Title: Psychological Disorders
1Psychological Disorders
- Psychological behaviors run a continuum from very
mild to extreme. Everyone has these behaviors to
one degree or another. -
- It is not until a behavior or feeling interferes
with your quality of life that they become a
disorder.
2Psychological Order
- Self-acceptance understanding yourself and
accepting the good and bad parts of yourself. - Positive relationships with others ability to
form good trusting interpersonal relationships. - Autonomy self-controlled and able to resist peer
pressure.
3Psychological Order
- Environmental masters internal locus of control
master of your domain. - Purpose in life goals and sense of direction
not diffused. - Personal Growth see yourself growing and
expanding self knowledge self actualization.
4Psychological Disorders are
- Atypical, disturbing, maladaptive, and
unjustifiable behavior. -
5Psychological Disorders Causes
- Are not usually caused by a single factor. The
medical model is probably not correct where you
can take a pill to rid yourself of a disorder. - The bio-psycho-social school most disorders are
caused by a biological predisposition,
physiological state, psychological dynamics, and
social circumstances.
6Defining Disorders
- DSM IV-Diagnostic and Statistical Manual vol. 4.
attempts to describe psychological disorders,
without explaining the causes, predicts the
future course, and suggests treatments. - Categorizes 230 disorders, in 17 categories.
7Dangers of Labeling
- Labeling someone with a disorder can create
self-fulfilling prophesies, where the label
creates the behavior. - Also, if a professional hears a person has a
disorder, they may look back at that persons
history and see things that caused those
behaviors, which might not be accurate.
8Anxiety Disorders
- Generalized Anxiety Disorder (GAD) Persistent
symptoms of an excited sympathetic, nervous
system sweating, heart racing, dizziness,
shakiness, accompanied by persistent negative
feelings and fearnot triggered by specific
events.
9Anxiety Disorders
- Panic Disorder unpredictable, minutes long
intense anxiety attack, as if you're going to be
killed any second, but no specific, real threat
is apparent. - Phobias persistent, irrational fear of a
specific object of situation. Very common.
Spiders, snakes, heights, water, enclosed spaces
are all very common phobias.
10Anxiety Disorders
- Obsessive-Compulsive disorder (OCD)
- Obsessions intrusive thoughts or fears.
- Compulsions repetitive behaviors that soothe the
fears
11Anxiety DisordersDifferent perspectives would
ascribe different causes
- Psychoanalytic repressed feelings during
childhood symbolized by trigger. - Behavioral learned fear, which has been
reinforced, or social learning, imitating others
who have fear, like parents. May be generalized
from other learned experiences one dog to all
dogs. - Biological predisposed genetically to be afraid
of things that can cause death snakes, spiders,
height, enclosed places, disease.
12Post Traumatic Stress Disorder
- PTSD--Caused by prolonged or intensely stressful
situations, like war or rape. - Symptoms difficulty sleeping, nightmares
anxiety attacks or GAD intrusive memories Guilt
associated with event - Some psychologists dismiss this disorder pointing
to those who do not get it after experiencing
similar trauma - That probably has more to do with biological
predisposition than to lack of evidence that PTSD
exists
13Multiaxial Classification in DSM-IV
Is a Clinical Syndrome (cognitive, anxiety, mood
disorders 16 syndromes) present?
Axis I
Is a Personality Disorder or Mental Retardation
present?
Axis II
Is a General Medical Condition (diabetes,
hypertension or arthritis etc) also present?
Axis III
Are Psychosocial or Environmental Problems
(school or housing issues) also present?
Axis IV
What is the Global Assessment of the persons
functioning?
Axis V
14Mood Disorders
- Some types Major, Clinical Depression Dysthymic
Depression Bipolar disorder - Mood disorders are the most common psychological
disorders called the common cold of disorders - Depression among the young is on the rise more
diagnosis or more cases?
15Major Depressive Disorder
- Major Depressive Disorder
- 2 or more weeks of depressed mood, intense
feelings of worthlessness and hopelessness and
diminished interest in things that were once
considered pleasurable. - People feel like they are in a deep black hole
with no way to get out. The hopeless feeling
often prevents them from seeing any reason to try
to get out. Very dangerous illness.
16Symptoms for Major Depressive Disorder
- Symptoms include
- discouraging feelings about the future
- life dissatisfaction
- isolation from others
- difficulty sleeping OR sleeping a lot
- inability to concentrate
- lethargy feelings of worthlessness
- loss of interest in friends or family activities
17Dysthymic Depression Symptoms
- Dysthymic Depression
- Down-in-the-dumps mood that lasts from months to
years the feelings aren't as intense, but they
last longer - Difficult to detect because of the lack of
intensity but takes a large toll on body and
psychology systems
18Treatments for Depression
- Cognitive Therapy is effective, coupled with
antidepressants trying to change internal
sentences. Because depressed people see the world
through dark glasses, their thoughts intensify
the feelings leading to a downward spiral. - Medical now treated with classes of Selective
Serotonin Reuptake Inhibitors. SSRIs. They keep
serotonin in the synapse longer, elevating mood.
(some well-known brands--Prozac, Zoloft, Paxil,
Lexapro)
19Treatment for Dysthymic Depression
- College students with dysthymic or moderate
depression responded far better to aerobics than
other treatments.
20Depression Facts
- Facts Major Depression usually lasts less than
three months may or may not return often
triggered by stressful events, although not
necessarily caused by it (biological
predisposition) - Dysthymic depression lasts two years or longer.
- Women are twice as likely to have it as men
- Depression is a whole body disorder with
biochemical and psychological roots, therefore
generally requires both therapy and
antidepressant treatment.
21Depression facts
- Those who are depressed often become socially
isolated as they withdraw from friends and
friends withdraw from them as their old self
changes. - The depressed person is likely to blame
themselves with negative self speak which
exacerbates the depression - Reciprocal Determinism
22Bipolar Disorder (formerly manic-depression)
- Bipolar Disorder
- alternates between hopelessness and lethargy of
depression and over-excited manic state.
23Bipolar Disorder (manic-depression) Some
Symptoms
- Manic state typically over-talkative
overactive little or no sleep highly impulsive,
loud, flighty, hard to interrupt, sexually less
inhibited. Grandiose optimism and self-esteem.
May be very irritable. - People then fall back to either a normal state,
or into a major depressed state
24Treatment for Bipolar Disorder
- TreatmentIn depressed state high levels of
neurotransmitter Norepinephrine. - Treatment usually with Lithiummood
stabilizer--for the manic state and
antidepressants for the depression. - Treatment is very effective if patients continue
using medication.
25Somatoform Disorders
- Characterized by physical symptomspain,
paralysis, blindness, or deafness W/OUT any
demonstrated physical cause - Differs from psychosomatic (tension headaches,
ulcers, heart problems brought on by stress) - as no physical damage is done
26Somatoform Disorders5 types
- 1.)Somatization disorder characterized by many
somatic symptoms that cannot be explained
adequately based on physical and laboratory
examinations. Specific characteristics include
the following - Onset of unexplained medical symptoms in persons
younger than 30 years - Multiple and chronic complaints of unexplained
physical symptoms
27Somatoform Disorders Somatization Symptoms contd
- Multiple pain symptoms involving multiple sites,
such as the head, neck, back, stomach, and limbs - At least 2 or more unexplained gastrointestinal
symptoms, such as nausea and indigestion - At least 1 sexual complaint and/or menstrual
complaint - At least 1 pseudoneurological symptom, such as
blindness or inability to walk, speak, or move
282 more Somatoform Disorders
- 2.) Conversion Disorderused to be known as
hysterialoss of function (becoming blind, deaf,
or paralyzed) w/out physical damage to the
affected organs nor their neural connections - 3.) Hypochondriasisperson unrealistically
interprets physical signspains, lumps, or
irritationsas evidence of serious disease
29Somatoform Disorders
- 4. Pain disorder somatoform disorder
characterized by a focused pain complaint that
cannot be entirely attributed to a specific
medical disorder. Specific symptoms of pain
disorder include the following - Pain in 1 or more anatomical sites producing a
predominant clinical focus - Psychological factors (felt to play an important
role in the onset, severity, or course of pain) - Pain symptom that is not feigned or intentionally
produced
30Somatoform Disorders
- 5.) Body Dysmorphic Disorder somatoform disorder
characterized by a focus on a physical defect
that is not evident to others. Specific
characteristics of body dysmorphic disorder
include the following - Preoccupation with an imagined defect in
appearance - May be associated with multiple, frantic, and
unsuccessful attempts to correct imagined defect
by cosmetic surgery
31Somatoform Disorders--Causes
- No definitive causes for most of the somatoform
disorders have been established. - Genetic and environmental influences appear to
contribute to somatization. - Children raised in homes with a high degree of
parental somatization may model somatization. - Sexual abuse may be associated with an increased
risk of somatization later in life. - Poor ability to express emotions (alexithymia)
may result in somatization.
32Somatoform Disorders--Treatment for specific
somatoform disorders
- Somatization disorder Patients may resist
suggestions for individual or group psychotherapy
because they view their illness as a medical
problem. - Patients who accept psychotherapy may be able to
reduce health care utilization. - Psychosocial interventions that focus on
maintaining social and occupational function
despite chronic medical symptoms may be helpful.
33Somatoform Disorders--Treatment
- Conversion disorder Limited studies about
specific psychotherapy exist for conversion
disorder. - Behavior therapy or hypnosis may be effective.
Symptoms often resolve spontaneously.
34Somatoform DisordersTreatment contd
- Hypochondriasis Physicians should attempt to
answer questions and reduce the patient's fear of
a specific illness. - Group psychotherapy may provide social support
and reduce anxiety. - Cognitive therapy strategies may help by focusing
on distorted disease-related cognitions. - Individual insight-oriented psychotherapy has not
been proven effective.
35Somatoform DisordersTreatment contd
- Pain disorder Behavior therapy, including
biofeedback, can be helpful. - Hypnosis also may be considered for chronic pain
syndromes. - Some outcome data supports the effectiveness of
individual psychotherapy. - Exploration of interpersonal effects of chronic
pain may reduce social complications of pain.
36Schizophrenia and Symptoms
- A group of severe psychotic disorders
characterized by disorganized thought and
delusional thinking disturbed perceptions and
inappropriate emotions and actions. Onset often
occurs in late adolescence. - Delusion-irrational, unjustifiable, grandiose,
usually paranoid, belief of persecution by an
unseen entity. - Hallucinations the perception of non-existent,
external stimuli, usually auditory.
374 Types of Schizophrenia
- Paranoid preoccupations with delusions and
hallucinationspositive symptoms - Catatonic immobility or excessive purposeless
movements.---negative symptoms flat affect - Disorganized disorganized speech or behavior,
inappropriate emotions. Word Salads scrambled or
nonsensical speech. - Undifferentiated symptoms, but doesn't fit above
models.
382 Levels of Schizophrenia
- 1.) Chronic slowly develops over time,
prognosisbad. - 2.) Acute reaction to life stresses, quick
onset, good prognosis. - Schizophrenic thinking may be seen as an
uncontrolled rapid change of selective attention,
where the mind rapidly shifts from one thought to
another.
39Causesof Schizophrenia
- Psychology triggering experiences, genes
predisposed but some react to traumatic triggers
(stressors) by developing schizophrenia. They
vary. - Biochemical 6 times the normal amount of
Dopamine receptors that increase brain activity
to manic levels. Thus dopamine blockers reduce
symptoms.
40Causes of Schizophrenia
- It is also thought to perhaps be triggered or
caused by the introduction of a prenatal virus
that affects brain development, possibly in the
thalamus. - People conceived in Winter months are more apt to
develop schizophrenia in Northern hemisphere,
while the reverse is true in the Southern.
41Rule of Thirds
- About 1/3 of people who develop schizophrenia
only have one episode, 1/3 have reoccurring
episodes, and 1/3 are chronic with unremitting
symptoms.
42Causes of Schizophrenia contd.
- Amphetamines and cocaine sometimes intensify
symptoms. - Dopamine is also associated with physical
movement, disruption of is associated with
schizophrenia(excess dopamine receptors) - Brain anatomy they have abnormal brain tissue,
low frontal lobe activity. - Thalamusstructure is smaller than normal and is
reactive--that may cause brain over -stimulation.
- People exposed to certain flu viruses during
prenatal development have higher incidences.
43Genetic factors of Schizophrenia
- Definite genetic link the closer you are
genetically to someone with Schizophrenia, the
more likely you are to get it. - 1 in 100 people get it.
- 1 in 10 of siblings
- 1 in 2 identical twins, even if raised apart
44Treatment for Schizophrenia
- Psychopharmaceuticals
- Antipsychotic Medication OR Neuroleptics
- Haldol, Clozaril, Thorazinedecreases
hallucinations, lessen agitated behavior - Negative side effects because the drugs are
Dopamine blockers - Tardive Dyskinesiaproblems walking, drooling,
involuntary muscle movements
45Dissociative Disorders
- Dissociation is the feeling that you are outside
of yourself, looking at yourself. That your mind
is separate from body. - Person has separated parts of their personality
or memory for consciousness.
46Dissociative Identity Disorder Multiple
Personality Disorder
- This is a disorder in which your mind partitions
itself into two or more distinct personalities
that may or may not know about each other. One
personality emerges to handle stressful
situations that the whole psyche or other parts
cannot handle. - Caused by traumatic event or events where the
mind represses parts of itself that cant handle
the pain. Repressed from a psychoanalytical
point of view.
47Dissociative Identity Disorder
- Skeptics believe that people are either lying,
are fantasy-prone, or have had this disorder
suggested to them by therapists. - It only seems to occur in places, like here,
where people know about it through books like the
Sybil and the Three Faces of Eve.
48Dissociative Amnesia
- Selective memory loss of a specific traumatic
event. The amnesia vanishes as abruptly as it
begins and rarely reoccurs.
49Dissociative Fugue
- In this type of dissociation, the person just
leaves their home and starts on new life, with no
memory of their past life. The memory may
reoccur and the person may return home, only to
leave again.
50Personality Disorders
- Personality consists of enduring traits or
characteristicsso personality disorderspersisten
t traits or characteristics that are atypical,
disturbing, maladaptive and unjustified. - Prognosis for treatment (intensive psychotherapy)
for many is not very good.
51Personality Disorders-6 Types
- 1.) Antisocial most common, person has no
conscience. Lacks a sense of wrongdoing, even
toward friends or family members. - Usually a man thing.
- Usually emerges before 15
- Person may be aggressive and/or ruthless.
Deceiving or conning others or be aggressive
sexuallyany all with no remorse. Psychopaths,
serial killers, sociopaths.
52Personality Disorders
- 2.) Histrionic displays shallow,
attention-getting behaviors, feeling
uncomfortable when not the center of attention. - Acting in an aggressive, sexual way that makes
others uncomfortable. - Rapid shifting of emotions. Dressing
provocatively to gain attention, speaks in
dramatic tones.
53Personality Disorders
- 3.) Narcissistic Preoccupied with themselves and
an exaggerated sense of their own importance.
54Personality Disorders
- 4.) Schizoid
- either desires nor enjoys close relationships,
including being part of a family - Almost always chooses solitary activities
- Has little, if any, interest in having sexual
experiences with another person - Takes pleasure in few, if any, activities
- Lacks close friends or confidants other than
first-degree relatives - Appears indifferent to the praise or criticism of
others - Shows emotional coldness, detachment, or
flattened affectivity - (Source MayoClinic.com)
55Personality Disorders contd.
- 5.) Avoidant
- Avoids occupational activities that involve
significant interpersonal contact, b/c of fears
of criticism or rejection. - Is unwilling to get involved w/people unless
certain of being liked. - Shows restraint w/in intimate relationships b/c
of the fear of being shamed or ridiculed. - Is preoccupied with being criticized or rejected
in social situations. - Is inhibited in new interpersonal situations
because of feelings of inadequacy. - Views self as socially inept, personally
unappealing, or inferior to others. - Is unusually reluctant to take personal risks or
to engage in any new activities because they may
prove embarrassing. (DSM-IV)
56Personality Disorders
- 6.) Borderline
- unstable sense of self
- rapidly changing affect will be clingy one
minute and then hostile the next - try to pull people close and then do things to
drive them away - very manipulative to gain attention unstable
relationships - Very poor prognosis for recovery, so some
therapists wont treat them