Psychological Disorders

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Psychological Disorders

• An Introduction

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• What are 2 major classifications of disorders?
• What makes a psychological disorder?
• What is the DSM-IV?
• What are culture-bound syndromes?
• What are anxiety disorders?
• What are mood disorders?
• What are somatoform disorders?
• What are dissociative disorders?
• What are schizophrenic disorders?
• What are sleep disorders?
• What are eating disorders?
• What are personality disorders?
• What is trephening?
• What is the Rosenhan Study?

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What is a Psychological Disorder?

• A harmful dysfunction in which behavior is
  judged to be atypical, disturbing, maladaptive
  and unjustifiable.

What is abnormal, disturbing, maladaptive and
unjustifiable depends on

• Culture

• Time Period

• Environmental Conditions

• Individual Person

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Early Theories

• Afflicted people were possessed by evil spirits.

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Early Theories

• Music or singing was often used to chase away
  spirits.

• In some cases trephening was used

Cutting a hole in the head of the afflicted to
let out the evil spirit.
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Trephening
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Early Theories

• Another theory was to make the body extremely
  uncomfortable.

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History of Mental Disorders

• In the 1800s, disturbed people were no longer
  thought of as madmen, but as mentally ill.

They were first put in hospitals.
Did this mean better treatment?
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Early Mental Hospitals

• They were nothing more than barbaric prisons.

• The patients were chained and locked away.

• Some hospitals even charged admission for the
  public to see the crazies, just like a zoo.

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Philippe Pinel

• French doctor who was the first to take the
  chains off and declare that these people are sick
  and a cure must be found!!!

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Somatogenic

• At this time- it was believed that mental illness
  had a bodily cause- Somatogenic.
• Remember that soma body

But Somatogenic could not explain disorders such
as hysteria (now called conversion disorder).
Many disorders are psychogenic the origin is
psychological, not physical.
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Current Perspectives

• Medical Perspective psychological disorders are
  sicknesses and can be diagnosed, treated and
  cured.

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Current Perspectives

• Bio-Psycho-Social Perspective assumes
  biological, psychological and sociocultural
  factors combine to interact causing psychological
  disorders.

Used to be called Diathesis-Stress Model
diathesis meaning predisposition and stress
meaning environment.
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Classifying Psychological Disorders

• What is the DSM-IV? Diagnostic Statistical Manual
  of Mental Disorders the book to classify mental
  disorders

Two Major Classifications Psychotic and neurotic
disorders.
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Psychotic Disorders

• Person loses contact with reality, experiences
  distorted perceptions

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Neurotic Disorders

• Distressing but one can still function in society
  and act rationally
• Spongebob may be hyperactive and manic, but not
  psychotic.

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Personality Disorders

• Psychological disorders characterized by
  inflexible and enduring behavior patterns that
  impair social functioning.

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Paranoid Personality Disorder

• Paranoid personality disorder is characterized by
  a distrust of others and a constant suspicion
  that people around you have sinister motives.

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Paranoid Personality Disorder

• They search for hidden meanings in everything and
  read hostile intentions into the actions of
  others.

• They are quick to challenge the loyalties of
  friends and loved ones and often appear cold and
  distant to others. They usually shift blame to
  others and tend to carry long grudges.

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Antisocial Personality Disorder

• antisocial personality disorder is characterized
  by a lack of conscience

• People with this disorder are prone to criminal
  behavior, believing that their victims are weak
  and deserving of being taken advantage of. They
  tend to lie and steal

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Antisocial Personality Disorder

• they are careless with money and take action
  without thinking about consequences

They are often aggressive and are much more
concerned with their own needs than the needs of
others.
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Borderline Personality Disorder

• characterized by mood instability and poor
  self-image

I hate you. Get away! Why did you leave me
asshole!
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Borderline Personality Disorder

• they will take their anger out on themselves,
  causing themselves injury

Suicidal threats and actions are not uncommon
They are quick to anger when their expectations
are not met.
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Histrionic Personality Disorder

• constant attention seekers

They need to be the center of attention all the
time, often interrupting others in order to
dominate the conversation.
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Histrionic Personality Disorder

• They may dress provocatively or exaggerate
  illnesses in order to gain attention.

They also tend to exaggerate friendships and
relationships, believing that everyone loves them
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Narcissistic Personality Disorder

• characterized by self-centeredness

They exaggerate their achievements, expecting
others to recognize them as being superior
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Narcissistic Personality Disorder

• They tend to be choosy about picking friends,
  since they believe that not just anyone is worthy
  of being their friend.

They are generally uninterested in the feelings
of others and may take advantage of them.
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Schizoid Personality Disorder

• People with schizoid personality disorder avoid
  relationships and do not show much emotion

They genuinely prefer to be alone and do not
secretly wish for popularity.
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Schizoid Personality Disorder

• They tend to seek jobs that require little social
  contact

Their social skills are often weak and they do
not show a need for attention or acceptance
They are perceived as humorless and distant and
often are termed "loners."
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Avoidant personality disorder

• characterized by a pervasive pattern of social
  inhibition, feelings of inadequacy, and extreme
  sensitivity to negative evaluation.
• consider themselves to be socially inept or
  personally unappealing, and avoid social
  interaction for fear of being ridiculed or
  humiliated.

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Dependent personality disorder

• characterized by a pervasive psychological
  dependence on other people.
• has difficulty making everyday decisions without
  an excessive amount of advice and reassurance
  from others

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Mood Disorders

• Psychological Disorders characterized by
  emotional extremes.

• Dysthymic Disorder

• Major Depressive Disorder

• Seasonal Affective Disorder

• Bipolar Disorder

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Major Depressive Disorder

• A person, for no apparent reason, experiences two
  or more weeks of depressive moods.

Includes feelings of worthlessness and diminished
interest or pleasure in most activities.
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Dysthymic Disorder

• Suffering from mild depression every day for at
  least two years.

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Seasonal Affective Disorder
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Bipolar Disorder

• Person alternates between the hopelessness and
  lethargy of depression and the overexcited state
  of mania.

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Bipolar Brain
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Norepinephrine
Increases arousal and boosts moods.
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Eating disorders

• Anorexia starving yourself
• Bulimia binging and purging

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Anxiety Disorders

• a group of conditions where the primary symptoms
  are anxiety or defenses against anxiety.

the patient fears something awful will happen to
them.
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What is anxiety?

• a state of intense apprehension, uneasiness,
  uncertainty, or fear.

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Generalized Anxiety Disorder

• An anxiety disorder in which a person is
  continuously tense, apprehensive and in a state
  of autonomic nervous system arousal.

The patient is constantly tense and worried,
feels inadequate, is oversensitive, cant
concentrate and suffers from insomnia.
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Panic Disorder

• An anxiety disorder marked by a minutes-long
  episode of intense dread in which a person
  experiences terror and accompanying chest pain,
  choking and other frightening sensations.

Can cause secondary disorders, such as
agoraphobia.
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Phobias

• A person experiences sudden episodes of intense
  dread.

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Obsessive Compulsive Disorder

• An anxiety disorder characterized by unwanted
  repetitive thoughts (obsessions) and/or actions
  (compulsions).

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Common Examples of OCD
Common Obsessions Common Compulsions
Contamination fears of germs, dirt, etc. Washing
Imagining having harmed self or others Repeating
Imagining losing control of aggressive urges Checking
Intrusive sexual thoughts or urges Touching
Excessive religious or moral doubt Counting
Forbidden thoughts Ordering/arranging
A need to have things "just so" Hoarding or saving
A need to tell, ask, confess Praying
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Explanations for Anxiety Disorders

• You Learn them through conditioning.

• Evolution

• Genes

• Physiology (the brain)

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Dissociative Disorders
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What are dissociative disorders?

• Dissociative fuge
• Dissociative amnesia

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Dissociative Disorders

• Disorders in which conscious awareness becomes
  separated (dissociated) from previous memories,
  thoughts and feelings.

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Dissociative Amnesia

• This disorder is characterized by a blocking out
  of critical personal information, usually of a
  traumatic or stressful nature.

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Dissociative Amnesia

• Dissociative amnesia, unlike other types of
  amnesia, does NOT result from other medical
  trauma (e.g. a blow to the head).

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Dissociative Fugue

• An individual with dissociative fugue suddenly
  and unexpectedly takes physical leave of his or
  her surroundings and sets off on a journey of
  some kind.

• These journeys can last hours, or even several
  days or months.

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Dissociative Fugue

• Individuals experiencing a dissociative fugue
  have traveled over thousands of miles.

An individual in a fugue state is unaware of or
confused about his identity, and in some cases
will assume a new identity (although this is the
exception).
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Dissociative Identity Disorder

• A rare dissociative disorder in which a person
  exhibits two or more distinct and alternating
  personalities.

• Also known as multiple personality disorder.

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Somatoform disorders

• Soma body
• Physical illnesses caused by the mind
• ex conversion disorder significant loss of
  bodily function with no physical cause
• Ex hysterical blindness blindness after
  traumatic event (no physical cause)
• Hysterical pregnancy body acts pregnant but no
  baby!
• Hypochondriasis excessive worry about getting
  sick.
• 
  

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Schizophrenia
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How Prevalent?

• About 1 in every 100 people are diagnosed with
  schizophrenia.

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Symptoms of Schizophrenia

• Disorganized thinking.

• Disturbed Perceptions

• Inappropriate Emotions and Actions

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Disorganized Thinking

• The thinking of a person with Schizophrenia is
  fragmented and bizarre and distorted with false
  beliefs.

• Disorganized thinking comes from a breakdown in
  selective attention.- they cannot filter out
  information.

Often causes
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Delusions (false beliefs)

• Delusions of Persecution

• Delusions of Grandeur

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Disturbed Perceptions

• hallucinations- sensory experiences without
  sensory stimulation.

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Inappropriate Emotions and Actions

• Laugh at inappropriate times.
• Flat Effect (no emotion)
• Senseless, compulsive acts.
• Catatonia- motionless Waxy Flexibility

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Positive v. Negative Symptoms

• Positive Symptoms
• Presence of inappropriate symptoms

• Negative Symptoms
• Absence of appropriate ones.

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Types of Schizophrenia
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Paranoid Schizophrenia

• preoccupation with delusions or hallucinations.
• Somebody is out to get me!!!!

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Disorganized Schizophrenia

• disorganized speech or behavior, or flat or
  inappropriate emotion.

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Catatonic Schizophrenia

• parrot like repeating of anothers speech and
  movements

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Undifferentiated Schizophrenia

• Many and varied Symptoms.

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• 1 A person who seeks therapy form a clinical
  psychologist because she is tense, has difficulty
  sitting still, and is continually worried about
  the future is suffering from a/an
  ____________________ disorder.
• A) anxiety
• B) panic
• C) obsessive-compulsive
• D) somatoform

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• 2 A college student seeks help from the
  counseling center because he is experiencing
  frequent episodes during which he becomes very
  fearful, or even terrified, often for no apparent
  reason. A likely diagnosis for this student's
  problem is ___________.
• A) phobic
• B) dysthymic
• C) panic
• D) conversion

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• 3 A person who has developed such an intense
  fear of insects that she rarely leaves her
  apartment has developed a _______________
  disorder.
• A) panic
• B) post-traumatic stress
• C) bipolar
• D) phobic

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• 4. A student visits the student health service
  several times each week complaining of severe
  stomach pain, but no physical cause of his
  symptoms can be found. The student is
  experiencing a __________ disorder.
• A) panic
• B) bipolar
• C) somatoform
• D) dissociative

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• 5. A young man found wandering the streets of
  his hometown claimed that he did not know his
  name or where he lived. He was taken to a
  hospital for examination, but no physical
  injuries were found. After several days in the
  hospital, he awoke and remembered that he had had
  an argument with his parents that included
  threats of physical violence on both sides. In
  order to escape this stressful situation, the
  young man developed ____________________.
• A) dissociative amnesia
• B) learned helplessness
• C) agoraphobia
• D) catatonic schiziophrenia

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• 6 A middle-aged woman did not return from a
  shopping trip one day and was not found until the
  police located her in another city three months
  later. Formerly a restaurant owner, she was
  working as a server in a restaurant and had just
  been promoted to a supervisory role. She had
  rented an apartment and was engaged to be
  married. This behavior is an example of
  ____________________.
• A) paranoid schizophrenia
• B) post-traumatic stress disorder
• C) dissociative fugue
• D) bipolar disorder

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• 7. A psychologist who spends most of his time
  treating people suffering from depression and
  bipolar disorders focuses on ____________________.
  
• A) phobic disorders
• B) somatoform disorders
• C) dissociative disorders
• D) mood disorders

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• 8 A college student seen by a counseling
  psychologist stated that he had cut almost all
  his classes during the past two weeks, had
  experienced difficulty sleeping, and felt like
  his academic situation was hopeless. The
  psychologist's diagnosis would be
  _____________________.
• A) dissociative disorder
• B) major depressive disorder
• C) undifferentiated schizophrenia
• D) bipolar disorder

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• 9. After being depressed for two years following
  her divorce, a middle-aged woman makes an
  appointment with a clinical psychologist. She
  tells the psychologist that in addition to her
  mood, she lost weight and has never felt happy
  for more than a week during this time. The
  psychologist's diagnosis would be
  ____________________,
• A) bipolar disorder
• B) major depressive disorder
• C) paranoid schizophrenia
• D) dysthymic disorder

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• 10. For the past two weeks, a realtor has been so
  depressed that she can barely make the effort to
  show houses to prospective buyers. However, this
  period of depression was preceded by a similar
  period when her energy and enthusiasm enabled her
  to sell several houses. She is consulting a
  clinical psychologist because this is a recurring
  behavior pattern. The psychologist's diagnosis
  will be ______________________.
• A) major depressive disorder
• B) hypochondriasis
• C) bipolar disorder
• D) panic disorder

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• 11. Because of his age, a man in late middle age
  has been unable to find a permanent job since
  being laid off by his employer three years ago.
  During this time, he has had to sell many of his
  possessions and has been unable to provide the
  medical care his wife requires. He is referred to
  a clinical psychologist because he is apathetic
  and tells people that he can do nothing about his
  situation. This behavior is an example of
  ____________________.
• A) learned helplessness
• B) post-traumatic stress disorder
• C) catatonic schizophrenia
• D) antisocial personality disorder

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• 12. A psychologist who bases his diagnosis of a
  man's mental disorder primarily on the presence
  of hallucinations and delusions is making a
  diagnosis of ____________________.
• A) phobic disorder
• B) mood disorder
• C) dysthymia
• D) schizophrenia

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• 13. A man believes that his escape from a house
  destroyed by a tornado was a message that he has
  a special mission in life to advise the president
  about religious matters. He has been referred to
  a clinical psychologist because he believes that
  people opposed to his views are attempting to
  kill him in order to keep him from expressing
  them. The psychologist diagnosis would be
  ________________ schizophrenia.
• A) catatonic
• B) disorganized
• C) paranoid
• D) undifferentiated

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• 14. A clinical psychologist is treating a man
  whose behavior includes hallucinations,
  delusions, and incoherent speech and mannerisms.
  However, the man's behavior does not clearly fit
  a particular type of schizophrenia. The man's
  behavior is an example of _______________
  schizophrenia.
• A) catatonic
• B) disorganized
• C) paranoid
• D) undifferentiated

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• 15. A clinical psychologist explains his
  diagnosis of paranoid schizophrenia to a client's
  family by stating that the client had a genetic
  predisposition to develop the disorder and that
  the stress of losing her job was probably the
  precipitating event. The psychologist's
  explanation is based on _______________.
• A) the diathesis-stress view
• B) learned helplessness
• C) an insanity defense
• D) DSM-IV