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unit 11 - Coggle Diagram

- - - - Working the Scientific Literacy Model:
        The Criminal Psychopath
        
        Although the term psychopath often gets used as a synonym for APD, there are some differences between the two.
        
        Psychopaths are frequently diagnosed using the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 2003), a 20-item checklist on which an assessor decides the degree to which a patient matches different characteristics.
        
        The PCL-R breaks down into two main factors
        
        The Interpersonal/Emotional factor contains items such as “superficial charm,” “pathological lying,” “lack of empathy,” and “lack of guilt.”
        
        The Social Deviance factor contains items such as “need for stimulation,” “impulsivity,” “poor behavioural controls,” and “early behavioural problems.”
        
        People with APD (but who are not psychopaths) tend to score highly on the Social Deviance items. Psychopaths, on the other hand, score high on both factors, but are particularly high on the Interpersonal/Emotional items. This result has led some psychiatrists to suggest that psychopathy is an extreme form of APD
  - - - Cluster A disorders are characterized by odd or eccentric behaviour.
      - Cluster B disorders are indicated by dramatic, emotional, and erratic behaviour.
      - Cluster C disorders are characterized by anxious, fearful, and inhibited behaviour.
      - In addition to these 10 disorders, the DSM-5 also identifies Personality Disorder Not Otherwise Specified, which is a diagnosis given to individuals who exhibit patterns of behaviour consistent with that of a personality disorder but that does not fit into any of the personality disorder categories described above.
- - - - MANIA: which included symptoms such as hallucinations and excessive energy
      - MELANCHOLIA: which included depression and anxiety; often curable
      - MEDICAL MODEL: sees psychological conditions through the same lens as Western medicine tends to see physical conditions—as sets of symptoms, causes, and outcomes, with treatments aimed at changing physiological processes in order to alleviate symptoms
      - Emil Kraepelin was one of the most influential clinicians in the history of psychiatry and psychology. His attempts to classify psychological disorders based on their long-term outcomes influenced how future clinicians diagnosed mental illnesses.
        
        stated that psychological disorders could be divided into 13 large groups
        
        PSYCHOSIS: when an individual has difficulties distinguishing between what is real and what is imagined
  - - - a clinician still has to subjectively decide whether a client displays each symptom and whether it is severe enough to be considered a symptom or just normal experience
      - different disorders often share many common symptoms
      - there is a fine, and essentially arbitrary, line between whether a person is considered to have a disorder or not
  - - - ataque de nervios - This disorder, which can occur in Latin American cultures, involves trembling, uncontrollable crying and/or shouting, fainting episodes, and, in some cases, aggressive behaviour.
      - neurasthenia or shenjing shuairuo - a relatively common Mandarin Chinese ailment in which a person experiences extreme fatigue, physical weakness, pain, and problems with relaxation after periods of mental effort.
      - However, although illnesses such as ataque de nervios and neurasthenia were both included in the DSM-IV, they were often viewed as interesting windows into a foreign culture rather than useful information that could affect how North Americans of Latino or Chinese heritage could be treated. In other words, culture was often viewed as something that influenced disorders that occurred “over there” rather than disorders that occur “here.”
      - An obvious question that arises from these cross-cultural studies is “If cultural information is important, can it actually be used to improve the accuracy of diagnoses?” In order to test this possibility, the DSM-5 now includes the Cultural Formulation Interview, a supplement aimed at helping clinicians collect additional information about cultural factors that could influence diagnoses
  - - - ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD): a developmental disorder in which children show inappropriate levels of hyperactivity and impulsivity while also having problems maintaining their attention to people or activities
    - - MENTAL DISORDER DEFENCE: claims that the defendant was in such an extreme, abnormal state of mind when committing the crime that they could not discern that the actions were legally or morally wrong
- - - - GENERALIZED ANXIETY DISORDER (GAD): involves frequently elevated levels of anxiety, generally from the normal challenges and stresses of everyday life
      - PANIC DISORDER: an anxiety disorder marked by occasional episodes of sudden, very intense fear
        
        PANIC ATTACKS: brief moments of extreme anxiety that include a rush of physical activity paired with frightening thoughts
        
        AGORAPHOBIA: an intense fear of having a panic attack in public; as a result of this fear, the individual may begin to avoid public settings and increasingly isolate themself
      - SOCIAL ANXIETY DISORDER: a very strong fear of being judged by others or being embarrassed or humiliated in public
  - - - SPECIFIC PHOBIA: an intense fear of a specific object, activity, or organism
      - Social Phobia (discussed earlier- social anxiety disorder)
      - 5 main types (see table):
        natural environment; situational; animal; blood/injection/injury; other
  - - - personal attributions -> stable attributions -> global attributions
      - DIATHESIS-STRESS MODEL: interaction between a genetic predisposition for a disorder and life stress
      - In the depressed brain, the amygdala is frequently overactive and overstimulates the HPA axis
- - - - Stages of Schizophrenia:
        
        PRODROMAL PHASE: people may become easily confused and have difficulty organizing their thoughts, they may lose interest and begin to withdraw from friends and family, and they may lose their normal motivations, withdraw from life, and spend increasing amounts of time alone, often deeply engrossed in their own thoughts
        
        ACTIVE PHASE: people typically experience delusional thoughts, hallucinations, or disorganized patterns of thoughts, emotions, and behaviour
        
        RESIDUAL PHASE: people’s predominant symptoms have disappeared or lessened considerably, and they may simply be withdrawn, have trouble concentrating, and generally lack motivation.
      - Symptoms of Schoziphrenia:
        
        POSITIVE SYMPTOMS: the presence of maladaptive behaviours, such as confused and paranoid thinking, and inappropriate emotional reactions
        
        HALLUCINATIONS: alterations in perception, such that a person hears, sees, smells, feels, or tastes something that does not actually exist, except in that person’s own mind
        
        DELUSIONS: beliefs that are not based on or well integrated with reality
        
        DISORGANIZED BEHAVIOUR: the considerable difficulty people with schizophrenia may have completing the tasks of everyday life
        
        NEGATIVE SYMPTOMS: the absence of adaptive behaviour, such as absent or flat emotional reactions, lack of interacting with others in a social setting, and lack of motivation.
        
        catatonia, a movement disorder in which an individual does not move and rigidly remains in a pose for a lengthy period of time
      - Sub-types of Schizophrenia:
        
        PARANOID SCHIZOPHRENIA: Symptoms include delusional beliefs that one is being followed, watched, or persecuted, and may also include delusions of grandeur or the belief that one has some secret, insight, power, or some other characteristic that makes one particularly special.
        
        DISORGANIZED SCHIZOPHRENIA: Symptoms include thoughts, speech, behaviours, and emotions that are poorly integrated and incoherent. People with disorganized schizophrenia may also show inappropriate, unpredictable mannerisms
        
        CATATONIC SCHIZOPHRENIA: Symptoms include episodes in which a person remains mute and immobile—sometimes in bizarre positions—for extended periods. Individuals may also exhibit repetitive, purposeless movements.
  - - - Studies using twin, adoption, and family history methods have shown that as genetic relatedness increases, the chance that a relative of a person with schizophrenia will also develop the disorder increases
    - - Size: People with schizophrenia have ventricles that are 20% to 30% larger than people without schizophrenia. The reason for these larger ventricles is a loss of brain matter, particularly in limbic system structures such as the amygdala and hippocampus. This thinning of brain structures can amount to a 2% reduction of total brain volume.
      - Function: People with schizophrenia show lower levels of activity in their frontal lobes, both in resting states and when engaged in cognitive tasks, suggesting that these brain regions are not functioning at an optimal level
      - Chemistry: People with schizophrenia have an increased rate of firing in dopamine-releasing cells. Some of this over-activity is in a part of the brain known as the basal ganglia, which is involved in a number of functions including reward responses. As a result of this firing, stimuli that should be meaningless are interpreted as being quite noteworthy
      - Chemistry: Glutamate, another neurotransmitter, appears to be underactive in certain brain regions, including the hippocampus and the frontal cortex. Glutamate is the brain’s primary excitatory neurotransmitter, so a reduction of glutamate in those areas would correspond to a reduction of their functioning. Improper functioning of glutamate systems in the brain is a likely cause of negative symptoms in schizophrenia
    - - Studies of populations that were experiencing famines found that if a mother experienced malnutrition during pregnancy, there was an increased likelihood of the child developing schizophrenia
      - Additionally, difficult births in which the umbilical cord limits oxygen to the baby were also linked to the later development of this disorder
      - Head injuries occurring prior to age 10 also put people who are genetically vulnerable to schizophrenia at greater risk for developing the disorder
      - Also, being raised in an environment where psychosocial stressors (e.g., interpersonal conflict, social isolation, poverty) are more abundant, such as modern urban environments, puts individuals at greater risk for developing schizophrenia, because schizophrenic episodes are often triggered by acutely stressful circumstances
      - Families high in emotional expressiveness (EE) tend to be overly critical and controlling, whereas families low in EE tend to be more supportive, accepting, and non-judging (O’Driscoll et al., 2019). As several teams of researchers have found, there are large differences between people with schizophrenia who live in high-EE versus low-EE families.
      - Some research suggests that a small proportion of people who use marijuana develop psychotic symptoms, possibly because the drug interacts with the genes involved in schizophrenia