2Defining Psychological Disorders Mental health workers view psychological disorders as persistently harmful thoughts, feelings, and actions.When behavior is deviant, distressful, and dysfunctional psychiatrists and psychologists label it as disordered (Comer, 2004).Intern’s Syndrome - diagnose yourself or those around you while studying a particular disorderOBJECTIVE 1| Identify criteria for judging whether behavior is psychologically disordered.
3Deviant, Distressful & Dysfunctional Deviant behavior (going naked) in one culture may be considered normal, while in others it may lead to arrest.Deviant behavior must accompany distress.If a behavior is dysfunctional it is clearly a disorder.MaladaptiveCarol BeckwithIn the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal.
4Abnormality Statistically rare Deviant from social norms Situational context - the social or environmental setting of a person’s behavior.Subjective discomfort - emotional distress or emotional pain.Maladaptive - anything that does not allow a person to function within or adapt to the stresses and everyday demands of life.
5Abnormality vs. Insanity Insanity is a legal termThe insanity defense is used to argue that a mentally ill person should not be held responsible for his or her actions.Not everyone diagnosed with a mental disorder would be able to claim insanity – that designation is determined by judges and juries.Not defined in DSM-IV-TR
6Understanding Psychological Disorders Ancient Treatments of psychological disorders include trephination, exorcism, being caged like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood.OBJECTIVE 2| Contrast the medical model of psychological disorders with the biopsychosocial perspective on disordered behavior.John W. VeranoTrephination (boring holes in the skull to remove evil forces)
8Medical ModelWhen physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders.Etiology: Cause and development of the disorder.Diagnosis: Identifying (symptoms) and distinguishing one disease from another.Treatment: Treating a disorder in a psychiatric hospital.Prognosis: Forecast about the disorder.
10DSM IVDiagnostic Statistical Manual of Mental Disorders: the big book of disorders.Operational definitions of each disorderDSM will classify disorders and describe the symptoms.DSM will NOT explain the causes or possible cures.400 psychological disorders compared to 60 in 1950’s
11Goals of DSMDescribe (400) disorders.Determine how prevalent the disorder is.Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar.Others criticize DSM-IV for “putting any kind of behavior within the compass of psychiatry.”
12Labeling Psychological Disorders Critics of the DSM-IV argue that labels may stigmatize individuals.David Rosenhan “pseudopatient” study 1970OBJECTIVE 4| Discuss the potential dangers and benefits of using diagnostic labels.Elizabeth Eckert, Middletown, NY. From L. Gamwell andN. Tomes, Madness in America, Cornell University Press.Asylum baseball team (labeling)
13Labeling Psychological Disorders 3. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.4. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes (STIGMA)Elaine Thompson/ AP PhotoTheodore Kaczynski(Unabomber)
14Anxiety DisordersA group of conditions where the primary symptoms are anxiety or defenses against anxiety.the patient fears something awful will happen to them.They are in a state of intense apprehension, uneasiness, uncertainty, or fear.Important that their behavior is maladaptive
15Phobias A person experiences sudden episodes of intense dread. Must be a deep seated, irrational fear.3 Basic CategoriesSpecificSocialAgoraphobiaPhobia List
16Generalized Anxiety Disorder GAD An anxiety disorder in which a person is continuously tense, apprehensive and in a state of autonomic nervous system arousal.The patient is constantly tense and worried, feels inadequate, is oversensitive, can’t concentrate and suffers from insomnia.No specific stimulusFree Floating
17Panic DisorderAn anxiety disorder marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking and other frightening sensations.Can be recurrent; unexpectedSymptoms: chest pain, muscle tightness, numbness and dizziness
18Obsessive-compulsive disorder Persistent unwanted thoughts (obsessions) cause someone to feel the need (compulsion) to engage in a particular action.Interfere with everyday living and cause the person distressExample: Obsession about dirt and germs may lead to compulsive hand washing.
19Obsessive-Compulsive Disorder OBJECTIVE 8| Describe the symptoms of obsessive-compulsive disorder.
20Post-Traumatic Stress Disorder Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD) after a deeply troubling event:Haunting memories2. Nightmares3. Social withdrawalOBJECTIVE 9| Describe the symptoms of post-traumatic stress disorder, and discuss survivor resiliency.4. Jumpy anxiety5. Sleep problemsBettmann/ Corbis
21Resilience to PTSDOnly about 10% of women and 20% of men react to traumatic situations and develop PTSD.Survivor Resilience- Holocaust survivors show remarkable resilience against traumatic situations.Post-traumatic Growth- All major religions of the world suggest that surviving a trauma leads to the growth of an individual and a new positive view on life.
22Somatoform DisordersOccur when a person manifests a psychological problem through a physiological symptom without a physiological causeTwo types……
23HypochondriasisHas frequent physical complaints for which medical doctors are unable to locate the cause.They usually believe that the minor issues (headache, upset stomach) are indicative are more severe illnesses.
24Body Dysmorphic Disorder Intense anxiety about perceived physical deformity or defectFlaw is usually minor or imaginedWestern Civilization and its effect…
25Dissociative Disorders These disorders involve a disruption in the conscious process.Separated from previous memories, thoughts, and feelings in response to a stressful situation
26Dissociative Identity Disorder Used to be known as Multiple Personality Disorder.A person exhibits two or more distinct and alternating personalitiesMay not know about one anotherPeople with DID commonly have a history of childhood abuse or trauma.
27DID CriticsCritics argue that the diagnosis of DID increased in the late 20th century. DID has not been found in other countries.Critics’ ArgumentsRole-playing by people open to a therapist’s suggestion.2. Learned response that reinforces reductions in anxiety.Psychoanalytic Viewpoint – protect us against a painful memory
28Mood Disorders Experience extreme or inappropriate emotion. Also known as Affective Disorders
29Major Depression A.K.A. unipolar depression Unhappy for at least two weeks with no apparent cause.Sadness, hopelessness and worthlessness, loss of energy, changes in appetite and sleepDepression is the “common cold” of psychological disorders.5.8% Men vs. 9.5% Women
30Theory of Depression Gender differences Women get sadder, men get madder.
31Neurotransmitters & Depression A reduction of norepinephrine and serotonin has been found in depression.Drugs that alleviate mania reduce norepinephrine.Pre-synapticNeuronSerotoninNorepinephrinePost-synapticNeuron
32The Depressed Brain & Genetic Influences PET scans show that brain energy consumption rises and falls with manic and depressive episodes. (Left Frontal Lobe)Identical Twins- 1 in 2 will have depressive disorder; 7 in 10 will have bipolar disorder
33Bipolar Disorder Formally manic depression. Involves periods of depression and manic episodes.Manic episodes involve feelings of high energy, euphoria, inflated self esteembut they tend to differ a lot…some get confident and some get irritableEngage in risky behavior during the manic episode.
34Bipolar DisorderMany great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase.WhitmanWolfeClemensHemingwayGeorge C. Beresford/ Hulton Getty Pictures LibraryEarl Theissen/ Hulton Getty Pictures LibraryThe Granger CollectionBettmann/ Corbis
35Personality Disorders Well-established, maladaptive ways of behaving that negatively affect people’s ability to function.Dominates their personality.Hard to tell apart and treat
36Antisocial Personality Disorder Lack of empathy.Little regard for other’s feelings.View the world as hostile and look out for themselves.Manipulative, rebellious, hurtfulSociopath/ (psychopath)Conduct Disorder
37Understanding Antisocial Personality Disorder PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow-up study repeat offenders had 11% less frontal lobe activity compared to normals (Raine et al., 1999; 2000).Courtesy of Adrian Raine,University of Southern CaliforniaNormalMurderer
38Histrionic Personality Disorder Needs to be the center of attention and a tendency toward highly emotional behavior.Whether acting silly or dressing provocatively.Needs reassurance they are worth something
39Narcissistic Personality Disorder Having an unwarranted sense of self-importance and an extreme preoccupation with themselves.Thinking that you are the center of the universe.Needs reassurance they are better
40Paranoid Personality Disorder Persistent suspicion marked by the chronic sense of being observed and persecutedHighly suspicious of others
41Borderline Personality Disorder Sudden and intense rages, deep insecurity and fear of abandonment, and general instability in relationshipsImpulsiveHigh suicide risk group
42Schizophrenic Disorders If depression is the common cold of psychological disorders, schizophrenia is the cancer.About 1 in every 100 people are diagnosed with schizophrenia.Schizophrenia strikes young people as they mature into adults.It affects men and women equally, but men suffer from it more severely than women.Symptoms of SchizophreniaDisorganized thinking.Disturbed PerceptionsInappropriate Emotions and Actions
43Disorganized Thinking The thinking of a person with Schizophrenia is fragmented and bizarre and distorted with false beliefs.Word SaladDisorganized thinking comes from a breakdown in selective attention.- they cannot filter out information.
44Disturbed Perceptions hallucinations- sensory experiences without sensory stimulation.Usually auditoryThey do not exist!
45Disturbed Perceptions Delusions- false beliefsDelusions of Persecution or ParanoiaDelusions of GrandeurDelusions of ReferenceBeautiful Mind
46Inappropriate Emotions and Actions ApathyLaugh at inappropriate times.may laugh at the news of someone dyingFlat Effect- show no emotion at allCatatoniamotionless Waxy Flexibilitysenseless, compulsive acts.may continually rub an arm, rock a chair, or remain motionless for hours
48Positive and Negative Symptoms Positive SymptomsSchizophrenics have inappropriate symptoms (hallucinations, disorganized thinking, deluded ways) that are not present in normal individuals.(presence)Negative SymptomsSchizophrenics also have an absence of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals.(absence)
50Understanding Schizophrenia: Biological Model Schizophrenia is a disease of the brain exhibited by the symptoms of the mind.Brain AbnormalitiesDopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain.OBJECTIVE 18| Outline some abnormal brain functions and structures associated with schizophrenia, and discuss the possible link between prenatal viral infections and schizophrenia.
51Abnormal Brain Activity Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Adolescent schizophrenic patients also have brain lesions.Paul Thompson and Arthur W. Toga, UCLA Laboratory of NeuroImaging and Judith L. Rapport, National Institute of Mental Health
52Abnormal Brain Morphology Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles.Effects frontal lobes and temporal lobesBoth Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC
53Genetic FactorsThe likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 1991).IdenticalBoth parentsFraternalOne parentSiblingNephew or nieceUnrelated46xOBJECTIVE 19| Discuss the evidence for a genetic contribution to the development of schizophrenia.6x
54Genetic FactorsThe following shows the prevalence of schizophrenia in identical twins as seen in different countries. Averages out to about 1 in 2
55Early warning signs of schizophrenia include: 1.A mother’s long lasting schizophrenia.2.Birth complications, oxygen deprivation and low-birth weight.3.Short attention span and poor muscle coordination.4.Disruptive and withdrawn behavior.5.Emotional unpredictability.6.Poor peer relations and solo play.