Unusual

Who falls outside the population curve

Violates social norms

Irrational/faulty perceptions of reality

Dilutional(can put you and others in great danger)

Discomfort (distess)

Maladaptive - Is the behavior adaptive.

Dangerous to paitent and others

Not all criteria are necessary

No single criteria is synonymous with "abnormal"

You always have to consider context (cultural relativism)

Psychopathology (scientific study of psychological disorders:

1)Description

2)Etiology,

3)Treatment.

It defines a mental disorder. A categorical system that tells you weather you have something or not. Yes or no.

Axis I - Major mental disorder (schizophrenia, anorexia)

Axis II - Underlying pervasive or personality conditions as well as mental retardation. (anti social personality disorders)

Axis III - General Medical Conditions

Axis IV - Psychosocial Stressors (whats going on in patients life)

Axis V - Global Assessment of functioning (on a scale from 100 to 0) (severity of case)

What is another word for etiology?

MZ/DZ twins?

Neurotransmitters?

Learning Theories?

The cause of a disease

Monozygotic twins are genetically identical. 100% of DNA is shared higher rates of both suffering from a mental disease

Dizygotic twins share 50% of DNA, like a brother or sister. Lower rates of both suffering from a mental disease

An increase or decrease in certain neurotransmitters can result in mental disease.

Learning Theories include classical conditioning (things that were associated with the past/rewards and punisments, observation)

Treatment can be inpatient or outpatient depending ont he severity of the case.

Providers - psychologist - PHD in psychology. Psychiatrist - Meidcal Doctors who can prescribe. Counselors - Masters Degree. Social Workers - Bachelor degree, think more broadly. Psychiatric Nurses - Can prescribe.

Outcome - Therapy works. Treated individuals better than 75% of untreated individuals. No medication is best. For some problems there are "best practices"

1st grouped into a single disorder in late 19th century by Emily Kraeplin

Dementia Praecox (sever intellectual deteroiration of adolescent onset)

1911 - Eugene Bleuler - not always intellectual deterioration or adolescent onset

"Schizophrenia" = splitting of mental associaitons (split mind)

DSM-IV criteria for Schizophrenia:

Not during depression, mania, other mood disorder, substance abuse, or general medical disorder.

-At least 2 symptoms for 1 month

-Some signs for 6 months or more

-Impaired functioning (work, relationships, self care)

Positive symptoms - Excesses (what "have")

-Hallucination, delusions, disorganized speech and behavior.

-Course is better

-Premorbid functioning is better

-More in females

-Responsive to medication

-Deficits (what "don't have")

-Flat affect (may be inappropriate; anhedonia - lack of pleasure/interest

-Alogia - poverty of speech

-Avolitional (lack of will/interest; withdrawn, not goal directed)

-Course = worse

-Premorbid functioning = worse

-Males > females

-Less responsive to medications

1. Prodromal phase - Before episode: Decreased interest in social activities, poor hygiene, work and school decline, behavior may seem odd, speech may be vague and rambling

2. Acute/active phase - equivalent to the DSM symptoms: Hallucinations, delusions

3. Residual phase - (after) Behavior returns to level that was characteristic of the prodromal phase: May be apathetic, difficulties in thinking/speaking, "odd" ideas, poor social skills.

-about 1% of population

-M=F? some evidence shows that M>F?

-Average age of onset = 25

-M: 18-25

-F 25-35

-Women have better course

-Better prognosis:

-premorbid social functioning

-symptoms onset very suddenly

-confused by symptoms

Course varies:

-majority will be rehospitalized

-majority stabalize across 5-10 years (treated)

-62% recovered across about 30 years (treated)

-10-15% die by suicide

-Genetics:

MZ = 46%

DZ = 14%

-Brain strucuture: Enlarged ventricles suggests deterioration of brain. Smaller prefrontal cortex

(language, emotional expression, planning, social interactions). Connected to limbic system (emotion and cognition) and basal ganglia (motor movement)

-Dopamine Hypothesis: Amphetamine psychosis (increase dopamine), Medications (phenothiazines; decrease functional dopamine), More dopamine receptors (some individuals with schizophrenia)

-Newer Dopamine Theory: Excess mesolimbic pathway and excess cognition and emotion. Deficit in the prefrontal area and a deficit in attention, motivaiotn, organization

-Delivery/pregnancy (availability of oxygen)

-Prenatal viral exposure: 2nd trimester

-Breech birth

-Lack of oxygen may lead to schizophrenia

-Family: EE (expressed emotion)

-hostile, critical, emotionally overinvolved

-relapse: 70% (high EE) vs. 31% (low EE)

-stress?

-Social class - higher in lower SES

-Environmental stress - adverse conditions may increase risk of predispotion emerging.

"Downward drift": symptoms interfere and push someone into a lower SES.

Treatment for Schizophrenia (Medications):

-Antipsychotics (phenothizaines) - block dopamine receptors

-Prolixin, Thorazine, Mellaril, Stelazine

-For positive symptoms. Prophylactic prescriptions

-May have motor side effects

-Tardive Dyskinesia - due to long term use of antipsycotics - involuntary lip smacking and jerking moves - about 20% (long-term use).

-Atypical Antipsychotics - Clozaril (agranulocytosis 1-2%). Risperidone. For negative symptoms and better side effects

-Family

-Skills - Medication management, social, occupational, community

-Schizoaffective Disorder - mood epidsodes + "psychotic episodes"

-Brief Psychotic Disorder - occurs around a time of overwhelming stress, lasts from 1 day to 1 month

-Schizophreniform Disorder - lasts more than 1 month but less than 6

Personality? aggressive, curious, annoying (who we are) controversial, reliability? Not very good for these disorders.

-Rigid ways of behaving, thinking, feeling, and/or relating to others.

-Adolescence or early childhood

-Don't often seek help

-Ego-syntonic (vs. ego-dystonic)

-out of synch with others, in synch with themsleves

Odd and or eccentric

1. Schizotypal Personality Disorder - cognitive/perceptual, ideas of reference, odd beliefs, odd thinking/speech, prodromal stage of schizophrenia? high rates of schizophrenia in family members, poor prognosis, slightly more males.

2. Paranoid Personality Disorder - Mistrust of others (pervasive), Distant and argumentative, Family history of schizophrenia common

3. Schizoid Personality Disorder - Detached/"loners", Restricted emotions, Indifferent, Detached.

-Dramatic, erratic, and emotional

1. Histrionic Personality Disorder

2. Narcissistic Personality Disorder

3. Borderline Personality Disorder

3. Antisocial Personality Disorder

-Attention seeking

-Emotional

-Dramatic, exaggerated

-Diagnosed more in women

-Biases?

-Frequently comorbid with depression and borderling personality disorder

-Grandiose

-Feel entitled

-Special/unique ("by association")

-Fantasies of success/power

-Need excessive admiration

-Lack empathy for toehrs - can't share perspective for others

-50-70% male

-Often rewarded in our culture

-sees "dependency" as "weakness"