Mental Health Disorders: Symptoms, Diagnoses, and Types - Prof. Pamela Woodruff, Study notes of Abnormal Psychology

Download Mental Health Disorders: Symptoms, Diagnoses, and Types - Prof. Pamela Woodruff and more Study notes Abnormal Psychology in PDF only on Docsity! Abnormal Psychology Chapter 14,15: Schizophrenia - psychosis: disorder that involves alterations in perception and thoughts, loss of contact with reality, does not understand that inferences are not real, most severe impact on person’s life of are the psychosis - symptoms of schizophrenia: grouped into 3 broad categories - positive symptoms: most able/ respond best to antipsychotic symptoms, most easily to identify, totally irrational behavior, bizarre symptoms, medicine works best o delusions- thought content: disturbance in content of thought, cannot be changed with clear proof that they are wrong, faulty interpretation of reality  delusions of control: belief that others are inserting/controlling/removing thoughts from their mind (martians or CIA)  delusions of reference: attaches personal significance to other people conversations, objects, events, actions, thoughts being broadcast, ex. dialogue between two people in a movie may be about them  delusions of persecution: fears that an individual/group/government is out to get them, spy on them, kill them  delusions of grandeur: thoughts about being an important person or well known person o disorganized thinking and speech- form of thought: structure/organization of thoughts  loose associations: speakers idea shift from one thought to another with no connection  clang associations: associated by the way they sound- rhyming words not used for meaning  incoherence: attempt to communicate with predominantly disorganized speech, “word salad” jumbling things together with no meaning  perseveration: repeating the same words or ideas over and over  neologisms- “pretigitis”: make up new words that only mean something to them o heightened perceptions and hallucinations: major perceptual disruptions (most dramatic form), unable to sort out sensory information, no external sources, any of the 5 senses can be involved, auditory hallucinations are most common, hearing voices, command hallucinations- voices may make you do something, voices sometimes serve as protection against reality o inappropriate affect: lack of appropriate emotions to certain situations, acting inappropriately when a situation occurs, laughing at news of death - negative symptoms: harder to treat- medication doesn’t help o poverty of speech:  alogia: using very few, brief responses  blocking: end of sentence before it is completed  poverty of content: amount of speech is adequate, but does not contain any meaning o blunted or flat affect: showing less emotion than expected, individual might masturbate in public and be oblivious, flat affect is no facial emotion, etc. o disturbances in volition: person is apathetic, inability to follow through with course of action, disruption in goal directed activity o disturbed relationships: antisocial, impaired interaction, social withdrawal, too involved with internal actions, outer world is excluded, called autism, poor hygiene is involved, don’t bathe, don’t brush teeth, don’t wash clothes - psychomotor symptoms: odd gestures, mannerisms o catatonia: little or excessive movement  catatonic stupor: motionless and speechless  catatonic rigidity: stands in on position and cannot be moved  catatonic posturing: change positions that stay in for long time  waxy flexibility: remains in one place but allow you to move/ reposition them  catatonic excitement: hard to control, can harm themselves or others, ex. flailing arms, walk fast - phases of the illness: onset- late teens or early adulthood, it is insidious- slow and gradual, 75% onset between 15 and 45 o prodromal: starts to deteriorate from previous level of functioning, some less severe symptoms, strange habits like collecting garbage o active-florid symptoms: person has full blown symptoms o residual: returns to prodromal level, 25% have full recovery, 50% go back to active phase - historic overview: o Bleuler- schizophrenia (split mind): disorganization of thorough process, split off of reality, does not mean multiple personality disorder, split intellect and reality, thoughts and emotions - DSM-IV: 5 types o disorganized type (hebephrenic): youth mind, immature thoughts, earliest age of onset, symptoms come on slowly, very poor prognosis, severe disintegration of personality, behavior is disorganized, fragmentary hallucinations, social impairment, flat affect, 4 delusions,  Harry Stack Sullivan: 1923, male schizophrenics, had to be non-threatening, fragile ego of schizophrenic is unable to handle internal stress, all male patients and orderlies  Frieda Fromm-Reichman: aloofness of schizophrenics was in order to not refill, believed patient could stay in their world until they are ready to do it - family therapy: support of family and environment at home, cannot be over involved or totally, educational proponent to it, therapist gives support to family so they can support the patient Chapter 16: Personality Disorders - personality disorder, Axis II: defective perception, rigidity in behavior, negative impact on other people but don’t think that they are doing anything wrong, lack of consideration, excuse themselves, little understanding of the participation in a problem - cluster A- odd/eccentric behaviors: detached behaviors o paranoid personality disorder: suspicious, argumentative, rigid, mistrust others, see themselves as blameless, envious of those in higher status, disdainful of people they think are lower than they are, may have brief delusional state, interpret motives of others as evil, perceived as cold, humorless, more males than females o schizoid personality disorder: reserved, socially withdrawn, little desire to have relationship, unable to express their emotions, disinterested, poor social skills, much rather watch than participate, hard time initiating conversation, avoid eye contact, more males than females o schizotypal personality disorder: oddities in thinking and perceiving, deviations are not as extreme as schizophrenia, often not understood, use common words in odd ways, loose associations, gets worse with stress, suspicious and aloof, most distinguishing feature peculiar thought patterns, delusions of reference (conversations they hear in film are about them), lack of confidence, mild form of schizophrenia? males- negative symptoms, females- positive symptoms - cluster B- dramatic, emotional or erratic behavior: o antisocial personality disorder: not asocial, going against norms of society, misloyal, irresponsible, not guilty, violates rights of others, cause- harsh punishment by parent, modeling o borderline personality disorder: fall between extreme mood disorders and personality disorders, short episodes of being out of touch with reality, unpredictable, low tolerance for frustration, chronic boredom, feel empty, bits of extreme anger, shift sexual orientation, narcissistic, manipulative, self mutilation, drastic mood shifts, intense but stormy relationships, suicide threats, 75% women, low serotonin level, release non REM and REM sleep o histrionic personality disorder: old name hysterical, being theatrical, display exaggerated display of emotion, concerned with appearance, constantly looking for approval, uncomfortable when not the center of attention, equally male and female o narcissistic personality disorder: self-absorbed, exaggerate self importance, preoccupied with fantasies of power, lack empathy, always try to place themselves in good light of others, more males have disorder - cluster c- anxious and fearful behavior: o avoidant personality disorder (tied to social phobias and depression): extremely shy, socially withdrawn, fear of criticism, exaggerate short comings, low self esteem, become socially isolated and depressed, equal male to female ratio o dependent personality disorder: lack self confidence to make decision, unable to function independently, try to make themselves pleasing, don’t want to be rejected or abandoned, obsessive need to be taken care of, weak and obedient in order to hold on to others, if they are paired with a dominant person there will be trouble, some battered women have this disorder o obsessive-compulsive personality disorder: very seriously and overly conscientious, into neatness, disturbed if anything ins out of place, not how it effects other people, preoccupied with lists, rigid and restricted, do not show irrational thinking and do not take part in rituals - disorders of impulse control: behaviors are desirable, behaviors that are inherently pleasurable, harmful to self o pyromania: “fire”, intense pleasure and relief once the fire is started, can’t be for money or concealment of crime, can’t be for revenge, can’t be for expression of political views, and can’t be responsive to delusion, much more likely in males, Malatov Cocktail: take a bottle, fill it with gasoline, put a soaked rag inside, light on fire and throw the bottle (has been used to make a political statement) o kleptomania: repeated failure to resist stealing objects that are of little monetary value, sense of tension before theft, release while making theft, linked to penis envy, symbolic love toward object, pleasure with getting away with theft, reinforcement by getting away, cannot be fore reasons of financial gain or expression of anger or revenge against someone o pathological gambling: persistent preoccupation with gambling or attaining money for gambling, gamble for more money or longer time than planned, don’t go to work/social situations in order to gamble, increase debt but still don’t stop, Freud believed that winning was the equivalent to having an orgasm and losing was the equivalent to being castrated, gamblers anonymous, individual has often lost their house, job, and family, extremely hard to revuild o trichotillomania: any hair disease, recurrent pulling out of hair from on body (armpits, head, eyebrows, lashes, etc), sometimes eat hair, noticeable loss of hair, fills sense of tension before hair pulling, release once it is done, cannot resist impulse, behavioral therapy, 90% female o intermittent explosive disorder: uncontrollable anger, violent behavior that results in destruction of property of harm to people, anger out of proportion to what happened, 5 episodes in the year to be diagnosed, more men than women, includes abuse and road rage Chapter 17: Disorders of Childhood - childhood anxiety disorders: many unique to children, not a younger form of an adult disorder, parents feel guilty for their child’s problem o separation anxiety disorder: panic or fear when the child is not with a primary care giver, play therapy, cognitive therapy, hypnosis, family therapy, child shows anxiety/panic when not with a person of dependence, fear of getting lost and not finding parent, won’t go to school/ friend’s house, complaints of physical symptoms- headache, heart rate, stomachache, can come and go, when you ask what they’re afraid of they may say getting lost, never finding their parent, fear of monsters, kidnappers, etc. In early childhood all children experience this but for this to be a disorder it has to go on for at least four weeks, and often times it may diminish but then come back, can stem from some sort of stress (family moving, pet dying), responds well to treatments, systematic desensitization works well - childhood depression: low self esteem, childhood should be happy time, 2% of children, 9% of adolescents, crying, withdrawal, crying for no reason, poor appetite, little eye contact, suicidal thoughts, always go to therapy but sometimes SSRIs, too few child psychologist - childhood bipolar disorder: 1 million children, often misdiagnosed with 2 other disorders, hard to diagnose, 1995 realized children could have it, rapid cycles, 1 parent= 30% chance, 2 parents= 75% chance, most children are rapid cyclers that they do it more than once in a day, too much activity in amygdala, too little activity in prefrontal cortex, individual and family therapy, limiting caffeine and soda - disruptive behavior disorders: oppositional defiant behavior, goes on for at least 6 months, have to have four of the following symptoms, argue with adults, defy adults rules, annoy others and easily annoy themselves, loss of temper quite easily, being angry and resentful towards others, being spiteful, vindictive, and may go on to develop conduct disorder. o oppositional defiant disorder: argue with adults, defy adult rules, annoys others and get annoyed o conduct disorder: repetitive and resistant patterns of behaviors, anti- social act, lying, stealing, cheating, defy rule and social norms, torture animals, very hard to treat, may go away or develop into new o moderate: (cretin- old medical terms), IQ 35-49, 10% of people have it, skill levels up to the 2nd grade, capable of doing jobs, transported there o severe: (imbecile- old medical term) IQ 20-34, 3-4% have it, can be taught to use bathroom on own and dress themselves o profound: (idiot- old medical term) IQ below 20, 1-2% have it - causes: if mother is over 35 1 in 100 chance of having child with autism (miscarried) o chromosomal: life expectancy= age 50  down syndrome: 3 #21 chromosomes, trisomy 21, 2 normal #21 chromosomes, other two with #13 or #15 chromosome, 1 more way, small heads, very round o metabolic:  phenylketonuria (phenylalanine hydroxylease; tyrosine; phenylketones)- PKU: excessive levels of acid, issue in brain, change diet for child and won’t become retarded  Tay-Sachs: comes from recessive genes, fat builds up in nerve cells, retardation, blindness, death by age 3 or 4, gene carried by Jews of Middle Eastern Europe Chapter 18: Disorders of Aging and Cognition - disorders of later life: onset in old age o depression: mood disorders, unipolar depression more common than bipolar, symptoms: worry, feeling of worthlessness, fatigue, lack of motivation, sometimes because of medications, losing people or things, physicians are often senseless o substance abuse: dependence, less use of alcohol than in young people, illegal drugs are not used currently, big issue is misuse of prescription and over the counter drugs, memory problems so don’t know if they have taken it o disorders of cognition: clouded state of consciousness, develops swiftly, mood swings o delirium: most commonly seen in very young and old, can be corrected, confusion, nutritional imbalance, metabolic imbalance - dementia: away from the mind, judgment, communication, by age 65 5% have dementia o Alzheimer’s disease: 5 million, early onset- age 39, genetic onset, leave tasks unfinished, hygiene becomes very poor, lose their personality, become self centered, primary degenerative dementia of the alzheimer’s type (DDAT), with early onset, 3 subtypes- Alzheimer’s with delirium, Alzheimer’s with delusions, and Alzheimer’s with depression, also can have complicated Alzheimer’s no cure, 2 drugs slow down memory loss- airecept (beginning) and brings memory back for a few months (later on), both are toxic to the liver, eventually just comfort care o Pick’s disease: progressive degenerative disorder, can only be diagnosed for sure by autopsy, become socially uninhibited, completely apathetic, personality alterations then memory loss, caused by abnormal protein deposit in brain cells, adderoll helps for a while, but it is a fatal disorder, die more quickly o Creutzfeldt- Jakob disease: onset 40s-60s, caused by an infectious protein smaller than a virus, fatigue, brain, sleep problems, inability to concentrate, memory loss, leg spasms, fatal, related to mad cow disease o Huntington’s disease: wide spread deterioration of basal ganglia and corpus collosum, hereditary, comes from single gene- 50% if have gene, fatal, neurotransmitter GABA is effected, mood disturbance, personality changes, movement disorders, symptoms usually start in the 40s but can be seen in the 20s, jerky movements, severe memory loss, bed ridden before death o Parkinson’s disease: degeneration of the basal ganglia, 60% develop memory loss (usually older and more developed), tremors of head and hands, muscles become rigid, speech becomes hard to understand, L-dopa medicine reregulate dopamine in person, experimentally by having fetal tissue put in the brain, most promising is stem cells - sleep disorders: o dyssomnias: disturbance in amount, quality, or timing of sleep  insomnia: most common  not being able to fall asleep  difficulty remaining asleep  waking up earlier than want  narcolepsy: sudden and irresistible need to sleep, stimulants don’t work  sleep apnea: frequent gasping for air and causes waking up and sleep disturbances, does not breath for 15-30 seconds o parasomnias: unusual behaviors while sleeping  sleep terrors (night terrors): abrupt awakening from non-REM sleep accompanied by intense feelings of panic, usually during slow wave sleep, accompanied by terror, shriek and sits up right, stare into space, don’t remember the dream, falls back asleep, can occur at any age but most commonly at ages 4-12  nightmares: anxiety arousing dreams that lead to awakening from REM sleep, vivid memory of dream, difficult to go back to sleep, common in children but can occur in adults  sleep walking: unknown cause, mostly in children, usually outgrow it by age 15, Freud- acting out dream (before you could electronically monitor brain, wrong), done during non- REM sleep, 5-45 minutes, eyes open, repetitive movements, can perform complicated activities (unlock door and walk out of house), if left alone they will eventually return to bed, can awaken someone who is sleep walking, related to high level of anxiety  sexsomnia: sex while asleep Chapter 19: Law, Society, and the Mental Health Profession - criminal commitment: judged mentally unstable, innocent of wrong doing, must go to mental hospital until judged not to be a harm, not able to defend themselves in court, trial is postponed until they are able - not guilty by reason of insanity: if person cannot distinguish from right or wrong because of mental disability, cannot be convicted and just placed in mental hospital o M’ Naughten rule- 1843: fatally shot secretary of prime minister, insanity base on suffering of morbid delusions, committed to criminal wing of mental hospital o Irresistible impulse test- 1834: Ohio, possible to know that an act is wrong but are driven by an irresistible impulse of a mental disorder to do what’s wrong o Durham test- 1954: DC, plumber in house, burglar, pled insanity, still convicted, Durham ruler- person not responsible for act if it was a result of mental defect, as determined by person at mental hospital o ALI test (1955); American Law Institute: guidelines more specific for jurors, person not responsible for personal conduct if at time has mental disease- unable to conform conduct to law, couldn’t have antisocial disorder- psychopath o Insanity Defense Reform Act- 1984: came about because of assassination, shot President Regan, received not guilty because of insanity, (John Hinkley), Congress made bill that became law- used by all federal courts- person charge with criminal offense should be called not guilty because of mental disorder or mental retardation if unable to say it was wrong - Guilty But Mentally Ill (GBMI): accuse person legally guilty, but receive treatment in person, don’t receive the treatment- no funding - diminished responsibility defense (guilty with diminished capacity): alternative to insanity defense, not charged with most serious form of what you could be charged with - competence to stand trial: affects many people, defense, prosecution and judge must know of mental state, must be able to take part in trial, cooperate with layer, what they must be able to do, otherwise against civil rights - civil commitment: o involuntary hospitalization: remove person from society because person is considered to be harmful to oneself and others  formal commitment: family member asks for person to be put in hospital  informal commitment: two physicians say person is danger