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Psychological Disorders
An Introduction
Psychological Disorder
• A “harmful dysfunction” in which behavior
is judged to be atypical, disturbing,
maladaptive and unjustifiable.
What is abnormal, disturbing maladaptive
and unjustifiable depends on:
•Culture
•Time Period
•Environmental Conditions
•Individual Person
Early Theories
• Afflicted people
were
possessed by
evil spirits.
Early Theories
• Music or singing was
often used to chase
away spirits.
•In some cases
trephening was
used:
Cutting a hole in
the head of the
afflicted to let out
the evil spirit.
Trephening
Early Theories
• Another theory was to make the body
extremely uncomfortable.
History of Mental Disorders
• In the 1800’s,
disturbed people
were no longer
thought of as
madmen, but as
mentally ill.
They were first put in hospitals.
Did this mean better treatment?
Early Mental Hospitals
• They were nothing more than barbaric
prisons.
•The patients were chained
and locked away.
•Some hospitals even charged admission
for the public to see the “crazies”, just like
a zoo.
Philippe Pinel
• French doctor who
was the first to take
the chains off and
declare that these
people are sick and
“a cure must be
found!!!”
Somatogenic
• At this time- it was believed that mental
illness had a bodily cause- Somatogenic.
General Paresis and Syphilis Example.
But Somatogenic could not explain
disorders such as hysteria (now
called conversion disorder).
Many disorders are psychogenic: the
origin is psychological, not physical.
Assessment Prompt #1
1. The purpose of trephening was to
a. Perform brain surgery
b. Give a haircut
c. Ensure sterilization
d. Let out the evil spirits
e. Find the part of the brain where the problem
resided.
2. In the late 1800’s, it was believed that mental illness
was __________, physical in nature,but some mental
illness is __________, psychological in nature.
a. Psychogenic; somatogenic
b. Psychotic; somatogenic
c. Somatogenic; psychotic
d. Somatogenic; psychogenic
e. Psychogenic; psychotic
Current Perspectives
• Medical Perspective: psychological
disorders are sicknesses and can be
diagnosed, treated and cured.
Current Perspectives
• Bio-Psycho-Social Perspective:
assumes biological, psychological and
sociocultural factors combine to interact
causing psychological disorders.
Used to be called Diathesis-Stress Model:
diathesis meaning predisposition and stress
meaning environment.
Classifying Psychological Disorders
• DSM-IV: Diagnostic
Statistical Manual of
Mental Disorders:
the big book of
disorders.
• Axis I-IV
Two Major Classifications:
Neurotic
Disorders
• Distressing but one can still
function in society and act
rationally
Psychotic Disorders
• Person loses contact with
reality, experiences
distorted perceptions
Assessment Prompt #2
1. A serious criticism of the medical model is the
theory that disorders are
a. Learned
b. Genetic
c. A disease
d. A hormonal imbalance
e. The fault of those experiencing the illness
2. The DSM-IV is organized by
a. Treatments
b. Causes
c. Situations
d. Symptoms
e. Cultural indicators
Mood
Disorders
Mood Disorders
• Psychological Disorders
characterized by
emotional extremes.
• Dysthymic Disorder
• Major Depressive
Disorder
•Seasonal Affective
Disorder
•Bipolar Disorder
Depression
• The common cold of psychological
disorders.
It is like a warning that
something is wrong.
Depression
Depression
Major Depressive Disorder
• A person, for no
apparent reason,
experiences two or
more weeks of
depressive moods.
Includes feelings of
worthlessness and diminished
interest or pleasure in most
activities.
Dysthymic Disorder
• Suffering from
mild depression
every day for at
least two years.
Seasonal Affective Disorder
-Related to Melatonin levels
Bipolar Disorder
• Person alternates between the
hopelessness and lethargy of
depression and the overexcited state
of mania.
Famous People with Bipolar
Norepinephrine
Increases arousal and boosts moods.
Assessment Prompt #3
1. ______ is the most common of all major mental
disorders
a. Mania
b. Schizophrenia
c. Depression
d. Seasonal affective disorder
e. Anorexia nervosa
2. Bipolar disorder was once known as
a. Manic-depressive disorder
b. ADHD
c. Clinical depression
d. Disasociative disorder
e. schizophrenia
Anxiety Disorders
a group of conditions where the
primary symptoms are anxiety or
defenses against anxiety.
the patient fears something
awful will happen to them.
Are anxiety disorders a neurosis or
psychosis.?
What is anxiety?
• is a state of
intense
apprehension,
uneasiness,
uncertainty, or
fear.
Generalized Anxiety Disorder
• An anxiety disorder in which a person
is continuously tense, apprehensive and
in a state of autonomic nervous system
arousal.
The patient is constantly tense and worried,
feels inadequate, is oversensitive, can’t
concentrate and suffers from insomnia.
Panic Disorder
• An anxiety disorder marked by a
minutes-long episode of intense dread in
which a person experiences terror and
accompanying chest pain, choking and
other frightening sensations.
Can cause secondary disorders, such as
agoraphobia.
Phobias
• A person experiences sudden
episodes of intense dread.
Obsessive Compulsive Disorder
• An anxiety disorder characterized
by unwanted repetitive thoughts
(obsessions) and/or actions
(compulsions).
Common Examples of OCD
Common Obsessions:
Common
Compulsions:
Contamination fears of germs, dirt,
Washing
etc.
Imagining having harmed self or
others
Repeating
Imagining losing control of
aggressive urges
Checking
Intrusive sexual thoughts or urges
Touching
Excessive religious or moral doubt
Counting
Forbidden thoughts
Ordering/arranging
A need to have things "just so"
Hoarding or saving
A need to tell, ask, confess
Praying
Explanations for Anxiety
Disorders
• You Learn them through
conditioning.
•Evolution
•Genes
•Physiology (the brain)
Assessment Prompt #4
1. The DSM-IV considers ____ an anxiety disorder
a. Schizophrenia
b. Bipolar disorder
c. OCD
d. Amnesia
e. Multiple personality disorder
2. Jenny feels anxious all the time, but is not afraid of
anything in particular. She is likely suffering from
a. Panic attacks
b. OCD
c. Agoraphobia
d. Generalized anxiety disorder
e. Anticipatory anxiety
Somatoform Disorders
• Somatoform disorders –
Psychological problems appearing in the
form of bodily symptoms or physical
complaints
• Conversion disorder –
Somatoform disorder marked by paralysis,
weakness, or loss of sensation, but with
no discernable physical cause
Copyright © Allyn & Bacon 2007
Somatoform Disorders
• Glove Anesthesia
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Somatoform Disorders
Hypochondriasis –
Somatoform disorder involving excessive
concern about health and disease
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Dissociative Disorders
Dissociative Disorders
• Disorders in which
conscious
awareness becomes
separated
(dissociated) from
previous memories,
thoughts and
feelings.
Dissociative Amnesia
• This disorder is
characterized by a
blocking out of
critical personal
information, usually
of a traumatic or
stressful nature.
Dissociative Amnesia
• Dissociative amnesia, unlike other types
of amnesia, does NOT result from other
medical trauma (e.g. a blow to the head).
Dissociative Fugue
• An individual with dissociative fugue
suddenly and unexpectedly takes
physical leave of his or her surroundings
and sets off on a journey of some kind.
•These journeys can last hours, or even
several days or months.
Dissociative Fugue
• Individuals experiencing a dissociative fugue
have traveled over thousands of miles.
An individual in a fugue state is unaware of or
confused about his identity, and in some
cases will assume a new identity (although
this is the exception).
Depersonalization Disorder
• is marked by a feeling of detachment or
distance from one's own experience,
body, or self.
One can easily relate to feeling as they
are in a dream, or being "spaced out."
A person's experience with depersonalization
can be so severe that he or she believes the
external world is unreal or distorted.
Dissociative Identity Disorder
• A rare dissociative disorder in which
a person exhibits two or more
distinct and alternating personalities.
•Also known as multiple personality
disorder.
Assessment Prompt #5
1. A key feature of _____ disorders is the presence of
physical symptoms without an apparent physical cause
a. affective
b. Dissociative
c. Somatoform
d. Organic
e. Hallucinatory
2. _____ involves persistent loss of memory, as well as
fleeing from one’s home, family and job
a. Conversion disorder
b. Dissociative fugue
c. Identity disorders
d. Somatoform disorder
e. Anxiety disorder
Schizophrenia
How Prevalent?
• About 1 in every 100 people are
diagnosed with schizophrenia.
Symptoms of Schizophrenia
• Disorganized thinking.
•Disturbed Perceptions
•Inappropriate Emotions and
Actions
Disorganized Thinking
• The thinking of a person with
Schizophrenia is fragmented and
bizarre and distorted with false beliefs.
•Disorganized thinking comes from a
breakdown in selective attention.they cannot filter out information.
Often causes………
Delusions (false beliefs)
• Delusions of
Persecution
• Delusions of
Grandeur
Disturbed Perceptions
• hallucinations- sensory experiences
without sensory stimulation.
Inappropriate Emotions and
Actions
• Laugh at
inappropriate times.
• Flat Effect
• Senseless,
compulsive acts.
• Catatoniamotionless Waxy
Flexibility
Positive v. Negative Symptoms
Positive Symptoms
• Presence of
inappropriate
symptoms
Negative Symptoms
• Absence of
appropriate ones.
Types of Schizophrenia
Paranoid Schizophrenia
• preoccupation
with delusions
or
hallucinations.
• Somebody is out
to get me!!!!
Disorganized Schizophrenia
• disorganized speech or behavior, or flat or
inappropriate emotion.
Catatonic Schizophrenia
• parrot like repeating of another’s speech
and movements
Undifferentiated Schizophrenia
• Many and varied Symptoms.
Possible Causes of Schizophrenia
Evidence for the causes of schizophrenia
has been found in a variety of factors
including genetics, abnormal brain
structure, and biochemistry
Diathesis-stress hypothesis –
Genetic factors place the individual at
risk, but environmental stress factors
transform this potential into an actual
schizophrenic disorder
Copyright © Allyn & Bacon 2007
Personality Disorders
Psychological disorders characterized by
inflexible and enduring behavior patterns
that impair social functioning.
Antisocial Personality Disorder
• antisocial personality disorder is
characterized by a lack of conscience
•People with this disorder are prone to
criminal behavior, believing that their victims
are weak and deserving of being taken
advantage of. They tend to lie and steal
Antisocial Personality Disorder
• they are careless with money and take
action without thinking about
consequences
They are often aggressive and are much
more concerned with their own needs
than the needs of others.
Borderline Personality Disorder
• characterized by mood instability and
poor self-image
People with this disorder are prone to
constant mood swings and bouts of
anger.
Borderline Personality
Disorder
• they will take their
anger out on
themselves, causing
themselves injury
Suicidal threats and actions
are not uncommon
They are quick to anger when their
expectations are not met.
Narcissistic Personality Disorder
• characterized
by selfcenteredness
They exaggerate their achievements,
expecting others to recognize them as
being superior
Narcissistic Personality Disorder
They tend to be
choosy about
picking friends,
since they believe
that not just
anyone is worthy of
being their friend.
They are generally uninterested in the
feelings of others and may take advantage
of them.
Developmental Disorders
Autism –
A developmental disorder marked by
disabilities in language, social interaction,
and the ability to understand another
person’s state of mind
Dyslexia –
A reading disability, thought by some
experts to involve a brain disorder
Copyright © Allyn & Bacon 2007
Developmental Disorders
Attention-deficit hyperactivity disorder –
A developmental disability involving short
attention span, distractibility, and extreme
difficulty in remaining inactive for any
period
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What is Therapy?
Therapy for psychological
disorders takes a variety of
forms, but all involve some
relationship focused on
improving a person’s mental,
behavioral, or social
functioning
Copyright © Allyn & Bacon 2007
Contemporary Approaches to Therapy
Psychological therapies –
Based on psychological principles (rather
than biomedical approach)
The psychological therapies
are often collectively
called psychotherapy
Copyright © Allyn & Bacon 2007
Contemporary Approaches to Therapy
Biomedical therapies –
Treatments that focus on altering the
brain, especially with drugs,
psychosurgery, or electroconvulsive
therapy
Copyright © Allyn & Bacon 2007
Types of Mental Health Care
Professionals
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Copyright © Allyn & Bacon 2007
Professional Title
Counseling psychologist
Specialty:
Clinical psychologist
Problems of
normal living
Psychiatrist
Work setting:
Psychoanalyst
Schools, clinics,
other institutions
Psychiatric nurse practitioner
Credentials:
Clinical social worker
Master’s in
counseling, PhD,
EdD, or PsyD
Pastoral counselor
Copyright © Allyn & Bacon 2007
Professional Title
Counseling psychologist
Specialty:
Clinical psychologist
Those with severe
disorders
Psychiatrist
Work setting:
Psychoanalyst
Private practice,
mental health
agencies,
hospitals
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Credentials:
PhD or PsyD
Copyright © Allyn & Bacon 2007
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Specialty:
Severe mental
disorders (often
by means of drug
therapies)
Work setting:
Private practice,
clinics, hospitals
Credentials:
MD
Copyright © Allyn & Bacon 2007
Professional Title
Counseling psychologist
Clinical psychologist
Specialty:
Psychiatrist
Psychoanalyst
Freudian therapy
Work setting:
Psychiatric nurse practitioner
Private practice
Clinical social worker
Credentials:
Pastoral counselor
MD
Copyright © Allyn & Bacon 2007
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse
practitioner
Clinical social worker
Pastoral counselor
Specialty:
Nursing specialty;
licensed to
prescribe drugs
Work setting:
Private practice,
clinics, hospitals
Credentials:
RN – plus special
training in treating
mental disorders
and prescribing
drugs
Copyright © Allyn & Bacon 2007
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Specialty:
Social worker with
specialty in
dealing with
mental disorders
Psychoanalyst
Work setting:
Psychiatric nurse practitioner
Often employed
by government
Clinical social worker
Pastoral counselor
Credentials:
MSW
Copyright © Allyn & Bacon 2007
Professional Title
Counseling psychologist
Clinical psychologist
Psychiatrist
Psychoanalyst
Psychiatric nurse practitioner
Clinical social worker
Pastoral counselor
Specialty:
Combines
spiritual guidance
with practical
counseling
Work setting:
Religious order or
ministry
Credentials:
Varies
Copyright © Allyn & Bacon 2007
Psychological Therapies
Psychotherapy
• An interaction between a trained
therapist and someone suffering from
psychological difficulties.
Eclectic Approach
• The most popular form of therapyit is basically a smorgasbord where
the therapist combines techniques
from different schools of
psychology.
Psychoanalysis
• Freud's therapy.
•Freud used free association, hypnosis
and dream interpretation to gain
insight into the client’s unconscious.
Psychoanalytic Methods
• Psychotherapists use their techniques
to overcome resistance by the client.
•The psychoanalyst wants you to
become aware of the resistance and
together interpret (ex. Latent
content) it’s underlying meaning.
Transference
• In psychoanalysis, the patient’s transfer to the
analyst of emotions linked with other
relationships.
Humanistic Therapy
• Focuses of people’s potential for selffulfillment (self-actualization).
•Focus on the present and future (not the past).
•Focus on conscious thoughts (not
unconscious ones).
•Take responsibility for you actionsinstead of blaming childhood anxieties.
Most widely used Humanistic technique is:
Client (Person) Centered Therapy
• Developed by Carl Rogers
•Therapist should
use genuineness,
acceptance and
empathy to show
unconditional
positive regard
towards their
clients.
Active Listening
• Central to Roger’s client-centered
therapy
•Empathetic listening where the
listener echoes, restates and clarifies.
Behavior Therapies
• Therapy that applies learning
principles to the elimination of
unwanted behaviors.
•The behaviors are the problems- so
we must change the behaviors.
Classical Conditioning Techniques
Counterconditioning:
• A behavioral therapy that conditions
new responses to stimuli that trigger
unwanted behaviors.
Two Types:
Systematic Desensitization
• A type of counterconditioning that
associates a pleasant relaxed state
with gradually increasing anxietytriggering stimuli.
How would I use
systematic
desensitization to reduce
my fear of old women?
Systematic Desensitization
Progressive Relaxation
Exposure Therapy
Flooding
Aversive Conditioning
• A type of counterconditioning that
associates an unpleasant state with an
unwanted behavior.
How would putting poop on the fingernails
of a nail biter effect their behavior?
Aversive Conditioning
Aversive Conditioning
What are some ways you
can change the behaviors
of your friends with
aversive conditioning?
Operant Conditioning
Token Economy: an operant
conditioning procedure that rewards a
desired behavior.
A patient exchanges a token of some sort,
earned for exhibiting the desired behavior,
for various privileges or treats.
Cognitive Therapies
• A therapy that teaches people
new, more adaptive ways of thinking
and acting; based on the
assumptions that thoughts
intervene between events and our
emotional reactions.
Cognitive Therapy
• Cognitive
Therapists try to
teach people new,
more
constructive ways
of thinking.
Is .300 a good or bad
batting average?
Aaron Beck and his view of
Depression
• Noticed that
depressed people were
similar in the way they
viewed the world.
• Used cognitive therapy
get people to take off
the “dark sunglasses” in
which they view their
surroundings
Evaluating the Psychological
Therapies
Eysenck proposed that people with nonpsychotic problems recover just as well
with or without therapy
Reviews of evidence have shown:
That therapy is better than no therapy
It appears advantageous to match specific
therapies with specific conditions
Copyright © Allyn & Bacon 2007
The Biomedical Therapies
Therapies aimed at the altering
the body chemistry.
Psychopharmacology
• The study of the effects of drugs
on mind and behavior.
Drugs and Hospitalization
Emptying of Mental Hospitals
Testing New Drugs
• When a new drug is released there
is always too much enthusiasm.
•Must use a double-blind procedure
to combat placebo and experimental
effects.
These experiments better able use to
classify different types of drugs:
Antipsychotic Drugs
• Antipsychotic drugs are a class of
medicines used to treat psychosis and
other mental and emotional conditions.
These drugs are beginning to help
schizophrenics with both positive and
negative symptoms.
These drugs (Thorazine) often have
powerful side effects
Antianxiety Drugs
• Includes drugs like Valium and
Librium.
•Like alcohol, they depress nervous
system activity.
•Most widely abused drugs.
Do they really solve the problem?
Antidepressant Drugs
• Lift you up out
of depression.
Most increase the
neurotransmitter Norepinephrine.
Prozac, Paxil Zoloft
• Work by blocking serotonin reuptake.
Electroconvulsive Therapy
• Biomedical therapy
for severely
depressed patients in
which brief electric
current is sent
through the brain of
an anesthetized
patient.
Psychosurgery
• Surgery that removes or destroys brain
tissue in an effort to change behavior.
Egas Moniz developed the
lobotomy in the 1930s.
Ice pick like instrument
through the eye sockets
cutting the links between the
frontal lobes and the
emotional control centers.
Lobotomy