Psychological Disorders

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Chapter 16

• Psychological Disorders
• (Wrapup)

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Announcements
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Announcements
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Chapter 16 Roadmap

• Schizophrenia
• Bipolar Disorder
• Personality Disorders (Especially Antisocial
  and Borderline)

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Schizophrenia (p. 669)

• Schizophrenia is one of the oldest known mental
  disorders. It is prevalent in all cultures with
  essentially the same spectrum of symptoms.

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Schizophrenia (p. 669)

• The textbook refers to it as the cancer of
  mental disorders.Schizophrenia is devastating
  to the individual and the family and community
  that surround the individual.

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Schizophrenia (p. 669)

• Movie A Beautiful Mind.

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Schizophrenia (p. 669)

• Disorganized and delusional thinking.
• Disturbed perceptions.
• Inappropriate emotions and actions.

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Schizophrenia (p. 669)

• Is an Axis I Disorder
• Appears to have a genetic component and runs in
  families
• Has both negative and positive symptoms
• Is often treated with psychopharmacology
• Is typically devastating for the individual

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Schizophrenia

• Is associated with hallucinations (hearing
  voices and sometimes seeing things)
• Is associated with delusions
• Delusions of Grandeur President of U.S.
• In Extreme form Jesus Christ or Satan
• Delusions of Persecution They are out to get
  me.
• The CIA is popular as well as them
• Is associated with Word Salad
• Negative Symptoms Flat Affect (No emotions)
• Is associated with Catatonia (frozen)
• Is degenerative patients virtually NEVER get
  better

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Schizophrenia
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Schizophrenia

• Flat affect and catatonia are symptoms most
  closely associated with
• Dysthymic Disorder
• Obsessive Compulsive Disorder
• Antisocial Personality Disorder
• Schizophrenia

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Schizophrenia

• Mr. Hunt believes that he is the president of the
  United States and that he will soon become the
  King of the Universe. Mr. Hunt is most clearly
  suffering from
• Dissociative Identity Disorder
• Obsessions
• Antisocial Personality Disorder
• Delusions

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Schizophrenia

• Is overdiagnosed
• Is a diagnosis associated with problem people
  who may not have the other symptoms (word salad
  flat affect etc.)
• Chronic Schizophrenics typically lose
  everything (and become homeless)

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Schizophrenia Remember this question?

• Our early ancestors commonly attributed
  disordered behavior to
• Bad Blood
• Brain Injury
• Laziness
• Evil Spirits

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Schizophrenia Remember this question?

• Schizophrenics were thought to be possessed by
  demons. (And, this is why they heard voices.)

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Depression and Bipolar Disorder (pp.658-659)

• Depression is the most common mental illness in
  the United States (and probably the world). It
  has been nicknamed the common cold of mental
  illness.

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Depression and Bipolar Disorder

• Depression is sometimes situationally based and
  related to situations such as economic and family
  conditions. (Loss of employment, excessive
  debt, divorce, death of family member, etc.)

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Mood Disorders Depression

• Some facts about Depression
• Of the estimated 17.5 million Americans who are
  affected by some form of depression, 9.2 million
  have major or clinical depression
• Two-thirds of people suffering from depression do
  not seek necessary treatment
• 80 of all people with clinical depression who
  have received treatment significantly improve
  their lives
• The economic cost of depression is estimated at
  30.4 billion a year but the cost in human
  suffering cannot be estimated
• Women experience depression about twice as often
  as men

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Mood Disorders Depression

• Depression and Gender Differences

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Mood Disorders Depression

• Depression and Suicide

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Mood Disorders Depression

• Depression and Neurotransmitters

Pre-synaptic Neuron
Serotonin
Norepinephrine
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Mood Disorders Depression

• Depression and Social-Cognition Models

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Mood Disorders Depression

• Do you know anyone who is depressed?

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Mood Disorders Depression

• Symptoms of Major Depression
• Sleep disturbances, especially insomnia and
  early morning awakening
• Unable to get out of bed in the morning
• Withdrawal from friends and family
• Feelings of being unlovable or unworthy
• Anhedonia an inability to experience ordinary
  pleasure

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Mood Disorders Depression

• Dysthymic Disorder Dysthymic disorder lies
  between a blue mood and major depressive
  disorder. It is a disorder characterized by daily
  depression lasting two years or more.

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Mood Disorders Depression

• Seasonal Affective Disorder Not present in the
  DSM-IIIR, but added in the DSM-IV is SAD, a mood
  disorder that appears to be related to the amount
  of daylight and is actually treated with light
  therapy.

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Depression

• For the last month, Gabrielle has felt lethargic
  and has been unable to get our of bed in the
  morning. She has withdrawn from friends and
  family because she feels worthless and unlovable.
  Gabrielle is most likely suffering from
• Agoraphobia
• PTSD
• Antisocial Personality Disorder
• Major Depressive Disorder

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Depression

• Between the blues and Major Depression lies an
  order called
• OCD
• Cyclothymia
• SAD
• Dysthymia

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Depression

• Not present in the DSM-IIIR, but added in the
  DSM-IV is _______, a mood disorder that appears
  to be related to the amount of daylight and is
  actually treated with light therapy.
• OCD
• Cyclothymia
• Dysthymia
• SAD

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Depression and Bipolar Disorder (p. 659-660)

• Bipolar Disorder is also an old and well-known.
  Bipolar comes in (at least) two variants (BPD-I
  and BPD-II). Formerly, it was known as
  manic-depressive disorder.

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Mood Disorders Bipolar

• Some facts about Bipolar Disorder
• Axis I formerly called Manic-Depressive
• Diagnosed as MDD until a manic episode occurs
• Manic Episodes are often characterized by
  destructive behavior and sometimes hallucinations
• Treatable primarily by psychopharmacology (mood
  stabilizers Lithium Depakote others)
• Sometimes misdiagnosed as Schizophrenia

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Mood Disorders Bipolar

• Bipolar Disorder and Creative Works (p. 660)
• Possibly Handels Messiah
• Walt Whitman
• Ernest Hemingway
• Margot Kidder

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Mood Disorders Bipolar

• Sometimes people diagnosed with Bipolar disorder
  STOP taking their medications. The resulting
  mania is somewhat analogous to a binge on
  Cocaine.

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Bipolar Disorder

• In which disorder do people alternate between
  states of lethargic hopelessness and wild
  overexcitement?
• Dissociative Identity Disorder
• Schizophrenia
• Antisocial Personality Disorder
• Bipolar Disorder

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Bipolar Disorder

• Variation in mood is normal in healthy people but
  extreme in people who are diagnosed with Bipolar
  disorder. Between the two is a disorder called.
  
• MDD
• SAC
• Dysthymia
• Cyclothymia

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Personality Disorders (p. 677)

• We will cover two of the several personality
  disorders (a) Antisocial and (b) Borderline

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Personality Disorders

• Psychological disorders characterized by behavior
  patterns that are
• Inflexible
• Enduring
• Socially maladpative

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Personality Disorders

• Psychological disorders characterized by
  inflexible, enduring, and socially maladaptive
  behavior patterns are called ______ disorders.
• Acute
• Dysthymic
• Mood
• Personality

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Personality Disorders (p. 677)

• Antisocial Personality Disorder(formerly known
  as sociopath or psychopath)

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Personality Disorders (p. 677)

• Antisocial Personality Disorder the essential
  feature of this disorder is a pattern of
  irresponsible and antisocial behavior beginning
  in childhood or adolescence and continuing into
  adulthood.

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Personality Disorders (p. 677)

• Antisocial Personality Disorder For this
  diagnosis to be given, the person must be at
  least 18 year of age and have a history of
  Conduct Disorder before the age of 15.

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Personality Disorders (p. 677)

• Antisocial Personality Disorder Lying,
  stealing, truancy, vandalism, initiating fights,
  running away from home, and physical cruelty are
  typical childhood symptoms. (DSM-III-R, p. 342)

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Antisocial Personality Disorder

• Antisocial Personality Disorder.
• Is an Axis II Disorder
• Failure to honor financial obligations
• Inability to sustain consistent work
• Destruction of property
• Harrassing others
• Stealing
• Having an illegal occupation

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Personality Disorders (p. 678)

• Henry Lee Lucas Once Ive done a crime, I just
  forget it.
• (Lucas appears to have killed more than 360
  people over a 32 year career of crime.)

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Personality Disorders

• An antisocial personality disorder is most likely
  to be characterized by
• A persistent irrational fear of people
• Episodes of intense autonomic nervous system
  arousal
• Disruptions in conscious awareness and sense of
  identity
• A lack of guilt feelings

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Personality Disorders

• Tony is 32 years old, well groomed, well dressed,
  and quite charming. He has swindled several
  elderly people out of their life savings, and he
  seems to have little feeling for his victims, nor
  does he fear getting caught. Tonys behavior is
  evidence of
• A legal education
• Obsessive-compulsive disorder
• A really smart guy
• A personality disorder

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Personality Disorders (p. 677)

• Borderline Personality Disorder

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Borderline Personality Disorder

• Movie Fatal Attraction

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Borderline Personality Disorder

• The essential feature of this disorder is a
  pervasive pattern of instability of self-image,
  interpersonal relationships, and mood, beginning
  by early adulthood and present in a variety of
  contexts.

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Borderline Personality Disorder

• A market and persistent identity disturbance is
  almost invariably present. This is often
  pervasive, and is manifested by uncertainty about
  several life issues, such as self-image, sexual
  orientation, long-term goals or career choice,
  types of friends or lovers to have, or which
  values to adopt.

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Borderline Personality Disorder

• Recurrent suicidal threats, gestures, or behavior
  and other self-mutilating behavior are common in
  the more severe forms of the disorder.These
  people have difficulty tolerating being along,
  and will make frantic efforts to avoid real or
  imagined abandonment.

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Borderline Personality Disorder

• According to the DSM-III-R, Borderline
  Personality Disorder is characterized by (p.
  347)
• A pattern of intense and unstable interpersonal
  relationships
• Extremes of overidealization and devaluation
• Affective instability
• Inappropriate, intense anger or lack of control
  of anger, frequent displays of temper, etc.
• Marked and persistent identity disturbance
• Chronic feelings of emptiness or boredom
• Recurrent suicidal threats or behavior

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Borderline Personality Disorders

• Deena was admitted to the hospital after an
  overdose of pills after her boyfriend of one week
  broke up with her. She has had 25 boyfriends in
  the past three years, and two similar prior
  suicide attempts. She now says she is bored
  and wants to dye her hair orange and blue. She
  tells you that you are the best thing that has
  ever happened to her. The possibility exists
  that Deena might be diagnosed with
• Dysthymic disorder
• Obsessive-compulsive disorder
• Antisocial personality disorder
• Borderline personality disorder

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Psychopathology A Warning

• If you are a student in this class, you are NOT
  qualified to diagnose someone.
• But, you if you see someone having difficulty,
  you can suggest that they seek help and point
  them in the right direction.

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Next Time

• Review of Exam I Material for Final Exam
• Review of Exam II Material for Final Exam
• Questions answered as needed

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Finis