Download Psychological Disorders

Abnormal Psychology
Psychological Disorders
A harmful dysfunction in which thoughts, feelings, or behaviors
are maladaptive, unjustifiable, disturbing, and atypical.
Criteria for Psychological Disorders
• Maladaptive – destructive to oneself or
others.
• Unjustifiable – without a rational basis.
• Disturbing – troublesome to other people.
• Atypical – so different that it violates a
norm.
• “MUDA” (mnemonic).
Early Theories
• Abnormal behavior was evil
spirits trying to get out.
• Trephining was often used.
Trephening
Early Theories
• Another way to deal with the demons
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 worked
to eliminate the
institutional brutality
(and declare that these
people are sick and “a
cure must be found”).
Medical Model
• Late 1800’s - it was believed that mental
illness had a physical or organic cause.
General Paresis and Syphilis examples.
But it doesn’t emphasize environmental
explanations like stress or upbringing.
Many disorders are psychogenic: the origin
is psychological, not physical.
Current Perspectives
• Bio-psycho-social model: assumes biological,
psychological and socio-cultural factors
interact to produce specific psychological
disorders. Most common view today.
Some disorders occur worldwide (schizophrenia)
while others are culture-bound (i.e. “anorexia” &
“susto” – fear of black magic in Latin America).
DSM-5
• Diagnostic Statistical
Manual of Mental
Disorders: the big book
of disorders.
• DSM will classify
disorders.
• Critics say it’s biased
towards the medical
model.
Two Major Classifications in the DSM
Neurotic Disorders
• Distressing but one can
still function in society
and act rationally.
Psychotic Disorders
• Person loses contact with
reality, experiences
distorted perceptions.
John Wayne Gacy
Danger of Diagnostic Labels
• In Rosenhan’s study his associates were
faking symptoms of hearing voices.
• They were ALL admitted for schizophrenia.
• None were exposed as imposters.
• They all left diagnosed with schizophrenia
in remission.
• What did this study show?
• 1.) It showed the biasing power of
diagnostic labels.
Childhood Disorders
• ADHD:
• Hyperactive behavior;
can’t stay on task long.
• 3-5% of children.
• Mostly boys.
• Ritalin, Adderall, and
Concerta – treatments.
Childhood Disorders
• Autism – often severely
incapacitating, developmental
disability appearing in the first 3
years.
• 1 out of 110.
• Trouble forming attachments with
people.
Journal # 27
What are your greatest fears?
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.
• They are in a state of
apprehension or nervousness.
• Are they a neurosis or
psychosis?
Taylor Manifest Anxiety Scale
1. F
2. T
3. F
4. F
5. T
6. T
7. T
8. T
9. F
10.T
11.T
12.F
13.T
14.T
15.F
16.T
17.T
18.F
19.T
20.F
21.T
22.T
23.T
24.T
25.T
26.T
27.T
28.T
29.F
30.T
31.T
32.F
33.T
34.T
35.T
36.T
37.T
38.F
39.T
40.T
41.T
42.T
43.T
44.T
45.T
46.T
47.T
48.T
49.T
50.F
Taylor Manifest Anxiety Scale
• Mean 14.5
– True indicate anxiety related to that item
• Learning theorist explain anxiety in terms
of classical conditioning.
• Psychoanalysts believe, unresolved
conflict that occurs when defense
mechanisms are weak or inadequate selfconcepts.
The Human Experience
GAD, Panic, Phobias
Generalized Anxiety Disorder (GAD)
• Marked by disruptive levels
of persistent feelings of
apprehension and tenseness.
• Symptoms include
restlessness, feeling on edge,
irritability, sleep disturbance.
• 2 out of 3 – women.
Panic Disorder
• Disorder marked by a sudden
bout of intense, unexplained
panic. Person experiences terror
and accompanying chest pain,
choking and other frightening
sensations.
• Can cause secondary disorders
like agoraphobia.
What do you Fear?
Research subjects list 2 or more times.
Highest intensity rating:
Untimely or early death
Speaking before a group
Not being a success
Illness/injury of loved one
Looking foolish
Suffocating
Death or a loved one
Snakes
Being self-conscious
Making mistakes
Failing a test
Phobias
• Marked by disruptive, irrational
fears of objects, activities, or
situations.
• Specific phobias – like
arachnophobia.
• Agoraphobia – fear of public
places.
Examples of Phobias
Name of the phobia:
Xenophobia
Ophidiophobia
Fear of:
Strangers
Snakes
Panophobia
Claustrophobia
Numerophobia
Everything
Closed spaces
Numbers
Arachnophobia
Murophobia
Mikrophobia
Acrophobia
Spiders
Mice
Germs
Heights
Aerophobia
Cynophobia
Anthropophobia
Flying
Dogs
People
Social Anxiety Thoughts (SAT)
•
•
•
•
Add #s in front of each item.
Range 21 – 105
Mean 42.3
Higher scores reflect greater social anxiety
Social Anxiety Thoughts (SAT)
• Four General Categories:
– Thoughts of general discomfort and social
inadequacy.
– Concerns with others’ awareness of distress
– Fear of negative evaluations
– Perceptions of autonomic arousal and
performance anxiety.
• Which category do you think your score is
highest from?
Social Anxiety Thoughts (SAT)
• Socially Anxious people:
– Seek to avoid potentially embarrassing social
situations
– If they cannot avoid eye contact experience
psychical symptoms
– Fear of detection
– Early signs start late childhood/early
adolescence; fear of public speaking or eating
in public
– Fear of criticism and of making a mistake
– Feel like imposters.
• Are any of the these things true for you?
Guidelines for dealing with Social Phobia:
1. In dealing with symptoms of anxiety, respond with
approach rather than avoidance.
2. Greet people with eye contact.
3. Create a list of possible topics of conversation and
listen carefully to others.
4. Initiate conversations by asking questions.
5. Speak clearly with out mumbling.
6. Be willing to tolerate some silence.
7. Wait for cues from others.
8. Learn to tolerate criticism and be willing to
introduce a controversial topic at an appropriate
point.
Obsessive-compulsive disorder
• Persistent unwanted
thoughts (obsessions)
cause someone to feel
the need to engage in
a particular repetitive
action (compulsion) .
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
A need to have things "just so"
Hoarding or saving
The Obsessive-Compulsive Scale
• Score 1 point for “true” responses on
questions: 1, 2, 4, 6, 7 8, 16, 17, 18 and
21.
• Score 1 point for “false” responses on
questions: 5, 9, 10, 11, 12, 13, 14, 19, 20
and 22.
• Range 0-20, higher scores reflecting
greater compulsivity.
• Male mean = 11.15
• Female mean = 11.24
The Obsessive-Compulsive Scale
• Approx. 20% have only obsession or
compulsion.
• Victims may even realize faulty logic of
obsession, but cannot stop.
• 4 Million Americans; Children – Adult
• Generally appears before age 25, linked to
stressful event and affects boys more than
girls.
• 80% involve washing rituals
• Runs in families, up to 20%
What’s the difference?
• Obsession – endless cycle of repetitive
thoughts.
• Compulsion – feeling that you they must
repeat certain actions again and again.
– Obsession: A young woman is continuously
terrified by the thought that cars might careen
onto the sidewalk and run her over
– Compulsion: She always walks as far from the
street pavement as possible and wears red
clothes so that she will be immediately visible to
an out of control car.
What’s the difference?
• Obsession: A mother is tormented by the concern that she
might inadvertently contaminate food as she cooks dinner
for her family.
• Compulsion: Every day she sterilizes all cooking utensils in
boiling water, scours every pot and pan before placing food
in it, and where's rubber gloves while handling food.
• Obsession: A woman cannot rid herself of the thought that
she might accidentally leave her gas stove turned on,
causing her house to explode.
• Compulsion: Every day she feels the irresistible urge to
check the stove exactly 10 times before leaving for work.
What’s the difference?
• Obsession: a college student has the urge to shout
obscenities while sitting through lectures in class.
• Compulsion: carefully monitoring his watch, he bites his
tongue every 60 seconds to ward off the inclination to
shout.
•
Obsession: a young boy worries incessantly that
something terribly might happen to his mother while
sleeping at night.
• Compulsion: on his way to bed each night, he climbs the
stairs accordingly to a fixed sequence of three steps up,
followed by two steps down to ward off danger.
Post-traumatic Stress Disorder (PTSD)
• Flashbacks or nightmares
following a person’s
involvement in or
observation of an
extremely stressful
event.
• Memories of the event
cause anxiety.
• War veterans and “shell
shock.”
Biological Causes of Anxiety Disorders
• Heredity or predisposition (twin studies).
• Brain function - (PET scans
of OCD patients show higher
frontal lobe activity).
• Evolution – likely to fear
situations that posed threat
to early humans.
Learning Factors and Anxiety Disorders
• Conditioning - remember
Little Albert?
• Observational learning –
seeing someone else respond
with fear (i.e. a sibling).
• Reinforcement – learning to
associate emotions with
actions and the results that
follow those actions.
All of a sudden, Roberto started sweating, his
heart started racing, and he felt like he couldn’t
breathe. Which of the following fits Roberto’s
symptoms?
A. Panic disorder
B. Social phobia
C. Post-traumatic stress disorder
D. Obsessive-compulsive disorder
A. PANIC DISORDER
A person with a(n) _________________ might
wash his or her hands 100 times each day.
COMPULSION
Yasmeen fears flying and feels relieved whenever
she can avoid traveling by air. This is an example
of how phobia can be influenced by
A. Observational learning
B. Reinforcement
C. Heredity
D. Evolution
D. EVOLUTION
TRUE OR FALSE: Obsessive-compulsive disorder
produces activity in the rear of the brain.
FALSE – Frontal Lobe
Journal # 28
Write a past experience associated with
each word:
train
shoe
road
ice
window
machine
wood
sign
rain
letter
meeting
roam
house
travel
water
race
reading
tunnel
Mood Disorders
• Psychological disorders characterized by emotional
extremes (i.e. depression, mania, or both).
The Zung Self-rating
Depression Scale
• Reverse #s: 2, 5, 6, 11, 12, 14, 16, 17, 18
and 20 ( 1=5, 2=4, 3=3, 4=2, 5=1)
• Range 20 -100
• 50-59 Mild to Moderate Depression
• 60-69 moderate to Severe Depression
• 70 and above indicates severe depression
Major Depressive Disorder
• Most common disability in the
world (6% of men & 10% of women).
• Unhappy for at least two weeks
with no apparent cause.
• Feelings of worthlessness and
diminished interest in most
activities.
• May have suicidal thoughts.
Journal # 30
How would you know if a friend
was suicidal? What would you
do if they were?
The Automatic Thoughts
Questionnaire
Identify the covert self-statements reported
by depressive as being representative of the
kinds of cognitions that depressed persons
experience.
• Personal maladjustment and desire for
change (14 and 20)
• Negative expectations (3 and 24)
• Low self-esteem (17 and 18)
• Helplessness (29 and 30)
The Automatic Thoughts
Questionnaire
Total Score Range 30 -150
– 30 little or no depression
– 150 maximum depression
Mean Scores
– 79.6 depressed samples
– 48.6 nondepressed samples
The Revised Facts on
Suicide Quiz
1.
2.
3.
4.
5.
6.
7.
8.
9.
F
T
T
F
F
F
T
F
T
10. F
11. F
12. T
13. T
14. T
15. F
16. F
17. T
18. T
19. A
20. C
21. B
22. A
23. B
24. A
25. B
26. C
27. A
28. C
29. A
30. C
31. C
32. B
33. B
34. A
35. B
36. C
Suicide
Suicide rates increase with age.
Suicide
But teen suicide rates increased from 1960
to 1990, but have dropped since 1990.
10 Common Characteristics of
Suicidal People
1. Unendurable psychological pain
2. Frustrated psychological needs
3. The search for a solution
4. An attempted to end consciousness
5. Helplessness and hopelessness
6. Constriction of options
7. Ambivalence
8. Communication of intent
9. Departure
10. Lifelong coping patterns
Journal #31
Name 5 people you could go to if you
needed to talk to somebody about negative
feelings you may have.
Bipolar Disorder
• Formally called manic depression.
• Involves periods of depression
and manic episodes.
• Manic episodes may involve long
periods of little sleep, racing
thoughts, and set impossible
goals.
• May have bursts of creative
energy during manic states (like
van Gogh).
Famous People with Bipolar
Bipolar Brain
Postpartum Depression
• Depression after
childbirth (“baby blues”).
• 5% to 10% of women.
• Sadness, fatigue, insomnia,
reduced libido, etc.
• Usually the first few
months after giving birth.
Seasonal Affective Disorder
• Experience depression
during the winter
months.
• Based not on
temperature, but on
amount of sunlight.
Biological Causes of Mood Disorders
• Heredity – twin studies.
• Brain function – PET scans
have shown lower brain activity
during depressed states.
• Serotonin and Norepinephrine
are lacking during times of
depression (Prozac helps
restore these
neurotransmitter levels).
Social-Cognitive Factors and Mood Disorders
• Learned helplessness.
• Attributions (explanatory
style) – Stable, internal and
global.
Dissociative Disorders
Dissociative Disorders
• Disorders in which the
sense of self has
become separated
(dissociated) from
previous memories,
thoughts, or feelings.
Dissociative Amnesia
• A partial or total
forgetting of past
experiences, without
organic cause.
• Usually in reaction to
a traumatic event.
Organic Amnesia
(not a dissociative disorder)
• Results from other medical trauma (e.g.
a blow to the head, stroke, alcoholism).
Dissociative Fugue
• A form of dissociative amnesia characterized
by physical relocation and the assumption of a
new identity with amnesia for the previous
identity. (“Traveling amnesia”).
•These journeys can last hours, even several days,
months or years.
Dissociative Identity Disorder (D.I.D.)
• Used to be known as Multiple
Personality Disorder.
• Rare & controversial disorder
where the person exhibits two
or more distinct and
alternating personalities.
• Number of cases increased
dramatically during the 1980’s
(popular book “Sybil”).
• Claims of child sexual abuse.
Somatoform Disorders
• Disorders in which
symptoms take a bodily
form without apparent
physical cause.
• Two types…
Hypochondriasis
• Characterized by
imagined symptoms of
illness.
• They usually believe
that the minor issues
(headache, upset
stomach) are indicative
of more severe
illnesses.
Conversion Disorder
• Loss or impairment
of some motor or
sensory function due
to a psychological
conflict.
• Formerly known as
hysteria.
• Many of Freud’s
patients suffered
from this.
Sigmund Freud
Journal #32
Have you ever thought you heard or saw
something that wasn’t actually there? How
did it make you feel? How did others react to
you? Imagine a life like this? What do you
think would be the hardest part?
Psychotic Disorders
Schizophrenia
• Is not one disorder but a
group of disorders.
• It is not “split personality.”
• Typically develops in late
adolescence.
Schizophrenia
• About 1% of people are
diagnosed with schizophrenia.
3 Symptoms of Schizophrenia:
1. Disorganized thinking.
2. Disturbed Perceptions.
3. Inappropriate Emotions and
Actions.
1.) Disorganized Thinking
• The thinking of a person
with schizophrenia is
fragmented and bizarre.
• 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
(people are out to get you). (belief that you are
more important than
you really are).
2.) Disturbed Perceptions
• Hallucinations –
(usually auditory) is a
false perception.
3.) Inappropriate Emotions and Actions
•
•
•
•
Laugh at inappropriate times.
Flat Effect (emotionless).
Senseless, compulsive acts.
Catatonia - motionless waxy
flexibility.
Types of Schizophrenia
Paranoid Schizophrenia
• Preoccupied with delusions
of persecution or grandeur
as well as hallucinations.
• Always looking over your
shoulder like somebody is
out to get you!
Catatonic Schizophrenia
• Flat emotion.
• Waxy flexibility.
• Little movement, or speech.
Disorganized Schizophrenia
• Disorganized speech or behavior, or
flat or inappropriate emotion.
• Clang associations: speaking in
rhyme.
• “I’m the worst
systematic, sympathetic
quite pathetic, apologetic,
paramedic.“
• Word salad: nonsense talk.
• “It’s all over for a squab true tray
and there ain’t no music. I’ve got to
travel all the time to keep my
energy alive.”
Undifferentiated Schizophrenia
• Doesn't match any of
the established types
of schizophrenia. (i.e.
paranoid, catatonic, or
disorganized)
Biological Causes of Schizophrenia
• No known single cause.
• Possible causes:
• Excess of dopamine
receptors (6x).
• Low activity in frontal
lobes.
• Genetics (50% chance
for identical twins).
Biological Causes of Schizophrenia
• Possible causes:
• Enlarged ventricles (fluid
filled spaces) in the brain.
• Shrinkage of brain tissue
in limbic system.
• Prenatal viruses.
Psychological Causes of Schizophrenia
• There is NO proof that any
social or psychological
factors “cause”
schizophrenia.
• We don’t know what role
stress or disturbed family
communications play.
• They just appear to be
correlated.
Personality Disorders
• Characterized by rigid and
lasting behavior patterns that
disrupt social functioning.
• 3 main clusters:
• A.) Related to anxiety
• B.) Odd or Eccentric Behaviors
• C.) Dramatic or Impulsive
Behaviors
A.) Related to Anxiety
• Avoidant Personality
Disorder – sensitive
about being rejected so
relationships become
difficult.
• Dependent Personality
Disorder – are clingy
and submissive.
B.) Odd or Eccentric Behaviors
• Paranoid Personality
Disorder – show deep
distrust of other people.
• Schizoid Personality
Disorder – are detached
from social relationships
(true hermits).
C.) Dramatic or Impulsive Behaviors
• Borderline Personality
Disorder (following slides).
• Antisocial Personality
Disorder (following slides).
Borderline Personality Disorder
• Characterized by unstable emotions and
relationships.
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 (cutting).
Suicidal threats and actions
are not uncommon.
Antisocial Personality Disorder
• Antisocial personality disorder is
characterized by a lack of conscience.
• People with this disorder are prone to criminal behavior
never feel sorry for harming others.
Antisocial Personality Disorder
• Also known as “sociopaths”. Examples would be
Charles Manson & Hannibal Lecter.
They are often aggressive and are much more concerned
with their own needs than the needs of others.