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Description
Causation
Bio-psycho-social factors
The factors all interact with each other; cause is never due to either/or
Treatment
Psychological
Sociocultural
Cause
Spirits; stars/moon; past
lives
Internal physical problems;
biological dysfunction; all
disorders are from a
biological source
Beliefs, perceptions, values,
goals, motivation etc;
psychological dysfunction;
people see things in a way
that causes them to suffer
Poverty, prejudice, social
and cultural systems
Treatment
Exorcisms, prayers etc
Bleeding, diet, celibacy,
exercise, rest, medication
Psychotherapy
Criticisms
Extreme reductionism
Certain complex psychological
phenomena (e.g creativity) may be
impossible to explain at a purely
neural/molecular level
Over-extrapolation from animal
research
Animals dont live in the complex
society that humans do live in, so
animal research overlooks many
social and psychological factors that
affect us in everyday life
Assuming causation from treatment
May not be applicable to
conceptualising and diagnosing mental
illnesses
Most dominant during first half of 20th century; usage discontinued by 1970s
Anxiety
Defence mechanisms
Environments that impose conditions of worth (e.g not being able to pursue a
dream career because of familys expectations)
Many treatment applications, such as implanting new learning to cover old learning
(extinction)
Critiques: does not factor in cognition or emotion, implies that we learn by doing
only
Bandura (1974) found that learning is not purely from behaviour with his
observational learning theory, which incorporated cognition to behaviourism
Cognitive-Behavioural Model
Cognitive biases; only picking up information that fits in with our believes
May reduce social stigma against those with mental health issues
Classification Systems
DSM
Development of DSM
DSM-I (1952), DSM-II (1968)
How much self depreciation must one exhibit before they can be diagnosed?
Can a patient still be suffering from mental health issues if some conditions are
not met?
Problematic validity
No theoretical assumptions about causation - all symptoms and causes can be seen
or shown through patient report, direct observation and measurement
Perception of threat
Escape/Avoidance
Aggression
Freezing
Specific phobias
Social phobia
Generalized anxiety disorder
Obsessive-Compulsive disorder
Anxiety disorders are highly comorbid (tend to occur with each other. Most people
with mental disorders will have several disorders at the same time) with each other as
well as Depression.
Specific Phobia
Selective Mutism
Social Phobia
Specific Phobia
Social Phobia
Panic Disorder
Panic Disorder
Agoraphobia
Obsessive-Compulsive Disorder
New Chapters in DSM-V:
Trauma- and Stressor-Related Disorders:
Inc. Post-traumatic stress disorders and Acute stress disorder
Obsessive-Compulsive and Related Disorders:
Inc. Obsessive-Compulsive disorder
Panic Attack
Has classic symptoms of autonomic arousal and other associated physical symptoms
Produces fear of dying, losing control, going mad, epilepsy and hear attacks
Two types:
Diagnostic (DSM-V)
At least 2 uncued panic
attacks
Having anxiety/worry
about having another
attack
Having concerns about
heart attacks, going mad,
epilepsy etc because of
the panic attacks
Significant behavioural
Causes/Associations
Cognitive theory of Panic
disorder:
Bodily sensations (heavy
breathing, shaking etc) maybe
after strenuous activity
Misinterpretation of
sensations as cues for heart
attack, death etc
Specific phobias
Generalized anxiety
disorder
Anxiety
Increased anxiety
However: conditioning is
heights etc
not sufficient nor
Person knows what they
necessary to cause phobia
fear and therefore will
Associated with
when encountering object
evolution: objects that
is exaggerated to danger
once posed significant
level
threat to survival
Can be associated with
Trait: tendency to
About wide range of
experience anxiety
outcomes (2+ for
Intolerance of uncertainty
diagnosis)
Reduced ability to
3-6(+) needed for
tolerate distress (have a
diagnosis
need to reduce possibility
Not classic autonomic
of distress)
arousal symptoms
Post-traumatic stress
disorder
Obsessions: repeated,
intrusive, irrational
thoughts or impulses that
cause severe anxiety or
distress
A minor thought could
cause big distress
Compulsions: ritualized
behaviours to relieve
anxiety caused by
obsessions
No longer anxiety
disorder because while
anxiety is a big part, lots
of other negative
emotions also occur
Intolerance of
uncertainty: need to be
sure obsessive thought
will not occur (leads to
repetition of compulsive
behaviour)
However trying to not
think about something
makes thoughts stronger
Inflated responsibility:
blames self for possible
negative outcome
Thought-action fusion:
thinking is as bad as
doing
Magical ideation: creating
superstitions and rules
that the self believes will
lead to good outcome
Exposure to actual or
threatened death, serious
injury or sexual violence
in 1(+) following ways:
Direct experience
Witnessing event that
occurred to others
Learning that traumatic
event occurred to close
family/friends (violent or
accidental)
Experiencing repeated or
extreme exposure to
aversive details of
traumatic events
Eating Disorders
DSM-IV
Anorexia Nervosa
Bulimia Nervosa
EDNOS
Subclinical AN or BN
Purging Disorder
Grazing
DSM-V
Anorexia Nervosa
Bulimia Nervosa
Pica
Rumination Disorder
Avoidant/Restrictive Food Intake
Disoder
Binge-Eating Disorder
Other Specified Feeding or Eating
Disorder
Unspecified Feeding or Eating
Disorder
Anorexia Nervosa
Refusal to maintain body weight
at a minimally normal weight
for age and height
Restricting: successful in
restricting intake of foods;
usually eat same foods
every day
Binging/Purging: sometimes
break restriction; then feel
like have to compensate for
extra calorie intake
Bulimia Nervosa
Binge eating +
compensatory behaviours
Recurrent episodes of binge
eating
Objective binging
Tend to be ashamed of
binging episodes
Recurrent inappropriate
compensatory behaviour to
prevent weight gain
Purging: self-induced
vomiting, laxative abuse
Non-purging: fasting,
excessive exercise
Tend to be normal/slightly
over weight
Because compensatory
methods do not work
Associated
Features
Epidemiology
amount
Body image disturbance
Denial/unable to realize
extent of underweight
Malnutrition, anaemia,
immune system suppression
Mortality rate of 5-10% over 10
year period
Anorexic thinking remains (e.g
obsessing over calories) even
after patient symptoms no longer
meet criteria for DSM-V
Prevalence
Psychological problems:
Comorbid mood
disorders, anxiety
disorders, substance
abuse, personality
disorders (BPD
[impulsive])
Physical problems:
Associated with
compensatory
behaviours e.g:
Dehydration,
Electrolyte disturbances
(irregular heartbeat,
heart failure)
Prevalence
Affects 1.0-3.0% of
females
Age of onset
Mid-late adolescence
(though getting earlier)
Course
BN are female
Age of onset
Late adolescence-early
adulthood
Course
Biological
Genetic factors
Psychological
Cognitive-Behavioural theory
(refer to Lecture 5 ppt)
Proposed Psycho-Social Causes
Family factors
Social-cultural values
Mood Disorders
Mood Disorders Chapter in DSM-IV:
Depressive Disorders
Such as:
Dysthymic Disorder
DD-NOS
Bipolar Disorders
Such as:
Bipolar I Disorder
Cyclothymic Disorder
NOS
NOTE: DSM-V both are given own chapters rather than under Mood Disorders
Depressive Disorders:
Major Depressive Disorder
Symptoms
Diagnosis
1. One or more major depressive episodes Major Depressive EPISODE:
with symptoms:
Dysthymic Disorder
Renamed persistent depressive disorder in DSM-V
Symptoms
Diagnosis
Heritability: 35-60%
Psychological Theories
Schema Theory
Treatments
Biological
Psychological
Method
Drugs
SSRIs
Effective in 70-80%
Electroconvulsive Therapy (ECT)
Effective in 80%
Cognitive-Behavioural Therapy
Behavioural Activation
Behavioural Experiments
Compared to drug therapy there is
lower rate of relapse
29% vs 60%
Explanation/Limitations
SSRIs only inhibit serotonin
re-uptake
Compared to unrealistically
negative viewpoint