2Psychological Disorder A “harmful dysfunction” in which behavior is judged to be atypical, disturbing, maladaptive and unjustifiable.What is abnormal, disturbing maladaptive and unjustifiable depends on:CultureTime PeriodEnvironmental ConditionsIndividual Person
3Defining 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).The 3 D’sOBJECTIVE 1| Identify criteria for judging whether behavior is psychologically disordered.
4Deviant, 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.Carol BeckwithIn the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal.
5Early TheoriesAfflicted people were possessed by evil spirits.
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)
7Early Theories In some cases trephening was used: Music or singing was often used to chase away spirits.In some cases trephening was used:Cutting a hole in the head of the afflicted to let out the evil spirit.
9Early TheoriesAnother theory was to make the body extremely uncomfortable.
10History of Mental Disorders In the 1800’s, disturbed people were no longer thought of as madmen, but as mentally ill.They were first put in hospitals.Did this mean better treatment?
11Early Mental Hospitals They were nothing more than barbaric prisons.The patients were chained and locked away.Some hospitals even charged admission for the public to see the “crazies”, just like a zoo.
12Philippe PinelFrench doctor who was the first to take the chains off and declare that these people are sick and “a cure must be found!!!”
13SomatogenicAt this time- it was believed that mental illness had a bodily cause- Somatogenic.But Somatogenic could not explain disorders such as hysteria (now called conversion disorder).Many disorders are psychogenic: the origin is psychological, not physical.
14Medical 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.
15Current PerspectivesMedical Perspective: psychological disorders are sicknesses and can be diagnosed, treated and cured.
16Current PerspectivesBio-Psycho-Social Perspective: assumes biological, psychological and sociocultural factors combine to interact causing psychological disorders.Used to be called Diathesis-Stress Model: diathesis meaning predisposition and stress meaning environment.
17Classifying Psychological Disorders The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe psychological disorders.The most recent edition, DSM-IV-TR (Text Revision, 2000), describes 400 psychological disorders compared to 60 in the 1950s.OBJECTIVE 3| Describe the goals and content of the DSM-IV.
18Classifying Psychological Disorders DSM-IV: Diagnostic Statistical Manual of Mental Disorders: the big book of disorders.Two Major Classifications:
19Neurotic DisordersDistressing but one can still function in society and act rationally
20Psychotic DisordersPerson loses contact with reality, experiences distorted perceptions
21Multiaxial Classification Axis IIs a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present?Axis IIIs a Personality Disorder or Mental Retardation present?Axis IIIIs a General Medical Condition (diabetes, hypertension or arthritis etc) also present?Axis IVAre Psychosocial or Environmental Problems (school or housing issues) also present?Axis VWhat is the Global Assessment of the person’s functioning?
22Multiaxial Classification Note 16 syndromes in Axis I
23Multiaxial Classification Note Global Assessment for Axis V
24Goals 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.”
25Labeling Psychological Disorders Critics of the DSM-IV argue that labels may stigmatize individuals.Rosenthal-Being sane in insane placesOBJECTIVE 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)
26Labeling Psychological Disorders 2. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.
27Labeling Psychological Disorders 3. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes.Elaine Thompson/ AP PhotoTheodore Kaczynski(Unabomber)
28Anxiety Disordersa group of conditions where the primary symptoms are anxiety or defenses against anxiety.the patient fears something awful will happen to them.
29What is anxiety?is a state of intense apprehension, uneasiness, uncertainty, or fear.
30Generalized Anxiety Disorder 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.
31Panic 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 cause secondary disorders, such as agoraphobia.
32PhobiasA person experiences sudden episodes of intense dread.
34Obsessive Compulsive Disorder An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions).
35Common Examples of OCD Common Obsessions: Common Compulsions: Contamination fears of germs, dirt, etc.WashingImagining having harmed self or othersRepeatingImagining losing control of aggressive urgesCheckingIntrusive sexual thoughts or urgesTouchingExcessive religious or moral doubtCountingForbidden thoughtsOrdering/arrangingA need to have things "just so"Hoarding or savingA need to tell, ask, confessPraying
36Explanations for Anxiety Disorders You Learn them through conditioning.EvolutionGenesPhysiology (the brain)
38Dissociative Disorders Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts and feelings.
39Dissociative AmnesiaThis disorder is characterized by a blocking out of critical personal information, usually of a traumatic or stressful nature.
40Dissociative AmnesiaDissociative amnesia, unlike other types of amnesia, does NOT result from other medical trauma (e.g. a blow to the head).
41Dissociative AmnesiaLocalized amnesia is present in an individual who has no memory of specific events that took place, usually traumatic. The loss of memory is localized with a specific window of time. For example, a survivor of a car wreck who has no memory of the experience until two days later is experiencing localized amnesia.Selective amnesia happens when a person can recall only small parts of events that took place in a defined period of time. For example, an abuse victim may recall only some parts of the series of events around the abuse.Generalized amnesia is diagnosed when a person's amnesia encompasses his or her entire life.Systematized amnesia is characterized by a loss of memory for a specific category of information. A person with this disorder might, for example, be missing all memories about one specific family member.
42Dissociative FugueAn individual with dissociative fugue suddenly and unexpectedly takes physical leave of his or her surroundings and sets off on a journey of some kind.These journeys can last hours, or even several days or months.
43Dissociative FugueIndividuals experiencing a dissociative fugue have traveled over thousands of miles.An individual in a fugue state is unaware of or confused about his identity, and in some cases will assume a new identity (although this is the exception).
44Depersonalization Disorder is marked by a feeling of detachment or distance from one's own experience, body, or self.One can easily relate to feeling as they in a dream, or being "spaced out."A person's experience with depersonalization can be so severe that he or she believes the external world is unreal or distorted.
45Dissociative Identity Disorder A rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities.Also known as multiple personality disorder.
51Major Depressive Disorder A person, for no apparent reason, experiences two or more weeks of depressive moods.Includes feelings of worthlessness and diminished interest or pleasure in most activities.
52Dysthymic DisorderSuffering from mild depression every day for at least two years.
61How Prevalent?About 1 in every 100 people are diagnosed with schizophrenia.
62Symptoms of Schizophrenia Disorganized thinking.Disturbed PerceptionsInappropriate Emotions and Actions
63Disorganized Thinking The thinking of a person with Schizophrenia is fragmented and bizarre and distorted with false beliefs.Disorganized thinking comes from a breakdown in selective attention.- they cannot filter out information.Often causes………
64Delusions (false beliefs) Delusions of PersecutionDelusions of Grandeur
65Disturbed Perceptions hallucinations- sensory experiences without sensory stimulation.
66Inappropriate Emotions and Actions Laugh at inappropriate times.Flat EffectSenseless, compulsive acts.Catatonia- motionless Waxy Flexibility
67Positive v. Negative Symptoms Positive SymptomsPresence of inappropriate symptomsNegative SymptomsAbsence of appropriate ones.
69Paranoid Schizophrenia preoccupation with delusions or hallucinations.Somebody is out to get me!!!!
70Disorganized Schizophrenia disorganized speech or behavior, or flat or inappropriate emotion.
71Catatonic Schizophrenia parrot like repeating of another’s speech and movements
72Undifferentiated Schizophrenia Many and varied Symptoms.
73Personality Disorders Psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning.
74Paranoid Personality Disorder Paranoid personality disorder is characterized by a distrust of others and a constant suspicion that people around you have sinister motives.
75Paranoid Personality Disorder They search for hidden meanings in everything and read hostile intentions into the actions of others.They are quick to challenge the loyalties of friends and loved ones and often appear cold and distant to others. They usually shift blame to others and tend to carry long grudges.
76Antisocial Personality Disorder antisocial personality disorder is characterized by a lack of consciencePeople with this disorder are prone to criminal behavior, believing that their victims are weak and deserving of being taken advantage of. They tend to lie and steal
77Antisocial Personality Disorder they are careless with money and take action without thinking about consequencesThey are often aggressive and are much more concerned with their own needs than the needs of others.
78Borderline Personality Disorder characterized by mood instability and poor self-imagePeople with this disorder are prone to constant mood swings and bouts of anger.
79Borderline Personality Disorder they will take their anger out on themselves, causing themselves injurySuicidal threats and actions are not uncommonThey are quick to anger when their expectations are not met.
80Histrionic Personality Disorder constant attention seekersThey need to be the center of attention all the time, often interrupting others in order to dominate the conversation.
81Histrionic Personality Disorder They may dress provocatively or exaggerate illnesses in order to gain attention.They also tend to exaggerate friendships and relationships, believing that everyone loves them
82Narcissistic Personality Disorder characterized by self-centerednessThey exaggerate their achievements, expecting others to recognize them as being superior
83Narcissistic Personality Disorder They tend to be choosy about picking friends, since they believe that not just anyone is worthy of being their friend.They are generally uninterested in the feelings of others and may take advantage of them.
84Schizoid Personality Disorder People with schizoid personality disorder avoid relationships and do not show much emotionThey genuinely prefer to be alone and do not secretly wish for popularity.
85Schizoid Personality Disorder They tend to seek jobs that require little social contactTheir social skills are often weak and they do not show a need for attention or acceptanceThey are perceived as humorless and distant and often are termed "loners."
86Schizotypal Personality Disorder characterized by a need for social isolation, odd behavior and thinking, and often unconventional beliefs such as being convinced of having extra sensory abilities.Some people believe that schizotypal personality disorder is a mild form of schizophrenia.
87Avoidant personality disorder characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and extreme sensitivity to negative evaluation.consider themselves to be socially inept or personally unappealing, and avoid social interaction for fear of being ridiculed or humiliated.
88Dependent personality disorder characterized by a pervasive psychological dependence on other people.has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
89Obsessive Compulsive Personality Disorder characterized by a general psychological inflexibility, rigid conformity to rules and procedures, perfectionism, and excessive orderliness.people with OCPD tend to stress perfectionism above all else, and feel anxious when they perceive that things aren't "right".