Chapter 16 pt. 1: Perspectives on Psychological Disorders and Anxiety

Defining Psychological Disorder A Psychological Disorder is: a “harmful dysfunction” in which behavior is judged to be: 1. atypical- not enough in itself 2. disturbing- varies with time & culture 3. maladaptive- harmful; causes suffering 4. unjustifiable- sometimes there’s a good reason

History of Understanding Psychological Disorders In Ancient times, disorders were thought to have been caused by movements of the sun and moon (lunacy is full moon) or by evil spirits. Treatments for people with mental illness were very inhumane even up until the mid 1900’s. Patients were often chained like animals, beaten, burned, castrated, etc.

Conditions for Psychologically Disabled European Traphines “released evil spirits.” Ancient Greek Traphines

Conditions for Psychologically Disabled

Conditions for Psychologically Disabled

Conditions for Psychologically Disabled

Deinstitutionalization the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability http://www.cbsnews.com/news/mentally-ill-youth-in-crisis/

Medical Model Improves Conditions Eventually the medical model came to dominate understandings of mental illness. Late 1800s The medical model assumes that diseases have physical causes that can be diagnosed based on their symptoms and be treated and in most cases cured. Assumption of medical model drastically improves conditions in mental hospitals.

Perspectives on Psychological Disorders What would Psychoanalytic psychologist argue as the cause? Humanistic would view cause?

Perspectives on Psychological Disorders Cognitive? Behavioral?

Perspectives on Psychological Disorders Biological? Socio-Cultural?

mood-related perceptions definition of normality Most Mental Health Professionals Assume Disorders Have Interlocking Causes Bio-Psycho-Social Perspective: assume biological, psychological, and socio-cultural factors interact to produce disorders. Biological (Evolution, individual genes, brain structures and chemistry) Psychological (Stress, trauma, learned helplessness, mood-related perceptions and memories) Sociocultural (Roles, expectations, definition of normality and disorder)

Classifying Psychological Disorders DSM-5: the most widely used manual for classifying psychological disorders. The DSM-5 currently lists 410 mental disorders up from 145 in the DSM-II (1968) and 60 in DSM-I (1951). 17 categories Does not explain causes

DSM V http://www.today.com/video/today/51915406#51915406

DSM AXIS Axis I: Clinical disorders, including major mental disorders, and learning disorders, Substance Use Disorders Depression, Anxiety, bipolar, autism, anorexia Axis II: Personality disorders and intellectual disabilities (although developmental disorders, such as Autism, were coded on Axis II in the previous edition, these disorders are now included on Axis I) Axis III: Acute medical conditions and physical disorders Brain injuries Axis IV: Psychosocial and environmental factors contributing to the disorder Axis V: Global Assessment of Functioning or Children's Global Assessment Scale for children and teens under the age of 18

Classifying Neurotic vs. Psychotic Disorders Neurotic disorder usually distressing but that allows one to think rationally and function socially Freud saw the neurotic disorders as ways of dealing with anxiety Psychotic disorder person loses contact with reality experiences irrational ideas and distorted perceptions

Pros and Cons of the DSM-IV and Labeling Reliable Need a DSM diagnosis for insurance Cons? Almost any behavior can be labeled Distorts how we perceive others Prejudice Self fulfilling prophecy

Anxiety Disorders Anxiety Disorders in general refer to disorders that involve persistent and distressing nervousness and apprehension OR maladaptive behaviors which reduce anxiety (defenses against anxiety). General Characteristics of Anxiety: Constant worrying, fear, or uncertainty Feels inadequate Oversensitive Difficulty concentrating May suffer insomnia

Causes of Anxiety Disorders from Biological Perspective 1. Evolution: certain fears help us survive. 2. Genes: correlations with identical twins and phobias. 3. Physiology: brain chemistry. Often see increased brain activities in brain areas involving impulse control. Ex: picture overactive frontal lobe activity involved in directing attention.

Causes of Anxiety Disorders from Learning Perspective (Behavioral) 1. Fear Conditioning : ex: rape victim may develop fear of being alone in apartment. 2. Stimulus Generalization: ex: fear of heights leads to fear of flying even without flying. 3. Reinforcement (ENCOURAGES behavior): avoiding places you have phobia about rewards you by lessening your anxiety. 4. Observational Learning/Modeling ex: monkeys with snakes.

Anxiety Disorders Generalized Anxiety Disorder: person is tense, apprehensive, and in a state of autonomic nervous system arousal.

Anxiety Disorders Panic Disorder: disorder marked by moments of intense dread in which a person experiences terror and accompanying chest pain or other frightening sensations. “Panic Attacks.” 1 in 75 people

Anxiety Disorders Obsessive Compulsive Disorder (OCD): disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions).

Anxiety Disorders Phobia: disorder marked by persistent, irrational fear and avoidance of specific object or situation.

Common Phobias Claustrophobic? Agoraphobic? Acrophobic? Xenophobic?

Phobias Triskaidekaphobia

Phobias Santa Claustrophobia

Phobia Trichophobia

Anxiety Disorders Post-Traumatic Stress Disorder: disorder brought on by traumatic experiences, memories. Characterized by haunting memories and nightmares, social withdrawal, or anxiety.

Anxiety Disorder (NOT IN BOOK) Tourettes Syndrome: involves involuntary twitching and the making of unusual sounds. -dopamine which helps control movement and norepinephrine, which helps body respond to stress seems to be involved in Tourettes Syndrome.

HYPOCHONDRIASIS Illness Anxiety Disorder – new label under DSM5 People interpret normal sensations (stomach cramp, aches and pains) as symptoms of a dreaded disease Sympathy or temporary relief may reinforce no physician can convince patient

CONVERSION DISORDER Functional Neurological Symptom Disorder Anxiety is converted into a physical symptom May lose sensation that makes no neurological sense Unexplained paralysis – stick pins in affected area and no response from the patient Blindness Inability to swallow