Download Psych8_Lecture_Ch16

Gleitman • Gross • Reisberg
Psychology
EIGHTH EDITION
Chapter 16
Psychopathology
©2011 W. W. Norton & Company, Inc.
Chapter Pretest
• What are Mental Disorders?
• How are Mental Disorders Defined,
Assessed, and Diagnosed?
• What are Anxiety Disorders?
• What are Mood Disorders?
• What are Schizophrenia Spectrum and
other Psychotic Disorders?
Chapter Topics
• Some Final Thoughts: Syndromes without
Stigma?
• Summary
Psychopathology
Psychopathology is defined as the study
of mental illness or mental distress. This
definition also includes the manifestation
of behaviors and experiences which may
be indicative of mental illness or
psychological impairment.
This is not the same as a “psychopath”.
Analogy: Biologists study biology.
Psychologists and Psychiatrists study
psychology.
Historical Views of Mental
Disorders
• Early views of mental disorders held to the
somatogenic hypothesis.
• Disorders are the result of a specific injury or
infection.
• Sigmund Freud, in contrast, argued for the
psychogenic hypothesis.
• Mental disorders are rooted in psychological
processes.
Modern Theories
• Diathesis-stress model
• Diathesis creates the predisposition or
vulnerability.
• Stress provides a trigger.
• There are also Protective Factors.
• Biopsychosocial model
• Multiple factors give rise to both diathesis and
stress.
Different Types of
Psychopathology
Psychopathology encompasses many
different issues.
These include, but are not limited to:
depression, anxiety, schizophrenia,
psychosis, bipolar depression, and
personality disorders.
Define, Assess, Diagnose
• A diagnosis is made with reference to the
Diagnostic and Statistical Manual for
Mental Disorders (DSM). The book now is
the DSM 5.
• The purpose of this book is to provide
clinicians with a way to make a Clinical
Case Formulation.
• https://youtu.be/G9srRI-XYrM
Clinical Case Formulation
A Clinical Case Formulation is defined as
a comprehensive assessment of
someone.
This includes knowing someone’s history,
and a concise summary of their
experiences with social, cultural,
psychological factors.
Clinical Case Formulation
This then provides a solid overview to
explain the reasons for why someone is
experiencing the symptoms and the
stressors they are currently going through.
This then allows the clinician and client to
find the better treatment plan options and
overall treatment plan.
Clinical Case Formulation
Lets explore completing a clinical case
formulation. You are about to view soap
opera extremes of mental health issues in
order to do that. These are not true.
https://youtu.be/GYEkyxaO6Bw
https://youtu.be/fz0q7YKjp48
Quiz 1
How would you define the practice of
psychopathology?
How would you define a clinical case
formulation?
What are three things psychologists and
therapist would look for when they are
completing the clinical case formulation?
 How would knowing these 3 things help
with treatment planning?
Assessment
• Assessment of any individual may include
• semi-structured interview
• The clinician evaluates symptoms and signs.
• self-report measures
• such as the Beck Depression Inventory
• projective measures
• such as the Thematic Apperception Test
Diagnosis
This is made after the assessment.
The assessment provides you with a
clinical case formulation.
The clinical case formulation should
always be flexible and ongoing.
In order to be considered a diagnosis, the
issues must cause a pervasive pattern or
problems in many areas of a person’s life.
Differential diagnoses, subtleties, unique.
Anxiety Disorders
Characterized by some level of fear and
stress.
One of the most common types of mental
health issue.
Separation Anxiety and Generalized
Anxiety.
PTSD, Social Anxiety, Phobias.
Anxiety Disorders
• Generalized anxiety disorder.
• continuous and pervasive feelings of anxiety
• Obsessive-compulsive and related disorders.
• obsessions (disturbing thoughts) and compulsions
(repetitive behaviors). Also includes BDD,
Trichotillomania, Skin Picking (Excoriation), and
Hoarding.
• The Trauma or Stress Related Disorders.
• the result of identifiable and horrific events.
• RAD, PTSD, Acute Stress, Adjustment Disorders,
etc.
Anxiety Disorders
Panic attacks and panic disorder.
Substance abuse or medication induced
anxiety disorder.
https://youtu.be/IaPN9KQoYbs
https://youtu.be/htxw16KhvkY
Genes and Anxiety
• A number of different genes are thought to
contribute to the anxiety disorders.
• Neuroimaging studies reveal that different
anxiety disorders have different biological
bases.
• Conditioning accounts of anxiety disorders
emphasize the role played by learning.
Quiz 2
What is needed to consider someone’s
symptoms a diagnosis?
What is meant by differential diagnosis?
What symptoms typically characterize an
anxiety disorder?
Please name two types of anxiety
disorders.
Depressive Disorders
• Characterized by signs and symptoms that
include a pervasive depressed mood and
feelings of hopelessness.
• Major Depression: issues with appetite,
sleep, mood, motivation, lack of pleasure,
feelings of worthlessness, and sometimes
suicide or thoughts of death.
• Persistent Depressive Disorder
(Dysthymia): Chronic lower grade
depression symptoms that last two years.
Depressive Disorders
• Mood disorders have important hereditary
components.
• A disruption of neurotransmission is also
implicated, involving the norepinephrine,
dopamine, and serotonin systems.
• https://youtu.be/dXeevtn9_Os
Depression
• Life crises often trigger depression.
• However, crises by themselves do not cause
the disorder.
• Aaron Beck
• negative cognitive schema
• Explanatory style
• Individuals who explain bad things that happen as
the result of internal, global, and stable factors
have an elevated risk of depression.
Bipolar and Related Disorders
Mania is the cardinal symptom of bipolar
disorder. Without the mania, it would be
considered Depressive Disorder.
There are several types of Bipolar
Disorder based upon the specific duration
and pattern of manic and depressive
episodes.
A Manic Episode
Inflated self-esteem or grandiosity (ranges
from uncritical self-confidence to a
delusional sense of expertise).
Decreased need for sleep.
Intensified speech (possible
characteristics: loud, rapid and difficult to
interrupt, a focus on sounds, theatrics and
self-amusement, non-stop talking
regardless of other person’s
participation/interest, angry tirades).
A Manic Episode
Rapid jumping around of ideas or feels like
thoughts are racing.
Distractibility (attention easily pulled away
by irrelevant/unimportant things).
Increase in goal-directed activity (i.e.
excessively plans and/or pursues a goal;
either social, work/school or sexual) or
psychomotor agitation (such as pacing,
inability to sit still, pulling on skin or
clothing).
A Manic Episode
Excessive involvement in pleasurable
activities that have a high risk
consequence.
A Hypomanic Episode is very similar to a
manic one, but less intense. It is only
required to persist for 4 days and it should
be observable by others that the person is
noticeably different from his or her regular,
non-depressed mood and that the change
has an impact on his or her functioning.
Bipolar and Related Disorders
A Mixed Episode would fulfill the symptom
requirements for both a Major Depressive
Episode and a Manic Episode nearly every
day but the mixed symptoms only need to
last for a 1-week period.
The main difference between BP I and BP
II is full mania (7 days) v. hypomania (4
days). Once a person experiences a full
manic episode, they will receive a BP I
diagnosis.
Bipolar and Related Disorders
https://youtu.be/D933-ImDasI
Quiz 3
What factors characterize a depressive
disorder?
What are the differences between a
depressive disorder and a bipolar
disorder?
Are there genetic components for people
who eventually experience one of these
types of mood disorders?
Schizophrenia Spectrum and
Other Psychotic Disorders
This illness is now considered a spectrum
disorder. It's a group of related mental
disorders that share some symptoms.
They affect your sense of what's real.
They change how you think, feel, and act.
Delusional Disorder, Psychotic Disorders,
Schizophreniform (similar to
schizophrenia, less severe), and
Schizoaffective (with mood episode).
Schizophrenia Spectrum and
Other Psychotic Disorders
• Someone with schizophrenia is likely to
suffer from these symptoms:
1. Delusions.
2. Hallucinations.
3. Disorganized speech (e.g., frequent
derailment or incoherence).
4. Grossly disorganized or catatonic
behavior.
5. Negative symptoms (i.e., diminished
emotional expression or avolition)
Schizophrenia
At least two of the five symptoms must be
present for at least one month. One of the
two symptoms must be
delusions, hallucinations,
or disorganized speech. Negative
symptoms, which impair function the most,
are now official.
Schizophrenia
• Possible factors contributing to
schizophrenia:
• genetic predisposition
• period of diminished oxygen supply to the
newborn
• a variety of prenatal viral infections
• https://youtu.be/yL9UJVtgPZY
Schizophrenia
• The evidence suggests that schizophrenia
is a neurodevelopmental disorder.
• Its precursors may be detected in early
childhood.
• Stress also contributes to schizophrenia.
Quiz
What are the five factors or symptoms
associated with schizophrenia?
Name two types of schizophrenia
spectrum disorders.
Are there genetic components in these
disorders?
Personality Disorders
Personality is a complex set of
characteristics that make us who we are,
at least when it comes to our typical
behaviors, ways of coping, and attitudes
toward ourselves and others. Many regard
our personalities as made up of
dispositions that remain relatively
consistent throughout our life situations
and relationships. According
toConscientiousness,
Agreeableness, Neuroticism, Openness to
Experience, and Extraversion.
Personality Disorders
• Personality disorders involve traits or
habits that characterize almost everything
a person does. They must be shown to be
pervasive in relationships.
• These disorders are difficult to diagnose.
• Diagnosis requires a very thorough history of
how someone has behaved in their
relationships with self and others.
Personality Disorders
They fall within 10 distinct types: paranoid
personality disorder, schizoid personality
disorder, schizotypal personality disorder,
antisocial personality disorder, borderline
personality disorder, histrionic personality,
narcissistic personality disorder, avoidant
personality disorder, dependent
personality disorder and
obsessivecompulsive personality disorder.
Personality Disorders
http://www.cbsnews.com/videos/mvpbrandon-marshall-on-bpd/
https://youtu.be/PzXB_1xi--8
https://youtu.be/wO5d8ig48XQ
Quiz
What is personality?
What are the 10 personality disorders?
How is personality disorder defined?
Concept Quiz
1) The diathesis-stress model of mental disorder
suggests that mental disorders result from:
a) unconscious psychological conflicts
originating in childhood experiences.
b) maladaptive learning.
c) the interaction of risk factors and life
experiences.
d) changes to the brain associated with disease
or injury.
Concept Quiz
2) Which of the following is an example of a
positive symptom used in the diagnosis of
schizophrenia?
a)
b)
c)
d)
social rejection
lack of emotional expression
catatonia
hallucinations
Concept Quiz
3) Evidence for the dopamine hypothesis of
schizophrenia comes from:
a) comparisons of the incidence of
schizophrenia in different countries
b) observations of the behavior of individuals
diagnosed with schizophrenia.
c) genetic studies using twins.
d) the effectiveness of antipsychotic drugs that
alter neurotransmitter activity in the brain.
Concept Quiz
4) Michelle’s mood has changed recently, and she
finds herself staying up all night, making
grandiose plans, and shopping compulsively.
Others have noticed that her speech has
become rushed and difficult to follow. Michelle
may be experiencing a period of:
a)
b)
c)
d)
depression.
mania.
dissociation.
post-traumatic stress disorder.
Concept Quiz
5) Which anxiety disorder seems to have the
largest biological basis (including genetic
factors and greater activation in the
orbitofrontal cortex, caudate nucleus, and
anterior cingulate)?
a)
b)
c)
d)
agoraphobia
obsessive-compulsive disorder
panic disorder
generalized anxiety disorder
Video Clips
This concludes the presentation
slides for Chapter 16
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