PSY 0010 – Psychological Disorders – page 1Defining psych disorders- patterns of thinking, feeling, behavingo uncommon/deviant (abnormal)o violates social norms (unconventional)o irrational (incomprehensible)o biological dysfunction (organic)o subjective distress (suffering)o impairment or disability (maladaptive)- parallel to idea of physical disorder – problem, diagnosisDisorders across time and culture- what is considered a disorder changeso prophets and patriarchso homosexuality, masturbationo female ambition- some disorders are culture-specifico bulimia nervosa (America/Europe)- some disorders appear to be universalo schizophrenia, psychopathyDiagnosis of disorders- advantageso enables problem identification and prescription of treatments disorder-specific treatmento enables professionals to communicate with each othero may reduce self-blame in those with disorders- disadvantageso blurs individual differenceso can reflect cultural biaseso labels can stick and stigmatize on being sane in insane places (Rosenhan 1973) once a label is attached to someone, others may see only the label- diagnostic and statistical manual of mental disorders (DSM-5, 2013)o American Psychiatric Association (APA) criteria for mental disorderso lists of symptoms and decision rules on how many symptoms must be present for a diagnosiso criteria of impairment/distress and duration for a disorder to be presentAnxiety disorders- anxietyo feeling: nervous, tense, anxiouso thoughts: worry, intrusionso bodily reactions: stress/arousal- generalized anxiety disordero excessive worry, anxiety for 6+ monthsPSY 0010 – Psychological Disorders – page 2 spend on average 60% of each day worrying, compared to 18%for the general population not about a specific situationo physical, cognitive, emotional symptoms restlessness, muscle tension, sleep disturbance; trouble concentrating; irritability- panic disordero repeated and unexpected panic attacks rapid escalation of anxiety into terror physical symptoms: sympathetic arousal and hyperventilation- heart racing, shortness of breath, chest pressure, choking catastrophic thoughts: dying, heart attacko change in behavior to prevent panic attacks worry, avoidance- agoraphobiao fear of being in a place or situation from which escape is difficult or embarrassing, or help is unavailable- social anxiety disordero marked fear of public appearances in which embarrassment or humiliation is possible public speaking, eating, performing, everyday social interactionso anticipation of negative evaluationCausal factors in anxiety disorders- diathesis-stress modelo biological vulnerability (predisposition) plus life events and stressors that trigger this vulnerability- learning theory factorso classical conditioning (Little Albert)o operant conditioning (reinforcement/punishment)o social/observational learning- cognitive factorso catastrophizing: anticipating terrible events despite low probabilityo anxiety sensitivity (fear of fear): misinterpretation of minor physical symptoms as dangerous- personality factors o neuroticism (5 factor theory) GAD associated with negative emotionality- biological factorso neurotransmitter effects GABA receptor deficiency and excess limbic (fear) activationo evidence of genetic heritability: 30-40% likelihood associated with genes- life event factorsPSY 0010 – Psychological Disorders – page 3o exposure to childhood violence/deprivation dramatically increases risk of anxiety disorder Adverse Childhood Events (ACE) study abuse, intimate partner violence, drug addiction, criminal behavior in householdo reflected in brain development before age 4Trauma & stress-related disorders- PTSDo traumatic stressor (catastrophic/horrifying event) war, attempted murder, rape, natural disasters, death of a loved one, physical/sexual abuse directly experienced it, witnessed it, learned of it happening to a loved one, repeatedly exposed to or reminded of details of ito symptoms at least 1 month after the event intrusive memories, dreams, flashbacks avoidance of situations or objects that might trigger recollection of the event cognitive symptoms (e.g. distorted blame) arousal and reactivity- difficulty sleeping, startling easily, irritability/anger, difficulty concentrating, reckless/destructive behavior- OCDo symptoms of OCD repeated, length (>1 hr/day) obsessions, compulsions, or both obsessions: persistent intrusive thoughts, images, or impulses that are unwanted and inappropriate, and cause marked distress (e.g. contamination, aggression)- may or may not recognize that fears are unrealistic/excessive- person attempts to neutralize/suppress them compulsions: repetitive behaviors or mental acts performed in response to obsessions, to reduce or prevent anxiety- unrealistic (e.g. checking, counting, mental rituals)o may or may not recognize thiso causal factors of OCD biological factors- evidence of genetic heritabilityo OCD and the caudate nucleus and limbic system “worry circuit”- neurotransmitter effectso serotonin, others implicated but causal influence is not well understood- streptococcal infections (PANDAS) – autoimmune? Depressive disorders- major depressive disorderPSY 0010 – Psychological Disorders – page 4o sad/low mood or diminished interest in pleasurable activities for at least 2 weekso at least 4 of the following weight/appetite loss/gain insomnia or excessive sleep agitation or psychomotor retardation fatigue/low energy lack of concentration or decisiveness feelings of worthlessness or excessive guilt thoughts of death/suicide- persistent depressive disordero depressed (sad/low) mood lasting at least 2 years, never absent for asmuch as 2 monthso at least 2 of the following appetite loss/gain insomnia/excessive sleep fatigue/low energy poor concentration or difficulty with decisions low self-esteem feelings of hopelessness- causal factors in depressiono life events exposure to violence/neglect in childhood loss/rejectiono lack of positive reinforcement limited opportunities for rewarding experiences as they become depressed, people stop engaging in behavior that promotes good feelings, which worsens depressiono lack of social support interpersonal conflicts or role transitions limited social skills- difficulty evoking positive responses from others- cognitive factorso rumination: recurrent focus on bad