Download Psychological Disorders - The Independent School

Psychological Disorders
Chapter 18
What are Psychological Disorders?


Psychological disorder: Behavior patterns or
mental processes that cause serious personal
suffering or interfere with a person’s ability to
cope with everyday life.
In 2001, WHO released findings from a survey
which estimates that 450 million people worldwide were suffering from a psychological
disorder, and that 25% of all people will have a
psychological disorder at some point in their
lives.
Symptoms



Most people with psychological disorders do not
differ from “normal” people.
Symptoms are usually exaggerations of “normal”
behavior or mental patterns.
Behaviors and mental processes that suggest
psychological disorders include:




Typicality
Maladaptivity
Emotional Discomfort
Socially Unacceptable Behavior
Classifications



The Diagnostic and Statistical Manual of Mental
Disorders, 4th Edition (DSM-IV) is the most
widely used method of classifying psychological
disorders.
In earlier versions, causes were primary
classification method. Today they are classified
by symptoms.
The DSM is in constant revision as research
brings new knowledge into the field.


Examples
The DSM-IV classifies 18 categories of
psychological disorders.
Categories









Diagnosed in Childhood*
Dementia, Delirium
Amnesiac, etc.*
Substance-Abuse*
Schizophrenia
Mood
Anxiety
Somatoform
Dissociative
Focus of Clinical
Attention*









Factitious
Sexual and Gender
Identity
Sleep*
Impulse-Control
Adjustment
Personality
Eating*
General Medical
Condition
Other
Anxiety Disorders

Anxiety refers to a general state of dread or
unease that occurs in response to a vague or
imagined danger.



Nervousness, concern about losing control, inability to
relax.
Result of overactivity in the sympathetic branch
of the automatic nervous system.
This is more than simply feeling nervous –
anxiety disorders are classified when they
interfere with effective living, achievement of
goals, life satisfaction or emotional comfort.
Anxiety Disorders
Phobic Disorders

Simple Phobia





Most common anxiety
disorder
Persistent or irrational
fear or an object or
situation.
Fear must lead to
avoidance behavior.
Examples
Social Phobia
Anxiety Disorders
Panic Disorders and Agoraphobia

Panic Disorder

Characterized by panic attacks, short periods of intense
fear or discomfort.



Shortness of breath, dizziness, rapid heartbeat, trembling,
shaking, sweating, choking, nausea, etc.
Patients typically fear future attacks.
Agoraphobia



Fear of being in places where escape is difficult or
impossible.
Most common phobia among adults.
Many who have panic disorder also have agoraphobia.
Anxiety Disorders
Generalized Anxiety Disorder

According to the DSM-IV, GAD is an excessive
or unrealistic worry about life situations that lasts
for at least 6 months.




Finances, accidents, illness, relationships
Sense of worry must be present all of the time to
warrant a diagnosis of GAD.
Most who have GAD have another anxiety
disorder (usually phobic disorders).
Those who may only have GAD often don’t seek
treatment because it is difficult to distinguish
from the anxiety or everyday life.
Anxiety Disorders
Obsessive Compulsive Disorder I




OCD is one of the most acute of the anxiety
disorders.
Obsessions are unwanted thoughts, ideas or
mental images that occur over and over. Most
with obsessions try to ignore or suppress them.
Compulsions are repetitive ritual behaviors,
which often involve checking or cleaning.
Compulsions frequently develop as ways of
dealing with obsessions.
Anxiety Disorders
OCD II



People who have OCD
are usually aware that
their behavior is
unjustified.
Compulsions often
alleviate the obsessive
impulses, however they
may interfere with daily
life.
OCD vs. OCPD

Anxiety Disorders
Ego Dystonic vs. Syntonic
Stress Disorders



Two most common stress disorders are post-traumatic
stress disorder and acute stress disorder.
PTSD is most common after rape, child abuse, severe
accident, plane crashes, natural disasters and war.
May begin 6 months or more after trauma, and last for
years or even decades.



Over 50% of the victims of Hurricane Katrina suffered from
PTSD.
Symptoms: Flashbacks, nightmares, numbness, avoidance,
sleeplessness, irritability and poor concentration.
Acute stress disorder is short-term, with symptoms
similar to PTSD. Starts within a month of the trauma and
lasts up to a few weeks.
Anxiety Disorders
Dissociative Disorders

Dissociation: The separation of certain
personality components or mental processes
from conscious thought.



Often a normal process.
It is difficult to determine the prevalence of
dissociative disorders because the DSM-IV
categorizes them differently.
Four common types: Dissociative Amnesia,
Dissociative Fugue, Dissociative Identity
Disorder, and Depersonalization Disorder.
Dissociative Disorders
Dissociative Amnesia




Also known as psychogenic amnesia – this is
characterized by a sudden loss of memories,
typically after a traumatic event, without physical
causes.
Less common is the phenomena of losing
memories of everything – self, others, etc.
Memory often recurs as suddenly as it
disappears, and does not often recur.
The incidence of dissociative amnesia rises
sharply during wartime or natural disasters.
Dissociative Disorders
Dissociative Fugue




Characterized by forgetting personal information
and past events, however subjects also take on
a new identity.
Usually follows some kind of traumatic event
which is psychologically stressful.
When those with dissociative fugue travel to
their new home or workplace, they become
socially active, and may not seem ill.
Once the fugue is over, they typically forget what
occurred in the fugue state.
Dissociative Disorders
Dissociative Identity Disorder

Formerly called multiple personality disorder,
this involves the existence of two or more
personalities in one individual.



The personalities may or may not know of one
another’s existence.
Often voice, “age”, handedness, facial expressions
and gender are different.
DID frequently stems from severe childhood abuse.

Frequently treatment involves trying to fuse the
separate personalities into a single individual.

DID / MPD Documentary
Dissociative Disorders
Depersonalization Disorder

Depersonalization refers
to feelings of detachment
from one’s mental
process or body.



Subjects typically describe
being “outside” of
themselves.
May also feel a lack of
control.
Depersonalization is a
syndrome itself as well as
a symptom of other
psychological problems –
depression and anxiety.
Dissociative Disorders
Somatoform Disorders

Somatization: Expressing psychological distress
through physical symptoms.


Statistics on prevalence are difficult to
determine.


Different from faking an illness – somatimatics are not
intentionally faking their illness.
Many cases are either misdiagnosed or undiagnosed.
Two most common types are conversion
disorder and hypochondriasis.
Somatoform Disorders
Conversion Disorder

Conversion disorder is characterized by the
sudden change in or loss of functioning in a
major part of the body.




No medical explanation
Examples: Eyesight, movement of legs
Often characterized by a lack of concern on the
part of the patient.
Most researchers believe conversion disorder is
a response to a traumatic or stressful event.
Somatoform Disorders
Hypochondriasis

Defined as a person’s
unrealistic
preoccupation with
the fear that he or she
has a serious
disease.



Often, minor
symptoms are blown
out of proportion.
Coughs
Treatment involves
therapy and anxiolytic
medications.
Somatoform Disorders
Mood Disorders
Moods are constantly shifting, reflecting
the ups and downs of everyday life.
 When mood changes are inappropriate or
inconsistent with the situation, a mood
disorder may be the cause.
 Most mood disorders fall into two
categories:

Depression
 Bipolar Disorder

Mood Disorders
Major Depression




Depression is the most common of all the
psychological disorders
Between 13-18 million Americans are affected
by depression each year – around 9.5% of the
population.
A 2004 report found that 4% of preschoolers
were clinically depressed.
A 2003 report found that 80% of depressed
individuals do not seek treatment.
Mood Disorders
Diagnosis

At least five of the
following:







Persistent depressed mood
for most of the day.*
Loss of interest or pleasure
in activities.*
Significant weight loss or
gain.
Sleeping more or less than
usual.
Speeding up or slowing
down of reactions.




Mood Disorders
Fatigue or loss of energy.
Feelings of worthlessness
or guilt.
Reduced concentration or
decision-making skills.
Recurrent thoughts of
death or suicide.
Must be present for 2
weeks and occur nearly
every day.
At least 15% of
depressed individuals
commit suicide.
Bipolar Disorder

Formerly called Manic Depressive
Disorder. Characterized by ups and downs
in mood (manic and depressive phases).
Manic phase is abnormally elevated: inflated
self-esteem, irritability, restlessness, racing
thoughts, difficulty concentrating.
 Can also involve delusions, hallucinations, or
impulsivity – it can be very disruptive.
 Depressive phase has the same symptoms as
depression.

Mood Disorders
Schizophrenia


Schizophrenia is usually considered one of the
most serious of the psychological disorders.
It is characterized by a loss of contact with
reality.





Hallucinations - both visual and auditory.
Delusions - over-confidence, paranoia, existence.
Mental processes – illogical thought patterns,
repetition, disorganized speech.
Social withdrawal - loss of social skills, loss of
emotion.
Catatonic stupor – immobile, coma-like state.

http://www.youtube.com/watch?v=UTUMt05_nCI&feature=related
Schizophrenia
Types of Schizophrenia - I


DSM-IV categorizes
schizophrenia as lasting
at least 6 months, along
with a combination of the
previously listed
symptoms.
Three types of
schizophrenia are
paranoid, disorganized,
and catatonic.
Schizophrenia
Types of Schizophrenia - II

Paranoid schizophrenia: Characterized by
delusions or frequent auditory hallucinations,
relating to a single theme.


May be caused by problems in early brain
development.


May be delusions of grandeur, persecution or
jealousy.
Too many or too few connections in pathways of
emotional development.
May also be caused by adolescent brain growth
in the prefrontal cortex.
Schizophrenia
Types of Schizophrenia - III
Disorganized schizophrenia is
characterized by incoherent thought and
speech and disorganized behavior.
 Also may have hallucinations or delusions,
but these are fragmented and
unconnected.
 Exhibit extremes of emotion.
 Neglecting of appearance and hygiene.

Schizophrenia
Types of Schizophrenia - IV

Catatonic schizophrenia is characterized
by a disturbance of movement or mobility.
Activity may slow down or turn quickly to
agitation.
 Patients may hold unusual or uncomfortable
body positions of long periods of time, to the
point that limbs may swell and stiffen.
 May also echo what others are saying
(echolalia) or mimic the movements of others
(echopraxia).

Schizophrenia
Personality Disorders

Personality disorders are patterns of inflexible
traits which disrupt social or work life and/or
distress the individual.


Usually show up in late adolescence and may affect
all aspects of personality.
Personality disorders must be differentiated from
other disorders.


Schizophrenia, phobias and OCD are all episodes of
an illness.
Personality disorders represent enduring traits that
are major components of personality.
Personality Disorders
Types of Personality Disorder





Paranoid: Suspicious and
distrustful
Schizoid: Detachment
from social relationships.
Schizotypal:
Eccentricities and social
discomfort.
Antisocial: Disregard of
the rights of others.
Borderline: Instability in
relationships or selfconcept.





Histrionic: Excessive
emotionality or need for
attention.
Narcissistic: Need for
admiration, lack of empathy.
Avoidant: Social inhibition
and inadequacy.
Dependent: Over-dependent
on others or clinging.
Obsessive-Compulsive:
Obsession with perfection,
neatness or control
Personality Disorders