How psychology works the facts visually explained (DK) (Z-Library)

Triggers include worry and stress, for example, problems at work or home or financial difficulties; a significant event, such as a bereavement; underlying health conditions; and alcohol or drug use.

Parasomnia often runs in families, so it may be

genetic; it is associated with medication or physical conditions such as sleep apnea. REM sleep behavior disorder can follow a brain disease.

Narcolepsy may be genetic or caused by a lack of melatonin (the brain chemical that regulates sleep), hormonal changes in puberty or menopause, or stress. It can follow infection or inoculation.

Hypersomnolence may be genetic or due to drug or alcohol abuse or other sleep disorders such as narcolepsy or sleep apnea. It can follow a tumor, head trauma, or injury in the central nervous system.

The person may have trouble falling asleep, wake often during the night, wake early and not go back to sleep, and be unable to nap. Tiredness causes irritability, anxiety, and poor concentration.

Common symptoms are sleepwalking, sleep talking, night terrors, confusional arousal, rhythmic movement, and leg cramps. More severe are nighteating disorder and REM sleep behavior disorder.

Symptoms include daytime sleepiness, sleep attacks, temporary loss of muscle control in response to emotions such as laughing (cataplexy), sleep paralysis, and hallucinations on falling asleep or before waking.

The person may be very sleepy during the day despite nighttime sleep of at least seven hours, have recurrent daytime naps or sleep lapses, struggle to wake up after long sleep, or feel unrefreshed after sleeping for 14–18 hours.

The person cannot relax, and excessive fatigue limits daytime activities. Work performance is impaired and relationships suffer. Bedtime can be anxiously anticipated, the stress worsening the insomnia.

The lack of refreshing sleep can result in mental impairment, disorientation, confusion, and memory problems. Those with REM sleep behavior disorder can become violent.

Narcolepsy disrupts daily life and can be difficult to cope with emotionally. An underactive thyroid gland, and other physical symptoms such as sleep apnea or restless legs, can exacerbate problems.

The person struggles to function in daily life. They may be anxious, irritable, and restless, and have little appetite and no energy. Thinking and speech are slow, and memory problems can develop.

Stimulus-control or sleep-restriction therapies and paradoxical intention are behavioral therapies (pp.122–129)—the person tries to stay awake for as long as possible to reduce anxiety around sleep.

Mild or harmless parasomnias need only practical safeguards such as removing possible sources of injury to sleepwalkers. Medication may be needed for REM sleep behavior disorder.

Adopting a healthy diet and lifestyle, regular bedtime routines, and evenly spaced naps

to manage excessive daytime drowsiness can all help.

Physical causes are treated first. If hypersomnolence persists, daytime activity is observed. Tailored behavioral therapies include introducing presleep routines and ordered sleep times, which are then altered gradually.

Tics are sudden, painless, nonrhythmic behaviors that are either motor (related to movement) or vocal. A disorder may be diagnosed when tics occur repeatedly and are apparently unconnected to the environment or situation.

What are they?

Tics—small, uncontrollable movements or sounds— are not usually serious and normally improve over time. However, if they persist they can be frustrating and interfere with everyday activities—especially if the person has more than one tic.

Changes in the parts of the brain that control movement are thought to cause tics. There is probably a genetic predisposition, too. Taking drugs such as amphetamines or cocaine can trigger tics, as can medical conditions, including cerebral palsy and Huntington’s disease, or psychological disorders such as ADHD (pp.66–67) and OCD (pp.56–57).

Tics are more common in children, but they can begin in adulthood. Statistics vary regarding the prevalence, with 0.3–3.8 percent of children described as having severe tics. Treatment may not be needed if a tic is mild; lifestyle management, such as avoiding stress or tiredness, is often all that is required.

GRIMACING

HEAD JERKING/TWITCHING

HEAD BANGING

SHOULDER SHRUGGING

THROAT CLEARING

COUGHING

GRUNTING

FREQUENT SPITTING

MAKING ANIMAL NOISES

HISSING AT PEOPLE

LOUD SWALLOWING

ADVANCE WARNINGS

Most people have an unusual or uncomfortable feeling before the tic occurs. Individuals often describe this as a rising tension that only the tic itself can release. Some people can suppress their tics for a short period, until the urge to do it becomes too strong, which may result in a more severe tic.

JERKING ARMS/HANDS

BENDING/SQUATTING

TAPPING FOOT/FEET

STEPPING IN PARTICULAR FORMATION

EYE BLINKING

NOSE TWITCHING/SNIFFING

REPEATING OWN WORDS/

PHRASES (PALILALIA)

REPEATING OTHERS’ WORDS/

PHRASES (ECHOLALIA)

UTTERING OBSCENITIES (COPRALALIA)

TWISTING THE BODY

TENSING ABDOMEN

TAPPING/CLICKING FINGERS

TOUCHING OBJECTS/PEOPLE

Simple and complex tics

TOURETTE’S SYNDROME

This is a condition characterized by multiple tics, named after George de la Tourette, who first described it in 1884. For a condition to be classified as Tourette’s syndrome, the tics must last for at least a year and at least one must be vocal. Most individuals have a combination of motor and vocal tics, which can be both simple and complex. The syndrome often runs in families.

Tourette’s syndrome is thought to be linked to problems with a part of the brain called the basal ganglia, or possibly to a childhood throat infection caused by a streptococcal bacteria. The first stage of diagnosis is to check other possible causes of the symptoms such as allergies or poor eyesight. A neurologist or psychiatrist then rules out conditions such as ASD (pp.68–69) before referring the person for psychotherapy. In a third of cases, the tics reduce, become less troublesome, or disappear over a 10-year period.

“The rhythm of music is very, very important for … patients with

Tourette’s.”

Oliver Sacks, British neurologist

TREATMENT

Tics take many forms. Some affect body movement and others are verbal. They may be simple or complex. A simple tic affects a small number of muscle groups, for example, blinking or clearing the throat. A complex tic involves coordinated patterns of several muscle groups, such as blinking in combination with a shoulder shrug, facial grimace, and spontaneous shouting.

Key

Behavioral therapies (pp.122–129) widely used for Tourette’s to expose the unpleasant feelings that precede the tic and encourage a response that stops it.

Habit reversal training to teach use of incompatible behaviors in place of the tic, so planned intentional movements compete with the tic and prevent it.

Lifestyle management such as relaxation techniques and listening to music to reduce frequency of tics.

Antidepressants or anti-anxiety medication (pp.142– 143) to support behavioral interventions if needed.

Cluster A

Cluster B

Cluster C

Paranoid PD

TREATMENT

Paranoid PD Schema-focused cognitive therapy (p.124) to enable links between problems, for example, emotions from childhood memories and current life patterns; also uses cognitive techniques to develop new appraisals. However, high dropout rates from treatment occur, even if sought, due to difficulty in building rapport and trust between therapist and patient.

Schizoid PD Cognitive behavioral therapy (p.125) or lifestyle support to reduce anxiety, depression, angry outbursts, and substance abuse; social skills training; medication (pp.142–143) prescribed for low mood or psychotic episodes. However, treatment is rarely sought.

Schizotypal PD Long-term psychotherapy to build a trusting relationship and cognitive behavioral therapy to help with identification and reevaluation of irrational thoughts; medication prescribed for low mood or psychotic episodes.

PEOPLE WITH PD often do not see themselves as having a problem so seeking treatment is rare.

PD (PERSONALITY DISORDERS)

Cluster B: dramatic/emotional/erratic

A person suffering from a Cluster B personality disorder struggles to regulate their feelings. They are usually overly emotional and unpredictable and display behavior patterns that others see as dramatic, erratic, threatening, and even disturbing. This creates a vicious cycle, as people are uncomfortable near them, so social and personal relationships are difficult to achieve and maintain, which in turn intensifies the initial symptoms.

PSYCHOPATHY

Sometimes considered a subset of antisocial personality disorder (below), psychopathy is one of the hardest disorders to diagnose and is largely resistant to treatment. Psychopathy presents as a specific set of personality traits and behaviors. Mental health professionals can use Robert Hare’s Psychopathy Checklist-Revised (PCL-R) to diagnose the disorder by scoring an individual on 20 listed traits with a value of 0, 1, or 2. A score of 30 and above in the US, or 25 and above in the UK, results in a diagnosis of psychopathy. Interpersonal traits include grandiosity, deceit, and arrogance; emotion-based traits, lack of guilt and empathy; and impulsive traits, sexual promiscuity as well as criminal behaviors such as stealing. Individuals lack inhibition and do not learn from experience. They can seem charming at first, but their inability to feel guilt, empathy, or love, along with the presence of casual, reckless attachments and behavior, quickly becomes evident. Many traits—especially the ability to make clear, emotion-free decisions—can be found in successful individuals, particularly in business and sports. Most psychopaths are men, and the disorder is unrelated to the society or culture they come from.

Cluster A

Cluster B

Cluster C