Lecture: Psychological Disorders
Lecture: Psychological Disorders APSY.UE.0002
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This 7 page Class Notes was uploaded by Brianda Hickey on Tuesday May 3, 2016. The Class Notes belongs to APSY.UE.0002 at NYU School of Medicine taught by Adina Schick, in Spring 2016. Since its upload, it has received 18 views. For similar materials see INTRODUCTION TO PSYCHOLOGY AND ITS PRINCIPLES in Psychlogy at NYU School of Medicine.
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Date Created: 05/03/16
Lecture: Psychological Disorders There is no known culture of the world that the people does not suﬀer from depression or schizophrenia Psychological Disorders are ongoing patterns of thoughts, feelings, and actions that are: Deviant - diﬀerent being diﬀerent from the people in your culture Ex. In many societies…if you indicate that you hear voices you are thoughts to have a psychological disorder. In some societies…speaking to the dead is treasured Deviant behavior needs to cause distress / be dysfunctional in order to be classiﬁed under a psychological disorder. Distressful Dysfunctional Understanding Disorders Medical Model Focus is on genetically inﬂuenced abnormalities in brain structure and biochemistry Psychological disorders have physical causes that can be diagnosed and treated An in some cases, cured - as like any form of physical illness Acknowledge that psychological factors (enduring and traumatic events) do play a role, but they place more emphasis on the brain chemistry Biopsychosocial Approach Mental illness denotes a sickness that must be found and cured In addition, there might be an issue in the person’s environment, interpretation of event, habits, social skills, etc. Acknowledges that mind and body are inseparable from one another Classifying Disorders Classiﬁcation aims to: Describe a disorder Predict the disorder’s future course Identify appropriate treatment Stimulate research to identify causes The classiﬁcation system is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Classiﬁcation results in labels Labels create preconceptions that guides our treatment Allows professionals to communicate what they are seeing and lay out a plan of action Without having a diagnosis/labels- insurance companies would not pay for treatment Anxiety Disorders Generalized Anxiety Disorders (GAD): Unexplainably and continually tense and unease Panic Disorder: Sudden episodes of intense dread Phobias: Irrationally and intensely afraid of a speciﬁc object or situation Obsessive-Compulsive Disorder: Troubled by repetitive thoughts or actions Post-Traumatic Stress Disorder: Lingering memories, nightmares, etc. for weeks after a severely threatening, uncontrollable event Generalized Anxiety Disorder Marked by excessive worrying and physical symptoms that run for at least 6 months Symptoms might seem commonplace; their persistence is not People continually worry, easy agitated, steel deprived and tense as a result Diﬃculty to identify the cause Much more common in women Rare after age 50 Much more likely to impact younger rather than older individuals Panic Disorders Anxiety escalates into a panic attack Panic Attack - minutes long episode of intense fear that something absolutely terrible is about to occur Recurrent panic attacks or the fear of having another panic attack Strikes suddenly, wreaks havoc, and disappears, leaving its mark. Prevalence is high. Smokers are at an especially high risk (2X as likely) Explanation: Nicotine serves as a stimulate, the person is much more susceptible to having a panic attack Phobias An irrational fear causes a person to avoid an object, event, or situation Not all phobias have speciﬁc triggers Problem: You don’t know what to avoid Common forms include claustrophobia, acrophobia, hydrophobia, and agoraphobia Social phobia is shyness taken to an extreme Have an intense fear of being scrutinize by others. Will avoid anything that might provide them with embarrassment The fear alone is not the disorder - it’s the steps you take to avoid it Ex. The thought of a storm coming causes you to hide under your bed for hours Obsessive-Compulsive Disorder Persistently interferes with everyday living and causes distress Ex. Washing hands before eating = normal behavior Washing hands so much before you eat that your skin becomes raw = disordered behavior 2%-3% of the population develop OCD More common among teens and young adults Post-Traumatic Stress Disorder 7% of the population have suﬀered from PTSD Common among war veterans, as well as survivors of accidents, disasters, and violent and sexual assaults The greater one’s emotional distress, the higher the risk for PTSD symptoms Come PTSD symptoms might be genetically predisposed Etiology of Anxiety Disorders Learning Perspective Conditioning Panic prone people start associating anxiety with certain queues Ex. Someone who was in a car accident would grow to afraid of all cars Observational Learning Learn fear from observing others around us Parents play a large role in transmitting their fears Biological Perspective Helps us understand why people develop lasting phobias after experiencing trauma, Why some individuals are more vulnerable to developing anxiety than others Natural Selection We seem biologically prepared to fear the threats that were feared by our ancestor Ex. Fear of : Animals, closed spaces, darkness Genetics Some people are genetically predisposed to disorders (Anxiety) Dissociative Disorders Conscious awareness becomes separated from previous memories, thoughts, and feelings Dissociative Amnesia Sudden loss of memory for important personal information that is too extensive that it’s due to normal forgetting Ex. cannot remember your name Dissociative Fugue Loss of memory for one’s entire life along with sense of personal identity Dissociative Identity Disorder Exhibiting two or more distinct and alternating personalities No longer called multiple personality disorder Typically a person with DID is nonviolent Those with DID exhibit diﬀerent eye movement with diﬀerent personalities A lot of controversy of whether this is a real thing The number of cases rose dramatically int he 1980s as the same time as the DSM included it as a disorder Much less preeminent outside of North America - nonexistent in Japan or India Points to a cultural phenomenon People say it is a disorder created / triggered by therapists Psychoalanysts Some people say DID is a form of PTSD Learning Theorists Mood Disorders Depression 44% of college students are so depressed that they cannot function A far greater number felt some aspect of depression, but to a lesser extent Depression is the most common reason people seek mental health services 13% of adults in the U.S. suﬀer from depressive disorders. An actual diagnosed disorder - not just some symptoms Depression impacts twice as many women as men Depression is associated with past or current loss (compare to anxiety where they are afraid of something happening) Major depressive disorder occurs when at least ﬁve signs of depression last for two or more weeks & are not caused by another medical issue Depressed Mood Diminished interest in pleasure Signiﬁcant weight loss or weight gain Changing in appetite Insomnia Fatigue Feelings of worthlessness - Feelings of excessive guilt Diminished ability to think or concentrate - can also manifest as excessive decisiveness Suicidal Ideation Sadness is adaptive and an important part of life….when does this response move to being maladaptive? Bipolar Disorder a mood disorder in which an individual alternates between depression and mania During a manic phase, the individual is: Overly-talkative Overactive Elated Little need for sleep Few sexual inhibitions Irritated by advice These do not last for long, the individual will either return to a normal state or to depression Much less common than major depressive disorder - eﬀects 1% of the population Typically much more dysfunctional Impedes a person’s daily excessively Aﬀects men and women equally Etiology of Mood Disorder Biological Perspective Genetic Inﬂuences Research has long demonstrated that mood disorders tend to run in family. Such as the risk of - increases signiﬁcantly if you have a parent or sibling diagnosed with one of the disorders If one identical twin is diagnosed with a major depressive disorder - the chances are 50% that the other twin will be diagnosed with a major depressive disorder If one If one identical twin is diagnosed with bipolar disorder- the chances are 70% that the other twin will be diagnosed with bipolar disorder Identical twins were reared apart in study Children adopted and suﬀering from a mood disorder most likely have a biological parent that suﬀers from a mood disorder Depressed Brain There is less brain activity during depressive states The left frontal lobe - regulating positive emotion is not functioning at full capacity when someone is depressed Norepinephrine that increases arousal is lessened during depressive state serotonin is scarce during periods of depression More brain activity during manic phase Norepinephrine is heightened during depressive state Bipolar disorder is commonly treated by targeting Norepinephrine, lessening it - can lead to depression. Too much serotonin is being produced Socio-Cognitive Perspective Self-defeating beliefs Play a huge role in feeding depressed state No matter what you do, you have no control over your future A learned feeling of helplessness…can lead to depression Women are far more prone to feelings of learned helplessness than are men Might explain why women are more prone to depression than men Negative explanatory style Women are more likely to “not let go” Why is it that some failures lead people to become depressed, but not everyone? One explanation is - where you place the blame Ex. IF you fail an exam…and you externalize the feelings (blame the failure on the diﬃculty of exam) you are more likely to feel anger…if you internalize the feelings (I should have studied more) you re more likely to feel depressed. Respond to negative events in very self blaming ways might directly lead to depressed states of hopelessness Depression is more common to be diagnosed in westerners because of individualism In western society, young people are socialized to take a self- blaming /individualistic response to failure / gain. Depression linked to how you hurt others around Etiology of Mood Disorders Cycle: Stressful Experience -> Negative explanatory style -> Depressed Mood -> Cognitive and behavioral changes-> Stressful Experience We remember negative experiences far more than positive experiences Schizophrenia 1 in 100 people will be diagnosed with Schizophrenia 24 million people suﬀer from schizophrenia the most dreaded form of mental disorder Schizophrenia = split mind Schizophrenia is marked by: Disorganized thinking Fragmented, bizzarre beliefs /delusions Paranoid Schizophrenics will have delusions of being persecuted Disturbed Perceptions might/might not suﬀer from hallucinations - having a sensory experience without any stimuli Seeing, feeling, tasting, smelling things that are not actually there More common ones - auditory; frequently voices making insulting remarks or commanding them Inappropriate Emotions & Actions Ex. Individual might laugh when remembering the death of a loved one There is a disconnect from their emotions and actions Catatonic - remain emotionless for hours on end Disrupt social relationships, diﬃcult to hold a job A signiﬁcant individuals with Schizophrenia will remain socially withdrawn from most of their lives Schizophrenia strikes as young people mature into adults Most often develops during the college years Strikes across cultures and contexts Males tend to develop schizophrenia earlier - develop more severe symptoms Males are slightly more diagnosed with schizophrenia than women For some…schizophrenia will happen suddenly, others will gradually develop schizophrenia Subtypes of schizophrenia include: Paranoid- most often depicted in media - preoccupied by their delusions and hallucinations often have themes of persecutions or grandiosity - they can do everything Disorganized Disorganized speech and behavioral patters Either no emotion or very inappropriate emotion Catatonic Excessive purposeless movement Ex. excessive rubbing of arm Extreme feeling of negativity Parrot like repetition of another person’s speech ( including inﬂection0 and movement Undiﬀerentiated Symptoms across diﬀerent forms of schizophrenia Residual Extreme withdrawal after delusions and hallucinations disappear Schizophrenia can be marked by positive symptoms or negative symptoms Postive symptoms (presence of inappropriate behaviors) Experiencing hallucinations Paranoia Exhibiting inappropriate emotions Negative Symptoms (absence of appropriate behaviors) Toneless Expressionless faces Mute or rigid bodies Etiology of Schizophrenia - most researched Brain abnormalities Most research suggests there is a biological aspect Imbalances in brain chemistry can lead to schizophrenia Dopamine Overactivity Seem to have an excess of dopamine that might create positive symptoms If their medication to reduce dopamine level is not adjusted properly - will exhibit rigid bodily movement Brain Structure Brian images look diﬀerently in people with schizophrenia Maternal viruses during pregnancy If there is an outbreak of the ﬂue virus, having a mother that contracted the ﬂu while pregnant will lead to an increased risk of developing schizophrenia Do not know why - just know there appears to be a connection Genetics 1 in 10 chances of developing disorder if parent or siblings have schizophrenia 1 in 2 if the sibling is an identical twin Psychological factors a trigger to schizophrenia Biosocial approach - there is a biological predisposition, there is often an environmental trigger that leads to schizophrenia
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