Lecture & Textbook Notes Ch 15
Lecture & Textbook Notes Ch 15 PSY 150A1
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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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