Unit 12

 Perspectives on Psychological Disorders  Anxiety Disorders  Somatoform Disorders  Dissociative Disorders  Mood Disorders  Schizophrenia  Personality Disorders  Rates of Disorder

 How should we define psychological disorders?  How should we understand disorders?  How should we classify psychological disorders?

 Psychological disorders  Deviant behavior  Distressful behavior  Harmful dysfunctional behavior

 Definition varies by context/culture  Attention deficit hyperactivity disorder (ADHD)

 Philippe Pinel  Medical model  Mental illness (psychopathology)

 Interaction of nature and nurture  Influence of culture on disorders

 Diagnostic and Statistical Manual of Mental Disorders (DSM)  DSM-IV-TR  DSM-5  International Classification of Diseases (ICD-10)  Criticisms of the DSM

CLASSIFYING PSYCHOLOGICAL DISORDERS

THE BIOPSYCHOSOCIAL APPROACH TO PSYCHOLOGICAL DISORDERS

 Rosenhan’s study  Power of labels  Preconception can stigmatize  Insanity label  Stereotypes of the mentally ill  Self-fulfilling prophecy

 Anxiety disorders  Generalized anxiety disorder  Panic disorder  Phobia  Obsessive-compulsive disorder  Post-traumatic stress disorder

1. I do not tire quickly 2. I believe I am no more nervous than others 3. I have very few headaches 4. I work under a great deal of tension 5. I frequently notice my hand shakes when I try do something 6. I blush no more often than others 7. I have diarrhea one a month or more 8. I worry quite a bit over possible misfortunes 9. I practically never blush 10. I am often afraid that I am going to blush 11. My hands and feet are usually warm enough 12. I sweat very easily even on cool days 13. Sometimes when embarrassed, I break out in a sweat 14. I hardly ever notice my heart pounding, and I am seldom short of breath 15. I feel hungry almost all of the time 16. I am very seldom troubled by constipation 17. I have a great deal of stomach trouble

18. I have had periods in which I lost sleep over worry 19. I am easily embarrassed 20. I am more sensitive than most other people 21. I frequently find myself worrying about something 22. I wish I could be as happy as others seem to be 23. I am usually calm and not easily upset 24. I feel anxiety about something or someone almost all of the time 25. I am happy most of the time 26. It makes me nervous to have to wait 27. Sometimes I become so excited I find it hard to get to sleep 28. I have sometimes felt that difficulties piling up so high I couldn't get over them 29. I admit I have felt worried beyond reason over small things 30. I have very few fears compared to my friends 31. I certainly feel useless at times 32. I find it hard to keep my mind on a task or job 33. I am usually self-conscious 34. I am inclined to take things hard 35. At times I think I am no good at all 36. I am certainly lacking in self-confidence 37. I sometimes feel that I am about to go to pieces 38. I am entirely self-confident

 Generalized anxiety disorder  2/3 women  Free floating anxiety

 Panic disorder  Panic attacks

 Phobias  Specific phobia  Social phobia  Agoraphobia

PHOBIAS

 Obsessive-compulsive disorder  An obsession versus a compulsion  Checkers  Hand washers 

OBSESSIVE-COMPULSIVE DISORDER

 Post-traumatic stress disorder  PTSD  “shellshock” or “battle fatigue”  Not just due to a war situation  Post-traumatic growth

 Fear conditioning  Stimulus generalization  Reinforcement  Observational learning

 Natural selection  Genes  Anxiety gene  Glutamate  The Brain  Anterior cingulate cortex

 Somatoform disorder  Somatic (body)  Conversion disorder  Hypochondriasis

 Dissociative disorders  Fugue state  Dissociate (become separated)

 Dissociative identity disorder (DID)  Multiple personality disorder

 Genuine disorder or not?  DID rates  Therapist’s creation  Differences are too great  DID and other disorders

 Mood disorders  Major depressive disorder  Bipolar disorder

 Major depressive disorder  Lethargy  Feelings of worthlessness  Loss of interest in family and friends  Loss of interest in activities

MAJOR DEPRESSIVE DISORDER

 Bipolar Disorder  Mania (manic) ▪ Overtalkative, overactive, elated, little need for sleep, etc.  Bipolar disorder and creativity 

 Many behavioral and cognitive changes accompany depression  Depression is widespread  Compared with men, women are nearly twice as vulnerable to major depression  Most major depressive episodes self-terminate  Stressful events related to work, marriage and close relationships often precede depression  With each new generation, depression is striking earlier and affecting more people

UNDERSTANDING MOOD DISORDERS

 Genetic Influences  Mood disorders run in families ▪ Heritability ▪ Linkage analysis  The depressed brain  Biochemical influences  Norepinephrine and serotonin

UNDERSTANDING MOOD DISORDERS THE BIOLOGICAL PERSPECTIVE

 Negative Thoughts and Moods Interact  Self-defeating beliefs ▪ Learned helplessness ▪ Overthinking  Explanatory style ▪ Stable, global, internal explanations  Cause versus indictor of depression?

UNDERSTANDING MOOD DISORDERS EXPLANATORY STYLE

 Depression’s Vicious Cycle  Stressful experience  Negative explanatory style  Depressed mood  Cognitive and behavioral changes

UNDERSTANDING MOOD DISORDERS: THE VICIOUS CYCLE OF DEPRESSION

UNDERSTANDING MOOD DISORDERS: THE VICIOUS CYCLE OF DEPRESSION

UNDERSTANDING MOOD DISORDERS: THE VICIOUS CYCLE OF DEPRESSION

UNDERSTANDING MOOD DISORDERS: THE VICIOUS CYCLE OF DEPRESSION

BIOPSYCHOSOCIAL APPROACH TO DEPRESSION

 Schizophrenia (split mind)  Not multiple personalities

 Disorganized thinking  Delusions ▪ Delusions of persecution (paranoid)/Word Salad  Breakdown in selective attention

 Disturbed perceptions  Hallucinations ▪ hearing voices

 Inappropriate Emotions  Flat affect  Inappropriate Actions  Catatonia  Disruptive social behavior

Disorganized Catatonic Paranoid Undifferentiated Residual Positive Negative

Disorganized Catatonic Paranoid Undifferentiated  Features incoherent speech, hallucinations, delusions, and bizarre behavior.  For example… talking to imaginary people Residual Type

Disorganized Catatonic Paranoid Undifferentiated  Involves either stupor or extreme excitement.  Two forms  Catatonic Stupor: Patients may remain motionless for hours, even days, …. sometimes holding rigid, statue like poses.  Catatonic Excitement: Patients become agitated, hyperactive Residual Type

Disorganized Catatonic Paranoid Undifferentiated  Prominent feature: combination of delusions and hallucinations. This becomes the basis of their real life!! Residual Type

Disorganized Catatonic Paranoid Undifferentiated  Persons displaying a combination of symptoms that do not clearly fit in one of the other categories Residual Type

Disorganized Catatonic Paranoid Undifferentiated  Individuals who have had a past episode of schizophrenia but are free of symptoms Residual Type

Positive Schizophrenia Negative Schizophrenia  Any form in which the person displays active symptoms (e.g. delusions, hallucinations)

Positive Schizophrenia Negative Schizophrenia  Any form distinguished by deficits, such as withdrawal and poverty of thought processes

 Statistics on schizophrenia  Onset of the disease  Positive versus negative symptoms  Chronic (process) schizophrenia  Acute (reactive) schizophrenia

 Dopamine Overactivity  Dopamine – D4 dopamine receptor  Dopamine blocking drugs  Glutamate

 Abnormal Brain Activity and Anatomy  Frontal lobe and core brain activity  Fluid filled areas of the brain

 Maternal Virus During Pregnancy  Studies on maternal activity and schizophrenia  Influence of the flu during pregnancy

 Genetic predisposition  Twin studies  Genetics and environmental influences

 Possible warning signs  Mother severely schizophrenic  Birth complications (low weight/oxygen deprivation)  Separation from parents  Short attention span  Poor muscle coordination  Disruptive or withdrawn behavior  Emotional unpredictability  Poor peer relations and solo play

 Personality Disorders  Anxiety cluster  Eccentric cluster  Dramatic/impulsive cluster

 Antisocial personality disorder  Sociopath or psychopath  Understanding antisocial personality disorder

 Mental health statistics  Influence of poverty  Other factors