Psychological Disorders
What are the statistics of disorders across the world?
47% NA
30% South Africa
17% China
26% France
What are two early theories around mental disorders?
SUPERNATURAL EXPLANATIONS
- belief was that people were possesed by demons
- cut holes in the head to let demons out; practiced until 1960
- Wrath of God for some transgression
DEMONOLOGY;
- genital mutilation
- beatings
- removal of teeth
- removal of intestines
- animal blood transfusions
- venesection and leeches
--> all with the idea of removing demons
BIOLOGICAL PERSPECTIVES:
- hippocrates: imbalance of humours
- too much black bile
- while this is wrong, it is known that disorders have biological causes
--> Can include:
- genetics
- imbalances in neurotransmitters
- brain abnormalities; function, size
Why is a biological perspective not enough?
EX: mother with schizophrenia
- stressful environment; 36% chance of child getting it
- healthy environment; 5.8% chance
What is the diathesis-stress model? (biopsychosocial)
DIATHESIS
- genes, brain structure, early learning, thinking style
- predisposition
STRESS
- abuse, illness, traumatic event, change in situation
What is a psychological disorder?
Harmful Dysfuntion:
- internal mechanisms; cognitions, perceptions and learning
all serve a purpose to keep us alive
- fear, anger and sadness are adaptive
- it is when these internal mechanisms break down (dysfunction), leading to negative consequences
What is the APA definition of a disorder?
- there are significant disturbances in thoughts, feelings, behaviours
- these disturbances reflect some kind of biological, psychological or developmental dysfunction
- these lead to significant distress or disabiliy in one's life
- these disturbances do not reflect expected or culturally approved responses to certain events
How are disorders classified?
there are categories of disorders
-EX: depressive, mood and anxiety disorders
- there's a set of diagnostic criteria
- there's also more i need to fill this in
- the DSM-5 has lists of diagnoses (237)
What is generalized anxiety disorder?
- over 60% of time spent worrying about something (300+ minutes a day)
- free floating anxiety; not worrying about anything specific
- can't switch the worry tap off
- impending sense of doom
- constant, difficult to control
- several physical ailments
How do you diagnose GAD?
- 6 months; excessive worry and anxiety
- difficult to control worry
- experience 3 or more:
- restlessness on edge
- easily fatigues
- difficulty concentrating
- irritability
- muscle tension
- sleep disturbance
** worry not accounted for by another disorder
** symptoms cause clinically significant distress/impairment
** not due to drugs/medication
What is the life-time prevalence of GAD?
lifetime prevalence = 5.7%
females > males
COVID:
- healthcare workers --> 32%
What causes GAD?
15-20% genetic component estimate
early traumatic experiences (childhood abuse)
mental strategy to avoid stronger negative emotions
Family history
What characterizes a panic attack ?
1. accelerated heart rate
2. sweating
3. shaking
4. shortness of breath
5. feeling of choking
6. chest pain or discomfort
7. nausea or abdominal distress
8. feeling dizzy / lightheaded
9. derealization or depersonalization
10. fear of losing control or going crazy
11. fear of dying/sense of doom
12. paresthesias (numbing or tingling sensations)
13. chills or hot flushes
PEAKS: 10 MINUTES
LASTS: 30 MINUTES
What is the diagnostic criteria for a panic disorder?
1. Two (or more) recurrent, unexpected panic attacks (within two weeks)
2. 1 month (or more) of one of the following
-- persistent concern about having more attacks
-- worry about implications of the attack
-- significant change of behaviour
3. Symptoms are not due to drugs / medication
What is the life time prevelance of panic disorders?
23% of population will experience 1 attack
LTP: 4.7%
Females > males
COVID:
- LTP: 13.7%
what causes panic disorders?
- norepinephrine made in locus coeruleus
- locus constantly producing norepinephrine via malfunction
Genetic component of 43%
classical conditioning
- sodium lactate
How are fears learned?
panic attack: unlearned stimulus
leads to fear; an unconditioned response
heavy breathing is a neutral response
gets associated with the fear that results from panic attacks
results in fear, which is now a learned response
What is a specific phobia?
an irrational fear for a particular object/situation that interferes with an individuals ability to function
1. animals
2. environments
3. situations
4. blood/injections
5. other
What is the diagnostic criteria for phobias?
STIMULUS
Persistent fear that is unreasonable / excessive
◦ Presence / anticipated presence
Anxiety Response (e.g., panic attack)
6 > months
Recognition that the fear = disproportionate
Steps are taken to avoid
◦ Interferes with normal daily living
What is the life-time prevalence of phobias?
12.5% Phobias
1.4% Agoraphobia
12% Social Anxiety Disorders
What causes specific phobias?
classical conditioning
vicarious learning
- the monkey & snake experiment
Teaching
Prepared learning
**fears are learned
What are we likely to develop phobias to? why?
More likely to develop phobias towards things that are not
really dangerous to us
Not so much for things that are actually dangerous
(weapons / motorcycles)
What is prepared learning?
We have been conditioned over centuries to fear stimuli that look a certain way
ex: snakes vs motorcycles
How is major depressive disorder diagnosed?
at least 5 of these for 2 or more weeks:
CORE:
- depressed mood most of the time
- dramatically reduced interest or enjoyment in most activities most of the timme
SOMATIC:
- significant challenges regulating weight and appetite
- significant challenges regulating sleep
- physical agitation or lethargy
- feeling listless or with much less energy
COGNITIVE:
- feelinng worthless; or unwarrented guilt
- problems in thinking, concentrating or making decisions
- thinking repetitively of death and suicide
what is the life-time prevalence of major depressive disorder?
“Common cold of mental disorders”
Lifetime prevalence: 16.9%
Highly recurrent
High rates of comorbidity
Females > Males
Underdiagnosis in minority populations
What is the genetic estimate for depression?
45%
What are the exitatory neurotramsitters?
dopamine
norepinephrine
What are the inhibitory Neurotransmitters?
serotonin
GABA
endorphins
Which neurotransmitters are relevant in depresson?
norepinephrine
seratonin
What is the relationship between depression and seratonin?
not enough seratonin
too few receptors
receptors are not sensitive to seratonin
how does depression affect the brain?
hightened amygdala responses
lower activity in the prefrontal cortex
What is the relationship between dopamine and schizophrenia?
- 6x as many receptors in people with schizo
- *list effects of extra dopamine*
What are differences between people with schizophrenia and those who don't in the brain?
- Smaller corpus callosum
--> connects brain's hemisphere
- larger ventricles
-->
- disregulation in thalamus
--> regulates sleep, consciousness and sensory information
- speech area (Broca's area)
--> can't tell difference between inner voice and real voices
- Reduced gray matter (especially in the frontal lobe)
What causes schizophrenia/what are some risk factors?
- first trimester of pregnancy
--> influenza
--> maternal stress
- environmental stressors
--> living in urban areas
--> stressful family relationships
- Substance use:
--> marijuana consumption 5x likelihood of developing psychosis
--> self-medication; people with schizophrenia seem to use it without any additional adverse effects