Module 47 Introduction to Psychological Disorders Module 47& 481

2 Medical Student Disease -- A warning

Module 47& 483 How Can we define abnormal Behavior? 1) Clinically significant - serious enough to warrant professional attention. -distress -disabling -dangerous to the person or to others.

Module 47& 484 2) Internal Source - stems from within 3) Involuntary Manifestations

Module 47& 485 Labeling and Psychological Disorders Rosenhan and 8 mentally healthy associates, ("pseudopatients“) were admitted to psychiatric hospitals by feigning auditory hallucinations (the words "empty", "hollow", "thud“) None had a history of mental illness. After admission symptoms disappeared and pseudopatients asked to be released.

Module 47& 486 Their stays ranged from 7 to 52 days, and the average was 19 days. All were discharged with a diagnosis of schizophrenia "in remission," which Rosenhan takes as evidence that mental illness is perceived as an irreversible condition creating a lifelong stigma rather than a curable illness.

Module 47& 487 Despite constantly and openly taking extensive notes on the behavior of the staff and other patients, none of the pseudopatients were identified as impostors by the hospital staff, although many of the other psychiatric patients seemed to be able to correctly identify them as impostors. Labels can effect perceptions of behaviors. Self-fulfilling prophecies

Module 47& 488 Factors Effecting Psychological Disorders 1) Predisposing factors - in place before the disorder begins. (Genetic, learned, societal) 2) Precipitating Causes current stressors. 3) Maintaining Causes - rewards (e.g., attention, avoidance of responsibilities)

Module 47& 489 Diagnostic and Statistical Manual of Mental Disorders (DSM -5 ) - specifies criteria (symptoms) for diagnosis. - attempt to increase reliability of diagnosis. DSM IV has 16 categories (each with several sub-categories).

Module 47& 4810 Anxiety Disorders Mood Disorders Somatoform DisordersSubstance-related Sleep disordersEating Disorders Adjustment disordersFactitious disorders Personality disorders

Module 47& 4811 Psychological factors affecting medical disorders Dissociative Disorders (Amnesia; DID) Schizophrenia and psychotic disorders Sexual and Gender Identity disorders Impulse control disorders Disorders diagnosed in childhood or adolescence Delirium, dementia, amnesia & cognitive disorders.

Module 48 Anxiety Disorders Module 47& 4812

Module 47& 4813 Anxiety and Avoidance Disorders Fear - specific item, situation or thought. Anxiety - vague, unspecified generalised fears or future fear. Easiest to treat (good prognosis).

Module 47& 4814 Generalized Anxiety Disorder (GAD) exaggerated worry and tension, often expecting the worst, even when there is no apparent reason for concern. They anticipate disaster and are overly concerned about money, health, family, work, or other issues. Free-floating anxiety

Module 47& 4815 GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months GAD develops slowly. It often starts during the teen years or young adulthood. More common in women, Rare after age 50. Symptoms may get better or worse at different times, and often are worse during times of stress.

Module 47& 4816 Panic Disorder Physiological symptoms e.g., heart racing, shortness of breath Psychological Symptoms e.g., fear of losing control or dying feeling of unreality Nicotine (stimulant) use doubles the risk of having Panic disorder

Module 47& 4817 Causes - genetics - brain abnormalities - mis-interpretation of physical symptoms. - Catastrophic Thinking Extreme case: Agoraphobia Fear of being separated from a safe place. - often can not leave their homes without a "safe" person. - more common in women.

Module 47& 4818 Phobias - intense, irrational fear of specific objects or events. Specific Phobias - fear of something specific - Usually arise in middle childhood - more common in females. -prevalence 30 to 40%

Module 47& 4819 Some ExamplesFear of: Acrophobiaheights Claustrophobiaenclosed places Hematophobiablood Gephyrophobiacrossing a bridge Kenophobiaempty rooms Aichmophobiasharp pointed objects AquaphobiaWater Cynophobiadogs Aerophobiaflying Entomophobiainsects Gamophobiamarriage Ophdophobiasnakes Xenophobiastrangers MelissophobiaBees HomilophobiaSermons Porphyrophobiathe color purple

Module 47& 4820

Module 47& 4821 B) Social Phobias excessive fear of being scrutinised or evaluated - Avg. age of onset 19 - equal for males and females - without intervention lifelong (chronic)

Module 47& 4822 Obsessive Compulsive Disorder (OCD) Obsessions - recurrent thoughts, impulses, or images -intrusive, inappropriate and cause distress. Compulsions repetitive behaviours Goal to reduce anxiety but not realistic prevention. - tends to begins before age 15 - genetic

Module 47& 4823 Common Types Checking Behavior Cleaning Behavior Washing Rituals Therapy Exposure Therapy Drug Therapies Clomipramine and Prozac - increases seratonin

Module 47& 4824 Post Traumatic Stress Disorder -Re-experiencing of traumatic events -dreams or thoughts -irritability -sleep problems -difficulty concentrating Video

Module 47& 4825 Treatments - exposure therapy (systematic desensitization) - cognitive therapy - EMDR Drug Therapies Tranquilizers (Valium, Xanax) - temporary solution - habit forming Clomipramine and Prozac - increases serotonin