic disorders c. Panic disorder d. Obsessive-compulsive disorder 3. Depressible and bipolar disorders: at the mercy of emotions a. Depressive disorders b. Bipolar disorder 4. Dissociative disorders: going to pieces a. Dissociative identity disorder b. Dissociative amnesia 5. Schizophrenia: losing the grasp on reality a. Symptoms and types of schizophrenia b. Biological factors c. Psychological factors 6. Personality disorders: going to extremes a. Types of personality disorders b. Antisocial personality disorder 7. Important information from PPT 1. Identifying psychological disorders: what is abnormal? a. Definition: Medical model: the conceptualization of psychological abnormalities as diseases that, like physical diseases, have biological causes, defined symptoms, and possible cures. DSM-5: (Diagnostic and statistical manual of mental disorders [fifth edition]).a classification system that describes the features used to diagnose each recognized mental disorder and indicates how the disorder can be distinguished from other similar problems. Comorbidity: the co-occurrence of two or more disorders in a single individual. Diathesis-stress model: a model suggesting that a person may be predisposed for a mental disorder that remains unexpressed until triggered by stress. b. Classification of disorders i. DSM-5 can classify 1. Three key elements to quality a potential mental disorder a. Disturbances in behavior, thoughts or emotions b. Personal distress or impairment c. Internal dysfunction (biological, psychological or both) 2. N.B.: a. When people undergo the mild sadness and distress after a break-upè not a mental disorderà because it is normal b. When people have prolonged period of unremitting sadnessè indicate depressionà mood disorder. ii. Types of disorders 1. Schizophrenia spectrum and other psychotic disorders: major disturbances in perception, thought, language, emotion and behavior 2. Bipolar and related disorders: major fluctuations in moodà mania to depressionà psychotic experiences 3. Depressive disorders: extreme and persistent periods of depressed mood 4. Anxiety disorders: excessive fear and anxiety to impair persons’ functioning a. E.g.: panic disorder, generalized anxiety disorder, specific phobia. 5. Obsessive-compulsive and related disorders: obsessive thinking followed by compulsive behavior in response to that thinking 6. Trauma-and stressor-related disorders: traumatic event, a. E.g.: post-traumatic stress disorder b. PPT i. Negative traumatic memory ii. Flashback iii. Actively resist negative thoughts iv. Memories get stronger, difficult to manage for the person 7. Dissociative disorders: disruptions and discontinuity in consciousness, memory, or identity a. E.g.: dissociative identity disorder 8. Somatic symptoms and related disorders: persons experience bodily symptoms associated with significant distress or impairment a. such as pain and fatigue 9. Personality disorders: enduring patterns of thinking, feeling and behaving that lead to significant life problems. 10. PPT Neurotic disorders/ non-psychotic disorders: a. No delusions or hallucinations b. No markedly impaired reality testing i. Absence of markedly impaired reality testing is seen in persons who are aware that their thinking and feelings are distorted, unreasonable or unreal, or products of their own mental processes ii. Summary: People know that they fear about the anxiety but don’t lose contact with reality iii. Comorbidity: the co-occurrence of two or more disorders in a single individual c. Causation of disorders i. Biological factors (internal) 1. Genetic influences 2. Biochemical imbalance s 3. Structural abnormalities of the brain ii. Psychological factors (internal)/ cognitive-behavioral factors 1. Maladaptive learning 2. Coping, cognitive biases 3. Dysfunctional attitudes iii. Environmental factors (external)/ family and sociocultural factors 1. Poor socialization 2. Stressful life circumstances 3. Cultural and social inequalities d. Treatments of disorders i. Diathesis-stress model: person may be predisposed for a psychological disorder that remains unexpressed until triggered by stress. 1. E.g.: people have strong emotional reactions towards the terrorist attack on September, 11, 2001è major life stressor è psychological disorder 2. N.B.: a. If people inherited of diathesis never encounter the precipitating stress, psychological disorder will not take place b. People who have little genetic propensity to a disorder get exposed to the right pattern of stress will have disorder 3. Conclusion: PPT a. Genetic and non-genetic factors are influential as predisposing factors b. Stress is triggering factor c. Stress is influenced by (increase people’s vulnerability) i. Objective major life events ii. Hassles iii. Cognitive and personality predispositions ii. PPT The “Diathesis-Stress” model integrates multiple perspectives 1. A general framework for explaining the causes (etiology) of mental disorders 2. Diathesis= predisposing factors a. Genetics b. Personality traits c. Environment d. Early and prolonged stressors and stress-responses e. Resulting in emotionally and behaviorally maladaptive “circuits” in the brain 3. Stress= precipitating factors or triggering factors a. Stressful major life events associated with the onset of psychopathological symptoms in adult hood i. Monozygotic twins, only one of them may develop mental disorders such as schizophrenia (trigger factors work) ii. Beyond genetic vulnerability 4. Bleeding diathesis: a tendency to suffer from a particular medical condition 5. This model shows that a person may be predisposed for a psychological disorder that remains unexpressed until triggered by stress iii. Intervention-causation fallacy: the perception error that if a treatment is to be effective, it must address the cause of the problem 1. E.g.: a. You are worried about your loved one’s illness b. And you took a sleeping pill to solve you lack-of-sleep problem c. So your anxiety and sleeplessness were due to your loved one’s illness d. Not to the absence of a sleeping pill 2. Conclusion: the cure does not necessarily point to the cause. e. Dangers of labeling i. Will have negative stereotypes and stigma 1. E.g.: a. mental disorder= personal weakness b. psychiatric patients are dangerous 2. Consequence: a. 70% people with diagnosable psychological disorder do not seek treatments ii. Case study by Rosenhan, 1973 1. When people “hearing voices” (schizophrenia) got admitted to the hospital, they reported that the symptom had ceased 2. Even so, doctors were reluctant to identify these “patients” as normal 3. Conclusion: once the hospital staff had labeled these “patients” as having a psychological disease, the label stuck. iii. Therefore, 1. We should just label the disorders not the people who have those disorders 2. Otherwise, it will develop an attitude of defeat and fail to work toward their own recovery iv. PPT The Value and Danger of Labels and Diagnosis: 1. Facilitate professional communication 2. Leads to shorthand description, implied meaning 3. Can stigmatize and lead to self-fulfilling prophesies 4. Risks involving: a. Biases b. Misunderstanding 2. Anxiety and obsessive-compulsive disorders: when fears take over a. Definition: Anxiety disorders: mental disorders in which anxiety is the predominant feature Generalized anxiety disorder (GAD): a disorder characterized by chronic excessive worry accompanied by three or more of the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, and sleep disturbance. Phobic disorders: disorders characterized by marked, persistent and excessive fear and avoidance of specific objects, activities, or situations Specific phobia: a disorder that involved an irrational fear of a particular object or situation that markedly interferes with an individual’s ability to function Social phobia: a disorder that involved an irrational fear of being publicly humiliated or embarrassed. Preparedness theory: the idea that people are instinctively predisposed toward certain fears Panic disorder: a disorder characterized by the sudden occurrence of multiple psychological and physiological symptoms that contribute to a feeling of stark terror Agoraphobia: an extreme fear of venturing into public places Obsessive-compulsive disorder (OCD): a disorder in which repetitive, intrusive thoughts (obsessions) and ritualistic behaviors (compulsions) designed to fend off those thoughts interfere significantly with an individual’s functioning Mood disorders: mental disorder that have mood disturbance as their predominant feature Major depressive disorder: a disorder characterized by a severely depressed mood that lasts 2 weeks or more and is accompanied by feelings of worthlessness and lack of pleasure, lethargy, and sleep and appetite disturbances. Seasonal affective disorder (SAD): depression that involved recurrent depressive episodes in a seasonal pattern. b. Generalized anxiety disorder (GAD) i. Anxiety about making mistakes/ self-doubt/worthless/ unable to control his debilitating anxiety/ headaches/ constant fatigue ii. GAD: a disorder characterized by chronic excessive worry accompanied by three or more of the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, and sleep disturbance. iii. PPT anxiety disorders: description 1. Generalized anxiety disorder a. Around 6 months b. Difficult to control the worry c. At least 3 symptoms (prone to physical expressions) i. Restlessness ii. Easily fatigues iii. Difficulty concentrating or mind going blank iv. Irritability v. Muscle tension vi. Sleep disturbance iv. Example: 1. A guy who is about to choose the suit would be so anxious about the wrong choice of the suit that he would not even enter the store. v. Factors: 1. Biological: a. Mild to moderate level of heritability b. Identical twins have modestly higher concordance rates 2. Psychological vi. PPT Details 1. Focus on threatening events content 2. “The doctor examined Emma’s growth” 3. Biological factors paly role 4. Inhibited temperaments related to anxiety a. High stress reactivityà anxiety disorder 5. Increase CNS activation related to panic disorder vii. Prescription drugsà treatment of GAD 1. Some drugs à stimulate the neurotransmitter GABAà suggesting neurotransmitter imbalances in the order 2. Other drugs (Prozac) 3. Drawbacks: a. Side effects 4. Popular circumstances for GAD a. Anxiety-provoking situations happen to people with low incomes or in large cities, or trapped in environments unpredictable by political and economic strife b. Higher rates of GAD are among women i. Due to the poverty ii. Discrimination iii. Subject for sexual or physical abuse viii. PPT Treatments 1. Better with cognitive-behavioral approaches than with medication alone 2. Systematic desensitization uses “fear hierarchies” to help people learn to manage dimensions of fear (easy to hard) 3. Virtual treatments can reduce fear responses ix. PPT treatments focusing on behavior and cognition are best for anxiety disordersà but some benefit from medication 1. SSRI’s help social phobia, but cognitive and behavioral methods and treatments of choice a. Disorder often co-exist b. Do the self-talk to control your body and mind c. Most helpful when combined with CBT 2. Panic disorder treatments often combine medication and CBT, but relapse is less with CBT c. Phobic disorders (classified as anxiety disorder)/(high degree of anxiety) i. Definition: 1. Phobic disorders: a marked, persistence, and excessive fear and avoidance of specific objects, activities, or situations 2. Specific phobia: an irrational fear of a particular object or situation that markedly interferes with an individual’s ability to function. ii. Type of phobic disorders 1. Specific phobias: elevators, spider, heights a. Claustrophobia: fear of enclosed spaces i. Example: ii. Mary: 1. in childhood, older siblings would scare her by locking her in closets and confining her under blankets 2. Right now, she would not dare to take the elevators or find a job that has elevators 2. Social phobia: an irrational fear of being publicly humiliated or embarrassed. a. Symptoms: avoid situations in which strangers might evaluate them à experience intense anxiety and distress b. Generations: i. Can develop during childhood and emerge between early adolescence and 25 ii. 11% of men and 15% of women diagnosed of that iii. Higher percentage found in people who are 1. undereducated 2. low incomes 3. or both 3. Agoraphobia a. Fear of venturing in public or having a panic attack in public iii. Preparedness theory: people are instinctively predisposed towards certain fears. st 1. 1 Experiment: a. Humans and monkeys can quickly be conditioned to have a fear response towards a spider or snake b. But no fear response towards neutral stimulus like flowers 2. 2 Experiment: a. People are more easily conditioned to fear angry facial expressions than other types of expressions 3. John Watson experiment: a. Phobia can be classically conditioned, BUT… i. Discomfort of a dog biteè conditioned association between dogs and pain ii. Irrational fear of all dogs iii. However, it is not the explanation for the phobic disorders because people who are bitten by dogs will normally not develop phobia. 4. Reasons for preparedness theory a. Neurobiological factors i. People with phobias have ii. Higher amount of Serotonin and Dopamine iii. Higher amygdala activities which links with the development of emotional associations d. Panic disorder: the sudden occurrence of multiple psychological and physiological symptoms that contribute to a feeling of stark terror PPT approximately 22% of the U.S. population reports having at least one panic attack i. Hypersensitive and physiological signs of anxiety 1. People believe that physical arousal and other symptoms of anxiety can mean something disastrous ii. Symptoms: 1. Last a few minutes 2. Shortness of breath 3. Heart palpitations 4. Sweating 5. Dizziness 6. Feelings of detachment or unreality 7. Fear that one is going crazy or about to die iii. Types 1. Agoraphobia: specific phobia involving a fear of venturing into public places a. Afraid of having a panic attack in the public place or around strangers who might view them with disdain or fail to help them 2. PPT Influence a. Go to fewer places, go with same person b. Isolated in the apartment c. Social and emotional function d. Distress e. Medical care 3. PPT thinking can induce to generate panic orders a. Symptoms of the panic attack, they think they have panic attacksà panic disorder generated iv. Panic disorder distribution 1. Twice as more in women than in men 2. One identical twin has this, there will be 30% that another will also have v. PPT 1. With and without Agoraphobia 2. Avoid panic attack experiences e. Obsessive-compulsive disorder: a disorder in which repetitive, intrusive thoughts (obsessions) and ritualistic behaviors (compulsions) designed to fend off those thoughts interfere significantly with an individual ≈People have compulsive behaviors to eliminate the feelings/ thoughts about something PPT roughly 1.3% of the population suffers; moderate heritability i. Examples 1. Women purchasing things more than four times in order to avoid the bad luck that would bring to her four children if she did not do so. 2. Fear of contamination will lead to a 15 minute-hand-washing or using hot water, scrubbing their hands until they bleed ii. PPT 1. Only disorder when going out of control when people is suffering severely from that a. Obsessions: i. Thoughts of somebody’s having ii. Germs on my handà I will get some disease iii. Can not stop the thoughts b. Compulsions: i. Wash hands to get rid of germsà for hours (disorder: cannot function in normal way) ii. Negatively reinforcedà wash handsà anxiety goes down every timeà rewards/ strengthens the odds of doing that again 2. Video clip: a young mother’s struggleà OCD (obsessive- compulsive disorders) a. Cant take eyes of her sons i. Suspect everyone is trying to harm her son ii. Set a trap with specific anglesà at homeà in case of the kidnap b. Fear of contamination i. Wash hands with super hot water before in contact with jack ii. Avoid litters on the pavements iii. PPT Causes of OCD 1. Caudate nucleus dysfunction 2. Caudate nucleus part of basal ganglia a. Involved in impulse suppression i. Theory: impulses leaking to consciousness and prefrontal cortex becomes overactive b. Strep infection i. Streptococcus: a bacterium of a genus that includes the agents of souring of milk and dental decay, hemolytic pathogens causing various infections such as scarlet fever and pneumonia iv. PPT OCD is Anxiety Disorderà Most Effective treatment? 1. OCD treatments blend medication and CBT with a focus on “Exposure” and “Response Prevention” 3. Depressible and bipolar disorders: at the mercy of emotions a. FACTS i. Heritability estimates for major depression range from 33% to 45% ii. Involve norepinephrine, serotonin iii. à diminished activity in left prefrontal cortex iv. àincreased activity in right prefrontal cortex b. Depressive disorders i. Dysfunctional, chronic, fall outside the range of socially or culturally expected responses ii. Major depressive disorder: 1. Unipolar depression, 2. Lasts 2 or more weeks 3. Feelings of worthlessness and lack of pleasure, lethargy and sleep and appetite disturbances 4. No sadness or despair 5. PPT Significant weight loss or weight gain 6. Insomnia or hypersomnia a. Sleep disturbances b. Sleepy all the time regularly (when you feel better after sleep, you will not have enough time to achieve your goals, finish your tasks) 7. Psychomotor agitation or psychomotor retardation (video example below) a. Agitation: depressionà feel depressed b. Retardation: super slow i. Difficult for them to do the things they need to do ii. Suffering iii. Struggling to keep functioning 8. Fatigue or loss of energy 9. Feelings of worthlessness and excessive guilt 10. Diminished ability to think, concentrate and make decisions 11. Recurrent thoughts of death or suicidal ideation iii. PPT Video clip: psychomotor retardation 1. A deep state people experience in the bipolar disorder 2. Psychological and physical slowing down due to the major depressive episodes 3. Behaviors a. Pause of talking b. Looking down c. Close to deathà cant help thinking about the death d. No emotional expressions e. Lack of energyà seems like it takes all the energy to talk f. Wouldn’t be able to chat or talk quickly iv. PPT Psychotic Features as “Specifier” 1. Hallmarks of psychosis: delusions and hallucinations, in general, “marked impairment in reality testing.” a. Presence of psychotic features in mood disorders is seen in i. Mood-congruent delusions (depressive delusions of worthlessness/repulsiveness of self; manic delusions of grandeur, unlimited power and influence) 1. Beyond self-talk ii. Hallucinations (typically auditory) v. PPT persistent depressive disorder (dysthymia): 1. Chronic (2 years’ duration or more) “low grade” depression (doesn’t meet criteria for “major depression”) indicated by 2 or more of the following a. Poor appetite or overeating b. Insomnia or hypersomnia c. Low energy or fatigue d. Low self-esteem e. Poor concentration or difficulty making decisions f. Feelings of hopelessness 2. Not as extreme as the major depressive disorder a. Person continuing the function (able to work, go to school) b. Major depressive episode does not have functions to do so vi. Seasonal affective disorder (SAD) 1. Reduced levels of light (fall or winter) 2. Can use virtual therapy to treat 3. Conclusion: a. Depression increases as light decreases b. Seem to be biologically related to the light vii. Major depression is about 12 weeks viii. Without treatment, 80% individuals will have at least one recurrence of the disorder ix. Genetic factors are important in twins with high concordance rates 1. 59% for identical twins 2. 30% for fraternal twins 3. women’s depression= 2* men’s depression a. sex differences in hormones: estrogen, androgen, progesteroneà influence depression b. women: postpartum depression (following childbirth) because of a change of hormone balances c. norepinephrine and serotonin influence depression i. drugs such as Prozac and Zoloft increase their levels à reduce depression d. however, increased level of norepinephrine is showed in depressed patients e. Antidepressant medications change can be done in less than a day but will not relieve the depressive symptoms until two weeks later f. Depressionà decreased activity in left prefrontal cortex; increased activity in the right prefrontal cortex (emotion region) x. Psychological factor 1. Helplessness theory: a. Prone to depression automatically attribute negative experiences to causes that are internal (their own fault), stable (unlikely to change) and global (can’t do anything right) b. Cognitive demands arise (time pressure, distraction, stress, and so forth) c. People at the risk for depression often display heightened levels of negative thinking d. PPT persons with pessimistic, self-blaming thought patterns (stress-reactivity as a trait)à develop depression in response to stressful life events i. Harsh on giving pressure on themselvesà goal and aim ii. Distorted cognitive processing à increases risk of depression xi. PPT Posttraumatic stress disorder: troubles after a trauma 1. PTSD: disorder characterized by chronic physiological arousal, recurrent unwanted thoughts or images of the trauma, and avoidance of things that call the traumatic event to mind 2. 12% of The U.S. veterans of recent operations in Iraqà PTSD 3. Observed rates are higher in non-western and developing countries 4. Brain Imaging Technique a. identifies important neural correlates i. heightened amygdala activity (higher emotion) ii. decreased medial prefrontal cortex activity (control the fear and memories) iii. smaller hippocampus (preexisting condition) 1. some people are more neutrally vulnerable 2. smaller hippocampus (preexisting condition) 3. monozygotic twinsà predispose somebodyà difficult to detangle 4. memory related for people c. Bipolar disorder i. Unstable emotional condition 1. Mania: Cycles of abnormal, persistent high mood 2. Depression: Cycles of Low moods 3. Symptoms: a. Grandiosity b. Decreased need for sleep c. Talkativeness d. Racing thoughts e. Distractibility f. Reckless behavior (compulsive gambling, sexual indiscretions) ii. Example: (1999) 1. Julie, 20, 5 days without sleep, extremely active, expressing bizarre thoughts and ideas 2. She did not menstruate because of “a third sex, gender above the two human sexes” 3. Switched souls with senior senator from her stateà could save the world from nuclear destruction iii. Highest rate of heritability (40%-70% for identical twins; 10% for fraternal twins) iv. Minority of people with bipolar disorder are super creative and outstanding in certain ways. 1. Abraham Lincoln, Ernest Hemingway, Winston Churchill, Theodore Roosevelt, Virginia Wolf v. Causes of bipolar disorder 1. Biochemical imbalance, but have not identified specific neurotransmitters 2. Stressful life experiences a. Study: i. Severely affected people need three times more than normal people to reflect on an event ii. Non-supporting families (critics/hostility towards patients) will cause relapse of patients than supporting families 4. PPT Different types of mood disorders a. Bipolar disorders include i. Manic and/ or hypomanic episodes 1. Sublevel of manic symptoms present ii. Bipolar disorder (include depression) iii. Cyclothymic (hypomanic+ no major depression) ≈dysthymia 1. Cycle component of the dysthymia b. PPT Bipolar disorder i. Bipolar I 1. Hx of manic episodes 2. Hx of depressive episodes à for most a. Look very depressed b. Manic period ii. Bipolar II 1. Hx of hypomanic episodes a. Sublevel of manic 2. Hx of major depressive episodes a. History of hypomanic episodes iii. Treatments could use SSRI to alleviate serotoninà but could lead to a more manic stage while alleviating depression iv. Video clip: Latiffaà Bipolar I 1. God of the winds and rains à delusionsà match their moods 2. Bipolar disorder with psychotic features 3. Idea-skipping 4. Manic episodes 5. Distractibility 6. Enjoyed elevated manic phrases v. Video clip: I’m Brilliant à during, then after he presence of manic episode (focus on whether his grandiosity is genuinely delusional/psychotic) 1. A man with the introduction of medication comes down from manic episode and move to a more normal state a. Hallucinations: not real, extra hearings(frightening sounds; not sure if it is imagining or real)à voice said noting or low-level of hallucination b. Time sequence: trouble experiencing on work; hearing noise from co-workers c. Forgot all about the police-thing: don’t talk about anything to anyone 2. Symptoms before taking medications (5 years ago) a. Quiet b. Nothing to self c. Self-conscious d. Unable to talk e. Depression 3. After taking medications a. Normal b. Able to talk about psychological state c. Got manic and depressive episodes c. PPT manic/hypomanic episodes i. Manic episode (DSM-IV diagnostic criteria) 1. Manic mood episodes: distict period; abnormally and persistenly; elevated or irritable mood; 3 or more of the following a. Inflated self esteem or grandiosity (different from narcissism) b. Decreased need for sleep i. Don’t feel like they need to sleep c. More talkative than usual or pressure to keep talking i. Too fast to be understood d. Flight of ideas or subjective experience that thoughts are racing i. Idea-shifting ii. Idea-skipping e. Distractibility i. Attention too easily drawn to unimportant or irrelevant external stimuli f. Increase in goal-directed activity or psychomotor agitation i. People in manic period; thinking that they are doing great 1. Resistant to take medications to take away these abilities that benefit from bipolar disorders 2. Would have something bad afterwards g. Excessive involvement in pleasurable activities that have a high potential for painful consequences i. Unrestrained buying sprees, sexual indiscretions, foolish business investment ii. Hypomanic episode 1. Restless, consumer with confidence, excessively energized 2. Not as prone to the gloom following mania 3. Hypomanic sates generate bursts of creative work 4. Have tendency to move to bipolar stage 5. Not diagnosable 6. Can diagnose bipolar II 7. If just hypomanic, its just fine d. Cyclothymic disorder i. 2-year duration ii. Alternating periods of hypomanic (low-level manic) symptoms and depressive symptoms (major depressive episodes) e. Diagnosing bipolar disorders i. Bipolar disorder 1. Mental states can be a. Manic episode b. Mixed episode (alternation between mood states within an episode) i. Case: rapid cyclingà moods move so quick ii. Period of your mood is not in your state c. Major depressive episode 2. Bipolar as long as there has been a past history of mania a. If currently depressed with a history of manic episodes i. Should be bipolar disorder, depressed 5. Dissociative disorders: going to pieces a. Definition: i. Normal cognitive processes are disjointed and fragmented ii. Significant disruption in memory, awareness, or personality iii. From minute to years b. Dissociative identity disorder (DID) i. Presence of two or more distinct identities ii. At different times iii. Take control of individual behavior 1. Multiple patterns of though and behaviorè different identities iv. Causes of DID 1. Severe childhood abuse and trauma a. Primitive psychological defense of splitting or dissociating to escape the pain and horror v. Disputation: 1. Trauma and DID may be linked by therapists’ expectations 2. Because patients are vulnerable to suggestive procedures such as hypnosis vi. We still don’t understand about “what it is; how it arises; how it can be treated” c. Dissociative amnesia i. Example: 1. Burt, 42, no identification documents; clueless about his past 2. Gene’s wife came to identify him 3. Burt is Gene 4. Before his disappearance, he has been experiencing pressure at home and at workè withdrawn and irritable ii. Definition: 1. Sudden loss of memory 2. For significant personal information 3. Mainly due to traumatic specific event/ period à can be extended periods 4. May be temporary 5. Recovered them later iii. Dissociative fugue 1. Subtype of dissociative amnesia 2. Sudden loss of memory of for one’s personal history 3. By an abrupt departure from home and assumption of a new identity iv. Causes: 1. Emergence in adulthood 2. Rarely occur after age of 50 3. Amnesia is temporary, can be recovered 4. Will not result from normal forgetting or brain injury, drugs or another mental disorder such as post-traumatic stress disorder 6. Schizophrenia: losing the grasp on reality a. Definition: Hallucination: a false perceptual experience that has a compelling sense of being real despite the absence of external stimulation Disorganized speech: a sever disruption of verbal communication in which ideas shift rapidly and incoherently from one o another unrelated topic Grossly disorganized behavior: behavior that is inappropriate for the situation or ineffective in attaining goals, often with specific motor disturbances Negative symptoms: emotional and social withdrawal, apathy, poverty of speech, and other indications of the absence or insufficiency of normal behavior, motivation and emotion Dopamine hypothesis: the idea that schizophrenia involved an excess of dopamine activity b. Example: i. Margaret, 39, god was punishing her for marrying a man she did not love and 2 children she gave birth to ii. They were cursed to be immortal iii. Suffer the disturbances in thought c. Definition: 1. disruption of basic psychological processes 2. Distorted perception of reality 3. Altered or blunted emotion 4. Disturbance in thought, motivation, and behavior d. Symptoms: 1. Delusion a. False belief system: bizarre, grandiose, irrationality b. Example: (famous-person-delusion) i. People consider they are Jesus Christ, Presidents of the Countries ii. The CIA/the demons/ the extraterrestrials are monitoring them à or control their minds 2. Hallucination a. False perceptual experience b. Compelling sense of being real despite the absence of external stimulation c. 65% reported hearing voce repeatedly 3. Disorganized speech a. Sever disruption of verbal communication b. Rapid ideas shifting c. Incoherence d. Example: i. - “can you tell me the name of the place?” ii. - “I have not been a drinker for 16 years.” 4. Grossly disorganized behavior / Catatonic behavior a. Inappropriate for the situation or ineffective in attaining goals b. Specific motor disturbances c. Symptoms i. Constant childlike silliness ii. Improper sexual behavior iii. Disheveled appearance iv. Loud shouting or swearing 5. Negative symptoms (things missing in people with schizophrenia) a. Emotional and social withdrawal: i. apathy, poverty of speech, indications of absence or insufficiency of normal behavior, motivation and emotion e. Generation: i. Late adolescence or early adulthood ii. Disproportionate rate of hospitalization for schizophrenia= testament to the devastation it causes in people’s lives f. However, people with the symptoms above could be people without the disorders i. 65% students reported to have hearing hallucinations g. Biological factors i. Dopamine hypothesis: schizophrenia has excess of dopamine activity ii. However, not all patients respond to the dopamine-block drugs iii. The drugs are not effective, only show relieve of symptoms a few weeks later iv. The role of neurotransmitters in schizophrenia has yet to be determined v. h. Psychological factors i. Family environmentà development of and recover from the condition 1. Study: compared the risk of schizophrenia in children adopted into healthy families and those adopted into severely disturbed families (extreme factors such as conflicts, lack of communication, chaotic relationships) 2. With the mothers having schizophrenia, the disturbed environment will stimulate the generation of schizophrenia in children 7. Personality disorders: going to extremes a. Definition: Personality disorders: disordered characterized by deeply ingrained, inflexible patterns of thinking, feeling, relating to others or controlling impulse that cause distress or impaired functioning Antisocial personality disorder (APD): a pervasive pattern of disregard for and violation o the rights of others that begins in childhood or early adolescence and continues into adulthood b. Types of personality disorders i. DSM-5: 10 personality disorders 1. Three clusters: 2. odd/eccentric a. schizotypal: eccentric manners of speaking or dressingà react oddly in conversations, or talking to oneself (mild form of schizophrenia) b. paranoid: distrust in people , suspicion about people with sinister motives, hostile intentions èjealous, guarded, secretive, serious c. schizoid: “loner”, extreme introversion/ withdrawal fro relationships, fearful of closeness, poor social skills 3. dramatic/erratic a. antisocial: impoverished moral sense or “conscience”; high risk of substance abuse and alcoholism b. borderline: unstable moods and intense; self-mutilation and suicidal threats to get attention or manipulate others; self image fluctuations; “all good”/ “all bad” c. histrionic: constant attention seeking, grandiose, shallow, “onstage” d. narcissistic: fantasies of self and success; own achievement; superior; poor longer term relationships; exploitative of others 4. anxious/ inhibited a. avoidant: socially anxious and uncomfortable; fear of rejection b. dependent: submissive, dependent, requiring excessive approval, uncomfortable when alone, suicidal if breakup is threatened c. obsessive-compulsive: conscientious, orderly, perfectionist, poor expression of emotions c. Antisocial personality disorder (APD) i. Definition: 1. Pervasive pattern of disregard for and violation of the rights of others 2. Begins in childhood/ early adolescence 3. Continues into adulthood ii. Sociopaths and psychopaths are cold-hearted, manipulative, and ruthless iii. Negative words such as hate or corpseè criminals have less activity in the amygdala and hippocampus than do noncriminal 8. PPT: the real world: suicide risk and prevention a. 11 leading cause of death in the U.S. b. 3 among high school and college students c. 50% of those committing suicide after a depressive episode d. Variety of motives for suicide i. biological or contagious (the Weather effect) e. Prediction and prevention are difficult f. BUT warning signs are abundant g. White males: highest rate of suicide 9. Comparisons between major depressive disorders and bipolar disorders a. Major depressive disorders show symptoms i. Sad mood ii. Decrease in pleasure iii. Sleep problems iv. Decreased appetite v. Low energy vi. Suicidal thinking b. Bipolar disorders i. Hypomanic symptoms 1. Elevated mood 2. Grandiose thinking 3. Rapid speech 4. Decreased sleep need 5. Last more than 3 days 6. If have cycles between hypomania and depressionà bipolar II ii. Manic symptomsà more severe form of bipolar disorder 1. Show all the symptoms present in hypomanic symptoms 2. Inconsistent expression with baseline personality a. Spending a lot of money b. Travelling without making appropriate plans c. Acting on sexual impulses inappropriately 3. May develop psychotic symptoms such as a. paranoid delusions b. auditory or visual hallucinations c. breakdowns in normal thinking processes 10. Comparisons between unipolar and bipolar disorders a. Unipolar: more stable moods than bipolar people b. Untreated bipolar stated people c. Can get away with the medications d. Bipolar i. Need medications ii. Unstable iii. Bipolar I (manic + major depressive) iv. Bipolar II (hypomanic + depressive) 11. PPT etiology/ causation of mood disorders a. Diathesis-stress models predominate i. Genes are important ii. iii. genetic contribution is lower in DZ than that in MZ iv. Bipolar is strongly genetically based and acquire medications to stabilize v. GENETIC RESEARCH SUGGESTS POLYGENIC CAUSATION 12. PPT Mood disorders have cognitive, situational and biological components a. Situational components i. Negative reactions of others to depressed persons can produce rejection and isolation in a downward spiral 1. Downward spiral takes place when social support removes ii. Social support may buffer and protect vulnerable persons


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