Chapter 18

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Chapter 18Psychological Disorders
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Are these statements true or false?

1. Abnormal behaviors are always bizarre.
2. A clear distinction can be drawn between normal
   and abnormal behaviors.
3. As a group, former mental patients are
   unpredictable and dangerous.
4. Mental disorders indicate a fundamental
   deficiency in personality, and are thus shameful.
5. Because mental illness is so common, there is
   reason to be fearful of ones own vulnerability.
6. Geniuses are particularly prone to emotional
   disorders.
7. Most mental disorders are incurable.

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Using your groups definition of abnormal, decide
if these are examples of psychological disorders.
X hears voices in her head telling her to do
dangerous things.

Z has a hard time getting out of bed three or
four days every week. She has lost interest in
playing basketball and seeing her friends, two
activities that she used to really enjoy.
R has a house that is neon green, a car that is
olive green, and a mailbox that is forest green.
She wears only green clothing. When asked why she
replies, I like green.
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Introduction to psychological disorders

• Section 1

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We will discuss the following disorders

• anxiety disorders
• somotoform disorders
• dissociative disorders
• mood disorders
• schizophrenia
• personality disorders

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What is a psychological disorder?

• behavior patterns or mental processes that cause
  serious personal suffering or interfere with a
  persons ability to cope with everyday life
• normal often means what is average for most
  people, therefore, abnormal is usually a
  deviation from the majority

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How do we determine if a psychological disorder
is present?

• typicality- normality of a behavior or mental
  process
• maladaptivity-
• a maladaptive behavior is one that impairs an
  individuals ability to function in everyday life
  or is hazardous to oneself/others

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• emotional discomfort- feelings of helplessness,
  hopelessness and extreme sadness. Lose interest
  in everything
• socially unacceptable behavior- violates a
  societys accepted norms might indicate a
  psychological disorder
• Culture-Bound Syndromes Clusters of symptoms
  that define or describe an illness.

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Does this man have a psychological disorder?
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• Alans performance at work has suffered because
  he has been drinking alcohol to excess. Several
  co-workers have suggested that he seek help for
  his problem, but he thinks that theyre getting
  alarmed over nothing. I just enjoy a good time
  once in a while, he says.
• Monica has gone away to college and feels lonely,
  sad, and dejected. Her grades are fine, and she
  gets along okay with the other students in the
  dormitory, but inside shes choked with gloom,
  hopelessness, and despair.

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• Boris believes that hes Napoleon reborn. He
  believes that he is destined to lead the U.S.
  military forces into a great battle to recover
  California from space aliens.
• Natasha panics with anxiety whenever she leaves
  her home. Her problem escalated gradually until
  she was absent from work so often that she was
  fired. She hasnt been out of her house in nine
  months and is deeply troubled by her problem.

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The DSM IV (1994)

• Diagnostic and Statistical Manual of Mental
  Disorders
• 18 different categories
• categorized by observable signs and symptoms.

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Types of anxiety disorders

• Section 2

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• Anxiety
• refers to a general state of dread or uneasiness
  that occurs in response to a vague or imagined
  danger
• different from fear, which is a response to a
  real danger or threat

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• Anxiety disorders are characterized by
• nervousness
• inability to relax
• concern about losing control
• physical signs or symptoms
• such as trembling sweating rapid heart rate
  shortness of breath increased blood pressure
  flushed face feelings of faintness/light-headedne
  ss
• Anxiety based disorders are among the most
  common.

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Types of Anxiety Disorders

• Phobic Disorders-
• phobia fear
• simple phobia- persistent excessive or irrational
  fear of a particular object or situation most
  common of all anxiety disorders
• to be diagnosed, the fear must lead to avoidance
  behavior that interferes with the affected
  persons normal life
• social phobiacharacterized by persistent fear of
  social situations in which one might be exposed
  to the close scrutiny of others and therefore
  might be observed doing something embarrassing or
  humiliating

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• Most common types of phobic disorders
• zoophobia
• (fear of animals)
• claustrophobia
• (fear of enclosed spaces)
• acrophobia
• (fear of heights)
• arachnophobia
• (fear of spiders)

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What do people fear?

• Men

• Women

1. Fear of being buried alive
2. Fear of heights
3. Fear of snakes
4. Fear of drowning
5. Fear of public speaking

1. Fear of snakes
2. Fear of being bound or tied up
3. Fear of being buried alive
4. Fear of heights
5. Fear of public speaking

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Do you experience

• acrophobia?
• mikrophobia?
• aquaphobia?
• ophidiophobia?
• arachnophobia?
• claustrophobia?

• triskaidekaphobia?
• uxoriphobia?
• Santa Claustrophobia?
• panaphobia?
• phobophobia?

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• Panic Disorder and Agoraphobia
• those with a panic disorder have recurring/
  unexpected panic attacks
• panic attackrelatively short period of intense
  fear or discomfort, characterized by
• shortness of breath, dizziness, rapid heart rate,
  trembling, shaking, sweating, choking, nausea
• many who suffer from panic disorder also have
  agoraphobia, or the fear of places/ situations
  where escape may be difficult

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• Generalized Anxiety Disorder
• excessive or unrealistic worry about life
  circumstances, for 6 or more months
• worries tend to focus on
• finances,work, interpersonal problems, accidents,
  illness

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• Obsessive-Compulsive Disorder (OCD)
• obsessions- unwanted thoughts, ideas or mental
  images that occur over and over often senseless
• compulsions- repetitive ritual behaviors often
  involve checking or cleaning
• people are usually aware that obsessions are
  unjustified which distinguishes them from
  delusions

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Obsessive-Compulsive Behaviors

• checking
• Did I lock the door? I know I checked, but I
  better check one more time. OK, its locked. Im
  satisfied. But maybe I better open the door and
  start over. Lock it again.
• washing
• My hands are a little raw, but I cant help
  feeling that they could be a little cleaner, that
  I might have missed a spot where bacteria can
  grow.
• hoarding
• I dont need the things that I save, I know
  that. But what if I throw something away that
  Ill need later? Of course there are some things
  I know I wont need. For instance, Ive been
  giving myself haircuts lately so that I can save
  the hair.

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• harming
• I used to enjoy smoking, but I cant help
  thinking that the matches I throw out will start
  a fire and hurt someone. Or when Im in a car and
  I hit a bump, I sometimes worry that Ive hit
  someone.
• counting
• I do it mainly when Im bored I count ceiling
  tiles, floor tiles, letters on billboards and
  street signs. Sometimes Ill even divide the
  letters into groups of three or four. I try to
  stop, but I cant help myself.
• performing rituals
• When I walk through a doorway, I need to make
  sure that there are six inches between each
  shoulder and the door jamb. If I walk through and
  I dont think Ive accomplished this, Ill walk
  out and try again.

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• Stress Disorders
• post-traumatic stress disorder- intense,
  persistent feelings of anxiety caused by
  traumatic experiences
• Examples of traumatic events rape, severe
  childhood abuse, assault, accidents, nautral
  disasters, war
• Symptoms flashbacks, nightmares, numbness or
  feeling, avoidance, increased tension
• can occur 6 or more months after the event and
  tend to last for years/decades
• acute stress disorder- short-term symptoms
  similar to PTSD follows a traumatic event
• differs from PTSD because symptoms occur
  immediately and they last for a few days to a few
  weeks

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Dissociative Disorders

• Section 3

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• dissociation- separation of certain personality
  components or mental processes from conscious
  thought
• ex daydreaming
• When is it considered to be a sign of a
  psychological disorder?
• when it occurs as a way to avoid stressful events
  or feelings

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Have you ever experienced these dissociative
experiences?

• Suddenly realizing, when you are driving the car,
  that you dont remember what has happened during
  all or part of the trip.
• Suddenly realizing, when you are listening to
  someone talk, that you did not hear part or all
  of what the person said.
• Having the experience of being in a familiar
  place but finding it strange and unfamiliar.

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• Becoming so absorbed in watching television or a
  movie that you are unaware of other events
  happening around you.
• Talking out loud to yourself when you are alone.
• Finding that you cannot remember whether or not
  you have just done something or perhaps had just
  thought about doing it.
• Feeling sometimes as if you were looking at the
  world through a fog such that people and objects
  appear faraway or unclear.

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Section 4
Somatoform Disorders
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• somatization- expression of psychological
  distress through physical symptoms
• What are the symptoms?
• psychological problems and unexplainable physical
  symptoms

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Mood Disorders

• Section 5

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What do all these people have in common?
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True or False?????

• Every year more than 32,000 Americans commit
  suicide.
• Approximately once every 16 minutes a suicide
  occurs in the United States.
• More women than men attempt suicide.
• Of those who attempt suicide, more men than women
  succeed.
• Suicide is most common among the elderly.
• Suicide is the second most common cause of death
  among college students.
• Individuals who threaten suicide or make an
  unsuccessful attempt usually are serious.

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• Approximately 70 of suicide victims threaten to
  kill themselves sometime during the three months
  preceding the suicide.
• Suicide rates among youth have nearly tripled
  since the 1950s.
• A firearm is used in over 60 of all suicides.
• Fewer than 5 of elderly suicide victims had been
  diagnosed with a terminal illness when they
  committed suicide.
• Nevada consistently has the highest suicide rate
  in the United States.
• States with stricter gun control laws have lower
  suicide rates.
• The suicide rate for children ages 10 to 14 more
  than doubled between 1985 and 2000.

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Edvard Munch

• born December 12, 1863Loten, Norway
• Norwegian painter and printmaker
• played an important role in the development of
  German expressionism
• parents, brother and sister died when he was
  young
• his work often displayed themes such as misery,
  sickness, death

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• Sickness and insanity and death were the black
  angels that hovered over my cradle and have since
  followed me throughout my life.

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Self-Portrait with Burning Cigarette, 1895
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The Scream (or The Cry), 1893
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Death in the Sickroom, 1895
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Two categories of mood disorders

• depression-typically involves feelings of
  helplessness, hopelessness, worthlessness, guilt,
  great sadness
• bipolar disorder-involves a cycle of mood changes
  from depression to wild elation and back again

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Types of Mood Disorder

• Major Depression
• To be diagnosed, you must exhibit 5 of the
  following 9 symptoms for at least 2 weeks, nearly
  every day.
• One of the 5 symptoms must be 1 or 2
• persistent depressed mood for most of the day
• loss of interest or pleasure in all, or almost
  all
• activities

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• The remaining 4 symptoms can be any of these
• 3. significant weight loss/gain due to changes
  in
• appetite
• 4. sleeping more or less than usual
• 5. speeding up or slowing down of physical and
  
• emotional reactions
• 6. fatigue or loss of energy
• 7. feelings of worthlessness or unfounded guilt
• 8. reduced ability to concentrate or make
  meaningful
• decisions
• 9. recurrent thoughts of death or suicide

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• Bipolar Disorder
• Characterized by dramatic ups and downs in mood
• manic phase- characterized by a mood that is
  persistently and abnormally elevated and by some
  of the following
• inflated self-esteem inability to sit still or
  sleep restfully pressure to keep talking and
  switching from topic to topic racing thoughts
  difficulty concentrating

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Robert, a dentist, awoke one morning with the
idea that he was the most gifted dental surgeon
in his tristate area. He decided that he should
try to provide services to as many people as
possible, so that more people could benefit from
his talents. Thus, he decided to remodel his
two-chair dental office, installing 20 booths so
that he could simultaneously attend to 20
patients. That same day he drew up plans for this
arrangement, telephoned a number of remodelers,
and invited bids for the work. Later that day,
impatient to get rolling on his remodeling, he
rolled up his sleeves, got himself a
sledgehammer, and began to knock down the walls
In his office. Annoyed when that didnt go so
well, he smashed his dental tools, washbasins,
and X-ray equipment. Later, Roberts wife became
concerned about his behavior and summoned two of
her adult daughters for assistance. The daughters
responded quickly, arriving at the family home
with their husbands. In the ensuing discussion,
Robertafter bragging about his sexual
prowessmade advances toward his daughters. He
had to be subdued by their husbands. (Adapted
from Kleinmuntz, 1980, p. 309)
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Characteristics Manic Episode Depressive Episode
Emotional elated, euphoric, very sociable, impatient at any hindrance gloomy, hopeless, socially withdrawn, irritable
Cognitive characterized by racing thoughts, flight of ideas, desire for action, and impulsive behavior talkative, self-confident experiencing delusions of grandeur characterized by slowness of thought processes, obsessive worrying, inability to make decisions, negative self-image, self-blame and delusions of guilt and disease
Motor hyperactive, tireless, requiring less sleep than usual, showing increased sex drive and fluctuating appetite less active, tired, experiencing difficulty in sleeping, showing decreased sex drive and decreased appetite
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Section 7
Personality Disorders
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What is a personality disorder?

• patterns of inflexible traits that disrupt social
  life or work and/or distress the affected
  individual

What is the difference between personality
disorders and other psychological disorders?

• other disorders are episodes of illness that an
  individual experiences P.D. are enduring
  traits that are major components of the
  individuals personality

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Types of Personality Disorders

• Paranoid Personality Disorder
• people tend to be distrustful and suspicious of
  others perceive others behavior is
  threatening/insulting
• Schizoid Personality Disorder
• no interest in relationships with other people
  lack normal emotional responsiveness

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• Antisocial Personality Disorder
• behavior pattern of disregard for/ violation of
  the rights of others does not feel guilt or
  remorse
• (less than 1 to almost 10 of the population)
• Avoidant Personality Disorder
• desire relationships, but prevented from forming
  them by tremendous fear of disapproval of others

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Section 6
Schizophrenia
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schism or split mind

• usually considered most serious
• characterized by a loss of contact with reality
• usually first appears in young adulthood
• often worsens over time
• affects approximately 1 of the worlds population

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• characterized by
• disorganized and delusional thinking
• disturbed perceptions
• inappropriate emotions and actions

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Paranoid Schizophrenia

• delusions or hallucinations relating to a single
  theme
• less disordered thoughts and bizarre behavior,
  but may be agitated, confused, afraid

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Disorganized Schizophrenia

• incoherent in their thought and speech
  disorganized in their behavior
• fragmented and unconnected delusions and
  hallucinations
• emotionless/inappropriate emotions
• may neglect appearance/hygiene

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Catatonic Schizophrenia

• disturbance of movement
• may hold unusual, uncomfortable body positions
  for long periods of time

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How do we treat psychological disorders?

• Two categories of therapy
• 1. psychotherapy-involves verbal interactions
  between a trained professional and person seeking
  help
• 2. biologically based- involves using drugs and
  other medical procedures to treat psychological
  disorders