Psychological Disorders

1
Psychological Disorders

• Ch 13
• Psyc103
• J. Wright

2

• T/F 40 of people develop some type of mental
  disorder in their lifetime
• Mental disorders
• 2nd greatest contributor to shortened life
• source of significant human suffering throughout
  the ages
• of patient
• of family
• of community
• Madness lunacy insanity
• thought by some
• to be a curse (and/or gift) from god(s)
• to be a source of criminality (moral insanity)
• to be a natural symptom of a sick society

3

• T/F Only recently has mental illness become
  viewed as disorder or disease (medical model).
• Benefits?
• Have natural causes
• Have symptoms
• Worthy of care
• (potentially) curable
• Downsides?

4
what is abnormal?

• All mental disorders involve abnormal mental
  states and behaviors.
• That is, they deviate in some way from the norm.
• But, not all mental states/behaviors that deviate
  from the norm should be considered mental
  disorders.
• With 40 of population developing disorder what
  is the norm and what isnt?
• Szaz The Myth Of Mental Illness
• Not a good definition (at least not by itself)

5
key elements of mental disorders

• Mental states/behaviors that deviate from norms
  AND
• Involves disturbances in behavior, thought, or
  emotion
• Stems from internal dysfunction
• biological, psychological, both

6

• Q When is something a disturbance? When is it a
  dysfunction?
• Involves significant personal distress or
  impairment.
• What if the person isnt distressed?
• e.g. Camille Claudel
• Historically, what has mattered more is other
  peoples distress.

7
GAF

• Global Assessment of Functioning
• Lack of self-care
• Inability to communicate
• Inability to interact
• Impaired judgment
• Cant function in daily society
• Work, school, friends
• Danger to self/others
• Avoided by others

8

• Categories of Metal Disorders
• Distortion of
• Sensation
• Perception
• Emotions
• Levels
• States
• Behavioral outcomes

9

• Issues concerning classification
• Co-morbidity
• Consequence of labeling
• Self-fulfilling prophecy
• Social stigma

10
issues concerning causation

• Diathesis-stress model
• Gene/environment interaction
• Diathesis internal predisposition
• Stress external trigger
• Epigenetics
• Environmental influence on genetic expression

11
anxiety disorders

• Generalized anxiety disorder (GAD)
• 2x as many women
• General fear no specific source
• Social anxiety disorder
• Separation anxiety disorder
• Which of the following is not a form of anxiety
  disorder?
• A) Panic disorder
• B) Phobic disorder
• C) Obsessive-compulsive disorder
• D) Post-traumatic stress disorder
• E) none of the above

12

• Panic disorder
• Attacks of intense terror
• High sensitivity to anxiety
• Agoraphobia
• Phobic disorder
• Strong fear and avoidance of particular
  objects/situations
• Obsessive-compulsive disorder
• Overcome with obsessive thoughts/compulsive
  actions
• Highly ritualized behaviors as coping mechanisms
• Contamination
• Order/Organization

13
(No Transcript)
14
PTSD

• Post-traumatic stress disorder
• Prevalent in high stress situations
• Poverty
• Discrimination
• Abuse
• War zones
• Unpredictable traumatic experiences
• Imbalance in neurotransmitters
• Damage to hippocampus

15
(No Transcript)
16
(No Transcript)
17
mood disorders

• Major depressive disorder
• Intense feelings of despair/helplessness,
  lethargy, gloom, lack of interest, lack of
  pleasure
• 3-6 months in duration
• Categories Melancholic, Psychotic, Catatonic
• Postpartum, Seasonal affective disorder
• Dysthymia
• Common factors involved in depression
• A) biological
• B) genetic
• C) psychological
• D) all of the above

18
contributors

• Biological factors
• Neurotransmitters norepinephrine/serotonin
• Neurological processing of emotions
• Reduced activation in left dorsolateral PFC
• Increased activation in right dorsolateral PFC
• Problems with negative emotion regulation
• Psychological factors
• Helplessness theory
• Negative attributes/experiences
• Internal, stable, global
• Q Does depression cause negative thoughts? Or do
  negative thoughts cause depression?

19
analytic-rumination hypothesis

• Pain or suffering of any kindis well adapted to
  make a creature guard itself against any great or
  sudden evilleading to the course of action which
  is most beneficial. Darwin
• Depression is like a fever that helps the immune
  system fight off infection.
• Withdrawal from distractions
• Extended rumination about problem
• Hyperactivation of left ventolateral PFC leads to
  increased analytic attention intense, focused
  deliberation
• Negative moods lead to better decision making

20
analytic-rumination hypothesis

• Heightened creativity problem-solving
• artists/writers/philosophers 8x more likely to
  suffer from depression
• depression intertwined with creative cognitive
  style
• persistence, obsessive/relentless focus
• Unfortunately, this type of thinking is often
  inseparable from the sufferingIf youre on the
  cutting edge, then youre going to bleed.
• Nancy Andreasen, neuroscientist
• Problems with this view?

21

• Bipolar disorder
• Mix of manic and depressive episodes
• Intense highs/intense lows
• Causes unclear
• Probably genetic
• Early trauma/abuse
• Triggers
• Stress
• Substance abuse
• Brain imbalance

22
dissociative disorders

• Loss or fragmentation of self
• Cognition, emotion, perception, memory
• Coping mechanism for traumatic events
• Depersonalization disorder
• Feeling of disconnection from self unreality
• Dissociative amnesia
• Impairment of recall resulting from emotional
  trauma
• Retrograde vs. anterograde amnesia
• Dissociative fugue
• Impaired recall of past, abandonment of past
• Assumption of new identity

23

• Dissociative identity disorder
• T/F Same thing as multiple personality disorder
• http//www.youtube.com/watch?vgfiB82OUXf0NR1fe
  aturefvwp
• http//www.youtube.com/watch?v7iHJfIH20TY
• Cause?
• Severe childhood trauma/abuse
• Split/dissociation
• Not associated with SES (middle-income families)

24
Schizophrenia

• Eugen Bleuler (1857-1939) Schizophrenia
• Abnormalities in perception and expression of
  reality
• Hallucinations
• Delusions
• Disorganized speech, thinking, and behavior
• Onset typically occurs in young adulthood
• Contributory factors
• Genetics
• Neurobiology increased dopamine
• Reduction in brain mass (5-10 over a decade)
• Early environment (trauma)

25

• Subtypes of schizophrenia
• Paranoid
• Delusions, hallucinations
• Catatonic
• Stupor or disorganized, purposeless behavior
• Disorganized
• Thought disorder, flat affect
• Child-onset schizophrenia
• Related to puberty induced brain development

26
(No Transcript)
27
Schizophrenia
28
Personality disorders

• Antisocial personality disorder
• "...a pervasive pattern of disregard for, and
  violation of, the rights of others that begins in
  childhood or early adolescence and continues into
  adulthood."
• history of conduct disorder
• sociopath and psychopath
• one study of 22,790 prisoners
• 47 of men and 21 of women were diagnosed with
  APD
• less activity in amygdala and hippocampus to
  words that elicit fear in non-APD

29
Behavioral markers

• Even though antisocial personality disorder
  cannot be diagnosed before adulthood, the
  presence of three behavioral markers, known as
  the Macdonald triad, can be found in some
  children who go on to develop ASPD.
• Bedwetting
• Abuse of animals
• Pyromania

30
Diagnosis

• Three or more of the following are required
• Failure to conform to social norms with respect
  to lawful behaviors as indicated by repeatedly
  performing acts that are grounds for arrest
• Deceitfulness, as indicated by repeatedly lying,
  use of aliases, or conning others for personal
  profit or pleasure
• Impulsivity or failure to plan ahead
• Irritability and aggressiveness, as indicated by
  repeated physical fights or assaults
• Reckless disregard for safety of self or others
• Consistent irresponsibility, as indicated by
  repeated failure to sustain consistent work
  behavior or honor financial obligations
• Lack of remorse, as indicated by being
  indifferent to or rationalizing having hurt,
  mistreated, or stolen from another.

31
Characteristics

• Persistent lying or stealing
• Superficial charm
• Apparent lack of remorse or empathy inability to
  care about hurting others
• Inability to keep jobs or stay in school
• Impulsivity and/or recklessness
• Lack of realistic, long-term goals -- an
  inability or persistent failure to develop and
  execute long-term plans and goals
• Inability to make or keep friends, or maintain
  relationships such as marriage
• Poor behavioral controls -- expressions of
  irritability, annoyance, impatience, threats,
  aggression, and verbal abuse inadequate control
  of anger and temper
• Narcissism, elevated self-appraisal or a sense of
  extreme entitlement
• A persistent agitated or depressed feeling
  (dysphoria)
• A history of childhood conduct disorders
• Recurring difficulties with the law
• Tendency to violate the boundaries and "rights"
  of others
• Substance abuse
• Aggressive, often violent behavior prone to
  getting involved in fights
• Inability to tolerate boredom
• Disregard for the safety of self or others
• People with a diagnosis of antisocial personality
  disorder often experience difficulties with
  authority figures.