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The Psychological Disorders Abnormal means not of the norm or not average Lebron James Einstein What is abnormal for psychologists? Refers to maladaptive.

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Presentation on theme: "The Psychological Disorders Abnormal means not of the norm or not average Lebron James Einstein What is abnormal for psychologists? Refers to maladaptive."— Presentation transcript:

1 The Psychological Disorders Abnormal means not of the norm or not average Lebron James Einstein What is abnormal for psychologists? Refers to maladaptive cognitions, affects, and or behaviors that are at odds with social expectations and result in distress or discomfort

2 Abnormal The reactions of people with psychological disorders are maladaptive They must be impaired somehow Not just strange May present itself in various ways Affect Behavior Cognition Social factors are also important Behavior at a party vs. school Distressing Psychological disorders are uncomfortable for those that have one as well as those around them

3 Diagnostic Statistical Manual of Mental Disorders (DSM) A way to classify and diagnose mental disorders. Lists 297 different diagnostic categories Does not attempt to address the causes of mental disorders It is an attempt to be as objective as possible in describing the symptoms of mental disorders

4 Anxiety Disorders, Somatoform Disorders, and Dissociative Disorders

5 Anxiety Disorders Definition of anxiety A feeling of general apprehension or dread accompanied by predictable physiological changes Two levels Subjective feelings Dread Fear Physiological responses Increased muscle tension Shallow rapid breathing Increased perspiration Drying of the mouth Sympathetic response

6 Anxiety Disorders Major symptom of anxiety Feeling of anxiety coupled with avoidance behavior Attempt to avoid situations that seems to produce anxiety Most common of all the psychological disorders Perhaps as many as 25-30% of people will experience an anxiety disorder at some time in their lives. more common in women

7 Five anxiety disorders 1) Generalized anxiety disorder (GAD) Unrealistic, excessive, persistent worry Chronic An intense anxiety that is diffuse Not brought on by anything specific No clear insight to what is causing the anxiety

8 2) Panic Disorder Recurrent, unpredictable, unprovoked onset of sudden, intense anxiety. Can last from seconds to hours No particular stimulus to bring it on More acute than GAD 1.5-3.5% of the population Age of onset is adolescence to mid twenties Initial attacks are often associated with stress Often accompanied with depression comorbid High rate of suicide attempts – 20 %

9 3) Phobic Disorders A persistent and excessive fear of some object, activity, or situation that consistently leads a person to avoid it. No real or significant threat involved The fear is unreasonable Two main categories of phobic disorders Specific Phobias Animals Physical environment – storms, heights Blood, injection, or injury Specific situations – tunnels, airplanes Social phobias Persistent fears of social or performance situations in which embarrassment could occur Public speaking

10 4) Obsessive-Compulsive Disorder (OCD) A pattern of recurrent obsessions and compulsions Obsessions Ideas or thoughts that involuntarily and constantly intrude into awareness Cleanliness, violence, disease, danger, doubt Did I turn off the stove? Compulsions Constantly intruding, repetitive behaviors Handwashing, grooming, counting, and checking Checking your alarm repeatedly to make sure it is set Video

11 Posttraumatic Stress Disorder (PTSD) Distressing symptoms that arise some time after the experience of a highly traumatic event Trauma as defined by the DSM-IV The person has experienced, witnessed, or been confronted with an event that involves actual or threatened death or serious injury The person’s response involves intense fear, helplessness, or horror.

12 Symptoms of PTSD Re-experiencing the traumatic event Flashbacks Nightmares Avoidance of any possible reminders of the event People who were there Increased arousal or alertness Irritability Insomnia Difficulty concentrating

13 Somatoform Disorders Disorders that involve some physical, bodily complaint Psychological disorders No known medical or biological cause for the symptoms. Three types Hypochondriasis Somatization disorder Conversion disorder

14 Hypochondriasis and Somatization Disorders hypochondriasis Fear of a nonexistent disease somatization disorder preoccupied with nonexistent symptoms Really the two disorders are quite similar

15 Conversion Disorder Loss or altering of physical function that suggests that there is some physical problem Paralysis – often times of just the hand Glove anesthesia Blindness Deafness This was Freud’s Hysteria Diagnosed much more often in Freud’s time

16 Dissociative Disorders To dissociate means to become separate or escape Dissociative amnesia Inability to recall important personal information Beyond simple forgetfulness Often times it involves forgetting some traumatic event Somewhat controversial disorder Like repressed memories

17 Dissociative Identity Disorder Multiple personality disorder Not schizophrenia – which we will talk about later The existence within the same person of two or more distinct personalities. Used to be very rare (but became more common since 1970s) Most recorded cases are restricted to North America Rare in France, England, Russia, and India None in Japan? Usually this disorder occurs in patients working closely with a therapist

18 Personality Disorders These disorders represent stable abnormal personality characteristics that people are born with and are difficult to treat.

19 What is a Personality Disorder? Personality disorder- an enduring pattern of inner experience and behavior that: deviates markedly from the expectation of the individual’s culture Is pervasive and inflexible Has an onset in adolescence or early adulthood Is stable over time Leads to distress or impairment

20 What is Impaired? To be diagnosed with a personality disorder, one must exhibit behavior that is abnormal with respect to any two of the following: Thinking Mood Personal relations The control of impulses

21 The DSM’s 3 Clusters of Personality Disorders Cluster A - Odd or Eccentric (paranoid, schizoid, schizotypal) Cluster B- Dramatic, Emotional, or Erratic (antisocial, borderline, histrionic, narcissistic) Cluster C- Anxious or Fearful (avoidant, dependent, obsessive-compulsive)

22 Cluster A Paranoid Schizoid Schizotypal

23 Paranoid Distrust of others, including the belief, without reason, that others are exploiting, harming, or trying to deceive them Belief in hidden meanings Unforgiving and grudge holding

24 Schizoid Very limited range of emotion, both in expression of and experiencing Indifferent to social relationships Prefer solitary interests

25 Schizotypal Peculiarities of thinking Odd beliefs (e.g.- belief that they have telepathic or magical powers) Eccentricities of appearance, behavior, interpersonal style, and thought (e.g.- “I am not a very talkable person”)

26 Cluster B Antisocial Borderline Histrionic Narcissistic

27 Antisocial Lack of regard for the moral or legal standards in the local culture Inability to get along with others or abide by societal rules Sometimes called “psychopaths” or “sociopaths”

28 Borderline Instability in affect and self-image Problems with self-identity Rapid changes in mood Intense unstable relationships Impulsivity

29 Histrionic Overly dramatic and attention seeking Exaggerated or inappropriate displays of emotional reactions theatrical Unusual clothing, hairstyle, or makeup used to draw attention to themselves Overly concerned with their physical attractiveness and are uncomfortable when they are not the center of attention Jenna on 30 Rock

30 Narcissistic Behavior or a fantasy of grandiosity A need to be admired by others Inability to see the viewpoints of others Relationships are disturbed because of their lack of empathy and feelings of envy, arrogance, and taking advantage of others Hypersensitive to the opinions of others

31 Cluster C Avoidant Dependent Obsessive-Compulsive

32 Avoidant Social inhibition Feelings of inadequacy Extremely sensitive to criticism

33 Dependent Extreme need of other people unable to make any decisions or take an independent stand on their own Fear of separation and submissive behavior Lack self-confidence

34 Obsessive-Compulsive Perfectionism Inflexibility Obsessive-compulsive personality disorder is NOT the same as obsessive- compulsive disorder No actual obsessions or compulsions

35 Alzheimer’s Dementia, Mood Disorders, and Schizophrenia

36 Alzheimer's Disease How many get it? 15% of people over 65 35% over 85 First signs? Decline in cognitive ability forgetfulness Emotional instability depression

37 Alzheimer’s Eventually Total dementia swallowing Terminal Definitively diagnosed by autopsy Amyloid plaques Neurofibrillary tangles


39 Alzheimer's Disease Loss of neurons is common Hippocampus Amygdala entorhinal cortex


41 Alzheimer’s Disease genetic component If immediate family member 50% chance if live into 80’s Cholinergic neurons Cholinergic agonists Many don’t respond Transgenic mouse

42 Mood Disorders affective disorders disturbance of the mood is the defining symptom Symptoms and Etiology All of us have experienced depression people in whom depression is so severe and so frequent, often without obvious cause, are said to be suffering from the psychiatric disorder of depression

43 Depression is characterized by Despair Hypoactivity sleep problems Withdrawal lack of appetite an inability to care for oneself

44 Mania opposite of depression overconfident, impulsive, distractible and highly energetic Many people who suffer from depression also suffer from mania bipolar disorder (1% of people) unipolar disorder (6% of people) depression only About 10% of people suffering from a mood disorder will commit suicide

45 Diathesis /Stress model Concordance rate for bipolar disorder identical twins about 60% fraternal twins about 15% thus, there is a strong genetic component Stress can play a major role 84% experienced a severe stress in the preceding year

46 Antidepressant Drugs monoamine oxidase (MAO) inhibitors Tricyclic Antidepressants Selective serotonin reuptake inhibitors (SSRIs) Prozac Recently, serotonin -norepinephrine reuptake inhibitors (SNRIs) have proven equally effective in the treatment of depression Effexor Cymbalta

47 Monoamine Theory of Depression Most widely accepted theory of depression All the drugs are serotonin and/or norepinephrine agonists Depression due to underactivity at serotonin and norepinephrine synapses?

48 Schizophrenia Symptoms and Etiology schizophrenia literally means a splitting of psychic function (“the shattered mind”) characterized by a complex and diverse set of symptoms

49 Positive vs. Negative Symptoms Positive Hallucinations False Perceptions Delusions False Beliefs Bizarre Behaviors Negative Emotional and social withdrawal Reduced energy and motivation Apathy Poor attention

50 types of Schizophrenia Paranoid presence of auditory hallucinations prominant delusional thoughts about persecution or conspiracy often function well, and symptoms may not present until later in life beautiful mind

51 Disorganized schizophrenia disorganization of thought process hallucinations and delusions less pronounced significant impairment in ability to maintain everyday activities dressing, bathing, brushing teeth disrupted emotions flattened affect inappropriate emotions laughing at funeral

52 catatonic schizophrenia disturbance in movement catatonic stupor voluntary movement stops catatonic excitement increased movement may become immobile resist any attempt to move them may hold any position in which they are placed may voluntarily choose a contorted body position and stay that way for long periods of time echolilia mimic what people say echopraxia mimic what people do

53 Undifferentiated and Residual Undifferentiated catch all this is the diagnosis when not easily classified into the other subtypes Residual diagnosed when patient is no longer displaying prominent symptoms some patients wax and wan though varying degrees of illness Video

54 Cause of Schizophrenia? About 1% of the population is schizophrenic the incidence appears to be about the same in all parts of the world A genetic basis the concordance rate of schizophrenia in identical twins is about 45% in fraternal twins or sibs it is about 10%

55 Cause of Schizophrenia? Experiential Factors prenatal trauma Nutritional deficiency Infection stress Clearly schizophrenia is influenced by both genetics and experience the current view is that people inherit a predisposition for schizophrenia which may or may not be activated by experience

56 Dopamine Theory of Schizophrenia Chlorpromazine and Reserpine quite different from each other in terms of chemical structure Effects were very similar Didn’t start working for 2 or 3 weeks Both drugs started to produce side effects mild tremors at rest muscular rigidity a decrease in voluntary movement symptoms of Parkinson's disease

57 Dopamine Hypothesis Parkinson’s patients have a deficiency of dopamine in their brains Looks like chlorpromazine and reserpine reduce brain dopamine levels Creating parkinson’s like symptoms But alleviating symptoms of schizophrenia Thus - It was proposed that schizophrenia is associated with excessive activity in dopaminergic systems in the brain

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