Chapter 12: Psychological Disorders Lectures 15

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Chapter 12 Psychological DisordersLectures 15
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Learning Outcomes

• Define psychological disorders and describe their
  prevalence.
• Describe the symptoms, types, and possible
  origins of schizophrenia.

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Learning Outcomes

• Describe the symptoms and possible origins of
  mood disorders.
• Describe the symptoms and possible origins of six
  types of anxiety disorders.

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Learning Outcomes

• Describe the symptoms and possible origins of
  somatoform disorders.
• Describe the symptoms and possible origins of
  dissociative disorders.
• Describe the symptoms and possible origins of
  personality disorders.

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Truth or Fiction?

• In the Middle Ages, innocent people were drowned
  as a way of proving that they were not possessed
  by the Devil.
• People with schizophrenia may see and hear things
  that are not really there.

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Truth or Fiction?

• Feeling elated may not be a good thing.
• Some people have more than one personality
  dwelling within them, and each one may have
  different allergies and eyeglass prescriptions.
• Some people can kill or maim others without
  feelings of guilt.

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What is Normal?
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1. When Behavior Is Abnormal/Disordered?

• Several Questions can help determine when
  behavior is abnormal
• Is the behavior considered strange within the
  persons own culture?
• Does the behavior cause personal distress?
• Is the behavior maladaptive?
• Is the person a danger to self or others?
• Is the person legally responsible for his or her
  act?

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2. What Are Psychological Disorders?

• Mental processes and/or behavior patterns that
  cause emotional distress and/or substantial
  impairment in functioning

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3. Explaining Psychological Disorders

• Biological Perspective
• Genetics, evolution, the brain,
  neurotransmitters, hormones
• Treatment
• Diagnose and treat like any other physical
  disorder (drugs, electroconvulsive therapy, or
  psychosurgery)

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4. Explaining Psychological Disorders

• Biopsychosocial perspective
• From combination of biological, psychological,
  social
• Treatment
• An eclectic approach employing treatments that
  include both drugs and psychotherapy

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5. Explaining Psychological Disorders

• Psychodynamic perspective
• Disorders are symptoms of underlying unconscious
  processes that stem from childhood conflicts
• Treatment
• Bring disturbing repressed material to
  consciousness and help patient work through
  unconscious conflicts

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6. Explaining Psychological Disorders

• Learning perspective
• Abnormal thoughts, feelings, behaviors are
  learned and sustained like any other behaviors,
  or there is a failure to learn appropriate
  behavior
• Treatment
• Use classical operant conditioning modeling
  to extinguish abnormal behavior and to increase
  adaptive behavior (behavior therapy, behavior
  modification)

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7. Explaining Psychological Disorders

• Cognitive Perspective
• Faulty thinking or distorted perceptions can
  cause psychological disorders
• Treatment
• Change faulty, irrational, /or negative thinking
  (Becks cognitive therapy, rational-emotional
  therapy)

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8. Classifying Psychological Disorders

• Diagnostic and Statistical Manual (DSM)
• Includes information on medical conditions,
  psychosocial problems and global assessment of
  functioning
• Concerns about reliability and validity of the
  standards
• Predictive validity

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9. Prevalence of Psychological Disorders

• 50 of us will experience a psychological
  disorder at some time
• Most often starts in childhood or adolescence
• 25 will experience a psychological disorder in
  any given year,
• More than 44 million adults, are diagnosed with
  mental disorder of some kind (NIMH, 2001)

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10.Schizophrenia

• DSM-IV
• Characterized by the presence of psychotic
  symptoms, including hallucinations, delusions,
  disorganized speech, bizarre behavior, loss of
  contact with reality
• Severe psychological disorder characterized by
  disturbances in
• Thoughts, language memory
• perception and attention
• motor activity
• mood
• social interaction communication
• Play Etta Video

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Schizophrenia
PLAY VIDEO
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11. Schizophrenia

• Afflicts nearly 1 of the population worldwide
• Onset occurs relatively early in life
• Adverse effects tend to endure

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12. Positive Versus Negative Symptoms

• Positive symptoms
• Excessive symptoms
• Hallucinations, delusion, looseness of
  association
• Negative symptoms (look in my book)
• Deficiencies
• Lack of emotional expression and motivation
• Social withdrawal
• Poverty of speech

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13. Positive Versus Negative Symptoms

• Positive symptoms
• More likely an abrupt onset
• Retain intellectual abilities
• More favorable response to antipsychotic
  medication

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14. Positive Versus Negative Symptoms

• Negative symptoms
• More likely a gradual onset
• Severe intellectual impairments
• Poorer response to antipsychotic medication

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15. Types of Schizophrenia

• Paranoid Schizophrenia
• Systematized delusions
• Disorganized Schizophrenia
• Incoherence extreme social impairment
• Catatonic Schizophrenia
• Motor impairment waxy flexibility
• Undifferentiated Schizophrenia
• When symptoms do not conform to the criteria of
  any of one type of sch. Or conform to more than
  one type

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16. Origins of Schizophrenia Biological
Perspectives

• Brain abnormality
• Risk factors
• Heredity, major part
• Complications during pregnancy and birth
• Birth during winter
• Dopamine theory of schizophrenia

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17. The Biopsychosocial Model of Schizophrenia
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18. Probability of Developing Schizophrenia

• Identical twins
• If one has schizophrenia, the other twin has 46
  chance also to develop it
• In fraternal twins
• 14 chance
• One parent schizophrenic
• 13 chance
• Both parents
• 46 chance
• Data from Nicol Gottesman (1983)

• Sibling
• Less than 10
• Nephew/niece
• 2-3
• SPOUSE
• 2
• Unrelated person
• Less than 1

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Mood Disorders
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19. Mood Disorders

• Characterized by extreme and unwarranted
  disturbances in emotion or mood

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20. Types of Mood Disorders

• Major Depressive Disorder (1 person in 5 or 6
  over the course of lifetime)
• Persistent feelings of sadness, loss of interest,
  feelings of worthlessness or guilt, and inability
  to concentrate
• Psychomotor retardation
• Bipolar disorder (1.2 of the U.S. population)
• Mood swings from ecstatic elation to deep
  depression

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Expression of Mood
PLAY VIDEO
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21. Origins of Mood Disorders

• Biological
• Genetic factors
• Psychological (cognitive factors)
• Learned helplessness
• Perfectionism and unrealistic expectations
• Ruminating about depression
• Attributional styles (internal/external/global/sp
  ecific/stable/unstable)
• Biopsychosocial
• Biologically predisposed interact with
  self-efficacy expectations and attitudes

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22. Risk Factors in Suicide

• 31,000 American commit suicide each year.
• Feelings of depression, hopelessness
• What psychological problems are common for
  suicidal adolescents?
• Stressful life events
• Anxiety over discovery
• Poor problem solver
• Familial experience with psychological disorders
  and/or suicide

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23. Sociocultural Factors in Suicide

• Third leading cause of death among young people
  aged 15 to 24
• More common among college students than people of
  the same age who do not attend college
• Older people are more likely to commit suicide
  than teenagers

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24. Sociocultural Factors in Suicide

• One in six Native Americans has attempted suicide
• African Americans are least likely to attempt
  suicide
• Three times as many females attempt suicide
• Four times as many males succeed in suicide

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25. Myths about Suicide

• Individuals who threaten suicide are only seeking
  attention
• People who would take their own lives are insane
• Discussing suicide with a depressed person

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Anxiety Disorders
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26. Anxiety Disorders

• Phobias, panic disorder, generalized anxiety,
  OCD, stress disorders.
• Psychological features of anxiety
• Worrying, fear of worst case scenario,
  nervousness, inability to relax
• Physical features of anxiety
• Arousal of sympathetic branch of autonomic
  nervous system

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27. Phobias

• Specific phobias
• Irrational fears of specific objects or
  situations
• Social phobias
• Persistent fears of scrutiny by others
• Claustrophobia
• Agoraphobia
• Fear of being in places from which it would be
  difficult to escape or receive help

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28. Panic Disorder

• Abrupt attack of acute anxiety not triggered by a
  specific object or situation
• Physical symptoms
• Shortness of breath, heavy sweating, tremors,
  pounding of the heart
• Other symptoms that may feel like a heart attack

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Panic Disorder Symptoms
PLAY VIDEO
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29. Generalized Anxiety Disorder

• Persistent anxiety
• Cannot be attributed to object, situation, or
  activity
• Symptoms include
• Motor tension
• Autonomic overarousal
• Excessive vigilance

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30. Obsessive-Compulsive Disorder

• Obsessions
• Recurrent, anxiety-provoking thoughts or images
  that seem irrational and beyond control
• Compulsions
• Thoughts or behaviors that tend to reduce the
  anxiety connected with obsessions
• Irresistible urges to engage in specific acts,
  often repeatedly

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Obsessive-Compulsive Disorder
PLAY VIDEO
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31. Stress Disorders

• Posttraumatic stress disorder (PTDS)
• Caused by a traumatic event
• May occur months or years after event
• Acute stress disorder, within a month (2-4 wks)
• Unlike PTDS, occurs within a month of event and
  lasts 2 days to 4 weeks

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32. Sleep Problems Among Americans Before and
After September 11, 2001
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33. Origins of Anxiety Disorders

• Biological
• Genetic factors
• Psychological and Social
• Phobias as conditioned fears
• Cognitive bias toward focusing on threats
• Biopsychosocial
• Interaction between biological, psychological,
  social factors

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Somatoform Disorders
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34. Somatoform Disorders

• Physical problems (such as paralysis, pain, or
  persistent belief of serious disease) with no
  evidence of a physical abnormality
• Conversion disorder, hypochondriasis, body
  dysmorphic disorder

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35. Conversion Disorder

• convert a source of stress into a physical
  difficulty
• Major change in, or loss of, physical
  functioning, although there are no medical
  findings to explain the loss of functioning.
• Not intentionally produced
• Loss of vision at night (pilots), paralyzed legs,
  loss of hearing, etc.

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36. Hypochondriasis

• Insistence of serious physical illness, even
  though no medical evidence of illness can be
  found
• May seek opinion of one doctor after another

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37. Body Dysmorphic Disorder

• Preoccupation with a fantasized or exaggerated
  physical defect in their appearance
• May assume others see them as deformed

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38. Origins of Somatoform Disorders

• Biopsychosocial perspective
• Psychologically, the disorder has to do with what
  one focuses on to the exclusion of conflicting
  information
• Self-hypnosis
• Tendencies toward perfectionism and rumination
  (heritable)

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Dissociative Disorders
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39. Dissociative Disorders

• Disorders in which, under unbearable stress,
  consciousness becomes dissociated from a persons
  identity or her or his memories of important
  personal events, or both
• Trauma, usually psychological.
• Dissociation- the loss of ones ability to
  integrate all the components of self into a
  coherent representation of ones identity.

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40. Types of Dissociative Disorders

• Dissociative Amnesia
• Suddenly unable to recall important personal
  information not due to biological problems
• Dissociative Fugue
• Abruptly leaves home or work and travels to
  another place, no memory of previous life

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41. Types of Dissociative Disorders

• Dissociative Identity Disorder
• Two or more identities, each with distinct
  traits, occupy the same person
• Formerly known as multiple personality disorder
• Play Video (CD231)

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Personality Disorders
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42. Personality Disorder

• A long standing, inflexible, maladaptive pattern
  of behaving and relating to others, which usually
  begins in early childhood or adolescence.
• Impair personal or social functioning
• The most common of mental disorder (10-15)
• Cause unknown, treatment options are few
• Source of distress
• Paranoid, schizotypal, schizoid, borderline,
  antisocial, avoidant personality disorder

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43. Cluster A Odd Behavior

• Paranoid Personality Disorder
• Interpret others behavior as threatening or
  demeaning (Stalin)
• Schizotypal Personality Disorder
• Odd appearance, unusual thought patterns,
  perceptions, or behavior, lack of social skills
• Schizoid Personality Disorder
• Indifference to relationships and flat emotional
  response isolates self from others

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44.Cluster B Erratic, overly dramatic behavior

• Narcissistic, Histrionic, BPD, Antisocial
• Borderline Personality Disorder
• Instability in relationships, self-image, and
  mood
• Antisocial Personality Disorder
• Persistently violate the law
• Show no guilt or remorse and are largely
  undeterred by punishment

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45. Cluster C Anxious, fearful behavior

• Obsessive-Compulsive Dependant
• Avoidant Personality Disorder
• Avoid relationships for fear of rejection

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46. Origins of Personality Disorders

• Biological
• Genetic factors
• Personality traits that may be inherited
• Antisocial personality less gray matter in
  prefrontal cortex
• Psychological
• Learning theory
• Childhood experiences
• Cognitive
• Misinterpretation of other peoples behaviors
• Sociocultural
• Borderline personality may reflect the
  fragmented society in which one lives

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Warning Signs of Suicide

• Changes in eating and sleeping patterns
• Difficulty concentrating on school or the job
• A sharp decline in performance and attendance at
  school or on the job
• Loss of interest in previously enjoyed activities
• Giving away prized possessions
• Complaints about physical problems when no
  medical basis for problems can be found

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Warning Signs of Suicide

• Withdrawal from social relationships
• Personality or mood changes
• Talking or writing about death or dying
• Abuse of drugs or alcohol
• An attempted suicide
• Availability of a handgun
• A precipitating event

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Warning Signs of Suicide

• In the case of adolescents, knowing or hearing
  about another teenager who has committed suicide
  (which can lead to cluster suicides)
• Threatening to commit suicide