Download Anxiety Disorders

Unit 12:
Abnormal Psychology
Perspectives on Psychological
Disorders
Questions…
• How should we define psychological
disorders?
• How should we understand disorders?
• How should we classify psychological
disorders?
•
•
•
•
•
•
•
•
•
•
•
Intellectual Disability
Learning Disorder
Tourette’s Disorder
Pica
Rumination
Binge Eating
Enuresis
Encopresis
Nightmare Disorder
Erectile Disorder
Female Orgasmic
Disorder
• Gender Dysphoria
• Oppositional Defiant
Disorder
• Kleptomania
• Pyromania
• Gambling Disorder
• Voyeuristic Disorder
• Exhibitionist Disorder
• Frotteuristic Disorder
Caffeine Use Disorder
Non-suicidal Self-Injury
Internet Addiction Disorder
Disorders We Need To Know…
• Anxiety Disorders
–
–
–
–
Anxiety
Generalized Anxiety
Panic
Phobias
• OCD
• PTSD
• Dissociative Disorders
– Dissociative Identity Disorder
– Dissociative Disorders
• Mood Disorders
– Major depressive disorder
– Mania
– Bipolar Disorder
• Somatic Symptom Disorders• Schizophrenia
– Somatoform
– Conversion
– Illness anxiety disorder
(hypochandriasis)
• Personality
– Personality disorders
– Antisocial
Defining Psychological Disorders
• Psychological disorders
– clinically significant disturbance in an
individual’s cognition, emotion regulation, or
behavior
– Dysfunctional: maladaptive – interfere with day-today life Japan: hissing is polite way to
show respect for superiors
– Distressful
Among the Karaki of New Guinea a man is
considered abnormal if he has not engaged in
sex with a man before marriage
Thailand: PDA between men & women unacceptable; but
men holding hands is a sign of friendship…& use of straws
is considered vulgar
– Deviant (different) behavior (from one’s culture)
Understanding Psychological Disorders
The Medical Model Demon
…led topossession
harsh and
• Philippe Pinel (1745-1826)
– reform inhumane conditions of mentally ill patients
as
ineffective
cause for
mental
remedial
illness
treatment
• Medical model
psychopathology
– Idea that mental illness has physical causes that
can be diagnosed based on symptoms &
sometimes cured through therapy in a hospital.
Contrast this with
the
biopsychosocial
approach to
disordered
behavior.
Perspectives – Causes of
Disordered Behavior
Psychoanalytic
unconscious conflict / childhood
Humanistic
no UPR /people putting CW on you
Cognitive
faulty thinking
Behavioral
faulty environment
Biopsychosocial
eclectic approach
Understanding Psychological Disorders
The Biopsychosocial Approach
Mind & body are inseparable; negative emotions
contribute to physical illness, and physical abnormalities
contribute to negative emotions.
self-focused
rumination
psycho
rejection from
others
social
low serotonin
bio levels
Why would it
be difficult to
explain
anorexia
nervosa
occurring
mostly in
Western
cultures in
terms of the
medical
model?
Classifying Psychological Disorders
• DSM-IV-TR DSM-5
– Diagnostic & Statistical Manual (5th Revision)
• What does it do? Why have it?
*DESCRIBES DISORDER / DOES NOT EXPLAIN*
– reliability of diagnoses by different psychologists (83%)
– focuses treatment
– common language
– preconception & stereotypes can stigmatize
– self-fulfilling prophecy
+
-
Rosenhan Study
• Use link on calendar to skim through or do
your own internet search to find the answers
to the following:
– What was the purpose of the Rosenhan study?
– What was the methodology?
– What were the results?
– Criticism of study?
Labeling Psychological Disorders
• Rosenhan’s study
Do the characteristics that lead to psychological diagnoses reside in
the patients themselves or in the environments in which observers
find them?
 “pseudopatients”
 “empty” “hollow” “thud”
 Schizophrenia
 Up to them to gain their release
 “note taking behavior”
 Average stay = 19 days (52)
Pseudopatient: “Pardon
me Dr.___, when will I be
allowed ground
priveileges?
Dr.: Good morning Dave.
How are you today?
Potential dangers and benefits of using
diagnostic labels.
Anxiety Disorders
Read
pages
569576
Anxiety Disorders
• Anxiety disorders – distressing
persistent worry / maladaptive
behaviors that reduce the worry
–Generalized anxiety disorder
–Panic disorder
–Phobia
–Obsessive-compulsive disorder
–Post-traumatic stress disorder
Generalized Anxiety Disorder
• Generalized anxiety disorder
– Continual worry
– No physical problem but can
manifest itself physically or lead to
physical problem
• jittery; agitated; sleep issues
– Women 2xs likely
– Often accompanied by
depression
300.02
3 of 6 need to be present
Panic Disorder
300.01
Panic Disorder
• Panic disorder
–Panic attacks (1 in 75)
• Strikes suddenly, minutes long, intense dread
• Heart palpitations, shortness of breath, choking
sensations, trembling or dizzy
smokers
have double
risk panic
disorder
• Phobias
Phobias
– Irrational fear causes person to avoid some
object, activity or situation
–Specific phobia
• Focus on animals, insects, heights,
small spaces – specific trigger
–Social Anxiety Disorder (social phobia)
Go to lengths to
–Agoraphobia
avoid situation
• Fear of situations where escape may
be impossible or where panic attack
happened before
Understanding Anxiety Disorders
The Learning Perspective
• Fear
conditioning
Two ways
to understand anxiety disorders:
– Anxious people are hyperaware to
possible threats
Learning Perspective
–Stimulus generalization
–Reinforcement (negative)
Perspective
•Biological
Observational
learning
– Parents communicate fear to
children
Understanding Anxiety Disorders
The Biological Perspective
• Natural selection
– phobias focus on fears faced by our
ancestors/compulsive acts exaggerate behaviors
that helped survival
• Genes
– Runs in families / identical twins
– anxiety gene
– Glutamate & Serotonin
• The Brain
– Over-arousal in brain areas – impulse control &
habitual behaviors
– Anterior cingulate cortex (frontal lobe) / (amygdala)
Obsessive-Compulsive Disorder
• Obsessive-Compulsive disorder
–Consistently interfere with everyday
–An obsession vs a compulsion
– Hoarders
– Checkers
– Counters
– Cleaners
https://youtu.be/LON36Xh
pdDs
DBS 5 min
https://youtu.be/3lvbcShuz14
Pediatric OCD 4 min
http://www.youtube.com/watch?v=dSZNnz9SM4g
https://youtu.be/OXjxbFQraL4
Afraid of Mom 1 min
Post-Traumatic Stress Disorder
• PTSD
• Numbed social withdrawal,
anxiety, insomnia
• “shellshock” or “battle fatigue”
– Not just due to a war situation
– 10%-32% of those who experience trauma will
develop
– Greater one’s stress during event
– Sensitive limbic system (stress hormones)
– 1/10 women & 1/20 men
• Post-traumatic growth
https://www.youtube.com/watch?v=7frOWBiU8D4
PTSD
“benefit finding”
Somatoform Disorders
Somatic
Symptom
Disorder
• mental illnesses that cause bodily
symptoms, including pain.
• may/may not be traced back to any
physical cause.
• not result of substance abuse or
another mental illness.
• not faking their symptoms.
• Doctors need to perform many tests to
rule out other possible causes before
they diagnosis
https://youtu.be/6xhypWbI0bk
Conversion disorder
– Weakness or paralysis
–
–
–
–
–
Conversion Disorder
http://www.youtube.com/watch?v=T9R
Ps_ysYgE
Conversion Disorder Today Show
Abnormal movement, such as tremors or difficulty walking
Loss of balance
Cause: stressful
Difficulty swallowing or "a lump in the throat"
event triggers
Seizures or convulsions
At Risk: females;
trauma; genetic
Episode of unresponsiveness
– anxiety converted into physical symptoms
– Illness Anxiety Disorder Hypochondriasis
• preoccupation with and fear of having or acquiring a serious
disorder.
• move from doctor to doctor (reinforcing)
–factitious disorders
» Munchasuen (Munchasuen by Proxy)
Cause Somatic Symptom Disorder
• Psychoanalytic: manifestation of unresolved
conflict
• Behaviorist: reinforced for behavior
Dissociative Disorders
http://www.youtube.com/w
atch?v=0tITzDjPf4g
Intro to DID – Inside (5:05)
https://youtu.be/n2atzoaA2NI
20 personalites (5 min)
DID
• Dissociative disorders
– 2+ distinct identities or personality states are present,
each w/ own relatively enduring pattern relating to the
environment and self.
– Amnesia must occur, defined as gaps in the recall of
everyday events, important personal information
and/or traumatic events. (dissociative fugue)
– The disturbance is not part of normal cultural or
religious practices.
• This DID criterion is to eliminate diagnosis in cultures or
situations where multiplicity is appropriate.
Understanding Dissociative Identity Disorder
 Genuine disorder or not?
 losing oneself in a role?
 hypnotizable
 DID rates
 1930s-60s = 2 per decade
 1980s = 20,000
 Therapist’s creation?
 Handedness & Shifting visual acuity
 Brain activity is different
 Result of trauma (PTSD/Freud) or reinforcing b/c
reduces anxiety?
Mood Disorders
http://www.youtube.com/watch?v=2rxeFgK
IS9s
Brain Imaging
http://www.youtube.com/watch?v=InNhDfD
fl5c
Synapse Review
• Mood disorders – emotional extremes
–Major depressive disorder (unipolar depression)
• 2+ weeks of
–
–
–
–
–
–
–
depressed mood
sleep disturbance
appetite disturbance
lack of energy
feelings of worthlessness
loss of interest in family and friends
loss of interest in activities
w/o clear
reason
–women 2xs as likely
Dysthymic Disorder – depressive state lasting more than 2 yrs.
Major Depressive Disorder
Women more likely to
attempt, men more
likely to succeed
Bipolar Disorder
• Bipolar Disorder
• Alternate between hopelessness &
lethargy of depression & overexcited
mania
Diagnosis of
young boys
has
skyrocketed
Afflicts men &
women
equally in
adults.
–Over-talkative, overactive, elated, little
need for sleep, etc. (agitated/restless)
• Bipolar disorder and creativity
Understanding Mood Disorders
• Trapped in depressed mood = inactive & unmotivated; when mood
lifts, these behavior & cognitive accompaniments disappear
• Very common = causes are probably common too
• Women are more vulnerable to disorders involving internalized state
(men tend to have external disorders = alcohol, antisocial conduct,
impulse control) Gender gap starts in adolescence
• Therapy speeds recovery but many return to “normal” w/o
professional help. Permanent if 1st episode strikes later in life.
• Risk of depression less than 1% w/o stressful life event
• Increase is probably authentic = more come forward
Mood Disorders
Genetic:
• Runs in families (twin studies)
• 35-40% heritable
Brain
• Hippocampus vulnerable to stress
• Less activity in frontal lobe (left)
Biochemical
• Serotonin
• Norepinephrine
• Prozac, Zoloft, Paxil / exercise
The Social-Cognitive Perspective
– Self-defeating beliefs & negative explanatory style
–Susan Nolan-Hoekseme says women
over-think– “ruminate”
–Aaron Beck says that there is a
“cognitive triad” – negative view of self,
circumstance, future
learned helplessness
–Martin Seligman says depressed
patients have a negative explanatory style
Stable, global, internal explanations
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
DEPRESSION
Successful Coping
Understanding Mood Disorders
The Vicious Cycle of Depression
Understanding Mood Disorders
The Vicious Cycle of Depression
Understanding Mood Disorders
The Vicious Cycle of Depression
Understanding Mood Disorders
The Vicious Cycle of Depression
Schizophrenia
http://www.youtube
.com/watch?v=nL_O
TM7I3C0
Childhood
Schizophrenia (4:59)
Symptoms of Schizophrenia
• Schizophrenia (split mind)
– Group of disorders characterized by disorganized &
delusional thinking, disturbed perceptions, &
inappropriate emotions & actions
1 in 100
– Not multiple personalities
24 million world wide
David Berkowitz
John Hinkley
Mark David Chapman
Symptoms of Schizophrenia
• Disorganized thinking • The sheep languished
–Delusions
• Delusions of
persecution paranoid
• Delusions of
grandeur
–“Word Salad”
– Breakdown in
selective attention
•
•
•
•
blue trains suffer
Run desk making dinner
sunglasses menu
Dogs sleep chicken
pencil trees
Garbage pink
composition solely bags
speak deodorant
Horse paper handbags
skipping forests play
together
Symptoms of Schizophrenia
• Disturbed perceptions
–Hallucinations
• Sensory experience w/o
sensory stimulation
–hearing voices most
common
http://www.youtube.com/watch?v=4LScZZOkeIs
Virtual Reality Hallucination (3:40 – start at :34
Positive Schizophrenia
• symptoms that are in
ADDITION to normal
behavior
• delusions
• hallucinations
• erratic emotions
• Acute (reactive)
schizophrenia
– increasingly odd behavior
over short period of time
Negative Schizophrenia
• Symptoms that are
TAKEN AWAY from
normal behavior
• Catatonia
– flat affect
• Emotionless state
– psychomotor (waxy
flexibility)
• Chronic (process)
schizophrenia
– longer term / slow to develop
characterized by lack of drive,
underactivity, social
withdrawal
Understanding Schizophrenia
Brain Abnormalities
1. Dopamine Hypothesis
–Dopamine overactivity
• Dopamine blocking drugs
• Thorazine
• Haldol
Understanding Schizophrenia
Brain Abnormalities
2. Abnormal Brain
Activity & Anatomy
– Frontal lobe & core
brain activity lessened
– Fluid filled areas of the
brain
• Surrounding
cerebral tissue is
smaller (thalamus)
Understanding Schizophrenia
Brain Abnormalities
3. Maternal Virus During Pregnancy
– Influence of the flu during pregnancy
4. Genetic predisposition
– 1 in 100 odds – 1 in 10 w/sibling or parent w/
disorder
– 1 in 2 if identical twin has schiz. (even when
reared apart)
Personality Disorders
http://www.youtube.co
m/watch?v=clw_97mqpM
Charles Manson
http://www.youtube.co
m/watch?v=ErB0R4wl
B64
Jeffery Dahmer
http://www.youtube.com/watch?v=PuB_ng5
uVaI
Anxiety Disorders Case Studies
Answers
1. GAD
2. Panic Attacks w/
Agoraphobia
3. Specific Phobia
4. OCD
5. PTSD
6. Specific Phobia
7. OCD
8. Agoraphobia
9. GAD
10. Social Phobia
11. PTSD
12. GAD
13. PTSD
Personality Disorders
• Personality disorders
– Maladaptive thought and behavior patterns that are
troublesome to others, harmful, or illegal. Feels no
anxiety, depression or delusion
– Borderline
• Emotionally unstable; impulsive; unpredictable; irritable;
prone to boredom
– Histrionic
• Excessively dramatic
– Narcissistic
• Unrealistically self-important; manipulative; lack empathy
– Antisocial
Antisocial Personality Disorder
• Antisocial personality disorder
–
–
–
–
–
–
–
–
–
Violate others’ rights w/ guilt or remorse
manipulative & exploitive
self-indulgent & irresponsible
can be charming(con-artist)
“sociopath” or “psychopath”
typically male
before 15
lower reaction to stress
Unconcerned w/ social rewards
http://www.youtube.co
m/watch?v=0qyCR9tP
DgM
https://youtu.be/_Cz7CjeVmKI
frontal lobe
Rates of Disorder
Rates of Disorder
• Mental health
statistics
• Influence of poverty
• Other factors
01. OCD
02. Conversion Disorder
03. Phobia
04. Dissociative Fugue
05. OCD
06. Panic Disorder
07. Phobia
08. Dissociative Amnesia
09. Obsessive-Compulsive Disorder
10. Conversion Disorder
11. Obsessive-Compulsive Disorder
12. Generalized Anxiety Disorder
13. Obsessive-Compulsive Disorder
14. Dissociative Amnesia
15. Conversion Disorder
16. Obsessive-Compulsive Disorder
1.
2.
3.
4.
5.
6.
7.
8.
Major Depression
Paranoid Schiz.
Disorganized Schiz.
Bipolar
Paranoid Schiz.
Catatonic Schiz.
Paranoid Schiz.
Paranoid Schiz.
The End
• Types of Files
Teacher Information
– This presentation has been saved as a “basic” Powerpoint file. While this file
format placed a few limitations on the presentation, it insured the file would be
compatible with the many versions of Powerpoint teachers use. To add
functionality to the presentation, teachers may want to save the file for their
specific version of Powerpoint.
• Animation
– Once again, to insure compatibility with all versions of Powerpoint, none of the
slides are animated. To increase student interest, it is suggested teachers
animate the slides wherever possible.
• Adding slides to this presentation
– Teachers are encouraged to adapt this presentation to their personal teaching
style. To help keep a sense of continuity, blank slides which can be copied and
pasted to a specific location in the presentation follow this “Teacher
Information” section.
Teacher Information
• Hyperlink Slides - This presentation contain two types of hyperlinks. Hyperlinks
can be identified by the text being underlined and a different color (usually purple).
– Unit subsections hyperlinks: Immediately after the unit title slide, a page (slide
#3) can be found listing all of the unit’s subsections. While in slide show mode,
clicking on any of these hyperlinks will take the user directly to the beginning of
that subsection. This allows teachers quick access to each subsection.
– Bold print term hyperlinks: Every bold print term from the unit is included in
this presentation as a hyperlink. While in slide show mode, clicking on any of
the hyperlinks will take the user to a slide containing the formal definition of
the term. Clicking on the “arrow” in the bottom left corner of the definition
slide will take the user back to the original point in the presentation.
These hyperlinks were included for teachers who want students to see or copy
down the exact definition as stated in the text. Most teachers prefer the
definitions not be included to prevent students from only “copying down what
is on the screen” and not actively listening to the presentation.
For teachers who continually use the Bold Print Term Hyperlinks option, please
contact the author using the email address on the next slide to learn a
technique to expedite the returning to the original point in the presentation.
Teacher Information
• Continuity slides
– Throughout this presentation there are slides, usually of graphics or tables, that
build on one another. These are included for three purposes.
• By presenting information in small chunks, students will find it easier to process and
remember the concepts.
• By continually changing slides, students will stay interested in the presentation.
• To facilitate class discussion and critical thinking. Students should be encouraged to think
about “what might come next” in the series of slides.
• Please feel free to contact me at [email protected] with
any questions, concerns, suggestions, etc. regarding these
presentations.
Kent Korek
Germantown High School
Germantown, WI 53022
262-253-3400
[email protected]
Division title (green print)
subdivision title (blue print)
• xxx
–xxx
–xxx
Division title (green print)
subdivision title (blue print)
Use this slide to add a table, chart, clip art, picture, diagram, or video clip. Delete
this box when finished
Definition Slide
= add definition here
Definition
Slides
Psychological Disorder
= deviant, distressful, and dysfunctional
patterns of thoughts, feelings, or
behaviors.
Attention-deficit Hyperactivity
Disorder (ADHD)
= a psychological disorder marked by the
appearance by age 7 of one or more of
three key symptoms; extreme inattention,
hyperactivity, and impulsivity.
Medical Model
= the concept that diseases, in this case
psychological disorders, have physical
causes that can be diagnosed, treated,
and, in most cases, cured often through
treatment in a hospital.
DSM-IV-TR
= the American Psychiatric Association’s
Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, updated
as of 2000 “text revision”; a widely used
system for classifying psychological
disorders.
Anxiety Disorders
= psychological disorders characterized by
distressing, persistent anxiety or
maladaptive behaviors that reduce anxiety.
Generalized Anxiety Disorder
= an anxiety disorder in which a person is
continually tense, apprehensive, and in a
state of autonomic nervous system
arousal.
Panic Disorder
= an anxiety disorder marked by
unpredictable minutes-long episodes of
intense dread in which a person
experiences terror and accompanying
chest pain, choking, or other frightening
sensations.
Phobia
= an anxiety disorder marked by a
persistent, irrational fear and avoidance of
a specific object, activity, or situation.
Obsessive-compulsive Disorder
(OCD)
= an anxiety disorder characterized by
unwanted repetitive thoughts (obsessions)
and/or actions (compulsions).
Post-traumatic Stress Disorder
(PTSD)
= an anxiety disorder characterized by
haunting memories, nightmares, social
withdrawal, jumpy anxiety, and/or
insomnia that lingers for four weeks or
more after a traumatic experience.
Post-traumatic Growth
= positive psychological changes as a result
of struggling with extremely challenging
circumstances and life crises.
Somatoform Disorder
= psychological disorder in which the
symptoms take a somatic (bodily) form
without apparent physical cause.
Conversion Disorder
= a rare somatoform disorder in which a
person experiences very specific genuine
physical symptoms for which no
psychological basis can be found.
Hypochondriasis
= a somatoform disorder in which a person
interprets normal physical sensations as
symptoms of the disease.
Dissociative Disorders
= disorders in which conscious awareness
becomes separated (dissociated) from
previous memories, thoughts, and
feelings.
Dissociative Identity Disorder
(DID)
= a rare dissociative disorder in which a
person exhibits two or more distinct and
alternating personalities. Formerly called
multiple personality disorder.
Mood Disorders
= psychological disorders characterized by
emotional extremes.
Major Depressive Disorder
= a mood disorder in which a person
experiences, in the absence of drugs or a
medical condition, two or more weeks of
significantly depressed moods, feelings of
worthlessness, and diminished interest or
pleasure in most activities.
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 manicdepressive disorder.)
Schizophrenia
= a group of severe disorders characterized
by disorganized and delusional thinking,
disturbed perceptions, and inappropriate
emotions and actions.
Delusions
= false beliefs, often of persecution or
grandeur, that may accompany psychotic
disorders.
Personality Disorders
= psychological disorders characterized by
inflexible and enduring behavior patterns
that impair social functioning.
Antisocial Personality Disorder
= a personality disorder in which the person
(usually a man) exhibits a lack of
conscience for wrongdoing, even toward
friends and family members. May be
aggressive and ruthless or a clever con
artist.