Psychological Disorders PDF

Preview

Summary

AND AND AND RELATED Excessive worry, occurring more days than not Prevalence in people inherit a at least 6 for a be tense The individual finds it difficult to control the period: vulnerability), and for a sense early on The anxiety and worry are associated with at for a period: events in their thre...

Description

DISOR DISORDER DER Generalized Anxiety Disorder (GAD)

Panic Disorder

Agoraphobia

Specific Phobia

ANX ANXIETY, IETY, TRAUM TRAUMAA- AN AND D SSTRES TRES TRESSOR SOR SOR-RELA -RELA -RELATED TED TED,, AND O OBSSES BSSES BSSESSIV SIV SIVE-COM E-COM E-COMPUL PUL PULSIVE SIVE AND RELA RELATED TED DIS DISORDE ORDE ORDERS RS CRITE CRITERIA RIA STATIS STATISTICS TICS CAUS CAUSES ES -some people inherit a tendency A. Excessive worry, occurring more days than not Prevalence in the population for a one-year to be tense (generalized for at least 6 months biological vulnerability), and they B. The individual finds it difficult to control the period: 3.1% Prevalence for adolescents develop a sense early on that worry important events in their lives C. The anxiety and worry are associated with at for a one-year period: 1.1% Gender: two thirds are are uncontrollable and least three or more of the following symptoms: potentially dangerous -restlessness, being easily fatigued, irritability, female Onset: early adulthood (generalized psychological muscle tension, sleep disturbance Median Age of Onset: 31 vulnerability) Course: chronic -this sets off intense worry with Prevalence rates for older resulting physical changes (less adults: 10% responsiveness—autonomic restrictors, chronic muscle tension), leading to GAD For Panic Attack Prevalence in the -agoraphobia often develops An abrupt surge of intense fear or intense population for a one-year after a person has unexpected discomfort that reaches a peak within minutes, period: 2.7% panic attacks and during which time four or more of the Prevalence in the -David Clark emphasizes the following symptom occur: palpitations, sweating, population at some point in specific psychological trembling, sensations of shortness of breath, their lives: 4.7% vulnerability of people with this feeling of choking, chest pains, nausea, Onset: early adulthood disorder to interpret normal lightheaded, chills, paresthesias, derealization, Median Age of Onset: physical sensations in a depersonalization, fear of losing control or dying between 20 to 24 catastrophic way A. marked fear or anxiety about two or more of Gender: two thirds are the following five situations: public female transportation, open spaces, enclosed places, Gender in Agoraphobia: standing in line or being in a crowd, being outside 75% are female the home alone B. the individual fears or avoids these situations E. the fear or anxiety is out of proportion F. the fear, anxiety or avoidance is persistent, typically lasting for 6 months direct experience A. marked fear or anxiety about a specific object Prevalence in the population for a one-year -experiencing false alarms in a or situation specific situation B. The phobic object or situation almost always period: 8.7% Prevalence for adolescents -observing someone else provokes immediate fear or anxiety experience severe fear C. The phobic object or situation is actively for a one-year period: avoided or endured with intense fear 15.8% (vicarious experience) Median Age of Onset: 7

TREATM TREATMEN EN ENTT Medication: Benzodiazepine (has negative effects, should be prescribed for no more than a week or two), Paroxetine (Paxil), Venlafaxine (Effexor) Psychological Intervention: CBT

Medications: Benzodiazepine (Xanax, hard to stop taking), SSRIs (Prozac and Paxil), SNRIs (Venlafaxine) Psychological Intervention: exposure-based treatments, anxiety-reducing coping mechanisms, Panic Control Treatment (PCT)

Psychological Intervention:: structured and consistent exposure-based exercises

Social Anxiety Disorder (Social Phobia)

Posttraumatic Stress Disorder (PTSD)

D. The fear or anxiety is out of proportion to the actual danger E. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more A. Marked fear or anxiety about one or more social situations in which the person is exposed to possible scrutiny by others B. The individual fears that he or she will act in a way, or show anxiety symptoms, that will be negatively evaluated C. The social situations almost always provoke fear or anxiety D. The social situations are avoided or endured with intense fear or anxiety D. The fear or anxiety is out of proportion to the actual threat posed by the social situation E. The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more

A. Exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways: directly, witnessing, learning that the event occurred to a close relative or friend, experiencing repeated or extreme exposure to aversive details of the event B. Presence of one or more of the following intrusion symptoms: recurrent, involuntary distressing memories of the event, recurrent distressing dreams, dissociative reactions, intense or prolonged psychological distress, marked physiological reactions to internal or external cues C. Persistent avoidance of stimuli associated with the event: avoidance of or efforts to avoid distressing memories, external reminders, inability to recall an important aspect of the trauma, marked diminished interest in significant activities, feeling of detachment from others, restricted range of affect, sense of foreshortened future

Course: chronic

-being told about danger (information transmission)

Prevalence in the population for a one-year period: 6.8% Prevalence for adolescents for a one-year period: 8.2% Prevalence in the population at some point in their lives: 12.1% Onset: begins during adolescents Median Age of Onset: 13 Gender: 50:50 Prevalent among: people who are young, undereducated, single, and of low socioeconomic class Prevalence in the population for a one-year period: 3.5% Prevalence for adolescents for a one-year period: 3.9% Prevalence in the population at some point in their lives: 6.8% Course: chronic

-someone could inherit a generalized biological vulnerability to develop anxiety, a biological tendency to be socially inhibited, or both -when under stress, someone might have an unexpected panic attack that would become associated to social cues -someone might experience a real social trauma resulting in a true alarm

Psychological Intervention: cognitive therapy program that emphasizes real-life experiences to disprove automatic perceptions of danger -interpersonal psychotherapy (IPT) Medication: SSRIs (Prozac), Ccycloserine (makes extinction work faster) Combined: DCS + CBT

-precipitating event: someone personally experiences a trauma and develops a disorder -a family history of anxiety suggests a generalized biological vulnerability for PTSD -support from loved ones reduces cortisol secretion and hypothalamic-pituitaryadrenocortical (HPA) axis activity

Psychological Intervention:: face original trauma, process the intense emotions, and develop effective coping procedures in order to overcome the debilitating effects of the disorder -catharsis -cognitive therapy Medication: SSRIs (Prozac and Paxil)

Obsessive-Compulsive Disorder

Body Dysmorphic Disorder

DISOR DISORDER DER Somatic Symptom Disorder

D. Negative alterations in cognitions and mood associated with the event: inability to remember an important aspect of the event due to dissociative amnesia, persistent and exaggerated negative beliefs, persistent distorted cognitions about the cause or consequence of the event, persistent negative emotional state, persistent inability to experience positive emotions E. Duration of the disturbance is more than one month A. Presence of obsessions, compulsions, or both B. The obsessions or compulsion are timeconsuming, or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

Lifetime prevalence: 1.6% -someone must develop anxiety 2.3% focused on the possibility of Prevalence in the having additional intrusive population for a one-year thoughts period: 1% Thought-Action Fusion – when Gender: 1:1 clients with OCD equate Age of Onset: childhood thoughts with the specific through the 30s actions or activity represented by the thoughts Median Age of Onset: 19 Course: chronic A. Preoccupation with one or more defects or Prevalence: hard to -defense mechanism of flaws in physical appearance that are not estimate because by its displacement—that is, an very nature, it tends to be observable or appear slight to others underlying unconscious conflict B. At some point during the course of the kept secret would be too anxiety provoking disorder, the individual has performed repetitive -far more common to admit into consciousness, so the person displaces it onto a behaviors or mental acts in response to Course: chronic body part Gender: 1:1 appearance concerns Age of Onset: early adolescent through the 20s Peak Age of Onset: 16-17 SOMA SOMATIC TIC SYM SYMPTOM PTOM AND REL RELATED ATED DISO DISORDERS RDERS AN AND D DIS DISSOCI SOCI SOCIATIV ATIV ATIVE E DISO DISORDE RDE RDERS RS CRITE CRITERIA RIA STATIS STATISTICS TICS CAUS CAUSES ES -psychological or behavioral A. One or more somatic symptoms that are Age of Onset: Adolescence factors are compounding the distressing and/or result in significant disruption Course: chronic and impairment Prevalence among: women, severity of daily life with physical B. Excessive thoughts, feelings, and behaviors unmarried, and from lower associated symptoms related to the somatic symptoms: socioeconomic groups -these disorders are basically disproportionate and persistent thought about Gender: women the seriousness of the symptoms, high level of disorders of cognition or health-related anxiety, excessive time and energy devoted to these symptoms or health concerns

Psychological Intervention Exposure and Ritual Prevention – the rituals are actively prevented and the patient is systematically and gradually exposed the feared thoughts or situations Psychosurgery – surgical lesion to the cingulate bundle Medication: SSRIs, clomipramine -psychological treatment is similar to those of OCD but are less successful

TREATM TREATMEN EN ENTT Psychological Intervention: explanatory therapy, CBT Medication: antidepressants, paroxetine (Paxil)

Illness Anxiety Disorder

Conversion Disorder (Functional Neurological Symptom Disorder)

C. Although any one symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months) A. Preoccupation with fears of having or acquiring a serious illness B. Somatic symptoms are not present or, if present, are only mild in intensity C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status D. The individual performs excessive healthrelated behaviors or exhibits maladaptive avoidance E. Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time

A. One or more symptoms of altered voluntary motor or sensory function B. Clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical conditions

Prevalence from DSM IV: 15% Prevalence of both Somatic Symptom and Illness Anxiety Disorders: 16.6% Age of Onset: adolescence

Prevalence in the neurological setting: 30% Gender: women Age of Onset: adolescence

perception with strong emotional contributions -using a stroop test, participants with these disorders show enhanced perceptual sensitivity to illness cues -individuals with these disorders may have learned from family members to focus their anxiety on specific physical conditions and illnesses 3 factors may contribute to this etiological process: 1. These disorders seem to develop in the context of a stressful life event 2. People who develop these disorders tend to have a disproportionate incidence of disease in their family when they were children 3. An important social and interpersonal influence may be involved Freud described 4 basic processes in the development of conversion disorder: 1. The individual experiences a traumatic event 2. Because the conflict and the resulting anxiety are unacceptable, the person represses the conflict, making it unconscious 3. The anxiety continues to increase and threaten to emerge into consciousness, and the

Psychological Intervention: -identify and attend to the traumatic or stressful life event, reduce any reinforcing or supportive consequences of the conversion symptoms (secondary gain), -hypnosis, CBT

person converts it into physical symptoms 4. The individual receives greatly increased attention and sympathy from loved ones and may also be allowed to avoid a difficult situation or task -individuals with conversion disorder have experienced a traumatic event that must be escaped at all cost DepersonalizationDerealization Disorder

Dissociative Amnesia

Dissociative Identity Disorder

DISOR DISORDER DER Major Depressive Episode

A. The presence of persistent or recurrent experiences of depersonalization, derealization, or both B. During the depersonalization or derealization experience, reality testing remains intact

Prevalence among the population: 0.8% to 2.8% Gender: 1:1 Mean Age of Onset: 16 Course: chronic A. An inability to recall important Prevalence: 1.8% to 7.3% autobiographical information, usually of a Onset: adulthood traumatic or stressful nature, that is inconsistent Course: chronic with ordinary forgetting

A. Disruption of identity characterized by two or more distinct personality states. The disruption of marked discontinuity in sense of self and sense of agency, accompanied by related alteration in affect, behavior, consciousness, memory, perception, cognition B. Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting

Average number of alter personalities: 15 Gender: Female 9:1 Male Age of Onset: 4 Course: chronic Prevalence in the population for a one-year period: 1.5%

MOOD DIS DISORDE ORDE ORDERS RS CRITE CRITERIA RIA STATIS STATISTICS TICS A. Five or more of the following symptoms have Duration if Untreated: 4 to 9 been present during the same 2-week period and months represent a change from previous functioning: at least one of the symptoms is either depressed mood or loss of interest or pleasure:

-forgetting is selective for Psychological Intervention: traumatic events or memories involves helping the patient reexperience the traumatic events rather than generalized in a controlled therapeutic manner to develop better coping skills -childhood trauma Psychological Intervention: -lack of social support during or therapy is long term, particularly after the abuse also seems with this disorder is the sense of trust between therapist and implicated -can be attributed to a chaotic, patient nonsupportive environment

family

CAUS CAUSES ES Central Indicator: physical changes along with the behavioral and emotional shut down

TREATM TREATMEN EN ENTT Medication: Selective Serotonin Reuptake Inhibitors (SSRIs): fluoxetine (Prozac)

Major Depressive Disorder

Persistent Depressive Disorder (Dysthymia)

1. depressed mood most of the day, nearly every day 2. markedly diminished interest or pleasure in all, or almost all, activities most of the day 3. significant weight loss when not dieting or weight gain, or decrease or increase in appetite 4. insomnia or hypersomnia 5. psychomotor agitation or retardation 6. fatigue or loss of energy 7. feelings of worthlessness or excessive or inappropriate guilt 8. diminished ability to think or concentrate, or indecisiveness 9. recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt A. At least one major depressive episode Course: chronic Median Lifetime Number of Major Depressive Episode: 4 to 7 Recurrent: if two or more major depressive episodes occurred and were separated by at least 2 months Mean Age of Onset: 30 Prevalence among Children Ages 2 to 5: 1.5% Gender among Adolescents: more female A. Depressed mood for most of the day, more Mean Age of Onset: 21 Prevalence among Children: days than not, for at least 2 years B. Presence, while depressed, of two or more of 0.07% the following: poor appetite or overeating, Prevalence among Adults: insomnia or hypersomnia, low energy or fatigue, 3%-6% low self-esteem, poor concentration, feelings of Mean Duration: 5 years hopelessness C. During the 2-year period of the disturbance, the person has never been without the symptoms in criteria A and B for more than 2 months at a time

Mixed Reuptake Inhibitors: venlafaxine (Effexor) Tricyclic Antidepressants: imipramine (Tofranil), amitriptyline (Elavil) Monoamine Oxidase (MAO) Inhibitors. Medication for Bipolar: Lithium Carbonate Psychological Intervention: CBT, Interpersonal Psychotherapy Psychological Intervention for Seasonal Affective Disorder: light therapy ETC: electroconvulsive therapy (ECT) -the causes of mood disorders lie in a complex interaction of biological, psychological, and social factors -from a biological perspective, researchers are particularly interested in the stress hypothesis and the role of neurohormones -psychological theories of depression focus on learned helplessness and the depressive cognitive schemas, as well as interpersonal disruptions -60% to 80% of the causes of depression can be attributed to environmental factors -low levels of serotonin in the causes of mood disorders but only in relation to other neurotransmitters -cortisol level is elevated in depressed patients

D. Criteria for major depressive disorder may be continuously present for 2 years

Manic Episode

Premenstrual Dysphoric Disorder (PMDD)

Disruptive Mood Dysregulation Disorder

A. A distinct period of abnormally persistent Duration: 1 week elevated, expansive, or irritable mood and Duration if Untreated: 3 to 4 abnormally persistently increased goal-directed months activity or energy, lasting at least 1 week and present most of the day, nearly everyday B. During the period of mood disturbance and increased energy or activity, three or more of the following symptoms are present to a significant degree: 1. inflated self-esteem or grandiosity 2. decreased need for sleep 3. more talkative than usual or pressure to keep talking 4. flight of ideas 5. distractibility 6. increase in goal-directed activity 7. excessive involvement in activities that have a high potential for painful consequences A. In the majority of menstrual cycles, at least 5 symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset, and become minimal in the week postmenses B. marked affective ability, marked irritability, marked depressed mood, marked anxiety C. decreased interest in usual activities, subjective difficulty in concentration, lethargy, marked change in appetite, hypersomnia or insomnia, sense of being overwhelmed, physical symptoms A. Severe recurrent temper outburst manifested verbally and/or behaviorally that are grossly out of proportion in intensity or duration to the situation or provocation

Dexamethasone Suppression Test (DST) – suppresses cortisol secretion -heightened levels of stress hormones can cause shrinkage of the hippocampus

Bipolar II Disorder

Bipolar I Disorder

Cyclothymic Disorder

DISOR DISORDER DER Bulimia Nervosa

B. The temper outbursts are inconsistent with developmental level C. The temper outbursts occur, on average, three or more times per week D. The mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and is observable by others E. Must be present for 12 or more months A. At least one hypomanic episode and at least one major de...