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Psych 1X03 C01 Professor Kim & Professor Cheal 06/04/12

Module 1: Introduction
Event consumed you so much, changed your entire life getting cheated on, family member was ill, waiting to hear about a job interview o Hard to do anything challenge to do simple daily tasks o Situation resolves itself & you can move on/function again What if you couldnt move on because it was a voice, or fear of strangers/ intense mysterious sadness way of life for millions suffering psychological disturbance

Module 2: What is Abnormality?

The 4 Ds Definition of normal/abnormal behaviour vary between people/cultures/time periods o Hard to have consensus on definition Clinicians use fixed criteria to define abnormality 4 Ds o Deviance, Distress, Dysfunction, Danger Criteria used as guidelines/exhibit one or more characteristics does not label someone as having psychological disorder Deviance Deviance: having thoughts/ emotions/ behaviours falling outside standards of what others are doing o Doesnt mean people differing from norms = psychological disorder (cultural practice of minority population) o Low IQ & high IQ = deviant? Distress Distress: experiences intense negative feelings due to behaviour anxiety/sadness/despair] o Another common characteristic of psychological abnormality Some expectations person who free of distress not necessarily psychologically healthy o Bipolar patients extremely elated/larger than life not distressed o Antisocial personality disorder No remorse/distress when causing harm Dysfunction Dysfunction: behaviour tends to interfere with ability to function properly daily o No longer work, earn living, run household Maladaptive: prevent people from adapting well to environment o Maladaptive behaviours caused by physical imbalances in brain require medicine Doesnt always mean psychological disorder stop functioning in society because of protest Danger Danger: engaging in risky behaviours leading to drug addiction/violence (danger to self or others) Dangerous behaviour alone psychological disorder extreme sports/office work& no exercise 1

Psych 1X03 C01 Professor Kim & Professor Cheal 06/04/12

Module 3: Classifying Disorders

The DSM Line dividing normal & abnormal is not clear Must be able to classify/diagnose disorders o Learn about potential causes/best treatment & prediction of the disorder Clinicians use Diagnostic & Statistical Manual (DSM) as a guideline to apply diagnosis DSM has 2 Functions 1. Categorizes and describes mental disorders common set of criteria 2. Common language allows researchers to talk to each other about disorders DSM has 2 general criteria (must be met before diagnosis made) 1. Must originate from within person (not reaction to external factors) Crying uncontrollably with thoughts of despair depression if experienced family death 2. Must be involuntary & unable to control symptoms experienced Dressing up in crazy clothes for football game Hunger strike as means of protest Categories in DSM DSM groups together disorders having similar sets of symptoms o Assumption: similarities suggest common cause = similar treatment Criteria for diagnosis/grouping disorder changes with new discoveries new DSM released Axes o Axis I: Clinical Syndromes o Axis II: Developmental Disorders & Personality Disorders o Axis III: Physical Conditions o Axis IV: Severity of Psychosocial Stressors o Axis V: Highest Level of Functioning

Module 4: Models of Psychopathology

Functions DSM only describes pattern of symptoms DOES NOT have explanation for disorder/treatment Label for set of abnormal behaviours = only helpful if leads to explanation/treatment plan 4 models of psychopathology : biological, psychodynamic, behavioural & cognitive Biological Models Assumes that psychological disorder results from malfunction in the brain Rain may malfunction because its physically damaged/abnormal activity of chemicals in brain (neurotransmitters) Brain malfunction explained by genetics, nutrition, disease, stress Causes of disorder are physical Advocates drugs to treat disorder extreme cases: electroconvulsive shock/brain surgery 2

Psych 1X03 C01 Professor Kim & Professor Cheal 06/04/12 Psychodynamic Model One of the earliest models pioneered by Freud Like biological model, believes mental disorders rooted in internal malfunction o Instead of physical malfunction( like bio model) thought to be psychological malfunction Mind & processes, not physical brain working improperly Mental disorder attributed to maladaptive attempts to deal with strong, unconscious conflicts o Fred believed theses conflicts stemmed from unresolved childhood issues This approach sees no physical therapy (drug treatment) curing mental disorder only temporary relief Psychoanalysis gets to root of problem to end disorder o Ex. Focus on personal insight help patients understand themselves to cope with stressors Behaviourist Model Medical & psychodynamic models mental disorder = internal problem Disordered and maladaptive behaviours seen on outside = symptoms of internal issues o Fever symptom of infection, limp symptom of leg injury Behaviourism psychological disorders = external, overt behaviour Disordered behaviours/emotions are NOT internal symptoms but the problem itself o instinctive sense abnormal behaviours= striking, draws attention Distorted behaviours come from instrumental/classical conditioning o Contingencies/rewards/punishments received for actions influence behaviour Ex. Behaviour leads to sympathy/attention keeps you out of anxiety situation o Some behaviours generalized from situations where its appropriate to those where its not Treatment of maladaptive behaviours using principles form conditioning o Classical conditioning to treat phobias Criticisms (some by cognitive model) o Someone hearing/responding to voices in head learned to behave that way? o Behavioural treatment effective in therapists office not always transferable to other environments o Treats people as reflexive beings react to environment without planning/ remembering/ predicting things Cognitive Model Mental disorder results from maladaptive ways of interpreting info from environment o Ex. Enjoying vs anxious feeling of public speaking effective message or evaluated negatively? o Interpretation = different behaviours may be considered abnormal o Assumes that experience/learning shape maladaptive thinking o Cognitive therapies identifies maladaptive thinking & change it through positive experiences 3

Psych 1X03 C01 Professor Kim & Professor Cheal 06/04/12 o Cognitive-behavioural therapies: change thinking and behaviour o Cognitive (+ interpretations) behavioural (+ actions) approaches complement each other

Module 5: Mood Disorders

Specific disorders listed in DSM

Characterizing Mood Disorders Disturbances in emotion depressed mood depression AND elevated mood of mania 2 main types of depressed mood disorders o Unipolar Depression o Bipolar Depression Ex.of Unipolar Depression aka Major Depression John lost job @ head engineer plant shut down 4 months ago. Spends time at home sleeping rather than looking for job; little interest in doing anything, stays in bed Usually physically active, not lately little appetite, chronic headaches/muscle sores When doing anything, moves very slow trouble concentrating on task Mind = negative thoughts failed fam, feels guilty, thinks of suicide to end misery o Severe case, not every symptom has to be there for diagnosis o Untreated repeated episodes of unipolar/major depression last many months o Between episodes return to normal functioning Because of risks (suicide/harmful effects) should be treated Dysthymia Symptoms of depression less severe (aka Mildly depressed all the time) Rarely return to normal levels of functioning in between episodes of depression Bipolar Disorder Same episodes of depression as Unipolar ALSO periods of elevated mood called mania heightened self esteem, activity, energy, little sleep o Racing thoughts ahead of ability to deal with them o Risky behaviour sexual promiscuity, risky business investments, shopping sprees Angry with those who act as obstacles to goals Causes of Depression All models have different causes Biological depression: abnormal levels of chemical activity of neurotransmitters in brain o Treatment drug therapy (antidepressantschange balance of neurotransmitters) Behavioural depression caused by those who lack social skills/difficult to make normal positive reinforcement of others sad/self blame of depression o Symptoms may elicit sympathy/attention unintentionally more reinforcement of symptoms 4

Psych 1X03 C01 Professor Kim & Professor Cheal 06/04/12 Leaned helplessness: helplessness of situation; subject learns to withhold responding Inspired by animal research phase 1, dogs exposed to inescapable electric shocks (try to escape, eventually give up). Phase 2, shocks now avoidable many continued to remain passive Cognitive depression arises in those who have particular/maladaptive way of evaluating themselves/experiences o Aaron Beck maladaptive thinking processes = depressogenic schemata Under stress people develop unrealistically negative interpretations of event himself world future Psychological treatments include psychoanalysis therapy/ cognitive behavioural therapy o Psychoanalysis treatment = promote insight/awareness Goal = increased understanding of oneself strengthen coping strategies o Cognitive behavioural treatment= make people aware of how they think/feel Encouraged to set goals/tasks (calling friend) to practice behavioural skills) Effective therapy for many no relapse to future episodes of depression Cases with clear suicide risk/weaken depressionCBT alone isnt enough o Common for psych and bio treatments to be combined o

Module 5: Anxiety Disorders

Introduction Most common form of mental health problems 1/10 people Anxiety feeling = common meeting new people/exam/presentation Anxiety disorders: persistent feeling of anxiety interferes with daily activity o 6 disorders falling under category Generalized Anxiety Disorder (GAD) Feels repeatedly worried about small normal things (mild) o Getting to work, finishing assignments on time, getting sick, disasters striking them Feelings repeatedly for at least 6 months Constantly worried impacts physical health o Always feels tense = dizziness/sleep problems/muscle tensions/headaches/fatigue o Irritable/hard to concentrate Obsessive-Compulsive Disorder (OCD) Symptoms recurring obsessions/compulsion disturbing person/interfering with day to day living o Obsession: idea/impulse/image cant get out of minds Intrudes way to conscious over and over again Did something wrong, fear loved one been injured o Compulsion: behavioural ritual compelled to perform over and over again Knows ritual = unreasonable feels anxious if not completed Ex. Hand washing tissue damaging, interferes with life Post-Traumatic Stress (PTSD) Extremely stressful event acting as trigger for anxiety disorder o Terrifying experience caused/threatened to cause physical hard to you/someone close 5

Psych 1X03 C01 Professor Kim & Professor Cheal 06/04/12 Persistent anxiety, intrusive thoughts about event occur (flashbacks) Not simple recollection of trauma re-living of it Research performed on soldiers in batter, sexual abuse, natural disasters, accidents, o Unexpected death of someone PTSD symptomology May feel the need to avoid certain situations/objects/people reminding them of event Trouble concentrating, nightmares, depression, irritable, startled easily Symptoms last many years/decades after event o To decreases development of PTSD, helpful for trauma survivors to discuss event with each other as often as possible & in detail o

Etiology & Treatment ID: immediate impulse gratification Ego: blocks inappropriate ego Psychoanalytical model anxiety disorders = displaced tensions between ego & id o Id impulses (seeking expression) & ego which wont allow it creates anxiety Anxiety displaced = symptoms of anxiety disorder Ex. OCD compulsion = defence against unacceptable ID impulse o Unacceptable impulse causes anxiety displaced on less disturbing idea/behaviour o Obsession/compulsion have symbolic relationship to true problem Generalized anxiety disorder tension displaced to everyday events Biological model physical causes o Genetics predispose someone to OCD; results inconclusive to FAD o Drugs that change balance of neurotransmitters effective in lowering anxiety o Combining drug therapy with psychological therapy most effective Behavioural / Cognitive model considered in cycle o Those with anxiety disorders cant shake of fear inducing thoughts Causes development of maladaptive behaviours Obsessions instrumentally conditioned avoidance responses. When they occur, the terminate/reduce classically conditioned fear o Cognitive-behavioural therapy many techniques to reduce anxiety symptoms Cognitive restructuring anxious interpretations of events into rational thoughts Behavioural component repeated exposure to feared objects/situations Ex. PTSd therapy talk about traumatic event in detail CBT techniques consciously slow breathing when confronted with stressor

Module 6: Somatoform Disorders

Psychophysiological Disorders Psychological health impacts physical health o Depression/anxiousness = fatigue/nausea; stress = lowered immune response = sick Extreme psychophysiological disorder caused in part by psychological problems, they are physical diseases (treated physically) 6

Psych 1X03 C01 Professor Kim & Professor Cheal 06/04/12 o Ex. Anxiety headache Tylenol for pain relief Somatoform Disorder: Pain/physical symptom that cant be explained with physical basis o Ex. Headache that doesnt go away no matter what treatment , numb in limbs test shows everything is fine, pain in left hand but arm recently amputated

Conversion Disorder Type of somatoform disorder specific sensory/motor symptom without physiological cause o Ex. Sudden loss of vision/ paralysis o Develop during stressful situation symptoms = sudden Freuds research large role in development of psychoanalysis theory o Early 1900s treating women for conversion disorder (hysteria) Used hypnosis and dream analysis as window to unconscious (hidden memories of traumatic events from childhood) Treatment long time to identify hidden memories Psychodynamic treatment used today, still limited evidence for effectiveness Hypochondriasis Someone who has fears of serious illness, despite medical evaluations to the contrary o Preoccupied with having illness & report pattern of symptoms consistent with it o Most common somatoform May be generated partly by misinterpretations of bodily signals o Overreaction to common symptoms pay attention to symptoms in future Therapy teaching patient to reinterpret signals more accurately Medstudent syndrome form of hypochondria; anxiety of having one or more disorders being studied