2 Defining 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 disorder
3 Deviant, Distressful & Dysfunctional 1.Deviant behavior (going naked) in one culture may be considered normal, while in others it may lead to arrest. 2.Deviant behavior must accompany distress. 3. If a behavior is dysfunctional it is clearly a disorder. Maladaptive In the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal. Carol Beckwith
Abnormality 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.
Abnormality vs. Insanity Insanity is a legal term The 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
6 Understanding 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. Trephination (boring holes in the skull to remove evil forces) John W. Verano
8 Medical Model When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. 1.Etiology: Cause and development of the disorder. 2.Diagnosis: Identifying (symptoms) and distinguishing one disease from another. 3.Treatment: Treating a disorder in a psychiatric hospital. 4.Prognosis: Forecast about the disorder.
9 Biopsychosocial Perspective
DSM IV Diagnostic Statistical Manual of Mental Disorders: the big book of disorders. Operational definitions of each disorder DSM 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 10
11 Goals of DSM 1.Describe (400) disorders. 2.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.”
12 Labeling Psychological Disorders 1.Critics of the DSM-IV argue that labels may stigmatize individuals. 2.David Rosenhan “pseudopatient” study 1970 study Asylum baseball team (labeling) Elizabeth Eckert, Middletown, NY. From L. Gamwell and N. Tomes, Madness in America, Cornell University Press.
13 Labeling 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) Theodore Kaczynski (Unabomber) Elaine Thompson/ AP Photo
Anxiety Disorders A 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 14
Phobias A person experiences sudden episodes of intense dread. Must be a deep seated, irrational fear. 3 Basic Categories Specific Social Agoraphobia Phobia List Phobia List Phobia List 15
Generalized 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 stimulus Free Floating 16
Panic Disorder An 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; unexpected Symptoms: chest pain, muscle tightness, numbness and dizziness 17
Obsessive-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 distress Example: Obsession about dirt and germs may lead to compulsive hand washing. 18
19 Obsessive-Compulsive Disorder
20 Post-Traumatic Stress Disorder Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD) after a deeply troubling event: 1.Haunting memories 2.Nightmares 3.Social withdrawal 4.Jumpy anxiety 5.Sleep problems Bettmann/ Corbis
21 Resilience to PTSD Only 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.
Somatoform Disorders Occur when a person manifests a psychological problem through a physiological symptom without a physiological cause Two types…… 22
Hypochondriasis Has 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. 23
Body Dysmorphic Disorder Intense anxiety about perceived physical deformity or defect Flaw is usually minor or imagined Western Civilization and its effect…
Dissociative Disorders These disorders involve a disruption in the conscious process. Separated from previous memories, thoughts, and feelings in response to a stressful situation 25
Dissociative Identity Disorder Used to be known as Multiple Personality Disorder. A person exhibits two or more distinct and alternating personalities May not know about one another People with DID commonly have a history of childhood abuse or trauma. 26
27 DID Critics Critics argue that the diagnosis of DID increased in the late 20 th century. DID has not been found in other countries. Critics’ Arguments 1.Role-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
Mood Disorders Experience extreme or inappropriate emotion. Also known as Affective Disorders 28
Major 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 sleep Depression is the “common cold” of psychological disorders. 5.8% Men vs. 9.5% Women 29
30 Theory of Depression Gender differences Women get sadder, men get madder.
31 Neurotransmitters & Depression Post-synaptic Neuron Pre-synaptic Neuron Norepinephrine Serotonin A reduction of norepinephrine and serotonin has been found in depression. Drugs that alleviate mania reduce norepinephrine.
32 The 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
Bipolar Disorder Formally manic depression. Involves periods of depression and manic episodes. Manic episodes involve feelings of high energy, euphoria, inflated self esteem but they tend to differ a lot…some get confident and some get irritable Engage in risky behavior during the manic episode. 33
34 Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Whitman WolfeClemensHemingway Bettmann/ Corbis George C. Beresford/ Hulton Getty Pictures Library The Granger Collection Earl Theissen/ Hulton Getty Pictures Library
Personality Disorders Well-established, maladaptive ways of behaving that negatively affect people’s ability to function. Dominates their personality. Hard to tell apart and treat 35
Antisocial Personality Disorder Lack of empathy. Little regard for other’s feelings. View the world as hostile and look out for themselves. Manipulative, rebellious, hurtful Sociopath/ (psychopath) Conduct Disorder 36
37 Understanding 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). Normal Murderer Courtesy of Adrian Raine, University of Southern California
Histrionic 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 38
Narcissistic 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 39
Paranoid Personality Disorder Persistent suspicion marked by the chronic sense of being observed and persecuted Highly suspicious of others
Borderline Personality Disorder Sudden and intense rages, deep insecurity and fear of abandonment, and general instability in relationships Impulsive High suicide risk group 41
Schizophrenic 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 Schizophrenia 1.Disorganized thinking. 2.Disturbed Perceptions 3.Inappropriate Emotions and Actions 42
Disorganized Thinking The thinking of a person with Schizophrenia is fragmented and bizarre and distorted with false beliefs. Word Salad Disorganized thinking comes from a breakdown in selective attention.- they cannot filter out information. 43
Disturbed Perceptions hallucinations- sensory experiences without sensory stimulation. Usually auditory They do not exist! 44
Disturbed Perceptions Delusions- false beliefs Delusions of Persecution or Paranoia Delusions of Grandeur Delusions of Reference Beautiful Mind 45
Inappropriate Emotions and Actions Apathy Laugh at inappropriate times. may laugh at the news of someone dying Flat Effect- show no emotion at all Catatonia motionless Waxy Flexibility senseless, compulsive acts. may continually rub an arm, rock a chair, or remain motionless for hours 46
Types of Schizophrenia 47
48 Positive and Negative Symptoms Positive Symptoms Schizophrenics have inappropriate symptoms (hallucinations, disorganized thinking, deluded ways) that are not present in normal individuals. (presence) Negative Symptoms Schizophrenics also have an absence of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals. (absence)
50 Understanding Schizophrenia: Biological Model Schizophrenia is a disease of the brain exhibited by the symptoms of the mind. Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain. Brain Abnormalities
51 Abnormal 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 Neuro Imaging and Judith L. Rapport, National Institute of Mental Health
52 Abnormal Brain Morphology Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles. Effects frontal lobes and temporal lobes Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC
53 Genetic Factors The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 1991) Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated 6x 46x
54 Genetic Factors The following shows the prevalence of schizophrenia in identical twins as seen in different countries. Averages out to about 1 in 2
55 Warning Signs Early warning signs of schizophrenia include: Birth complications, oxygen deprivation and low-birth weight. 2. Short attention span and poor muscle coordination.3. Poor peer relations and solo play.6. Emotional unpredictability.5. Disruptive and withdrawn behavior.4. A mother’s long lasting schizophrenia.1.