|


  

A constellation of symptoms that

create significant distress or
impairment in work, school, family,
relationships, and/or daily living
 |

  
ë iagnosis/categorization of mental illnesses can
be very subjective«
± Homosexuality until 1973
± Body ysmorphic isorder
ë While in the 
, is not recognized by H
s
± Koro ± outheast Asia
ë
en can develop a fear that ones penis will withdraw into
ones abdomen, causing death
± Winigo ± Algonquin ndian hunters
ë ntense fear of being turned into a cannibal by supernatural
monster
 |

  
ë iagnosis/categorization of mental illnesses
can be very subjective«
± Rosenhan (1973) study
ë
entally healthy confederates were admitted with

schizophrenia into psychiatric hospitals

ë They then behaved normally in the hospitals, but
their normal behavior was interpreted as
pathological based on previous diagnosis

  


ë fficial categorization of psych disorders in U. .
ë 5Axis model adopted in 1980
± Axis 1
ë Clinical disorders (e.g., mood & anxiety disorders)
± Axis 2
ë Personality disorders (e.g., narcissism, antisocial) & mental
retardation
± Axis 3
ë
edical (physical) conditions influencing Axis 1 & 2 disorders

± Axis 4
ë Psychosocial & environmental stress influencing Axis 1 & 2 disorders

± Axis 5
ë Global Assessment of Functioning score: highest level of functioning
patient has achieved in work, relationships, and activities
 2
 

   
| 
  
ë Axis 1
ë Panic isorder
± udden, unexpected attacks ± overwhelming anxiety
± Heart palpitations, difficulty breathing, chest pain, nausea,
sweating, dizziness, etc.
± Fear of dying or losing ones mind
± Can lead to agoraphobia: fear of places which may cause a
panic attack
± Hypothesized causes
ë Hypersensitivity of locus coeruleus (in brainstem; ³alarm system´ for fight or
flight response)
ë Personal belief that physiological arousal is harmful; high number of stressful
childhood/adolescent events
 2
 

    |
ë Axis 1
ë imple
± ntense, irrational fear of a specific object or situation
± Geer (1965)
ë
ost intense fears
± Untimely/early death
± llness, injury or death of a loved one
± peaking before a group
± nakes
± Not being a success, making mistakes, failing a test
± uffocating
 2
 

    |
ë ocial
± Fear public scrutiny and embarrassment
±
ost common phobia
ë Hypothesized causes
± Hyperactivity of amygdala in certain situations
involving the feared entity
± Extreme shyness in childhood perpetuates social phobia
into adulthood
± Classical and operant conditioning (Little Albert)
± ocial modeling of others who have phobias
2
 

   | 

   |

ë Axis 1
ë Typically occur after a traumatic event (especially
crimes, war)
± ymptoms include reexperiencing trauma (dreams,
flashbacks), avoidance of anything associated with trauma,
and constant state of hypervigilance
ë ense of having no control over the traumatic event
± ³the world is a dangerous place´
ë rug abuse is high w/ PT 
± Negative reinforcement (avoidance of symptoms with use)
2
 

    | 

   |

ë Hypothesized causes
± Hypersensitivity of locus coeruleus (³alarm system´)
and limbic system
± Those with lower s, fewer cognitive/intellectual
resources
± Belief that world is a dangerous place
± Lack of family/friend/social support after trauma
 2
 

   
  
  

   

ë Axis 1
ë bsessions
± Recurrent, intrusive thoughts
ë Compulsions
± Recurrent urges to perform ritualistic actions
± Washing: thoughts of contamination
± Checking: id  lock the car?
± Counting: Count to 100 so that the obsessive thought of
disaster will not happen
2
 

      
 
 
   

ë Hypothesized causes
±
alfunction of caudate nucleus of the basal ganglia
± Not turning off recurrent thoughts
± erotoninbased medications reduce symptoms
(although ³why´ is not known)
± perant conditioning: compulsions relieve anxiety
created by obsessions
± Rejecting families lead to higher stress, which
manifests into C for rejected person
  2

ë For each of the following words, write a sentence that
describes an experience you had that is associated
with that respective word«
ë Train
ë ce
ë House
ë
eeting
ë
achine
ë Road
ë Rain
ë Tunnel
  2

ë For each experience you wrote down, rate
whether the experience was pleasant or
unpleasant
ë After you have rated all experiences, tally
the total number of pleasant and unpleasant
experiences
  2

ë How have you felt today?
± Happy? ad? omewhat depressed?
± The number of pleasant vs. unpleasant
experiences you recalled should be related to
your mood today.
± When we are depressed, we remember more
unpleasant than pleasant events.
 
  
ë Emotional disturbances that interfere with normal
life functioning
± Axis 1
ë
ajor epressive isorder
± At least 2 weeks of depressed mood/loss of interest
along with several other symptoms, including«
± ignificant weight loss (but not through a diet)
± nsomnia or hypersomnia
± Restlessness or sluggishness
± ndecisiveness, lack of concentration
± Thoughts of death or suicide
 
   

 
  
ë Hypothesized causes
± Low activity in frontal lobe area that controls
emotional centers of brain
±
arkedly different levels of serotonin &
norepinephrine than normal levels
± Negative view of world, self, & future (internal
& stable attributions of selfblame)
± Critical & unsupportive families
 
    
ë 30% of clinically depressed people attempt
suicide
± Remember
ë f someone talks about it, theyre really thinking about it

ë Attempters often dont really want to die

ë omeone whos been depressed & is suddenly better may

have made the decision
ë f you have any reason to wonder ± GET HELP!
 
   

  
ë
anic phases & depressive episodes
±
anic phases last at least a week and are characterized
by intense agitation and/or elation
± Followed by depressive episodes
± Left untreated, these extreme shifts in mood can
progress to a constant state
ë Hypothesized causes
± Enlarged amygdala (lymbic system: emotions)
± Abnormal levels of serotonin & norepinephrine
± Abnormal and continuous exposure to electric lights
± Critical and unsupportive families
 ] 
  
ë Axis 1
± 90% of diagnoses are women
ë Anorexia nervosa
± ntense fear of gaining weight ± constant desire to
keep losing weight
ë They usually weigh less than 85% of avg weight for height
± istorted body image
± Loss of menstrual periods (amenorrhea)
± ~ 10% die from this disorder
 ] 
   
2 
 !  
ë Hypothesized causes
± Family history of C
± Being ³perfectionistic´, irrational about
expectations for body
± Feelings of mastery over body
± Cultural emphasis on being thin
 ] 
   
 !  
ë Recurrent binge eating followed by purging,
fasting, and/or intense exercising
ë Hypothesized causes
± Lower levels of serotonin (creates feeling of
satiety)
± ieting in some extreme cases can lead to onset
± Normative influence: approval by peers
 " 
  
ë Axis 1
ë Grossly impaired/altered functioning
± ocial
ë Withdrawn, few friends, usually since childhood
± Affect (emotional)
ë Flat affect, inappropriate displays
± Cognitive
ë elusions, hallucinations
±
otor
ë Tracing patterns in the air or holding one pose for hours
± Positive (presence of abnormal behavior) vs. negative
(absence of normal functioning) symptoms
 " 
  
ë Catatonic
± Bizarre, immobile, or relentless motor behaviors
ë Paranoid
± Hallucinations (voices), delusions of persecution and/or
grandeur (Jesus), suspicion
± ntellect and affect are usually normal
ë isorganized
± Personality deterioration, bizarre behavior (public
urination), disorganized speech
± r flat, inappropriate affect (laughter)
ë Undifferentiated: no specific category is
appropriate
 " 
  
ë About 1 in 100 develop schizophrenia worldwide
ë Hypothesized causes
± Having relatives with schizophrenia increases risk
ë But, over 80% w/ a schizophrenic relative do not develop it
± mpaired frontal lobe functioning
ë Abstract thinking & planning
± Abnormally high levels of dopamine
± Complications at birth which lead to oxygen
deprivation
 |   

  
ë Axis 2
ë table, inflexible, and maladaptive personality
traits, causing distress in normal functioning,
especially noticeable over repeatedly
interactions
 |   

   
2 
  |   

  
ë A.k.a. psychopaths, sociopaths, social deviants
ë Pattern of disregard for others, violation of the
rights of others
± Lack of conscience, empathy, remorse
ë While only 12% of U. . population, ~ 60% of
male prisoners are estimated to have this
personality disorder
± erial killers are good example
 |   

   
2 
  |   

  
ë Hypothesized causes
± Emotional deprivation, abuse, and
inconsistent/poor parenting
± Underresponsive nervous system
± ensationseeking & unaffected by social
rejection, mild punishment, and/or legal
consequences
 |   

  
ë Criticism #1
± Too much overlap with Axis  disorders
± E.g., avoidant personality disorder sounds a lot
like a social phobia
ë Criticism #2
± nly difference with a lot of personality
disorders from normal behavior is the quantity
of symptoms (i.e., symptoms in moderation are
regarded as µnormal)
 2     

 "   #
ë cientific µguesses
± t is very, very important to know that the causes listed here
are merely scientific µguesses
± The causes often seem to work in tandem with each other to
increase likelihood of particular disorder
± No one µguess is likely to cause the disorder in isolation
± iathesis tress
odel
ë f its in your genes (genetic predisposition), a disorder may not
evolve unless environmental stressors occur to trigger the disorder
± And, to boot, many of these µguesses may actually turn out
to be consequences rather than causes
ë The chickenortheegg question ± which comes first?