Psychopathology

Psychopathy (con t)

Psychopathy Characteristics High impulsivity Thrill seeking Low empathy Low anxiety

What is the common factor? Callous Self-Centeredness N M P

Dr. Robert Hare World s expert on psychopathy Read his book: Without Conscience

Psychopathy

Emotional Processing in Psychopathy

Cognitive Processing in Psychopathy ADHD Top down vs bottom up processing

Empathy in Psychopaths Emotion Perception VS Theory of Mind

Cognitive Load

Dual-Process Models

Disfluencies

Study Overview Signal Analysis Emotional Content Analysis Content Complexity Analysis Social Perception Study 1 Study 2

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Content Analysis Word Emotion Token Value Word Emotion Token Value love anger 0 love anticipation 0 love disgust 0 love fear 0 love joy 1 love negative 0 love positive 1 love sadness 0 love surprise 0 love trust 0 killing anger 1 killing anticipation 0 killing disgust 0 killing fear 1 killing joy 0 killing negative 1 killing positive 0 killing sadness 1 killing surprise 0 killing trust 0

Content Analysis: Complexity

Fluency in the psychopathic population as a function of motivation and cognitive load High Cognitive Load Low Cognitive Load High Motivation Unknown High Fluency Low Motivation Low Fluency Normal Fluency

Psychopathology

Psychopathology Models Four Main Perspectives Biomedical View Some biological part of you is broken Psychodynamic View Internal psychological conflict Behavioural View Maladaptive learning or faulty habits Diathesis- Stress View

Modern Views: Diathesis-Stress Model Diathesis Predisposition (e.g., genetic) for disorder Stress Triggers disorder Both diathesis (risk) and stress must be present for disorder Broken legs example

Modern Views: Multicausal Models Expands diathesis-stress models Multiple diatheses E.g., genetics, styles of thinking Multiple stresses E.g., relationship problems, victim of a crime Biopsychosocial perspective All three can contribute to mental disorders

Risk of Mental Illness Is Widespread Point prevalence How many people live with a disorder at a given time Lifetime prevalence How many people will experience a given disorder at any point in life Lifetime prevalence among adults = 46%

DSM-IV-TR (2000-2012) Diagnosis Guidelines: DSM-V Previously, 5 major axes I. Clinical syndromes and II. III. IV. disorders Personality disorders and mental retardation Medical conditions Psychosocial and environmental stressors V. Global assessment of functioning DSM-V (2013-Present) Revised, nonaxial Biopsychosocial diagnosis and risk factors (Axes I-III) Psychosocial and environmental stressors (Axis IV) Disability (Axis V) Better aligned with international standards (WHO, ICD)

DSM-V Definition of Mental illness

Assessing Mental Disorders Assessment is critical for understanding reasons for symptoms and developing a treatment plan 3 primary methods of assessment Clinical interviews Semi-structured interview with a professional Self-report measures Questionnaires Projective tests

Projective Tests Projective test types Thematic Apperception Test (TAT) Rorschach (inkblot) Test Meant to indirectly reveal unconscious wishes or conflicts

What are the benefits of diagnosis?

Major Categories of Mental Disorders Anxiety disorders Mood disorders Schizophrenia Other Axis I & II disorders

Anxiety Disorders

Anxiety: Coping with Intense Emotions Characterized by feelings of intense distress or worry Similar to, but not the same as, nervousness Disruptive and unsuccessful attempts at coping with those feelings

Phobias = Fear + Avoidance Specific phobias E.g., acrophobia (heights), claustrophobia (enclosed places), arachnophobia (spiders) Social phobia (social anxiety disorder) Avoidance may exacerbate psychological or physical harm E.g., more extreme avoidance of related fears, resorting to substance abuse dependence

Panic Disorder As Physical Anxiety Panic attacks Sudden onset of terrifying bodily symptoms Labored breathing Choking Dizziness Tingling hands & feet Sweating Trembling Heart palpitations Chest pain

Anxiety Can Be Continuous & Pervasive Phobias Need a stimulus Panic attacks Not constant Generalized Anxiety Disorder Visibly worried nearly all the time Anxiety is not specific to any stimulus

Obsessive-Compulsive Disorder (OCD) Obsessions Recurrent, unwanted or disturbing thoughts Compulsions Repetitive or ritualistic acts that may help cope with obsessions

Post-Traumatic Stress Disorders Triggered abruptly by identifiable, horrific event Dissociation Numbness to traumatic event Reactions include intense, intrusive recurrent nightmares and flashbacks Affects women and men equally Can be cause by events such as : Sexual assault, violent crime, or even a break-up (in extreme cases).

PTSD Symptoms persist >1 month Re-experience Nightmares, flashbacks Arousal Difficulty sleeping, concentrating, hyper vigilance Avoidance Avoid anything related to trauma 7% lifetime prevalence

Some brain areas (amygdala, insula) are hyperactive (red) across phobias, social anxiety, and PTSD Hypoactivation (blue) may be related to blunted affect in PTSD Etkin & Wager, 2007 Roots of Anxiety

Changes in the brain: The cause, or effect of mental health problems?

Mood Disorders

Depression Mood: Persistent Ups and/or Downs Extremely common lifetime prevalence 1 in 4 women, 1 in 10 men Global deficits or disruption in Affect (sadness, loss of pleasure) Behavior (sleep, diet, bodily functions) Cognition (attention, working memory)

Mood: Persistent Ups and/or Downs Bipolar Disorder Depressive & manic episodes (hours-months in duration) Mania racing thoughts and speech, irritability or euphoria, impaired judgment

Mood: Persistent Ups and/or Downs Bipolar Disorder Hypomania (mild) Mania Acute/Psychotic Mania Short-lived periods, particularly insidious progression Switching doesn t always happen, but there can be mixed states (signs of both depression and mania) Lifetime prevalence of 4%...

Schizophrenia

Schizophrenia: The Split Mind Group of severe mental disorders Disturbance of thought, withdrawal, inappropriate or flat emotions, delusions, hallucinations Lifetime prevalence = 1% Commonly diagnosed in adolescence or early adulthood; more often in men

Signs and Symptoms of Schizophrenia Positive or negative symptoms based on presence or absence in healthy people Cognitive symptoms reflect impaired attention, working memory, inhibitory control, and even early sensory processing Psychosis is a break from reality

Positive Symptoms of Schizophrenia Not typically present in healthy individuals Delusions Systematized false beliefs of grandeur or persecution (delusions of reference) Hallucinations Sensory experience without actual external stimulation Disorganized behavior Strangely dressed, violent or nonsensical behavior

Negative Symptoms of Schizophrenia Not typically absent or low in healthy individuals Flat affect Little to no display of emotion Catatonic behavior Anhedonia No interest in pleasurable activities Withdrawal Isolation from social interactions Development of idiosyncratic thoughts and behavior

Schizophrenia has a strong genetic component Risk increases with closer relations Genetics & Development in Schizophrenia

Enlarged ventricles Decreased white and gray matter volume Shenton et al., 2001 Neural Bases of Schizophrenia Decreased gray matter in prefrontal cortex Impaired executive control