Introduction to Psychological Disorders

Defining Disorder

Psychological Disorder A “harmful dysfunction” in which behaviors are maladaptive, unjustifiable, disturbing, and atypical

Maladaptive An exaggeration of normal, acceptable behaviors Destructive to oneself or others

Unjustifiable A behavior which does not have a rational basis

Disturbing A behavior which is troublesome to other people

Atypical A behavior so different from other people’s behavior that it violates a norm Norms vary from culture to culture

MUDA A mnemonic device used to remember the four attributes of a psychological disorder – Maladaptive – Unjustifiable – Disturbing – Atypical

Early Views of Mental Illness In ancient times, mental illness was usually explained through a supernatural model; the person was possessed or a sinner During the Middle Ages treatment methods were inhumane and cruel

Philippe Pinel ( ) French physician who worked to reform the treatment of people with mental disorders Encouraged more humane treatment

Understanding Disorders: The Medical Model

The Medical Model Concept that mental illnesses have physical causes that can be diagnosed, treated, and in most cases, cured. Psychological disorders can be diagnosed based on their symptoms and treated or cured through therapy. Psychological disorders are similar to a physical illness.

Understanding Disorders: The Bio-Psycho-Social Model Module 29: Introduction to Psychological Disorders

Bio-Psycho-Social Model Contemporary perspective that assumes biological, psychological, and sociocultural factors combine and interact to produce psychological disorders

Bio-Psycho-Social Perspective

Classifying Disorders

DSM-IV-TR Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition The text of the DSM- IV was recently revised, hence “TR” at the end

DSM-IV-TR Published by the American Psychiatric Association Lists and describes all the currently accepted categories of mental disorders

DSM-IV-TR Divides mental disorders into 17 major categories Includes the symptoms but not the causes of each disease Has changed significantly since the first edition

DSM-IV-TR Axis

Personality Disorders Take very careful notes on these disorders…you will be playing one tomorrow!

Personality Disorders Psychological disorders characterized by rigid and lasting behavior patterns that disrupt social functioning Divided into three clusters: – With odd and eccentric behaviors – With dramatic or impulsive behaviors – Related to anxiety

Cluster A Includes paranoid, schizoid, and schizotypal personality disorders. People with these disorders often seem odd or eccentric, with unusual behavior ranging from distrust and suspiciousness to social detachment.

Paranoid Suspiciousness and mistrust of others guarded, overcautious, unforgiving, tendency to see self as blameless on guard for perceived attacks by others reluctant to confide in others hypersensitive, bear grudges not usually psychotic

Schizoid Inability to form social relationships and a lack of interest in doing so do not have good friends unable to express feelings and are seen by others as cold and distant lack social skills and can be classified as loners or introverts solitary interests and occupations do not take pleasure in many activities indifferent to praise or criticism not very emotionally reactive

Schizotypal Not excessively introverted and have pervasive social and interpersonal deficits they also have cognitive and perceptual distortions and eccentricities in their communication and behavior. Although reality contact is usually maintained, highly personalized and superstitious thinking exhibited. Believe they have magical powers and may engage in magical rituals.

Cluster B Includes histrionic, narcissistic, antisocial, and borderline personality disorders. Individuals with these disorders have in common a tendency to be dramatic, emotional, and erratic. Their impulsive behavior, often involving antisocial activities, is more colorful, more forceful, and more likely to bring them in contact with mental health or legal authorities than the behaviors characterizing disorders in Cluster A.

Histrionic Excessive attention seeking behavior and emotionality tend to feel unappreciated if not the center of attention lively, dramatic, and excessively extroverted styles in seeking attention, their appearance and behavior are often quite theatrical and emotional, as well as sexually provocative and seductive highly suggestible and consider relationships to be closer than they really are relationships are stormy self centered and vain over concerned about approval of others

Narcissistic Exaggerated sense of self importance preoccupation with being admired lack of empathy for the feelings of others strong tendency to overestimate their abilities and accomplishments while underestimating the abilities and accomplishments of others

Antisocial With dramatic or impulsive behaviors

Borderline Show a pattern of behavior characterized by impulsivity and instability in interpersonal relationships, self image, and mood disturbances in basic identity sense of self is unstable fear abandonment hard to control anger, outbursts low tolerance for frustration sense of emptiness mood swings self destructive behaviors (excessive gambling, sex, substance abuse, driving)

Cluster C Includes avoidant, dependent, and obsessive- compulsive personality disorders. In contrast to the other clusters, anxiety and fearfulness are often part of these disorders, making it difficult in some cases to distinguish them form anxiety based disorders. People with these disorders, because of their anxieties, are more likely to seek help.

Avoidant Pattern of extreme social inhibition and introversion leading to lifelong patterns of limited social relationships and reluctance to enter into social interactions. Fear of criticism. Do not enjoy their aloneness. Low self esteem and self consciousness.

Dependent Extreme dependence on other people clinging submissive behavior Difficulty in separating in relationships discomfort at being alone subordination of needs in order to keep others involved in a relationship indecisiveness can’t make decisions on own need constant reassurance lack self confidence

Obsessive Compulsive Excessive concern with order, rules, and trivial details perfectionistic lack of expressiveness and warmth difficulty in relaxing and having fun very scheduled fear mistakes and constantly check to make sure they are not making mistakes don’t get much accomplished because of constant checking