XII. Psychological Disorders

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XII. Psychological Disorders
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A. Who is mentally ill?What is disordered
behavior?

• Psychological disorder typically includes
  constellation of cognitive, emotional, and
  behavioral symptoms that create significant
  stress (impair work, relationships, etc.)
• 1. Characteristics of disordered behavior.
• Atypical, but...
• Disturbing, but particularly worrisome when ...
• Maladaptive
• Unjustifiable
• Involuntary

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A. Who is mentally ill?What is disordered
behavior?

• 2. Diagnosing disordered behavior.
• 230 possible diagnoses.
• a. Development of the DSM
• (Diagnostic and Statistical Manual for Mental
  Disorders)
• First edition 1952 too subjective.
• Third edition 1980 created objective criteria.
• Today - Fourth Edition
• - How it is used
• Important today for insurance.

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A. Who is mentally ill?What is disordered
behavior?

• ii. The DSM and labeling.
• - Can giving people a label be problematic?
• - Rosenhan et al., (1973)
• - Stigma associated with mental illness.

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B. Why are people mentally ill?

• 1. Historically (1600-1700s)
• Supernatural, witch craft.
• Treatment?
• Bleeding, magic, drill holes in skull
• Institutions like zoos

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B. Why are people mentally ill?

• 2. Medical Model
• In reaction to maltreatment.
• First scientific approach to disorders.
• Psychological disorders are caused by physical
  conditions that can be cured.
• (disease not depravity).

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B. Why are people mentally ill?

• 3. Bio-Psycho-Social Perspective
• - More contemporary.
• Considers more influences.
• Biological (genes, brain chemistry)
• Environment (stress, roles, expectations)
• Culture
• - Reflects the nature/nurture perspective.

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C. Anxiety Disorders

• 1. General Description
• experience extreme/intense fear, panic, anxiety
• most treatable, best prognosis
• 2. Generalized Anxiety Disorder
• Unfocused, free-floating anxiety
• 5 of N. Americans experience disorder at some
  point in life.
• Symptoms physiological
• psychological
• visual
• Must occur for more days than not for 6 month
  period.

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C. Anxiety Disorders

• 2. Generalized Anxiety Disorder
• Causes
• Genetic predisposition
• Hyper-vigilance/Over-arousal in brain
• Environment
• Can lead to panic attacks, panic disorder.

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C. Anxiety Disorders

• 3. Phobias
• Focus anxiety on specific source.
• - Examples
• - Causes Learning approach
• Classical conditioning
• Observational learning
• Genetic (amygdala)
• Freud

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C. Anxiety Disorders

• 4. Obsessive Compulsive Disorder
• - Trapped in endless cycle of repetitive thoughts
  (obsessions) and actions (compulsions).
• - Possibly 4 million people have OCD at one time
  in life.
• Examples...

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C. Anxiety Disorders

• Symptoms
• Severe, prolonged, disrupts normal living
• Consumes more than one hour a day.
• Causes similar to generalized anxiety.
• Post-Traumatic Stress Disorder see text.

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D. Dissociative Disorders

• 1. General Description
• - Most controversial of disorders.
• - Experience sudden loss of memory or change
  identity.
• - Dissociate in response to stressful event.

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D. Dissociative Disorders

• 2. Dissociative Amnesia
• - Selective memory loss in response to
  intolerable psychological stress.
• - Cannot remember distant/recent past
• name, identity

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D. Dissociative Disorders

• 3. Dissociative Fugue
• - Flight from ones home and identity accompanies
  memory loss.
• (take on complete new identity in different
  place).

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D. Dissociative Disorders

• 4. Dissociative Identity Disorder
• - Previously called multiple personality.
• - People have two or more distinct personalities
  that alternately control behavior.
• - Why is this disorder so controversial?

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D. Dissociative Disorders

• Causes
• - natural, protective response
• - often women who were abused as kids
• - may be encouraged by inborn, biological
  capacity
• Or - contrived fantasy?
• Or - created by therapist?

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E. Schizophrenia

• 1. General Description and Symptoms.
• - Accounts for higher of patient population in
  mental hospitals than any other disorder.

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E. Schizophrenia

• 1. Symptoms
• Disorganized Thinking no organization,
  fragmented, includes delusions.
• Disturbed Perceptions perceive things that
  arent there, hallucinations.
• (typically auditory hear voices)
• Inappropriate Emotions Actions Strike out, cry
  when should laugh, flat affect, movement -
  rocking, rubbing, motionless

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E. Schizophrenia

• 2. Types of Schizophrenia
• Positive - disorganized, deluded, acting out
• Negative - mute, catatonic, expressionless
• Chronic or Process - develops gradually, long
  history, recovery doubtful.
• Acute or Reactive - develops in reaction to life
  stress, recovery more likely.

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E. Schizophrenia

• Causes
• Genetic
• Many genes involved
• Brain
• Excess number of dopamine receptors.
• Abnormal brain tissue.
• Low brain activity in frontal lobes.
• Environment? need to have predisposition.

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F. Mood Disorders

• Mood
• Prolonged emotional state that colors many (or
  all) aspects of thoughts behavior.
• Spans from severe sad/bad (depression) to
  unbridled elation, happiness (mania).
• Depression
• - Number one reason people seek mental health
  services.

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F. Mood Disorders

• 1. Depression
• Symptoms
• focused on negative
• absence of pleasure, hopelessness
• self-blame, worthlessness
• affects sleep, speech, movement, eating

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F. Mood Disorders

• 1. Major Depressive Disorder
• - 2 levels
• Dysthymic Disorder - sad mood, low energy,
  difficulty concentrating.
• Major Depressive Disorder - more disabling,
  possibly with suicidal thoughts.

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F. Mood Disorders

• 1. Major Depressive Disorder
• Causes
• - Brain neurotransmitters
• - Genetic twin studies

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F. Mood Disorders

• 1. Major Depressive Disorder
• Causes
• - Socio-Cognitive Perspective
• Influence of interpreting events coping.
• Attribution process for negative events
• internal, stable, global
• Ruminate, develop hopelessness and learned
  helplessness.

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F. Mood Disorders

• 2. Bipolar Disorder
• - Was manic depressive disorder.
• - Alternate between hopelessness (dep) and
  overexcitedness (mania).
• Symptoms
• overtalkative, easily irritated, little need for
  sleep, loud speech, high opinion of self,
  reckless, fewer sexual inhibitions

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F. Mood Disorders

• 2. Bipolar Disorder
• Causes
• - genetic 7 in 10 chance for twins.
• - brain neurotransmitters abundant during mania
• - environmental influence unclear.

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• Disorders rates are increasing
• 1 in 6 Americans
• Symptoms by age 24

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G. Personality Disorders see text

• Inflexible and enduring patterns of behavior that
  impair ones social functioning.
• 1. Histrionic shallow, attention-getting
• 2. Narcissistic unwarranted sense of
  self-importance, cannot accept criticism, demand
  for constant attention.

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G. Personality Disorders

• 3. Antisocial socio or psychopath.
• Typically male, lack of conscience.
• Lie, steal, fight, unrestrained sexual behavior,
  fear and feel for few, no guilt.
• 4. Borderline unstable identity,
  relationships, and emotions.

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C. Anxiety Disorders

• 5. Posttraumatic Stress Disorder see text
• - Only anxiety disorder directly tied to
  experiencing or witnessing traumatic event(s).
• - Symptoms
• nightmares, reliving events
• sleeplessness, irritability, guilt
• emotional numbing, depression
• - Importance of social support/genetics.