Psych 301, 10/6/3
Disorders of mind & body
How are mental disorders conceptualized and classified?
Classification of mental disorders
Diagnostic and Statistical Manual (DSM-IV)
Multiaxial system: Recognizes multiple and interacting causes of mental disorders
Modern definitions focus on maladaptivity and interference with daily life, not just non-conformity
Multiple causes of disorders
Psychological approaches
Psychodynamic approach: Unconscious factors cause disorders
Family systems model: Considers symptoms within an individual as indicating problems in the family
Sociocultural model: Views psychopathology as the result of the interaction between individuals and their cultures
Cognitive-behavioral approach
Behavioral approach: Mental disorders are the result of classical and operant conditioning
Cognitive approach: Thought and beliefs also contribute to creation and maintenance of maladaptive behaviors
Biological factors
Genetic factors influence mental illness
The fetus is particularly vulnerable
Environmental toxins and malnutrition
Maternal illness
Brain imaging indicates that changes in some areas of the brain are associated with disorders
Diathesis-stress model
Vulnerability
A predisposition or “diathesis”
Caused by biological or environmental factors (e.g., childhood trauma)
May not itself trigger psychopathology
Stress
Current difficult life circumstances
May exceed individual’s ability to cope
The stigma of mental illness
Legal definitions of psychopathology
Separate from clinical definitions
Legal criteria for criminal responsibility
knowing right from wrong
behavior due to mental defect
ability to appreciate criminality of act
burden of proof on defense
Standards for involuntrary commitment
must be dangerous to self or others
very difficult to predict
Anxiety disorders
Phobic disorder
Phobia: Irrational and exaggerated fears of specific objects and situations
Specific phobias: Fear of particular objects and situations
Social phobias: Fear of being negatively evaluated
Generalized anxiety disorder
Anxiety is not focused on anything specific
Constant anxiety and concern about even minor matters
Hypervigilance
Constant alertness to potential problems
Results in distractibility, fatigue, irritability, and sleep problems
Panic disorder
People experience attacks of terror that are sudden and overwhelming
Triggers for attack
External stimuli
Internal thought processes
Typically last several minutes
Physical symptoms – heartrate, breathing, dizziness, sweating
Obsessive-compulsive disorder
Obsessions: Recurrent, intrusive, and unwanted thoughts
Compulsions: Particular acts the OCD patient feels driven to perform repeatedly
Most common behaviors: cleaning, checking, and counting
Fear what they might do or might have done
Causes of OCD
Operant conditioning
Anxiety is paired with a specific event
The person engages in compulsive activity to reduce anxiety
People with OCD have small caudate nucleus, a region that suppresses impulses
People with damage to this area demonstrate OCD symptoms
The prefrontal cortex may be involved
Panic disorder & agoraphobia
Agoraphobia – Fear of being in places from which escape is difficult or embarrassing
Thought to arise from learned associations
May be the result of untreated panic attacks
Panic disorder patients respond to physical arousal with feelings of panic
Thought to be due to biological factors
Mood disorders
Depressive disorders
Major depression
A disorder characterized by severe negative moods and a lack of interest in normally pleasurable activities
Appetite & weight changes
Sleep disturbances& loss of energy
Feelings of self-reproach
Thoughts of suicide and death
Episodes can last weeks or years
Dysthymia
Depression of mild to moderate severity
Nearly constant depression lasting for many years
Often considered a personality disorder rather than a mood disorder
Bipolar disorder
Periods of major depression
Alternating episodes of mania
Elevated moods&increased activity
Diminished need for sleep
Grandiose ideas
Extreme distractibility
Hypomanic episodes
Bipolar I, Bipolar II, Cyclothymia
Causes of depressive disorders
Twin studies show a genetic component
Medications increasing norepinephrine and serotonin alleviate depression
Damage to the left prefrontal cortex often leads to depression
Seasonal affective disorder
Periods of depression linked to times of the year and sunlight
Suggests that disruption of biological rhythms may be associated with depression
Situational factors in depression
Stressful life events are associated with onset of depression
People with close friends are less likely to become depressed when faced with stress
Cognitive & behavioral factors
The cognitive triad
Depressed people think about themselves, their situation, and the future in a negative manner
Negative attributional style: Viewing negative outcomes as results of permanent and pervasive problems
Learned helplessness
Animals become passive, unresponsive and lose motivation when raised in a constantly aversive environment
Feel unable to escape
People with learned helplessness
Have negative expectations
Feel hopeless about positive changes
Causes of bipolar disorder
Bipolar disorder is predominantly a biological disorder
Twin studies show a high concordance rate
Runs in families
In families with bipolar disorder, successive generations show more severe illness and earlier onset