1. Psychological Disorders
Definition, diagnosis and treatment

2. What constitutes a disorder?
Behavior is ___________

3. Understanding psychological disorders through the ages
Ancient Greece: imbalance of the “four humours”
Dark ages-Middle ages: devil or witchcraft
18th century: medical (biological) model of disease
20th century: biopsychosocial model of psychological disorders

4. Classification of disorders
DSM-IV-TR - diagnostic manuals used by clinicians
Symptoms
Labels
Prognoses
Sample cases
Statistics

5. Anxiety disorders
Characterized by feelings of excessive apprehension and anxiety
Generalized anxiety disorder
Phobic disorders
Panic disorder
Obsessive-compulsive disorder
Post-traumatic stress disorder

6. Generalized Anxiety disorder
Symptoms -
Prevalence
Treatment

7. Phobic disorders Persistent and irrational fears Social phobias
Specific phobias
Acrophobia, claustrophobia, hemophobia, pyrophobia, triskadekaphobia, ophidiophobia, astraphobia, nyctophobia, aichmophobia, coulrophobia, trichophobia…

8. Treatment for phobias Exposure Classical Conditioning Rationale
Systematic Desensitization
Flooding
Imaginal vs. In Vivo
Classical Conditioning Rationale
Anxiety hierarchy
Subjective Units of Distress (SUDS)
Response prevention
Safety Cues

9. Panic disorder
Panic attacks
Symptoms
Not:
May result in agoraphobia

10. Treatment for Panic Disorder
Exposure is still used, but this time the cue for the fear is _________________.
Hypervigilance
Exposure Techniques:
Breathing Retraining and Muscle Relaxation

11. Obsessive-Compulsive disorder
Persistent obsessions and compulsions
Obsession =
Compulsion =

12. Treating OCD Exposure with Ritual Prevention Cognitive Restructuring
Operational conditioning of fear through avoidance
Self Monitoring
Block compulsion responses to anxiety
Cognitive Restructuring
Catastrophic Thinking
Psychopharmacology
Clomipramine (anafranil). Fluoxetine (prozac), Fluvoxamine (luvox)

13. Post-Traumatic Stress disorder
Result of severe trauma and emotional distress.
Symptoms
Lasting 4+ weeks
Relies on (lack of) emotional resilience

14. Treating PTSD Prolonged Exposure
Expose to memories and cues related to trauma
Imaginal: recite memories in first person repeatedly until SUDS go down.
In vivo: spend time in similar environments that create anxiety related to the trauma

15. Treatment for anxiety disorders
Biological
Antianxiety drugs
Antidepressant drugs
D-Cycloserine
Cognitive
Cognitive-behavior therapy
Behavioral
Exposure therapy
Systematic desensitization

16. Mood disorders Disorders characterized by emotional extremes
Major depressive disorder
Bipolar disorder

17. Major Depressive disorder
Overwhelming sadness, hopelessness and loss of interest
Symptoms
Emotional
Cognitive
Motivational
Somatic
Symptoms last 2+ weeks
Prevalence

18. Treating Depression Albert Ellis – Cognitive Therapy
Confronting Irrational Thinking
Beck – Cognitive Behavioral Therapy
Socratic Dialogue
Thought Records
Event – Feelings – Cognitions – Other interpretations
Cognitive Restructuring
Collaborative Empiricism
Behavioral Homework Assignments
Scheduling Activities (Mastery, Pleasure, Tests)
Jacobson – Behavioral Activation
Increase opportunities for reinforcement
Overgeneralizing
Selective abstraction (only failure matters)
Excessive responsibility
Assuming temporal causality
Self references- Everyone notices how bad I am
Catastrophizing
Dichotomous

19. Bipolar disorder
Characterized by wide swings between two emotional extremes
Mania
Depression
Cyclic switching between moods
Treatment – Lithium and behavioral therapies

20. Treatment for mood disorders
Biological
Antidepressants (depression)
Mood stabilizers (bipolar)
Electroconvulsive therapy (depression)
Deep-brain stimulation (depression)
Transcranial magnetic stimulation (depression)
Psychotherapy
Cognitive-behavioral therapy
Psychodynamic/Interpersonal therapy

21. Personality disorders
Maladaptive behaviors which impair social functioning
Antisocial personality disorder
Borderline personality disorder

22. Antisocial personality disorder
Marked by a lack of conscience and malicious behavior patterns
Symptoms
Prevalence
Low in ______________ population,
high in _______________ populations

23. Antisocial personality disorder
Associated with reduced cortical volume and activation of the frontal cortex
Also associated with low levels of stress hormones and arousal

24. Borderline personality disorder
Unstable personality, mood, identity and behavior
Symptoms
Emotional instability
Impulsivity
Unstable identity
Fear of abandonment
Paranoid ideation
Prevalence
3:1 Females:Males

25. Treating BPD Linehan - Dialectical Behavior Therapy Individual Therapy
Acceptance-Change dialectic
Group Skills Training
Emotion Regulation
Distress Tolerance
Interpersonal Effectiveness
Mindfulness
Therapist Consult Team
24 Hour Phone Consultation

26. Schizophrenia Split from reality
Disorganization of thought, perceptions, emotions and behaviors
Prevalence

27. Schizophrenia Symptoms Positive Negative Thought disorder
Hallucinations
Delusions
Negative
Flat affect
Lack of motivation
Decline in communication and interaction

28. Schizophrenia
Dopamine hypothesis - excess of DA causes positive symptoms
Prenatal factors
Virus
Stress
Environmental or developmental factor influences onset

29. Treatment for Schizophrenia
Biological
Antipsychotic drugs
Reduce dopamine
Long-term consequences
Behavioral
Operant conditioning
Token economy