Psychological Disorders and Therapy and Treatment

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Ensure that you read the attachment, it includes the week's lesson that will assist in correctly completing this assignment. Psychological Disorders and Therapy and Treatment lessons. This week we studied psychological disorders. Which of the disorders covered in your lessons do you think would be the most challenging to have and why? Which of its symptoms would prove the most difficult for you? What would you most need from society and loved ones if you had the disorder you selected? What might be some treatment options you could pursue to alleviate symptoms of your selected disorder?

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On Monday, September 16, 2013, a gunman killed 12 people as the workday began at the Washington Navy Yard in Washington, DC. Aaron Alexis, 34, had a troubled history: he thought that he was being controlled by radio waves. He called the police to complain about voices in his head and being under surveillance by “shadowy forces” (Thomas, Levine, Date, & Cloherty, 2013). While Alexis’s actions cannot be excused, it is clear that he had some form of mental illness. Mental illness is not necessarily a cause of violence; it is far more likely that the mentally ill will be victims rather than perpetrators of violence (Stuart, 2003). If, however, Alexis had received the help he needed, this tragedy might have been averted. Clive Wearing is an accomplished musician who lost his ability to form new memories when he became sick at the age of 46. While he can remember how to play the piano perfectly, he cannot remember what he ate for breakfast just an hour ago (Sacks, 2007). James Wannerton experiences a taste sensation that is associated with the sound of words. His former girlfriend’s name tastes like rhubarb (Mundasad, 2013). John Nash is a brilliant mathematician and Nobel Prize winner. However, while he was a professor at MIT, he would tell people that the New York Times contained coded messages from extraterrestrial beings that were intended for him. He also began to hear voices and became suspicious of the people around him. Soon thereafter, Nash was diagnosed with schizophrenia and admitted to a state-run mental institution (O’Connor & Robertson, 2002). Nash was the subject of the 2001 movie A Beautiful Mind. Why did these people have these experiences? How does the human brain work and what happens when the brain and behavior go awry? Video: Psychological Disorders https://youtu.be/wuhJ-GkRRQc Video: OCD and Anxiety Disorders https://youtu.be/aX7jnVXXG5o Video: Trauma and Addiction https://youtu.be/343ORgL3kIc Video: Depressive and Bipolar Disorders https://youtu.be/ZwMlHkWKDwM Video: Schizophrenia and Dissociative Disorders https://youtu.be/uxktavpRdzU Video: Personality Disorders https://youtu.be/4E1JiDFxFGk Causes of Autism Spectrum Disorder Neurodevelopmental disorders are a group of disorders that are typically diagnosed during childhood and are characterized by developmental deficits in personal, social, academic, and intellectual realms; these disorders include attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder. ADHD is characterized by a pervasive pattern of inattention and/or hyperactive and impulsive behavior that interferes with normal functioning. Genetic and neurobiological factors contribute to the development of ADHD, which can persist well into adulthood and is often associated with poor long-term outcomes. The major features of autism spectrum disorder include deficits in social interaction and communication and repetitive movements or interests. As with ADHD, genetic factors appear to play a prominent role in the development of autism spectrum disorder; exposure to environmental pollutants such as mercury have also been linked to the development of this disorder. Although it is believed by some that autism is triggered by the MMR vaccination, the evidence does not support this claim. Early theories of autism placed the blame squarely on the shoulders of the child’s parents, particularly the mother. Bruno Bettelheim (an Austrian-born American child psychologist who was heavily influenced by Sigmund Freud’s ideas) suggested that a mother’s ambivalent attitudes and her frozen and rigid emotions toward her child were the main causal factors in childhood autism. In what must certainly stand as one of the more controversial assertions in psychology over the last 50 years, he wrote, “I state my belief that the precipitating factor in infantile autism is the parent’s wish that his child should not exist” (Bettelheim, 1967, p. 125). As you might imagine, Bettelheim did not endear himself to a lot of people with this position; incidentally, no scientific evidence exists supporting his claims. The exact causes of autism spectrum disorder remain unknown despite massive research efforts over the last two decades (Meek, Lemery-Chalfant, Jahromi, and Valiente, 2013). Autism appears to be strongly influenced by genetics, as identical twins show concordance rates of 60%–90%, whereas concordance rates for fraternal twins and siblings are 5%–10% (Autism Genome Project Consortium, 2007). Many different genes and gene mutations have been implicated in autism (Meek et al., 2013). Among the genes involved are those important in the formation of synaptic circuits that facilitate communication between different areas of the brain (Gauthier et al., 2011). A number of environmental factors are also thought to be associated with increased risk for autism spectrum disorder, at least in part, because they contribute to new mutations. These factors include exposure to pollutants, such as plant emissions and mercury, urban versus rural residence, and vitamin D deficiency (Kinney, Barch, Chayka, Napoleon, and Munir, 2009). Child Vaccinations and Autism Spectrum Disorder In the late 1990s, a prestigious medical journal published an article purportedly showing that autism is triggered by the MMR (measles, mumps, and rubella) vaccine. These findings were very controversial and drew a great deal of attention, sparking an international forum on whether children should be vaccinated. In a shocking turn of events, some years later the article was retracted by the journal that had published it after accusations of fraud on the part of the lead researcher. Despite the retraction, the reporting in popular media led to concerns about a possible link between vaccines and autism persisting. A recent survey of parents, for example, found that roughly a third of respondents expressed such a concern (Kennedy, LaVail, Nowak, Basket, and Landry, 2011); and perhaps fearing that their children would develop autism, more than 10% of parents of young children refuse or delay vaccinations (Dempsey et al., 2011). Some parents of children with autism mounted a campaign against scientists who refuted the vaccine-autism link. Even politicians and several well-known celebrities weighed in; for example, actress Jenny McCarthy (who believed that a vaccination caused her son’s autism) co-authored a book on the matter. However, there is no scientific evidence that a link exists between autism and vaccinations (Hughes, 2007). Indeed, a recent study compared the vaccination histories of 256 children with autism spectrum disorder with that of 752 control children across three time periods during their first two years of life (birth to 3 months, birth to 7 months, and birth to 2 years) (DeStefano, Price, and Weintraub, 2013). At the time of the study, the children were between 6 and 13 years old, and their prior vaccination records were obtained. Because vaccines contain immunogens (substances that fight infections), the investigators examined medical records to see how many immunogens children received to determine if those children who received more immunogens were at greater risk for developing autism spectrum disorder. The results of this study, a portion of which is shown in the figure, clearly demonstrate that the quantity of immunogens from vaccines received during the first two years of life was not at all related to the development of autism spectrum disorder. There is not a relationship between vaccinations and autism spectrum disorders. A graph has an x-axis labeled “total cumulative immunogens” and a y-axis with percentage numbers. For children aged 0–3 months, the data is approximately as follows: 0–25 immunogens are about 48% for ASD cases and 41% for controls, 26– 50 immunogens are 5% for ASD cases and 6% for controls, and for 3000–3258 immunogens45% for ASD cases and 50% for controls. For children aged 0– 7months, the data is approximately as follows: 26–50 immunogens are about 20% for ASD cases and 18% for controls, 51–75 immunogens are 25% for ASD cases and 22% for controls, 3000–3258 immunogens are 45% for ASD cases and 52% for controls, 6000–6258 immunogens are 10% for ASD cases and 8% for controls, and for 9000–9258 immunogens 33% for ASD cases and 40% for controls. For children aged 0–24 months, the data is approximately as follows: 151–175 immunogens are about 25% for ASD cases and 25% for controls, 176–200 immunogens are 18% for ASD cases and 13% for controls, 9000–9528 immunogens are 17% for ASD cases and 20% for controls, and for 12000–12258 immunogens 25% for ASD cases and25% for controls. Figure: In terms of their exposure to immunogens in vaccines, overall, there is not a significant difference between children with autism spectrum disorder and their age-matched controls without the disorder (DeStefano et al., 2013). Why does concern over vaccines and autism spectrum disorder persist? Since the proliferation of the Internet in the 1990s, parents have been constantly bombarded with online information that can become magnified and take on a life of its own. The enormous volume of electronic information pertaining to autism spectrum disorder, combined with how difficult it can be to grasp complex scientific concepts, can make separating good research from bad challenging (Downs, 2008). Notably, the study that fueled the controversy reported that 8 out of 12 children—according to their parents—developed symptoms consistent with autism spectrum disorder shortly after receiving a vaccination. To conclude that vaccines cause autism spectrum disorder on this basis, as many did, is clearly incorrect for a number of reasons, not the least of which is because correlation does not imply causation, as you’ve learned. Additionally, as was the case with diet and ADHD in the 1970s, the notion that autism spectrum disorder is caused by vaccinations is appealing to some because it provides a simple explanation for this condition. Like all disorders, however, there are no simple explanations for autism spectrum disorder. Although the research discussed above has shed some light on its causes, science is still a long way from the complete understanding of the disorder. Licenses and Attributions Psychology. Authored by: OpenStax College. Located at: http://cnx.org/contents/4abf04bf-93a0-45c3-9cbc2cefd46e68cc@4.100:1/Psychology. License: CC BY: Attribution. License Terms: Download for free at http://cnx.org/content/col11629/latest/. References: https://cnx.org/contents/Sr8Ev5Og@5.73:LMdT4sx_@5/Introduction Causes of ADHD Neurodevelopmental disorders are a group of disorders that are typically diagnosed during childhood and are characterized by developmental deficits in personal, social, academic, and intellectual realms; these disorders include attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder. ADHD is characterized by a pervasive pattern of inattention and/or hyperactive and impulsive behavior that interferes with normal functioning. Genetic and neurobiological factors contribute to the development of ADHD, which can persist well into adulthood and is often associated with poor long-term outcomes. Family and twin studies indicate that genetics play a significant role in the development of ADHD. Burt (2009), in a review of 26 studies, reported that the median rate of concordance for identical twins was .66 (one study reported a rate of .90), whereas the median concordance rate for fraternal twins was .20. This study also found that the median concordance rate for unrelated (adoptive) siblings was .09; although this number is small, it is greater than 0, thus suggesting that the environment may have at least some influence. Another review of studies concluded that the heritability of inattention and hyperactivity were 71% and 73%, respectively (Nikolas and Burt, 2010). The specific genes involved in ADHD are thought to include at least two that are important in the regulation of the neurotransmitter dopamine (Gizer, Ficks, and Waldman, 2009), suggesting that dopamine may be important in ADHD. Indeed, medications used in the treatment of ADHD, such as methylphenidate (Ritalin) and amphetamine with dextroamphetamine (Adderall), have stimulant qualities and elevate dopamine activity. People with ADHD show less dopamine activity in key regions of the brain, especially those associated with motivation and reward (Volkow et al., 2009), which provides support to the theory that dopamine deficits may be a vital factor in the development this disorder (Swanson et al., 2007). Brain imaging studies have shown that children with ADHD exhibit abnormalities in their frontal lobes, an area in which dopamine is in abundance. Compared to children without ADHD, those with ADHD appear to have smaller frontal lobe volume, and they show less frontal lobe activation when performing mental tasks. Recall that one of the functions of the frontal lobes is to inhibit our behavior. Thus, abnormalities in this region may go a long way toward explaining the hyperactive, uncontrolled behavior of ADHD. By the 1970s, many had become aware of the connection between nutritional factors and childhood behavior. At the time, much of the public believed that hyperactivity was caused by sugar and food additives, such as artificial coloring and flavoring. Undoubtedly, part of the appeal of this hypothesis was that it provided a simple explanation of (and treatment for) behavioral problems in children. A statistical review of 16 studies, however, concluded that sugar consumption has no effect at all on the behavioral and cognitive performance of children (Wolraich, Wilson, and White, 1995). Additionally, although food additives have been shown to increase hyperactivity in non-ADHD children, the effect is rather small (McCann et al., 2007). Numerous studies, however, have shown a significant relationship between exposure to nicotine in cigarette smoke during the prenatal period and ADHD (Linnet et al., 2003). Maternal smoking during pregnancy is associated with the development of more severe symptoms of the disorder (Thakur et al., 2013). Is ADHD caused by poor parenting? Not likely. Remember, the genetics studies discussed above suggested that the family environment does not seem to play much of a role in the development of this disorder; if it did, we would expect the concordance rates to be higher for fraternal twins and adoptive siblings than has been demonstrated. All things considered, the evidence seems to point to the conclusion that ADHD is triggered more by genetic and neurological factors and less by social or environmental ones. Why is the Prevalence Rate of ADHD Increasing? Many people believe that the rates of ADHD have increased in recent years, and there is evidence to support this contention. In a recent study, investigators found that the parent-reported prevalence of ADHD among children (4–17 years old) in the United States increased by 22% during a 4-year period, from 7.8% in 2003 to 9.5% in 2007 (CDC, 2010). Over time this increase in parent-reported ADHD was observed in all sociodemographic groups and was reflected by substantial increases in 12 states (Indiana, North Carolina, and Colorado were the top three). The increases were greatest for older teens (ages 15–17), multiracial and Hispanic children, and children with a primary language other than English. Another investigation found that from 1998–2000 through 2007–2009 the parent-reported prevalence of ADHD increased among U.S. children between the ages of 5–17 years old, from 6.9% to 9.0% (Akinbami, Liu, Pastor, and Reuben, 2011). A major weakness of both studies was that children were not actually given a formal diagnosis. Instead, parents were simply asked whether or not a doctor or other health-care provider had ever told them their child had ADHD; the reported prevalence rates thus may have been affected by the accuracy of parental memory. Nevertheless, the findings from these studies raise important questions concerning what appears to be a demonstrable rise in the prevalence of ADHD. Although the reasons underlying this apparent increase in the rates of ADHD over time are poorly understood and, at best, speculative, several explanations are viable: ADHD may be over-diagnosed by doctors who are too quick to medicate children as a behavior treatment. There is greater awareness of ADHD now than in the past. Nearly everyone has heard of ADHD, and most parents and teachers are aware of its key symptoms. Thus, parents may be quick to take their children to a doctor if they believe their child possesses these symptoms, or teachers may be more likely now than in the past to notice the symptoms and refer the child for evaluation. The use of computers, video games, iPhones, and other electronic devices has become pervasive among children in the early 21st century, and these devices could potentially shorten children’s attentions spans. Thus, what might seem like inattention to some parents and teachers could simply reflect exposure to too much technology. ADHD diagnostic criteria have changed over time. Licenses and Attributions Psychology. Authored by: OpenStax College. Located at: http://cnx.org/contents/4abf04bf-93a0-45c3-9cbc2cefd46e68cc@4.100:1/Psychology. License: CC BY: Attribution. License Terms: Download for free at http://cnx.org/content/col11629/latest/. References: https://cnx.org/contents/Sr8Ev5Og@5.73:LMdT4sx_@5/Introduction
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Psychological Disorders and Therapy and Treatment
Which of the disorders covered in your lessons do you think would be the most challenging
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