1. Psychological Disorders
An Introduction

2. Psychological 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:
Culture
Time Period
Environmental Conditions
Individual Person

3. Defining 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’s
OBJECTIVE 1| Identify criteria for judging whether behavior is psychologically disordered.

4. 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.
Carol Beckwith
In the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal.

5. Early Theories
Afflicted people were possessed by evil spirits.

6. 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.
OBJECTIVE 2| Contrast the medical model of psychological disorders with the biopsychosocial perspective on disordered behavior.
John W. Verano
Trephination (boring holes in the skull to remove evil forces)

7. Early 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.

8. Trephening

9. Early Theories
Another theory was to make the body extremely uncomfortable.

10. History 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?

11. Early 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.

12. Philippe Pinel
French doctor who was the first to take the chains off and declare that these people are sick and “a cure must be found!!!”

13. Somatogenic
At 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.

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.
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.

15. Current Perspectives
Medical Perspective: psychological disorders are sicknesses and can be diagnosed, treated and cured.

16. Current Perspectives
Bio-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.

17. Classifying 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.

18. Classifying Psychological Disorders
DSM-IV: Diagnostic Statistical Manual of Mental Disorders: the big book of disorders.
Two Major Classifications:

19. Neurotic Disorders
Distressing but one can still function in society and act rationally

20. Psychotic Disorders
Person loses contact with reality, experiences distorted perceptions

21. Multiaxial Classification
Axis I
Is a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present?
Axis II
Is a Personality Disorder or Mental Retardation present?
Axis III
Is a General Medical Condition (diabetes, hypertension or arthritis etc) also present?
Axis IV
Are Psychosocial or Environmental Problems (school or housing issues) also present?
Axis V
What is the Global Assessment of the person’s functioning?

22. Multiaxial Classification
Note 16 syndromes in Axis I

23. Multiaxial Classification
Note Global Assessment for Axis V

24. Goals of DSM
Describe (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.”

25. Labeling Psychological Disorders
Critics of the DSM-IV argue that labels may stigmatize individuals.
Rosenthal-Being sane in insane places
OBJECTIVE 4| Discuss the potential dangers and benefits of using diagnostic labels.
Elizabeth Eckert, Middletown, NY. From L. Gamwell and
N. Tomes, Madness in America, Cornell University Press.
Asylum baseball team (labeling)

26. Labeling Psychological Disorders
2. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.

27. Labeling 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 Photo
Theodore Kaczynski
(Unabomber)

28. Anxiety Disorders
a group of conditions where the primary symptoms are anxiety or defenses against anxiety.
the patient fears something awful will happen to them.

29. What is anxiety?
is a state of intense apprehension, uneasiness, uncertainty, or fear.

30. Generalized 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.

31. Panic Disorder
An 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.

32. Phobias
A person experiences sudden episodes of intense dread.

33. The Phobia List Link

34. Obsessive Compulsive Disorder
An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions).

35. Common Examples of OCD Common Obsessions: Common Compulsions:
Contamination fears of germs, dirt, etc.
Washing
Imagining having harmed self or others
Repeating
Imagining losing control of aggressive urges
Checking
Intrusive sexual thoughts or urges
Touching
Excessive religious or moral doubt
Counting
Forbidden thoughts
Ordering/arranging
A need to have things "just so"
Hoarding or saving
A need to tell, ask, confess
Praying

36. Explanations for Anxiety Disorders
You Learn them through conditioning.
Evolution
Genes
Physiology (the brain)

37. Dissociative Disorders

38. Dissociative Disorders
Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts and feelings.

39. Dissociative Amnesia
This disorder is characterized by a blocking out of critical personal information, usually of a traumatic or stressful nature.

40. Dissociative Amnesia
Dissociative amnesia, unlike other types of amnesia, does NOT result from other medical trauma (e.g. a blow to the head).

41. Dissociative Amnesia
Localized 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.

42. Dissociative Fugue
An 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.

43. Dissociative Fugue
Individuals 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).

44. Depersonalization 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.

45. Dissociative Identity Disorder
A rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities.
Also known as multiple personality disorder.

46. Mood Disorders

47. Mood Disorders
Psychological Disorders characterized by emotional extremes.
Dysthymic Disorder
Major Depressive Disorder
Seasonal Affective Disorder
Bipolar Disorder

48. Depression The common cold of psychological disorders.
It is like a warning that something is wrong.

49. Depression

50. Depression

51. Major 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.

52. Dysthymic Disorder
Suffering from mild depression every day for at least two years.

53. Seasonal Affective Disorder

54. Bipolar Disorder
Person alternates between the hopelessness and lethargy of depression and the overexcited state of mania.

55. Famous People with Bipolar

56. Bipolar Brain

57. Norepinephrine
Increases arousal and boosts moods.

58. Suicide

59. Suicide

60. Schizophrenia

61. How Prevalent?
About 1 in every 100 people are diagnosed with schizophrenia.

62. Symptoms of Schizophrenia
Disorganized thinking.
Disturbed Perceptions
Inappropriate Emotions and Actions

63. Disorganized 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………

64. Delusions (false beliefs)
Delusions of Persecution
Delusions of Grandeur

65. Disturbed Perceptions
hallucinations- sensory experiences without sensory stimulation.

66. Inappropriate Emotions and Actions
Laugh at inappropriate times.
Flat Effect
Senseless, compulsive acts.
Catatonia- motionless Waxy Flexibility

67. Positive v. Negative Symptoms
Positive Symptoms
Presence of inappropriate symptoms
Negative Symptoms
Absence of appropriate ones.

68. Types of Schizophrenia

69. Paranoid Schizophrenia
preoccupation with delusions or hallucinations.
Somebody is out to get me!!!!

70. Disorganized Schizophrenia
disorganized speech or behavior, or flat or inappropriate emotion.

71. Catatonic Schizophrenia
parrot like repeating of another’s speech and movements

72. Undifferentiated Schizophrenia
Many and varied Symptoms.

73. Personality Disorders
Psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning.

74. Paranoid Personality Disorder
Paranoid personality disorder is characterized by a distrust of others and a constant suspicion that people around you have sinister motives.

75. Paranoid 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.

76. Antisocial Personality Disorder
antisocial personality disorder is characterized by a lack of conscience
People 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

77. Antisocial Personality Disorder
they are careless with money and take action without thinking about consequences
They are often aggressive and are much more concerned with their own needs than the needs of others.

78. Borderline Personality Disorder
characterized by mood instability and poor self-image
People with this disorder are prone to constant mood swings and bouts of anger.

79. Borderline Personality Disorder
they will take their anger out on themselves, causing themselves injury
Suicidal threats and actions are not uncommon
They are quick to anger when their expectations are not met.

80. Histrionic Personality Disorder
constant attention seekers
They need to be the center of attention all the time, often interrupting others in order to dominate the conversation.

81. Histrionic 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

82. Narcissistic Personality Disorder
characterized by self-centeredness
They exaggerate their achievements, expecting others to recognize them as being superior

83. Narcissistic 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.

84. Schizoid Personality Disorder
People with schizoid personality disorder avoid relationships and do not show much emotion
They genuinely prefer to be alone and do not secretly wish for popularity.

85. Schizoid Personality Disorder
They tend to seek jobs that require little social contact
Their social skills are often weak and they do not show a need for attention or acceptance
They are perceived as humorless and distant and often are termed "loners."

86. Schizotypal 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.

87. Avoidant 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.

88. Dependent 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

89. Obsessive 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".