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Psychological Disorders (7-9%)
DEFINING ABNORMALITY
Psychological Disorders: UMAD behavior that is Unjustifiable (irrational- does not make sense to most people) Maladaptive (harmful), Atypical (not shared by
many others, unusual), Disturbing (to others-EX pedophilias sexual attraction to children).
DSM IV TR: Diagnostic and Statistical Manual – Identifies Psychological Disorders. The DSM does not suggest causes or treatments. Clients are assessed at various
AXIS levels, .Axis I is a clinical disorder, II is personality disorder, III is medical condition (physical related to mental) and IV psychosocial (stressful life events).
Causes of Psychological Disorders
Perspective
Psychoanalytic / Psychodynamic
Humanistic
Behavioral
Causes
Internal, Unconscious childhood conflicts and/or repressed thoughts/ memories
Failure to strive towards one potential (self-actualize), low self-esteem, lack of unconditional positive regard in
one’s environment
Behavior is learned through modeling or reinforcements of behavior, people are conditioned (through
association) into behavior, the environment affects behavior
Self-defeating, irrational and/or negative thinking, maladaptive thinking or interpretation of events.
Biochemical imbalances (neurotransmitters), genetic predisposition for illness
Cognitive
Biomedical / Biological
ANXIETY DISORDERS
Phobias: irrational fears of specific object or situation (EX agoraphobia- open spaces)
Generalized anxiety disorder (GAD): constant low-level anxieties
Obsessive-Compulsive disorder (OCD): unwanted thoughts (obsessions) cause the need to engage in particular action or ritual (compulsions) to reduce the
anxiety.
Posttraumatic stress disorder (PTSD): flashbacks, nightmares because of involvement in war or natural disaster.
Panic attacks: episodes of intense anxiety without any apparent provocation
SOMATOFORM DISORDERS
Hypochondriasis: complains of physical illness to doctor but cannot find cause
Conversion disorder: people will complain of severe physical problem such as paralysis or blindness. They will be unable to move their arms or see but no
biological cause can be identified.
DISSOCIATIVE DISORDERS
Dissociative Fugue or amnesia (not biologically caused) causes someone to suddenly be in unfamiliar environment after
their brain dissociative from their real self.
Dissociative Identity disorder: (aka multiple personalities) dissociate themselves from their true identity. Do not remember dissociation occurring. Caused
by intense childhood physical/sexual abuse. Some claim the subject is role playing the disorder from the therapist’s questions’
MOOD OR AFFECTIVE DISORDERS
Seasonal Affective Disorder (SAD) - experience depression when there is less sunlight. Treatment is light therapy
Major Depressive disorder (unipolar depression)- the common cold of psychology. DSM criteria is more than 2 weeks of hopelessness, worthlessness,
fatigue, and/or change of appetite, sleeping pattern. Women are 2 times more likely to get.
Dysthymic Disorder mild depression 2 years or more
Bipolar disorder (manic depressive): extreme highs (mania- characterized by high energy, confidence, creativity) and extreme lows (depression)
SCHIZOPHRENIA
Symptoms of schizophrenia: delusions (unrealistic beliefs) of persecution (people are out to get me), delusions of grandeur (belief that you have greater
power/influence than you do. EX “I am the President” Hallucinations- hearing voices, seeing things that aren’t present, disorganized thinking. Positive
symptoms – added unusual behaviors. Negative symptoms- absence of appropriate behavior.
- Paranoid (delusions of persecution), Disorganized (word salad, neologisms), Catatonic (strange body postures, motionless), Undifferentiated (no
particular category)
Causes of Schizophreniastrong genetic influences through twin studies and the fact that 1% of population in almost all cultures has it
excess of neurotransmitter dopamine. Parkinson’s Patients who take dopamine increasing meds often have hallucinations
Correlates to Schizophrenia
enlarged brain ventricles
prenatal viruses
PERSONALITY DISORDERS (PD’s) (least debilitating of all disorders but negatively affects people’s ability to function)
Most PD’s can be deuced about it’s symptoms from the name EXCEPT antisocial
Paranoid (mild persecution)
Obsessive-Compulsive- OCD but not debilitated
Dependent- need attention and help from others
Narcissistic: seeing oneself as the center of the universe, self-absorbed, self-love
Antisocial: little regard for other people’s feelings, no sense of guilt, often law breakers.
Histrionic: overly dramatic behavior
Other Psychological disorders include: philias (unusual sexual attractions to objects or persons), eating disorders, substance abuse, autism, ADHD
David-Rosenhan Study:
Faked a mental illness (said he heard voices) once labeled, every behavior within hospital was interpreted as a sign of schizophrenia. One of his confederates
remained hospitalized for 58 days. (even acting normal).
This showed the powerful influence of labeling someone with a disorder; it also questioned the care for the mentally ill.
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Treatments of Psychological Disorders (5-7 %)
HISTORYTrephining - holes placed in peoples heads might let the evil spirits out
Dix, Pinel - movement to reform treatment of mentally ill, no longer caging/treating as criminals.
Medical model- looked at mental illness as curable like physical illnesses.
Deinstitutionalization (1950s) - emptying of institutions because of new attitudes and advent of drug therapy pros- save $, helped patients cons- led to
increase of homeless.
Preventive Psychology – focuses on preventing people from getting a disorder (reduces suffering for client and costs for society)
Primary prevention – Reduce joblessness, homelessness, poverty, or prejudice
Secondary prevention – includes getting treatment for those at risk. EX. grief counseling – the govt. offers counseling to war veterans
Tertiary prevention – is stopping the manifested symptoms from becoming too severe.
TYPES OF THERAPY
Biological (Biomedical) Therapy
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Psycho Surgery- destruction of part of the brain to change behavior
o
Prefrontal lobotomy- cuts the main neurons leading to the frontal lobe. Rarely done because of risks
Electro Convulsive Therapy (ECT) - Electric current passed through both hemispheres of the brain. This is often used for severe depression. Side effects include
memory loss.
Drug therapy
o
antianxiety- Ex. Xanax, Valium (Tranquilzers- barbiturates)
o
antidepressants- Ex. Prozac, Zoloft, MAO inhibitors, SSRI’s (increase activity of serotonin)
o
anti-psychotic- Ex. Thorazine, Haldol (block receptors sites for Dopamine). Excessive use of these can lead to Tardiv Dyskenesia- muscle
tremor associated with Parkinson’s
o
mood stabilizers- Ex. Lithium (Bi-Polar Disorder)
Psychoanalytic Therapy
Insight Therapies – revealing the repressed problems in the unconscious
Hypnosis- people are less likely to repress troubling thoughts
Free Association- to say whatever comes to mind without thinking (reveals clues and provides insight about what is really bothering us in our unconscious.
Dream Analysis- through symbols reveal the latent (underlying) content of dream. Dreams are a window into the unconscious
Resistance- patient disagrees with therapist’s analysis because painful thoughts are surfacing into the ego (denial is much easier), barrier to bringing out the
unconscious
Transference- patients sometimes transfer strong threatening feelings (of love or anger) they have toward parents or partners (or siblings) onto the therapist.
(Resembles displacement)
Behavioral Therapy
Counter Conditioning- Reversing the present conditioned response.
Systematic Desensitization- teaching client to gradually replace anxious feelings with relaxed ones. This is effective with phobias.(EX.- using anxiety
hierarchy such as seeing a spider from 25 ft. away then seeing a spider crawl up your leg until the fear is extinguished)
Exposure Therapy – exposure to what you normally avoid (virtual reality)
Flooding therapy- exposure to fear but start with most frieghtening fear first. EX. Throw boy in room with dog.
Aversive Conditioning- pairing unwanted behavior with an unpleasant stimulus (Ex. a nauseous pill is given to an alcoholic in his/her drink.) Alcohol is
associated with sickness. Bed wetters can be shocked out of unwanted behavior.
Modeling- watch people behave in a calm manner.
Token economy- rewarded for every wanted behavior.
Cognitive Therapy
(Beck) Changing/Challenging thought patterns or beliefs about themselves or events. Emphasis on more positive thinking.
Rational Emotive Behavior Therapy (REBT. Ellis) replaces irrational beliefs with rational ones aka cognitive restructuring.
Humanistic Therapy (Rogers, Maslow, Perls - Gestalt)
Client or person- centered therapy (Rogers) in which the therapist accepts the client no matter what he says/does (unconditional positive regard), shows empathy,
uses active listening (EX. paraphrasing feelings/statements by client). Therapist helps client to self-actualize and grow as a person.
Gestalt Therapy (Perls) – get in touch with the “whole” self.
Existential Therapy – finding meaning within life
Group Therapy- family therapy or AA where one sees that they are not alone with problems.
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