1. Module 36 - Introduction to Psychological Disorders

2. What is a Psychological Disorder?
Persistently harmful thoughts, feelings. And behaviors
A disordered behavior is one that is DEVIANT, DISTRESSFUL, and DYSFUNCTIONAL
Deviant  atypical for that culture at that time
Distressful  the behavior is upsetting or disturbing for the person
Dysfunctional  it impairs normal functioning, it is disabling

3. Beware!
Normal and abnormal behaviors are points on a continuum: Everyone experiences some of the symptoms some of the time.
SAD
DEPRESSED
WORRIED
ANXIETY DISORDER
PROUD
NARCISSISM
VIVID IMAGINATION
SCHIZOPHRENIA

4. Perspectives on the causes of psychological disorders
Historical perspective: Evil supernatural forces
Medical perspective
Bio-Psycho-Social Perspective
Each perspective suggests a distinct approach to treatment

5. Turkish historical perspective: cinnet

6. Examples of historical perspective: Demonic possession
Almost all worldly religions have alluded to demonic (evil) possession
Buddhism
Zen
Hinduism
Christianity (early, Catholicism, Protestantism, Anglicanism, Lutheranism, Methodism)
Scientology
Symptoms of a variety of recognized disorders
Schizophrenia, hysteria, mania, psychosis, dissociative identity disorder, epilepsy, Tourette’s syndrome

7. The Medical Perspective: our MENTAL HEALTH
Originated from the idea that diseases have physical causes
The case of syphilis among upper classes in late 1700
Current discoveries about connections to brain structure and brain biochemistry
Mental illness can be diagnosed  it has recognizable symptoms
Mental illness can be treated through therapy (may include medication and hospitalization)
Mental illness can be cured

8. Medical Perspective: The case of syphilis
It is an STD that spreads through unprotected sex with multiple partners
"French disease" in Italy and Germany
"Italian disease" in France
"Spanish disease“ in Holland
"Polish disease“ in Russia
"Christian disease“ (frengi) in Turkey
"British disease“ in Tahiti
The bacteria can invade the CNS  psychological symptoms
Early treatments included mercury  direct application and mercury vapors

9. Mercury exposure as a “treatment”
All forms of exposure, especially vapors of mercury
Brain damage: tremors, irritability, vision and hearing problems, problems with motor coordination, language problems and memory problems
Lung damage
Kidney damage
Developmental problems of the fetus

10. The Biopsychosocial Perspective
All behavior (including disordered behavior) is a product of genetic factors, physiological factors, and experiences (past and present)
Symptoms of psychological disorders vary across cultures:
Eating disorders  Western
Susto – fear of black magic  Latin American
Taijin-kyofusho – social anxiety  Japanese
Some disorders are universal: depression and schizophrenia

11. Biopsychosocial Perspective: Psychological Disorders

12. Difference between the medical and the biopsychosocial perspectives
Focus on disease:
Disease can be understood and treated
Disease can be separated from the person
Focus on the person and the circumstances of the person:
Disorder can be understood by understanding the person’s thoughts and emotions, his/her experiences, and the biology and genetics of the disorder
Mind is not separable from the social and individual circumstances

13. Rates of Psychological Disorders

14. Very high level of distress
Among college students? Level of psychological distress that impairs functioning
College students
General Population
Very high level of distress
Males
8.6%
2.7%
Females
8.4%
5.4%
High level of distress
12.1%
3.1%
16.2%
5.5%
Note: Data from Australia, Stallman (2008)

15. In Turkey?
In a nationally representative sample of mothers (TECGE), there is indication of mental disorder in 12.4%, with at least some symptoms that are at “disorder” level.
Who experiences psychological disorders in Turkey?

16. Who experiences high levels of psychological symptoms among Turkish mothers?
Mothers’ Characteristics
Rate of high levels of psychological symptoms
Rural
Urban
8.9%
15.5%
Low SES
Middle SES
High SES
15.1%
12.2%
8.4%
No education
Grade school completed
Some secondary education
Secondary education completed
Some college education
18.9%
13.0%
11.0%
7.9%
3.6%
1 or 2 children
3 children
4 or more children
16.9%

17. Do friends and family help?
Those who do not have symptoms
Those who have high levels of symptoms
Level of support from friends 60 46
Level of support from family 80 66
Level of support from husband 81 56
Level of support from the neighbors 65 52

18. How do we study and treat psychological disorders? Classification
Diagnosis
The process of identifying and grouping mental disorders with similar symptoms
Goals of Classification
Common shorthand language used by clinicians and treatment specialists
Agreed upon terms
Understanding of etiology (causes)
Treatment planning

19. How do we classify psychological disorders?
DSM-IV
American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)
a widely used system for classifying psychological disorders
Categories increased from 60 in 1950’s to 400 today.
Problems with diagnosis: STIGMATIZING POWER OF LABELS

20. Major Types of Psychological Disorders
Anxiety Disorders
Mood Disorders
Personality Disorders
Schizophrenic Disorders

21. Personality Disorders
Paranoid Personality Disorder
Consistent pattern of distrust and suspiciousness about the motives of the others
Histrionic Personality Disorder
Patterns of excessive emotionality and attention seeking
Narcissistic Personality Disorder
A grandiose sense of self-importance, a preoccupation with fantasies of successor power, and a need for constant admiration
Antisocial Personality Disorder
A long standing pattern of irresponsible or unlawful behavior that violates social norms

22. Dissociative Disorders
Disturbance in integration of identity, memory, or consciousness
Dissociative Amnesia
Inability to remember personal experiences
Dissociative Identity Disorder (DID)
Notion of Multiple Personality
Two or more distinct personalities (contrasting with the original self)

23. Psychological Disorders of Childhood
Mental retardation
IQs below scores of 70-75
A variety of adaptive skills
Attention-deficit hyperactivity disorder (ADHD)
Inattention that is not consistent with level of development
Hyperactivity- impulsivity
Autistic disorder
Severe disruption in ability to form social bonds
Delayed/limited spoken ability, narrow interest in the world.