1. Copyright © Allyn & Bacon 2007 Chapter 12 Psychological Disorders

2. Copyright © Allyn & Bacon 2007 The medical model takes a “disease” view, while psychology sees psychological disorders as an interaction of biological, cognitive, social, and behavioral factors. What are Psychological Disorders?

3. Copyright © Allyn & Bacon 2007 What are Psychological Disorders? Psychopathology – Any pattern of emotions, behaviors, or thoughts inappropriate to the situation and leading to personal distress or the inability to achieve important goals. Also referred to as: Mental illness Mental disorder Psychological disorder

4. Copyright © Allyn & Bacon 2007 What are Psychological Disorders? Three classic signs suggest severe psychopathology: 1. Hallucinations -false sensory experiences that may suggest mental disorder. 2. Delusions - persistent false beliefs. 3. Severe affective disturbances - emotion or mood.

5. Copyright © Allyn & Bacon 2007 The Medical Model The view that mental disorders are diseases that, like ordinary physical diseases, have objective physical causes and require specific treatments. Mental disorders are best treated with drug therapy.

6. Copyright © Allyn & Bacon 2007 The Cognitive-Behavioral Approach Behavioral perspective – Abnormal behaviors can be acquired through behavioral learning – operant and classical conditioning. Cognitive perspective – Abnormal behaviors are influenced by mental processes – how people perceive themselves and their relations with others.

7. Copyright © Allyn & Bacon 2007 The Social-Cognitive-Behavioral Approach A psychological alternative to the medical model that views psychological disorder through a combination of the social, cognitive, and behavioral perspectives. Cognition Environment Behavior

8. Copyright © Allyn & Bacon 2007 DistressMaladaptiveness IrrationalityUnpredictability Unconventionality and undesirable behavior Indicators of Abnormality Other signs of a disorder are more subtle, and a diagnosis depends heavily on clinical judgment.

9. Copyright © Allyn & Bacon 2007 How are Psychological Disorders Classified? The most widely used system, found in the DSM-IV, classifies disorders by their mental and behavioral symptoms.

10. Copyright © Allyn & Bacon 2007 Overview of DSM-IV DSM-IV – Fourth edition of the Diagnostic and Statistical Manual of Mental Disorders; the most widely accepted classification system in the United States. In multiaxial diagnosis, professionals look at the entire person, not just their “abnormal” behavior.

11. Copyright © Allyn & Bacon 2007 DSM - IV Axis IClinical disorders Axis IIPersonality disorders and Mental retardation Axis IIIGeneral medical conditions Axis IVPsychosocial and environmental factors Axis VGlobal assessment of functioning

12. Copyright © Allyn & Bacon 2007 Axis I – Clinical Disorders Anxiety Disorders Eating Disorders Bipolar Disorder Depression Schizophrenia Phobias ADHD Substance abuse

13. Copyright © Allyn & Bacon 2007 Axis II – Personality Disorders & Mental Retardation Paranoid Antisocial Avoidant Borderline Narcissistic MR (mild, moderate, severe, profound)

14. Copyright © Allyn & Bacon 2007 Axis III – General Medical Conditions Infectious diseases Complications of pregnancy Diabetes Brain injury Poisoning Alcohol cirrhosis

15. Copyright © Allyn & Bacon 2007 Axis IV – Psychosocial & Environmental Factors Legal difficulties Occupational problems Educational problems Economic problems Divorce Unemployment Crime

16. Copyright © Allyn & Bacon 2007 Axis V – Global Assessment of Functioning (GAF) Measures patients overall levels of functioning. 100 point scale GAF scale: - Plan treatment - Measure its impact - Predict outcomes

17. Copyright © Allyn & Bacon 2007 Mood Disorders Major Depression A condition lasting most of the day, day after day, with a loss of interest and pleasure and a lack of productive activity. Symptoms: -Trouble concentrating -Lack of appetite -Sleep abnormalities -Feelings of worthlessness

18. Copyright © Allyn & Bacon 2007 Causes: Genetic predisposition Biological basis Environment Low self-esteem Gender differences Cognitive aspects

19. Copyright © Allyn & Bacon 2007 Mood Disorders Seasonal Affective Disorder (SAD) A condition in which people become seriously depressed in one season of the year; usually winter. Causes: Deprivation of sunlight

20. Copyright © Allyn & Bacon 2007 Mood Disorders Bipolar Disorder A condition in which a person alternates between periods of depression and periods of mania ( excessive elation or manic excitement ). Causes: Genetic component

21. Copyright © Allyn & Bacon 2007 Anxiety Disorders Mental problems characterized mainly by anxiety. Anxiety Disorders

22. Copyright © Allyn & Bacon 2007 Anxiety Disorders Generalized anxiety disorder – Characterized by persistent and pervasive feelings of anxiety, without any external cause. Panic disorder – Marked by panic attacks that have no connection to events in a person’s present experience. Agoraphobia – Fear of public places/open spaces.

23. Copyright © Allyn & Bacon 2007 Anxiety Disorders Phobias– A group of anxiety disorders involving a pathological fear of a specific object or situation. Preparedness hypothesis – Notion that we have an innate tendency, acquired through natural selection, to respond quickly and automatically to stimuli that posed a survival threat to our ancestors.

24. Copyright © Allyn & Bacon 2007 Anxiety Disorders Obsessive-compulsive disorder – Condition characterized by patterns of persistent, unwanted thoughts and behaviors. The 3 C’s

25. Copyright © Allyn & Bacon 2007 Somatoform Disorders Somatoform disorders – Psychological problems appearing in the form of bodily symptoms or physical complaints. Conversion disorder – Somatoform disorder marked by paralysis, weakness, or loss of sensation, but with no discernable physical cause.

26. Copyright © Allyn & Bacon 2007 Somatoform Disorders Hypochondriasis – Somatoform disorder involving excessive concern about health and disease.

27. Copyright © Allyn & Bacon 2007 Dissociative amnesia Dissociative fugue Depersonalization disorder Dissociative identity disorder Dissociative Disorders Dissociative disorders – Group of pathologies involving “fragmentation” of the personality.

28. Copyright © Allyn & Bacon 2007 A psychologically induced loss of memory for personal information. Dissociative amnesia Dissociative fugue Depersonalization disorder Dissociative identity disorder Dissociative Disorders

29. Copyright © Allyn & Bacon 2007 Dissociative amnesia with the addition of “flight” from one’s home, family, and job. Dissociative amnesia Dissociative fugue Depersonalization disorder Dissociative identity disorder Dissociative Disorders

30. Copyright © Allyn & Bacon 2007 Abnormality involving the sensation of mind and body having separated. Dissociative amnesia Dissociative Fugue Depersonalization disorder Dissociative identity disorder Dissociative Disorders

31. Copyright © Allyn & Bacon 2007 Condition in which the individual displays multiple identities. Dissociative amnesia Dissociative Fugue Depersonalization disorder Dissociative identity disorder Dissociative Disorders

32. Copyright © Allyn & Bacon 2007 Eating Disorders Anorexia nervosa – Eating disorder involving persistent loss of appetite that endangers an individual’s health – stemming from psychological reasons. Bulimia – Eating disorder characterized by binge eating followed by “purges,” induced by vomiting or laxatives.

33. Copyright © Allyn & Bacon 2007 Schizophrenic Disorders Schizophrenia – Psychotic disorder involving distortions in thoughts, perceptions, and/or emotions. Hallucinations Delusions

34. Copyright © Allyn & Bacon 2007 Major Types of Schizophrenia Disorganized Catatonic Paranoid Undifferentiated Residual Positive Negative

35. Copyright © Allyn & Bacon 2007 Disorganized Catatonic Paranoid Undifferentiated Major Types of Schizophrenia Features incoherent speech, hallucinations, delusions, and bizarre behavior. Residual Type

36. Copyright © Allyn & Bacon 2007 Disorganized Catatonic Paranoid Undifferentiated Major Types of Schizophrenia Involves a spectrum of motor dysfunctions: catatonic stupor and catatonic excitement. Residual Type

37. Copyright © Allyn & Bacon 2007 Disorganized Catatonic Paranoid Undifferentiated Major Types of Schizophrenia Prominent feature: delusions of persecution and grandiosity. Residual Type

38. Copyright © Allyn & Bacon 2007 Disorganized Catatonic Paranoid Undifferentiated Major Types of Schizophrenia Persons displaying a combination of symptoms that do not clearly fit in one of the other categories. Residual Type

39. Copyright © Allyn & Bacon 2007 Disorganized Catatonic Paranoid Undifferentiated Major Types of Schizophrenia Individuals who have had a past episode of schizophrenia but are free of symptoms. Residual Type

40. Copyright © Allyn & Bacon 2007 Positive Schizophrenia Negative Schizophrenia Major Types of Schizophrenia Any form in which the person displays active symptoms. (e.g. delusions, hallucinations)

41. Copyright © Allyn & Bacon 2007 Positive Schizophrenia Negative Schizophrenia Major Types of Schizophrenia Any form distinguished by deficits, such as withdrawal and poverty of thought processes.

42. Copyright © Allyn & Bacon 2007 Possible Causes of Schizophrenia Evidence for the causes of schizophrenia has been found in a variety of factors including genetics, abnormal brain structure, and biochemistry. Diathesis-stress hypothesis – Genetic factors place the individual at risk, but environmental stress factors transform this potential into an actual schizophrenic disorder.

43. Copyright © Allyn & Bacon 2007 Personality Disorders Personality disorders – Conditions involving a chronic, pervasive, inflexible, and maladaptive pattern of thinking, emotion, social relationships, or impulse control.

44. Copyright © Allyn & Bacon 2007 Personality Disorders Narcissistic personality disorder Characterized by a grandiose sense of self-importance, a preoccupation with fantasies of success and power, and a need for constant attention.

45. Copyright © Allyn & Bacon 2007 Personality Disorders Antisocial personality disorder – Characterized by a long-standing pattern of irresponsible behavior indicating a lack of conscience and a diminished sense of responsibility to others. Video Clip

46. Copyright © Allyn & Bacon 2007 Personality Disorders Borderline personality disorder – An unstable personality given to impulsive behavior.

47. Copyright © Allyn & Bacon 2007 Developmental Disorders Autism – A developmental disorder marked by disabilities in language, social interaction, and the ability to understand another person’s state of mind. Dyslexia – A reading disability, thought by some experts to involve a brain disorder.

48. Copyright © Allyn & Bacon 2007 Developmental Disorders Attention-deficit hyperactivity disorder – A developmental disability involving short attention span, distractibility, and extreme difficulty in remaining inactive for any period.

49. Copyright © Allyn & Bacon 2007 Adjustment Disorders and Other Conditions That May Be a Focus of Clinical Attention Mild depression Physical complaints Marital problems Academic problems Parent-child problems BereavementMalingering Job problems

50. Copyright © Allyn & Bacon 2007 Ideally, accurate diagnoses lead to proper treatments, but diagnoses may also become labels that depersonalize individuals and ignore the social and cultural contexts in which their problems arise. What are the Consequences of Labeling People?

51. Copyright © Allyn & Bacon 2007 M’Naghten Rule A defendant is not criminally responsible if, at the time of committing an unlawful act, the person was laboring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or if he did know it, that he did not know he was doing wrong. Daniel M‘Naghten Prime Minister Sir Robert Peel Edward Drummond

52. Copyright © Allyn & Bacon 2007 The Plea of Insanity “Not guilty by reason of insanity” Insanity – A legal term, not a psychological one, referring to a person who is unable, because of a mental disorder or defect, to confirm his or her behavior to the law.

53. Copyright © Allyn & Bacon 2007 End of Chapter 12