ch 14 notes - Ch 14 Psychological Disorders Defining...

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Unformatted text preview: Ch. 14: Psychological Disorders Defining Abnormality Distress Impairment Danger Cultural and social influences Explaining Abnormality: The DiathesisStress Model "Diathesis"=Biological Factors Stress Genes Neurotransmitters Brain Structure and Function Illness, injury trauma Relationship problems Cultural/societal influences Labels and Abnormality Rosenhan: "On being sane in insane places" 8 pseudopatients claimed to hear voices Admitted to psychiatric hospitals Stopped reporting symptoms Categorizing Disorders Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSMIV) Axis I: clinical disorders Axis II: personality disorders and mental retardation Axis III: general medical conditions Axis IV: psychosocial and environmental problems Axis V: global assessment of functioning Mood Disorders Major Depressive Disorder Affect, Behavior, Cognition Diagnosed with 2+ weeks of 5 or more of these: Depressed mood. Significant weight (loss > 5%) within 1 month not due to diet. Insomnia or hypersomnia. Diminished interest or pleasure in activities. Psychomotor agitation or retardation (observable by others). Fatigue or loss of energy. Feelings of worthlessness, inappropriate/excessive guilt. Diminished ability to think or concentrate, or indecisiveness. Thoughts of death or suicide. Depression Depression Statistics 23 times more common in ______ Prevalence: Duration: Depression and Suicide 30% of clinically depressed people attempt suicide; Strategies to Prevent Suicide Half succeed (4:1 men) Ask about it. Talk about it when it's brought up. Encourage and facilitate steps to get help. Remove firearms, drugs, and avoid leaving the person alone. Watch for planning and increased activity. Explaining Mood Disorders Genetics 69% concordance between MZ twins Depression or anxiety disorders are 3x more likely in offspring of depressed parents Brain Prefrontal Cortex May not stimulate key neurotransmitters: Amygdala HPA Axis Hippocampi The person Beck's negative triad Learned helplessness Attributional style Rumination The group Life stressors Daily hassles vs. uplifts Withdrawal=lack of social reinforcement Contagion (being around depressed people) Mood Disorders Bipolar disorder 1+ Manic episode, which is 1+ week of: Grandiosity, elevated selfesteem Reduced need for sleep Increase in talkativeness, pressure to talk Racing thoughts Distractibility, poor attentional focus Increased goaldirect activity (projects)/psychomotor agitation Excessive pleasure seeking and risk taking Mood Disorders Lifetime prevalence of Bipolar: Often cycles with depression Genes: Formerly called "manic depression" Brain Function: 80% concordance btw. bipolar and mood disorders in identical twins Runs in families w/depression, ADD and OCD Treating Mood Disorders Depression Drug Treatments: Selective Serotonin Reuptake Inhibitor (SSRI's) MAOInhibitors Tricyclics New finding: Substance P (in amygdala, also signals pain) blocker may reduce depression. Treating Mood Disorders Bipolar Drug Treatments: Lithium Antiepileptic drugs (increase GABA) Reduces intracellular activity producing action potentials Anxiety Disorders Generalized anxiety disorder Panic disorder (~3% lifetime prevalence) ~3% of population Excessive and nonspecific anxiety or worry Panic attacks (unpredictable and life altering) =>Agoraphobia Locus coeruleus The BIS Anxiety sensitivity Anxiety Disorders Phobias Social phobia Specific phobia Lifetime prevalence 13% Animal fears Bloodinjectioninjury fears Natural environment fears Situation fears Miscellaneous fears Lifetime prevalence 10% Obsessivecompulsive disorder (OCD) Anxiety Disorders Obsession Compulsion Lifetime prevalence 23% Anxiety Disorders Understanding Obsessive Compulsive Disorder Brain Person Overactivity of the caudate nucleus of basal ganglia a loop for repetitive thoughts and action Negative reinforcement Metacognitive accuracy Family stress or rejection Group Anxiety Disorders Drug Treatments for Anxiety Disorders Panic Disorder, Social phobia, OCD Generalized Anxiety, Specific phobia encounters Benzodiazepines (increase GABA) Xanax, Valium, Librium Replaced Barbiturates (Phenobarbital) Antidepressants (SSRI's) Anxiety Disorders Posttraumatic stress disorder (PTSD) Traumatic event Fear and helplessness Symptoms Reexperience event Avoidance and emotional numbing Heightened arousal Lifetime prevalence 8% (among Americans) Anxiety Disorders Brain level: Genetic predisposition Person level: Overactive locus coeruleus (Symp. N.S.) & Amygdala Small hippocampi, linked to intrusive memories More cortisol receptors (stronger stress response) Anxiety Disorders Group level: Trauma involving personal interaction is more likely to lead to PTSD than natural disasters or 2nd/3rd party events. Social support helps prevent PTSD ...
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