1. Chapter 14: Psychological Disorders

2. Stereotypes of Psychological Disorders
Psychological Disorders are incurable
People with Psychological Disorders are often violent & dangerous
People with Psychological Disorders behave in bizarre ways
Chapter 14: Psychological Disorders

3. Chapter 14: Psychological Disorders
Abnormal Behavior
The Medical Model
Diagnosis (Distinguishing)
Etiology (Causation & Development)
Prognosis (Forecast)
What is abnormal behavior?
Deviant
Maladaptive
Causing personal distress
A continuum of normal/abnormal
Chapter 14: Psychological Disorders

4. Psychodiagnosis: The Classification of Disorders
American Psychiatric Association (APA)
Diagnostic and Statistical Manual of Mental Disorders – 4th ed. (DSM - 4)
Chapter 14: Psychological Disorders

5. Chapter 14: Psychological Disorders
Five Axes
Axis I – Clinical Syndromes
Axis II – Personality Disorders or Mental Retardation
Axis III – General Medical Conditions
Axis IV – Psychosocial and Environmental Problems
Axis V – Global Assessment of Functioning
Chapter 14: Psychological Disorders

6. Prevalence, Causes, & Course
Epidemiology (Distribution in the population)
Prevalence (Percent of population who has a disorder)
Lifetime prevalence (Percent of population who at some point in their life will have a disorder)
U.S. about 1/3 (about 45%)
Chapter 14: Psychological Disorders

7. Lifetime Prevalence of Psychological Disorders
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8. Normality & Abnormality as a Continuum
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9. Axis I Clinical Syndromes
Anxiety Disorders
Somatoform Disorders
Dissociative Disorders
Mood Disorders
Schizophrenic Disorders
Chapter 14: Psychological Disorders

10. Clinical Syndromes: Anxiety Disorders (4 Types)
Generalized Anxiety Disorder
“free-floating anxiety” ANS arousal
Phobic Disorder
Specific focus of irrational fear
Panic Disorder and Agoraphobia
Panic. anxiety attacks, terror, chest pain choking
Agoraphobia. Fear of going out into public places 2/3 suffer from it. Females. Late adolescences to Early adults
Obsessive Compulsive Disorder. 2.5% of population. Onset before 35
Obsessions. Thoughts
Compulsions. Rituals
Posttraumatic Stress Disorder
Chapter 14: Psychological Disorders

11. Chapter 14: Psychological Disorders
OCD
Common Obsessions and Compulsions Among
People With Obsessive-Compulsive Disorder
Thought or Behavior
Percentage*
Reporting Symptom
Obsessions (repetitive thoughts)
Concern with dirt, germs, or toxins
Something terrible happening (fire, death, illness)
Symmetry order, or exactness
Excessive hand washing, bathing, tooth brushing,
or grooming
Compulsions (repetitive behaviors)
Repeating rituals (in/out of a door,
up/down from a chair)
Checking doors, locks, appliances,
car brake, homework
Chapter 14: Psychological Disorders

12. Etiology of Anxiety Disorders
Biological factors
Genetic predisposition, anxiety sensitivity
GABA circuits in the brain
Conditioning and learning
Acquired through classical conditioning or observational learning
Maintained through operant conditioning
Cognitive factors
Judgments of perceived threat
Personality
Neuroticism
Stress
a precipitator
Chapter 14: Psychological Disorders

13. Twin studies of Anxiety Disorders
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14. Conditioning as an Explanation for Phobias
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15. Cognitive Factors in Anxiety Disorders
Chapter 14: Psychological Disorders

16. Clinical Syndromes: Somatoform Disorders (3 Types)
Somatization Disorder
Physical complaints that appear to be psychological in origin, distinguishing factor is the diversity of complaints. Females.
Conversion Disorder
Significant loss of physical function with no organic basis.
Hypochondriasis
Constantly monitoring physical condition looking for signs of illness, disbelieving doctors. Coexist w/ Anxiety & depression.
Etiology
Reactive autonomic nervous system
Personality factors- Histrionic, High Neuroticism
Cognitive factors- Draw catastrophic conclusion about minor complaints
The sick role- Helps prevent confronting problems
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17. Chapter 14: Psychological Disorders
Glove Anesthesia
Chapter 14: Psychological Disorders

18. Clinical Syndromes: Dissociative Disorders (3 Types)
Dissociative Amnesia (Stress induced)
Sudden extensive loss of memory of personal information.
Dissociative Fugue
Flight from one’s home & identity accompanies amnesia
Dissociative Identity Disorder (aka: Multiple Personality Disorder)
Coexistence of two or more personalities’ in one person. Each different name, race, gender, & physical mannerism. Unaware of the other personalities
Etiology
severe emotional trauma during childhood
- Controversy: Media creation?
Chapter 14: Psychological Disorders

19. Clinical Syndromes: Mood Disorders
2 Types of Mood Disorders:
Unipolar (extreme emotion at one end of the continuum)
Bipolar (extreme emotions at both ends)
Major depressive disorder. Persistent feeling of sadness, loss of interest, low energy, last for minimum 5 months. For no reason
Dysthymic disorder. Not severe enough to be classified as MDD (7-18% U.S., 2XHigher in Women)
Bipolar disorder (Manic Depressive Disorder) 1 or 2 episodes
Cyclothymic disorder. Milder symptoms 20% have 4 manic or depressive episode a year.
Etiology
Genetic vulnerability
Neurochemical factors
Cognitive factors
Interpersonal roots
Precipitating stress
Chapter 14: Psychological Disorders

20. Episodic Patterns in Mood Disorders
Chapter 14: Psychological Disorders

21. Twin Studies of Mood Disorders
Chapter 14: Psychological Disorders

22. Negative Thinking & Prediction of Depression
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23. Interpersonal Factors in Depression
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24. Clinical Syndromes: Schizophrenia
Schizophrenia- “Split Mind”, fragmented thought process
General symptoms
Delusions and irrational thought (false beliefs)
Delusion of Grander, Persecution, Sin or Guilt, Influence
Hallucinations (false sensations)
Inappropriate emotions & actions
Prognostic factors
Chapter 14: Psychological Disorders

25. Subtyping of Schizophrenia
4 subtypes
Paranoid type. Delusion of persecution & delusion of grandeur
Catatonic type. Motor disturbances, motionlessness or hyperactive, parrotlike repeating of speech & movement of other people
Disorganized type. Severe deterioration of adaptive behavior, emotional indifference complete withdrawal. Delusion center on bodily functions (my brain is melting)
Undifferentiated type. Doesn't fit into the other categories, usually a mixture of the 3.
New model for classification
Positive vs. negative symptoms
Chapter 14: Psychological Disorders

26. Course & Outcome of Schizophrenia
Schizophrenia emerges during adolescence, could be sudden or gradual. Milder cases are treated and recover. Chronic illness result in permanent hospitalization. ½ of patients have a reasonable recovery. Males have earlier onset, more hospitalization, and higher relapse rate.
Onset sudden
Onset later age
Adjustment prior was good
Proportions of negative symptoms are low
Patient has healthier supportive family
Chapter 14: Psychological Disorders

27. Etiology of Schizophrenia
Genetic vulnerability
Neurochemical factors
Structural abnormalities of the brain
The neurodevelopmental hypothesis
Expressed emotion
Precipitating stress
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28. Chapter 14: Psychological Disorders
Schizophernia
Lifetime risk
of developing
schizophrenia
for relatives of
a schizophrenic 40 30 20 10
General
population
Siblings
Children
Fraternal
twin
of two
victims
Identical
Chapter 14: Psychological Disorders

29. The dopamine hypothesis as an explanation for schizophrenia
Chapter 14: Psychological Disorders

30. The neurodevelopmental hypothesis of schizophrenia
Chapter 14: Psychological Disorders

31. Personality Disorders
Anxious-fearful cluster
Avoidant. Fear of rejection, humiliation or shame but want acceptance
Dependent. Lack self reliance, passive in decision making, need other’s.
Obsessive-compulsive. Organizing, rules, schedules, serious, not emotional
Dramatic-impulsive cluster
Histrionic. Overly dramatic, seeking attention
Narcissistic. Self importance, lack of empathy
Borderline. Unstable self image, impulsive and unpredictable
Antisocial. Violates the rights of others, doesn't accept social norms
Chapter 14: Psychological Disorders

32. Personality Disorders Continued
Odd-Eccentric cluster
Schizoid. Not capable of forming social relationships, absence of warm tender feelings for others.
Schizotypal. Social deficits & oddities of thinking, perception & communication that resembles schizophrenia
Paranoid. Showing pervasive & unwarranted suspiciousness. Mistrust people, overly sensitive prone to jealousy.
Etiology
Genetic predispositions, inadequate socialization in dysfunctional families
Chapter 14: Psychological Disorders

33. Personality Disorders

34. Psychological Disorders & the Law
Insanity (Not a diagnosis, it’s a legal concept). A person cannot be held accountable for their actions because of mental illness. “out of their mind”
M’naghten rule
Involuntary commitment. People are hospitalized in psychiatric facilities against their own will because of what they might do.
danger to self
danger to others
in need of treatment
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35. The insanity defense: public perceptions & actual realities
Chapter 14: Psychological Disorders

36. Chapter 14: Psychological Disorders
Culture & Pathology
Cultural variations
Relativistic View. Mental illness varies across cultures there is no universal standard. DSM only reflect western cultures.
Culture bound disorders
Schizophrenia, Depression & Bipolar are found in all culture.
Anorexia nervosa. Only found in U.S.
Chapter 14: Psychological Disorders