Mental Disorder may involve:
Dysfunctional patterns of cognition, emotionality, and/or behaviour
Considered deviant in the person’s society/culture
Important criteria in describing mental disorders:
Statistical rarity
Subjective distress
Impairment
Biological dysfunction
Deviance
General Historical Perspectives:
Supernatural theories: attribute mental illness to _______________________
Somatogenic theories: attribute mental illness to ________________________
Psychogenic theories:
________________________
supernatural or otherworldly causes
Evil spirits, angry gods, sin, celestial events, and curses
bodily causes
Genetics, abnormal brain structure, brain damage, neurochemical imbalances, humors, and other (alleged) physical/physiological causes
Trauma, learning, or distorted perception
Ancient Perspectives:
Middle Ages and The Demonic Model:
Trephanation began ~6500 BC (at least)
Ancient Chinese Medicine: imbalances of “yin” and “yang”
Physical causes in Egyptian and Greek civilizations (e.g., “hysteria”)
View of mental illness in which hearing voices, talking to oneself, and other odd behaviours were attributed to the actions of evil spirits infesting the body
Later, mentally ill (disproportionally women) were persecuted as witches
Malleus Malleficarum
Medical Model:
_____________________
Asylums; unscientific treatments, such as bloodletting and terror induction
Phillippe Pinel (1748-1826) and Dorothea Dix (1802-1887) promoted _______ __________ of people with mental illness
View of mental illness as a physical disorder
moral treatment
Modern Era:
_____________________
Deinstitutionalization: releasing of hospitalized ____________ ___________ and closing of mental hospitals
Advent of effective medications
psychiatric patients
Culture-bound Syndromes:
___________________
mental illnesses that are specific to one or a few societies
What does DSM stand for?
Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Includes diagnostic criteria for _______________________
Originated in 1952, now in its 5th edition.
all clinically recognized disorders
Important Features of the DSM:
Warns diagnosticians to “________ _____________” – rule out medical causes
Provides information about the ______________ and prevalence of disorders
Takes the _________________ view and recognizes people as more than their disorders
Recognizes __________ in ethnicity/culture, sexual identities, and socioeconomic backgrounds
think organically
characteristics
biopsychosocial
diversity
Criticisms of the DSM:
Are all diagnoses valid?
Comorbidity: distinct issues or a underlying condition?
Categorical Model:
_____________________
Differences are often on a continuum, rather than being categorically separate (i.e., dimensional model)
Medicalization of normality
model in which a mental disorder differs from normal functioning in kind rather than degree
Anxiety:
An emotion characterized ________________________
Generalized Anxiety Disorder:
Continual feelings of ________________________
Can adversely affect work, school, social interactions, and sleep
Risk factors: female, widowed, divorced, low SES, drug and alcohol use; genetics
by feelings of tension, worried thoughts, and physiological changes
worry, anxiety, physical tension, and irritability across many areas of life functioning
Panic Disorder:
________________________
Panic Attack: brief, intense episode of _________ ______ characterized by sweating, dizziness, light headedness, racing heartbeat, and feelings of impending death or going crazy.
Can result from specific situations/fears or arise ‘out of nowhere’
Onset: late adolescence or early adulthood
Risk Factors: female; genetics (runs in families)
Repeated and unexpected panic attacks, along with either persistent concerns about future attacks or a change in personal behaviour in an attempt to avoid them.
extreme fear
Phobia:
________________________
An intense fear of an object or situation that is greatly out of proportion to its actual threat
Agoraphobia refers to a fear of ________________________
Emerges in ____________
Often an outgrowth of panic disorder; can occur without panic disorder
Debilitating: __________ of public places like grocery stores, malls, public transportation
Onset: Adolescence or early adulthood
Risk Factors: panic attacks, fear response to panic attacks, other phobias, sensitivity to anxiety, adverse experiences in childhood, and having a relative with agoraphobia
being in a place or situation from which escape is difficult or embarrassing, or in which help is unavailable in the event of a panic attack.
mid-teens
avoidance
Specific Phobias include:
________________________
Animals and insects (e.g., spiders), natural environments (e.g., storms), blood and injury (e.g., needles, blood), situations (e.g., enclosed spaces, flying)
Social Anxiety Disorder:
Distress causes significant _____________ to daily routine
Individual is typically aware that the distress is excessive/unreasonable
Onset: childhood or early adolescence
Risk Factors: Genetics, lifetime stress
intense fear of negative evaluation in social situations
disruptions
Post-Traumatic Stress Disorder (PTSD):
________________________
Experience vivid memories, images, emotions pertaining to traumatic experience - commonly called “flashbacks”
Rumination, nightmares, uncontrollable thoughts about the event
Attempts to avoid reminders of the trauma (e.g., thoughts, places, emotions)
Risk Factors (beyond exposure to trauma):
Severity and duration of trauma
Lack of social support
Other life stressors or mental health problems
Marked emotional disturbance after experiencing or witnessing a severely stressful situation: a lasting reaction to trauma
Obsessive-Compulsive Disorder:
________________________
Obsession: a persistent idea, thought, or _______ that is unwanted and inappropriate, causing ________ _____________
Compulsion: repetitive ____________ or mental act performed to reduce or prevent ________
Onset: adolescence or early adulthood
Risk Factors: genetics; childhood abuse or neglect may influence development of OCD
Condition marked by repeated and lengthy (at least one hour per day) immersion in obsessions, compulsions, or both
O: impulse, marked distress
C: behaviour, stress
Biology:
_______________________
Anxiety disorders are heritable: _____ _________ show genetic influence
Trait neuroticism is heritable; genes may also affect expression of anxiety disorders
Structural and functional differences in anxious brains
Learning:
Anxiety may be created through positive punishment and avoidance reinforced through negative reinforcement (e.g., operant conditioning)
Other Experiential Factors:
Adverse childhood experiences: may lead to hyperactive stress response and emotional dysregulation
Associated with more anxiety vs. non-abusive childhoods
Anxiety sensitivity, a tendency to catastrophize, and appraise situations negatively
Evolutionary roots of anxiety
twin studies
Mood:
________________________
Moods naturally vary from time to time
Good moods promote ________ and interaction with others; bad moods promote _________ and a focus on the negative
A disposition to respond emotionally in a particular way that may last for hours, days, or even weeks, even at a low level and without the person knowing what prompted the state
activity
isolation
Two Basic Categories of Mood Disorders:
- Depression
- Bipolar disorder
Major Depressive Disorder (MDD):
________________________
Feelings of guilt, worthlessness, hopelessness; lack of energy
MDD is a major risk factor for ________________ and __________
Onset: can affect people of any age; peaks in late adolescence and early adulthood
Risk Factors: females are more likely to experience MDD; Indigenous Canadians experience 2x rates; more common in younger people; fewer social connections; substance use; stress/trauma
MDD has risen in the last 100 years
Chronic or recurrent state in which a person experiences low mood, diminished interest in pleasurable activities, low self-esteem, and other symptoms including weight loss and difficulty sleeping
self-harm and suicide
Bipolar Disorder:
______________________
Cycle between ____________ and _______
A condition marked by a history of at least one manic episode, and which causes intense shifts in mood, energy levels, thinking patterns, and behaviour
depression and mania
