Perspectives on the Causes of Mental Disorders Psychodynamic – Results from intrapsychic conflict and ineffective defense mechanisms Medical – Caused by abnormalities of brain & nervous system Cognitive-Behavioral – Due to learning and/or faulty beliefs Humanistic – Being overly sensitive to the expectations & criticisms of others Sociocultural – Mismatch between behavior & expectations of culture Diathesis-Stress Model – Genetic predispositions triggered by stress that exceeds coping ability

Classification of Mental Disorders The DSM-IV How are diagnoses done? – The clinical approach: Based upon experience of therapist – The actuarial approach: Applying statistical rules based on research – Research shows actuarial approach to be superior

Types of Psychological Disorders Psychoses – Severely Disordered Thinking – Delusional – Person may be unaware that anything is wrong Neuroses – People are anxious, fearful, unhappy, depressed – Behavioral/Perceptual Strategies no longer work well – Person knows that something is wrong Mood Disorders Miscellaneous Disorders

Psychoses (Schizophrenia) Positive Symptoms of Schizophrenia – Thought Disorders Loose associations; word salads; clang associations Excessively concrete thinking – Hallucinations (Usually auditory) – Delusions Persecution Grandeur Somatic Control Reference Negative Symptoms of Schizophrenia – Flattened, blunted emotions; apathetic – Poverty of speech – Social Withdrawal – Lack of Initiative – Inability to experience pleasure

Classification of Schizophrenia Catatonic – Catatonic postures; Waxy Flexibility – Alternates with repetitive activity Paranoid – Delusions of persecution & grandeur Disorganized – Progressive, irreversible disturbances of thought Undifferentiated – Pattern of symptoms change; a little bit of everything

Causes of Schizophrenia There have been a variety of different theoretical explanations over time, but it has a clear biological basis A Biological predisposition activated by stress – Positive symptoms seem to be the result of the overproduction of Dopamine (Can be treated by Chlorpromazine [brand name = Thorazine]) – Negative symptoms appear to be due to an actual loss of brain tissue Evidence indicates a genetic link Neurodevelopmental hypothesis: – Nervous system impairments that develop around the time of birth (not necessarily genetic) (e.g., People in North born in winter are at greater risk)

Neuroses Anxiety Disorders – Generalized Anxiety Disorder – Panic Disorder Attacks of terror (may last seconds or hours) Often afraid that they are dying or going crazy Hyperventilation More common in women – Phobic Disorders Agoraphobia Social Phobias Specific Phobias Obsessive-Compulsive Disorders Somatoform Disorders Dissociative Disorders

Neuroses Obsessive-Compulsive Disorders – Obsession (thought) leads to compulsion (behavior) – Obsessions center on doubts/uncertainty or fear of doing something prohibited – Common categories: counting, checking, cleaning, avoidance Somatoform Disorders – Physical symptoms without apparent cause – Somatization Disorder: Pain, heart symptoms, gastrointestinal symptoms – Conversion Disorder: Blindness, deafness, loss of felling, paralysis. – Often occurs in response to an event Dissociative Disorders – Dissociative Amnesia – Dissociative Fugue State (Fugue State) – Dissociative Identity Disorder (DID) (Multiple personality Disorder)

Mood Disorders Seasonal Affective Disorder (SAD) – Overeating, oversleeping, lethargy Bipolar Disorder – Alternating Mania & Depression Severe Depression – Sad, apathetic mood – Feelings of worthlessness/hopelessness – Social Withdrawal – Sleeplessness, loss of appetite & sexual desire – Change in activity level – In extreme cases there may be delusions – CAUSES: Faulty cognitions; internal attributions for negative things; genetic predisposition – TREATMENT: ECS; Lithium Carbonate (Bipolar); Anti-depressants; Cognitive Therapy

Miscellaneous Disorders Substance Abuse Disorders (More common in men) Impulse Control Disorders – Intense drive; behaviors reduce tension – Gambling, Pyromania, Kleptomania Psychosexual Disorders – Gender Identity Issues (Transexualism, Transvestism) – Paraphilias – Sexual Dysfunction Personality Disorders – Narcissism – Anti-Social Personality (Psychopath, Sociopath)

Types of Psychotherapy Insight Therapies – Psychoanalysis – Person-Centered Therapy (Humanistic) – Existential Therapy Gestalt Therapy Behavior Therapies – Systematic Desensitization – Aversion Therapy – Implosive Therapy/Flooding – Behavior Modification Cognitive-Behavior Therapies – Rational-Emotive Therapy (RET) – Beck’s Cognitive Therapy for Depression – Cognitive-Behavior Therapy

Types of Psychotherapy Somatic/Biological Therapy – Psychosurgery – Electroconvulsive Therapy – Psychopharmacology Group Therapy

Does Psychotherapy Work?

Professionals Involved in Therapy

A History of Treating Mental Disorders