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Dopamine Hypothesis- schizophrenia has been linked to overactive dopamine receptors located in prefrontal cortex and sensory regions of the brain. ■ High concordance rates: probability that a pair of related individuals will each develop a disorder of genetic heritability o Drug Treatment: Antipsychotic drugs are dopamine antagonist (haldol or Thorazine) controls delusional thinking and hallucinations Neurodevelopmental Disorders - manifests during early childhood development and characterized by deficits/ delays in personal development. ● Autism Spectrum Disorder O Deficits in social communication and interactions ■ Difficulties with conversation, eye contact, emotional reciprocity Repetitive behaviors and interests o ■ Intense preoccupation with objects or activities o Severity of disorders: the level of support needed to assist with communication and behavior • Anxiety Disorders- marked by excessive fear or anxiety and maladaptive behaviors to avoid or cope with anxiety. O Panic disorder-panic attacks: an intense and abrupt surge of fear or discomfort (including accelerated heart rate, sweating, dizziness, chest pains, etc) ■ Anticipatory anxiety: persistent worry about when/where next attack will O occur ■ Maladaptive behaviors occur to avoid these attacks Generalized Anxiety Disorder: excessive worry about varied events or activities. ■ "generalized" anxiety means that the anxiety is longer in duration and more pervasive than a panic attack o Specific Phobias: intense fear of a specific object or situation. ■ The fear is "out of proportion to the actual danger posed" and maladaptive behaviors are adapted O Social Anxiety Disorder: fear is triggered by social interactions (conversations, meeting other people, etc). Maladaptive behaviors to avoid these interactions o Agoraphobia: fear is triggered by being unable to escape from or being embarrassed in public places (public transportation, enclosed public spaces). Maladaptive behaviors to avoid these situations. o Drug Treatment: Benzodiazepines (Xanax/Valium) enhances the effectiveness of GABA o Systematic Desensitization (a form of exposure therapy): employs the idea of counter-conditioning- remove unwanted response by pairing the spider with a new more calming sensation ■ Exposure to the trigger of anxiety is done SYSTEMATICALLY ● The length of time and proximity to the trigger is incrementally increased Weakness: time consuming; over exposure can be overwhelming • Depressive Disorders- marked by extreme sadness or emptiness. Maladaptive thoughts and behaviors to lessen/avoid kthat mood. o 2 Key Symptoms must be present everyday for a 2 week period Persistent sadness, hopelessness or a feeling of emptiness Anhedonia: loss of interest/ pleasure in activities Other symptoms include: weight loss/gain, insomnia/hypersomnia, fatigue, excessive guilt, contemplation of suicide/death o Seasonal Patterns in depression: Symptoms coincides with a particular time of O ■ year Causes of Depression: ■ Behavioral approach learned helplessness (Martin Seligman: locking dogs in boxes) ■ Neurotransmitter abnormalities in serotonin ■ Cognitive-Behavioral Cycle: • Cognitive: Certain people have a pessimistic explanatory style and tend to blame themselves for negative events and believe these negative events will continue indefinitely Person performs maladaptive behaviors as a coping mechanism O substance abuse, social isolation which leads to... O Career issues, poor health, strain on social relationships ● Behavioral: negative consequences of these behaviors reinforces the pessimism Aaron Beck's Cognitive Triad • Depressed individuals have an irrational and pessimistic thought process leading them to have negative thoughts about three key elements: themselves, the world, the future O Depression Therapies ■ Cognitive Therapy- by Aaron Beck: get the person to identify these irrational thoughts (caused by the individual) and reverse them I Rational emotive behavioral Therapy (REBT)- by Albert Ellis: challenges person to realize disorders may be rooted in irrational beliefs • Ex) overly high expectations = over reactions to setbacks ● Positive reinforcement positive thinking ■ Light Therapy for Seasonal Depression: light box simulates natural sunlight (w/o UV risks) along with antidepressants. ■ Antidepressants Medication: ● Selective serotonin reuptake inhibitors (Zoloft or Prozac) maintain higher serotonin levels • MAOI's inhibits enzymes that break down serotonin Electro-Convulsive Therapy (ECT) ● Low voltage electrical current administered unilaterally (to one hemisphere) or bilaterally (to both hemispheres) • Highly effective in treating depression that has not responded to anti-depressants Bipolar and Related Disorders- alternating episodes of Depressive Episodes and Manic Episodes o Symptoms of Manic episodes include: Inflated self esteem Little need for sleep Talkativeness ● O ■ ■ ■ Racing thoughts ■ Distractibility ■ In monozygotic twins the concordance rates are 60-70% Treated with mood stabilizers (Lithium/ Depakote) ■ Antidepressants alone are NOT effective and studies show they may increase this alternation of episodes or suicidal thoughts • Obsessive-Compulsive Disorder- marked by obsessions (recurring and persistent intrusive thoughts) and compulsions (repetitive and ritualistic maladaptive behaviors to lessen the anxiety of an obsession) O Increase in goal directed activities ■ Engaging in impulsive behaviors with a high risk for negative outcome Exact Causes are unknown O Behavioral approach to causes: Negative Reinforcement-> compulsive behaviors are encouraged because they end the unpleasant obsessive thoughts Trauma and Stressor Related Disorders- exposure to a traumatic or stressful event Post traumatic stress disorder (PTSD) O ■ Exposure to threatened death, serious injury or sexual abuse. Can be directly experienced, witnessed or through repeated exposure to the details of a traumatic event ■ Experience distressing memories, dreams or flashbacks of event ■ Maladaptive avoidance of locations/stimuli of event • Negative changes to thought and mood (excessively blaming oneself for the event) O Somatic Symptom Disorder ■ Experience of physical symptoms without a physiological and neurological cause. Or symptoms do have a medical cause but the reaction is disproportionate to its actual seriousness ■ Ex) Conversion Disorder: a loss of motor function or sensory abilities that can't be attributed to a medical condition • Personality Disorders- enduring and inflexible personality traits that deviate from cultural norms. Cause the individual distress or impair social relationships o Develop in adolescence or early adulthood. They don't result from childhood development or social experiences ● Dissociative Disorders- marked by a separation between conscious awareness and past memories o Ex) Dissociative Identity Disorders- subject exhibits 2 or more distinct personality traits: "alters" and an original (host) personality • Therapy O Behavioral Therapies: since maladaptive behaviors develop from classical/operant conditioning, this method is used to reverse those maladaptive behaviors by replacing them with more adaptive behaviors. ■ Mary Cover Jones (Mother of Behavioral Therapy) used to "Little Peter" experiment to discover ■ Joseph Wolpe developed systematic desensitization as a treatment for WWII with "war neurosis" (PTSD) but this treatment was ineffective. • Developed the "anxiety hierarchy" O Psychotherapy: influenced by Freud's psychoanalytic approach by emphasizing the role of the unconscious (thought and memory we aren't aware of) in causing anxiety. ■ Insight therapy: goal is to understand the difficulties as opposed to directly treating symptoms. Ex) TALK therapy ■ Therapists pay attention to certain cues that may indicate the unconscious forces behind a patient's difficulties. ● Resistance: unwillingness to discuss a certain topic ● Transference: projection of a client's strong feelings for someone else onto therapist ■ Free association: client can speak on a topic they want to speak about Word association: client is asked to describe whatever comes to mind when prompted with a specific cue. ■ o Psychodynamic Therapy (Neo-Freudian aspect) -reject the radical elements and extend theories in a practical way ■ A talk therapy that emphasizes the defense mechanisms that are used. Emphasis is on conscious awareness especially on social and interpersonal relationships ■ ■ Adult/adolescent experiences are emphasized O Humanistic Approach to Therapy (Carl Rogers) ■ Used "client" over "patient" to downplay the idea of the person having an illness O ■ Some cases of anxiety, depression stems from lack of supportive environment so therapist provides Rogerian concept of unconditional positive regard Non-Directive Therapy ■ Client determines the course of therapy ■ Extension of self actualization and fully functioning person Reflective Listening: Therapeutic technique to show understanding of and empathy for client ■