Psychological Disorders

Definition  A harmful dysfunction that occurs when behavior is atypical, disturbing, maladaptive, and unjustifiable

Breaking it down  Atypical- outside the average scope of human behavior  Ex. A person who disregards social norms like wearing a costume every day  Disturbing- bothersome to you or others  Ex. A person who sees or hears things that does not exist and then tries to respond to those stimuli  Maladaptive- gets in the way of living one’s life  Ex. A person won’t go to work because it makes him anxious  Unjustifiable- no external explanation for the behavior  Ex. When a person is sad even though their life is going well.

Perspectives  Medical- disorders are sicknesses that can be diagnosed with symptoms and treated with therapy  Bio-Psycho-Social- disorders are a product of biology, psychology, and sociocultural factors

DSM-V  Diagnostic Statistical Manual for Mental Disorders  Classifies disorders according to symptoms, treatments, and expected duration

Types of Disorders

Anxiety Disorders  Characterized by fear or anxiety.

Types of Anxiety Disorders  generalized anxiety disorder (person is continually tense, apprehensive, and in a state of autonomic nervous system arousal)  panic disorder (episodes of intense dread accompanied by physiological reactions)  phobias (persistent, irrational fear marked by avoidance)  obsessive-compulsive disorder (unwanted repetitive thoughts and actions)  post-traumatic stress (people in a state of anxiety or fear after a traumatic event)

Causes Learning Perspective  Anxiety is a result of classically conditioned fear.  Fear is generalized  Behavior that reduces fear is reinforced (because it takes the fear away)  We learn anxiety by observing the fears of others Biological Perspective  Natural selection makes some fears more likely  Some people are genetically predisposed to have more fear  Physiology- brain areas involved in emotion and fear are overactive

Dissociative and Personality Disorders  Break from normal personality  Abnormal personality

Types of Dissociative and Personality Disorders  dissociative-identity disorder (multiple personalities)- very sketchy in terms of research  avoidant personality disorder (fear of rejection and therefore withdrawal from others)  schizoid personality disorder (eccentric behaviors such as social disengagement)  histrionic personality disorder (shallow, attention- getting emotions, goes to great lengths to get praise and reassurance)  narcissistic personality disorder (exaggerate their own importance, aided by fantasies)  antisocial personality disorder (sociopath, one who lacks conscience)

Debate over Dissociative Disorders Those who say yes:  There are distinct brain and body states associated with different personalities  Handedness can switch  Visual acuity and eye- muscle balance changes  Subtle memories don’t transfer Those who say no:  Those with dissociative disorders are also highly hypnotizable  Only 2 cases per decade from  20,000 cases in 1980s  Almost solely diagnosed in North America

Causes  A way of dealing with childhood trauma?  Then why do the children who survived the Holocaust not exhibit an increased rate of personality disorders?

Mood Disorders  Characterized by unstable moods

Types of Mood Disorders  major depressive disorder (two or more weeks of depressed moods with no apparent cause)  bipolar disorder (alternating between manic and depressive episodes)

Explanations of Mood Disorders  Behavior and cognition- depressed people have negative thoughts about their behavior  Depression is common- it’s causes must likewise be common  Women are twice as likely to have major depression  Most major depressive episodes self-terminate  Stressful events often precede major depression

Perspectives Biological  Mood disorders linked to genetics  Genes change neurotransmitters:  Norepinephrine is overabundant in mania and scarce in depression  Serotonin is scarce during depression Social-Cognitive  Negative thoughts lead to negative moods  Negative moods lead to negative actions  Negative actions lead to a negative response from others  Negative response leads to negative thoughts

Schizophrenia  Characterized by disorganized thinking, disturbed perceptions, and inappropriate emotions and actions

Types of Schizophrenia  paranoid (preoccupation with delusions or hallucinations)  disorganized (disorganized speech or behavior or flat or inappropriate emotion)  catatonic (immobility or repetitive movements, extreme negativism or parroting others)  undifferentiatied (many or varied symptoms)  residual (withdrawal after hallucinations and delusions have disappeared)

Potential Causes  Brain abnormalities  Dopamine overactivity  Low activity in frontal lobe  High activity in thalamus during hallucination  Large fluid-filled areas that shrink cerebral tissue  Maternal virus during pregnancy  Genetic factors  Identical twins are much more likely to both have the disorder than are fraternal twins  Psychological factors

Psych Therapies

Psychotherapy  An emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties  Eclectic approach- uses techniques from various therapies to help a client

Psychoanalysis

Traditional Psychoanalysis  Started by Freud in the late 1800’s  Assumption is that disorders are caused by repressed traumas (usually from childhood)  Freud used free association, where the patient would start discussing any memory focusing on thoughts and feelings  When the patient hit a block, called resistance, the psychoanalyst would interpret the underlying wishes, feelings, and conflicts.

Traditional Psychoanalysis  Another method is dream interpretation  Freud believed that the content of dreams could tell an analyst about a clients repressed feelings and drives

Psychodynamic Therapy  Psychodynamic therapy is an update to psychoanalysis  Focuses on interpretation of past memories

Comparing Therapies Psychoanalysis  Therapist is out of the line of vision  Client comes several times a week  Client comes for several years Psychodynamic  Therapist may talk to client face-to- face  Client comes once a week  Client comes from a few weeks

Interpersonal Therapy  A brief alternative to psychodynamic therapy  Especially used for depressed clients  Focus is on improving current relationships and interpersonal skills

Humanistic Therapies

Basic Principles  Focus on the present and the future  Focus on conscious thoughts and feelings  Taking immediate responsibility for one’s feelings and actions  Promotes growth instead of cures illness

Methods  Client-centered therapy- developed by Carl Rogers, a technique where the therapist creates an accepting, genuine and empathetic environment  Active listening- a type of listening in which the listeners echoes, restates, and clarifies what the speaker has said

Behavior Therapies Focus on Classical and Operant Conditioning Techniques

Classical Conditioning Techniques  Counterconditioning- conditioning new responses to stimuli that trigger unwanted behaviors  Two types:  Systematic Desensitization- associating a relaxed state with something that would normally cause anxiety  Exposure therapies- treat anxiety by exposing people to the things they fear or avoid  Aversive Conditioning- associating an unpleasant state with an unwanted behavior

Operant Conditioning Techniques  Using rewards or punishments to change behavior  Token economy- a way to reward desired behavior  Patient exchanges a token earned for exhibiting the desired behavior for privileges or treats

Cognitive Therapies

Basic Ideas  Teaches people more adaptive ways of thinking and acting  Based on the assumption that our thoughts intervene between our events and our emotional reactions

Example Event You lose your job Event You lose your job Thought “I’m worthless. It’s hopeless.” Result Depression Thought “I deserve something better.” Result No Depression

Biomedical Therapies

Drug Therapies  Antipsychotic drugs- block dopamine receptor sites  Patients must be carefully monitored  Can produce symptoms akin to Parkinson’s disease  Antianxiety drugs- depress central nervous system activity  Treat symptoms but not causes  Antidepressant drugs- increase the availability of certain neurotransmitters (serotonin and norepinephrine)

Electroconvulsive Therapy  A therapy for severely depressed patients where a brief electrical current is sent through the brain of an anesthetized patient  We don’t know for sure why it works  Only for severe depression  After 3 sessions a week for two to four weeks, 80% of patients show improvement

Psychosurgery  Surgery that removes or destroys brain tissue  Only used as a last resort because the operations are irreversible  Can reduce uncontrollable seizures by deactivating specific nerve clusters  Can also cut the circuits involved in severe obsessive compulsive disorder

Lobotomies  A psychosurgery procedure used during the 1930s-1950s  Used to control uncontrollably violent or emotional patients  Procedure severs the nerves that connect the frontal lobes to the emotion- controlling centers of the inner brain  This procedure is rarely used today

Group and Family Therapies

Basic Principles  Using psych therapy techniques in small groups  Saves the patient time and money and is generally just as effective  Provides social support for patients  Family therapy uses group therapy principles to better family relationships

Alternative Therapies

Types  Therapeutic Touch- a practitioner hovers her hands over a patient to move “energy fields”  Eye Movement Desensitization and Reprocessing (EMDR)- rapidly moving one’s eyes in order to relieve anxiety or stress  Light exposure therapy- exposing seasonally depressed people to a bright light

Evaluating Psychotherapies

Is It Worth It?  Clients often enter therapy in a crisis, so their positive expectations can enhance healing  Unusual events tend to regress toward the mean  Clients generally like their therapists and speak kindly of them  80% of people have poorer outcomes than the average treated person  The type of therapy depends on the problem

Commonalities  Therapy offers hope  Therapy offers an explanation for behavior and a way to change that behavior  Clients and therapists have an empathic, trusting, and caring relationship