4 Defining Psychological Disorders THINKING CRITICALLY ABOUT: ADHD—Normal High Energy or Genuine Disorder? Understanding Psychological Disorders The Medical Model The Biopsychosocial Approach
5 Classifying Psychological Disorders CLOSE-UP: The “un-DSM”: A Diagnostic Manual of Human Strengths Labeling Psychological Disorders
6 Rates of Psychological Disorders THINKING CRITICALLY ABOUT: Insanity and Responsibility Mood Disorders Major Depressive Disorder Bipolar Disorder Understanding Mood Disorders CLOSE-UP: Suicide
7 Psychological Disorders I felt the need to clean my room … would spend four to five hours at it… At the time I loved doing it. Then I didn't want to do it any more, but I couldn’t stop… The clothes hung… two fingers apart… I touched my bedroom wall before leaving the house… I had constant anxiety… I thought I might be nuts. Marc, diagnosed with obsessive-compulsive disorder (from Summers, 1996)
8 Psychological Disorders People are fascinated by the exceptional, the unusual, and the abnormal. This fascination may be caused by two reasons: 1.During various moments we feel, think, and act like an abnormal individual. 2.Psychological disorders may bring unexplained physical symptoms, irrational fears, and suicidal thoughts.
9 Defining Psychological Disorders Mental health workers view psychological disorders as ongoing patterns of thoughts, feelings, and actions that are deviant, distressful, and dysfunctional (Comer, 2004). Standards for deviance vary from culture to culture and over time.
10 Deviant, 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. In the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal. Carol Beckwith
ADHD—Normal High Energy or Genuine Disorder? Attention-Deficit Hyperactivity Disorder (ADHD) is marked by the appearance by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity. Increasing rates of diagnoses of ADHD has lead to skepticism over whether normal childhood energy is being misdiagnosed as a psychological disorder. 11
12 Understanding 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.
14 Medical Model When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. A mental illness must be diagnosed on the basis of symptoms and cured through therapy which may include treatment in a hospital.
15 The Biopsychosocial Approach Assumes that biological, socio-cultural, and psychological factors combine and interact to produce psychological disorders.
16 Classifying Psychological Disorders Diagnostic classification aims to describe a disorder as well as predict its course, suggest treatment, and stimulate research. 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.
17 Classifying Psychological Disorders Disorders outlined by DSM-IV-TR are reasonably reliable. Therefore, diagnoses by different professionals are similar. Others criticize DSM-IV-TR for casting too wide a net and putting too many people in the category of having a mental disorder.
18 Labeling Psychological Disorders There are benefits to labelling disorders. Labels are helpful for healthcare professionals in communicating about their cases, trying to understand underlying causes, and discerning effective treatment.
19 Labeling Psychological Disorders Critics of the DSM argue that labels may stigmatize individuals and may become self-fulfilling prophecies. With continued knowledge, some of the stigma seems to be lifting, but stereotypes linger and those with disorders are often portrayed negatively. Howie Mandel uses humor to deal with his OCD and to help others understand the disorder.
21 Rates of Psychological Disorders The prevalence of psychological disorders during the previous year is shown below (WHO, 2004).
22 Mood Disorders Emotional extremes of mood disorders come in two principal forms. 1.Major depressive disorder 2.Bipolar disorder
23 Major Depressive Disorder Depression is the “common cold” of psychological disorders. It is the leading cause of disability worldwide affecting 5.8% of men and 9.5% of women report depression in a given year (WHO, 2002). To feel bad as a reaction to sad events is a normal response. But prolonged, this can become maladaptive.
24 Major Depressive Disorder Major depressive disorder occurs when at least five signs of depression (including lethargy, feelings of worthlessness, or loss of interest in family or friends) last two weeks or more and are not caused by drugs or medical conditions.
25 Bipolar Disorder Formerly called manic-depressive disorder, bipolar disorder is an alternation between the lows of depression and the euphoric, hyperactive state of mania. Though it is less common than major depressive disorder, it is often more dysfunctional.
26 Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Whitman WolfeClemensHemingway Bettmann/ Corbis George C. Beresford/ Hulton Getty Pictures Library The Granger Collection Earl Theissen/ Hulton Getty Pictures Library
27 Explaining Mood Disorders Since depression is so prevalent worldwide, investigators want to develop a theory of depression that will suggest ways to treat it. Lewinsohn et al., (1985, 1998) note that a theory of depression should explain the following: 1.Behavioral and cognitive changes 2.Common causes of depression
28 Theory of Depression 3.Women and more than twice as vulnerable as men to major depression.
29 Theory of Depression 4.Most depressive episodes self-terminate. 5.Stressful events often precede depression. 6.Depression is increasingly striking earlier in life and affecting more people.
30 Suicide The most severe form of behavioral response to depression is suicide. Each year some 1 million people commit suicide worldwide. 1.National differences 2.Racial differences 3.Gender differences 4.Age differences 5.Other differences Suicide Statistics Fig 32.4
31 Biological Perspective Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%). Linkage analysis link possible genes and dispositions for depression.
32 The Depressed Brain PET scans show that brain energy consumption rises and falls with manic and depressive episodes. Courtesy of Lewis Baxter an Michael E. Phelps, UCLA School of Medicine
At least two neurotransmitter systems play a role in depression. Norepinephrine, which boosts mood and increases arousal and serotonin. Both are scare during depression. 33 The Depressed Brain
34 Social-Cognitive Perspective The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles.
35 Negative Thoughts and Moods Explanatory style plays a major role in becoming depressed.
36 Depression Cycle 1.Negative stressful events. 2.Pessimistic explanatory style. 3.Hopeless depressed state. 4.These hamper the way the individual thinks and acts, fueling personal rejection.