PSYCHOLOGICAL DISORDERS n Redefining our perceptions of what constitutes psychological disorders. n Learning to ask “Why?” n Focus on observable data.

n Learning Objectives: n Introduction: 3 cases n Anxiety Disorders n Dissociative Disorders n Somatoform Disorders n Mood Disorders n Schizophrenia n Personality Disorders PSYCHOLOGICAL DISORDERS

Psychological Disorders n Three cases: u Jim Gordon u Vincent “The Chin “Gigante u Andrea Yates n What is Insanity? n Disease vs. Disorder (illness) What’s your perception? n Psychological Disorders

Psychological Disorders n A brief history: the pendulum swings u Greeks: perceived natural causes u Middle Ages: natural & supernatural causes u Colonial America: supernatural or natural? u hysteria + ergot = trouble u Present: natural versus supernatural u The role of technology

Anxiety Disorders n Phobias (irrational fears) u specific, social n Panic Disorder n Generalized Anxiety Disorders u at least 6 months duration n Obsessive-Compulsive Disorder u thoughts and actions

Anxiety Disorders n Post Traumatic Stress Disorder (PTSD) n Acute Stress Disorder u occurs w/i 1 month of event, lasts 2 days - 4 weeks n Gamma-aminobutyric Acid (GABA) u Inhibitory neurotransmitter implicated in anxiety reactions u aids in calming us during anxiety

Dissociative Disorders n Sudden, temporary changes in consciousness or self identity. u Dissociative Amnesia, Fugue (fleeing) u Depersonalization Disorder u Dissociative Identity Disorder (MPD); Most extreme form of chronic PTSD, Dissociation as coping mechanism F Four Cases: n Chris Sizemore; Shirley Ardell Mason; Billy Milligan; Truddi Chase.

Somatoform Disorders n Complaints of physical (somatic) problems despite physical abnormalities. n Symptoms are not intentional. n Motivation for illness is unconscious

Conversion Disorder n unconscious conflicts are converted into physical symptoms. n Symptoms are often significant to the patient. n Can persist for years.

Conversion Disorder n FYI: Hysteria = womb / uterus u Psychosomatic (Hysterical) Blindness u Psychosomatic (Hysterical) Pregnancy F Couvade n “La belle Indifference” u characterized by an indifference to their symptoms.

Conversion Disorder n Hypochondriasis u Not attention seeking behavior n Related Somatoform Disorders: u Pain Disorder u Body Dysmorphic Disorder

Mood Disorders n Major Depression u Characteristics u Types n Bipolar Disorder (manic depression) u Types n Seasonal Affective Disorder

Suicide n Rates u 300,000 people per year n Factors u Links to depression / hopelessness n Diversity n Myths

Schizophrenia n Split between thought and reality n Characteristics u Delusions u Stupor u Loss of control of thought processes u inappropriate emotional responses u Onset n 1% of population

Schizophrenia n Three types: u Paranoid u Disorganized u Catatonic : waxy flexibility, mutism n Dopamine Hypothesis: Glutamate may be the more important precursor.

Personality Disorders Enduring patterns of maladaptive behavior. u Sources of distress to the individual or others. n Overview of Types of Personality Disorders. u Paranoid / Schizotypal / Schizoid / Avoidant / Antisocial

Personality Disorders n Paranoid Personality Type u Persistent suspiciousness u Emotionally detached u bear persistent grudges. n Schizotypal Personality Type u Oddities of thought and behavior u Eccentricities of behavior u “Magical thinking” u inappropriate dress

Personality Disorders n Schizoid Personality Type u Social withdrawal u Express few emotions n Avoidant Personality Type u Generally unwilling to enter relationships without assurance of acceptance u High levels of emotional discomfort

Personality Disorders n Antisocial Personality Type ( “Sociopath”) u Frequent conflict with society, undeterred by punishment u little guilt, anxiety, or remorse for actions u Ongoing disregard for the rights of others u Deceitfulness u Repeated lying (lying for personal gain and/or pleasure) u Must be at least 18 years old

Personality Disorders n Malingering: “disease forgery” n Factitious Disorder u attention u Munchausen Syndrome (by proxy) F hero / victim u Rarely treated successfully

Personality Disorders n Narcissistic Personality Type u exaggerated sense of self importance, entitlement u Disturbed self-centered relationships. n Histrionic Personality Type u excessive emotionality n Borderline Personality Type u Pattern of unstable personal relationships. u poor self image, impulse control. n Impulse Control Disorders: u Kleptomania, Pyromania, Trichotillomania (hair pulling)