1. Psychological Disorders

2. U – njustifiable
M – aladaptive
A – typical
D – istorted thinking,
D-isturbed

3. Qualitatively
Quantitatively

4. Etiology Psychoanalytic theory Humanistic theory Behavioral theory
Cognitive theory
Psychophysiological
Cultural

5. Classifying Psychological Disorders
DSM IV TR
Classification orders and describes symptoms
Predicts its future course
Treatment
Stimulate research

6. Five Levels of Diagnosis
Axis I: Is a clinical syndrome present?
Axis II: Is a personality disorder or mental retardation present?
Axis III: General medical condition present?
Axis IV: Are psychosocial or environmental problems present?
Axis V: What is the global assessment?

7. Anxiety Disorders Most common disorder after substance abuse
What differentiates phobias and normal fear?
Intensity
Length of anxiety
Able to adequately respond

8. Anxiety Disorders Generalized anxiety disorder – continuously tense
Phobic disorder – irrational and intense fear of object
Obsessive compulsive disorder – repetitive thoughts or actions
Panic disorder – anxiety tornado
“fear of fear”, sudden episodes
Post traumatic stress disorder – after trauma

9. Panic Disorder:
Minute-long episodes of intense dread which may include feelings of terror, chest pains, choking, or other frightening sensations.
Anxiety is a component of both disorders (generalized anxiety disorder and panic disorder). It occurs more in the panic disorder, making people avoid situations that cause it.

10. Post-traumatic stress disorder (PTSD)
Affects soldiers from Vietnam, Operation Desert Storm, and Iraqi wars; also Nazi death camp and prison camp survivors)
Suffering severe reactions years after traumatic event (some recover, some get worse over time)
Experiences include:
Dreams with horror
Intense emotional bodily reactions
Difficulty concentrating or sleeping

11. Stressors Causing PTSD
Combat-related events
Sudden death of loved one
Involved in or witnessing accidents
Physical assault, rape, sexual molestation experienced by women
Terrorism experiences

12. Who Develops PTSD Four factors involved Severity of stress
Risk increased when physical injury occurs
Person’s characteristics before event
Affects those with higher anxiety levels, lower intelligence, previous mental health problems
Social support
More support lessens risk
Sex of the victim
Women more at risk

13. Etiology of Anxiety Disorders
Psychoanalytic –
GAD – id overcomes ego => anxiety
Phobias – Little Hans
OCD – fixated an anal stage
Behavioral – classical conditioning, modeling, reinforcement
Little Albert
Humanistic – gap between one’s real self and ideal self
Cognitive – misinterpret bodily sensations, lack ability to cope with stress
Biomedical
– genetic predisposition,
Lower levels of GABA neurotransmitter – inhibitory “brakes of a car”
Malfunctions in amygdala – part of brain that deals with agression and fear

14. Kinds of Phobias - Intense, unrealistic or irrational fear
Agoraphobia
Phobia of open places.
Acrophobia
Phobia of heights.
Claustrophobia
Phobia of closed spaces.
Hemophobia
Phobia of blood.

15. Phobias Agoraphobia – fear of panic attacks in public places
Social phobias – social anxiety disorders
More women than men
Irrational fear of being embarrassed, judged or critically evaluated by others
Realize that their fear is excessive but they still approach social situations with tremendous anxiety

16. Phobias More unusual phobias: Amathophobia- fear of dust
Amenophobia – fear of wind
Aphephobia – fear of being touched by another person
Bibliophobia- fear of books
Catotrophobia – fear of breaking a mirror
Ergophobia – fear of work or responsibility
Gamophobia – fear of marriage
Hypertrichophobia – fear of growing excessive amounts of body hair
Levophobia – fear of things being on the left side of your body
Phobophobia – fear of acquiring a phobia
Phonophobia – fear of sound of your own fource
Triskaidekaphobia – fear of the number 13

17. Phobias
Humans are predisposed – biologically prepared to acquire certain fears
Fear of particular situations – flying, driving, tunnels, bridges, elevators, crowds, enclosed places
Fear of features of the natural environment – thunder, heights, water
Fear of injury or blood – injections, needles, medical or dental procedures
Fear of animals and insects – snakes, spiders, dogs, slugs, bats

18. Agoraphobia – fear of panic attacks in public places
Social phobias – social anxiety disorders
More women than men
Irrational fear of being embarrassed, judged or critically evaluated by others
Realize that their fear is excessive but they still approach social situations with tremendous anxiety

19. Somatoform Disorders Four types
Experiencing symptoms of physical health problems with psychological causes, Symptoms take a somatic (bodily) form without apparent physical cause
Four types
Hypochondriasis – preoccupation with health
Conversion disorders – symptoms not medically possible
person experiences very specific genuine physical symptoms for which no physiological basis can be found
Somatoform pain disorders – primary symptom is pain with no physical cause
Body dysmorphic disorder - exaggerated concern and preoccupation about minor or imagined defects in appearance

20. Somatoform Disorders
Symptoms take a somatic (bodily) form without apparent physical cause
Conversion disorder: person experiences very specific genuine physical symptoms for which no physiological basis can be found
Hypocondriasis: person interprets normal physical sensations as symptoms of a disease
Body dysmorphic disorder: exaggerated concern and preoccupation about minor or imagined defects in appearance

21. Disassociative Disorders
Broad category of loosely related conditions
Conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. People lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity
Dissociative amnesia – psychological cause
Dissociative fugue – complete loss of memory
Dissociative identity disorder – once known as multiple personality disorder; very controversial issue

22. Criticism of DID
Critics argue that the diagnosis of DID increased in the late 20th century. DID has not been found in other countries.
Role-playing by people open to a therapist’s suggestion.
Learned response that reinforces reductions in anxiety

23. Mood Disorders
Extreme and persistent feelings of despondency, worthlessness and hopelessness, causing…
impaired emotional, cognitive, behavioral and physical functioning
Blue mood
Major Depressive Disorder
Gasping for air after a hard run
Chronic shortness of breath

24. impaired emotional, cognitive, behavioral and physical functioning
Mood Disorders
Extreme and persistent feelings of despondency, worthlessness and hopelessness, causing…
impaired emotional, cognitive, behavioral and physical functioning

25. Types of mood disorders
Major depression – “common cold” of psychological disorders
Dysthymic disorder
Seasonal affect disorder – depression associated with seasons
Bipolar – emotional roller coaster
Cyclothymic Disorder - moderate mood swings

26. Etiology of Mood Disorders
Genetic predisposition
Disruptions in brain chemistry
Antidepressants – increase 2 neurotransmitters
Norepinephrine
Seratonin
Lithium – regulates avaliability of NT called glutamate
Stress

27. Inability to make decisions
Bipolar disorder
Formerly called manic-depressive disorder. An alternation between depression and mania signals bipolar disorder.
Gloomy
Elation
Withdrawn
Euphoria
Inability to make decisions
Desire for action
Tired
Hyperactive
Slowness of thought
Multiple ideas

28. Explaining Depression…
Cognitive
Beck
Attributions
Internal personal factors/external situational factors
Stable or unstable over time
Global /specific implications
People who make global, stable, internal
personal attribution => more prone to depression
Seligman: learned helplessness
Depression is caused by person learning that his effort does not pay off “giving up behavior”
Originally conditioning => more cognitive slant

29. Etiology of Depression (con’t)
Cognitive
Beck
Attributions
Internal personal factors/external situational factors
Stable or unstable over time
Global /specific implications
People who make global, stable, internal
personal attribution => more prone to depression
Seligman: learned helplessness
Depression is caused by person learning that his effort does not pay off “giving up behavior”
Originally conditioning => more cognitive slant

30. Etiology of Depression (con’t)
Behavioral:
Inadequate social skills
Not enough reinforcement of social relationships
Depressed people can be depressing to be around

31. Social-Cognitive Perspective
The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles.

32. Disassociative Disorders
People lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity
Disassociatve amnesia
Disassociative fugue
Disassociatve Identity Disorder or Multiple personality disorder

33. Schizophrenia “split mind” – split from reality Disorganized thinking
Delusions -false beliefs, grandeur
Disorganized perceptions
Hallucinations – sensory experiences without sensory stimulation
Inappropriate emotions or action
Laughing when inappropriate/flat affect

34. Subtypes of schizophrenia
Paranoid
Disorganized
Catatonic
Undifferentiated

35. Schizophrenia “split mind” – split from reality Disorganized thinking
Delusions -false beliefs, grandeur
Disorganized perceptions
Hallucinations – sensory experiences without sensory stimulation
Inappropriate emotions or action
Laughing when inappropriate/flat affect

36. Schizophrenia Subtypes Paranoid schizophrenia
False beliefs, delusions (grandeur, paranoia, persecution), hallucinations
Disorganized schizophrenia
Delusions, hallucinations, cognitive processes highly disorganized or fragmented
Extreme social withdrawal
Catatonic schizophrenia
May have delusions and hallucinations; most abnormalities in social interaction, body posture and movement (waxy flexibility in stupors)

37. Schizophrenics have inappropriate symptoms (hallucinations, disorganized thinking, deluded ways) that are not present in normal individuals (positive symptoms). Schizophrenics also have an absence of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals (negative symptoms).

38. Understanding Schizophrenia
Schizophrenia is a disease of the brain exhibited by the symptoms of the mind.
Brain Abnormalities
Dopamine 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.

39. 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

40. Abnormal Brain Morphology
Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles.
Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC

41. Viral Infection
Schizophrenia has also been observed in individuals who contracted a viral infection (flu) during the middle of their fetal development.

42. 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
OBJECTIVE 19| Discuss the evidence for a genetic contribution to the development of schizophrenia.

43. Genetic Factors
The following shows the prevalence of schizophrenia in identical twins as seen in different countries.

44. Psychological Factors
Psychological and environmental factors can trigger schizophrenia if the individual is genetically predisposed (Nicols & Gottesman, 1983).
The genetically identical Genain
sisters suffer from schizophrenia. Two more than others, thus there are contributing environmental factors.
OBJECTIVE 20| Describe some psychological factors that may be early signs of schizophrenia in children.
Courtesy of Genain Family
Genain Sisters

45. Personality Disorders
Personality disorders are characterized by inflexible and enduring behavior patterns that impair social functioning. They are usually without anxiety, depression, or delusions.
Schizoid personality disorder
Blunted emotions, social withdrawal, but no serious cognitive disturbances
Antisocial personality disorder
Feel little guilt, exploit others, frequent violation of social rules and laws
Difficulty with personal relationships
Low tolerance for frustration, lie easily/skillfully
OBJECTIVE 21| Contrast the three clusters of personality disorders, and describe the behaviors and brain activity associated with antisocial personality disorders.

46. Personality Disorders
Inflexible, maladaptive patterns of thoughts, emotions, behavior and interpersonal functioning that are stable over time and across situations, and deviate from the expectations of the individual’s culture
Person doesn’t consider his personality characteristics as problematic => don’

47. Types of Personality Disorders
Odd, eccentric
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Dramatic, emotional, erratic
Antisocial Personality Disorder
Borderline Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
Anxious, fearful
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder

48. Antisocial Personality Disorder
A disorder in which the person (usually men) exhibits a lack of conscience for wrongdoing, even toward friends and family members. Formerly, this person was called a sociopath or psychopath.

49. Understanding Antisocial Personality Disorder
Like mood disorders and schizophrenia, antisocial personality disorder has biological and psychological reasons. Youngsters, before committing a crime, respond with lower levels of stress hormones than others do at their age.

50. 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).
Courtesy of Adrian Raine,
University of Southern California
Normal
Murderer

51. Understanding Antisocial Personality Disorder
The likelihood that one will commit a crime doubles when childhood poverty is compounded with obstetrical complications (Raine et al., 1999; 2000).

52. Risk and Protective Factors
Risk and protective factors for mental disorders (WHO, 2004).

53. Risk and Protective Factors