Cognitive Disorders, Anxiety Disorders and Mood Disorders

Cognitive Disorders, Anxiety Disorders and Mood Disorders

Schizophrenia Severe psychological disorder characterized by disturbances in thought and language perception and attention motor activity mood social interaction

Schizophrenia Afflicts nearly 1% of the population worldwide Onset occurs relatively early in life Males most likely to experience their first psychotic break prior to the age of 25 Females most likely to experience their first psychotic break after the age of 25 Adverse effects tend to endure Very rare for a person to fully recover from Schizophrenia

Positive Versus Negative Symptoms Positive symptoms Active unusual symptoms Hallucinations, delusion, looseness of association Negative symptoms Deficiencies a lack of normal functioning Lack of emotional expression and motivation Social withdrawal Poverty of speech

Positive Versus Negative Symptoms Positive symptoms More likely to have an abrupt onset The person retains their intellectual abilities More favorable response to antipsychotic medication

Positive Versus Negative Symptoms Negative symptoms More likely to have a gradual onset Severe, lasting intellectual impairments Poorer response to antipsychotic medication

Types of Schizophrenia Paranoid Schizophrenia Systematized delusions Disorganized Schizophrenia Incoherence; extreme social impairment Catatonic Schizophrenia Motor impairment; waxy flexibility

Brain abnormality Risk factors Heredity Origins of Schizophrenia Biological Perspectives Complications during pregnancy and birth Birth during winter Dopamine theory of schizophrenia

Origins of Schizophrenia Psychological perspectives Conditioning and social situations Sociocultural perspectives Relationship between schizophrenia and lower socioeconomic status Biopsychosocial perspective Genetic predisposition

Types of Schizophrenia Paranoid the most common form of schizophrenia characterized by the belief that others are controlling them or trying to harm them. Disorganized speech is often jumbled and non-sensical (word salad) perception of reality is inaccurate (disheveled appearance and incoherent) Catatonic frozen motor activity (remain in unusual and uncomfortable poses for hours) unresponsive to stimuli from the environment. Residual currently has no positive symptoms (hallucinations/delusions) continues to have negative symptoms (e.g. flat affect)

The Biopsychosocial Model of Schizophrenia

Other Cognitive Disorders Delusional Disorders persistent irrational belief even in the face of contrary evidence Erotomanic ( the president is in love with me ) Grandiose ( I am Jesus Christ - a Messiah Complex), Persecutory or paranoid, (my neighbor is poisoning my well water) Jealous ( my wife is having an affair with the mailman ) Somatic ( I have leprosy and my nose is going to fall off )

Two Abnormal Moods Depression Mania Feelings of sadness, hopelessness, despair Lack of energy or motivation Sleeping too much Anhedonia Lack of enjoyment in any activity Feelings of extreme elation, grandiosity High energy and unusual motivation No need for sleep Risk-taking behaviors, lack of judgment

Biological Origins of Mood Disorders Genetic factors Psychological Learned helplessness Perfectionism and unrealistic expectations Attributional styles Intrinsic vs Extrinsic Locus of Control Biopsychosocial Biologically predisposition interacts with selfefficacy expectations and attitudes

Mood Disorders Bi-Polar Disorder (formerly called Manic- Depression) Typically cycle between two extremes of mood (depression and mania) every few weeks Mania is a period of racing thoughts, high energy, elation, sleeplessness and agitation Treated with Lithium salts or Depacote or an antidepressant or Abilify Cyclothymia Similar to bi-polar disorder except that the mood swings occur more frequently (every few hours) and are not as extreme as in bi-polar disorder (hypomania)

Mood Disorders Dysthymia A persistent state of pessimism, blue mood, mild depression which lasts for two years or more Treatment is with anti-depressants Major Depression A persistent state of blue mood, lack of energy, failure to enjoy normally enjoyable activities, excessive sleep and feelings of despair which lasts at least two weeks The most effective treatment is anti-depressant medication plus psychotherapy.

Risk Factors in Suicide Feelings of depression, hopelessness 15% of all people who experience Major Depression will commit suicide Stressful life events Anxiety over being outed as a homosexual Academic or social failure Divorce, loss of job, bankruptcy, death of loved one Poor problem solver poor coping skills Familial experience with psychological disorders and/or suicide

Sociocultural Factors in Suicide Third leading cause of death among young people aged 15 to 24 #1 Accidents, #2 Homicide, #3 Suicide More common among college students than people of the same age who do not attend college Older people are more likely to commit suicide than teenagers

Sociocultural Factors in Suicide One in six Native Americans has attempted suicide African Americans are least likely to attempt suicide Three times as many females attempt suicide Four times as many males succeed in suicide

Myths about Suicide Individuals who threaten suicide are only seeking attention not true, they feel despair People who would take their own lives are insane not true, but they are likely depressed Once a person is suicidal, they are always at risk not true, people regain normal equilibrium If I talk to the person about suicide, it will increase the risk that they will do it not true, talking to someone about their suicidal feelings actually reduces the likelihood that they will follow thru

Myths about Suicide Suicide happens without warning not true, there are always subtle signs: Giving away prized possessions Talking about disillusionment with life Withdrawing from family and friends Talking or writing about suicide Risky behaviors, reckless behaviors Symptoms of depression or mood swings Extreme anger or rage Loss of interest in previously enjoyed activities

Assessing Suicidal Ideation Passive Suicidal Ideation Daydreams about being dead, wishing one were dead Wishing for an accident to end the suffering Do you ever feel like you d be better off dead? Active Suicidal Ideation Has made a plan set a date, time, method

Anxiety Disorders Psychological features of anxiety Worrying, fear of worst case scenario, nervousness, inability to relax Physical features of anxiety Over-arousal of sympathetic branch of autonomic nervous system Treatment of Anxiety Disorders Discourage the use of Benzodiazepines or Tranquillizers, as both are addictive Drugs may be used for those whose anxiety is debilitating Behavioral or Cognitive-Behavioral interventions are the most effective

Theories: Cause of Anxiety Disorders Biological Genetic factors Psychological and Social Phobias as conditioned fears Cognitive bias toward focusing on threats Biopsychosocial Interaction between biological, psychological, social factors

Anxiety Disorders Simple Phobia a fear of a specific stimulus which is out of proportion to the actual risk the result of classical conditioning treatment is via flooding or systematic desensitization. Social Phobia Persistent fears of scrutiny by others

Anxiety Disorders Panic Disorder (Panic Attacks) a disorder where the sympathetic system of the peripheral nervous system is over-active unpredictable eruptions of the fight/flight reaction (racing heart, sweating palms, adrenaline rush, nausea, dizziness, etc.) characterized by persistent fear of having another panic attack (anxiety about anxiety) Agoraphobia usually a complication of a Panic Disorder fear of being in public places fear of being in public when a panic attack occurs often become home-bound

Anxiety Disorders Generalized Anxiety Disorder A person who is anxious about and worries about everything not just a specific object of worry or anxiety Symptoms include motor tension, autonomic over-arousal, excessive vigilance Post-Traumatic Stress Disorder (PTSD) Persistent state of high alert/arousal (fight/flight) Repetitive re-experiencing of the traumatic experience via dreams, flashbacks Treated via talk therapy, EMDR (Eye Movement Desensitization and Reprocessing Therapy), hypnosis, or Cognitive-Behavioral Therapy

Obsessive-Compulsive Disorder Obsessions Recurrent, anxiety-provoking thoughts or images that seem irrational and beyond control Compulsions Thoughts or behaviors that tend to reduce the anxiety connected with obsessions Irresistible urges to engage in specific acts, often repeatedly

Anxiety Disorders OCD Obsessive Compulsive Disorder plagued by obsessive thoughts which cause anxiety obsessions can be temporarily stopped by performing a compulsion (washing hands, cleaning, checking the refrigerator door) performing the compulsion is negatively reinforced (operant conditioning) resulting in a repeat of the compulsion controlled with medication which breaks up the obsessions, and by behavioral therapies which prevents a person from quelling their anxiety via their compulsive rituals.