Psychological Disorders

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Chapter 12

• Psychological Disorders

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What is Psychological Disorder?

• Psychopathology Any pattern of emotions,
  behaviors, or thoughts inappropriate to the
  situation and leading to personal distress or the
  inability to achieve important goals
• Synonymous terms include
• Mental illness
• Mental disorder
• Psychological disorder
• Abnormal psychology

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Indicators of Abnormality

• Three classic signs suggest a severe
  psychological disorder
• Hallucinations
• Delusions
• Severe affective (mood) disturbances
• Other signs of a disorder are more subtle, and a
  diagnosis depends heavily on clinical judgment

Atypical
Maladaptiveness
Disturbing
Unjustifiable
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Changing Concepts ofPsychological Disorder

• Medical Model Diseases of the mind objective
  causes require specific treatments
• Disadvantages Encourages patient to be passive,
  psychologists not as important as psychiatrists,
  overmedicating
• Psychological Models
• Behavioral perspective Abnormal behaviors can
  be acquired through behavioral learning
• conditioning (class/operant) - fears, anxiety
• Cognitive perspective Abnormal behaviors are
  influenced by mental processes
• how people perceive themselves and relations with
  others
• locus of control, coping mechanisms
• Both have a social component as well!
• Social-Cognitive-Behavioral Approach

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The Biopsychology of Mental Disorder

• Although there is reservation about the medical
  model, psychologists do not deny the influence of
  biology on thought and behavior
• Biopsychology influence of biology on thought
  and behavior
• Biopsychosocial Model combination!!!
• Diathesis-stress hypothesis Genetic factors
  place the individual at risk, but environmental
  stress factors transform this potential into an
  actual disorder

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Overview of DSM-IV Classification System

• DSM-5 Diagnostic and Statistical Manual of
  Mental Disorders
• Most accepted classification system in US
• Closely tied to medical model
• Avoids endorsing theories of cause or treatment
• Statistics data

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Somatic Symptom and Related Disorders

• Somatic Symptom Disorders Prominence of somatic
  symptoms associated with distress and impairment.
• Somatic Symptom Disorder distressing somatic
  symptoms plus abnormal thoughts, feelings and
  behaviors in response to them
• Illness Anxiety Disorder Preoccupation with
  having or acquiring a serious illness without
  somatic symptoms.
• Conversion disorder Altered voluntary motor or
  sensory functions without physical cause
  (paralysis, weakness, or loss of sensation)
  video

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Personality Disorders

• Personality disorders Enduring pervasive and
  inflexible pattern of inner experience and
  behavior that deviates from ones culture and is
  stable over time
• Personality traits to an excessive degree and in
  rigid ways that undermine their adjustment
• Handout focus on middle column (Cluster B)
• Antisocial, Borderline, Histrionic, Narcissistic

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Feeding and Eating Disorders

• Persistent disturbance of eating or related
  behavior resulting in altered consumption or
  absorption of food that impairs health or
  functioning
• The following involve undue influence of weight
  or shape on self-evaluation
• Anorexia Nervosa restriction of energy intake
  that leads to significantly low weight with a
  fear of gaining weight
• Bulimia Nervosa recurrent episodes of binge
  eating and behaviors to prevent weight gain
• Pica, Rumination, Avoidant, Binge Eating

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Anxiety Disorders

• Share features of excessive fear, anxiety and
  related behavioral disturbances(survey)
• Fear emotional response to real/perceived threat
• Anxiety anticipation of future of threat
• Specific Phobia Marked fear of a specific
  object or situation
• Significantly interferes with daily routine,
  occupation, or social life.
• Animal, Enviro, Situational, Injury/blood/inject
• Preparedness hypothesis innate tendency to
  respond quickly and automatically to stimuli that
  posed a survival threat to our ancestors

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Anxiety disorders (contd)

• Social Anxiety Disorder A persistent fear of 1
  social or performance situations in which the
  person is exposed to unfamiliar people or to
  possible scrutiny by others.
• Fears that he or she will act in a way that will
  be embarrassing and humiliating.
• Generalized anxiety disorder Excessive anxiety
  and worry about a number of things without any
  real external cause
• Panic disorder Recurrent, unexpected panic
  attacks followed by worry of another
• http//www.youtube.com/watch?vWWngA_ZMCD4

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Anxiety Disorders

• Agoraphobia Fear of being in places where it
  may be difficult or embarrassing to get out
  quickly or where you may have a panic attack and
  can't get help
• Avoid places where you think you may have a panic
  attack or panic-like symptoms.
• Often leads to not wanting to leave your home
  (video)
• Causes of Anxiety Disorders
• Genetics
• Abnormal neurotransmitters
• Environment
• Learning

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Trauma and Stressor Related Disorders

• Post-Traumatic Stress Disorder Recurrent,
  involuntary, and intrusive distressing memories
  of traumatic events
• Actual or threatened death, serious injury,
  sexual violence
• Direct experience, witness, learning about,
  extreme exposure
• Avoid associated stimuli, negative cognitions/
  moods, alterations in arousal/reactivity

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Obsessive-compulsive and related disorders

• Obsessive-compulsive disorder Presence of
  obsessions and /or compulsions
• Obsession Intrusive, persistent thought, image,
  or urge
• Compulsion Repetitive behavior or mental act
  one feels driven to do in response to an
  obsession
• Take up more than 1 hour of the day
• Handout, video clips, survey
• http//www.youtube.com/watch?v44DCWslbsNM
  (AGAIG)
• http//www.youtube.com/watch?vRn1OYlYzgm8
  (Spokesperson)

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Obsessive-compulsive and related disorders

• Body Dysmorphic Disorder Preoccupation with one
  or more perceived defects or flaws in physical
  appearance that are not observable or appear
  slight to others
• Hoarding Persistent difficulty discarding or
  parting with possessions regardless of their
  value
• Trichotillomania, Excoriation

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Dissociative Disorders

• Dissociative disorders Disruption in the
  integration of consciousness, memory, identity,
  emotion, perception, and behavior
• Intrusion into awareness or inability to access
  information/control mental functions
• Extreme stress consciousness becomes
  dissociated (split) from previous thoughts and
  memories
• Trouble integrating dimensions of consciousness
• They remain split and operate independently of
  each other

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Dissociative Disorders

• Dissociative Amnesia A psychologically induced
  inability to recall biographical information,
  usually of traumatic or stressful nature
• May be localized, selective or generalized
• May involve fugue purposeful traveling or
  bewildered wandering
• Dissociative Identity Disorder Disruption of
  identity characterized by 2 distinct personality
  states
• Marked discontinuity in sense of self
• Recurrent gaps in everyday events, personal info
• 90 have history of childhood abuse and neglect
• http//www.youtube.com/watch?vYXuG2zI39yAfeature
  related

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Depressive Disorders

• Sad, empty, or irritable mood, accompanied by
  somatic cognitive changes that significantly
  affect functioning
• Major depression Form of depression that has
  clear cut changed in affect, cognition, and
  behavior with inter-episode remissions
• A change in previous functioning for a 2 week
  period
• Must have a depressed mood or loss of interest or
  pleasure along with 4 other symptoms
• Symptoms slide
• With Seasonal Pattern Onset and remission of MD
  episodes at characteristic times of year
• Persistent Depressive Disorder (Dysthymia)
  Depressed mood for most of the day, more days
  than not, for at least two years symptoms not as
  severe as MDD
• Causes of DDs Genetics, chemical (serotonin)
  environment, cognitions

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Bipolar Disorder and related disorders

• Bipolar disorder Periods of elevated mood
  (mania) and periods of depression
• Manic Episodes
• Excessively high, overly good, euphoric, maybe
  angry
• Increased energy, activity, irritability,
  restlessness
• Racing thoughts, talking very fast, cant
  concentrate well
• Little sleep needed, poor judgment, spending
  sprees
• Unrealistic beliefs in ones abilities
• Increased sexual drive, abuse of drugs, denial of
  problem
• Bipolar I Typically severe mania and depression
• Bipolar II Typically hypomania and severe
  depression
• Cyclothymic Typically hypomania with less
  severe depression

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Schizophrenic Disorders

• Schizophrenia Abnormalities in 1 of the
  following delusions, hallucinations,
  disorganized thinking, abnormal motor behavior,
  and negative symptoms reality falls apart
• Delusion false belief that a person maintains in
  the face of contrary evidence
• Reference everything related to you
• Persecution everybody plotting against/harm
• Grandeur more important, powerful, wealthy
• Hallucination sensory perception w/ no external
  cause usually auditory related to delusions

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Symptoms of Schizophrenia

• Positive
• Any form in which the person displays active
  symptoms
• Excess or distortion of normal functions
• Delusions, hallucinations, word salads
• Responds to anti-psychotic meds

• Negative
• Any form distinguished by deficits
• Loss of normal functioning
• Alogia, avolition, decreased emotional expression
  (flat affect)
• Does not usually respond to anti-psychotic meds
• Catatonia

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Possible Causes of Schizophrenia

• Variety of factors - genetics, abnormal brain
  structure, and biochemistry
• Fundamentally a brain disorder
• Dopamine Hypothesis caused by over-active
  dopamine system in brain
• Drugs that block dopamine reduce positive
  symptoms
• Diathesis-stress model