Psychologi cal Disorders

How do we decide if someone has a psychological disorder? 1. What criteria should we use? 2. How do we define it? 3. What causes it? 2

3 4 scenarios Air bath man Woman afraid of snakes Mountain boy Teenage girl

Psychological Disorders Persistently harmful thoughts, feelings, and actions. Must have the 3 D ’ s : – Deviant – Distressful – Dysfunctional 4

3 D ’ s Deviant – – Behavior in one culture may be considered normal, while in others it may lead to arrest. Distressful – Causes pain, suffering, etc. Dysfunctional – Interferes / impairs a normal life 5

What happened here? 6

7 Understanding Psychological Disorders Ancient Treatments of psychological disorders include – trephination – Exorcism – being caged like animals, – being beaten, – burned, – castrated, – mutilated, – transfused with animal ’ s blood.

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9 Medical Perspective Philippe Pinel ( ) from France, insisted that madness was not due to demonic possession, but an ailment of the mind. Remove the chains and replace with gentleness Dance in the madhouse.

The Medical Model Concept that diseases have physical causes These can be diagnosed, treated, and in most cases, cured Do we believe this today? 10

11 Biopsychosocia l Perspective Assumes that biological, socio - cultural, and psychological factors combine and interact to produce psychological disorders.

Classifying Psychological Disorders You walk into a psychiatrist ’ s office wanting to be diagnosed What do they do? Diagnostic and Statistical Manual of Mental Disorders – DSM - V (2013) Describes 400 psychological disorders compared to 60 in the 1950 s. 12

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

Goals of DSM 1. Describe (400) disorders. 2. Determine how prevalent the disorder is. Criticisms Creates a stigma when person is labeled Ethical questions – murder trials with “ insanity ” 15

Anxiety Disorders What is anxiety? What if you experienced that a lot? Generalized anxiety disorders 2. Phobias 3. Panic disorders 4. Obsessive - compulsive disorders

Worry Questionnaire 17

Generalized Anxiety Disorder 1. Persistent and uncontrollable tenseness and apprehension. 2. Autonomic arousal. 3. Inability to identify or avoid the cause of certain feelings. 18

GAD GtDD4http:// GtDD4 19

Panic Disorder Minute - long episodes of intense dread Feelings of terror, chest pains, choking, or other frightening sensations. 20

21 Phobia Marked by a persistent and irrational fear of an object or situation that disrupts behavior.

22 Kinds of Phobias Phobia of blood.Hemophobia Phobia of closed spaces.Claustrophobia Phobia of heights.Acrophobia Phobia of open places.Agoraphobia

23 Obsessive - Compulsive Disorder Persistence of : –1. Unwanted thoughts ( obsessions ) –2. Urges to engage in senseless rituals ( compulsions ) that cause distress.

24 A PET scan of the brain of a person with Obsessive - Compulsive Disorder ( OCD ). High metabolic activity ( red ) in the frontal lobe areas are involved with directing attention. Brain Imaging Brain image of an OCD

Howard Hughes Howie Mandel g&feature=relatedhttp:// g&feature=related 25

26 Post - Traumatic Stress Disorder Four or more weeks of the following symptoms constitute post - traumatic stress disorder ( PTSD ): 1. Haunting memories 2. Night mares 3. Social withdraw al 4. Jumpy anxiety 5. Sleep problems Bettmann/ Corbis

Resilience to PTSD Only about 10% of women and 20% of men react to traumatic situations and develop PTSD. Holocaust survivors have shown remarkable resilience against traumatic situations. All major religions of the world suggest that surviving a trauma leads to the growth of an individual. 27

How do we explain anxiety disorders? Why do they start? Repression Observational learning Classical Conditioning Biological Causes – natural selection, genes, brain 28

Mood Disorders Psychological Disorders characterized by emotional extremes 1. Major depressive disorder 2. Bipolar disorder 29

Major Depressive Disorder Depression is the “ common cold ” of psychological disorders. In a year, 5.8% of men and 9.5% of women report depression worldwide ( WHO, 2002). 30 Chronic shortness of breath Gasping for air after a hard run Major Depressive DisorderBlue mood

Major Depressive Disorder Signs of depression last two weeks or more and are not caused by drugs or medical conditions. 1. Lethargy and fatigue 2. Feelings of worthlessness 3. Loss of interest in family & friends 4. Loss of interest in activities 31

Gender Differences 32

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Depression ’ s Vicious Cycle 34

35 Explanatory style plays a major role in becoming depressed.

36 Bipolar Disorder What do you know about bipolar? Formerly called manic - depressive disorder. An alternation between depression and mania signals bipolar disorder. Multiple ideas Hyperactive Desire for action Euphoria Elation Manic Symptoms Slowness of thought Tired Inability to make decisions Withdrawn Gloomy Depressive Symptoms

37 Bipolar Disorder What do they have in common? Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Whitman WolfeClemensHemingway

Explaining Mood Disorders Bio - psycho - social? Gender differences Increasing suicide rates, especially teens Run in family ( genes for depression? ) Reduction of serotonin Brain areas Thought processes 38

Schizophrenia What have you heard about schizophrenia? If depression is the common cold of psychological disorders, schizophrenia is the cancer. Nearly 1 in a 100 suffer from schizophrenia 39

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Symptoms “ Split Mind ” 1. Disorganized and delusional thinking. 2. Disturbed perceptions. 3. Inappropriate emotions and actions. 41

1. Disorganized and Delusional Thinking “ This morning when I was at Hillside [ Hospital ], I was making a movie. I was surrounded by movie stars … I ’ m Marry Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.” Delusions – “ I ’ m Mary Poppins ” – False beliefs – Often of persecution or grandeur 42

2. Disturbed Perceptions 43 Hallucinations – Perceive things that are not there ( Voices, noises ) Some see, feel, taste, or smell things that are not there

3. Inappropriate Emotions and Actions A schizophrenic person may laugh at the news of someone dying or show no emotion May continually rub an arm, rock a chair, or remain motionless for hours ( catatonia ). 44

45 Subtypes of Schizophrenia

Positive and Negative Symptoms Positive symptoms – have inappropriate symptoms that are not present in normal individuals – hallucinations, disorganized thinking, deluded ways Negative symptoms – have an absence of appropriate symptoms that are present in normal individuals – apathy, expressionless faces, rigid bodies 46

Chronic and Acute Schizophrenia Chronic / process – slow to develop – Recovery is doubtful – Negative symptoms Acute / reactive – rapidly develops – Recovery is better – Positive symptoms 47

48 Subtypes

49 Understanding Schizophrenia Schizophrenia is a disease of the brain exhibited by the symptoms of the mind. Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain. Brain Abnormalities

50 Abnormal Brain Activity Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Adolescent schizophrenic patients also have brain lesions. Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro Imaging and Judith L. Rapport, National Institute of Mental Health

51 Abnormal Brain Morphology Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles. Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC

52 Viral Infection Schizophrenia has also been observed in individuals who contracted a viral infection (flu) during the middle of their fetal development.

53 Genetic Factors The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 1991) Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated

54 Genetic Factors The following shows the prevalence of schizophrenia in identical twins as seen in different countries.

55 Psychological Factors Psychological and environmental factors can trigger schizophrenia if the individual is genetically predisposed (Nicols & Gottesman, 1983). Genain Sisters The genetically identical Genain sisters suffer from schizophrenia. Two more than others, thus there are contributing environmental factors. Courtesy of Genain Family

56 Warning Signs Early warning signs of schizophrenia include: Birth complications, oxygen deprivation and low-birth weight. 2. Short attention span and poor muscle coordination. 3. Poor peer relations and solo play.6. Emotional unpredictability.5. Disruptive and withdrawn behavior.4. A mother’s long lasting schizophrenia.1.

1. What are the three categories of symptoms for schizophrenia? 2. What are delusions? 3. What are hallucinations? 4. Name three subtypes of schizophrenia. 5. What are the differences between positive and negative symptoms? 57

Dissociative Disorders What does it mean to “ dissociate? ” – Disconnect, separate 58

Dissociative Identity Disorder Two or more distinct identities 59

The Three Faces of Eve 8XQ0A 60

Personality Disorders 61 Characterized by inflexible and enduring behavior patterns that impair social functioning. They are usually without anxiety, depression, or delusions. – Avoidant personality disorder – Schizoid personality disorder – Histrionic personality disorder – Narcissistic personality disorder – Borderline personality disorder

Antisocial Personality Disorder “ Sociopath ” or “ Psychopath ” Exhibits a lack of conscience for wrongdoing, even toward friends and family members. – Usually men Lies, steals, fights, displays unrestrained sexual behavior 62

Characteristi cs Unable to keep a job, irresponsible as a spouse and parent, assaultive, criminal Most criminals do not fit – They show concern for their friends and family Antisocial – fear and feel little 63

Henry Lee Lucas Confessed to bludgeoned, suffocated, stabbed, shot, or mutilated 360 women, men, and children “ Once I ’ ve done a crime, I just forget it.” “ I think of killing like smoking a cigarette, like another habit.” 64

Understanding Antisocial Personality Disorder Biological and psychological reasons. Youngsters, before committing a crime, respond with lower levels of stress hormones than others do at their age.

66 Understanding Antisocial Personality Disorder PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow - up study repeat offenders had 11% less frontal lobe activity compared to normals Normal Murderer Courtesy of Adrian Raine, University of Southern California

67 Understanding Antisocial Personality Disorder The likelihood that one will commit a crime doubles when childhood poverty is compounded with pregnancy complications

68 Rates of Psychological Disorders

69 Rates of Psychological Disorders The prevalence of psychological disorders during the previous year is shown below (WHO, 2004).

70 Risk and Protective Factors Risk and protective factors for mental disorders (WHO, 2004).

71 Risk and Protective Factors