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Psychopathology or Psychological Disorders

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DSM-IV American Psychiatric Association's Diagnostic and Statistical Manual of ... Leo Tolstoy. Mark Twain. Virginia Woolf. Tennessee Williams. Creativity Connection ... – PowerPoint PPT presentation

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Title: Psychopathology or Psychological Disorders


1
Psychopathology or
Psychological Disorders
KING LEAR
2
Prevalence
3
Lifetime Rates by Gender
4
Diagnosis A Necessary Step
  • Diagnosis
  • Process of identifying and grouping mental
    disorders with similar symptoms
  • DSM-IV American Psychiatric Associations
    Diagnostic and Statistical Manual
    of Mental Disorders (4th Edition)

5
Advances in diagnosis and therapy are success
stories for clinical psychology/ psychiatry
In 1955, 500,000
institutionalized for psychological
disorders Today 65,000 But mental hygiene
arrests continue to this day (suicide, squalor,
starving)
6
Major Affective Disorders
The mind is its own place, and of itself Can
make a Heaven of Hell, a Hell of Heaven
- John Milton (Paradise Lost)
7
Major Affective Disorders
8
What is Bipolar disorder?
9
Mood cycles
10
Creativity Bipolar
11
Creativity Mood Dysfunction
Iowa Writers Workshop, Andreasen, 1987
Other studies find 30x normal incidence rate in
writers, musicians
Why are they linked?
12
Famous Bipolar Artists
Hans Christian Anderson Ludwig von Beethoven
Lord Byron Charles Dickens T. S. Eliot Ralph
Waldo Emerson William Faukner F. Scott
Fitzgerald Paul Gauguin Vincent van Gogh
Ernest Hemingway Michelangelo Sylvia Plath
Edgar Allan Poe Gordon Sumner (Sting) Peter
Tchaikovsky Leo Tolstoy Mark Twain Virginia
Woolf Tennessee Williams
  • Creativity Connection
  • Emotional reactive (unfiltered life)
  • Disinhibited (loose associations)
  • Absorption (focus)
  • Intense creative episodes during hypomania

13
Vicious Cycle of Depression
14
Beck Depression Inventory (BDI)
Twenty-one dimensions of depression 1.
Sadness                              12. Social
withdrawal 2. Pessimism                          
13. Indecisiveness 3. Sense of failure            
       14 Change in body image 4.
Dissatisfaction                     15.
Retardation 5. Guilt                              
     16. Insomnia 6. Expectation of punishment   
17. Fatigability 7. Dislike of self               
        18. Loss of appetite 8. Self
Accusation                    19. Loss of
Weight 9. Suicidal ideation                   20.
Somatic preoccupation 10. Episodes of
crying              21. Low level of energy 11.
Agitation In past week including today 0 I do
not feel sad 1 I feel sad 2 I am sad all the
time and I cant snap out of it 3 I am so sad
that I cant stand it 0-63 max score (30
indicates severe depression)
Aaron Beck
15
Treatment for Unipolar
16
Antidepressants
17
Suicide
30,000 Americans each year Nearly 2x the
homicide rate 8th leading cause of death,
3rd for teens 2 x above the world rate -
16.7/100K Japan (1997) - 11.9/100K USA
(1997) Females attempt 3x males, but males
succeed 4x 60 successes with firearms Since
1950, suicide rates in teens has tripled
Myth of Sisyphus (Camus) There is only one
really serious philosophical question, and that
is suicide
18
Suicide in Depression Cycle
19
Anxiety Disorders
20
Phobia
Intense irrational fear of object or situation
21
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22
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23
Obsessive-Compulsive Disorder (OCD)
  • Obsessions repetitive thoughts
  • - germs, terrible events, symmetry order
  • Compulsions repetitive behaviors
  • - grooming, rituals, checking locks, appliances

24
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25
Dissociative Identity Disorder
  • Previously Multiple personality disorders (MPD)

26
Schizophrenia
Split Mind Disorders involving gross
distortions of thoughts and perceptions and by
loss of contact with reality
27
Scz the Disorder of Science and Math
Isaac Newton suffered psychotic break Albert
Einstein autistic traits, Scz son John Nash Jr
chronic schizophrenia Bertrand Russell James
Joyces daughter Syd Barrett (of Pink
Floyd) Socrates (perhaps, or temporal lobe
epilepsy)
28
Types of Schizophrenia
  • Paranoid Delusions or hallucinations often
    include extreme suspiciousness and hostility
  • Disorganized Exhibit signs of illogical thinking
    and speech
  • Catatonic Exhibit extremes in motor behavior
  • Undifferentiated Do not clearly fit into a type
  • Catatonia

29
Positive Negative Symptoms
  • Positive Sx cognitive, emotional, and behavioral
    excesses.
  • hallucinations, delusions, thought disorders, and
    bizarre behaviors.
  • Negative Sx cognitive, emotional, and behavioral
    deficits.
  • apathy, flattened affect, social withdrawal,
    inattention, and slowed speech or no speech.

30
Schizophrenia rates
  • 1 across all cultures, despite few offspring
  • Male females, or slightly more males
  • More in jails than psychiatric hospitals
  • 50 never accept that they are ill
  • 90 go off meds once (relapse within 3y)
  • Nearly 100 smoke (self-stimulation)
  • Higher prevalence in lower socioeconomic class
  • 25 full remission, 50 recurrent relapses
    (living independently on meds or less
    autonomously in group homes), 25 permanently
    hospitalized
  • 40 attempt suicide, 10 succeed

31
DSM-IV Criteria
  • Delusions
  • Hallucinations
  • Speech changes
  • Motor symptoms
  • Mood symptoms
  • Cognitive symptoms
  • Must show 2 of following for 6 months

32
Delusions incorrect conclusions about
perceptions
  • Peculiar beliefs, culturally based aliens,
    secret lovers, paranoia, grandiosity, thought
    insertion or broadcast, erotomania
  • Ideas of reference events
    has special personal meaning
  • Magical thinking
    control events from afar

33
DSM-IV Criteria
  • Delusions
  • Hallucinations
  • Speech changes
  • Motor symptoms
  • Mood symptoms
  • Cognitive symptoms
  • Must show 2 of following for 6 months

34
Hallucinations inaccurate perceptions
  • Most auditory some visual, olfactory, tactile
  • Commanding voice of authority God, historical
    figure, parent alive or dead
  • Derisive, insulting
  • Running commentary of life, feelings, thoughts

35
DSM-IV Criteria
  • Delusions
  • Hallucinations
  • Speech changes
  • Motor symptoms
  • Mood symptoms
  • Cognitive symptoms
  • Must show 2 of following for 6 months

36
Speech changes
  • Mute vs pressured (word salad)
  • Insensitive to the informational needs of
    audience
  • Overall, a poverty of speech

37
DSM-IV Criteria
  • Delusions
  • Hallucinations
  • Speech changes
  • Motor symptoms
  • Mood symptoms
  • Cognitive symptoms
  • Must show 2 of following for 6 months

38
Motor symptoms
  • Catatonia
  • Peculiar (e.g., strip naked to greet)
  • Bizarre gestures, grimaces
  • Stereotypies (rocking, flapping)
  • Violence to self, or family members

39
DSM-IV Criteria
  • Delusions
  • Hallucinations
  • Speech changes
  • Motor symptoms
  • Mood symptoms
  • Cognitive symptoms
  • Must show 2 of following for 6 months

40
Mood symptoms
  • Blunted, inappropriate, or exaggerated
  • Flat affect, anhedonia, avolitional, vegetative
  • Suicidal

41
DSM-IV Criteria
  • Delusions
  • Hallucinations
  • Speech changes
  • Motor symptoms
  • Mood symptoms
  • Cognitive symptoms
  • Must show 2 of following for 6 months

42
Cognitive Symptoms
  • Attention disorder
  • Loose associations (knights move)
  • Memory impairment
  • Executive functioning serial, perseveration,
    monitoring

43
Knights Move
44
Impaired Theory of Mind
  • Failure to monitor
  • what different people can know
  • ones own intentional actions
  • informational needs of others
  • one simply thought something
  • mental and physical distinctions

45
Course of Onset (Warning signs)
  • lt7y Failure to develop dominant hand early (55
    autistics fail as well)
  • 8-12 y interpersonal problems, poor emotional
    control, high IQ, sensitive
  • 12-16y cognitive problems begin,
    underachievement, disorganized thoughts, poor
    emotional rapport, few friends
  • 17-20y prodomal or precursory withdrawal,
    decreased grooming, altered school or work
    performance, delusions emerging, abuse
    hallucinogens like marijuana or LSD

46
Genetic Component
  • Risk of developing schizophrenia in ones
    lifetime increases as genetic relatedness with a
    diagnosed schizophrenic increases.
  • Dopamine hypothesis
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