Psychological Disorders

I. General Information  A. Definitions  a. Atypical: not typical  b. Disturbing: troubles others emotionally or mentally  c. Maladaptive: harmful to one’s ability to function  d. Unjustifiable: no good reason for behavior or thought

B. DSM-IV Diagnostic and Statistical Manual  Axis I: Is a Clinical Syndrome present?  Axis II: Is a Personality Disorder or Mental Retardation present?  Axis III: Is a General Medical Condition, such as diabetes, hypertension, or arthritis, also present?  Axis IV: Are Psychosocial or Environmental Problems, such as school or housing issues, also present?  Axis V: What is the Global Assessment of this person’s functioning?

II. Anxiety Disorders  A. Panic Disorders  1. Characteristics: person experiences sudden episodes (usually lasting a few minutes) of intense dread/fear  2. Non-specific: No particular trigger

B. Phobia Disorders  1. Phobia: irrational fear that disrupts behavior.  2. Specific: only the phobia triggers response

C. Generalized Anxiety  1. Generalized Anxiety disorder: person is continually tense, apprehensive, and in a state of autonomic nervous system arousal  2. Very few people seek treatment because they think it is just a part of their personality

D. Obsessive Compulsive Disorder  1. Obsession: repetitive thoughts  2. Compulsions: repetitive behaviors  3. OCD: anxiety disorder characterized by unwanted repetitive thoughts &/or actions  4. Causes: anxiety, stress, genetic factors  (autism? Link in strep throat?)

E. Stress Disorders  1. PTSD: characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, &/or insomnia that lingers for four weeks or more after a traumatic experience

 2. Acute Stress Disorder: development of severe anxiety, dissociative, and other symptoms that occurs within one month after exposure to an extreme traumatic stressor

III. Somatoform Disorders  A. Conversion Disorders  1. Definition: physical symptoms that resemble those of a neurological disorder develop. The symptoms are triggered by mental factors such as conflicts or other stresses.  2. US Naval Academy: entered with 20/20 vision, many leave with blurred vision.

B. Hypochondria  1. Definition: preoccupying fear of having a serious illness  2. Causes: no known causes, but… could be a form of OCD.  3. Faking it??? True hypochondriacs are not faking it.

Dissociative Disorders Dissociative Disorders  A. Dissociative Amnesia (psychogenic)  Definition: person blocks out certain information, usually associated with a stressful or traumatic event, leaving him or her unable to remember important personal information.

B. Fugue  1. Definition: People with dissociative fugue temporarily lose their sense of personal identity and impulsively wander or travel away from their homes or places of work.  2. Cause: linked to severe stress, which might be the result of traumatic events— such as war, abuse, accidents, disasters or extreme violence—that the person has experienced or witnessed.  example example

C. Dissociative Identity  1. Definition: two or more distinct identities that alternately control the person’s behavior, with memory impairment across the different personality states.  2. Roles: Each personality has its own voice and mannerisms, and the original one typically denies any awareness of the other(s)  3. Causes:  an innate ability to dissociate easily  repeated episodes of severe physical or sexual abuse in childhood  example example

V. Mood Disorders  A. Major Depression  1. Definition: two or more weeks of significantly depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities.

B. Mania  1. Definition: mood disorder marked by a hyperactive, wildly optimistic state.

C. Bipolar Disorder (manic depression)  1. Definition: person alternates between the hopelessness of depression and the overexcited state of mania.  2. Causes: possibly genetics or stress

VI. Schizophrenia **Disorganized thoughts**  A. Types  1. Paranoid: delusions or hallucinations often of persecution or grandiosity  2. Catatonic: Immobility, extreme negativism, &/or parrotlike repeating of another’s speech or movements  3. Disorganized: disorganized speech or behavior, flat or inappropriate emotion  4. Undifferentiated or Residual: withdrawal after delusions or hallucinations disappear

B. Perspectives on Schizophrenia  1. Psychological: stress induced, possible bad family circumstances.  2. Biological: Ventricles are larger (more fluid, less brain tissue)  3. Multifactorial: Biological predisposition and stressful situation triggers it.

 MRI scans of 28-year-old male identical twins showing the enlarged brain ventricles in the twin with schizophrenia (right) compared to his well brother (left).

VII. Personality Disorders  A. Antisocial: exhibits a lack of conscience from wrongdoing, even toward friends & family. (usually a man)  B. Borderline: switch moods quickly/abruptly.  C. Dependent: Require others approval for everything. Afraid of abandonment.

VIII.  Diathesis: Stress Model: explains all disorders as the cause being a mixture of biological predisposition and stress induced.