Chapter 15 Psychological Disorders

Chapter Preview Defining/Explaining Abnormal Behavior Anxiety Disorders Mood Disorders Dissociative Disorders Schizophrenia Personality Disorders Psychological Disorders and Health and Wellness

Abnormal Behavior Behavior that is… deviant (atypical) maladaptive (dysfunctional) personally distressing (despair) IM: Theoretical Approaches Activity

Theoretical Approaches Biological Approach: Medical Model disorders with biological origins Psychological Approach experiences, thoughts, emotions, personality Sociocultural Approach social context Biopsychosocial Model interaction of biological, psychological and sociocultural factors

DSM-IV Classification System Advantages provides a common basis for communication helps clinicians make predictions naming the disorder can provide comfort Disadvantages stigma (shame, negative reputation) medical terminology implies internal cause focus on weaknesses ignores strengths IM: The DSM-IV Classification System Activity

Psychological Disorders – Real or Myth? Szasz & Cruise phrase “mental illness” is presumptuous medication of mental illnesses is presumptuous Response of Medical Professionals mental illnesses are real medical conditions drugs effectively alleviate symptoms ADHD: over-diagnosed or non-medical? should prescription drugs be used to treat ADHD?

DSM-IV-TR Axes Multiaxial System Axis I and II: Psychological Disorders Axis III: General Medical Conditions Axis IV: Psychosocial/Environmental Problems Axis V: Current Level of Functioning

Anxiety Disorders …uncontrollable fears that are disproportionate and disruptive generalized anxiety disorder panic disorder phobic disorder obsessive-compulsive disorder post-traumatic stress disorder IM: Activity Handout 14.1: What type of Anxiety Disorder Is It?

Generalized Anxiety Disorder Diagnosis and Symptoms persistent anxiety for at least 6 months inability to specify reasons for the anxiety Etiology biological factors - genetic predisposition, GABA deficiency, respiration psychological and sociocultural factors - harsh self-standards, critical parents, negative thoughts, trauma IM: Generalized Anxiety Disorder Activity

Panic Disorder Diagnosis and Symptoms Etiology recurrent, sudden onsets of intense terror that often occur without warning Etiology biological factors: genetic predisposition psychological factors: misinterpret arousal sociocultural factors: gender differences

Phobic Disorder Diagnosis and Symptoms Etiology an irrational, overwhelming, persistent fear of a particular object or situation (e.g., social phobia) Etiology biological factors: genetic disposition psychological factors: learned IM: Phobic Disorders Activity

Examples of Phobic Disorders

Social Phobias in the U.S.

Obsessive-Compulsive Disorder Diagnosis and Symptoms persistent anxiety-provoking thoughts and/or urges to perform repetitive, ritualistic behaviors to prevent or produce a situation Etiology biological factors: genetic predisposition psychological factors: life stress

Post-Traumatic Stress Disorder Diagnosis and Symptoms Symptoms develop as a result of exposure to a traumatic event, oppressive situation, natural or unnatural disasters - flashbacks - constricted ability to feel emotions - excessive arousal - difficulties with memory and concentration - feelings of apprehension - impulsive outbursts

Post-Traumatic Stress Disorder Etiology trauma - combat and war-related - sexual abuse and assault - natural and unnatural disasters vulnerability - previous history of trauma - genetic predispositions

Mood Disorders Symptoms may include Types …disturbance of mood that affects entire emotional state Symptoms may include cognitive, behavioral, or physical symptoms interpersonal difficulties Types major depressive disorder, dysthymic disorder bipolar disorder IM: Depressive Disorder Activity

Major Depressive Disorder (MDD) Diagnosis and Symptoms significant depressive episode that lasts for at least two weeks defined by presence of at least 5 out of 9 symptoms daily functioning is impaired

Dysthymic Disorder (DD) Diagnosis and Symptoms chronic depression - unbroken depressed mood lasting at least two years (adult) or one year (child) fewer symptoms than MDD - defined by presence of 2 out of 6 symptoms

Major Depressive Disorder (MDD) Etiology biological factors: genetic disposition - underactive prefrontal cortex - regulation of neurotransmitters psychological factors: - learned helplessness - ruminating on negative, self-defeating thoughts - pessimistic attribution sociocultural factors - poverty - gender differences

Childhood Depression Developmental Psychopathology risk factors for depression - parental psychopathology - genetics protective factors - supportive adult role model, or strong extended family

Bipolar Disorder Characterized by extreme mood swings Bipolar I and Bipolar II Frequency and separation of episodes usually separated by 6 months to a year Etiology strong genetic component swings in metabolic activity in cerebral cortex levels of neurotransmitters

Suicide Prevalence over 32,000 in year 2004 one completion for every 8 to 25 attempts 3rd leading cause of death in early adolescence IM: Suicide Activity

Suicide Biological factors Psychological Factors Sociocultural Factors low levels of serotonin poor health Psychological Factors mental disorders trauma (recent/immediate and highly stressful) substance abuse Sociocultural Factors chronic economic hardship cultural and religious norms gender differences IM: Suicide Activity 24

When Someone is Threatening Suicide

Dissociative Disorders …sudden loss of memory or change in identity Dissociation protection from extreme stress or shock problems integrating emotional memories Types dissociative amnesia dissociative fugue dissociative identity disorder (DID)

Dissociative Disorders Dissociative Amnesia individuals experience extreme memory loss caused by extensive psychological stress Dissociative Fugue individuals experience amnesia, unexpectedly travel away, and sometimes assume a new identity IM: Dissociative Amnesia and Dissociative Fugue Activity

Dissociative Identity Disorder Diagnosis and Symptoms the same individual possesses two or more distinct personalities each personality has unique memories, behaviors, and relationships only one personality is dominant at a time personality shifts occur under distress Etiology extraordinarily severe abuse in early childhood social contagion mostly women runs in families IM: Dissociative Identity Disorder Activity

Schizophrenia highly disordered thought split from reality (psychotic) typically diagnosed in early adulthood high suicide risk

Symptoms of Schizophrenia Positive Symptoms hallucinations and delusions thought disorders and disorders of movement Negative Symptoms flat affect Cognitive Symptoms attention difficulties and memory problems impaired ability to interpret information and make decisions IM: Symptoms of Schizophrenia Activity

Etiology of Schizophrenia Biological Factors genetic predisposition structural brain abnormalities regulation of neurotransmitters Psychological Factors diathesis-stress model Sociocultural Factors influence how disorder progresses

Personality Disorders …chronic maladaptive cognitive-behavioral patterns Antisocial Personality Disorder Diagnosis and Symptoms - guiltless lawbreaking, violence, deceit - impulsive, irritable, reckless, irresponsible Etiology - biological factors (genetic, brain, and ANS differences) IM: Activity Handout 14.3: Which Personality Disorder Is It?

Personality Disorders Borderline Personality Disorder Diagnosis and Symptoms instability in interpersonal relationships & self-image impulsive, insecure, unstable & extreme emotions Etiology genetic childhood abuse irrational belief one is powerless, unacceptable, and that others are hostile IM: Activity Handout 14.3: Which Personality Disorder Is It? 33

Psychological Disorders and Health and Wellness Stereotypes and Stigma Rosenhan’s study - fake psychiatric patients negative attitudes toward mentally ill physical health risk successfully functioning individuals with mental illness reluctant to “come out” Note: Instructors might mention that the availability heuristic likely influences our perception of individuals with psychological disorders. Discussion/Activity: Instructors might use this as an opportunity to have students discuss or reflect on society’s stereotypes of psychologically-disordered people. IM: Targeting Illness Activity

Chapter Summary Discuss the characteristics, explanations, and classifications of abnormal behavior. Distinguish among the various anxiety disorders. Compare the mood disorders and specify risk factors for depression and suicide. Describe the dissociative disorders. Characterize schizophrenia. Identify behavior patterns typical of personality disorders. Explain the impact of the stigma associated with mental illness. Note: Instructors may use the learning objectives presented on this slide or the following four slides to summarize the chapter material.

Chapter Summary Abnormal Behavior Theoretical Approaches deviant, maladaptive, or personally distressing Theoretical Approaches biological, psychological, and sociocultural biopsychosocial Classifying Abnormal Behavior DSM-IV-TR Axes advantages and disadvantages

Chapter Summary Anxiety Disorders generalized anxiety disorder panic disorder phobic disorder obsessive-compulsive disorder post-traumatic stress disorder

Chapter Summary Mood Disorders Dissociative Disorders major depressive disorder dysthymic disorder bipolar disorder suicide Dissociative Disorders dissociative amnesia dissociative fugue dissociative identity disorder

Chapter Summary Schizophrenia Personality Disorders positive, negative and cognitive symptoms etiology (biological, psychological, sociocultural) Personality Disorders antisocial personality disorder borderline personality disorder Psychological Disorders and Health & Wellness stigmas and stereotypes