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Psychological Disorders

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1 Psychological Disorders
9/12/2018 Psychological Disorders Prepared by Michael J. Renner, Ph.D. These slides ©2002 Prentice Hall Psychology Publishing. Chapter 16 ©2002 Prentice Hall ©2002 Prentice Hall

2 Psychological Disorders
9/12/2018 Psychological Disorders Defining and diagnosing disorder. Anxiety disorders. Mood disorders. Personality disorders. Drug abuse and addiction. Dissociative identity disorder. Schizophrenia. ©2002 Prentice Hall ©2002 Prentice Hall

3 Defining and Diagnosing Disorder
Psychological Disorders 9/12/2018 Defining and Diagnosing Disorder Dilemmas of definition. Dilemmas of diagnosis. Dilemmas of measurement. ©2002 Prentice Hall ©2002 Prentice Hall

4 Dilemmas of Definition
Psychological Disorders 9/12/2018 Dilemmas of Definition Possible Models for Defining Disorders: Mental disorder as a violation of cultural standards. Mental disorder as maladaptive or harmful behavior. Mental disorder as emotional distress. Mental Disorder Any behavior or emotional state that causes an individual great suffering or worry, is self-defeating or self-destructive, or is maladaptive and disrupts the person’s relationships or the larger community. ©2002 Prentice Hall ©2002 Prentice Hall

5 Diagnostic and Statistical Manual
Psychological Disorders 9/12/2018 Diagnostic and Statistical Manual Axis I: Primary clinical problem Axis II: Personality disorders Axis III: General medical conditions Axis IV: Social and environmental stressors Axis V: Global assessment of overall functioning ©2002 Prentice Hall ©2002 Prentice Hall

6 Explosion of Mental Disorders
Psychological Disorders 9/12/2018 Explosion of Mental Disorders Supporters of new categories answer that is important to distinguish disorders precisely. Critics point to an economic reason: diagnoses are needed for insurance reasons so therapists will be compensated. ©2002 Prentice Hall ©2002 Prentice Hall

7 Concerns About Diagnostic System
Psychological Disorders 9/12/2018 Concerns About Diagnostic System The danger of overdiagnosis. The power of diagnostic labels. Confusion of serious mental disorders with normal problems. The illusion of objectivity and universality. ©2002 Prentice Hall ©2002 Prentice Hall

8 Psychological Disorders
9/12/2018 Advantages of the DSM When the manual is used correctly and diagnoses are made with valid objective tests, the DSM improves the reliability of and agreement among clinicians. The DSM-IV included for the first time a list of culture-bound syndromes, disorders specific to a particular culture. ©2002 Prentice Hall ©2002 Prentice Hall

9 Psychological Disorders
9/12/2018 Projective Tests Projective Tests Psychological tests used to infer a person’s motives, conflicts, and unconscious dynamics on the basis of the person’s interpretations of ambiguous stimuli. Rorschach Inkblot Test A projective personality test that asks respondents to interpret abstract, symmetrical inkblots. Figure from p 337 of Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall. A sample inkblot ©2002 Prentice Hall ©2002 Prentice Hall

10 Psychological Disorders
9/12/2018 Objective Tests Inventories Standardized objective questionnaires requiring written responses; they typically include scales on which people are asked to rate themselves. Minnesota Multiphasic Personality Inventory (MMPI) A widely used objective personality test. ©2002 Prentice Hall ©2002 Prentice Hall

11 Psychological Disorders
9/12/2018 Anxiety Disorders Anxiety and panic. Fears and phobias. Obsessions and compulsions. ©2002 Prentice Hall ©2002 Prentice Hall

12 Psychological Disorders
9/12/2018 Anxiety and Panic Generalized Anxiety Disorder A continuous state of anxiety marked by feelings of worry and dread, apprehension, difficulties in concentration, and signs of motor tension. Panic Disorder An anxiety disorder in which a person experiences recurring panic attacks, feelings of impending doom or death, accompanied by physiological symptoms such as rapid breathing and dizziness. ©2002 Prentice Hall ©2002 Prentice Hall

13 Posttraumatic Stress Disorder (PTSD)
Psychological Disorders 9/12/2018 Posttraumatic Stress Disorder (PTSD) An anxiety disorder in which a person who has experienced a traumatic or life-threatening event has symptoms such as psychic numbing, reliving the the trauma, and increased physiological arousal. Diagnosed only if symptoms persist for 6 months or longer. May immediately follow event or occur later. ©2002 Prentice Hall ©2002 Prentice Hall

14 Psychological Disorders
9/12/2018 Panic Disorder An anxiety disorder in which a person experiences: recurring panic attacks, periods of intense fear, and feelings of impending doom or death, accompanied by physiological symptoms such as rapid heart rate and dizziness. ©2002 Prentice Hall ©2002 Prentice Hall

15 Psychological Disorders
9/12/2018 Fears and Phobias Phobia An exaggerated, unrealistic fear of a specific situation, activity, or object. ©2002 Prentice Hall ©2002 Prentice Hall

16 Psychological Disorders
9/12/2018 Agorophobia A set of phobias, often set off by a panic attack, involving the basic fear of being away from a safe place or person. ©2002 Prentice Hall ©2002 Prentice Hall

17 Obsessions and Compulsions
Psychological Disorders 9/12/2018 Obsessions and Compulsions Obsessive-Compulsive Disorder (OCD) An anxiety disorder in which a person feels trapped in repetitive, persistent thoughts (obsessions) and repetitive, ritualized behaviors (compulsions) designed to reduce anxiety. Person understands that the ritual behavior is senseless but guilt mounts if not performed. ©2002 Prentice Hall ©2002 Prentice Hall

18 Psychological Disorders
9/12/2018 Mood Disorders Depression and Bipolar Disorder. Theories of Depression. ©2002 Prentice Hall ©2002 Prentice Hall

19 Psychological Disorders
9/12/2018 Depression Major Depression A mood disorder involving disturbances in emotion (excessive sadness), behavior (loss of interest in one’s usual activities), cognition (thoughts of hopelessness), and body function (fatigue and loss of appetite). ©2002 Prentice Hall ©2002 Prentice Hall

20 Symptoms of Depression
Psychological Disorders 9/12/2018 Symptoms of Depression DSM IV Requires 5 of these within the past 2 weeks Depressed mood. Reduced interest in almost all activities. Significant weight gain or loss, without dieting. Sleep disturbance (insomnia or too much sleep). Change in motor activity (too much or too little) . Fatigue or loss of energy. Feelings of worthlessness or guilt. Reduced ability to think or concentrate. Recurrent thoughts of death. ©2002 Prentice Hall ©2002 Prentice Hall

21 Gender, Age, & Depression
Psychological Disorders 9/12/2018 Gender, Age, & Depression Women are about twice as likely as men to be diagnosed with depression. True around the world After age 65, rates of depression drop sharply in both sexes. Figure from Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall. ©2002 Prentice Hall ©2002 Prentice Hall

22 Psychological Disorders
9/12/2018 Bipolar Disorder Bipolar Disorder: A mood disorder in which episodes of depression and mania (excessive euphoria) occur. ©2002 Prentice Hall ©2002 Prentice Hall

23 Psychological Disorders
9/12/2018 The Bipolar Brain Bipolar disorder can have rapid mood swings These wild changes are shown in brain activity (right) Figure from Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall. ©2002 Prentice Hall ©2002 Prentice Hall

24 Theories of Depression
Psychological Disorders 9/12/2018 Theories of Depression Biological explanations emphasize genetics and brain chemistry. Social explanations emphasize the stressful circumstances of people’s lives. Attachment explanations emphasize problems with close relationships. Cognitive explanations emphasize particular habits of thinking and ways of interpreting events. “Vulnerability-Stress” explanations draw on all four explanations described above. ©2002 Prentice Hall ©2002 Prentice Hall

25 Vulnerability-Stress Model
Psychological Disorders 9/12/2018 Vulnerability-Stress Model ©2002 Prentice Hall ©2002 Prentice Hall

26 Personality Disorders
Psychological Disorders 9/12/2018 Personality Disorders Problem Personalities. Antisocial Personality Disorder. ©2002 Prentice Hall ©2002 Prentice Hall

27 Problem Personalities
Psychological Disorders 9/12/2018 Problem Personalities Personality Disorder Rigid, maladaptive patterns that cause personal distress or an inability to get along with others. Narcissistic Personality Disorder A disorder characterized by an exaggerated sense of self-importance and self-absorption. Paranoid Personality Disorder A disorder characterized by habitually unreasonable and excessive suspiciousness and jealousy. ©2002 Prentice Hall ©2002 Prentice Hall

28 Antisocial Personality Disorder (APD)
Psychological Disorders 9/12/2018 Antisocial Personality Disorder (APD) A disorder characterized by antisocial behavior such as lying, stealing, manipulating others, and sometimes violence; and a lack of guilt, shame and empathy. Sometimes called psychopathy or sociopathy Occurs in 3% of all males and 1% of all females. ©2002 Prentice Hall ©2002 Prentice Hall

29 Emotions and Antisocial Personality Disorder
Psychological Disorders 9/12/2018 Emotions and Antisocial Personality Disorder People with APD were slow to develop classically conditioned responses to anger, pain, or shock. Such responses indicate normal anxiety. Figure from Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall. ©2002 Prentice Hall ©2002 Prentice Hall

30 Psychological Disorders
9/12/2018 DSM Criteria for APD Must have 3 of these criteria and a history of behaviors Repeatedly break the law. They are deceitful, using aliases and lies to con others. They are impulsive and unable to plan ahead. They repeatedly get into physical fights or assaults. They show reckless disregard for own safety or that of others. They are irresponsible, failing to meet obligations to others. They lack remorse for actions that harm others. ©2002 Prentice Hall ©2002 Prentice Hall

31 Psychological Disorders
9/12/2018 Causes of APD Abnormalities in central nervous system. Genetically influenced problems with impulse control. Brain damage. ©2002 Prentice Hall ©2002 Prentice Hall

32 Drug Abuse and Addiction
Psychological Disorders 9/12/2018 Drug Abuse and Addiction Biology and addiction. Learning, culture, and addiction. Debating the causes of addiction. ©2002 Prentice Hall ©2002 Prentice Hall

33 Psychological Disorders
9/12/2018 Biology and Addiction The biological model holds that addiction, whether to alcohol or other drugs is due primarily to: a person’s biochemistry, metabolism, and genetic predisposition, Most evidence comes from twin studies. ©2002 Prentice Hall ©2002 Prentice Hall

34 Learning, Culture, and Addiction
Psychological Disorders 9/12/2018 Learning, Culture, and Addiction Addiction patterns vary according to cultural practices and the social environment. Policies of total abstinence tend to increase addiction rates rather than reduce them. Not all addicts have withdrawal symptoms when they stop taking a drug. Addiction does not depend on the properties of the drug alone, but also on the reason for taking it. ©2002 Prentice Hall ©2002 Prentice Hall

35 Failure of the Addiction Prediction
Psychological Disorders 9/12/2018 Failure of the Addiction Prediction 75% of US Soldiers who tested “drug positive” in reported being addicted during their tour. Fewer reported post-Vietnam drug use (blue bar). Even fewer still showed dependency(green bar). This contradicts what the biomedical model of addiction would predict. Figure from Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall. ©2002 Prentice Hall ©2002 Prentice Hall

36 Debating the Causes of Addiction
Psychological Disorders 9/12/2018 Debating the Causes of Addiction Problems with drugs are more likely when: A person has a physiological vulnerability to a drug. A person believes she or he has no control over the drug. Laws or customs encourage people to take the drug in binges, and moderate use is neither tolerated nor taught. A person comes to rely on a drug as a method of coping with problems, suppressing anger or fear, or relieving pain. Members of a person’s peer group use drugs or drink heavily, forcing the person to choose between using drugs or losing friends. ©2002 Prentice Hall ©2002 Prentice Hall

37 Dissociative Identity Disorder
Psychological Disorders 9/12/2018 Dissociative Identity Disorder Defining identity disorders. The MPD controversy. The sociocognitive explanation. ©2002 Prentice Hall ©2002 Prentice Hall

38 Dissociative Identity Disorders
Psychological Disorders 9/12/2018 Dissociative Identity Disorders A controversial disorder marked by the appearance within one person of two or more distinct personalities, each with its own name and traits; commonly known as “Multiple Personality Disorder (MPD).” ©2002 Prentice Hall ©2002 Prentice Hall

39 Psychological Disorders
9/12/2018 The MPD Controversy First view MPD is common but often unrecognized or misdiagnosed. The disorder starts in childhood as means of coping. Trauma produced a mental splitting. 2nd view Created through pressure and suggestions by clinicians. Handfuls to since 1980. ©2002 Prentice Hall ©2002 Prentice Hall

40 Sociocognitive Explanation
Psychological Disorders 9/12/2018 Sociocognitive Explanation MPD is an extreme form of our ability to present many aspects of our personalities to others. MPD is a socially acceptable way for some troubled people to make sense of their problems. Therapists looking for MPD may reward patients with attention and praise for revealing more and more personalities. ©2002 Prentice Hall ©2002 Prentice Hall

41 Psychological Disorders
9/12/2018 Schizophrenia Defining schizophrenia and psychosis. Symptoms of schizophrenia. Theories of schizophrenia. ©2002 Prentice Hall ©2002 Prentice Hall

42 Symptoms of Schizophrenia
Psychological Disorders 9/12/2018 Symptoms of Schizophrenia Bizarre delusions. Hallucinations and heightened sensory awareness. Disorganized, incoherent speech. Grossly disorganized and inappropriate behavior. ©2002 Prentice Hall ©2002 Prentice Hall

43 Delusions and Hallucinations
Psychological Disorders 9/12/2018 Delusions and Hallucinations Delusions False beliefs that often accompany schizophrenia and other psychotic disorders. Hallucinations Sensory experiences that occur in the absence of actual stimulation. ©2002 Prentice Hall ©2002 Prentice Hall

44 Psychological Disorders
9/12/2018 Positive Symptoms Cognitive, emotional, and behavioral excesses Examples of Positive Symptoms Hallucinations. Bizarre delusions. Incoherent speech. Inappropriate/Disorganized behaviors. ©2002 Prentice Hall ©2002 Prentice Hall

45 Psychological Disorders
9/12/2018 Negative Symptoms Cognitive, emotional, and behavioral deficits. Examples of Negative Symptoms Loss of motivation. Emotional flatness. Social withdrawal. Slowed speech or no speech. ©2002 Prentice Hall ©2002 Prentice Hall

46 Theories of Schizophrenia
Psychological Disorders 9/12/2018 Theories of Schizophrenia Genetic predispositions Structural brain abnormalities Neurotransmitter abnormalities Prenatal abnormalities ©2002 Prentice Hall ©2002 Prentice Hall

47 Genetic Vulnerability to Schizophrenia
Psychological Disorders 9/12/2018 Genetic Vulnerability to Schizophrenia The risk of developing schizophrenia (i.e., prevalence) in one’s lifetime increases as the genetic relatedness with a diagnosed schizophrenic increases. Figure from Wade, C., & Tavris, C. (2002). Invitation to Psychology, 2nd Ed. Upper Saddle River, NJ: Prentice Hall. ©2002 Prentice Hall ©2002 Prentice Hall

48 Structural Brain Abnormalities
Psychological Disorders 9/12/2018 Structural Brain Abnormalities Several abnormalities exist, especially when schizophrenia is characterized by primarily negative symptoms: Decreased brain weight. Decreased volume in temporal lobe or hippocampus. Enlargement of vetricles. About 25% do not have these observable brain deficiencies ©2002 Prentice Hall ©2002 Prentice Hall

49 Neurotransmitter Abnormalities
Psychological Disorders 9/12/2018 Neurotransmitter Abnormalities Include serotonin, glutamate, and dopamine. Many schizophrenics have high levels of brain activity in brain areas served by dopamine as well as greater numbers of particular dopamine receptors. Similar neurotransmitter abnormalities are also found in depression and alcoholism. ©2002 Prentice Hall ©2002 Prentice Hall

50 Prenatal Problems or Birth Complications
Psychological Disorders 9/12/2018 Prenatal Problems or Birth Complications Damage to the fetal brain increases chances of schizophrenia and other mental disorders. May occur as a function of maternal malnutrition, maternal illness. May also occur if brain injury or oxygen deprivation occurs at birth. ©2002 Prentice Hall ©2002 Prentice Hall

51 Adolescent Abnormalities in Brain Development
Psychological Disorders 9/12/2018 Adolescent Abnormalities in Brain Development Normal pruning of excessive synapses in the brain occurs during adolescence. In schizophrenics, a greater number of synapses are pruned away. Many explain why first episode occurs in adolescence or early adulthood. ©2002 Prentice Hall ©2002 Prentice Hall


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