Psychological Disorders An Introduction

Psychological Disorder A “harmful dysfunction” in which behavior is judged to be atypical, disturbing, maladaptive and unjustifiable. What is abnormal, disturbing maladaptive and unjustifiable depends on: Culture Time Period Environmental Conditions Individual Person

Defining Psychological Disorders Mental health workers view psychological disorders as persistently harmful thoughts, feelings, and actions. When behavior is deviant, distressful, and dysfunctional psychiatrists and psychologists label it as disordered (Comer, 2004). The 3 D’s OBJECTIVE 1| Identify criteria for judging whether behavior is psychologically disordered.

Deviant, Distressful & Dysfunctional Deviant behavior (going naked) in one culture may be considered normal, while in others it may lead to arrest. Deviant behavior must accompany distress. If a behavior is dysfunctional it is clearly a disorder. Carol Beckwith In the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal.

Early Theories Afflicted people were possessed by evil spirits.

Understanding Psychological Disorders Ancient Treatments of psychological disorders include trephination, exorcism, being caged like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood. OBJECTIVE 2| Contrast the medical model of psychological disorders with the biopsychosocial perspective on disordered behavior. John W. Verano Trephination (boring holes in the skull to remove evil forces)

Early Theories In some cases trephening was used: Music or singing was often used to chase away spirits. In some cases trephening was used: Cutting a hole in the head of the afflicted to let out the evil spirit.

Trephening

Early Theories Another theory was to make the body extremely uncomfortable.

History of Mental Disorders In the 1800’s, disturbed people were no longer thought of as madmen, but as mentally ill. They were first put in hospitals. Did this mean better treatment?

Early Mental Hospitals They were nothing more than barbaric prisons. The patients were chained and locked away. Some hospitals even charged admission for the public to see the “crazies”, just like a zoo.

Philippe Pinel French doctor who was the first to take the chains off and declare that these people are sick and “a cure must be found!!!”

Somatogenic At this time- it was believed that mental illness had a bodily cause- Somatogenic. But Somatogenic could not explain disorders such as hysteria (now called conversion disorder). Many disorders are psychogenic: the origin is psychological, not physical.

Medical Model When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. Etiology: Cause and development of the disorder. Diagnosis: Identifying (symptoms) and distinguishing one disease from another. Treatment: Treating a disorder in a psychiatric hospital. Prognosis: Forecast about the disorder.

Current Perspectives Medical Perspective: psychological disorders are sicknesses and can be diagnosed, treated and cured.

Current Perspectives Bio-Psycho-Social Perspective: assumes biological, psychological and sociocultural factors combine to interact causing psychological disorders. Used to be called Diathesis-Stress Model: diathesis meaning predisposition and stress meaning environment.

Classifying Psychological Disorders The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe psychological disorders. The most recent edition, DSM-IV-TR (Text Revision, 2000), describes 400 psychological disorders compared to 60 in the 1950s. OBJECTIVE 3| Describe the goals and content of the DSM-IV.

Classifying Psychological Disorders DSM-IV: Diagnostic Statistical Manual of Mental Disorders: the big book of disorders. Two Major Classifications:

Neurotic Disorders Distressing but one can still function in society and act rationally

Psychotic Disorders Person loses contact with reality, experiences distorted perceptions

Multiaxial Classification Axis I Is a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present? Axis II Is a Personality Disorder or Mental Retardation present? Axis III Is a General Medical Condition (diabetes, hypertension or arthritis etc) also present? Axis IV Are Psychosocial or Environmental Problems (school or housing issues) also present? Axis V What is the Global Assessment of the person’s functioning?

Multiaxial Classification Note 16 syndromes in Axis I

Multiaxial Classification Note Global Assessment for Axis V

Goals of DSM Describe (400) disorders. Determine how prevalent the disorder is. Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar. Others criticize DSM-IV for “putting any kind of behavior within the compass of psychiatry.”

Labeling Psychological Disorders Critics of the DSM-IV argue that labels may stigmatize individuals. Rosenthal-Being sane in insane places OBJECTIVE 4| Discuss the potential dangers and benefits of using diagnostic labels. Elizabeth Eckert, Middletown, NY. From L. Gamwell and N. Tomes, Madness in America, 1995. Cornell University Press. Asylum baseball team (labeling)

Labeling Psychological Disorders 2. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.

Labeling Psychological Disorders 3. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes. Elaine Thompson/ AP Photo Theodore Kaczynski (Unabomber)

Anxiety Disorders a group of conditions where the primary symptoms are anxiety or defenses against anxiety. the patient fears something awful will happen to them.

What is anxiety? is a state of intense apprehension, uneasiness, uncertainty, or fear.

Generalized Anxiety Disorder An anxiety disorder in which a person is continuously tense, apprehensive and in a state of autonomic nervous system arousal. The patient is constantly tense and worried, feels inadequate, is oversensitive, can’t concentrate and suffers from insomnia.

Panic Disorder An anxiety disorder marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking and other frightening sensations. Can cause secondary disorders, such as agoraphobia.

Phobias A person experiences sudden episodes of intense dread.

The Phobia List Link

Obsessive Compulsive Disorder An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions).

Common Examples of OCD Common Obsessions: Common Compulsions: Contamination fears of germs, dirt, etc. Washing Imagining having harmed self or others Repeating Imagining losing control of aggressive urges Checking Intrusive sexual thoughts or urges Touching Excessive religious or moral doubt Counting Forbidden thoughts Ordering/arranging A need to have things "just so" Hoarding or saving A need to tell, ask, confess Praying

Explanations for Anxiety Disorders You Learn them through conditioning. Evolution Genes Physiology (the brain)

Dissociative Disorders

Dissociative Disorders Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts and feelings.

Dissociative Amnesia This disorder is characterized by a blocking out of critical personal information, usually of a traumatic or stressful nature.

Dissociative Amnesia Dissociative amnesia, unlike other types of amnesia, does NOT result from other medical trauma (e.g. a blow to the head).

Dissociative Amnesia Localized amnesia is present in an individual who has no memory of specific events that took place, usually traumatic. The loss of memory is localized with a specific window of time. For example, a survivor of a car wreck who has no memory of the experience until two days later is experiencing localized amnesia. Selective amnesia happens when a person can recall only small parts of events that took place in a defined period of time. For example, an abuse victim may recall only some parts of the series of events around the abuse. Generalized amnesia is diagnosed when a person's amnesia encompasses his or her entire life. Systematized amnesia is characterized by a loss of memory for a specific category of information. A person with this disorder might, for example, be missing all memories about one specific family member.

Dissociative Fugue An individual with dissociative fugue suddenly and unexpectedly takes physical leave of his or her surroundings and sets off on a journey of some kind. These journeys can last hours, or even several days or months.

Dissociative Fugue Individuals experiencing a dissociative fugue have traveled over thousands of miles. An individual in a fugue state is unaware of or confused about his identity, and in some cases will assume a new identity (although this is the exception).

Depersonalization Disorder is marked by a feeling of detachment or distance from one's own experience, body, or self. One can easily relate to feeling as they in a dream, or being "spaced out." A person's experience with depersonalization can be so severe that he or she believes the external world is unreal or distorted.

Dissociative Identity Disorder A rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Also known as multiple personality disorder.

Mood Disorders

Mood Disorders Psychological Disorders characterized by emotional extremes. Dysthymic Disorder Major Depressive Disorder Seasonal Affective Disorder Bipolar Disorder

Depression The common cold of psychological disorders. It is like a warning that something is wrong.

Depression

Depression

Major Depressive Disorder A person, for no apparent reason, experiences two or more weeks of depressive moods. Includes feelings of worthlessness and diminished interest or pleasure in most activities.

Dysthymic Disorder Suffering from mild depression every day for at least two years.

Seasonal Affective Disorder

Bipolar Disorder Person alternates between the hopelessness and lethargy of depression and the overexcited state of mania.

Famous People with Bipolar

Bipolar Brain

Norepinephrine Increases arousal and boosts moods.

Suicide

Suicide

Schizophrenia

How Prevalent? About 1 in every 100 people are diagnosed with schizophrenia.

Symptoms of Schizophrenia Disorganized thinking. Disturbed Perceptions Inappropriate Emotions and Actions

Disorganized Thinking The thinking of a person with Schizophrenia is fragmented and bizarre and distorted with false beliefs. Disorganized thinking comes from a breakdown in selective attention.- they cannot filter out information. Often causes………

Delusions (false beliefs) Delusions of Persecution Delusions of Grandeur

Disturbed Perceptions hallucinations- sensory experiences without sensory stimulation.

Inappropriate Emotions and Actions Laugh at inappropriate times. Flat Effect Senseless, compulsive acts. Catatonia- motionless Waxy Flexibility

Positive v. Negative Symptoms Positive Symptoms Presence of inappropriate symptoms Negative Symptoms Absence of appropriate ones.

Types of Schizophrenia

Paranoid Schizophrenia preoccupation with delusions or hallucinations. Somebody is out to get me!!!!

Disorganized Schizophrenia disorganized speech or behavior, or flat or inappropriate emotion.

Catatonic Schizophrenia parrot like repeating of another’s speech and movements

Undifferentiated Schizophrenia Many and varied Symptoms.

Personality Disorders Psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning.

Paranoid Personality Disorder Paranoid personality disorder is characterized by a distrust of others and a constant suspicion that people around you have sinister motives.

Paranoid Personality Disorder They search for hidden meanings in everything and read hostile intentions into the actions of others. They are quick to challenge the loyalties of friends and loved ones and often appear cold and distant to others. They usually shift blame to others and tend to carry long grudges.

Antisocial Personality Disorder antisocial personality disorder is characterized by a lack of conscience People with this disorder are prone to criminal behavior, believing that their victims are weak and deserving of being taken advantage of. They tend to lie and steal

Antisocial Personality Disorder they are careless with money and take action without thinking about consequences They are often aggressive and are much more concerned with their own needs than the needs of others.

Borderline Personality Disorder characterized by mood instability and poor self-image People with this disorder are prone to constant mood swings and bouts of anger.

Borderline Personality Disorder they will take their anger out on themselves, causing themselves injury Suicidal threats and actions are not uncommon They are quick to anger when their expectations are not met.

Histrionic Personality Disorder constant attention seekers They need to be the center of attention all the time, often interrupting others in order to dominate the conversation.

Histrionic Personality Disorder They may dress provocatively or exaggerate illnesses in order to gain attention. They also tend to exaggerate friendships and relationships, believing that everyone loves them

Narcissistic Personality Disorder characterized by self-centeredness They exaggerate their achievements, expecting others to recognize them as being superior

Narcissistic Personality Disorder They tend to be choosy about picking friends, since they believe that not just anyone is worthy of being their friend. They are generally uninterested in the feelings of others and may take advantage of them.

Schizoid Personality Disorder People with schizoid personality disorder avoid relationships and do not show much emotion They genuinely prefer to be alone and do not secretly wish for popularity.

Schizoid Personality Disorder They tend to seek jobs that require little social contact Their social skills are often weak and they do not show a need for attention or acceptance They are perceived as humorless and distant and often are termed "loners."

Schizotypal Personality Disorder characterized by a need for social isolation, odd behavior and thinking, and often unconventional beliefs such as being convinced of having extra sensory abilities. Some people believe that schizotypal personality disorder is a mild form of schizophrenia.

Avoidant personality disorder characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and extreme sensitivity to negative evaluation. consider themselves to be socially inept or personally unappealing, and avoid social interaction for fear of being ridiculed or humiliated.

Dependent personality disorder characterized by a pervasive psychological dependence on other people. has difficulty making everyday decisions without an excessive amount of advice and reassurance from others

Obsessive Compulsive Personality Disorder characterized by a general psychological inflexibility, rigid conformity to rules and procedures, perfectionism, and excessive orderliness. people with OCPD tend to stress perfectionism above all else, and feel anxious when they perceive that things aren't "right".