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Lecture & Textbook Notes Ch 15

by: Lorelei Wong

Lecture & Textbook Notes Ch 15 PSY 150A1

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Lorelei Wong
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Psychological Disporders
Structure of Mind & Behavior
Dr. Adam Lazarewicz
Class Notes
Psychological, disorders, structure, Of, mind, and, behavior, psy, 150A
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This 10 page Class Notes was uploaded by Lorelei Wong on Tuesday April 19, 2016. The Class Notes belongs to PSY 150A1 at University of Arizona taught by Dr. Adam Lazarewicz in Spring 2016. Since its upload, it has received 94 views. For similar materials see Structure of Mind & Behavior in Psychlogy at University of Arizona.


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Date Created: 04/19/16
PSY 150A1 With Prof. Lazarewicz Lecture Notes Chapter 15: Psychological Disorders  Psychological disorder – characterized as deviant, distressful, & dysfunctional patterns of thoughts, feelings, & behaviors o Deviant – violation of norms, or rules in society that are defined as “right & wrong”  Ex: personal space o Distressful  Judge own normality  No distress = no disorder  Problem: lack of distress does not equal harmless behavior  Behavior can still be harmful even if not causing distress o Ex: alcoholism o Dysfunctional – disrupts life & routine  Ex: compulsive hand-washing  Explaining Psychological Disorders o Ancient societies  Ancient Egypt was the first known culture that made metal health a priority  First known psychiatric test, mental hospital, mental physicians, etc.  Ancient Greece & Hippocrates (460-360 BC)  Mental illness due to natural causes o Middle ages  Witchcraft th th  Mid 15 to end of 17 centuries: 100,000 “witches” executed in European witch-hunts  Possession/evil spirits  Exorcisms o Thought torture would make the body an inhabitable place for a spirit so they would leave o Trepanation – drilling holes into the skull to allow the evil spirit to escape  When people survived these (most cases), they would be changed  (wouldn’t happen to do with the fact that they were just basically tortured and drilled into without anesthesia)  Big holes … not small  Motivation to act differently o Medical model  Return to a more medicinal approach by the 1800’s  Physical causes for mental disorders  Asylums (psychiatric hospitals) – institutions that offered shelter & support to the mentally ill o Often had very poor living conditions and excluded from the rest of society PSY 150A1 With Prof. Lazarewicz  Overcrowding, lack of resources & care, etc.  Terminology – mental health/illness, diagnosis, symptoms, cures, therapy, treatment, etc.  Classifying Psychological Disorders o Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – lists of all symptoms & diagnostic criteria for all disorders  Most common diagnostic tool in clinical psychology  Disorders organized into categories (anxiety, mood, etc.)  Pros:  Standardized (diagnosis & treatment)  Fairly reliable  Cons:  More disorders = more mental illnesses o 60 categories in 1950s DSM; 400 today o Nearly 30% of adults qualify for at least one disorder  Diagnostic criteria include everyday behaviors… at what point is it considered a disorder then?  Labeling problem – labeling people as a person with disorders and only considering them by that  David Rosenhan (1973): On Being Sane in Insane Places  Can 8 psychologically healthy people fake way into mental hospitals? What happens if they do? o 3 psychologists, 1 psychiatrist, 1 psychology graduate student, 1 pediatric, 1 painter, 1 home maker  Present selves at separate hospital (5 states)  3 lies told:  False names  False careers for psychologist & psychiatrists  Hearing voices  All 8 admitted with schizophrenia  No further voices, any other abnormal behavior  Behaviors seen as consistent with mental illness  Ex: note talking: “Patient engaging in pathological writing behavior”  Fooled doctors, but patients were the ones to challenge them  Challenged by a different mental hospital  can’t fool us!  Rosenhan to send at least 1 imposter over a 3- month span  Admitted 193 patients o 41 considered imposters, another 42 considered suspicious PSY 150A1 With Prof. Lazarewicz o 0 sent by Rosenhan  Anxiety disorders o Anxiety – state of fear (behavioral, subjective experience with psychological reactions)  Can be adaptive  Anxiety disorder – deviant, distressful, & dysfunctional anxiety o Generalized anxiety disorder (GAD)  Symptoms  Persistent state of anxiety  Continually waiting for something bad to happen  Restless, jittery, insomnia  Difficulty concentration, irritable  Increased heart rate & muscle tension, easily tired  Secondary anxiety – anxiety about their anxiety o Only makes it worse  Groups at risk  2/3 of diagnoses are female o Women more likely to seek help than men  All ages o Panic disorder  Symotoms  Repeated un-cued panic attacks o Panic attack – sudden period of intense fear  Often short of breath, heart palpitations, sweating, dizziness  exhaustion after attack  Usually only a few minutes o Cued – situationally bound in response to a trigger  Ex: phobias o Un-cued – unexpected, random, “out of the blue”, not connected to a trigger  Agoraphobia – fear of future attacks in public  Fear of inescapable situations where help may not be available  May tend to stay close to home, only leave with companions (or don’t leave home at all)  Complication of panic disorder & own disorder o Agoraphobics without panic disorder, panic disorder without agoraphobia  Both can be the case  Bottom line: panic attacks can cause agoraphobia, but are not a prerequisite  Groups at risk  Panic disorder: o 3.5% of US  7% have experienced a panic attack PSY 150A1 With Prof. Lazarewicz  Agoraphobia: o 5.3% of US o More common in women o Median average of onset = 24 o Phobias – intense, persistent fear of an object/situation, avoidance of it, cued panic attacks  Specific phobias  Top 10 most common o Heights o Enclosed spaces o Injection/needles o Thunder/lightning o The number 13 o The dark o Snakes o Spiders o Disease o Germs  Social phobia  Symptoms o Anxiety in social situations or thinking about them o Fear of embarrassment & humiliation  avoid certain situations  Ex: public speaking, eating in public, using the public restrooms  Social phobia vs. agoraphobia  Social phobia o Afraid of social disapproval, embarrassment o Comforted by avoiding others  Agoraphobia o Afraid of the anxiety itself, not having help o Comforted by being with others  Groups at risk  Specific phobias o Average onset age is 11-17 o 9-10% of people o 2x as common in women  Social phobia o Usually early adolescence is the average onset age o 13% of people o No sex differences o Obsessive compulsive disorder – uncontrollable anxiety due to obsessions compulsions  Obsessions – unwanted, repetitive thoughts  Ex: dirt/germs, something bad happening, order/symmetry  Compulsions – unwanted, repetitive behaviors  Ex: excessive washing, repeating behaviors, checking PSY 150A1 With Prof. Lazarewicz  Groups at risk  2-3% of people  Median onset age: 23  Men & women at equal risk o Men  checking o Women  cleaning o Post-traumatic stress disorder (PTSD)  Symptoms  Haunting memories of trauma  Easily startled  Irritability  Nightmares  Social withdrawal  Insomnia  4+ weeks after a traumatic event (incubation period)  War, terrorism, natural disasters, accidents, abuse, etc. o The closer were are to the event, the more traumatizing it is…  Groups at risk  5-8% of people  Certain jobs (military, EMTs)  Females 2x that of men o Possible causes of anxiety disorders: Nature vs. Nurture  Nurture  Fear conditioning o Ex: phobias, PTSD o Ex: little Albert o Ex: OCD handwashing germs  Learned behavior o Anxiety runs in families  Modeled behavior  Nature  Genes o Runs in families o Twin studies o The brain  OCD: hyperactivity in the anterior cingulate cortex  Region of the frontal lobe that monitors our actions – defects errors & mistakes  Panic disorder: hyperactivity in the locus ceraleus  Controls norepinephrine (fight-or-flight)  Mood disorders o Mood disorder – significant increase or decrease in mood o Major depressive disorder (MDD) PSY 150A1 With Prof. Lazarewicz  Depressive episodes  5+ of these symptoms & must have one of top two o Low mood o Loss of interest in activities o Feeling worthlessness o Sleep: insomnia/hypersomnia o Difficulty concentrating o Appetite: weight loss/gain o Sluggishness, fatigue, low energy o Thoughts of death, suicide  Dysthymia – low mood & two other symptoms listed above  15 million Americans  15% of college students  1 in 5 in their lifetime  Who is at risk?  Women 2x as likely  At any given time o 4% men o 6% women  Rates of depression are rising worldwide  Seasonal affective disorder (SAD) – depressive symptoms that arise in late autumn & winter  Majority are females  Ex: Finland 9.5% & Alaska 8.9%  May be related to less light exposure o Affects circadian rhythm o Body shows down as if it is nighttime  Treatment o Light therapy – exposure to artificial light for several hours a day  75% improvement o Bipolar disorder – group of disorder marked by mania  Subsyndromal symptoms = 24.9%  Symptoms  Elevated/euphoric or irritable mood  High energy  Decreased need for sleep  Grandiosity  Racing thoughts, short attention span  Reckless/risky behavior  Manic episodes – these symptoms occur most of the day, nearly every day for 1 week  Hypomanic episode – these symptoms occur most of the day nearly every day, for 4 days PSY 150A1 With Prof. Lazarewicz  Bipolar 1 – 1+ manic episode (may or may not involve depressive episode)  Bipolar 2 – 1+ depressive episode & 1+ hypomanic episode  Cyclothymia – manic & depressive episodes that do not meet full DSM criteria— subtler than bipolar 1 or 2  Possible causes  1. Biological influences o Genes o Neurotransmitters  Depression: low levels of serotonin, norepinephrine  Mania: high levels of norepinephrine o Area 25: smaller than normal = higher risk of depression  2. Psychological/cognitive influences o Self-defeating beliefs  Negative assumptions about self, present, and future o Explanatory style  How we interpret & explain an event to ourselves  3. Environmental influences o Negative experiences  Traumatic events  Stressful environment  Stressful experiences o Vulnerability-stress model  Vulnerability (diathesis): predisposition  Stressor: life even or series of events  Vicious cycle  Stressful experience  negative explanatory style  depressed mood  cognitive & behavioral changes  stressful experience (& repeat)  Schizophrenia – distortion of thoughts, moods, perceptions, & weird behaviors o Approx. 1 in 100 people o Incredibly universal  Men afflicted earlier, more severely, and slightly more often than women o Symptoms  Detachment from reality  Hallucinations  Delusions  Actions don’t reflect understanding o 3 types of symptoms  1. Distortions to thought & language  Delusions – false beliefs, firmly held with no basis in reality o Ex: some types of delusions  Persecution  Control  Sin & guilt  Reference PSY 150A1 With Prof. Lazarewicz  Nihilistic  Grandeur  Bizarre hypochondriacally  Thought insertion  Thought withdrawal  Thought broadcasting o Thought tampering  Broadcasting – “people can hear everything I’m thinking”  Insertion – “they put it in my mind”  Withdrawal – “they took it from my mind”  Word salad – jumble of words all together that doesn’t make much sense with little to no coherence o Like someone threw a bunch of word magnets at a fridge and read it  Clanging – rhyming of words or sounds while talking, sentences don’t make much sense  Poverty of content – more like a grammatically correct stream of consciousness without any rhyme or reason as to why they are talking or what the purpose of them talking is  Neologisms – combination of regular words to create new ones or sayings that aren’t common or associated in society o Possible schizophrenics who demonstrate this know what they are trying to say, but don’t know how to say it  2. Perception – breakdown of selective attention  Hallucinations – sensory experiences without sensory input o Mind creates images or noises without there actually being such o Any sense b auditory most common (70% of schizophrenics) o Some are aware of the hallucinations, others are not and cannot tell or are not aware that they have a problem  Which are the real voices, and which are imaginary?  PET scans show activity in Broca’s area while hearing voices  3. Inappropriate emotions & behaviors – reduced emotional responsiveness  Blunt affect – showing little emotion  Flat affect – showing no emotion o Dimensions of schizophrenia  1. Reactive vs. process schizophrenia  Reactive – rapid development, often in response to stress o Recovery fairly likely  Process – more gradual onset, slow development o Recovery doubtful  2. Positive vs. negative symptoms  Positive – presence of inappropriate behaviors PSY 150A1 With Prof. Lazarewicz o Ex: hallucinations, word salad, inappropriate emotions o Usually respond well to medication o Type I schizophrenia  Negative – absence of appropriate behaviors o Ex: flat affect, toneless voice, rigid body o Harder to treat o Usually not as responsive to medication o Type II schizophrenia o Possible causes: Nature vs. Nurture  Nature  Genetics o The more closely related to a schizophrenic you are the more likely you are to be schizophrenic as well o If a genetic predisposition likely exists, may not be sufficient enough to be schizophrenic though  Brain abnormalities o 1. Excess dopamine receptors  6x as many in schizophrenics  Intensifies neural signals  positive symptoms (hallucinations  Medications block symptoms o 2. Shrinking in brain  Tissue loss in the cortex thalamus  Environmental factors o Flu during pregnancy  4x higher risk of schizophrenia  Higher rate in urban areas (faster viral spread)  Born during winter & spring (after fall-winter flu season) = 5-8% increased risk  Southern hemisphere: flipped months PSY 150A1 With Prof. Lazarewicz Textbook Notes  Abnormal behavior – causes distress and prevents daily functioning  Medical perspective – cause of abnormal behavior rooted in individual possibly due to hormone imbalance, chemical deficiency, or brain injury  Psychoanalytic perspective – abnormal behavior stems from childhood conflicts over opposing wishes regarding sex and aggression  Behavioral perspective – rewards and punishments in the environment which influence and determine abnormal behavior  Cognitive perspective – central part of people’s abnormal behavior is from thoughts and beliefs  Humanistic perspective – people responsible for own behavior  Sociocultural perspective – society shapes people’s behaviors  Illness anxiety disorder – people fear illness and are preoccupied with their health  Conversion disorder – physical disturbance of a somatic symptom disorder  Dissociative disorders – dysfunctional characteristics of a person’s personality  Dissociative identity disorder – multiple personalities displayed within a single person  Dissociative amnesia – significant selective memory loss  Dissociative fugue – leaving home and assuming a new identity suddenly  Narcissistic personality disorder – exaggerated sense of self importance  Attention-deficit hyperactivity disorder – low tolerance for frustration, inattention, easily distracted, impulsive, and decent amount of inappropriate activity


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