* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Psychological Disord..
Obsessive–compulsive disorder wikipedia , lookup
Death anxiety (psychology) wikipedia , lookup
Major depressive disorder wikipedia , lookup
Selective mutism wikipedia , lookup
Substance use disorder wikipedia , lookup
Gender dysphoria in children wikipedia , lookup
Memory disorder wikipedia , lookup
Bipolar II disorder wikipedia , lookup
Broken windows theory wikipedia , lookup
Impulsivity wikipedia , lookup
Addictive personality wikipedia , lookup
Bipolar disorder wikipedia , lookup
Rumination syndrome wikipedia , lookup
Obsessive–compulsive personality disorder wikipedia , lookup
Eating disorders and memory wikipedia , lookup
Psychological trauma wikipedia , lookup
Panic disorder wikipedia , lookup
Anxiety disorder wikipedia , lookup
Social anxiety disorder wikipedia , lookup
Autism spectrum wikipedia , lookup
Factitious disorder imposed on another wikipedia , lookup
Eating disorder wikipedia , lookup
Depersonalization disorder wikipedia , lookup
Schizoaffective disorder wikipedia , lookup
Personality disorder wikipedia , lookup
Mental disorder wikipedia , lookup
Separation anxiety disorder wikipedia , lookup
Munchausen by Internet wikipedia , lookup
Conduct disorder wikipedia , lookup
Depression in childhood and adolescence wikipedia , lookup
Conversion disorder wikipedia , lookup
Generalized anxiety disorder wikipedia , lookup
Glossary of psychiatry wikipedia , lookup
Asperger syndrome wikipedia , lookup
Causes of mental disorders wikipedia , lookup
Spectrum disorder wikipedia , lookup
Antisocial personality disorder wikipedia , lookup
Diagnostic and Statistical Manual of Mental Disorders wikipedia , lookup
Child psychopathology wikipedia , lookup
History of mental disorders wikipedia , lookup
Diagnosis of Asperger syndrome wikipedia , lookup
Narcissistic personality disorder wikipedia , lookup
Summary: Criteria of Psychological Disorders 1. Occurs in a minority of people. 2. Maladaptive (interferes with normal functioning). 3. Personally distressing (usually) Diagnosis of psychological disorders • Definition of Diagnosis – • “Process of matching a person's symptoms, life history, and current functions with pre-established categories of disorders.” Diagnostic Tools – Diagnostic and Statistical Manual of Mental Disorders–IV Consensual definition of mental disorders • • “Each of the mental disorders is conceptualized as: A clinically significant (=abnormal) behavioural or psychological syndrome or pattern that – Occurs in a person and that is associated with present distress (a painful symptom) – Or disability (impairment in one or more important areas of functioning) or with significantly increased risk of suffering death, disability, or an important loss of freedom... • Not merely an expectable response to a particular event (e.g., death of a loved one) • Mental disorders are not defined by… – deviant behaviour per se – Nor conflicts that are primarily between the individual and society “ [From DSM] Major Diagnostic Categories of the DSM-IV DSM: Five Axes Psychological Disorders: Medical Model • Medical Model • concept that diseases have physical causes • can be diagnosed, treated, and in most cases, cured • assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital Psychological Disorders: Bio-psycho-social Perspective Biological (Evolution, individual genes, brain structures and chemistry) Bio-psycho-social Perspective – assumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders Psychological Sociocultural (Roles, expectations, definition of normality and disorder) (Stress, trauma, learned helplessness, mood-related perceptions and memories) Psychological Disorders- Etiology • Neurotic disorder (term seldom used now) – usually distressing but that allows one to think rationally and function socially – Freud saw the neurotic disorders as ways of dealing with anxiety • Psychotic disorder – person loses contact with reality – experiences irrational ideas and distorted perceptions Diagnosis of psychological disorders (cont.) • The three most common categories of psychological disorders are – – – mood disorders (= affective disorder, especially depression) anxiety disorders substance dependence/abuse. Rate and Gender differences in psychological disorders Anxiety Disorders • Anxiety Disorders – distressing, persistent anxiety or maladaptive behaviors that reduce anxiety • Generalized Anxiety Disorder – client is tense, apprehensive, and in a state of autonomic nervous system arousal • Phobia – persistent, irrational fear of a specific object or situation Case Vignette 1: Symptoms Case Vignette 1: Diagnosis Panic Disorder • Brief periods of intense anxiety; feeling out of control; sudden unpredictable onset – – – E.g., Lecture Case History I Panic DO (without agorophobia) Often misdiagnosed as agoraphobia Phobic Disorders • • Fear has little or no justification in reality; individual knows fear is not rational (unlike some delusions) but still can't control it Agoraphobia: fear of public places where escape might be difficult – • • Individuals often won't leave home Social phobia: fear of being in groups or interacting with others, of embarrassing themselves Simple phobia: other phobias, including fear of animals, darkness, pain, needles Anxiety Disorders • Common and uncommon fears 100 Percentage 90 of people 80 surveyed 70 60 50 40 30 20 10 0 Snakes Being Mice Flying Being Spiders Thunder Being Dogs in high, on an closed in, and and alone exposed airplane in a insects lightning In a small house places place at night Afraid of it Bothers slightly Not at all afraid of it Driving Being Cats a car In a crowd of people Little-Known Phobia Radical Phobia Therapy Generalized Anxiety Disorder • Persistent non-specific anxiety, feels constantly threatened Anxiety Disorders • Obsessive-Compulsive Disorder – characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) Obsessive-Compulsive Disorder • Obsessions: persistent, disturbing, non-volitional ideas or images – – – – – E.g., thinking hands remain dirty despite washing Disabling fear that loved one has been hurt or killed Repeatedly thinking left door unlocked Worrying constantly about leaving toaster on Repeatedly thinking about a specific sexual act Obsessive-Compulsive Disorder (cont.) • Compulsions: repetitive behaviors performed to ward off anxiety, not for pleasure – – – – E.g., checking work again and again Checking toaster again and again before leaving home Performing same behavior again and again in exactly same way Repeated hand washing Anxiety Disorders: ObsessiveCompulsive Disorder: Types Common Obsessions and Compulsions Among People With Obsessive-Compulsive Disorder Thought or Behavior Percentage* Reporting Symptom Obsessions (repetitive thoughts) Concern with dirt, germs, or toxins 40 Something terrible happening (fire, death, illness) 40 Symmetry order, or exactness 24 Compulsions (repetitive behaviors) Excessive hand washing, bathing, tooth brushing, or grooming 85 Repeating rituals (in/out of a door, up/down from a chair) Checking doors, locks, appliances, car brake, homework 51 46 The Obsessive-Compulsive Personality Style Test Mark each statement as it applies to you: 1 - none or little of the time 2 - some of the time 3- a good part of the time 4- most or all of the time 1. I prefer things to be done my way. 2. I am critical of people who do not live up to my standards or expectations. 3. I stick to my principles, no matter what. 4. I am upset by changes in the environment or in the behaviour of people. 5. I am meticulous and fussy about my possessions. 6. I get upset if I don’t finish a task. 7. I insist on full value for everything I purchase. The Obsessive-Compulsive Personality Style Test (cont) Mark each statement as it applies to you: 1 - none or little of the time 2 - some of the time 3 - a good part of the time 4 - most or all of the time 8. I like everything I do to be perfect. 9. I follow an exact routine for everyday tasks. 10. I do things precisely to the last detail. 11. I get tense when my days schedule is upset. 12. I plan my time so I won’t be late. 13. It bothers me when my surroundings are not neat and tidy. 14. I make lists for my activities. 15. I think that I worry about minor aches and pains. The Obsessive-Compulsive Personality Style Test (cont) Mark each statement as it applies to you: 1 - none or little of the time 2 - some of the time 3 - a good part of the time 4 - most or all of the time 16. I like to be prepared for any emergency. 17. I am strict about fulfilling every one of my obligations. 18. I think that I expect high moral standards in others. 19. I am badly shaken when someone takes advantage of me. 20. I get upset when people do not replace things exactly as I left them. 21. I keep used or old things because they might be useful. The Obsessive-Compulsive Personality Style Test (cont) Mark each statement as it applies to you: 1 - none or little of the time 2 - some of the time 3 - a good part of the time 4 - most or all of the time 22. I think that I am sexually inhibited. 23. I find myself working rather than relaxing. 24. I prefer being a private person. 25. I budget carefully and do not buy things on credit. Scoring the Obsessive-Compulsive Personality Style Test • 25-45 You are not obsessive-compulsive • 46-55 You are mildly obsessive-compulsive. Your compulsiveness is adaptive, generally having a beneficial effect. • 56-70 Moderately obsessive-compulsive. You are adaptive but “uptightness” has crept into your functioning and you experience days of high tension. • 71-100 Severely obsessive-compulsive. You are adaptive but quite “uptight”, hard-driving and stressed. You have many days of nervous tension that should be eased off. If close to 100, depression could be a problem. Somatoform disorders • • Somatoform disorders are characterized by the expression of psychological conflicts via physical/bodily symptoms. All involve physical complaints but no apparent physical damage, and no apparent physical cause for condition. Somatoform disorders (cont.) • Different from psychosomatic DOs (e.g., ulcer induced by stress) – In that case, cause of condition isn't "physical' (e.g., virus, wound, dysfunction of metabolism like cancer), but there is real and discernible physical damage (e.g., bleeding in stomach wall) Case History 2: Symptoms Case History 2: Symptoms Case History: Bear • 1. 2. 3. 4. Has symptoms of Conversion Disorder Loss of physical functioning (he is paralyzed) Physical damage cannot explain loss of functioning Surprising indifference/lack of concern about problem Good evidence for psychological causation: – – – Friend with paralysis partly caused by him Bear's paralysis began at same site Bear did not easily remember friend's paralysis, nor relate it to own Conversion Disorder • • • One or more major physical symptoms that greatly impair functioning Used to be known as “hysterical paralysis” or just “hysteria” Sometime particular professions or situations develop “appropriate” physical disabilities, e.g.: – – • Machinist develops paralysis in hand A student in one of my classes became blind before each exam Often (although not always) accompanied by apparent lack of concern about symptom—'la belle indifference' Conversion Disorder (cont.) • • Freud did a great deal of work with this condition; he attributed it to repressed sexual feelings (surprise!). However, he is credited in being one of the first researchers to point out that conversion disorder (then called hysteria) occurs in men as well as women. General Comments: Somatoform Disorders • Are they faking it? – No, not in somatoform conditions; the pain is real, even if it does not have physical causes or involve tissue damage • In two other conditions, pain is not 'real'; symptoms are faked: • Malingering: faking condition for personal benefit – E.g., faking a whiplash injury to collect insurance • Factitious Disorder: faking a condition to get attention, usually medical General Comments: Somatoform Disorders (cont.) • Subtype: Factitious disorder by proxy – (also called Munchausen syndrome by proxy) • Relatively rare, but every hospital emergency room probably sees some cases • Parents (almost always mothers) who create illnesses in their children in order take them to hospital and be seen as caring parent; emotionally rewarding • Mothers may rub child skin to produce rash; give child drugs to induce vomiting; or more severe injuries • Mothers were themselves often abused as children; had problems with their mother • Will usually deny condition General Comments: Somatoform Disorders (cont.) • Implication: in cases of young children (under 3 years) children who are repeatedly treated for puzzling physical symptoms, the possibility that the symptoms have been induced by a parent should be considered (could also be simple case of child abuse). • Simple child abuse differs from Factitious disorder by proxy because in child abuse parents not abusing in order to be seen as caring; differing motivations. Case History: Timmy Dissociative Disorders: Dissociative Fugue • • • • Timmy’s disorder is called Dissociative Fugue Person suddenly travels to new place, assumes a new identity, and forgets about his/her old one Can be quite short-term, but generally lasts for months Different from Dissociative Amnesia (another dissociative disorder), because in Dissociative Fugue 1. The person is unaware that they have forgotten their old identity. 2. The loss of the old identity is usually accompanied by a move to new locale. 3. There is often the assumption of a new identity. Dissociative disorders • Dissociative disorders are characterized by a disturbance or alteration in the integrative functions of identity, memory or consciousness • In these disorders, person is not aware of or loses contact with some aspect of their personality • Relatively rare, but often used in plots of novels, movies, soap operas Dissociative Disorders: Dissociative Amnesia • Sudden loss of important memories, often after stressful event • Can occur after traumatic event, such as in wartime • Not just usual forgetting, or loss of memories due to alcohol, drugs, Alzheimers, etc. Dissociative Disorders: Dissociative Identity Disorder Formerly called Multiple Personality Disorder • Person appears to have two or more different personalities, one of which is dominant at a given time • Often, one or more personalities are unaware of others • Often, conflict between personalities Dissociative Disorders: Dissociative Identity Disorder (cont.) • Some psychologists doubt whether such syndromes actually exist (or whether many of the reported cases may be misdiagnoses). • Many of the cases may be better explained as excuses for wrongdoing, attention-seeking, and responding to implicit suggestions by interviewing psychologists Other Disorders: Video Vignettes • Gary: Schizoid Personality Disorder – • Pervasive pattern of detachment from social relationships and restricted range of emotion. Rita: Delusional Disorder (Erotomanic subtype): – – Delusional disorder Involves fixed, pervasive and false belief system Erotomanic subtype involves the false belief that you are involved in an intimate or romantic relationship with someone Personality Disorders •Jeffrey Dahmer : •Ted Bundy –antisocial personality disorder/ –serial murderer –antisocial personality disorder/ –serial murderer –Murdered several male youths in the U.S. –Murdered over 100 women in the U.S. •Paul Bernardo: •Clifford Olson –antisocial personality disorder/ –serial murderer –antisocial personality disorder/ –serial murderer – Murdered several women in Ontario –Murdered 13 children in BC Personality Disorders (cont) • Karla Homolka: – antisocial personality disorder/serial murderer – Assisted in killing several women in Ontario •Aileen Wourmos –antisocial personality disorder/serial murderer –killed seven men in Florida Personality Disorders • Extreme and inflexible personality traits that are distressing to the persons who have them or cause such individuals to have problems in school, work or interpersonal relations • usually without anxiety, depression, or delusions Personality Disorders (cont.) • Three distinct clusters: 1. Odd and eccentric 2. Dramatic, emotional and erratic 3. Anxious and fearful • Antisocial personality disorder is classified in the dramatic, emotional and erratic category Personality Disorders: DSM-IV Clusters Personality Disorders: DSM-IV Clusters Personality Disorders: DSM-IVClusters Antisocial Personality Disorder • • The serial murderers displayed earlier would be diagnosed as having a psychological disorder called (in DSM IV) Antisocial Personality Disorder But an earlier term for the disorder is Psychopathy (people with it called psychopaths) Antisocial Personality Disorder (cont.) • • Will use term psychopath in lecture, following one of the world's experts on psychopathy, Robert Hare of UBC Psychology Department Hare has researched psychopaths for many years – – Largely in the BC prison system See Hare's book, Without Conscience: The Disturbing World of the Psychopaths Among Us) Antisocial Personality Disorder (cont.) • Do you think all psychopaths are murderers or criminals? – – • No Hare says most are not (but the criminal psychopaths get most attention because of the horrific nature of their crimes) So what essentially differentiates psychopaths from the rest of us? Psychopath exercise • • • • Consider someone you know (or think of a fictional character) who you think might be a psychopath. Score them 'yes' or 'no' according to the following twelve characteristics Score 'yes' if the characteristic consistently or often is in evidence. Score 'no' if the characteristic rarely or never is in evidence. Psychopath exercise (cont.) • Glib and superficial – – • entertaining conversationalists tell unlikely but often convincing stories Egocentric and grandiose – – • see themselves as superior, entitled to live by own rules love power and control Lack of remorse or guilt – – • no genuine guilt or shame, no matter what they do (although they may try to fake it) explain away or minimize problems; shrug off responsibility Lack of empathy – e.g., one example more concerned about car being towed than about daughter being apprehended by social services Psychopath exercise (cont.) • Deceitful and manipulative – – • lying and manipulation is very natural and expert don't really care if they get caught lying Shallow emotions – – • don't experience real grief, fear, pride, joy, despair or love (but may fake them) equate sexual arousal with love Impulsive – • often quit jobs, break relationships, hurt people; seldom complete extensive educational or training courses Poor behaviour controls – – short-tempered may respond to criticism or frustration with sudden verbal abuse, threats or violence (but minutes later act like nothing has happened) Psychopath exercise (cont.) • Need for excitement – – • easily bored, thrill-seeking (gambling, stimulant drugs/alcohol, sexual promiscuity) don't like routine or dull jobs Irresponsible – • skip work, break dates, meetings, leave children with unreliable child care Early behaviour problems – • as children often torture animals, lie, cheat, steal, set fires, bully, run away Adult anti-social behaviour – engage in dishonest business practices, spouse or child abuse, victimize acquaintances and strangers Psychopath exercise (cont.) • • 10 -12 yeses: probably psychopathic 6-10 yeses: may be some psychopathic tendencies Psychopaths among us • Hare suggests a number of occupations and categories that may include a significant proportion of psychopaths: – – – – – – – – – – – – – Stock promoters, unscrupulous charity fund organizers Spousal abusers Players (as in “guys who sleep around”) Corporate climbers Repeat dangerous driving offender Cult leaders Disbarred professionals Child abusers Political leaders Serial killers Gang members Repeat or serial rapists Pimps, terrorists, mercenaries Antisocial Personality Disorder (cont.) • • Hare has developed a psychological scale that helps us determine if a person is a psychopath: the Psychopathy Checklist-Revised (PCL-R) The PCL-R is a 20 item scale that another person (not the individual being assessed) checks off, based on a semi-structured interview and access to files detailing the individual's past history Antisocial Personality Disorder (cont.) • PCL-R suggests two basic factors to psychopathy: 1. Interpersonal and emotional characteristics: egocentricity, lack of remorse, callousness, etc. 2. Lifestyle characteristics: impulsive, antisocial, unstable What Psychological Disorder do/did these people show symptoms of? •Bill Gates •Albert Einstein •Glenn Gould •Isaac Newton Asperger’s Syndrome •Bill Gates Asperger’s syndrome? •Albert Einstein Asperger’s syndrome? •Glenn Gould •Isaac Newton Asperger’s syndrome? Asperger’s syndrome? Pervasive Developmental Disorder A category of developmental disability that includes some or all of the following characteristics: • • • • • • • • Ritualistic behaviors Repetitive behaviors Short attention Span Impaired communication/ verbal expression Limited social interaction Over or under responsive to sensory stimulation Over or under physical activity Apparently baseless tantrums Pervasive Developmental Disorder • Affects approximately 1 in 500 children • Statistics show this rate may be rising to as high as 1 in 200 children • Boys are approximately 4 times more susceptible that girls • PDDs cross racial, ethnic and lifestyle • Children of lower socio-economic status may be more susceptible to PDD • PDD symptoms are usually apparent by age 2 or 3 • PDDs are frequently associated with mild to severe mental retardation • Subclasses of PDD include autism and Asperger’ syndrome Autism Characteristics apparent by age 6 Impaired social interaction Including non-verbal behaviors, lack of eye gaze, body posture and gestures to discourage social interaction Lack of social or emotional reciprocity Lack of spontaneous enjoyment or interest No or few friends Impaired communication Delay or total lack of spoken language For those with speech, they do not initiate conversation Stereotyped or repetitive use of language (maybe echolalia) Lack of imaginative play Restrictive or Repetitive Behaviors Preoccupation with one or more patterns of intense interest Inflexibility to change in routine Repetitive motor mannerisms Asperger’s Syndrome Impaired social interaction (apparent before age 2) Including non-verbal behaviors, lack of eye gaze, body posture and gestures to discourage social interaction Lack of social or emotional reciprocity Lack of spontaneous enjoyment or interest No or few friends Restrictive or Repetitive Behaviors Preoccupation with one or more patterns of intense interest Inflexibility to change in routine Repetitive motor mannerisms No Significant delay in language No Significant delay in cognitive development (self-help skills, curiosity, and adaptive behaviors) Mood Disorders • Mood Disorders – characterized by emotional extremes • Major Depressive Disorder – a mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities Mood Disorders • Mania – a mood disorder marked by a hyperactive, wildly optimistic state • Bipolar Disorder – a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania – formerly called manic-depressive disorder Mood Disorders- Suicide Suicides per 70 100,000 people 60 50 The higher suicide rate among men greatly increases in late adulthood 40 30 20 10 0 15-24 25-34 35-44 45-44 55-64 65-74 75-84 85+ Males Females Mood Disorders-Suicide Suicide rate per 100,000 people In recent decades teen suicides have soared 12 8 4 0 1960 Ages 15-19 1993 All Ages Mood Disorders-Depression Around the world women are more susceptible to depression Percentage 20 of population aged 18-84 experiencing 15 major depression at some point In life 10 5 0 USA Edmonton Puerto Rico Males Females Paris West Florence Beirut Germany Taiwan Korea New Zealand Mood Disorders-Bipolar • PET scans show that brain energy consumption rises and falls with emotional swings Depressed state Manic state Depressed state Mood Disorders-Depression Brain chemistry Cognition Mood • Altering any one component of the chemistry-cognitionmood circuit can alter the others Mood Disorders-Depression 1 Stressful experiences 4 Cognitive and behavioral changes 2 Negative explanatory style 3 Depressed mood • The vicious cycle of depression can be broken at any point Schizophrenia • Schizophrenia – literal translation “split mind” – a group of severe psychotic disorders characterized by: • disorganized and delusional thinking • disturbed perceptions • inappropriate emotions and actions Schizophrenia • Delusions – false beliefs, often of persecution or grandeur, that may accompany psychotic disorders • Hallucinations – false sensory experiences such as seeing something without any external visual stimulus Schizophrenia Subtypes of Schizophrenia Paranoid: Preoccupation with delusions or hallucinations Disorganized: Disorganized speech or behavior, or flat or inappropriate emotion Catatonic: Immobility (or excessive, purposeless movement), extreme negativism, and/or parrotlike repeating of another’s speech or movements Undifferentiated or residual: Schizophrenia symptoms without fitting one of the above types Schizophrenia Lifetime risk 40 of developing schizophrenia 30 for relatives of a schizophrenic 20 10 0 General population Siblings Children Identical Fraternal Children twin twin of two schizophrenia victims