1. Introduction to Psychological Disorders
Module 47
Introduction to Psychological Disorders
Module 47& 48

2. Medical Student Disease -- A warning
Module 47& 48

3. How Can we define abnormal Behavior?
1) Clinically significant - serious enough
to warrant professional attention.
distress
disabling
dangerous to the person or to others.
Module 47& 48

4. 2) Internal Source - stems from within
3) Involuntary Manifestations
Module 47& 48

5. Labeling and Psychological Disorders
Rosenhan and 8 mentally healthy associates, ("pseudopatients“) were admitted to psychiatric hospitals by feigning auditory hallucinations (the words "empty", "hollow", "thud“)
None had a history of mental illness.
After admission symptoms disappeared and pseudopatients asked to be released. 
Module 47& 48

6. Their stays ranged from 7 to 52 days, and the average was 19 days.
All were discharged with a diagnosis of schizophrenia "in remission," which Rosenhan takes as evidence that mental illness is perceived as an irreversible condition creating a lifelong stigma rather than a curable illness.
Module 47& 48

7. Labels can effect perceptions of behaviors. Self-fulfilling prophecies
Despite constantly and openly taking extensive notes on the behavior of the staff and other patients, none of the pseudopatients were identified as impostors by the hospital staff, although many of the other psychiatric patients seemed to be able to correctly identify them as impostors.
Labels can effect perceptions of behaviors.
Self-fulfilling prophecies
Module 47& 48

8. Factors Effecting Psychological Disorders
1) Predisposing factors - in place before the
disorder begins.
(Genetic, learned, societal)
2) Precipitating Causes current stressors.
3) Maintaining Causes - rewards
(e.g., attention, avoidance of responsibilities)
Module 47& 48

9. Diagnostic and Statistical Manual of Mental Disorders (DSM -5 )
- specifies criteria (symptoms) for diagnosis.
- attempt to increase reliability of diagnosis.
DSM IV has 16 categories (each with several sub-categories).
Module 47& 48

10. Anxiety Disorders Mood Disorders
Somatoform Disorders Substance-related
Sleep disorders Eating Disorders
Adjustment disorders Factitious disorders
Personality disorders
Module 47& 48

11. Psychological factors affecting medical disorders
Dissociative Disorders (Amnesia; DID)
Schizophrenia and psychotic disorders
Sexual and Gender Identity disorders
Impulse control disorders
Disorders diagnosed in childhood or adolescence
Delirium, dementia, amnesia & cognitive disorders.
Module 47& 48

12. Module 48
Anxiety Disorders
Module 47& 48

13. Anxiety and Avoidance Disorders
Fear - specific item, situation or thought.
Anxiety - vague, unspecified generalised fears or future fear.
Easiest to treat (good prognosis).
Module 47& 48

14. Generalized Anxiety Disorder (GAD)
exaggerated worry and tension, often expecting the worst, even when there is no apparent reason for concern.
They anticipate disaster and are overly concerned about money, health, family, work, or other issues.
Free-floating anxiety
Module 47& 48

15. GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months
GAD develops slowly. It often starts during the teen years or young adulthood.
More common in women,
Rare after age 50.
Symptoms may get better or worse at different times, and often are worse during times of stress.
Module 47& 48

16. Physiological symptoms e.g., heart racing, shortness of breath
Panic Disorder
Physiological symptoms
e.g., heart racing, shortness of breath
Psychological Symptoms
e.g., fear of losing control or dying
feeling of unreality
Nicotine (stimulant) use doubles the risk of having Panic disorder
Module 47& 48

17. - mis-interpretation of physical symptoms. - Catastrophic Thinking
Causes
- genetics
- brain abnormalities
- mis-interpretation of physical symptoms.
- Catastrophic Thinking
Extreme case: Agoraphobia
Fear of being separated from a safe place.
- often can not leave their homes without a "safe"
person.
- more common in women.
Module 47& 48

18. Phobias - intense, irrational fear of specific objects or events.
Specific Phobias - fear of something specific
- Usually arise in middle childhood
- more common in females.
prevalence 30 to 40%
Module 47& 48

19. Claustrophobia enclosed places Hematophobia blood
Some Examples Fear of:
Acrophobia heights
Claustrophobia enclosed places
Hematophobia blood
Gephyrophobia crossing a bridge
Kenophobia empty rooms
Aichmophobia sharp pointed objects
Aquaphobia Water
Cynophobia dogs
Aerophobia flying
Entomophobia insects
Gamophobia marriage
Ophdophobia snakes
Xenophobia strangers
Melissophobia Bees
Homilophobia Sermons
Porphyrophobia the color purple
Module 47& 48

20. Module 47& 48

21. excessive fear of being scrutinised or evaluated
B) Social Phobias
excessive fear of being scrutinised or evaluated
- Avg. age of onset 19
- equal for males and females
- without intervention lifelong (chronic)
Module 47& 48

22. Obsessive Compulsive Disorder (OCD)
Obsessions - recurrent thoughts, impulses, or images
-intrusive, inappropriate and cause distress.
Compulsions repetitive behaviours
Goal to reduce anxiety but not realistic prevention.
- tends to begins before age 15
- genetic
Module 47& 48

23. Clomipramine and Prozac - increases seratonin
Common Types
Checking Behavior
Cleaning Behavior
Washing
Rituals
Therapy
Exposure Therapy
Drug Therapies
Clomipramine and Prozac
- increases seratonin
Module 47& 48

24. Post Traumatic Stress Disorder Re-experiencing of traumatic events
dreams or thoughts
irritability
sleep problems
difficulty concentrating
Video
Module 47& 48

25. - exposure therapy (systematic desensitization) - cognitive therapy
Treatments
- exposure therapy (systematic desensitization)
- cognitive therapy
- EMDR
Drug Therapies
Tranquilizers (Valium, Xanax)
- temporary solution
- habit forming
Clomipramine and Prozac
- increases serotonin
Module 47& 48

26. Module 49 - Mood disorders

27. Major Depressive Episode
Depressed mood
Loss of interest in pleasurable activities
Decrease or increase in appetite OR significant weight loss or gain
Persistently increased or decreased sleep
Psychomotor agitation or retardation
Fatigue or low energy
Feelings of worthlessness or inappropriate guilt
Decreased concentration or indecisiveness
Recurrent thoughts of death, suicidal ideation, or suicide attempt
Five or more symptoms present for ≥ 2 weeks

28. Module 49 - Mood disorders
Most depressions last less four months.
1/2 who have one episode never have another.
1/4 have a multiple recurrence.
According to NAMI
The lifetime risk of suicide for patients whose depression goes untreated is nearly 20%, the risk for treated patients is a mere 0.141%.
Suicide was the second leading cause of death for adults between the ages of 10 and 34 years in the United States.
Module 49 - Mood disorders

29. Module 49 - Mood disorders
According to NAMI (2012)
The lifetime risk of suicide for patients whose depression goes untreated is nearly 20%, the risk for treated patients is a mere 0.141%.
Suicide was the second leading cause of death for adults between the ages of 10 and 34 years in the United States.
Module 49 - Mood disorders

30. Module 49 - Mood disorders
Preventing Suicide
If someone tells you they are thinking of suicide . . .
1) Take it seriously
70% tell someone before hand.
2) Talk to them about it
3) Recognise symptoms
- giving away possessions
- sudden recovery from depressed mood
4) Don’t leave them alone!
Module 49 - Mood disorders

31. Module 49 - Mood disorders
5) Encourage them to get help
and Get help yourself .
6) Discourage Drinking. Alcohol is a depressant.
It just makes it worse!
Module 49 - Mood disorders

32. Module 49 - Mood disorders
Symptoms of Mania
- abnormal, persistent elevated or irritable mood
- inflated self esteem or grandiosity
- decreased need for sleep
- uncontrolled talking
racing thoughts
- excessive risky activities (spending sprees, sexual indiscretions, foolish business investments)
- generally develops before 30
- if untreated episodes last from 2 to 6 weeks
Module 49 - Mood disorders

33. Module 49 - Mood disorders
Bipolar Disorder
reoccurring episodes of depression and mania often with normal moods in between.
Hypomania – less sever mania
Dysthymia - less sever depression.
Cyclothymia - less sever bipolar disorder
- generally begin in early adulthood and rarely leads to suicide.
Module 49 - Mood disorders

34. Causes of mood disorders

35. Module 49 - Mood disorders
Causes
Biological Perspective
Genetics
- twin Studies
- linkage Studies
Brain Activity
Neurochemicals
- Norepinephrine and Seratonin
Module 49 - Mood disorders

36. Module 49 - Mood disorders
Social Cognitive Perspective
Learned Helplessness
Rumination (Negative Thoughts)
- state dependant memories
Module 49 - Mood disorders

37. Module 49 - Mood disorders
Social Cognitive Perspective
Explanatory Style
Module 49 - Mood disorders

38. Module 49 - Mood disorders
Stressors Reactive Depression - response to an identifiable stressor(s).
Poor coping strategies
Module 49 - Mood disorders

39. Module 49 - Mood disorders
Drug Therapy
Serotonin & norepinephrine
Tricyclics
Monoamine Oxidase Inhibitors
Prozac Family
Cognitive Therapy – Challenge Stinking Thinking
Module 49 - Mood disorders

40. Module 49 - Mood disorders
Drugs or Talk Therapy --- Which works best?
Both Work.
The combination:
- works better for people with Major Depression
- decrease probability of re-occurrence
Module 49 - Mood disorders

41. Module 50
Schizophrenia

42. Schizophrenia – break with reality (psychosis)
- lifetime prevalence 1%
Symptoms
Delusions - false beliefs despite clear evidence to the contrary
- delusions of control.
- delusions of grandeur.
delusions of reference
delusions of persecution

43. Hallucinations - seeing and hearing things that are not there.
Disorded Thoughts - unusual associations
Flat Affect or Inappropriate Emotions and Action

44. Subtypes
Paranoid Type
- delusions of persecution
- well organized delusions
Disorganised Type
- speech disorganisation (word salads)
- poorly developed delusions

45. Catatonic Schizophrenia
Motor symptoms
Waxy inflexibility - remain in same position
Undifferentiated Schizophrenia

46. Statistics

47. Causes of Schizophrenia
- genetics
- triggered by environmental factors (illness,
stress)
Dopamine Over activity
Maternal Virus During Midpregnancy
Amphetamine Psychosis - drugs that increase dopamine (amphetamines, cocaine, angel dust) increase symptoms in schizophrenics and produce symptoms in normals.

48. Personality Disorders
Module 51
Personality Disorders

49. Personality Disorders
- stable (long-term)
- extreme personality characteristics
- impair functioning and/or social relationships
Cluster A: Odd-Eccentric Personality Disorders
Paranoid, Schizoid and Schizotypal
Disordered Thought Patterns
- genetically linked to schizophrenia
- no psychosis

50. Paranoid Personality Disorders
Feel “everyone and everything is out to get them”.
- misinterpret situations in line with this paranoia
- intensifies under stress
- May act on these feelings.
Treatment - Cognitive Therapy to increase self-
efficacy for dealing with problems.
- does not challenge paranoid beliefs.

51. Cluster B - Dramatic-Emotional
Antisocial, Borderline, Histrionic, Narcissistic
Impulsive and Dramatic
Show little regard for their own safety of others
Total lack of concern for others

52. Antisocial Personality Disorders (Psychopath)
-often appear very charming
- no remorse or feelings of responsibility for
actions.
- don’t learn from punishment
- impulsive, risk takers, aggressive
- often have problems with the law
- stalker, violent crimes
2 to 3 % of the population
80% are men.

53. Borderline Personality Disorder
- cling to others, overly possessive.
- short-term stormy relationships
- act impulsively
- prone to self-destruction
- drinking, drug abuse, self-mutilation,
reckless driving and suicide
75% are female.
Childhood sexual abuse may play a role
Main cause is biological!

54. Cluster C Anxious-Fearful Personality Disorders
Avoidant, Dependant, Obsessive-Compulsive
Obsessive-Compulsive Personality Disorder
Rigid behavior, perfectionists, dogmatic &
emotionally blocked.
- This cluster treated with behavioral Therapy